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C. G. Bianciotto, C. L. Shields, C. Pirondini, A. Mashayekhi, M. Furuta, J. A. Shields; Proliferative Radiation Retinopathy Following Plaque Brachytherapy for Uveal Melanoma. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5756.
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To determine risk factors, incidence, management and outcome of treatment of proliferative radiation retinopathy (PRR) after plaque radiotherapy for uveal melanoma.
Retrospective review of medical records.Main outcome measure: The occurrence of PRR after plaque radiotherapy for uveal melanoma.
Of 3841 eyes treated with plaque radiotherapy for uveal melanoma, PRR developed in 0.3% of patients at 1 year, 1.7% at 2 years, 5.8% at 5 years and 7% at 10 and 15 years using Kaplan-Meier analysis. The mean time to onset of RPR was 32 months. On univariate analysis factors predictive of PRR (p<0.05) included younger age, diabetes, shorter tumor distance to the optic disc and the foveola, Bruchs’ membrane rupture, mushroom tumor shape, choroidal location of the tumor, higher radiation dose to the optic nerve and to the foveola, and notched plaque. In the multivariate model, younger age and diabetes were related to the occurrence of PRR. The most common forms of management included panretinal photocoagulation (70%), vitrectomy (21%), observation (17%) and enucleation (11%).
PRR develops in 7% of eyes by 10 years following plaque radiotherapy for uveal melanoma. The main factors for development of PRR on the multivariate analysis were diabetes and younger age of the patients at presentation.
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