Proton beam irradiation of choroidal hemangiomas after unsuccessful photodynamic therapy

Abstract

PurposeTo study the outcome of patients treated for a choroidal hemangioma with proton beam irradiation following unsuccessful PDT and compare the therapeutic results with that of a control group that received proton therapy as a primary treatment.MethodsProton beam irradiation was applied to twelve cases of choroidal hemangioma that had been unsuccessfully treated with PDT (N of sessions: 1–5). Their functional results were compared to those of a control group of 48 cases treated only with proton therapy. The latter were matched (4 to 1) for the duration of symptoms before primary treatment, extent of retinal detachment as well as distance to the macula.ResultsThe mean follow‐up following proton beam irradiation therapy was 28 months [range: 6 months‐5 years] in the PDT group and 41 months [range: 6 months‐10 years] in the control group. In all patients, the retinal detachment and macular edema disappeared following proton therapy. In the study group, final visual acuity was ≤0.1 in 25%, 0.2–0.5 in 25% and ≥0.6% in 50% of cases. Visual acuity improved in 50%, remained stable in 42% and decreased in 8% of cases. In the control group, final visual acuity was ≤0.1 in 4%, 0.2‐0.5 in 38% and ≥0.6 in 58% of cases. Visual acuity improved in 65%, remained stable in 29% and decreased in 6% of cases.ConclusionsProton beam irradiation is a valid therapeutic option after inconclusive results following PDT for choroidal hemangioma. Within the limits of this study, therapeutic results were slightly better for those patients that received proton therapy as a primary treatment.