Лечение ограниченной гемангиомы хориоидеи: термотерапия или брахитерапия. Сравнительный анализ

Abstract

Purpose. To carry out a comparative analysis of results in the treatment of the circumscribed choroidal hemangioma (CCH) by methods of diode-laser transpupillary thermotherapy and brachytherapy. Material and methods. The data of treatment of 185 patients (185 eyes) with circumscribed choroidal hemangioma were analyzed, previously the patients were divided into groups by type of treatment. For the comparative analysis, the groups were standardized by tumor thickness, length of the base, tumor localization, follow-up period, initial visual acuity, frequency of detectable retinal detachment. As a result, the group of diode-laser thermotherapy consisted of 54, and the group of brachytherapy – 33 individuals. Results. After the treatment, the average visual acuity after treatment in the group of transpupillary thermotherapy was significantly higher (0.47) than in the group of brachytherapy (0.2) (p=0.0004). It was noted that the improvement of visual acuity after transpupillary thermotherapy was achieved in 27 (53%) cases more often than after brachytherapy – in 5 cases (15%) (p=0.01 χ 2 criterion). Each of the treatment types led to the resorption of the subretinal transudate and the reposition of the detached retina in all cases. In the evaluation of changes in average visual acuity before and after the treatment in each group, there were noted statistically significant differences in the group of transpupillary thermotherapy (0.33 before the treatment, 0.47 after the treatment; p=0.046) and their absence in the group of brachytherapy (0.22 before treatment, 0.2 after treatment; p=0.7). Conclusion. Diode laser transpupillary thermotherapy leads to better functional results compared with brachytherapy. Taking into consideration the absence of surgical trauma in transpupillary thermotherapy and an increased risk of complications in brachytherapy, the priority in the choice of a treatment method for CCH should be given to transpupillary thermotherapy.