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Alexander Aizman, MD; Paul T. Finger, MD; Uri Shabto, MD; Andrzej Szechter, PhD; Anthony Berson, MD

Arch Ophthalmol. 2004;122:1652-1656.

Objective  To describe clinical experience with palladium 103 (¹⁰³Pd) ophthalmic plaque radiotherapy for choroidal hemangioma.

Methods  One course of ¹⁰³Pd ophthalmic plaque radiotherapy was used in each of 5 patients with circumscribed choroidal hemangioma who had progressive loss of vision due to subretinal exudation. A mean apex dose of 2900 cGy (2900 rad) was delivered. Functional tests of outcome included best-corrected visual acuity. Anatomic results included changes in tumor height and subretinal fluid documented by ophthalmoscopy, fluorescein angiography, and ultrasonography.

Results  All patients had complete resolution of subretinal fluid with reattachment of the retina. All tumors decreased in height (mean, 50%) after treatment. Three patients (60%) demonstrated improvement in visual acuity at the last follow-up, and in 1 patient vision remained stable with resolution of metamorphopsia. Twenty-four months after treatment, 1 patient whose visual acuity had recovered from 20/160 to 20/32 had a loss of vision to 20/160 because of radiation maculopathy. For all patients, a mean visual acuity improvement of 2 lines was documented (95% confidence interval, 0.23-0.88). Mean follow-up was 18.6 months (range, 6-29 months).

Conclusions  A single ¹⁰³Pd plaque radiation treatment was effective in decreasing tumor height, eliminating subretinal fluid, and improving visual acuity in patients with symptomatic circumscribed choroidal hemangiomas.

Author Affiliations: Departments of Ophthalmology, New York Eye Cancer Center (Drs Aizman and Finger), New York Eye and Ear Infirmary (Drs Shabto and Berson), and New York University School of Medicine (Drs Aizman and Finger), and Department of Radiation Oncology, St Vincent’s Comprehensive Cancer Center (Drs Szechter and Berson), New York.

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