Seibel, I.; Cordini, D.; Hager, A.; Riechardt, A.I.; Klein, J.P.; Heufelder, J.; Moser, L.; Joussen, A.M.: Long-term results after proton beam therapy for retinal papillary capillary hemangioma. American Journal of Ophthalmology 158 (2014), p. 381-386
10.1016/j.ajo.2014.05.003

Abstract:
Purpose To evaluate the potential benefit and risk of proton beam therapy in the treatment of symptomatic retinal papillary capillary hemangioma. Design Retrospective interventional case series. Methods This study included patients presenting with symptomatic exudative retinal papillary capillary hemangioma with or without association with von Hippel–Lindau disease. All patients were treated either as a first or a secondary treatment option by proton beam therapy between 2001 and 2009. The minimum follow-up was 30 months. Results Eight eyes of 8 patients (3 male and 5 female, with a mean age of 36 years [range 22–80 years]) were treated for symptomatic papillary retinal hemangioma. The median interval between onset of macular edema and proton beam therapy was 1.7 months (range 0.5–3.3 months). The median follow-up period was 84 months (range 32–106 months) between proton beam treatment and last follow-up. Exudation completely resolved in all but 1 patient after 4.2 months on average (range 2.8–7.2 months). Mean visual acuity prior to proton beam irradiation was 0.7 logMAR (0.2 DIN (DIN 58220 norm)) (range 2-0.3 logMAR) and declined to 0.8 logMAR (0.16 DIN; range 2-0.1 logMAR) at last follow-up examination (no statistical significance, P = .071). Conclusion The anatomic outcome after proton beam therapy for retinal papillary hemangioma is convincing, whereas functional outcome may be compromised because of tumor location, long-persisting macular edema, extensive exudation, and poor initial visual acuity. In patients with extended retinal detachment surgical intervention was still necessary. Although proton beam therapy is proven to be a therapeutic option, treatment will remain challenging. Inquiries to Ira Seibel, Department of Ophthalmology, Charité, University Medicine Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany