Purpose:
To report on palladium-103 plaque radiation therapy for iris and iridociliary melanoma.
Methods:
A retrospective clinical case series of thirty eyes in 30 patients with melanomas limited to the iris or invading the ciliary body. The main outcome measures include: demographic information, laterality, tumor size, location, visual acuity, radiation dose, local control, retinal evaluation and duration of follow up.
Results:
Thirty patients were followed for a median 36 months (range, 12 to 90). Sixteen (n=16/30, 53%) of tumors were pure iris melanomas and (n=14/30, 47%) were primary iris melanomas extending into the ciliary body. Radiation dosimetry in Gray (Gy) showed that the median tumor apex dose was 85 Gy (range, 75-100Gy), lens dose 43.5 Gy (range, 17.8-60 Gy), fovea dose 1.8 Gy (range, 1.3-5Gy) and central optic disc dose 1.7 Gy (range, 1.3-4.7 Gy). Cataracts developed in 20 of the 28 phakic eyes (71.4%). No patient in this series (0%) developed radiation maculopathy or radiation optic neuropathy. Last best-corrected visual acuity was equal to or more than 20/25 in (n=28/30, 93%) at a median 36 months follow up.
Conclusions:
Though visual acuities were transiently affected by radiation cataract, no radiation maculopathy or optic neuropathy has been noted after palladium-103 treatment of iris and iridociliary melanomas.
Keywords: iris • tumors • radiation therapy