Ruthenium-106 plaque therapy for diffuse choroidal hemangioma in sturge-weber syndrome

Abstract

Diffuse choroidal hemangiomas associated with Sturge-Weber syndrome (SWS) are classically treated with external beam radiotherapy (EBR), but there are a few reports usually of single cases indicating the usefulness of plaque therapy. We present our observations on two cases of diffuse choroidal hemangiomas with exudative retinal detachment associated with SWS treated with Ruthenium-106 plaque therapy. Outcomes included best-corrected visual acuity (BCVA) and regression in tumor thickness measured by ultrasonography. The initial BCVA of the affected eyes was counting fingers at 1 meter and light projection. Pretreatment tumors thickness was 3.5 mm and 4.7 mm. In a follow-up period of 18-24 months, significant reduction in thickness of choroidal hemangiomas up to 1.2 mm and 1.4 mm with prompt resolution of exudative retinal detachment was observed. BCVA achieved 20/200 and 20/400, respectively. The findings in this paper indicate that Ruthenium-106 plaque therapy is effective in treatment of diffuse choroidal hemangiomas associated with SWS.

Figure 1

Diffuse nevus flammeus involving the left upper eyelid and forehead associated with Sturge-Weber syndrome.

Figure 2

Fundus and B-scan ultrasonography demonstrating diffuse choroidal hemangioma with extensive exudative retinal detachment.

Figure 3

The same eye 18 months after Ruthenium-106 plaque therapy—regression of the tumor, no subretinal fluid is present.