Supplementary Material for: Retinal pigment epithelial adenoma: Initial treatment outcomes following episcleral brachytherapy

Introduction: To explore the safety and efficacy of episcleral brachytherapy as a primary management option for eyes with retinal pigment epithelial (RPE) adenoma. Methods: Retrospective chart review of the demographic, clinical, ancillary, and post-operative outcome data of patients with RPE adenoma in 2 tertiary referral centers. Tumor regression, final visual acuity, and complications were assessed. Results: 5 patients (3 females and 2 males) were included. 4 of the 5 eyes had peripheral and mid-peripheral lesions, while one tumor was juxtapapillary. 3 eyes were treated with Ruthenium-106 (100 Gray), and 2 received Iodine-125 episcleral plaques (85 Gray). All eyes showed clinical and imaging-based evidence of regression. 4 eyes had stable or improved visual acuity, while 1 eye exhibited one line loss of visual acuity due to radiation retinopathy. Local recurrence was not observed in any eye over a median follow-up of 24 (range 6-112) months. Conclusions: Episcleral brachytherapy is an effective management option for select cases of RPE adenoma that is capable of achieving tumor regression while maintaining favorable visual acuity. The initial safety profile of brachytherapy is good without significant vision-compromising complications.