scholarly journals Iodine-125 Episcleral Plaque Brachytherapy for AJCC T4 Posterior Uveal Melanoma: Clinical Outcomes in 158 Patients

2019 ◽  
Vol 5 (5) ◽  
pp. 340-349
Author(s):  
Benjamin A. King ◽  
Caroline Awh ◽  
Brad T. Gao ◽  
Jiajing Wang ◽  
Mehmet Kocak ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Treatment Failure ◽  
Uveal Melanoma ◽  
Cumulative Incidence ◽  
Vitreous Hemorrhage ◽  
Patient Age ◽  
Ocular Morbidity ◽  
Iodine 125 ◽  
Baseline Visual Acuity ◽  
Plaque Brachytherapy

Background/Aims: The aim of this study is to report the burden of ocular morbidity following iodine-125 episcleral plaque brachytherapy (EPBT) in the treatment of American Joint Committee on Cancer (AJCC) T4-staged posterior uveal melanoma (PUM). Methods: Clinical records of patients with T4-staged PUM treated with 125I EPBT were analyzed for incidence of treatment failure and radiation-induced complications. Results: Cumulative incidence of local treatment failure was 9% (95% CI 5–15%) at 5 years and was associated with decreased tumor height (HR = 0.78; p = 0.01). Cumulative incidence of enucleation at 5 years was 21% and was correlated with worsening baseline visual acuity (HR = 1.42; p = 0.05). Increasing patient age was associated with higher rates of vitreous hemorrhage (HR = 1.03; p = 0.02) and cataract surgery (HR = 1.05; p < 0.001). Increased tumor height was associated with higher rates of neovascular glaucoma (HR = 1.16; p = 0.03) and vitreous hemorrhage (HR = 1.23; p < 0.001). Conclusion: 125I EPBT is an effective treatment for T4-staged PUM and achieves high rates of local control. Treatment failure appears to be more common among minimally elevated tumors. Other causes of ocular morbidity were associated with increasing tumor height, patient age, and baseline visual acuity.

scholarly journals Conjunctival Dehiscence and Scleral Necrosis following Iodine-125 Plaque Brachytherapy for Uveal Melanoma: A Report of 3 Cases

2018 ◽  
Vol 4 (5) ◽  
pp. 291-296 ◽  
Author(s):  
Duncan E. Berry ◽  
Dilraj S. Grewal ◽  
Prithvi Mruthyunjaya
Keyword(s):  
Uveal Melanoma ◽  
Iodine 125 ◽  
Plaque Brachytherapy

scholarly journals No Gender Differences in Long-Term Survival after Brachytherapy of 1,541 Patients with Uveal Melanoma

2019 ◽  
Vol 5 (6) ◽  
pp. 432-439 ◽  
Author(s):  
Gustav Stålhammar ◽  
Thonnie Rose See ◽  
Maria Filì ◽  
Stefan Seregard
Keyword(s):  
Uveal Melanoma ◽  
Therapeutic Interventions ◽  
Term Survival ◽  
Men And Women ◽  
Kaplan Meier ◽  
Iodine 125 ◽  
Gender Based ◽  
Survival Differences ◽  
Related Mortality ◽  
Plaque Brachytherapy

Background: In several malignancies, gender-based survival differences after specific therapeutic interventions have been demonstrated. It is not known whether such differences exist after plaque brachytherapy of uveal melanoma. Methods: All patients who received brachytherapy for uveal melanoma at St. Erik Eye Hospital from November 1, 1979 through November 20, 2017 were included (n = 1,541). Retrospective data were retrieved including baseline patient and tumor characteristics, brachytherapy nuclide (ruthenium-106 or iodine-125), radiation dose, treatment duration, tumor relapses, date of metastasis, and cause of death. Results: A total of 775 men and 766 women were treated with plaque brachytherapy. There were no significant differences between the genders in baseline characteristics, treatment, or follow-up. Men and women had similar rates of tumor relapses, hazard for repeated brachytherapy (men vs. women 0.8, p = 0.47), enucleation-free survival, and survival after detection of metastasis. Five-, 10-, and 15-year melanoma-related mortality was 14, 24, and 27% for men and 15, 26, and 32% for women, respectively. There were no significant differences in hazard for melanoma-related mortality (men vs. women 0.9, p = 0.32), median Kaplan-Meier disease-specific survival (men 18.2 years, women 15.5 years, p = 0.22), or median overall survival (men 13.5 years, women 12.6 years, p = 0.60). Conclusion: There are no relevant differences between men and women in ocular or patient survival after brachytherapy for uveal melanoma.

scholarly journals Regression patterns of uveal melanoma after iodine-125 plaque brachytherapy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rui Fang ◽  
Heng Wang ◽  
Yang Li ◽  
Yue-Ming Liu ◽  
Wen-Bin Wei
Keyword(s):  
Uveal Melanoma ◽  
Tumor Regression ◽  
Chi Square ◽  
Basal Diameter ◽  
Regression Rate ◽  
Chi Square Test ◽  
Iodine 125 ◽  
Plaque Brachytherapy ◽  
Uveal Melanomas

Abstract Background Tumor regression of uveal melanomas (UMs) after radiotherapy has been reported as a valuable prognostic factor for metastasis and metastatic death. But its effect on prognosis is questionable. The purpose of this study was to summarize the regression features of uveal melanoma after iodine-125 plaque brachytherapy and the relationship with prognosis. Methods Adult uveal melanoma patients who only received iodine-125 plaque brachytherapy between December 2009 and March 2018 at the Beijing Tongren Hospital, Capital Medical University were enrolled in this study. The regression rate was calculated as the percent change in tumor height, and each eye was classified for four main regression patterns: Decrease (D), Stable (S), Others (O), and Increase (I), according to the trend of height change. Statistical analysis was performed using one-way ANOVA and chi-square test, univariate and multivariate logistic regression, and Kaplan-Meier analysis. Results A total of 139 patients was included in the study. The median follow-up was 35 months. Regression patterns status was pattern D in 65 tumors (46.8%), pattern S in 50 tumors (36.0%), pattern O in 6 tumors (4.3%), and pattern I in 18 tumors (12.9%). Reductions of tumor mean height for each follow-up visit were 5.26% (3 months), 10.66% (6 months), 9.37% (12 months), and 14.68% (18 months). A comparison (D vs. S vs. O vs. I) revealed the preoperative height of pattern I was significantly lower than the pattern D, S and O (mean: 7.24 vs. 7.30 vs. 6.77 vs. 5.09 mm, respectively; P = 0.037). LBD (largest basal diameter) was strongly associated with the metastasis (P = 0.03). However, an association between the tumor regression and subsequent melanoma-related metastasis and mortality could not be confirmed (P = 0.66 and P = 0.27, respectively). The tumor regression rate increased with increasing tumor height (P = 0.04) and decreased with increasing of LBD (P = 0.01). Conclusion Our study showed a lack of association between the prognosis and the regression of uveal melanomas following I-125 plaque radiotherapy. The LBD and original height of the tumor have predictive value in tumor regression rate, and LBD was positively associated with metastasis.

Epiretinal Membrane Peeling in Patients With Good Preoperative Vision

2017 ◽  
Vol 1 (1) ◽  
pp. 52-56 ◽  
Author(s):  
Nicholas D. Chinskey ◽  
Gaurav K. Shah
Keyword(s):  
Visual Acuity ◽  
Epiretinal Membrane ◽  
Chart Review ◽  
Vitreous Hemorrhage ◽  
Retrospective Chart Review ◽  
Corrected Visual Acuity ◽  
Additional Procedure ◽  
Pars Plana ◽  
Baseline Visual Acuity

Objective: To evaluate the outcomes of patients undergoing removal of an epiretinal membrane (ERM) with good starting visual acuity. Design: Retrospective chart review. Participants: Forty eyes of 40 patients seen at a tertiary, referral-based private practice. Methods: All patients undergoing pars plana vitrectomy with removal of an ERM by a single surgeon (G.K.S.) from the years 2012 to 2014 were evaluated. Patients who were phakic, had a baseline visual acuity of 20/50 or worse, and those who had surgery less than 6 months prior to data collection were excluded. Results: Of the 40 patients included, only 2 (5%) developed a serious postoperative complication. One had a vitreous hemorrhage that cleared without further surgical intervention, and another developed a macula on retinal detachment that required 1 additional procedure. Nineteen (47.5%) had improved best-corrected visual acuity (BCVA), 10 (25%) maintained their initial BCVA, 7 (17.5%) lost 1 to 2 lines, and 4 (10%) lost 3 lines or greater at their last follow-up visit. When looking only at idiopathic ERMs in the group, the results were similar with 48% with improved vision, 29% maintained the initial BCVA, 16% lost 1 to 2 lines, and 6% lost 3 lines or greater. Discussion: Surgery to remove an ERM is a reasonable option for those with significant metamorphopsia and highly symptomatic blurring of central vision, even with good baseline visual acuity.

scholarly journals Multifocal Intraretinal Tumour Deposits following Treatment of an Ipsilateral Choroidal Melanoma

2020 ◽  
Vol 6 (6) ◽  
pp. 410-415
Author(s):  
Aaron Jamison ◽  
Julie Connolly ◽  
Paul Cauchi ◽  
Chee Thum ◽  
Vikas Chadha
Keyword(s):  
Visual Acuity ◽  
Malignant Melanoma ◽  
Uveal Melanoma ◽  
Choroidal Melanoma ◽  
Black Spot ◽  
Retrospective Case ◽  
Snellen Visual Acuity ◽  
Choroidal Malignant Melanoma ◽  
A Site ◽  
Plaque Brachytherapy

<b><i>Background/Aims:</i></b> The aim of this study was to report a patient who, following plaque brachytherapy for a choroidal melanoma, developed two separate retinal foci of malignant melanoma in the same eye, and suggest possible mechanisms that might explain such an occurrence. <b><i>Methods:</i></b> We conducted a retrospective case report. <b><i>Results:</i></b> A 79-year-old Caucasian male developed a left inferotemporal choroidal melanoma in 2016 and subsequently underwent ruthenium-106 plaque brachytherapy under the care of the Scottish Ocular Oncology Service. Serial B-scan ultrasonography demonstrated a post-treatment reduction in tumour height to &#x3c;2 mm. In 2018, 27 months after the treatment, the patient complained of a “black spot” in the centre of his left eye vision. His visual acuity had reduced to counting fingers from 6/24 (corrected Snellen visual acuity). Several new areas of pigmentation and elevation were observed, and uveal melanoma recurrence was initially suspected. Given the multifocal nature of the presentation, the multi-disciplinary team recommended enucleation. Histological examination of the enucleated eye revealed three discrete foci of malignant melanoma – the previously treated choroidal malignant melanoma, and two solitary deposits of malignant melanoma within the retina. <b><i>Conclusion:</i></b> Retinoinvasive melanoma is a rare subtype of uveal melanoma, characterised by transvitreal melanoma invasion of the retina at a site non-contiguous with the uveal tumour, which may explain the clinical and pathological findings of the reported case.

scholarly journals Two Cases of Giant Melanocytoma (Hyperpigmented Magnocellular Nevus)

2020 ◽  
Vol 6 (5) ◽  
pp. 344-352
Author(s):  
David I.T. Sia ◽  
Jorge Agi ◽  
Parampal Grewal ◽  
Laurie Russell ◽  
Ezekiel Weis
Keyword(s):  
Optic Nerve ◽  
Retinal Detachment ◽  
Ciliary Body ◽  
Rhegmatogenous Retinal Detachment ◽  
Vitreous Hemorrhage ◽  
Melanocytic Nevus ◽  
First Case ◽  
Iodine 125 ◽  
The Right ◽  
Plaque Brachytherapy

Melanocytoma or hyperpigmented magnocellular nevus is a variant of melanocytic nevus that is most commonly seen in the optic nerve, but has also been reported to occur in the iris, ciliary body, choroid, sclera, and conjunctiva. We present two cases of giant uveal melanocytoma with histopathology. The first case occurred in a 10-year-old girl who presented with decreased vision in the right eye and a mushroom-shaped pigmented choroidal lesion measuring 15.5 mm in apical height. The lesion was abutting the lens but not causing a cataract. This was diagnosed as a choroidal melanocytoma on open scleral window biopsy. The second case was in a 68-year-old lady, referred for a left nasal pigmented choroidal lesion measuring 8 mm in apical height and having a mushroom configuration. The lesion grew to 8.6 mm in height and was complicated by a vitreous hemorrhage and rhegmatogenous retinal detachment and was treated with iodine-125 plaque brachytherapy. Subsequently, the treated eye became a painful phthisical eye and was enucleated. Histopathology confirmed melanocytoma with extrascleral extension but without malignant transformation. Features of melanocytoma and other very large cases reported in the literature are discussed.

23-mm iodine-125 plaque for uveal melanoma: benefit of vitrectomy and silicone oil on visual acuity

2016 ◽  
Vol 254 (12) ◽  
pp. 2461-2467 ◽  
Author(s):  
Tara A. McCannel ◽  
Mitchell Kamrava ◽  
Jeffrey Demanes ◽  
James Lamb ◽  
John D. Bartlett ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Uveal Melanoma ◽  
Silicone Oil ◽  
Iodine 125
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