Le traitement des hemangiomes de la choroide par radiotherapie. [Irradiation treatment of choroidal hemangiomas]

Therapeutic results obtained following the treatment of 24 cases of choroidal hemangiomas (21 solitary and 3 in a Sturge-Weber syndrome) treated with 60Co applicators or an accelerated proton beam were analyzed. The observation period was less than 2 years for 4 cases, 2 to 5 years for 10 cases, 5 to 10 years for 7 cases and more than 10 years for 3 cases. Reabsorption of retinal detachment without any recurrency was obtained for all the cases. The V.A. was increased in 16 cases, did not change in 4 cases and decreased in 4 other cases. Final V.A. was 6/7.5 or more in 9 cases (37.5%), 6/60 a 6/7.5 in 6 cases (25%), and 6/60 or less in 9 cases (37.5%). None of the cases we treated presented complications induced by radiotherapy (actinic papillitis, circulatory disturbances in the macular area, or neovascular glaucoma). The comparison of the results we obtained with cases treated by photocoagulation or external radiotherapy demonstrated a slight advantage in favour of the focalized radiotherapy, which is not statistically significant because of the small number of cases included in the studies. Meanwhile, contact radiotherapy and irradiation with an accelerated proton beam seems to be a substantial alternative for the treatment of large hemangiomas and tumors invading the macula