Gamma Knife Radiosurgery for Choroidal Hemangioma: A Single-Institute Series

Objective: Choroidal hemangioma (CH) is a benign vascular tumor that induces subretinal fluid collection or exudative retinal detachment and consequent visual symptoms. Current standard treatments for CH include cryotherapy, diathermy, photocoagulation, photodynamic therapy, transpupillary thermotherapy, and radiation therapy. Stereotactic radiosurgery has recently been applied to the treatment of CH because of its characteristic stiff dose-fall-off and accuracy. We have adopted gamma knife radiosurgery (GKRS) to treat CH and have retrospectively assessed tumor volume reductions and improvements to visual acuity achieved thereby. Methods: Fourteen patients with CHs were treated with GKRS from November 2006 to December 2017. Eight patients had circumscribed CH, and 6 exhibited diffuse CHs and were diagnosed with Sturge-Weber syndrome. The mean age of patients was 27.1 years (range: 8–68 years) and the mean duration of clinical or radiological follow-up was 40.2 months (range: 5–105 months). The mean volume of the tumors at the time of GKRS was 533.5 mm³ (range: 124–1150 mm³), and the mean prescribed marginal dose was 11.6 Gy (range: 10–16 Gy) with 50% isodose lines. Results: The tumor volume decreased by the last follow-up in all patients. The visual acuity improved in 9 patients (64%) and decreased in 1 (7%). Six patients (43%) required trans-pars plana vitrectomy before or after GKRS. There were no symptomatic complications from radiation injury during the follow-up periods. Conclusions: GKRS could be an acceptable alternative treatment for symptomatic CH when standard therapy is not feasible.