Radiation-induced optic neuropathy following brachytherapy of uveal melanomas.
In a prospective study the incidence of optic neuropathy following 106Ru/106Rh-brachytherapy of uveal melanomas was evaluated. Pattern visual evoked potentials (VECP) were measured before radiation and at regular follow-up intervals. Patients were grouped according to tumor location in peripheral melanomas with a central tumor margin of more than 60 degrees to the optic disc (n = 11) and central melanomas with a tumor within 15 degrees to the optic disc (n = 28). No patient with peripheral tumor had clinical signs of optic neuropathy or pathological VECPs after radiation. In patients with central melanomas clinical signs were seen in 5/28 (18%), but pathological VECPs developed in 14/28 (50%). The visual loss after radiation was greater in patients with pathological VECPs (P < 0.03). Radiation-induced optic nerve damage depends on tumor location and is more frequent than clinically expected.
Kellner
U
U
FU Berlin, Klinikum Steglitz, Augenklinik und Poliklinik, Hindenburgdamm, Germany.
Bornfeld
N
N
Foerster
M H
MH
D001918:Brachytherapy / Q000009:adverse effects*; D005074:Evoked Potentials, Visual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000532:radiotherapy*; D009901:Optic Nerve Diseases / Q000209:etiology* / Q000503:physiopathology; D010364:Pattern Recognition, Visual; D011446:Prospective Studies; D011832:Radiation Injuries / Q000209:etiology* / Q000503:physiopathology; D014604:Uveal Neoplasms / Q000473:pathology / Q000532:radiotherapy*