Plaque Radiotherapy for Ocular Melanoma
Abstract
:Simple Summary
Abstract
1. Introduction
2. Indications for Treatment
3. Comparison with Other Treatment Options
4. Types of Radioisotopes and Comparison
5. Plaque Size, Materials, and Dosimetry Innovations
6. Surgical Technique
7. High Dose Rate (HDR) Brachytherapy
8. Adjunctive Procedures: Cytology and Cytogenetics
9. Efficacy of Treatment
10. Complications of Plaque Radiotherapy and Its Treatment
10.1. Scleral and Corneal Complications
10.2. Neovascular Glaucoma
10.3. Radiation-Induced Cataract
10.4. Radiation-Induced Retinopathy and Maculopathy
10.5. Radiation-Induced Optic Neuropathy
10.6. Visual Acuity
10.7. Extraocular Muscle Dysfunction and Diplopia
11. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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General information |
|
Ruthenium-106 [34] |
|
Iodine-125 [31] | |
Palladium-103 [18] |
Complication | Mechanism | Management |
---|---|---|
Keratitis and dry eye syndrome | Radiation exposure during plaque radiotherapy may lead to goblet cell and limbal stem cell injury [101]. | Topical lubricants and gels |
Neovascular glaucoma | Upregulation of vascular endothelial growth factor (VEGF) and iris vasculature damage can cause rubeosis iridis, potentially progressing to neovascular glaucoma (NVG), which carries a poor prognosis and may require enucleation if untreated [107]. | Topical eye-pressure-lowering medications, oral acetazolamide, laser cyclophotocoagulation, glaucoma filtration surgery [107] |
Radiation-induced cataract | Ionizing radiation can damage lens fibers, leading to posterior subcapsular, cortical, or nuclear sclerotic cataracts, with posterior subcapsular cataracts being most common [108]. | Cataract surgery, treated similarly to age-related cataracts [108] |
Radiation-induced retinopathy and maculopathy | Ionizing radiation can lead to closure of the retinal vascular bed, causing intraretinal hemorrhage, cotton-wool spots, non-perfusion of vessels, neovascularization, cystoid macular edema, and vitreous hemorrhage [109]. | Macular edema: intravitreal anti-VEGF and steroid injections Ischemic radiation retinopathy: laser photocoagulation, anti-VEGF injections [109] |
Radiation-induced optic neuropathy | Characterized by optic disk hyperemia, edema, hemorrhage, and cotton-wool spots [110]. | Intravitreal triamcinolone acetate injections, hyperbaric oxygen therapy [110] |
Visual acuity loss | Various; linked to higher radiation doses, larger tumor size, and proximity of the tumor to critical structures [111]. | Treatment of the specific cause |
Extraocular muscle dysfunction and diplopia | Intraoperative muscle disinsertion, radiation-induced extraocular muscle dysfunction [112]. | May recover spontaneously; prisms and botulinum toxin injections for symptoms persisting <6 months; strabismus surgery if symptoms persist >6 months [113] |
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Thomas, G.N.; Chou, I.-L.; Gopal, L. Plaque Radiotherapy for Ocular Melanoma. Cancers 2024, 16, 3386. https://doi.org/10.3390/cancers16193386
Thomas GN, Chou I-L, Gopal L. Plaque Radiotherapy for Ocular Melanoma. Cancers. 2024; 16(19):3386. https://doi.org/10.3390/cancers16193386
Chicago/Turabian StyleThomas, George Naveen, I-Ling Chou, and Lingam Gopal. 2024. "Plaque Radiotherapy for Ocular Melanoma" Cancers 16, no. 19: 3386. https://doi.org/10.3390/cancers16193386
APA StyleThomas, G. N., Chou, I. -L., & Gopal, L. (2024). Plaque Radiotherapy for Ocular Melanoma. Cancers, 16(19), 3386. https://doi.org/10.3390/cancers16193386