Retrospective Analysis of Radiation-Induced Complications of Uveal Melanoma Patients Treated With Brachytherapy in the Era of Anti-VEGF

To associate clinical factors and radiation doses delivered by iodine-125 plaque brachytherapy to visual outcomes and development of radiation-induced ocular complications in patients with uveal melanoma in the era of anti–vascular endothelial growth factor (anti-VEGF) injections. Retrospective coho...

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Veröffentlicht in:American journal of ophthalmology 2024-04, Vol.260, p.49-59
Hauptverfasser: Hasegawa, Naomi, Teh, Bin S., Tran, Kevin, Ivey, Forrest, Olek, Devin, Pino, Ramiro, Chuang, Alice Z., Bretana, Maria E., Butler, Edward Brian, Schefler, Amy C.
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container_issue
container_start_page 49
container_title American journal of ophthalmology
container_volume 260
creator Hasegawa, Naomi
Teh, Bin S.
Tran, Kevin
Ivey, Forrest
Olek, Devin
Pino, Ramiro
Chuang, Alice Z.
Bretana, Maria E.
Butler, Edward Brian
Schefler, Amy C.
description To associate clinical factors and radiation doses delivered by iodine-125 plaque brachytherapy to visual outcomes and development of radiation-induced ocular complications in patients with uveal melanoma in the era of anti–vascular endothelial growth factor (anti-VEGF) injections. Retrospective cohort study. A retrospective chart review was performed for 225 patients treated with iodine-125 brachytherapy for uveal melanoma. The effects of radiation doses (focal doses, average dose to the entire eye, and integral dose) on visual outcomes and development of radiation complications (radiation retinopathy, radiation optic neuropathy, vitreous hemorrhage, and neovascular glaucoma) were analyzed using multivariate Cox regression snalysis. Median follow-up was 33.6 months (range, 12-105.6 months). Radiation retinopathy was associated with younger age, tumor distance to optic nerve
doi_str_mv 10.1016/j.ajo.2023.12.005
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Retrospective cohort study. A retrospective chart review was performed for 225 patients treated with iodine-125 brachytherapy for uveal melanoma. The effects of radiation doses (focal doses, average dose to the entire eye, and integral dose) on visual outcomes and development of radiation complications (radiation retinopathy, radiation optic neuropathy, vitreous hemorrhage, and neovascular glaucoma) were analyzed using multivariate Cox regression snalysis. Median follow-up was 33.6 months (range, 12-105.6 months). Radiation retinopathy was associated with younger age, tumor distance to optic nerve &lt;6 mm, and maximum radiation dose to fovea. Radiation optic neuropathy was associated with White race, tumor distance to optic nerve &lt;6 mm, and integral radiation dose. Vitreous hemorrhage was associated with White race and integral radiation dose. Incidence of neovascular glaucoma was low in our study, with 2 patients (0.9%) developing the complication. Of the 123 patients who developed radiation retinopathy, 82 patients (66.7% of radiation retinopathy patients, 37.3% of total patients) received anti-VEGF injections. Our study found multiple associations between radiation doses and complications as well as visual outcomes on multivariate analysis. Given that the majority of our patients who developed radiation retinopathy received anti-VEGF injections, our study helps to illustrate the course and progression of radiation-induced complications in the new era of anti-VEGF.</description><identifier>ISSN: 0002-9394</identifier><identifier>ISSN: 1879-1891</identifier><identifier>EISSN: 1879-1891</identifier><identifier>DOI: 10.1016/j.ajo.2023.12.005</identifier><identifier>PMID: 38081570</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><ispartof>American journal of ophthalmology, 2024-04, Vol.260, p.49-59</ispartof><rights>2023 Elsevier Inc.</rights><rights>Copyright © 2023. 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title Retrospective Analysis of Radiation-Induced Complications of Uveal Melanoma Patients Treated With Brachytherapy in the Era of Anti-VEGF
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