Histopathological changes in malignant melanomas of the choroid after cobalt plaque therapy.

Abstract

with malignant melanoma of the choroid of which 300 were treated by primary enucleation and 100 by the application of a cobalt plaque. Others were treated by light coagulation, and in some cases, particularly in older people, no active treatment was given but the patient was kept under careful observation.The purpose of this paper is to report 23 cases in which the eyes have been removed after cobalt plaque therapy for malignant melanoma of the choroid and to describe the histopathological changes. Case reportsThe ages of the patients varied between 30 and 75 years (average 51 years), and there were 14 males and 9 females. The interval between treatment by cobalt plaque therapy and enucleation of the affected eye varied from 7 months to 13 years and 10 months, but when the latter case is excluded the average interval was 32 months. The reasons for enucleation fell into 2 groups-failure of treatment with strong suspicion or clear clinical evidence of continued growth of the tumour, and radiation complications in the treated eye.

Long-term Choroidal Vascular Changes after Iodine Brachytherapy versus Transpupillary Thermotherapy for Choroidal Melanoma

“…Moreover, choroidal vascular changes in IBT-treated eyes were never associated with tumor recurrence. These lesions may be an early and immature form of choroidal vessels and confirm the plastic reaction of choroidal vascular system to radiation damage (21,24,28).…”

“…The introduction of ICGA in clinical practice has documented that the effects of TTT are not limited to the retinal circulation, but involve choroidal circulation as well (18). Moreover, some studies have documented that the histologic changes of local radiotherapy of choroidal melanoma include sclerosis of choroidal vessels and atrophy of choroidal layers and Bruch membrane (20,21). Using IC-GA, we have demonstrated that occlusion of choriocapillaris is constant in all IBT-and TTT-treated eyes, whereas patent medium and/or large choroidal vessels may be de-tected in TTT-treated eyes.…”

Long-term Choroidal Vascular Changes after Iodine Brachytherapy versus Transpupillary Thermotherapy for Choroidal Melanoma

“…Moreover, choroidal vascular changes in IBT-treated eyes were never associated with tumor recurrence. These lesions may be an early and immature form of choroidal vessels and confirm the plastic reaction of choroidal vascular system to radiation damage (21,24,28).…”

“…The introduction of ICGA in clinical practice has documented that the effects of TTT are not limited to the retinal circulation, but involve choroidal circulation as well (18). Moreover, some studies have documented that the histologic changes of local radiotherapy of choroidal melanoma include sclerosis of choroidal vessels and atrophy of choroidal layers and Bruch membrane (20,21). Using IC-GA, we have demonstrated that occlusion of choriocapillaris is constant in all IBT-and TTT-treated eyes, whereas patent medium and/or large choroidal vessels may be de-tected in TTT-treated eyes.…”

Histologic Findings of Choroidal Vasculopathy in Eyes Enucleated following Radiation Therapy for Uveal Melanoma: Radiation Choroidopathy

“…There are two studies in the literature that have evaluated indocyanine green angiography of the choroidal vasculature after radiation, which suggested that there is not only vascular closure but also dilation of existing vessels, leakage of the vessels near the site of radiation, and possible choroidal neovascularization [15,16]. Finally, another prior histopathologic study of cases treated with plaque brachytherapy discussed that some cases had hyalinization of vessels, dilation of some vessels, and intratumoral as well as subretinal hemorrhages, but the evaluation was not as specifically directed to evaluating the choroidal vasculature as this study; but the fact that some cases had similar findings suggests that the findings that we have described have been seen by others by ICG as well as by histology [17].…”

OCT Angiography Analysis of Retinal and Choroidal Flow after Proton Beam Therapy for Choroidal Melanoma

“…Prior histologic studies showed choroidal circulation alterations including sclerosis and hyalinization of choroidal vessels, atrophy of different layers of the choroid and Bruch membrane, proliferation of the retinal pigment epithelium, and vascular closure after brachytherapy. 15 , 16 These changes were observed at and around the tumor. 16 Prior imaging analysis showed changes in choroidal flow at the base of the tumor in eyes with CM treated with brachytherapy.…”

Long-term Choroidal Vascular Changes after Iodine Brachytherapy versus Transpupillary Thermotherapy for Choroidal Melanoma

“…Moreover, choroidal vascular changes in IBT-treated eyes were never associated with tumor recurrence. These lesions may be an early and immature form of choroidal vessels and confirm the plastic reaction of choroidal vascular system to radiation damage (21,24,28).…”

“…The introduction of ICGA in clinical practice has documented that the effects of TTT are not limited to the retinal circulation, but involve choroidal circulation as well (18). Moreover, some studies have documented that the histologic changes of local radiotherapy of choroidal melanoma include sclerosis of choroidal vessels and atrophy of choroidal layers and Bruch membrane (20,21). Using IC-GA, we have demonstrated that occlusion of choriocapillaris is constant in all IBT-and TTT-treated eyes, whereas patent medium and/or large choroidal vessels may be de-tected in TTT-treated eyes.…”

Histologic Findings of Choroidal Vasculopathy in Eyes Enucleated following Radiation Therapy for Uveal Melanoma: Radiation Choroidopathy

“…There are two studies in the literature that have evaluated indocyanine green angiography of the choroidal vasculature after radiation, which suggested that there is not only vascular closure but also dilation of existing vessels, leakage of the vessels near the site of radiation, and possible choroidal neovascularization [15,16]. Finally, another prior histopathologic study of cases treated with plaque brachytherapy discussed that some cases had hyalinization of vessels, dilation of some vessels, and intratumoral as well as subretinal hemorrhages, but the evaluation was not as specifically directed to evaluating the choroidal vasculature as this study; but the fact that some cases had similar findings suggests that the findings that we have described have been seen by others by ICG as well as by histology [17].…”

OCT Angiography Analysis of Retinal and Choroidal Flow after Proton Beam Therapy for Choroidal Melanoma

“…Prior histologic studies showed choroidal circulation alterations including sclerosis and hyalinization of choroidal vessels, atrophy of different layers of the choroid and Bruch membrane, proliferation of the retinal pigment epithelium, and vascular closure after brachytherapy. 15 , 16 These changes were observed at and around the tumor. 16 Prior imaging analysis showed changes in choroidal flow at the base of the tumor in eyes with CM treated with brachytherapy.…”

Long-term Choroidal Vascular Changes after Iodine Brachytherapy versus Transpupillary Thermotherapy for Choroidal Melanoma

“…Moreover, choroidal vascular changes in IBT-treated eyes were never associated with tumor recurrence. These lesions may be an early and immature form of choroidal vessels and confirm the plastic reaction of choroidal vascular system to radiation damage (21,24,28).…”

“…The introduction of ICGA in clinical practice has documented that the effects of TTT are not limited to the retinal circulation, but involve choroidal circulation as well (18). Moreover, some studies have documented that the histologic changes of local radiotherapy of choroidal melanoma include sclerosis of choroidal vessels and atrophy of choroidal layers and Bruch membrane (20,21). Using IC-GA, we have demonstrated that occlusion of choriocapillaris is constant in all IBT-and TTT-treated eyes, whereas patent medium and/or large choroidal vessels may be de-tected in TTT-treated eyes.…”

Histologic Findings of Choroidal Vasculopathy in Eyes Enucleated following Radiation Therapy for Uveal Melanoma: Radiation Choroidopathy

“…There are two studies in the literature that have evaluated indocyanine green angiography of the choroidal vasculature after radiation, which suggested that there is not only vascular closure but also dilation of existing vessels, leakage of the vessels near the site of radiation, and possible choroidal neovascularization [15,16]. Finally, another prior histopathologic study of cases treated with plaque brachytherapy discussed that some cases had hyalinization of vessels, dilation of some vessels, and intratumoral as well as subretinal hemorrhages, but the evaluation was not as specifically directed to evaluating the choroidal vasculature as this study; but the fact that some cases had similar findings suggests that the findings that we have described have been seen by others by ICG as well as by histology [17].…”

OCT Angiography Analysis of Retinal and Choroidal Flow after Proton Beam Therapy for Choroidal Melanoma

“…Prior histologic studies showed choroidal circulation alterations including sclerosis and hyalinization of choroidal vessels, atrophy of different layers of the choroid and Bruch membrane, proliferation of the retinal pigment epithelium, and vascular closure after brachytherapy. 15 , 16 These changes were observed at and around the tumor. 16 Prior imaging analysis showed changes in choroidal flow at the base of the tumor in eyes with CM treated with brachytherapy.…”