钯103(103 Pd)敷贴放射治疗伴有视网膜脱离的局限性脉络膜血管瘤

Palladium 103 (103Pd) plaque radiation therapy for circumscribed choroidal hemangioma with retinal detachment

Objective: To describe clinical experience with palladium 103 ( 103Pd) ophthalmic plaque radiotherapy for choroidal hemangioma. Methods: One course of 103Pd ophthalmic plaque radiotherapy was used in each of 5 patients with circumscribed choroidal hemangioma who had progressive loss of vision due to subretinal exudation. A mean apex dose of 2900 cGy (2900 rad) was delivered. Functional tests of outcome included bestcorrected visual acuity. Anatomic results included changes in tumor height and subretinal fluid documented by ophthalmoscopy, fluorescein angiography, and ultrasonography. Results: All patients had complete resolution of sub- retinal fluid with reattachment of the retina. All. tumors decreased in height (mean, 50% ) after treatment. Three patients (60% ) demonstrated improvement in visual acuity at the last follow- up, and in 1 patient vision remained stable with resolution of metamorphopsia. Twenty- four months after treatment, 1 patient whose visual acuity had recovered from 20/160 to 20/32 had a loss of vision to 20/160 because of radiation maculopathy. For all patients, a mean visual acuity improvement of 2 lines was documented (95% confidence interval, 0.23- 0.88). Mean follow- up was 18.6 months (range, 6- 29 months). Conclusions: A single 103Pd plaque radiation treatment was effective in decreasing tumor height, eliminating sub- retinal fluid, and improving visual acuity in patients with symptomatic circumscribed choroidal hemangiomas.