Abstract
Purpose :
Plaque radiotherapy has long been the most widely used eye-sparing treatment of ocular melanoma. Both the effectiveness and the long-term adverse effects of brachytherapy on treated eyes has been well documented, however very little research has investigated the outcomes of fellow eyes following plaque radiation. Our work aims to identify and describe long-term postoperative changes in fellow eye visual acuity (VA) in patients who have undergone plaque radiotherapy for treatment of uveal melanoma.
Methods :
A retrospective cohort of 213 patients with unilateral uveal melanoma treated by the senior author was identified. Method of treatment, patient demographics, baseline VA, and VA at 6 months, 1 year, 5 years, and 10 years post-treatment were recorded. Fellow eye VA at each follow-up time point was compared to baseline VA at time of diagnosis for both patients treated with plaque radiotherapy or another treatment modality using a two-sample t-test. Statistical analysis was performed using SAS (statistical analysis system) software.
Results :
The mean (SD) patient age at time of uveal melanoma diagnosis was 62.5 (12.7) years. In patients (n=171) treated with plaque brachytherapy, there were no significant changes in fellow eye visual acuity at 6 months (t(1p=0.41), 1 year (p=0.080), 5 years (p=0.45), or 10 years (p=0.49) post-treatment. In patients (n=42) treated with either transpupillary thermotherapy (TTT) or proton beam therapy (PBT), there were also no significant changes in fellow eye visual acuity at 6 months (p=0.25), 1 year (p=0.59), 5 years (p=0.72), or 10 years (p=0.52) post-treatment.
Conclusions :
No long-term deficits in fellow eye visual acuity were found in patients whose ocular melanoma was treated with plaque radiotherapy. Patients who underwent TTT or PBT also showed no decrease in visual acuity over the length of follow-up. However, more investigation is needed into fellow eye outcomes following these non-plaque treatments due to the low sample size of these patients in our study. This data will allow surgeons and uveal melanoma patients who highly prioritize retention of pre-treatment VA to make more well-informed decisions regarding their choice of treatment modality.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.