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Iodine I 125 Plaque Radiotherapy for Vasoproliferative Tumors of the Retina in 30 Eyes
Victoria M. L. Cohen, MD;
Carol L. Shields, MD;
Hakan Demirci, MD;
Jerry A. Shields, MD
Arch Ophthalmol. 2008;126(9):1245-1251.
Objective To report the efficacy of iodine I 125 plaque radiotherapy for the treatment of vasoproliferative tumors (VPTs) of the ocular fundus.
Methods The clinical features and outcomes of patients with VPTs who underwent iodine I 125 plaque radiotherapy were evaluated. Univariate and multivariate logistic regression analyses were performed to assess the effect of preoperative findings on visual acuity and complications. Kaplan-Meier survival estimates for the probability of adverse outcomes were performed.
Results Of the 30 eyes treated, 17 (57%) had primary and 13 (43%) had secondary VPTs. The median tumor base was 8.6 mm (range, 3.5-18.0 mm) and median tumor thickness was 3.7 mm (range, 2.5-6.3 mm). Exudative retinal detachment was present in 23 eyes (77%). Tumor regression was observed in 29 of 30 eyes (97%) and retinal detachment completely resolved in 15 of 23 eyes (65%). Visual acuity improved or remained stable in 22 eyes (73%). The only factor predictive of visual improvement was the classification of primary VPT (relative risk, 19; 95% confidence interval, 2-185; P = .01). Kaplan-Meier estimates of radiation complications at 5 years predicted cataract in (48%), transient vitreous hemorrhage in (16%), and neovascular glaucoma in (8%) of eyes. No patient developed radiation maculopathy or papillopathy.
Conclusions Iodine I 125 plaque radiotherapy is an effective method of treating larger (>2.5-mm thickness) VPTs with extensive exudative retinal detachment.
Author Affiliations: Ocular Oncology Service, Wills Eye Institute, Philadelphia, Pennsylvania. Dr Cohen is now with Moorfields Eye Hospital, London, England.
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