Rhegmatogenous retinal detachment in eyes with uveal melanoma.
OBJECTIVE
To describe the clinical features, surgical management, and outcome of patients with uveal melanoma who presented with or later developed a rhegmatogenous retinal detachment.


METHODS
We retrospectively identified four patients who presented with uveal melanoma and rhegmatogenous retinal detachment simultaneously and six patients in whom a rhegmatogenous retinal detachment developed 11-100 months (mean, 44.8 months) after radiotherapy for a choroidal melanoma.


RESULTS
All four patients with simultaneous presentation of uveal melanoma and retinal detachment underwent successful retinal detachment repair (cases 1 and 4, scleral buckle; case 2, pars plana vitrectomy, and case 3, pneumatic retinoplexy). Rhegmatogenous retinal detachment occurring after proton beam or plaque radiotherapy of uveal melanoma was repaired successfully in five of six patients with scleral buckling alone or in combination with pars plana vitrectomy. In the short follow-up period of this study, we did not observe tumor recurrence either before or after retinal detachment repair.


CONCLUSIONS
Rhegmatogenous retinal detachment associated with uveal melanoma may be treated successfully using conventional retinal surgical techniques. The benefits of retinal detachment repair must be weighed against any theoretical increased risk of extra-scleral extension of the melanoma. Long-term follow-up evaluation will be required to determine the safety of various retinal detachment repair techniques in these eyes.
Haimovici
R
R
Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.
Mukai
S
S
Schachat
A P
AP
Haynie
G D
GD
Thomas
M A
MA
Meredith
T A
TA
Gragoudas
E S
ES
D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects; D017679:Cryotherapy; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008545:Melanoma / Q000150:complications* / Q000532:radiotherapy; D008875:Middle Aged; D011832:Radiation Injuries / Q000150:complications / Q000209:etiology / Q000473:pathology / Q000601:surgery; D011882:Radiotherapy, High-Energy / Q000009:adverse effects; D012160:Retina / Q000528:radiation effects; D012163:Retinal Detachment / Q000150:complications* / Q000209:etiology / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D012591:Scleral Buckling; D014604:Uveal Neoplasms / Q000150:complications* / Q000532:radiotherapy; D014821:Vitrectomy
D007457:Iodine Radioisotopes