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Inflamation and scleral defect following ocular radiotherapy. Therapeutic appraoch
Author(s) -
DESJARDINS L,
LEVY C,
LUMBROSOLE ROUIC L,
CASSOUX N,
DENDALE R,
PLANCHER C,
ASSELAIN B
Publication year - 2011
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2011.3264.x
Subject(s) - medicine , radiation therapy , ciliary body , retrospective cohort study , melanoma , uveitis , necrosis , complication , inflammation , uvea , surgery , ophthalmology , eye disease , cancer research
Purpose to describe inflammation and scleral necrosis following irradiation for uveal melanoma, their risk factors and their therapeutic approach. Methods retrospective review of patients treated in Curie Institute; all the data concerning the initial tumor, the treatment and the follow up are registered in the data base .Statistical analysis has been performed. Results Twenty‐three patients treated with a single plaque therapy (cobalt‐60 (Co(60)) or iodine‐125 (I(125)) (1.5% of treated patients) or proton beam radiotherapy (0.45% of treated patients) for choroidal or ciliary body melanoma, presented scleral necrosis as a post‐radiation complication .In a retrospective series of 2413 patients treated with proton beam with a median follow up of 98 months 21% of patients have had inflammation and 3,3% of them have active inflammation. Risks factors were essentially tumour related and were correlated with larger lesions (height > 5 mm, diameter > 12 mm, volume > 0.4 cm Multivariate analysis identified initial tumour height and irradiation of a large volume of the eye as the two most important risk factors. Conclusion Treatment options: Scleral necrosis usually requires only observation Ocular inflammation often consisted of mild anterior uveitis, resolving rapidly after topical steroids and cycloplegics. Nevertheless for large tumors, inflammation can be associated with neovascular glaucoma and can be more severe. The use of anti VEGF is useful to obtain regression of iris néovasculariastion. Preventive endorésection of the tumor scar if possible gives the best results.