Plaque Radiotherapy for Juxtapapillary Choroidal Melanoma

Abstract

The choice of treatment for choroidal melanoma near the optic disc (juxtapapillary melanoma) is often influenced by the expected outcomes and complications of available methods. Such treatment modalities include plaque radiotherapy,^1-3 proton beam radiotherapy,^4,5 stereotactic radiosurgery,^6-8 transpupillary thermotherapy (TTT),⁹ or enucleation.¹⁰ In a previous report, equivalent survival of patients with juxtapapillary melanoma treated by enucleation vs plaque radiotherapy has been documented.¹¹ Detailed information on the radiotherapy risks to these eyes has received little attention in the literature. Known complications of plaque radiotherapy with or without TTT include retinopathy, maculopathy, papillopathy, cataract, glaucoma, retinal vascular occlusion, and secondary enucleation.^12-16 In some centers, plaque radiotherapy is commonly followed with adjunctive TTT to consolidate regressed melanoma or to reduce intraocular exudative response.^9,16 In this report, we analyze treatment-related complications and visual acuity outcomes in the same cohort as our previous report on tumor control.¹⁷