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Predictive risk factors for radiation retinopathy and optic neuropathy after proton beam therapy for uveal melanoma

  • Oncology
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Abstract

Purpose

This study was performed in order to evaluate the incidence of radiation retinopathy and optic neuropathy occurring after proton beam therapy for uveal melanoma.

Methods

Included in this study were all patients who had been treated with primary proton beam therapy for uveal melanoma at the oncology service between May 1998 and June 2014 with a minimum follow-up of 12 months. Excluded were all patients who underwent re-irradiation, or vitrectomy due to exudative retinal detachment or for tumor-resection.

Results

During this period, 1127 patients matched the inclusion criteria, of whom 768 (68.1 %) and 463 (41.0 %) developed radiation retinopathy and optic neuropathy after a median time of 18.9 months (2.0–99.84 months) and 19.8 months (0.2–170.4 months), respectively. Mean follow-up was 53.4 months (12–170.4 months). Included were 558 men (49.5 %) and 569 women (50.5 %). Mean age was 61 years (16–89 years). Visual acuity slightly decreased from initial levels of 0.3 logMAR–0.4 logMAR in patients without developing any radiation-induced complication but severely decreased to 1.0 logMAR or 1.5 logMAR in the case of developing radiation retinopathy only or optic neuropathy, respectively. Independent risk factors for radiation retinopathy were a centrally (<2.5 mm from sensitive structures) located tumor or a thick tumor located more than 2.5 mm from sensitive structures, while those for radiation optic neuropathy comprised a short distance and applied dose to the optic disk.

Conclusion

The risk for radiation retinopathy is higher in central uveal melanoma.

Mid-/peripheral tumors are at high risk for radiation retinopathy and maculopathy if presenting with increased thickness.

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Acknowledgments

Statistical analysis was performed by Dr. Ulrich Gauger, medical statistician, Berlin, Germany

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Authors and Affiliations

  1. Augenklinik, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany

    Ira Seibel, Dino Cordini, Annette Hager, Johanna Tillner, Aline I. Riechardt, Jens Heufelder, Anja M. Davids, Matus Rehak & Antonia M. Joussen

  2. Berlin Protonen am Helmholtz-Zentrum Berlin für Materialien und Energie, Charité Universitätsmedizin Berlin, Lise-Meitner-Campus, Berlin, Germany

    Dino Cordini & Jens Heufelder

Authors
  1. Ira Seibel
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  2. Dino Cordini
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  3. Annette Hager
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  4. Johanna Tillner
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  5. Aline I. Riechardt
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  7. Anja M. Davids
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  9. Antonia M. Joussen
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Corresponding author

Correspondence to Ira Seibel.

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Funding

No funding was received for this research

Conflict of interest statement

Prof. A. Joussen and Dr. M. Rehak report personal fees from Bayer, personal fees from Novartis, and personal fees from Allergan, outside the submitted work. All other authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Seibel, I., Cordini, D., Hager, A. et al. Predictive risk factors for radiation retinopathy and optic neuropathy after proton beam therapy for uveal melanoma. Graefes Arch Clin Exp Ophthalmol 254, 1787–1792 (2016). https://doi.org/10.1007/s00417-016-3429-4

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  • DOI: https://doi.org/10.1007/s00417-016-3429-4

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