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C. G. Bianciotto, C. Pirondini, C. L. Shields, M. Furuta, A. Mashayekhi, J. A. Shields; Vitreous Hemorrhage After Plaque Radiotherapy for Uveal Melanoma. Invest. Ophthalmol. Vis. Sci. 2008;49(13):47.
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To determine the incidence, etiology and management of late-onset vitreous hemorrhage after plaque radiotherapy for uveal melanoma.
Of 3813 eyes treated with plaque radiotherapy for uveal melanoma, 403 (11%) developed late-onset vitreous hemorrhage. The prevalence of diabetes and hypertension in these patients was 15% and 35%, respectively. Presumed causes of hemorrhage included proliferative radiation retinopathy (28%), tumor necrosis (21%), posterior vitreous detachment (15%),retinal invasion (10%), and unknown (18%). The mean interval between plaque radiotherapy and vitreous hemorrhage was 26 months. The tumors were mushroom shaped in 40% and showed retinal invasion in 18%. The most common forms of management included observation in 48%, laser photocoagulation in 24%, and vitrectomy in 18%. After a mean follow up period of 5 years, the rate of tumor recurrence was 7%; metastasis 9%, and enucleation 15%. In the subset of patients who underwent vitrectomy, these rates were not increased (3%, 5% and 9% respectively).
The overall incidence of late-onset vitreous hemorrhage after plaque radiotherapy for uveal melanoma was 11%. Proliferative radiation retinopathy, tumor necrosis and posterior vitreous detachment were the most common etiologies. Tumor recurrence at 5 years was 7%.
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