Radioactive plaque therapy for metastatic choroidal carcinoma

Abstract

Purpose To describe the outcome of radioactive episcleral plaque therapy for treatment of metastatic carcinoma to the choroid. Design Retrospective, noncomparative case series. Participants Five patients (six eyes) with carcinoma metastatic to the choroid. Methods Retrospective review of the clinical records of five patients (six eyes) who underwent radioactive episcleral plaque therapy for choroidal metastases. Main outcome measures Tumor height, visual acuity, radiation optic neuropathy, and radiation retinopathy. Results Radioactive episcleral plaque therapy resulted in shrinkage of the treated tumors and resolution of subretinal fluid in all eyes. After plaque treatment, best-corrected visual acuity was maintained within two lines of initial visual acuity for two eyes, decreased more than two lines for one eye, and improved more than two lines in three eyes. The treatment was well tolerated and there was no acute toxicity. Late complications included optic nerve atrophy (at 2 years) with proliferative radiation retinopathy (at 3 years) in one eye and optic atrophy (at 6 months) in another eye that had received prior external beam therapy. Conclusions In carefully selected cases, radioactive episcleral plaque therapy appears to be an effective and reasonable treatment for carcinoma metastatic to the choroid.