Ruthenium-106 plaque radiotherapy for retinal vasoproliferative tumors

Purpose: To evaluate the effect of radiation with Ruthenium-106 (Ru-106) plaques in the control of retinal vasoproliferative tumors. Methods: This study is a retrospective, interventional nonrandomized case series. Seven eyes of seven patients (four males and three females) with retinal vasoproliferative tumors were enrolled. The eyes were treated by Ru-106 plaques with mean apex dose of 39 Gy (range, 38-43 Gy) in low-dose (LD) group (four cases) and 79 Gy (range, 76-81 Gy) in high-dose (HD) group (three cases). Mean (±SD) follow-up duration was 18 (±8) months (range, six to 31 months) Main outcome measures were tumor thickness reduction and clinical and visual improvement. Results: Mean (±SD) preoperative logMAR visual acuity improved from 0.92 (±0.49) to 0.85 (±0.71) at the last follow-up (P=0.50). Significant exudative retinal detachments, which were presented before brachytherapy in five patients (71.4%), completely reabsorbed following brachytherapy. Radiation retinopathy was seen in three patients during the follow-up period. Tractional rhegmatogenous retinal detachment developed in one patient of LD group which was managed with pars plana vitrectomy and silicon oil tamponade. Conclusion: Brachytherapy with high-dose Ru-106 plaques is an effective treatment modality for retinal vasoproliferative tumors in terms of functional and anatomic results. Further investigations with enough sample sizes are suggested to identify the optimal apex dose.