Ocular complications after therapeutic irradiation.

Macfaul, P A; Bedford, Michael

doi:10.1136/bjo.54.4.237

Cited by 203 publications

(53 citation statements)

References 5 publications

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“…We found only a single case report that occurred before postoperative month 4 [5, 6]. While corneoscleral necrosis as a complication of plaque brachytherapy has been reported in the literature, we believe our cases, presenting sooner in the postoperative course, represent a distinct clinical entity [3, 6-9]. …”

Section: Commentmentioning

confidence: 88%

“…Scleral necrosis is an uncommon radiation complication associated with placement and removal of plaque brachytherapy because of the radioresistant nature (tolerance 15–100 Gy) of this avascular, hypocellular tissue [2]. While the theoretical risk of acute conjunctival necrosis following plaque brachytherapy has been suggested, it has not been reported to date [3]. …”

Section: Novel Insightsmentioning

confidence: 99%

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Conjunctival Dehiscence and Scleral Necrosis following Iodine-125 Plaque Brachytherapy for Uveal Melanoma: A Report of 3 Cases

2018

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Background/Aims: Plaque brachytherapy is currently the most common treatment for uveal melanoma and has many known potential complications. Here we present 3 cases of early conjunctival and scleral necrosis following iodine-125 plaque. Methods: This study was conducted as a retrospective case series. Results: We identified 3 cases of early conjunctival and scleral necrosis following iodine-125 plaque. All patients were managed conservatively with resolution of the necrosis. Conclusions: While delayed corneoscleral necrosis following plaque brachytherapy has been previously reported, occurring many months to years after treatment, the 3 cases in this series presented within 2–6 weeks in the postoperative period. While we were unable to identify a specific etiology, we believe this represents a distinct clinical entity of post-brachytherapy cornea-scleral necrosis that is important to recognize. Possible causes include acute radiation toxicity, mechanical trauma, and/or conjunctival microinfection.

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Section: Commentmentioning

confidence: 88%

Section: Novel Insightsmentioning

confidence: 99%

Conjunctival Dehiscence and Scleral Necrosis following Iodine-125 Plaque Brachytherapy for Uveal Melanoma: A Report of 3 Cases

2018

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“…The risks of cosmetic and functional deformities and cataract are also increased by radiation therapy [24][25][26]. Large tumours and those with vitreous seeding respond poorly to radiation therapy and often require enucleation.…”

Section: Discussionmentioning

confidence: 99%

Nucleoside Diphosphate Kinase (nm23 Protein) Expression in Retinoblastoma

Bardak

Çekıç²,

Ayhan

et al. 2000

Ophthalmic Res

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Forty-two enucleated eyes of 42 patients with unilateral retinoblastoma were studied histologically, including histochemically examiantion with anti-nm23 polyclonal antibody which does not recognise cDNA but its product. Primary tumours of >15 mm diameter with less evidence of apoptosis and with the most pleomorphic and anaplastic nuclei were associated with an increased risk of distant metastasis, but rosette formation did not discriminate. A high intensity of nm23 staining also indicated a tendency to meastasise, consistent with childhood neuroblastoma but in contrast to findings in carcinoma of the breast, colon and uterine cervix.

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“…Scleral necrosis as a complication of irradiation of ocular tissues has been described as far back as the 1950s [7,8]. Necrosis after plaque brachytherapy of any kind for malignant intraocular tumors has been reported in 0-33% of patients [1,2,3,4,5].…”

Section: Discussionmentioning

confidence: 99%

Extrascleral Tumor Extension Associated with Localized Scleral Melt following Plaque Brachytherapy for Uveal Melanoma: Clinical and Histologic Findings

2017

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Background/Aims: Our study aims to better characterize the clinical and histopathologic features of eyes with extrascleral uveal melanoma associated with scleral melt following brachytherapy. Methods: A retrospective review was performed on patients who had undergone ¹²⁵I (iodine-125) brachytherapy for uveal melanoma at our institution between 1992 and 2015. Patients with postradiation scleral necrosis who required enucleation were identified, and an analysis including a review of histopathology results was performed on those cases. Results: A total of 301 patients underwent plaque brachytherapy for uveal melanoma, of whom 31 required eventual enucleation. The histologic analysis showed extraocular extension through full-thickness scleral discontinuities in 6 cases. All but 1 (5 of 6) of these eyes exhibited either mitotic figures or Ki-67 positivity. Mitotic figures were noted in 4 specimens, including 3 eyes exhibiting mitoses within or adjacent to the extrascleral portion of the tumor. Two eyes exhibiting mitoses, as well as the case with Ki-67 positivity, also had clinical evidence of tumor regrowth. Conclusion: We found evidence of mitotic activity at the area of scleral discontinuity in some eyes with and in some without clinical evidence of tumor regrowth. Protruding pigmented material in areas of scleral necrosis after plaque brachytherapy may represent actively proliferating tumors even without internal evidence of tumor regrowth.

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Ocular complications after therapeutic irradiation.

Cited by 203 publications

References 5 publications

Conjunctival Dehiscence and Scleral Necrosis following Iodine-125 Plaque Brachytherapy for Uveal Melanoma: A Report of 3 Cases

Conjunctival Dehiscence and Scleral Necrosis following Iodine-125 Plaque Brachytherapy for Uveal Melanoma: A Report of 3 Cases

Nucleoside Diphosphate Kinase (nm23 Protein) Expression in Retinoblastoma

Extrascleral Tumor Extension Associated with Localized Scleral Melt following Plaque Brachytherapy for Uveal Melanoma: Clinical and Histologic Findings

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