Tumour location affects the incidence of cataract and retinopathy after ophthalmic plaque radiation therapy.
OBJECTIVE
To examine how tumour location affects ocular morbidity after ophthalmic plaque radiotherapy for uveal melanoma.


METHODS
69 eyes were irradiated and followed for a mean 42 months. There were 23 anterior uveal melanomas and 46 were posterior to the equator. Anterior and posterior tumours had similar basal dimensions. Their mean apical heights were 4.8 mm (anterior) and 3.5 mm (posterior) which received a mean 88 Gy and 83.4 Gy respectively.


RESULTS
Only one patient (4%) plaqued for an anterior uveal melanoma developed secondary retinopathy (cystoid macular oedema). In contrast, 24 (52%) of the posterior choroidal melanoma patients developed retinopathy (p value <0.0001). Cataract developed in 18 (86%) eyes with phakic anterior tumour compared with seven (17%) eyes with posterior tumours (p value <0.0000). No posterior nasal tumours lost more than two lines of vision though 45% developed retinopathy.


CONCLUSIONS
While plaque radiation of anterior melanomas is more likely to cause reversible vision loss secondary to cataract, treatment of posterior tumours is more likely to be associated with irreversible loss because of retinopathy. Nasal location is also protective against severe loss of vision.
Finger
P T
PT
New York Eye Cancer Centre, New York Eye and Ear Infirmary, and Department of Ophthalmology, New York University School of Medicine, New York City 10021, USA. pfinger@eyecancer.com
D002386:Cataract / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008545:Melanoma / Q000473:pathology / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000150:complications*; D012164:Retinal Diseases / Q000209:etiology* / Q000473:pathology; D012307:Risk Factors; D014604:Uveal Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D014792:Visual Acuity / Q000528:radiation effects