Predictive risk factors for radiation retinopathy and optic neuropathy after proton beam therapy for uveal melanoma

Purpose This study was performed in order to evaluate the incidence of radiation retinopathy and optic neuropathy occurring after proton beam therapy for uveal melanoma. Methods Included in this study were all patients who had been treated with primary proton beam therapy for uveal melanoma at the oncology service between May 1998 and June 2014 with a minimum follow-up of 12 months. Excluded were all patients who underwent re-irradiation, or vitrectomy due to exudative retinal detachment or for tumor-resection. Results During this period, 1127 patients matched the inclusion criteria, of whom 768 (68.1 %) and 463 (41.0 %) developed radiation retinopathy and optic neuropathy after a median time of 18.9 months (2.0–99.84 months) and 19.8 months (0.2–170.4 months), respectively. Mean follow-up was 53.4 months (12–170.4 months). Included were 558 men (49.5 %) and 569 women (50.5 %). Mean age was 61 years (16–89 years). Visual acuity slightly decreased from initial levels of 0.3 logMAR–0.4 logMAR in patients without developing any radiation-induced complication but severely decreased to 1.0 logMAR or 1.5 logMAR in the case of developing radiation retinopathy only or optic neuropathy, respectively. Independent risk factors for radiation retinopathy were a centrally (