Long-term follow-up of gamma knife surgery for nondistensible orbital venous malformations

Keywords: gamma knife, orbit, venous malformation, vision, outcome

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     Orbital lesions are suitable for stereotactic radiosurgery.
Our purpose was to assess the long-term results of Gamma Knife surgery (GKS) in patients with nondistensible orbital venous malformations(NOVM).
     The series included 9 men and 16 women with a median age of 18 (range 2-56) years.
     Twenty-five patients with NOVM were treated with GKS between 1995 and 2005.  Prior resection had been performed in 19 patients, and GKS was performed as the sole treatment option in 6 patients. Prescription peripheral dose varied from 12 to 20 Gy (mean 15.6 Gy); the corresponding central dose was 24 to 40Gy. The mean volume of the tumor at GKS was 7.6 cm3 (range, 1.0 to 30.2 cm3).
     At a median follow-up period of 56 months (range, 30 to 120 months), tumor shrinkage was observed in all patients. Visual acuity improved in 15 patients, remained stable in 8 patients (including 3 patients who were completely blind before GKS) and deteriorated in 2 cases. All patients had symptomatic improvement. Except for reversible conjunctival edema in 4 cases, no other serious acute side effect was observed.
     This was a retrospective series.
     Gamma Knife surgery provides long-term tumor control for NOVM. 
     The results of this study add substantial evidence that GKS may definitely become a standard treatment approach in selected cases of NOVM.


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