Supplementary Material for: Ruthenium-106 plaque brachytherapy for circumscribed choroidal hemangioma: A case series and review of literature.

Introduction: We aim to report the anatomical and functional outcomes of ruthenium-106 brachytherapy in management of circumscribed choroidal hemangiomas (CCH). Methods: This is a single-center retrospective case series including patients with unilateral symptomatic CCH treated with ruthenium-106 brachytherapy at Cairo University ocular oncology service. Patients’ records were analyzed for patients’ demographics, best corrected visual acuity (BCVA), tumor dimensions (thickness and largest base diameter), foveal subretinal fluid, radiation-related complications, and recurrence. Results: Seven patients were included in the study (including 6 males) with mean age 39.3±15.4 years; ruthenium-106 plaque was used to deliver 50 Gray to tumor apex. After a mean follow-up duration of 12.5 months, all patients had significant improvement in BCVA after treatment, mean tumor height decreased significantly from 4.76 ±1.76 mm to 1.70±1.2 mm (p-value 0.01). Largest tumor base diameter also decreased significantly from 9.13±2.68 mm to 4.65±3.75 mm (p-value 0.05). Subretinal fluid and exudative retinal detachment resolved in all patients and no significant radiation-related complications were observed in any patient. None of the patients needed any further treatment or experienced recurrence within the follow-up period. Conclusion: Ruthenium-106 brachytherapy is an effective tool in the management of symptomatic CCH with a good visual prognosis and safety profile.