eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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5/2023
vol. 15
 
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abstract:
Original paper

A study comparing baseline and best-corrected visual acuity after iodine-125 episcleral brachytherapy in uveal melanoma

David Miguel
1
,
Jesús María de Frutos
1
,
Pilar Alonso
1
,
Ciro García-Álvarez
1
,
María Antonia Saornil
1
,
Patricia Diezhandino
1
,
Maria Isabel Garavis
1
,
Patricia Valencia
1

  1. Intraocular Tumors Unit, Valladolid University Hospital, Valladolid, Spain Institution address: Av. Ramón y Cajal, 3, 47003 Valladolid, Spain
J Contemp Brachytherapy 2023; 15, 5: 350–356
DOI: https://doi.org/10.5114/jcb.2023.132658
Online publish date: 2023/10/31
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Purpose:
The aim of this study was to analyze the course of visual acuity (VA) in visual outcomes of patients treated with iodine-125 (125I) brachytherapy in our center, based on original VA before treatment.

Material and methods:
Visual acuity was prospectively assessed using a case series of 305 patients treated with 125I between 1996 and 2022. To examine how VA behaves over time, we divided patient sample into 4 groups: (1) Patients with visual acuity of less than V ≤ 0.1 at baseline; (2) Patients with low to moderate VA, ranging 0.1 < V < 0.4; (3) Patients with moderate-high VA, ranging 0.4 < V < 0.8; (4) Patients with very high VA of V > 0.8. Each of the four groups was studied separately over a 60-month period to determine the percentage of patients with VA improvement, worsening, or with the same VA status. Finally, visual outcomes over time were estimated with 95% confidence interval (CI) using Kaplan-Meier analysis, and VA maintenance rates were reported at 1, 3, 5, 10, 15, and 20 years of follow-up.

Results:
The median follow-up time was 78.2 months (range, 6-254 months). The cumulative probabilities of survival analysis at 1, 3, 5, and 10 years were 16%, 3%, 2%, and none for the first sub-group; 46%, 20%, 17%, and 14% for the second; 65%, 53%, 29%, and 15% for the third; and 86%, 56%, 48%, and 41% for the fourth sub-group. The median survival in years was 0.30, 0.80, 3.10, and 4.40 for each sub-cohort, respectively.

Conclusions:
The decrease and maintenance of VA depends on the initial VA of patients. Most patients experience a marked worsening of their VA, regardless of their VA status before treatment with episcleral brachytherapy. Patients with a higher baseline VA retain VA best over time.

keywords:

uveal melanoma, outcomes, visual acuity

  
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