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DISCUSSION
From our experience, it appeared that more patients had a better outcome when treated within six months of onset of symptoms compared to those treated six months after onset of symptoms (86% versus 50%). Similarly, in the series of Shields et al[26], 42% of patients treated within six months and 72% of those treated after six months from the onset of symptoms had a poor visual outcome.
In terms of treatment modalities, an improvement of 2 or more lines was noted in 75% of those treated with TTT alone and 86% with brachytherapy alone. Overall, an improvement in visual acuity was noted in 69% of our patients with only one patient having a visual acuity of less than 6/60 after a mean followup of 35 months. Although our retrospective study involved a small population referred to a tertiary centre which precludes strong conclusions, this review of our outcomes compares favourably with those reported in the literature (Table 1, 2) (TTT/ICG Transpupillary thermotherapy with indocyanine green enhancement)
We currently recommend treatment within 6 months of onset of symptoms with PL for anteriorly located lesions not accessible with PDT. The visual outcome is influenced by the location of the haemangioma and the duration of symptoms prior to treatment. The majority of patients may expect to retain or achieve some improvement in their vision following treatment. No side effects were observed after a mean followup of 35 months. This paper adds to the small number of patients who benefited from Ruthenium plaque brachytherapy for CCH reported in the current literature.
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