title: Intraoperative sonographically assisted radioactive iodine 125 plaque brachytherapy for choroidal melanoma: visual acuity outcome.
abstract: OBJECTIVE
  The purpose of this study was to present a retrospective series of cases from a single Canadian academic center assessing visual acuity outcomes after intraoperative sonographically assisted iodine 125 ((125)I) plaque brachytherapy treatment.
  
  
  METHODS
  The cases of 28 patients (16 male and 12 female; mean age ± SD diagnosis, 62.3 ± 15 years) with choroidal melanoma treated with (125)I plaque brachytherapy using intraoperative sonography between 1997 and 2002 were reviewed.
  
  
  RESULTS
  The mean longitudinal, transverse, and depth dimensions were 11.4, 10.6, and 4.7, respectively. The median follow-up was 48 months (range, 3-102 months) for our cohort of patients. The prescribed dose was 85 Gy to a height of 5 mm (for an apex height ≤5 mm) or to the tumor apex (for an apex height >5 mm). Five years after (125)I plaque brachytherapy, all tumors had regressed in their longitudinal, transverse, and depth dimensions. The prebrachytherapy tumor depth (P = .023) and sclera dose (P = .036) were found to significantly affect visual acuity after plaque brachytherapy at 24 months. One recurrence was recorded 6 years after plaque brachytherapy.
  
  
  CONCLUSIONS
  This study supports (125)I plaque brachytherapy as an efficacious treatment for patients with choroidal melanoma, and intraoperative sonography may help with optimizing tumor control. In addition, to our knowledge, this study is the first to report the sclera dose as a significant predictor of visual acuity.
authors.affiliation: Department of Ophthalmology, McGill University, Montreal, Canada.
authors.forename: Sean
authors.initials: S
authors.lastname: Quinlan-Davidson
authors.forename: Tahra
authors.initials: T
authors.lastname: AlMahmoud
authors.forename: George
authors.initials: G
authors.lastname: Shenouda
authors.forename: Michael
authors.initials: M
authors.lastname: Evans
authors.forename: Magdi
authors.initials: M
authors.lastname: Mansour
authors.forename: Chaim
authors.initials: C
authors.lastname: Edelstein
authors.forename: Gregory
authors.initials: G
authors.lastname: Pond
authors.forename: Jean
authors.initials: J
authors.lastname: Deschênes
mesh_terms: D001918:Brachytherapy / Q000295:instrumentation* / Q000379:methods; D002830:Choroid Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008545:Melanoma / Q000150:complications / Q000175:diagnosis* / Q000532:radiotherapy*; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000379:methods; D061089:Radiotherapy, Image-Guided / Q000379:methods; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D014792:Visual Acuity
chemical_list: D007457:Iodine Radioisotopes
keywords: brachytherapy; choroidal melanoma; iodine 125; sonography