title: Factors predictive of radiation retinopathy post (125)Iodine brachytherapy for uveal melanoma.
abstract: OBJECTIVE
  To report the host, tumour, and radiation-related predictive factors for developing radiation retinopathy post (125)Iodine brachytherapy for uveal melanoma.
  
  
  METHODS
  A retrospective clinical case series.
  
  
  METHODS
  Three hundred consecutive patients with uveal melanoma treated with (125)Iodine brachytherapy.
  
  
  METHODS
  Electronic chart review of demographic, clinical, treatment, and follow-up data. Proliferative and (or) nonproliferative radiation retinopathy patients were included. Cumulative incidence rates were calculated using Kaplan-Meier estimates. Univariate and multivariate statistical regression analyses were performed to identify factors predictive of radiation retinopathy.
  
  
  RESULTS
  The mean follow-up period was 48 months. Radiation retinopathy occurred in 107 patients (36%). Actuarial incidence of radiation retinopathy was 30% (CI 24%-36%) at 24 months post-treatment. In the multivariate model, the predictive factors were a younger age (hazard ratio [HR] 0.98, p < 0.03), diabetes (HR 2.17, p < 0.007), and hypertension (HR 2.17, p < 0.004). Tumour-related factors were proximity to optic disc (HR 0.95, p < 0.02) and proximity to foveola (HR 0.96, p < 0.02). Pretreatment tumour dimensions, other tumour characteristics, and total radiation dose did not demonstrate statistically significant risks for developing radiation retinopathy.
  
  
  CONCLUSIONS
  Radiation retinopathy affects 30% of patients 2 years following (125)Iodine brachytherapy for uveal melanoma. The predictive factors for radiation retinopathy are a younger age, comorbidity with diabetes or hypertension, and proximity of the tumour margin to the optic disc or foveola. Identifying the predictive factors for developing radiation retinopathy can modify follow-up for patients at risk, which may permit earlier management of the developing radiation-induced ischemic retinal changes.
authors.affiliation: Ocular Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada. htmkrm19@yahoo.com
authors.forename: Hatem
authors.initials: H
authors.lastname: Krema
authors.forename: Wei
authors.initials: W
authors.lastname: Xu
authors.forename: David
authors.initials: D
authors.lastname: Payne
authors.forename: Luz Maria
authors.initials: LM
authors.lastname: Vasquez
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Pavlin
authors.forename: Rand
authors.initials: R
authors.lastname: Simpson
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects*; D015897:Comorbidity; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007457:Iodine Radioisotopes / Q000009:adverse effects*; D008297:Male; D008545:Melanoma / Q000532:radiotherapy*; D008875:Middle Aged; D010781:Photography; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology*; D011879:Radiotherapy Dosage; D012160:Retina / Q000528:radiation effects*; D012164:Retinal Diseases / Q000175:diagnosis / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014604:Uveal Neoplasms / Q000532:radiotherapy*; D055815:Young Adult
chemical_list: D007457:Iodine Radioisotopes