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Mazzini C, Vicini G, Di Leo L, Massi D, Rizzo S, Giansanti F. Anatomical and Functional Outcomes after Endoresection and Adjuvant Ruthenium Brachytherapy for Uveal Melanoma: A Single-Center Experience. Life (Basel) 2023; 13:902. [PMID: 37109431 PMCID: PMC10146230 DOI: 10.3390/life13040902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/19/2023] [Accepted: 03/24/2023] [Indexed: 03/31/2023] Open
Abstract
PURPOSE To evaluate the anatomical and functional outcomes of endoresection and adjuvant ruthenium (Ru)-106 brachytherapy for uveal melanoma (UM). METHODS Retrospective case series of 15 UM patients (15 eyes) treated at our center (Careggi University Hospital, Florence). RESULTS Six patients (40%) were male and nine were female (60%). The mean age of patients at the time of treatment was 61.6 years (±19.41). The mean BCVA at baseline was 20/50. In all cases UM originated from the choroid. The mean tumor thickness at baseline was 7.14 mm (±2.05), and the mean largest basal diameter was 11.2 mm (±1.92). A concurrent retinal detachment was diagnosed in 11 patients (73.3%). Two patients (13.3%) showed vitreous seeding at baseline. Eleven patients (73.3%) were treated with primary endoresection, while four patients (26.7%) were treated with a "salvage endoresection" after primary treatment failure (previous radiation treatment). The mean follow-up time was 28.9 months (±10.6). Thirteen out of fifteen patients were alive and showed no evidence of local recurrence or distance metastasis at the last follow-up visit. The treatment achieved local control of the disease in 14 out of 15 cases (93.3%). In one case, the patient underwent enucleation for disease recurrence. The overall survival rate at the end of the follow-up was 93.3%. The mean BCVA at last follow-up visit was 20/40. Treatment was well tolerated, without significant complications. CONCLUSIONS Endoresection and adjuvant Ru-106 brachytherapy is a valuable conservative option for selected UM patients and can be used both as a primary treatment and as a salvage therapy. It can control melanoma and avoid enucleation, reduce radiation-related complications, and provide tumor tissue for chromosomal analysis and prognostic testing.
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Affiliation(s)
- Cinzia Mazzini
- Unit of Ocular Oncology, Neuromuscular and Sense Organs Department, Careggi University Hospital, 50134 Florence, Italy
- Eye Clinic, Neuromuscular and Sense Organs Department, Careggi University Hospital, 50134 Florence, Italy
| | - Giulio Vicini
- Unit of Ocular Oncology, Neuromuscular and Sense Organs Department, Careggi University Hospital, 50134 Florence, Italy
- Eye Clinic, Neuromuscular and Sense Organs Department, Careggi University Hospital, 50134 Florence, Italy
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, 50121 Florence, Italy
| | - Laura Di Leo
- Unit of Ocular Oncology, Neuromuscular and Sense Organs Department, Careggi University Hospital, 50134 Florence, Italy
- Eye Clinic, Neuromuscular and Sense Organs Department, Careggi University Hospital, 50134 Florence, Italy
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, 50121 Florence, Italy
| | - Daniela Massi
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, 50121 Florence, Italy
- Section of Pathological Anatomy, Department of Health Sciences, University of Florence, 50139 Florence, Italy
| | - Stanislao Rizzo
- Ophthalmology Unit, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, 00168 Rome, Italy
- Consiglio Nazionale delle Ricerche (CNR), 56124 Pisa, Italy
| | - Fabrizio Giansanti
- Unit of Ocular Oncology, Neuromuscular and Sense Organs Department, Careggi University Hospital, 50134 Florence, Italy
- Eye Clinic, Neuromuscular and Sense Organs Department, Careggi University Hospital, 50134 Florence, Italy
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Allon G, Lemaître S, Hay G, Rees A, Westcott M. Iris melanoma versus syphilitic iris nodule: A diagnostic challenge. J Fr Ophtalmol 2023; 46:e106-e107. [PMID: 36775730 DOI: 10.1016/j.jfo.2022.09.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 09/12/2022] [Indexed: 02/12/2023]
Affiliation(s)
- G Allon
- Retina Service, Moorfields Eye Hospital, 162, City road, EC1V 2PD London, United Kingdom.
| | - S Lemaître
- Retina Service, Moorfields Eye Hospital, 162, City road, EC1V 2PD London, United Kingdom; Ocular oncology service, Moorfields Eye Hospital NHS Foundation Trust, 162, City road, EC1V 2PD London, United Kingdom
| | - G Hay
- Ocular oncology service, Moorfields Eye Hospital NHS Foundation Trust, 162, City road, EC1V 2PD London, United Kingdom
| | - A Rees
- Retina Service, Moorfields Eye Hospital, 162, City road, EC1V 2PD London, United Kingdom
| | - M Westcott
- Retina Service, Moorfields Eye Hospital, 162, City road, EC1V 2PD London, United Kingdom
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Zhou X, Ishikawa H, Gomi F. Macular hole and vitreous hemorrhage subsequent to stereotactic hypofractionated radiotherapy for choroidal melanoma: A case report and review of the literature. Front Oncol 2022; 12:1060307. [PMID: 36483031 PMCID: PMC9723233 DOI: 10.3389/fonc.2022.1060307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/07/2022] [Indexed: 11/23/2022] Open
Abstract
Choroidal melanoma is the leading primary intraocular tumor with potentially fatal outcomes in adults. The coexistence of choroidal melanoma and a macular hole is extremely rare, and treatment strategies and information on the prognosis of associated complications are currently lacking. We report the first case of choroidal melanoma complicated with a macular hole and vitreous hemorrhage after stereotactic hypofractionated radiotherapy in Japan, and review the relevant literature in relation to the possible mechanisms, treatment strategies, and outcomes. An 83-year-old male with choroidal melanoma was treated with stereotactic hypofractionated radiotherapy in January 2021. Five months later, a full-thickness macular hole developed, followed by an acute massive vitreous hemorrhage about 2 weeks later. Following confirmation of tumor regression, the patient underwent a pars plana vitrectomy and internal limiting membrane peeling. The macular hole was closed postoperatively and the patient’s best-corrected visual acuity improved to 20/125. There was no evidence of intraocular tumor dissemination or distant metastases during follow-up. A systematic literature search only identified 10 previous cases of choroidal melanoma with a macular hole in eight reports worldwide, mainly in females. Macular edema may be the primary cause of macular hole formation in these cases. Most patients who underwent vitrectomy for complications after tumor regression achieved a good prognosis. The development of a macular hole is a rare complication associated with choroidal melanoma. Anterior-posterior traction of posterior vitreous detachment and secondary macular edema may have contributed to the formation of the macular hole in the current case.
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Affiliation(s)
- Xiaoyin Zhou
- Department of Ophthalmology, Hyogo College of Medicine, Hyogo, Japan
| | - Hiroto Ishikawa
- Department of Ophthalmology, Hyogo College of Medicine, Hyogo, Japan
- Department of Ophthalmology, Mirai Eye & Skin Clinic, Osaka, Japan
- *Correspondence: Hiroto Ishikawa,
| | - Fumi Gomi
- Department of Ophthalmology, Hyogo College of Medicine, Hyogo, Japan
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