Iodine I 125 plaque radiotherapy for vasoproliferative tumors of the retina in 30 eyes.
OBJECTIVE
To report the efficacy of iodine I 125 plaque radiotherapy for the treatment of vasoproliferative tumors (VPTs) of the ocular fundus.


METHODS
The clinical features and outcomes of patients with VPTs who underwent iodine I 125 plaque radiotherapy were evaluated. Univariate and multivariate logistic regression analyses were performed to assess the effect of preoperative findings on visual acuity and complications. Kaplan-Meier survival estimates for the probability of adverse outcomes were performed.


RESULTS
Of the 30 eyes treated, 17 (57%) had primary and 13 (43%) had secondary VPTs. The median tumor base was 8.6 mm (range, 3.5-18.0 mm) and median tumor thickness was 3.7 mm (range, 2.5-6.3 mm). Exudative retinal detachment was present in 23 eyes (77%). Tumor regression was observed in 29 of 30 eyes (97%) and retinal detachment completely resolved in 15 of 23 eyes (65%). Visual acuity improved or remained stable in 22 eyes (73%). The only factor predictive of visual improvement was the classification of primary VPT (relative risk, 19; 95% confidence interval, 2-185; P = .01). Kaplan-Meier estimates of radiation complications at 5 years predicted cataract in (48%), transient vitreous hemorrhage in (16%), and neovascular glaucoma in (8%) of eyes. No patient developed radiation maculopathy or papillopathy.


CONCLUSIONS
Iodine I 125 plaque radiotherapy is an effective method of treating larger (>2.5-mm thickness) VPTs with extensive exudative retinal detachment.
Cohen
Victoria M L
VM
Ocular Oncology Service, Wills Eye Institute, Philadelphia, Pennsylvania, USA. victoria.lendrum@gmail.com
Shields
Carol L
CL
Demirci
Hakan
H
Shields
Jerry A
JA
D000293:Adolescent; D000328:Adult; D000368:Aged; D001918:Brachytherapy; D005260:Female; D005654:Fundus Oculi; D006391:Hemangioma / Q000401:mortality / Q000503:physiopathology / Q000532:radiotherapy*; D006801:Humans; D007457:Iodine Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D019572:Retinal Neoplasms / Q000401:mortality / Q000503:physiopathology / Q000532:radiotherapy*; D015996:Survival Rate; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
D007457:Iodine Radioisotopes