May 2003
Volume 44, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2003
Histopathologic Characterization of Eyes Enucleated following Brachytherapy in the Collaborative Ocular Melanoma Study (COMS)
Author Affiliations & Notes
  • R.B. Avery
    Ophthalmology and Visual Science, University of Wisconsin, Madison, WI, United States
  • D.M. Albert
    Ophthalmology and Visual Science, University of Wisconsin, Madison, WI, United States
  • W.R. Green
    Ophthalmology, The Johns Hopkins University, Baltimore, MD, United States
  • H.E. Grossniklaus
    Ophthalmology, Emory University, Atlanta, GA, United States
  • M. Diener-West
    Biostatistics, The Johns Hopkins University, Baltimore, MD, United States
  • Footnotes
    Commercial Relationships  R.B. Avery, None; D.M. Albert, None; W.R. Green, None; H.E. Grossniklaus, None; M. Diener-West, None.
  • Footnotes
    Support  Unrestricted grant from Research to Prevent Blindness
Investigative Ophthalmology & Visual Science May 2003, Vol.44, 1555. doi:
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      R.B. Avery, D.M. Albert, W.R. Green, H.E. Grossniklaus, M. Diener-West; Histopathologic Characterization of Eyes Enucleated following Brachytherapy in the Collaborative Ocular Melanoma Study (COMS) . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1555.

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

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Abstract

Abstract: : Purpose: To describe the histopathologic findings in eyes with uveal melanoma that were enucleated following brachytherapy. Eyes had been randomized to the I-125 plaque treatment in the COMS medium-sized tumor study. Methods: Following enucleation within the COMS protocol, eyes were examined independently by three ophthalmic pathologists. Findings were recorded on a standardized data form. A composite of findings was obtained after adjudication. Results: Seventy-eight eyes were available for analysis. In 44 eyes (56%), the lesion was entirely posterior to the equator. The iris was involved in 3(4%) and 11(14%) eyes had ciliary body involvement. The cell-types were classified as epithelioid (9%), spindle (5%), mixed (82%), or other (4%). In a count of 40 high-power fields, no mitotic figures could be identified in 37% of the tumors. Of the 49 tumors with mitotic figures, the mean number counted was 1.4 (range 1-16 per 40 hpf). Inflammation was graded as none-to-minimal (32%), moderate (56%), or marked (12%). The degree of necrosis was categorized as none (23%), 1-50% (60%), or >50% (17%). Pigmentation was graded as minimal (44%), moderate (32%), or heavy (24%). Vascular lakes were seen in 81% of eyes and tumor vessels were prominent in 73%. The retina was invaded in 68% and retinal detachment was seen in 91%. Rubeosis was present in 37% and tumor cells were seen in the vitreous in 36%. Conclusions: Eyes undergoing secondary enucleation after plaque brachytherapy have specific histopathologic characteristics. These may represent factors associated with plaque failure or changes following brachytherapy.

Keywords: melanoma • oncology • pathology: human 
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