PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of brjopthalBritish Journal of OphthalmologyVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
 
Br J Ophthalmol. 1996 February; 80(2): 117–124.
PMCID: PMC505401

Long term visual outcome of radiated uveal melanomas in eyes eligible for randomisation to enucleation versus brachytherapy.

Abstract

AIMS: To determine the long term visual outcome of patients who were eligible for randomisation to enucleation versus brachytherapy in a US collaborative ocular melanoma study (COMS) but were treated with either helium ion or 125I radioactive plaque therapy. METHOD: A retrospective analysis was performed of 426 ciliochoroidal melanomas that met COMS inclusion criteria for randomisation to enucleation versus radioactive plaque but were treated with either helium ions or 125I brachytherapy. RESULTS: At 3 years 36.0% of eyes had 6/12 or better visual acuity. The length of visual retention was most dependent on tumour thickness, tumour location with respect to the optic nerve, fovea, or ciliary body, and patient age. In addition to these factors, the retention of 6/12 visual acuity and the time to 6/120 visual acuity were dependent on the preoperative visual acuity. The risk of visual loss was greatest immediately after treatment and decreased with time. The 5 year actuarial metastatic rate was approximately 13%. Patients at the greatest risk of post-radiation visual loss had significantly greater risk of tumour related mortality. CONCLUSIONS: Some patients who would have been eligible for randomisation to either enucleation or radioactive plaque therapy can be irradiated with retention of excellent vision.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.4M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Seddon JM, Gragoudas ES, Albert DM, Hsieh CC, Polivogianis L, Friedenberg GR. Comparison of survival rates for patients with uveal melanoma after treatment with proton beam irradiation or enucleation. Am J Ophthalmol. 1985 Mar 15;99(3):282–290. [PubMed]
  • Lommatzsch PK. Results after beta-irradiation (106Ru/106Rh) of choroidal melanomas: 20 years' experience. Br J Ophthalmol. 1986 Nov;70(11):844–851. [PMC free article] [PubMed]
  • Augsburger JJ, Gamel JW, Sardi VF, Greenberg RA, Shields JA, Brady LW. Enucleation vs cobalt plaque radiotherapy for malignant melanomas of the choroid and ciliary body. Arch Ophthalmol. 1986 May;104(5):655–661. [PubMed]
  • Gragoudas ES, Seddon JM, Egan K, Glynn R, Munzenrider J, Austin-Seymour M, Goitein M, Verhey L, Urie M, Koehler A. Long-term results of proton beam irradiated uveal melanomas. Ophthalmology. 1987 Apr;94(4):349–353. [PubMed]
  • Adams KS, Abramson DH, Ellsworth RM, Haik BG, Bedford M, Packer S, Seddon J, Albert D, Polivogianis L. Cobalt plaque versus enucleation for uveal melanoma: comparison of survival rates. Br J Ophthalmol. 1988 Jul;72(7):494–497. [PMC free article] [PubMed]
  • De Potter P, Shields CL, Shields JA, Cater JR, Tardio DJ. Impact of enucleation versus plaque radiotherapy in the management of juxtapapillary choroidal melanoma on patient survival. Br J Ophthalmol. 1994 Feb;78(2):109–114. [PMC free article] [PubMed]
  • Char DH, Castro JR, Kroll SM, Irvine AR, Quivey JM, Stone RD. Five-year follow-up of helium ion therapy for uveal melanoma. Arch Ophthalmol. 1990 Feb;108(2):209–214. [PubMed]
  • Seddon JM, Gragoudas ES, Polivogianis L, Hsieh CC, Egan KM, Goitein M, Verhey L, Munzenrider J, Austin-Seymour M, Urie M, et al. Visual outcome after proton beam irradiation of uveal melanoma. Ophthalmology. 1986 May;93(5):666–674. [PubMed]
  • Char DH, Quivey JM, Castro JR, Kroll S, Phillips T. Helium ions versus iodine 125 brachytherapy in the management of uveal melanoma. A prospective, randomized, dynamically balanced trial. Ophthalmology. 1993 Oct;100(10):1547–1554. [PubMed]
  • Char DH, Stone RD, Irvine AR, Crawford JB, Hilton GF, Lonn LI, Schwartz A. Diagnostic modalities in choroidal melanoma. Am J Ophthalmol. 1980 Feb;89(2):223–230. [PubMed]
  • Hillis A, Maguire M, Hawkins BS, Newhouse MM. The Markov process as a general method for nonparametric analysis of right-censored medical data. J Chronic Dis. 1986;39(8):595–604. [PubMed]
  • Samuelsen SO, Kongerud J. Interval censoring in longitudinal data of respiratory symptoms in aluminium potroom workers: a comparison of methods. Stat Med. 1994 Sep 15;13(17):1771–1780. [PubMed]
  • Caplan RJ, Pajak TF, Cox JD. Analysis of the probability and risk of cause-specific failure. Int J Radiat Oncol Biol Phys. 1994 Jul 30;29(5):1183–1186. [PubMed]
  • Young LH, Gragoudas ES. Macular uveal melanoma treated with proton beam irradiation. 10-year follow-up observation with histopathologic correlation. Retina. 1994;14(1):43–46. [PubMed]
  • Meecham WJ, Char DH, Kroll S, Castro JR, Blakely EA. Anterior segment complications after helium ion radiation therapy for uveal melanoma. Radiation cataract. Arch Ophthalmol. 1994 Feb;112(2):197–203. [PubMed]
  • Fine SL. Do I take the eye out or leave it in? Arch Ophthalmol. 1986 May;104(5):653–654. [PubMed]
  • Butler P, Char DH, Zarbin M, Kroll S. Natural history of indeterminate pigmented choroidal tumors. Ophthalmology. 1994 Apr;101(4):710–717. [PubMed]
  • Augsburger JJ, Goel SD. Visual function following enucleation or episcleral plaque radiotherapy for posterior uveal melanoma. Arch Ophthalmol. 1994 Jun;112(6):786–789. [PubMed]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Group