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Long-term results after proton beam therapy for retinal papillary capillary hemangioma.
[von hippel-lindau disease]
To
evaluate
the
potential
benefit
and
risk
of
proton
beam
therapy
in
the
treatment
of
symptomatic
retinal
papillary
capillary
hemangioma
.
Retrospective
interventional
case
series
.
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
.
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
)
.
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
.