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15.09.2020 | Original Article - Tumor - Other

Stereotactic radiosurgery for orbital cavernous venous malformation: a single center’s experience for 15 years

verfasst von: Won Jae Lee, Kyung-Rae Cho, Jung-Won Choi, Doo-Sik Kong, Ho Jun Seol, Do-Hyun Nam, Yoon-Duck Kim, Kyung In Woo, Jung-Il Lee

Erschienen in: Acta Neurochirurgica | Ausgabe 2/2021

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Abstract

Background

Stereotactic radiosurgery such as Gamma Knife radiosurgery (GKRS) has been shown to have a good treatment effect for orbital cavernous venous malformation (CVM). However, radiation-induced retinopathy or optic neuropathy is a vision-threatening complication of orbital irradiation. Predicting the post-treatment visual outcome is critical.

Methods

Clinical and radiological outcomes were investigated in 30 patients who underwent GKRS for orbital CVM between July 2005 and February 2020. Measurement of peripapillary retinal nerve fiber layer (pRNFL) thickness using optical coherence tomography (OCT) was obtained in 14 patients.

Results

The median clinical and radiological follow-up periods were 46.6 months (range, 15.9–105.8) and 27.5 months (range, 15.4–105.8), respectively. Twenty-eight patients underwent multisession (4 fractions) GKRS. The median cumulative marginal dose was 20 Gy (range, 16–24). Two patients underwent single-session GKRS. Marginal doses were 15 Gy and 10.5 Gy in each patient. The volume of CVM decreased in 29 (97%) patients. Visual acuity was improved in 6 (20%) patients and was stable in 22 (73%) patients. Visual field defect and exophthalmos were improved in all patients. Serial investigation of OCT showed no statistically significant difference in pRNFL thickness after GKRS. Patients with normal average pRNFL thickness showed better visual recovery than patients with thin average pRNFL thickness.

Conclusions

GKRS is an effective and safe treatment option for orbital CVM. The pRNFL thickness before GKRS can be a prognostic indicator for visual recovery in orbital CVM after GKRS.

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Titel: Stereotactic radiosurgery for orbital cavernous venous malformation: a single center’s experience for 15 years
verfasst von: Won Jae Lee
Kyung-Rae Cho
Jung-Won Choi
Doo-Sik Kong
Ho Jun Seol
Do-Hyun Nam
Yoon-Duck Kim
Kyung In Woo
Jung-Il Lee
Publikationsdatum: 15.09.2020
Verlag: Springer Vienna
Erschienen in: Acta Neurochirurgica / Ausgabe 2/2021
Print ISSN: 0001-6268
Elektronische ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-020-04575-4

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Abstract

Background

Methods

Results

Conclusions

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