J Korean Ophthalmol Soc.  2020 Oct;61(10):1156-1163. 10.3341/jkos.2020.61.10.1156.

Short-term Effect of Gamma Knife Radiosurgery for a Choroidal Tumor

Affiliations
  • 1Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
  • 2Department of Ophthalmology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
  • 3Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Abstract

Purpose
To evaluate the effectiveness and safety of treating choroidal melanoma and cancer that has metastasized to the choroid with gamma knife radiosurgery (GKR).
Methods
We performed a retrospective chart review that included 10 eyes of eight patients with a diagnosis of choroidal tumors who underwent GKR between January 2016 and February 2019 and who had at least one month follow-up visit.
Results
The mean patient age was 57.9 ± 14.6 years (range, 32-83 years). The choroidal tumor group included six choroidal metastases and four choroidal melanomas. The mean follow-up period after GKR was 7.0 ± 4.3 months (range, 2-13 months). The mean cumulative marginal dose was 25.36 ± 7.35 Gy (range, 16-45 Gy). Pre- and postoperative magnetic resonance imaging revealed a reduction in tumor volume in eight of the 10 eyes and five of them presented with improved visual symptoms. One patient showed increased tumor volume; however, a new choroidal lesion was not observed. Another patient showed no reduction in tumor size; however, the pain had worsened, and the eye was enucleated. The mean maximum tumor diameter decreased from 1.60 ± 0.37 cm before to 1.22 ± 0.47 cm after GKR (p = 0.004), and the mean minimum diameter decreased from 0.62 ± 0.27 cm before to 0.38 ± 0.35 cm after GKR (p = 0.031). No radiation-induced optic neuropathy, retinopathy, or cataracts was observed in any of the cases during the follow-up period.
Conclusions
GKR was shown to be safe for choroidal lesions identified in orbital magnetic resonance imaging with a reduction in the size of choroidal tumors and eyeball preservation expected with this treatment approach.

Keyword

Choroidal melanoma; Choroidal metastasis; Gamma knife radiosurgery
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