Original articleRisk Factors for Radiation Maculopathy after Ophthalmic Plaque Radiation for Choroidal Melanoma
Section snippets
Methods
We report on 384 consecutive patients with uveal melanomas treated with 103Pd. Our methods of diagnosis, informed consent, treatment, and follow-up have been described.14 Aspects of particular importance to this study include that tumor basal dimensions were determined by ophthalmoscopy, transillumination, fluorescein angiography, and ultrasonography.
Results
Follow-up time ranged from 0 (unrelated death at time of therapy) to 204.7 months, with a mean of 47.2 months. The mean time from plaque brachytherapy to diagnosis of RM was 23.2 months (range, 3 to 72 months). This was significant in that most of the patients in this series were followed up for more than 2 years. Specifically, the number of patients who were followed up for at least 12 months, 24 months, and 36 months was 296 (77%), 229 (60%), and 176 (46%), respectively. Four patients
Discussion
Biomarkers are objectively measured indicators of a normal biologic processes, pathogenic processes, or response to a therapeutic intervention. This study suggests that radiation dose to the fovea can be used as a biomarker to predict the risk of developing radiation retinopathy in the macula. This is important because RM is the most common and irreversible cause of radiation-related loss of vision.
In an earlier study on plaque radiation therapy for choroidal melanoma, Finger noted that plaque
References (29)
Radiation therapy for orbital tumors: concepts, current use and radiation side-effects
Surv Ophthalmol
(2009)Radiation therapy for choroidal melanoma
Surv Ophthalmol
(1997)- et al.
An interactive treatment planning system for ophthalmic plaque radiotherapy
Int J Radiat Oncol Biol Phys
(1990) - et al.
Palladium-103 plaque radiotherapy for choroidal melanoma: an 11-year study
Int J Radiat Oncol Biol Phys
(2002) - et al.
Review of eye plaque dosimetry based on AAPM Task Group 43 recommendationsAmerican Association of Physicists in Medicine
Int J Radiat Oncol Biol Phys
(1998) - et al.
The American Brachytherapy Society recommendations for brachytherapy of uveal melanomas
Int J Radiat Oncol Biol Phys
(2003) - et al.
American brachytherapy society recommendations for clinical implementation of NIST-1999 standards for (103)palladium brachytherapyThe clinical research committee of the American Brachytherapy Society
Int J Radiat Oncol Biol Phys
(2000) Anti-VEGF bevacizumab (Avastin) for radiation optic neuropathy
Am J Ophthalmol
(2007)Radiation retinopathy is treatable with anti-vascular endothelial growth factor bevacizumab (Avastin)
Int J Radiat Oncol Biol Phys
(2008)Principles of radiologic physics, dosimetry and treatment planning
Advances in three-dimensional treatment planning and conformal dose delivery
Semin Oncol
Radiation dose-rate: a factor of importance in radiobiology and radiotherapy
Br J Radiol
Weiss lectureThe dose-rate factor in radiation biology
Int J Radiat Biol
Clinical applications of electron beam therapy
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2023, Survey of OphthalmologyCitation Excerpt :Finger initially noted that epibulbar plaque position (anterior versus posterior) played a significant role in determining the visual acuity outcomes. Specifically, plaque irradiation of posteriorly located tumors was more likely to result in vision loss from radiation maculopathy and radiation optic neuropathy.34,40,41,124 Finger and also Materin showed that laser photocoagulation could be used to decrease the tumor blood flow and destroy radiation-induced retinal ischemia in an effort to treat, prevent or delay radiation induced maculopathy.30,42,73,118
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