To print: Select File and then Print from your browser's
menu
-----------------------------------------------------------------------------------
Title: Visual Acuity Outcomes Vary after Plaque Radiotherapy for
Uveal Melanoma
URL:
http://archopht.ama-assn.org/issues/v118n9/abs/ecs90228.html
09/21/2000
03:25:32 PM
By Elda Hauschildt
Patient age, general health and initial visual acuity are among various
factors that affect ultimate visual outcome after plaque radiotherapy for
uveal melanoma.
Tumor location and size, sub-retinal fluid,
radioactive isotope and final tumor control are other factors,
Philadelphia researchers report.
"Visual acuity is most effectively
preserved in eyes with small tumors outside a radius of five millimetres
from the optic disc and foveola," they note.
Investigators studied
1,300 consecutive patients with uveal melanoma and initial visual acuity
of 20/100 or better. All of the participants were treated with plaque
radiotherapy between July 1976 and June 1992.
Investigators used
two end points to evaluate post-treatment visual acuity -- final visual
acuity level and loss of visual acuity. Visual acuity was considered good
if it ranged from 20/20 to 20/100, and poor for 20/200 to no light
perception.
Minimal loss of visual acuity was defined as less than
five lines Snellen visual acuity or as moderate when it was equal to or
more than five lines.
Results indicate that 1,106 of the
participants had visual acuity of 20/100 or better when they began
treatment. Of the total, 34 percent had poor visual acuity at five years
post-treatment. At 10 years post-treatment, 68 percent had poor visual
acuity.
Nine clinical factors were found to best predict poor
visual-acuity results. These included increasing tumor thickness,
proximity to foveola of less than 5 mm, notched plaque shape, tumor
recurrence, age of 60 years or older, sub-retinal fluid, cobalt isotope,
anterior tumor margin posterior to equator and worse initial visual
acuity.
Moderate loss of visual acuity was found in 33 percent at
five-year follow-up and in 69 percent at 10-year follow-up.
Eight
factors were related to moderate loss. These were increasing tumor
thickness, worse initial visual acuity, notched plaque shape, tumor
recurrence, proximity to foveola of less than 5 mm, age 60 years or older,
sub-retinal fluid and diabetes mellitus or
hypertension.
-----------------------------------------------------------------------------------
-----------------------------------------------------------------------------------
|
