Abstract Title:

Incidence of radiation retinopathy after high-dosage single-fraction gamma knife radiosurgery for choroidal melanoma.

Abstract Source:

Ophthalmology. 2002 May ;109(5):909-13. PMID: 11986096

Abstract Author(s):

Anton Haas, Oliver Pinter, Georg Papaefthymiou, Martin Weger, Andrea Berghold, Oskar Schröttner, Klaus Müllner, Gerhard Pendl, Gerald Langmann

Article Affiliation:

Department of Ophthalmology, Karl-Franzens University, Graz, Austria.

Abstract:

OBJECTIVE: To investigate the incidence and clinical findings of radiation retinopathy after single-fraction high-dose gamma knife radiosurgery for choroidal melanoma.

DESIGN: Retrospective noncomparative interventional case series.

PARTICIPANTS: Thirty-two patients with choroidal melanoma.

METHODS: Review of charts, color fundus photographs, and fluorescein angiograms of 32 choroidal melanoma patients after radiosurgery. All patients were treated with the Leksell gamma knife in one fraction with a marginal dose between 40 and 80 Gy (median, 50 Gy) and were followed for at least 24 months (or until enucleation because of complications secondary to radiation).

MAIN OUTCOME MEASURES: Any clinical feature of radiation retinopathy and neovascular glaucoma.

RESULTS: During a mean follow-up of 38 months (range, 6-81 months) we found radiation retinopathy in 84% of our patients. The most common findings in these patients were intraretinal hemorrhages with an incidence of 70%, macular edema and capillary nonperfusion in 63%, and hard exudates in 52% of the patients. Less common were microaneurysms in 30% and retinal neovascularization in 22%. The time of onset of the various radiation-associated retinal findings ranged between 1 and 22 months. Forty-seven percent of all patients developed neovascular glaucoma. In our study there was no correlation between radiation dosage applied and clinical findings.

CONCLUSIONS: Single-fraction high-dose Leksell gamma knife radiosurgery of choroidal melanomas with a median marginal dose of 50 Gy is highly associated with early radiation retinopathy and with neovascular glaucoma.

Study Type : Human Study

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