Long-term results after proton beam therapy for retinal papillary capillary hemangioma.

Abstract

PURPOSE:

To evaluate the potential benefit and risk of proton beam therapy in the treatment of symptomatic retinal papillary capillary hemangioma.

DESIGN:

Retrospective interventional case series.

METHODS:

This study included patients presenting with symptomatic exudative retinal papillary capillary hemangioma with or without association with von Hippel-Lindau disease. All patients were treated either as a first or a secondary treatment option by proton beam therapy between 2001 and 2009. The minimum follow-up was 30 months.

RESULTS:

Eight eyes of 8 patients (3 male and 5 female, with a mean age of 36 years [range 22-80 years]) were treated for symptomatic papillary retinal hemangioma. The median interval between onset of macular edema and proton beam therapy was 1.7 months (range 0.5-3.3 months). The median follow-up period was 84 months (range 32-106 months) between proton beam treatment and last follow-up. Exudation completely resolved in all but 1 patient after 4.2 months on average (range 2.8-7.2 months). Mean visual acuity prior to proton beam irradiation was 0.7 logMAR (0.2 DIN (DIN 58220 norm)) (range 2-0.3 logMAR) and declined to 0.8 logMAR (0.16 DIN; range 2-0.1 logMAR) at last follow-up examination (no statistical significance, P=.071).

CONCLUSION:

The anatomic outcome after proton beam therapy for retinal papillary hemangioma is convincing, whereas functional outcome may be compromised because of tumor location, long-persisting macular edema, extensive exudation, and poor initial visual acuity. In patients with extended retinal detachment surgical intervention was still necessary. Although proton beam therapy is proven to be a therapeutic option, treatment will remain challenging.

• Authors: Ira Seibel, Dino Cordini, Annette Hager, Aline I Riechardt, Julian P Klein, Jens Heufelder, Lutz Moser, Antonia M Joussen
• Journal: American journal of ophthalmology (Am J Ophthalmol) Vol. 158 Issue 2 Pg. 381-6 (Aug 2014) ISSN: 1879-1891 [Electronic] United States
• PMID: 24844975 (Publication Type: Journal Article, Multicenter Study)
• Copyright: Copyright © 2014 Elsevier Inc. All rights reserved.

Topics

• Adult
• Aged
• Aged, 80 and over
• Female
• Fluorescein Angiography
• Follow-Up Studies
• Fundus Oculi
• Hemangioma, Capillary (pathology, radiotherapy)
• Humans
• Male
• Middle Aged
• Proton Therapy (methods)
• Retina (pathology, radiation effects)
• Retinal Neoplasms (pathology, radiotherapy)
• Retrospective Studies
• Time Factors
• Treatment Outcome
• Visual Acuity
• Young Adult