IMPORTANCE: The treatment of juxtapapillary choroidal melanoma is challenging because of the proximity of the tumor to visually important structures. OBJECTIVE: To report the complications of treatment of juxtapapillary choroidal melanoma with plaque radiotherapy. DESIGN, SETTING, AND PARTICIPANTS: In this retrospective case series of patients from the Ocular Oncology Service, Wills Eye Hospital, 650 consecutive eyes with juxtapapillary choroidal melanoma (≤1 mm to optic disc) treated with plaque radiotherapy from October 1, 1974, through November 30, 2005, were studied. MAIN OUTCOMES AND MEASURES: Kaplan-Meier analysis of rates of radiation complications, secondary enucleation, and visual acuity outcomes. RESULTS: The 5-year (10-year) rate of nonproliferative retinopathy was 66% (75%); proliferative retinopathy, 24% (32%); maculopathy, 56% (65%); papillopathy, 61% (77%); cataract, 66% (80%); neovascular glaucoma, 15% (22%); vitreous hemorrhage, 35% (42%); and secondary enucleation, 16% (26%). Visual acuity of 20/200 or worse occurred in 54% (87%), and loss of more than 5 lines of Snellen visual acuity was found in 45% (78%). CONCLUSIONS AND RELEVANCE: Among this case series, plaque radiotherapy for juxtapapillary choroidal melanoma commonly led to retinopathy and papillopathy, but globe retention was 84% at 5 years. Vision loss should be anticipated in 45% by 5 years. Plaque radiotherapy remains a suitable choice for the treatment of juxtapapillary melanoma with a high globe retention rate.
IMPORTANCE: The treatment of juxtapapillary choroidal melanoma is challenging because of the proximity of the tumor to visually important structures. OBJECTIVE: To report the complications of treatment of juxtapapillary choroidal melanoma with plaque radiotherapy. DESIGN, SETTING, AND PARTICIPANTS: In this retrospective case series of patients from the Ocular Oncology Service, Wills Eye Hospital, 650 consecutive eyes with juxtapapillary choroidal melanoma (≤1 mm to optic disc) treated with plaque radiotherapy from October 1, 1974, through November 30, 2005, were studied. MAIN OUTCOMES AND MEASURES: Kaplan-Meier analysis of rates of radiation complications, secondary enucleation, and visual acuity outcomes. RESULTS: The 5-year (10-year) rate of nonproliferative retinopathy was 66% (75%); proliferative retinopathy, 24% (32%); maculopathy, 56% (65%); papillopathy, 61% (77%); cataract, 66% (80%); neovascular glaucoma, 15% (22%); vitreous hemorrhage, 35% (42%); and secondary enucleation, 16% (26%). Visual acuity of 20/200 or worse occurred in 54% (87%), and loss of more than 5 lines of Snellen visual acuity was found in 45% (78%). CONCLUSIONS AND RELEVANCE: Among this case series, plaque radiotherapy for juxtapapillary choroidal melanoma commonly led to retinopathy and papillopathy, but globe retention was 84% at 5 years. Vision loss should be anticipated in 45% by 5 years. Plaque radiotherapy remains a suitable choice for the treatment of juxtapapillary melanoma with a high globe retention rate.
Authors: Catharina Busch; Julia Löwen; Daniel Pilger; Ira Seibel; Jens Heufelder; Antonia M Joussen Journal: Graefes Arch Clin Exp Ophthalmol Date: 2018-06-12 Impact factor: 3.117
Authors: I D Fabian; A W Stacey; V Papastefanou; L Al Harby; A K Arora; M S Sagoo; V M L Cohen Journal: Eye (Lond) Date: 2017-03-24 Impact factor: 3.775
Authors: John V Hegde; Tara A McCannel; Colin A McCannel; James Lamb; Pin-Chieh Wang; Darlene Veruttipong; Robert Almanzor; D Jeffrey Demanes; Mitchell Kamrava Journal: Graefes Arch Clin Exp Ophthalmol Date: 2017-06-09 Impact factor: 3.117
Authors: Irena Tsui; Robert M Beardsley; Tara A McCannel; Scott C Oliver; Melissa W Chun; Steve P Lee; Phillip E Chow; Nzhde Agazaryan; Fei Yu; Bradley R Straatsma Journal: Open Ophthalmol J Date: 2015-06-26