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01-02-2021 | Original Article - Tumor - Other

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

Authors: 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

Published in: Acta Neurochirurgica | Issue 2/2021

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.

Ares WJ, Flickinger JC, Lunsford LD (2019) Leksell radiosurgery for orbital, uveal, and choroidal tumors. Prog Neurol Surg 34:298–305PubMed

Arnett ALH, Reynolds MM, Pulido JS, Parney IF, Laack NN (2017) Gamma Knife stereotactic radiosurgery for the treatment of primary and metastatic ocular malignancies. Stereotact Funct Neurosurg 95:363–368PubMed

Bagheri A, Jafari R, Salour H, Aletaha M, Yazdani S, Baghi S (2018) A new surgical technique for excision of orbital cavernous hemangioma: a 15-year experience. Orbit 37:429–437PubMed

Bekdemir S, Gunduz AK, Ersoz CC (2020) Orbital cavernous hemangioma presenting with a dome-shaped maculopathy-like appearance on swept-source optical tomography imaging. Case Rep Ophthalmol Med 2020:5354609PubMedPubMedCentral

Budenz DL, Anderson DR, Varma R, Schuman J, Cantor L, Savell J, Greenfield DS, Patella VM, Quigley HA, Tielsch J (2007) Determinants of normal retinal nerve fiber layer thickness measured by Stratus OCT. Ophthalmology 114:1046–1052PubMedPubMedCentral

Calandriello L, Grimaldi G, Petrone G, Rigante M, Petroni S, Riso M, Savino G (2017) Cavernous venous malformation (cavernous hemangioma) of the orbit: current concepts and a review of the literature. Surv Ophthalmol 62:393–403PubMed

Chung KS, Chang WS, Chang JH, Lee SC, Chang JW, Park YG, Jung HH (2020) Gamma Knife radiosurgery for choroidal hemangioma: a single-institute series. World Neurosurg 133:e129–e134PubMed

Colletti G, Biglioli F, Poli T, Dessy M, Cucurullo M, Petrillo M, Tombris S, Waner M, Sesenna E (2019) Vascular malformations of the orbit (lymphatic, venous, arteriovenous): diagnosis, management and results. J Craniomaxillofac Surg 47:726–740PubMed

Danesh-Meyer HV, Papchenko T, Savino PJ, Law A, Evans J, Gamble GD (2008) In vivo retinal nerve fiber layer thickness measured by optical coherence tomography predicts visual recovery after surgery for parachiasmal tumors. Invest Ophthalmol Vis Sci 49:1879–1885PubMed

10.

Dsouza S, Kandula P, Kamath G, Kamath M (2017) Clinical profile of unilateral proptosis in a tertiary care centre. J Ophthalmol 2017:8546458PubMedPubMedCentral

11.

Goh ASC, Kim YD, Woo KI, Lee JI (2013) Benign orbital apex tumors treated with multisession Gamma Knife radiosurgery. Ophthalmology 120:635–641PubMed

12.

Haas A, Pinter O, Papaefthymiou G, Weger M, Berghold A, Schrottner O, Mullner K, Pendl G, Langmann G (2002) Incidence of radiation retinopathy after high-dosage single-fraction Gamma Knife radiosurgery for choroidal melanoma. Ophthalmology 109:909–913PubMed

13.

Hamed-Azzam S, Verity DH, Rose GE (2018) Lateral canthotomy orbitotomy: a rapid approach to the orbit. Eye (Lond) 32:333–337

14.

Iorga RE, Moraru A, Ozturk MR, Costin D (2018) The role of optical coherence tomography in optic neuropathies. Rom J Ophthalmol 62:3–14PubMedPubMedCentral

15.

Jayaram A, Cohen LM, Lissner GS, Karagianis AG (2017) A retrospective review of cases preoperatively diagnosed by radiologic imaging as cavernous venous malformations. Orbit 36:128–134PubMed

16.

Jeon C, Park KA, Hong SD, Choi JW, Seol HJ, Nam DH, Lee JI, Shin HJ, Kong DS (2019) Clinical efficacy of optical coherence tomography to predict the visual outcome after endoscopic endonasal surgery for suprasellar tumors. World Neurosurg 132:e722–e731PubMed

17.

Jo KI, Im YS, Kong DS, Seol HJ, Nam DH, Kim YD, Lee JI (2012) Multisession Gamma Knife surgery for benign orbital tumors. J Neurosurg 117(Suppl):102–107PubMed

18.

Johnson S, Niranjan A, Kano H, Lunsford LD (2019) Leksell radiosurgery for the 3 H tumors: hemangiomas, hemangioblastomas, and hemangiopericytomas. Prog Neurol Surg 34:223–231PubMed

19.

Jones B, Dale RG, Deehan C, Hopkins KI, Morgan DA (2001) The role of biologically effective dose (BED) in clinical oncology. Clin Oncol (R Coll Radiol) 13:71–81

20.

Jung S, Bosch A, Ott C, Kannenkeril D, Dienemann T, Harazny JM, Michelson G, Schmieder RE (2020) Retinal neurodegeneration in patients with end-stage renal disease assessed by spectral-domain optical coherence tomography. Sci Rep 10:5255PubMedPubMedCentral

21.

Khan AA, Niranjan A, Kano H, Kondziolka D, Flickinger JC, Lunsford LD (2009) Stereotactic radiosurgery for cavernous sinus or orbital hemangiomas. Neurosurgery 65:914–918 discussion 918PubMed

22.

Khan SN, Sepahdari AR (2012) Orbital masses: CT and MRI of common vascular lesions, benign tumors, and malignancies. Saudi J Ophthalmol 26:373–383PubMedPubMedCentral

23.

Kim BS, Im YS, Woo KI, Kim YD, Lee JI (2015) Multisession Gamma Knife radiosurgery for orbital apex tumors. World Neurosurg 84:1005–1013PubMed

24.

Kim CY, Lee SY (2012) Orbital paraganglioma: Gamma Knife surgery as a therapeutic option. J Craniofac Surg 23:1127–1128PubMed

25.

Kim MS, Park K, Kim JH, Kim YD, Lee JI (2008) Gamma Knife radiosurgery for orbital tumors. Clin Neurol Neurosurg 110:1003–1007PubMed

26.

Kim YT, Kang SW, Lee JI (2011) Gamma Knife radiosurgery for choroidal hemangioma. Int J Radiat Oncol Biol Phys 81:1399–1404PubMed

27.

Liu D, Li Y, Zhang Y, Zhang Z, Song G, Xu D (2018) Volume-staged Gamma Knife radiosurgery for orbital venous malformations. J Neurosurg 129:26–30PubMed

28.

Liu X, Xu D, Zhang Y, Liu D, Song G (2010) Gamma Knife surgery in patients harboring orbital cavernous hemangiomas that were diagnosed on the basis of imaging findings. J Neurosurg 113(Suppl):39–43PubMed

29.

Loo JL, Tian J, Miller NR, Subramanian PS (2013) Use of optical coherence tomography in predicting post-treatment visual outcome in anterior visual pathway meningiomas. Br J Ophthalmol 97:1455–1458PubMed

30.

Maberley DA, Hollands H, Chuo J, Tam G, Konkal J, Roesch M, Veselinovic A, Witzigmann M, Bassett K (2006) The prevalence of low vision and blindness in Canada. Eye (Lond) 20:341–346

31.

Milano MT, Grimm J, Soltys SG, Yorke E, Moiseenko V, Tome WA, Sahgal A, Xue J, Ma L, Solberg TD, Kirkpatrick JP, Constine LS, Flickinger JC, Marks LB, El Naqa I (2018) Single- and multi-fraction stereotactic radiosurgery dose tolerances of the optic pathways. Int J Radiat Oncol Biol Phys. https://doi.org/10.1016/j.ijrobp.2018.01.053

32.

Millar WT, Hopewell JW, Paddick I, Lindquist C, Nordstron H, Lidberg P, Garding J (2015) The role of the concept of biologically effective dose (BED) in treatment planning in radiosurgery. Phys Med 31:627–633PubMed

33.

Modorati GM, Dagan R, Mikkelsen LH, Andreasen S, Ferlito A, Bandello F (2020) Gamma Knife radiosurgery for uveal melanoma: a retrospective review of clinical complications in a tertiary referral center. Ocul Oncol Pathol 6:115–122PubMed

34.

Niyazi M, Brada M, Chalmers AJ, Combs SE, Erridge SC, Fiorentino A, Grosu AL, Lagerwaard FJ, Minniti G, Mirimanoff RO, Ricardi U, Short SC, Weber DC, Belka C (2016) ESTRO-ACROP guideline “target delineation of glioblastomas”. Radiother Oncol 118:35–42PubMed

35.

Paddick I, Lippitz B (2006) A simple dose gradient measurement tool to complement the conformity index. J Neurosurg 105(Suppl):194–201PubMed

36.

Ratnayake GS, McNab AA, Dally MJ, Zajarski C, Senthi S, Ruben JD (2019) Fractionated stereotactic radiotherapy for cavernous venous malformations of the orbital apex. Ophthalmic Plast Reconstr Surg 35:322–325PubMed

37.

Scheuerle AF, Steiner HH, Kolling G, Kunze S, Aschoff A (2004) Treatment and long-term outcome of patients with orbital cavernomas. Am J Ophthalmol 138:237–244PubMed

38.

Schmidt P, Kempin R, Langner S, Beule A, Kindler S, Koppe T, Volzke H, Ittermann T, Jurgens C, Tost F (2019) Association of anthropometric markers with globe position: a population-based MRI study. PLoS One 14:e0211817PubMedPubMedCentral

39.

Seibel I, Cordini D, Hager A, Tillner J, Riechardt AI, Heufelder J, Davids AM, Rehak M, Joussen AM (2016) Predictive risk factors for radiation retinopathy and optic neuropathy after proton beam therapy for uveal melanoma. Graefes Arch Clin Exp Ophthalmol 254:1787–1792PubMed

40.

Shchurova IN, Pronin IN, Mel’nikova-Pitskhelauri TV, Serova NK, Grigor'eva NN, Fadeeva LM, Shishkina LV (2018) Orbital hemangiomas: capabilities of modern neuroradiological diagnostics. Zh Vopr Neirokhir Im N N Burdenko 82:57–69PubMed

41.

Singh D, Pushker N, Bajaj MS, Saxena R, Sharma S, Ghose S (2012) Visual function alterations in orbital tumors and factors predicting visual outcome after surgery. Eye (Lond) 26:448–453

42.

Tailor TD, Gupta D, Dalley RW, Keene CD, Anzai Y (2013) Orbital neoplasms in adults: clinical, radiologic, and pathologic review. Radiographics 33:1739–1758PubMed

43.

Tanaka A, Mihara F, Yoshiura T, Togao O, Kuwabara Y, Natori Y, Sasaki T, Honda H (2004) Differentiation of cavernous hemangioma from schwannoma of the orbit: a dynamic MRI study. AJR Am J Roentgenol 183:1799–1804PubMed

44.

Tata A, Cohen-Inbar O, Sheehan JP (2016) Treatment of orbital solitary fibrous tumour with Gamma Knife radiosurgery and systematic review of literature. BMJ Case Rep 2016. https://doi.org/10.1136/bcr-2016-217114

45.

Thompson TP, Lunsford LD, Flickinger JC (2000) Radiosurgery for hemangiomas of the cavernous sinus and orbit: technical case report. Neurosurgery 47:778–783PubMed

46.

Xu D, Liu D, Zhang Z, Zhang Y, Li Y, Liu X, Jia Q, Zheng L, Song G (2010) Gamma Knife surgery in the management of orbital tumors. J Neurosurg 113(Suppl):34–38PubMed

47.

Xu D, Liu D, Zhang Z, Zhang Y, Song G (2011) Gamma Knife radiosurgery for primary orbital varices: a preliminary report. Br J Ophthalmol 95:1264–1267PubMed

48.

Young SM, Kim KH, Kim YD, Lang SS, Park JW, Woo KI, Lee JI (2019) Orbital apex venous cavernous malformation with optic neuropathy: treatment with multisession Gamma Knife radiosurgery. Br J Ophthalmol 103:1453–1459PubMed

49.

Young SM, Kim YD, Lee JH, Woo KI (2018) Radiological analysis of orbital cavernous hemangiomas: a review and comparison between computed tomography and magnetic resonance imaging. J Craniofac Surg 29:712–716PubMed

50.

Zamber RW, Kinyoun JL (1992) Radiation retinopathy. West J Med 157:530–533PubMedPubMedCentral

Title: Stereotactic radiosurgery for orbital cavernous venous malformation: a single center’s experience for 15 years
Authors: 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
Publication date: 01-02-2021
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 2/2021
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-020-04575-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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