Gallo, B;
Hussain, R;
Al-Jamal, R;
Khalid, H;
Stoker, I;
Hay, G;
Arora, AK;
(2025)
Long-term visual outcomes and side effects of ruthenium plaque brachytherapy in 310 eyes with small choroidal melanoma.
British Journal of Ophthalmology
10.1136/bjo-2023-324686.
(In press).
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Abstract
BACKGROUND/AIMS: To report the long-term visual outcomes and side effects in patients with small choroidal melanoma (CM) undergoing ruthenium-106 (Ru-106) plaque brachytherapy. METHODS: Retrospective, interventional, consecutive series of small CM ≤2.5 mm in height and ≤16 mm in largest basal diameter treated with Ru-106 plaque with a median radiation dose of 100 Gy prescribed to tumour apical height. RESULTS: 310 patients (160 men) with a mean (SD) age of 58.4±14.1 years met the study inclusion criteria. The median follow-up was 57.5 (range 3.4–170.5) months. The mean tumour baseline thickness was 1.9±0.4 (range 0.4–2.5) mm. The mean baseline logarithm of the minimum angle of resolution (logMAR) of best corrected visual acuity (BCVA) was 0.21±0.4 (Snellen equivalent 6/9; range −0.1 to 1.5). Mean final BCVA was ≤0.3 logMAR (Snellen equivalent 6/12) in 161 patients (54.2%), better than 1.0 logMAR (Snellen equivalent 6/60) and <0.3 logMAR in 59 patients (19.9%), and ≥1.0 logMAR in 77 patients (25.9%). Kaplan-Meier estimates of poor final VA (≥1.0 logMAR) were 13.2% at 5 years and 54.5% at 10 years. Early and late complications developed in 20.6% and 42.6% of cases, respectively. Radiation maculopathy was the most frequent late side effect (29% of patients) with Kaplan-Meier rates of 18.2%, 31.7% and 42.1% at 3, 5 and 10 years, respectively. Older age, lipofuscin, proximity to fovea, final tumour elevation and radiation maculopathy predicted visual loss ≥5 Snellen lines. CONCLUSION: Despite early and late complications in 20.6% and 42.6% of cases, Ru-106 brachytherapy for small CM allows retention of BCVA ≤0.3 logMAR in half of the eyes.
| Type: | Article |
|---|---|
| Title: | Long-term visual outcomes and side effects of ruthenium plaque brachytherapy in 310 eyes with small choroidal melanoma |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1136/bjo-2023-324686 |
| Publisher version: | https://doi.org/10.1136/bjo-2023-324686 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Choroid, Imaging, Macula, Neoplasia, Retina |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10204866 |
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