Laser Indirect Ophthalmoscopy-Guided Transpupillary Thermotherapy Versus I-125 Plaque Brachytherapy for Choroidal Hemangioma.
Laser-guided thermotherapy linked to visual gains; plaque brachytherapy improved no eyes
Laser Indirect Ophthalmoscopy-Guided Transpupillary Thermotherapy Versus I-125 Plaque Brachytherapy for Choroidal Hemangioma.
Choroidal hemangioma, a rare benign vascular tumor, can cause visual loss due to subretinal fluid.
We retrospectively reviewed 13 patients with choroidal hemangioma treated at King Hussein Cancer Center.
5 of 7 laser-treated eyes saw better afterward; none got worse
All patients had unilateral circumscribed choroidal hemangioma, and 10 (77%) were males.
Tumor thickness was 3.0-5.0 mm in 12 (92%) cases; the median thickness in the I-125 plaque brachytherapy group was 4.5 mm (range, 4.5-5.0 mm), whereas in the laser indirect ophthalmoscopy-guided transpupillary thermotherapy group it was 3.8 mm (range, 2.9-5.0 mm).
This difference was statistically significant ( p = 0.021).
Tumor thickness was reduced in both groups, with a median reduction of -56% in the plaque group and -36% in the transpupillary thermotherapy group.
Laser indirect ophthalmoscopy-guided transpupillary thermotherapy is an effective vision-preserving treatment for choroidal hemangioma.
While both modalities-controlled tumor growth, only transpupillary thermotherapy resulted in significant visual improvement.
This study demonstrates that laser indirect ophthalmoscopy-guided transpupillary thermotherapy can replace plaque brachytherapy in regions where verteporfin (photodynamic therapy) is unavailable, offering an accessible, practical, and superior alternative for preserving vision in patients with choroidal hemangioma.