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Cinzia Mazzini, Giulia Pieretti, Nicola Santoro, Stanislao Rizzo; Secondary glaucoma after stereotactic radiosurgery with gamma-knife and brachytherapy for uveal melanoma. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4305.
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© ARVO (1962-2015); The Authors (2016-present)
Evaluation of secondary glaucoma (SG) in patients affected by uveal melanoma that underwent treatment either with Gamma Knife (GK) or Brachytherapy with Ru106 plaques (BT) in our Unit in Florence. We correlated SG and 3 parameters: tumor size, tumor location and maximum radiation dose
Retrospective study that included 30 patients affected by uveal melanoma evaluated between December 2013 and October 2017. Thirteen patients had tumor thickness ≤ 5 mm and underwent BT between January 2016 and October 2017; seventeen patients, having tumor thickness > 5 mm, were treated with GK between December 2013 and October 2017. BT was performed with ruthenium 106 plaques, giving 100 Gy at tumor apex for 1-5 days. GK had a mean prescription dose of 28.52 Gy
Between patients treated with GK, 7 developed SG after a mean time of 10,8 months, 5 developed rubeosis iridis (RI), 2 developed radiation retinopathy (RR); 3 patients underwent enucleation, 1 for tumor recurrence and 2 for SG; 1 patient developed liver metastases. In the BT group, only 1 patient developed SG, none RI or RR; no patient underwent enucleation or developed metastases. Overall survival in both groups was 100% at last follow-up. We found a correlation between tumor size at diagnosis and SG: greater the dimensions (thickness and/or basal diameter) and greater the SG occurrence. Moreover, posterior tumors demonstrated more trend to develop SG than those located between equator and periphery. Finally, maximum radiation dose to target was related to SG too: greater the dose and greater the SG occurrence.We also evaluated other parameters: visual acuity decreased and tumor size decreased in both groups . We found also a correlation between tumor size and final visual acuity: greater the tumor size and worse the final visual acuity.
We reported data of uveal melanoma patients treated in our Unit with BT and GK. Sven patients treated with GK and only 1 patient treated with BT developed SG. We found a correlation between tumor size, tumor location, maximum radiation dose and SG occurence, though not statistically significant. It was not possible an objective comparison between the two groups of patients because the difference in follow-up was significant.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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