Program Book

Evangelos S. Gragoudas, Anne Marie Lane, Ivana Kim
(evangelos_gragoudas@meei.harvard.edu)
Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical
School, Boston, MA
Purpose. To evaluate the tolerance of the intraocular optic nerve to
different doses of proton irradiation.
Methods. We evaluated 1121 patients with choroidal melanoma treated
with protons in whom the optic nerve was exposed to doses between
3.5 Gy and 70 Gy. The relationship between radiation exposure and
incidence of radiation papillopathy and optic atrophy (disc pallor and
visual acuity of NLP) was assessed. Vision loss (worse than 20/200)
due to radiation-induced damage to the optic nerve was evaluated
in a subgroup of 171 patients with tumours 46.7 Gy).
Conclusions. These data suggest that exposure of the optic nerve
to radiation doses up to 47 Gy is well-tolerated, with visual loss only
observed in patients who received higher doses (> 47 Gy).
Financial disclosure. None
133 UM29
PROTON BEAM RADIOTHERAPY OF PARAPAPILLARY
CHOROIDAL MELANOMA
G.D. Willerding1, D. Cordini2, N.E. Bechrakis4, M.H. Foerster5, J. Heufelder2,
A.M. Joussen1, N. Lakotka1, L. Moser3(gregor.willerding@charite.de)
1. Charité, BerlinProtonen am HZB, Berlin, Germany; 2. Charité,
Augenklinik, Campus 1. Charité, Augenklinik, Campus Benjamin Franklin,
Berlin, Germany; 2 Charité, BerlinProtonen am HZB, Berlin, Germany; 3
Charité, Klinik für Strahlentherapie, Campus Benjamin Franklin, Berlin,
Germany; 4. Department of Ophthalmology, Medical University of
Innsbruck, Innsbruck, Austria; 5.Department of Ophthalmology, DRK
Kliniken Berlin - Westend, Berlin, Germany
Purpose. To report the results of optic disc involvement in proton beam
radiotherapy of posterior choroidal melanoma.
Methods. Retrospective case series of patients without endoresection
following radiation, where treatment planning has been done with
EYEPLAN. 159 patients, who received a cumulative dose of 50-60
CGE to the optic disc during fractionated proton beam irradiation of
choroidal melanoma between December 1998 and December 2005 were
identified.
Results. Radiation treatment controlled the tumour in 94 %. Medium
follow-up was 64 (4 to 140) months. Mean visual acuity before
radiotherapy was 0,3 and dropped to 0.05 and 0.04 after 3 and 5 years.
Mean tumour thickness decreased from 3.7 to 2.5 and 2.1 after 3 and 5
years. Recurrences occured in 6%. Main complications were radiation
optic neuropathy in 81% and vitreous bleeding in 30% irrespective of
secondary treatment. Secondary enucleation was performed in 3%.
UVEAL MELANOMA
Abstracts
105
Metastasis developed in 15% during follow-up.
Conclusions. Significant decrease in visual acuity develops after optic
disc irradiation in proton beam therapy. Rates of tumour control and eye
retention in this group of patients are favourable.
Financial disclosure. None
1414 UM30
HEMODYNAMIC MODIFICATIONS OF THE RETINA
AND THE CHOROÏD FOLLOWING PROTON BEAM
IRRADIATION OF UVEAL MELANOMAS
Leonidas Zografos, Ann Schalenbourg, Line Chamot, (leonidas.
zografos@fa2.ch)
Jules-Gonin Eye Hospital, Lausanne, Switzerland
Purpose. To study the mechanisms of hemodynamic modifications of
the retina and the choroïd following proton beam irradiation of uveal
melanomas.
Methods. Panoramic ICG and panoramic fluorescein angiography was
performed with the Staurenghi contact lens and the HRA2 camera.
223cases of uveal melanomas, previously treated with proton beam
irradiation. The main hemodynamic modifications of the choroïd and
retina are: Partial choroïdal Ischemia 58%, vortex vein occlusion 49%,
arterio venous communications between the posterior cilliary arteries
and the vortex veins 29 %, localised retinal ischemia 54 %, diffuse
retinal ischemia 18%, inferior retinal ischemia 22%.
Results. Following laser coagulation a decrease of the vascular
density of the choroïd was observed in all the cases associated to a
decrease of the permeability of the previously observed arterio venous
communications.
Conclusions. Panoramic ICG and fluorescein angiography provide useful
informations about the hemodynamic modifications of the retina and the
choroïd following proton beam irradiation of uveal melanomas as well
as after extensive laser coagulation witch allows to introduce valuable
antivasoprolifératives strategies.
Financial disclosure. None
2358 UM31
PERIOCULAR TRIAMCINOLONE FOR PREVENTION OF
MACULAR EDEMA FOLLOWING PLAQUE RADIOTHER-
APY OF UVEAL MELANOMA: THREE YEAR FOLLOW-
UP
Noel Horgan, Carol L. Shields, Melissa Murphy, Arman Mashayekhi,
Pedro F. Salazar, Miguel A. Materin, Myra O’Regan, Jerry A. Shields
(noelhorg@hotmail.com)
Royal Victoria Eye and Ear Hospital, Dublin
Wills Eye Institute, Philadelphia
Trinity College, Dublin
Purpose. To determine the efficacy and safety of periocular triamcinolone
acetonide (40 mg) for the prevention of macular edema in patients
undergoing plaque radiotherapy for uveal melanoma.
Methods. A prospective randomized controlled clinical trial recruited nehundred
and sixty-three patients with newly diagnosed uveal melanoma
undergoing Iodine125 plaque radiotherapy . Fifty-five patients were
randomized to the control group and 108 to the triamcinolone group.