Vitreoretinal Surgery for Intraocular Complications Following Radiotherapy Treatment of Uveal Melanoma - PubMed
7 hours ago
- #radiotherapy
- #uveal melanoma
- #vitrectomy
- Globe-sparing radiotherapy is widely used for uveal melanoma but often leads to complications requiring vitreoretinal surgery.
- A study reviewed 1794 patients treated with radiotherapy for uveal melanoma (2012-2022), with 70 undergoing secondary vitrectomy.
- Complications requiring vitrectomy were more common after proton-beam radiotherapy (5.4%) than plaque brachytherapy (3.0%).
- Common indications for vitrectomy included vitreous haemorrhage (39%) and retinal detachment/toxic tumour syndrome (31%).
- Tumors requiring vitrectomy were larger, often ciliary body in origin, and associated with worse prognosis.
- Vitrectomy patients had higher rates of enucleation (9% vs. 3%), metastasis (16% vs. 6%), and visual decline (average 0.60 LogMAR).
- Limited visual improvement was observed (≥3-line gain in 13%), with proton-beam patients having worse outcomes than plaque brachytherapy.
- Timely vitreoretinal intervention by experienced specialists can help patients retain their eyes, avoiding enucleation.
- Multidisciplinary collaboration between vitreoretinal surgeons and ocular oncologists is crucial for managing complications and improving outcomes.