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A.C. Tiberti, A. Scupola, E. Balestrazzi, M.A. Blasi; Optical Coherence Tomography Findings Following Brachytherapy and Combined Therapy of Choroidal Melanoma . Invest. Ophthalmol. Vis. Sci. 2005;46(13):3384.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To evaluate secondary retinal changes associated with uveal melanoma after brachytherapy and combined therapy (brachytherapy and TTT) as documented by optical coherence tomography (OCT). Methods: Twenty patients (20 eyes) with choroidal melanoma treated with brachytherapy and twenty patients (20 eyes) with choroidal melanoma treated with combined therapy have been studied. OCT, ophthalmoscopy and A–B scan ultrasonography were performed before treatment and at follow–up examinations 1, 3, 6 months and 1 year after treatment in all eyes. OCT scans of the macular region and across the surface of the tumor were acquired for all patients. OCT parameters included retinal thickness, retinal pigment epithelium alterations, choriocapillary reflectivity and subretinal fluid distribution. Results: Retinal oedema and serous retinal detachment were observed in all patients before treatment. OCT exhibited a more evident and faster resolution of subretinal fluid in tumors treated with combined therapy compared with brachytherapy alone (on average 4,5 weeks compared with 16 weeks). Tumors treated with combined therapy showed a more remarkable decrease of retinal oedema (on average 227 µm compared with 384 µm) overlying the lesion and more extensive development of epiretinal fibrotic changes. Macular morphology and thickness did not vary significatively in the two groups. Conclusions: OCT may be helpful in evaluating the regression of secondary retinal changes associated with tumor activity. The association of brachytherapy and TTT revealed improved short term results, in term of reduction of exudation, compared with radiotherapy alone. OCT features of uveal melanomas after conservative approaches support the application of combined treatment modalities.
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