Objective: To evaluate tumor control and treatment complications following plaque radiotherapy combined with transpupillary thermotherapy for choroidal melanoma.
Design: Prospective noncomparative interventional case series.
Intervention: All patients received treatment for choroidal melanoma using plaque radiotherapy followed by 3 sessions of transpupillary thermotherapy provided at plaque removal and at 4-month intervals.
Participants: Two hundred seventy patients with newly diagnosed choroidal melanoma.
Main Outcome Measures: The 2 main outcome measures included local tumor recurrence and treatment-related complications. The clinical data regarding patient features, tumor features, radiotherapy and thermotherapy parameters were analyzed for their effect on the 2 main outcomes using Cox proportional hazards regression models.
Results: Prior to treatment, the median base of the tumor was 11 mm (range, 4-21 mm) and the median thickness was 4 mm (range, 2-9 mm). Most tumors were located in the posterior pole with a median proximity of 2 mm to the foveola and 2 mm to the optic disc. The median radiotherapy dose to the tumor apex was 9000 rad. Transpupillary thermotherapy was applied in 3 sessions at 4-month intervals for a median of 700 mW. The tumor decreased in thickness to a median of 2.3 mm by 1 year and 2.1 mm by 2 years' follow-up with stable findings thereafter. Using Kaplan-Meier estimates, tumor recurrence was 2% at 2 years and 3% at 5 years. Risk factors for tumor recurrence included macular location of the tumor epicenter (P =.03), diffuse tumor configuration (P =.005), and tumor margin extending underneath the foveola (P =.001). Using Kaplan-Meier estimates, treatment-related complications at 5 years included maculopathy in 18% of the participants, papillopathy in 38%, macular retinal vascular obstruction in 18%, vitreous hemorrhage in 18%, rhegmatogenous retinal detachment in 2%, cataract in 6%, and neovascular glaucoma in 7%. Enucleation for radiation complications was necessary in 3 cases (1%).
Conclusion: Plaque radiotherapy combined with transpupillary thermotherapy provides excellent local tumor control with only 3% recurrence at 5 years' follow-up.
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http://dx.doi.org/10.1001/archopht.120.7.933 | DOI Listing |
Surv Ophthalmol
January 2025
Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China; Key Lab of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing 100730, China. Electronic address:
Because of its benign nature and rarity, circumscribed choroidal hemangioma (CCH) often receives limited attention, leading to a high rate of misdiagnosis and a lack of standardized treatment protocols. We provide a thorough clarification of the demographics, clinical features, diagnosis, management, and prognosis of CCH. We conducted a systematic search of the PubMed, EMBASE, and Ovid databases up to December, 2023, to identify relevant studies.
View Article and Find Full Text PDFCan J Ophthalmol
January 2025
Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology &Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Objective: To investigate the clinical and prognostic features of uveal metastasis in a Chinese population and compare these features across different primary cancers.
Design: Retrospective cross-sectional study.
Participants: 161 patients with uveal metastasis at Beijing Tongren Hospital.
Cureus
December 2024
Department of Ophthalmology, Xi'an No. 3 Hospital, the Affiliated Hospital of Northwest University, Xi'an, CHN.
Choroidal nevus is the most common intraocular tumor, and most cases are benign and have no symptoms. However, choroidal nevus carries a low risk for transformation into melanoma, which is a highly aggressive and deadly cancer. In this case report, we present a male patient with blurred vision in his left eye for six months.
View Article and Find Full Text PDFRetina
November 2024
Anant Bajaj Retina Institute, LV Prasad Eye Institute, Hyderabad, India.
Int Ophthalmol
July 2024
Ocular Oncology Service, Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey.
Purpose: To review long-term outcomes of circumscribed choroidal hemangioma (CCH).
Methods: Hospital charts of all CCH cases diagnosed from 2008 to 2019 were retrospectively reviewed.
Results: All 172 patients were managed with either observation, transpupillary thermotherapy, argon laser photocoagulation, photodynamic therapy, plaque brachytherapy or stereotactic radiosurgery.
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