Trans-scleral local resection of toxic choroidal melanoma after proton beam radiotherapy

    loading  Checking for direct PDF access through Ovid

Abstract

Purpose

To report on trans-scleral local resection of choroidal melanoma as treatment for serous retinal detachment after proton beam radiotherapy (PBR)

Methods

Retrospective study of patients underwent trans-scleral local resection of choroidal melanoma after previous PBR from 2000 to 2008 to the Liverpool Ocular Oncology Service.

Results

The 11 patients (5 female, 6 male) had a median age of 48.8 years (range 20 – 76) included in this study. The tumor margins extended anterior to ora serrata in 6 patients. On echography, the largest basal tumor dimension averaged 11.9 mm (range 5.7 – 13.2) and the tumor height averaged 7 mm (range 4.5 – 9.9). The retinal detachment was total in 4 cases. Neovascular glaucoma was present in 4 patients. The time between proton beam radiotherapy and local resection had a mean of 17.4 months (range 1 – 84). The follow-up time after the local resection procedure had a mean of 96 months (range 60 – 156). At the last known status, the eye was conserved in 9 patients, with a flat retina in all of these patients and visual acuity better than 6/30 in 5 patients. The reasons for enucleation were: retinal detachment (1 patient) and phthisis (1 patient.

Conclusion

Serous retinal detachment and neovascular glaucoma after proton beam radiotherapy of a choroidal melanoma can both resolve after trans-scleral local resection of the tumor. Our findings indicate that these complications are caused by the persistence of the irradiated tumor within the eye (‘toxic tumor syndrome’).

Related Topics

    loading  Loading Related Articles