PT  - JOURNAL ARTICLE
AU  - Renato Jose Yupari
AU  - James Bena
AU  - Allan Wilkinson
AU  - John Suh
AU  - Arun Singh
TI  - Small choroidal melanoma: outcomes following apical height dose brachytherapy
AID  - 10.1136/bjophthalmol-2020-316873
DP  - 2021 Aug 01
TA  - British Journal of Ophthalmology
PG  - 1161--1165
VI  - 105
IP  - 8
4099  - http://bjo.bmj.com/content/105/8/1161.short
4100  - http://bjo.bmj.com/content/105/8/1161.full
SO  - Br J Ophthalmol2021 Aug 01; 105
AB  - Aim To assess the outcomes of small choroidal melanoma following iodine-125 episcleral brachytherapy (apical height dose of 85 Gy).Methods Patients with small choroidal melanoma that underwent iodine-125 episcleral brachytherapy between January 2004 and December 2017 were reviewed. Inclusion criterion for this study was the COMS small tumour size (tumour apical height of 1.0–2.5 mm and largest basal diameter (LBD) <16.0 mm). Patients that received any form of prior therapy or adjuvant transpupillary thermotherapy were excluded. Outcome measures were visual acuity (VA), recurrence, ocular survival and metastasis at 3 years. Kaplan-Meier estimation was calculated for VA, recurrence, ocular survival and survival outcome (overall and metastasis-free survival rate) at 3 years.Results 161 cases of choroidal melanoma were included in this study, with the mean (SD) age of 59.6 (14.1) years, and 93 (58%) were males. The mean (SD) apical height for the tumours were 2.1 (0.4) mm and mean (SD) LBD was 8.3 (2.2) mm. The mean (SD, median) follow-up was 40.7 months (37.1, 25 months). The VA was 20/50 or better in 69%. Only one recurrence event (1%) and one enucleation event (1%) were observed. Overall survival was 97%, and no metastatic events were observed at 3 years.Conclusion Small choroidal melanomas treated with iodine-125 episcleral brachytherapy have excellent outcomes. The majority (69%) of patients retained VA of 20/50 or better with very high local control and ocular survival rate (99.3%) with the absence of metastasis (100%).