Gamma knife radiosurgery for circumscribed choroidal hemangioma
Sungkyunkwan University, Sŏul, Seoul, South KoreaActa Neurochirurgica (Impact Factor: 1.77). 07/2005; 147(6):651-4; discussion 654. DOI: 10.1007/s00701-005-0499-1
The authors report a case of circumscribed choroidal hemangioma (CCH) treated by stereotactic radiosurgery with gamma knife. A thirteen-year-old boy presented with a 4-year history of progressive visual loss in his right eye. Because of the large size and fluid collection under the macula, gamma knife radiosurgery was done. During 2 years of follow-up, there was resolution of retinal detachment, regression in tumor thickness, and no complications. Gamma knife radiosurgery may be a reasonable alternative treatment option for symptomatic CCHs which are difficult to manage using standard therapeutic options such as photocoagulation.
Chapter: Uveal Vascular Tumors
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ABSTRACT: To determine the feasibility of gamma knife radiosurgery (GKS) in the treatment of symptomatic choroidal hemangioma (CH). Observational case series. Three patients who had CH were treated with GKS. Ophthalmologic examinations revealed submacular fluid collection and retinal detachment associated with CH in all cases. GKS was performed as an initial treatment in two cases of circumscribed CH and as secondary treatment after failure of photocoagulation in the other diffuse CH. The follow-up period ranged from 18 to 36 months, and visual acuity of the affected eyes was improved in all cases. The volume of CHs and submacular fluid collection were decreased. There were no adverse effects of radiation such as retinopathy or optic neuropathy. GKS may be a useful alternative treatment for symptomatic CHs that are difficult to be managed with a standard therapeutic option such as photocoagulation.
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ABSTRACT: Patients with choroidal hemangioma (CH), a benign ocular hamartoma, frequently presents with visual disturbance as a result of exudative retinal detachment (RD), which originates in subretinal fluid accumulation. We report our experience using the Leksell Gamma Knife in the management of symptomatic CH. Seven patients with symptomatic CH (circumscribed form in 3 patients and diffuse form in 4) were treated with the Leksell Gamma Knife at our institution during a 7-year period. All patients presented with exudative RD involving the macula that resulted in severe visual deterioration. The prescription dose to the target margin was 10 Gy in all cases. The mean tumor volume receiving the prescription dose was 536 mm3 (range, 151-1,057). The clinical data were analyzed in a retrospective fashion after a mean follow-up of 34.4 months (range, 9-76). The resolution of exudative RD was achieved within 6 months, and the visual acuity of the affected eye had improved at the latest follow-up examination (p=.018) in all patients. No recurrence of exudative RD occurred. Thinning of the CHs was observed in most patients; however, symptomatic radiation toxicity had not developed in any of the patients. Symptomatic CHs can be safely and effectively managed with Gamma Knife radiosurgery using a marginal dose of 10 Gy.
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