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I. Tsui, R. M. Beardsley, T. A. McCannel, S. C. Oliver, M. Chun, S. Lee, F. Yu, B. R. Straatsma; Central Vision Two Years After Treatment of Ciliochoroidal Melanoma With Iodine-125 Brachytherapy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4767.
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To report central visual function and causes of visual impairment in patients with ciliochoroidal melanoma 2 years after treatment with Iodine-125 brachytherapy.
Prospective single center cohort study of patients with medium-sized ciliochoroidal melanoma treated with Iodine-125 brachytherapy at a dose of 8,500 rads to the tumor apex. Best-corrected visual acuity assessed after COMS protocol refraction using the ETDRS chart, Pelli-Robinson contrast sensitivity and HRR color vision were assessed within one month prior to, one year after and two years after brachytherapy. Charts were reviewed for adverse effects of plaque brachytherapy at two years.
37 patients (37 eyes) had a mean age of 58 years (range 30-81 years). Prior to, one year after and two years after brachytherapy mean best-corrected visual acuity was 47 (20/30), 38 (20/63), 30 (20/80) ETDRS letters respectively; mean Pelli-Robinson contrast sensitivity was 30 (4.4%), 26 (6.2%), 18 (18%) letters; mean HRR color vision was 13/14, 10/14, 6/14. Adverse effects two years after brachytherapy included radiation maculopathy (16 eyes), retinal pigment epithelium atrophy (5 eyes), optic neuropathy (5 eyes), and retinal detachment/vitreous hemorrhage (2 eyes). These complications did not correlate with visual acuity (p>0.05).
Central visual function decreased significantly two years after brachytherapy for ciliochoroidal melanoma, but a cohort of patients maintain good visual acuity. Mean best-corrected visual acuity was 20/80. Adverse effects of plaque brachytherapy, although prevalent, may still allow for good visual acuity.
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