Early macular morphological changes following plaque radiotherapy for uveal melanoma.

Abstract

PURPOSE:

To evaluate the time of onset and risk factors for the development of macular edema following plaque radiotherapy for uveal melanoma, using optical coherence tomography (OCT).

METHODS:

This observational case series included 135 consecutive patients with uveal melanoma treated with Iodine(125) plaque radiotherapy and adjunctive transpupillary thermotherapy (TTT) laser. Patients were evaluated at baseline and 6-month intervals following treatment using ophthalmoscopy, B-scan ultrasonography, fundus photography, and OCT.

RESULTS:

Median follow-up was 24 months. The mean time to onset of macular edema by OCT was 12 months. Median best-corrected logMAR visual acuity at the time of onset of OCT-evident macular edema was 0.3 (equivalent to 20/40 Snellen). The development of OCT-evident macular edema was significantly associated with maximum tumor thickness (P = 0.0016), largest tumor base (P < 0.0001), radiation dose, and dose-rate to the tumor base (P = 0.0315 and P = 0.0204, respectively). Neither radiation dose to the foveola nor treatment with adjunctive TTT laser was significantly associated with the development of macular edema.

CONCLUSIONS:

OCT is useful in the early detection of radiation-induced macular edema, before clinical signs of radiation maculopathy develop and before substantial visual loss occurs. The development of macular edema is significantly associated with larger initial tumor size.

• Authors: Noel Horgan, Carol L Shields, Arman Mashayekhi, Luiz F Teixeira, Miguel A Materin, Jerry A Shields
• Journal: Retina (Philadelphia, Pa.) (Retina) Vol. 28 Issue 2 Pg. 263-73 (Feb 2008) ISSN: 0275-004X [Print] United States
• PMID: 18301032 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Iodine Radioisotopes

Topics

• Adult
• Aged
• Aged, 80 and over
• Brachytherapy (adverse effects)
• Combined Modality Therapy
• Female
• Humans
• Hyperthermia, Induced
• Iodine Radioisotopes (adverse effects)
• Macular Edema (diagnosis, etiology)
• Male
• Melanoma (radiotherapy)
• Middle Aged
• Ophthalmoscopy
• Radiation Injuries (diagnosis, etiology)
• Retina (pathology, radiation effects)
• Risk Factors
• Time Factors
• Tomography, Optical Coherence
• Uveal Neoplasms (radiotherapy)
• Vision Disorders (diagnosis, etiology)
• Visual Acuity