Lipid exudation following plaque radiotherapy for posterior uveal melanoma.
OBJECTIVE
To investigate factors associated with lipid exudation after plaque radiotherapy for uveal melanoma.


METHODS
Retrospective interventional case series.


METHODS
Records of 139 consecutive uveal melanoma patients treated with I-125 plaque radiotherapy were reviewed. Lipid exudation was the major outcome measured.


RESULTS
Lipid exudation was detected in 19 patients (13.7%). Mean time from plaque therapy to lipid exudation was 10 months (range, 3-23 months). Lipid exudation was associated with younger patient age (P = .0002), increased low-density lipoprotein (P = .004), decreased high-density lipoprotein (P = .026), increased tumor thickness (P = .024), and exudative retinal detachment (P = .016). Patients with lipid exudation had worse visual outcome (P < .0001) and increased neovascular glaucoma (P = .01).


CONCLUSIONS
Lipid exudation after plaque radiotherapy for uveal melanoma is associated with poor ocular outcome. Factors associated with this lipid exudation are distinct from those associated with radiation retinopathy, and they may suggest interventions to combat this complication.
Ocular Oncology Service, Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, 660 South Euclid Avenue, St Louis, MO 63110, USA.
Michael D
MD
Mills
J William
JW
Harbour
D001918:Brachytherapy / Q000009:adverse effects*; D005122:Exudates and Transudates; D006801:Humans; D007457:Iodine Radioisotopes / Q000009:adverse effects*; D008075:Lipoproteins, HDL / Q000378:metabolism; D008077:Lipoproteins, LDL / Q000378:metabolism; D008545:Melanoma / Q000532:radiotherapy*; D008563:Membrane Lipids / Q000378:metabolism*; D012163:Retinal Detachment / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D012189:Retrospective Studies; D013997:Time Factors; D014604:Uveal Neoplasms / Q000532:radiotherapy*
D007457:Iodine Radioisotopes; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D008563:Membrane Lipids