Knorr H. L. J, Lang G. E., Lang G. K., Naumann G. O. H.

Augenklinik mit Poliklinik, Friedrich-Alexander Universität Erlangen- Nürnberg, Schwabachanlage 6, 91054 Erlangen; Augenklinik mit Poliklinik, Universitätsklinikum Ulm, Prittwitzstr. 43, 89075 Ulm

Objective: This study aimed to evaluate the efficacy and safety of ruthenium-106 brachytherapy of large subretinal granulomas.
Design and Methods: In 5 eyes with therapy resistant (after cryocoagulation or argon laser coagulation) subretinal granulomas ruthenium-106 brachytherapy (scleral dosis 500 to 600 Gy) for granulomas was performed. The patients data were analyzed regression, occurrence of retinal detachment, requirement of additional vitreoretinal surgery, visual outcome, and final retinal status. Preoperative visual acuity of all treated eyes ranged from 20/200 to 20/40, granulomas diameter was 10.8 mm to 15.4 mm, all eyes showed an exsudative retinal detachment, in two eyes with sub- and intraretinal hemorrhage and coarse-grained vitreal cholesterol plaques. The alterations induced in two eyes a secundary cystoid macular edema and in one eye an epiretinal gliosis.
Results: The follow-up in all five eyes showed inactivation of subretinal granuloma with regression of exsudative retinal detachment and complete resorption of sub and intraretinal hemorrhage during 2 to 3 months. Postoperatively final acuity was unchanged.
Conclusion: Subretinal granulomas can be ablated effectively by ruthenium-106 brachytherapy resulting in preservation of visual acuity and complete resorption of subretinal fluid and cholesterol.

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