title: Scleral Buckle-Associated Ciliochoroidal Melanoma.
abstract: OBJECTIVE
  To describe a case of a ciliochoroidal melanoma arising from the site of a scleral buckle.
  
  
  METHODS
  Observational case report.
  
  
  METHODS
  A 69-year-old female was referred for evaluation of decreased vision and occasional floaters in the left eye for two months. Eight years previously, she had undergone vitrectomy and scleral buckling for rhegmatogenous retinal detachment repair in the same eye. Clinical examination revealed an elevated, pigmented choroidal mass in the inferonasal periphery at the crest of the scleral buckle. Clinical and ultrasonographic features were consistent with ciliochoroidal melanoma.
  
  
  RESULTS
  The patient underwent Iodine-125 brachytherapy with plaque placement directly on the scleral buckle. Intraoperative ultrasonography confirmed accurate plaque position. Appropriate tumor response was demonstrated at serial follow up-evaluations; however, over 48 months, the patient developed gradual decline in vision secondary to radiation retinopathy.
  
  
  CONCLUSIONS
  Choroidal melanomas may arise from the same location as a scleral buckle and local tumor control with brachytherapy can be achieved without manipulation or removal of the buckle element. However, we encourage orbital surgeons to consider the radiation attenuating effect of silicone, found in the buckle, in order to prevent undertreatment of these melanomas.
authors.affiliation: a Ophthalmic Oncology Center, Stein Eye Institute, Department of Ophthalmology , University of California, David Geffen School of Medicine , Los Angeles (UCLA) , California , USA.
authors.forename: Meghna V
authors.initials: MV
authors.lastname: Motiani
authors.affiliation: a Ophthalmic Oncology Center, Stein Eye Institute, Department of Ophthalmology , University of California, David Geffen School of Medicine , Los Angeles (UCLA) , California , USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Almanzor
authors.affiliation: a Ophthalmic Oncology Center, Stein Eye Institute, Department of Ophthalmology , University of California, David Geffen School of Medicine , Los Angeles (UCLA) , California , USA.
authors.forename: Tara A
authors.initials: TA
authors.lastname: McCannel
mesh_terms: D000368:Aged; D044963:Biopsy, Fine-Needle; D002830:Choroid Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D002924:Ciliary Body / Q000473:pathology*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008545:Melanoma / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D011183:Postoperative Complications; D012163:Retinal Detachment / Q000601:surgery*; D012591:Scleral Buckling / Q000009:adverse effects*; D014604:Uveal Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D000098943:Uveal Melanoma