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Kavitha Sivaraman, Clement Chow, William Mieler; Choroidal Thickness after Treatment of Uveal Melanoma with Plaque Brachytherapy. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5835. doi: https://doi.org/.
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To characterize choroidal thickness using enhanced-depth imaging optical coherence tomography (EDI-OCT) in patients who underwent treatment of uveal melanoma with plaque brachytherapy.
Retrospective chart review of 24 eyes of 24 patients who underwent treatment of uveal melanoma with an Iodine-125 radioactive plaque (brachytherapy). Charts were reviewed for demographic information, location of the tumor, presence of radiation retinopathy, location of the plaque and post-operative choroidal thickness as measured by enhanced-depth imaging optical coherence tomography (EDI-OCT). Choroidal thickness was obtained using internal calipers on the Heidelberg Spectralis Imaging system (Heidelberg Engineering, Heidelberg, Germany) to measure the subfoveal distance between the hyper-reflective line of the RPE and the inner surface of the sclera. The subfoveal choroidal thickness of the contralateral healthy eye was used as a control.
In patients without radiation retinopathy (n=14) , the subfoveal choroidal thickness was on average 36 microns (29%) thinner in the irradiated eye compared to the contralateral eye (P = 0.04). In contrast, among patients with active radiation retinopathy (n=10), the subfoveal choroidal thickness was on average 56 microns (29%) thicker than the contralateral eye, but this did not reach statistical significance (P = 0.187). However, the mean difference in choroidal thickness between the irradiated eye and the contralateral eye was significantly different in eyes with radiation retinopathy compared to eyes that did not develop this complication (+56 microns vs. -36 microns, P = 0.025).
Patients who underwent plaque brachytherapy had a thinner subfoveal choroidal thickness in the treated eye compared to the contralateral, untreated eye. This is consistent with previous studies that show reduction in choroidal thickness in other diseases with compromised vasculature such as diabetes. Patients with radiation retinopathy tended to have a thicker choroid compared to patients who did not develop this complication after brachytherapy. This may be a consequence of increased vascular permeability in both the retina and choroid, but further studies are needed to elucidate the mechanism behind this phenomenon.
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