Abstract
Background Macular and juxtapapillary circumscribed choroidal haemangiomas (CCH) have always posed a diagnostic and therapeutic challenge. Proton beam therapy has been advocated by Zografos and associates as optimal for treating these tumours in this critical region as charged particles have a highly localised and uniform dose distribution.
Patients We present 3 cases of CCH treated with proton beam therapy. Two patients developed radiation optic neuropathy and maculopathy, and one had a persistent exudative macular detachment following treatment.
Conclusion Our experience with proton therapy of these tumours has been disappointing in preventing radiation optic neuropathy and maculopathy and offers little advantage over external irradiation. The majority of our patients with this condition are now treated with low-dose lens-sparing external beam radiotherapy or brachytherapy, which has encouraging visual results and is a far more cost-effective option.
Similar content being viewed by others
Article PDF
References
Plowman PN, Hungerford JL . Radiotherapy for ocular angiomas [editorial]. Br J Ophthalmol 1997;81:258–9.
Witshchel H, Font RL . Hemangioma of the choroid: a clinicopathologic study of 71 cases and a review of the literature. Surv Ophthalmol 1976;20:415–31.
Ausburger JJ, Shields JA, Moffat KP . Circumscribed choroidal hemangiomas: long term visual prognosis. Retina 1981;1:56–61.
Sanborn GE, Augsburger JJ, Shields JA . Treatment of circumscribed choroidal haemangiomas. Am J Ophthalmol 1982;89:1374–80.
Anand R, Augsburger JJ, Shields JA . Circumscribed choroidal hemangiomas. Arch Ophthalmol 1989;107:1338–42.
Humphrey WT . Choroidal hemangioma response to cryotherapy. Ann Ophthalmol 1979,11:101–4.
Schilling HS, Sauerwein W, Lommatzsch A, Fredrichs W, Brylak S, Bornfeld N, Wessing A . Long term results after low dose irradiation for choroidal haemangiomas. Br J Ophthalmol 1997;81:267–73.
Nicholson J, DeVos D . Applications of proton beam therapy. Radiol Technol 1996;67:439–41.
Zografos L, Bercher L, Chamot L, Gailloud C, Raimondi S, Egger E . Cobalt-60 treatment of choroid hemangiomas. Am J Ophthalmol 1996;121:190–9.
Zografos L, Gailloud C, Bercher L . Le traitement des hemangiomes de la choroide par radiotherapie. J Fr Ophtalmol 1989;11:797–807.
Char DH, Castro JR . Helium ion therapy for choroidal melanoma. Arch Ophthalmol 1982;100:935–40.
Gragoudas ES, Goitein M, Verhey L, Munzenreider J, Suit HD, Koehler A . Proton beam irradiation. Ophthalmology 1980;87:571–81.
Gragoudas ES, Seddon J, Goitein M, Verhey L, Munzenreider J, Urie M, Suit HD, Blitzer P, Koehler A . Current results of proton beam irradiation of uveal melanomas. Ophthalmology 1985;92:285–91.
Chisholm IH, Blach RK . Choroidal haemangioma: a diagnostic and therapeutic problem. Trans Ophthalmol Soc UK 1973;93:161–9.
Norton EW, Gutman F . Fluorescein angiography and hemangioma of the choroid. Arch Ophthalmol 1967;78:121–5.
Ossoinig KC, Blodi FC . Preoperative differential diagnosis of tumours with echography. III. Diagnosis of intraocular tumours. In: Blodi FC, editor. Current concepts of ophthalmology. St Louis: CV Mosby, 1974:296–313.
Shields JA, Stephens RF, Eagle RC Jr, Shields CL, De Potter P . Progressive enlargement of a circumscribed choroidal hemangioma: a clinicopathologic correlation. Arch Ophthalmol 1992;110:1276–8.
Madreperla SA, Hungerford JL, Plowman PN . Choroidal haemangiomas: visual and anatomical results of treatment by photocoagulation or radiotherapy. Ophthalmology (in press).
Foss AJE, Whelehan I, Hungerford JL, Anderson DP, Errington RD, Kacperek A, Restori M, Kongerud J, Sheen M . Predictive factors for the development of rubeosis following proton beam therapy for uveal melanoma. Br J Ophthalmol 1997;81:748–54.
Hornback NB, Sandison G, Bloch C, Cameron J, Nelson PD . Proton beam therapy using the IU cyclotron facility. Indiana Med 1993;86:326–8.
Antoine FS . Proton beam therapy:-cost vs benefits. J Natl Cancer Inst 1989;81:559–62.
Author information
Authors and Affiliations
Additional information
Presented as a poster at the Tenth Anniversary Congress of the Royal College of Ophthalmologists, Glasgow 1998
Rights and permissions
About this article
Cite this article
Lee, V., Hungerford, J. Proton beam therapy for posterior pole circumscribed choroidal haemangioma. Eye 12, 925–928 (1998). https://doi.org/10.1038/eye.1998.240
Issue Date:
DOI: https://doi.org/10.1038/eye.1998.240
Keywords
This article is cited by
-
Long-term (4Â years) results of choroidal hemangioma treated with proton beam irradiation
Graefe's Archive for Clinical and Experimental Ophthalmology (2014)