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Eun-Ah Kim, Mitchell Kamrava, James Lamb, Joseph Caprioli, Tara A McCannel; Glaucoma after Iodine-125 Brachytherapy for Uveal Melanoma: Incidence and Risk Factors. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4100.
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© ARVO (1962-2015); The Authors (2016-present)
To report the incidence and to identify clinical risk factors of secondary open-angle glaucoma (SOAG) and neovascular glaucoma (NVG) after iodine-125 brachytherapy for uveal melanoma in patients at the Ophthalmic Oncology Center, Stein Eye Institute, University of California, Los Angeles (UCLA).
A retrospective review of patients treated at the Ophthalmic Oncology Center, Stein Eye Institute, UCLA was performed between December 2004 and June 2014. SOAG was defined in eyes with at least one occasion of intraocular pressure (IOP) of 25 mmHg or higher after the removal of iodine-125 plaques with or without the use of glaucoma eyedrops, an open angle, no neovascularization of the iris and angle, and inability to maintain IOP lower than 22 mmHg without medical or surgical treatment. NVG was defined in eyes with at least one occasion of IOP of 21 mm Hg or higher and neovascularization on the iris or angle reported. Incidence was calculated and survival analysis was used to analyze risk factors for SOAG and NVG.
Thirty-one eyes (8.6%) were diagnosed as SOAG and 25 eyes (6.7%) were diagnosed as NVG from a total of 374 eyes. Multivariate analysis identified risk factors for SOAG as: older age, larger tumor height, greater tumor basal diameter, iris melanoma, high baseline IOP, ciliary body involvement and vitrectomy with silicone oil tamponade performed at the time of brachytherapy. Identified risk factors for NVG were: larger tumor height, greater tumor basal diameter, number of pack-years of smoking history, pseudophakia, and more advanced radiation vasculopathy.
The incidence of SOAG in patients with uveal melanoma undergoing iodine-125 brachytherapy at our center was 8.6%. The incidence of NVG was 6.7%. The significant risk factors demonstrated in the multivariate Cox regression analysis for SOAG were different from those for NVG. Patients undergoing uveal melanoma treatment must be monitored and treated for the development of secondary glaucoma following brachytherapy.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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