May 2007
Volume 48, Issue 13
ARVO Annual Meeting Abstract  |   May 2007
Slotted Plaque in Brachytherapy of Medium-to-Large Malignant Uveal Melanomas
Author Affiliations & Notes
  • D. Yu
    Ophthalmology, Doheny Eye Institute, Los Angeles, California
  • M. Astrahan
    Radiation Oncology, University of Southern California, Los Angeles, California
  • J. I. Lim
    Ophthalmology, Doheny Eye Institute, Los Angeles, California
  • Footnotes
    Commercial Relationships D. Yu, None; M. Astrahan, None; J.I. Lim, None.
  • Footnotes
    Support EY03040 and RPB
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 5242. doi:
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    • Get Citation

      D. Yu, M. Astrahan, J. I. Lim; Slotted Plaque in Brachytherapy of Medium-to-Large Malignant Uveal Melanomas. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5242.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose:: To report the use and outcomes of a novel 2 mm thick, slotted I125 episcleral plaque that collimates each I-125 seed individually resulting in more homogeneous dose to the tumor and underlying sclera and significantly reduced lateral radiation spread to uninvolved structures compared to other plaque designs.

Methods:: Retrospective chart review of tumor characteristics, imaging studies and visual outcomes after slotted plaque treatment.

Results:: Seven eyes of seven patients diagnosed with larger medium (height greater than 6 mm) and large choroidal melanomas (height > 8 mm)) were treated with the slotted plaque between 1998 and 2006. Patients ranged in age from 24 to 89 years old (median 63 years). Eighty-five Gy was delivered to the apex of each tumor, and the plaque was removed on average at seven days. Length of follow-up ranged from 30 to 66 months (median 49 months). Median tumor size decreased from 7.50 mm (6.20 to 9.10 mm) pre-operatively to 3.06 mm (1.65 to 7.80 mm) at the last visit. Median visual acuity was 20/50 (20/25 to CF at 2ft) on presentation, and was CF at 2 ft (20/100 to HM) at the last follow up. One eye developed tumor recurrence. One successfully treated choroidal tumor patient developed a lung metastasis at five-years follow-up. There were no deaths at four-years follow-up.

Conclusions:: The large choroidal tumors were successfully treated with the episcleral slotted plaque. The local recurrence and metastasis rates (14.3% in an average of 3 years) were relatively low in these patients with large choroidal melanomas.

Keywords: melanoma • tumors • radiation therapy 

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