Room: ePoster Forums
Purpose: Treatment of a vasoproliferative retinal tumor (VPT) using I-125 eye plaque radiotherapy. VPT is an uncommon benign tumor of the eye which can be idiopathic or secondary to other retinal disease. Standard treatment involves laser therapy and cryosurgery. We present a case of a patient with a VPT that had shown resistance to these standard treatments. Radiation plaque therapy was offered as an alternative solution.
Methods: The patient had VPT in both eyes. The left eye tumor was stable. However, the right eye tumor continued to have disease progression despite standard treatments. Tumor dimensions on ultrasound measured 10.8 x 14 mm, with a height of 2.77 mm. The patient was referred to our center for radioactive plaque therapy to the right eye VPT. We adopted a prescription of 40 Gy after review of a retrospective study of vasoproliferative tumors reported by the Wills Institute. The plan was developed using the Plaque Simulator software, incorporating the tumor dimensions and spatial location from the ophthalmologistâ€™s fundus diagram. The plan used a fully loaded Eye Physics plaque (model 2025). The plaque was attached to the outer sclera of the eye under general anesthesia. The plaque was left in place for 96 hours. The plaque was then removed and the patient was released.
Results: The patient tolerated the procedure well. The prescription dose covered the base of the tumor with an average 2 mm margin and 1 mm at apex. Doses to critical ocular structures were within acceptable tolerances.
Conclusion: Plaque radiotherapy can be used as a treatment modality for vasoproliferative retinal tumors which have proven resistant to conventional therapies. Our clinic has used plaque radiotherapy extensively for ocular melanomas. This case presented a unique opportunity to apply plaque therapy to a non-cancerous lesion of the eye. Follow-up with the patient is planned.