Program Book

2038 Ump119
VALUE OF DOPPLER ANALYSIS IN THE REGRESSION
OF UVEAL MELANOMA AFTER PLAQUE
Mónica Asencio-Duran, Pilar Garcia-Raya, Pilar Moreno, Isabel
Rodriguez-Rodriguez, Eva Corredoira (masedur@hotmail.com)
Hospital La Paz, Madrid, Spain
Purpose. To study the vascularization of melanoma as a sign of tumoral
activity.
Methods. 50 cases of melanoma treated with brachytherapy from
July 2005 to June 2010 were reviewed. The median follow-up was 29
months (13.7-69 months). Doppler was performed at diagnosis and
every 6 months. The average age was 60 years; there were 26 men and
24 women. 70 % of tumors were melanotic, 18 % amelanotic and 12
% mixed. Posterior location 30 %, equatorial 22 %, peripheral 20 %,
ciliary body 12 % and postequatorial 16 %. The median basal size at
diagnosis was 12.1 mm and median thickness 5.6 mm. The most used
plaque was the COMS (70 %), Ruthenium (28 %) and in 10 cases TTT
was associated. The apical dose was 85 cGy in all.
Results. Doppler detected intratumoral vascularization at diagnosis in
21 of 50 cases (42 %), of which 7 persisted at 6, 12 and 18 months. At
24 months this was 5 of 31 (16 %), at 30 months 3/20 (15 %), at 36
months 1/12 (8 %), at 42 months 1/6 (16.7 %), at 48 months 1/3 (33.3
%), at 54 months 1 of 2 (50 %) and at 60 months 0/1 (0 %). 8 avascular
tumors at diagnosis experienced new vascularization, of them, only 1
recurred and was enucleated, and 7 presented with ophthalmoscopic
and echographic regression. Of those with persistent vascularization
during the follow-up (6), 1 case recurred and was enucleated, another
developed metastasis, and 4 are regressed melanomas.
Conclusions
Results suggest that doppler is an important tool in management
of melanoma after plaque. Persistent intratumoral vascularization
seems to be associated with large tumour sizes, tumoral recurrence or
appearance of vascular congestion in neovascular glaucoma. The new
vascularized cases can be explained by the persistence of old vessels
not found before (wrong angulation of the probe), tumour recurrence or NVG.
Financial disclosure. None
65 Ump120
EVALUATION OF CHOROIDAL TUMORS BY OCT-
ENHANCED DEPTH IMAGING
Hakan Demirci, Dolly A. Padovani-Claudio, Alexis Smith, Brandon Smith,
Grant M. Comer (hdemirci@med.umich.edu)
W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, MI
Purpose. To evaluate the role of OCT-enhanced imaging technique (OCT-
EDI) in the imaging of choroidal tumors.
Methods. Prospective, single-center case series of 30 patients
Results. Hyporeflectivity was seen in choroidal nevus and melanoma,
while hyper-reflectivity was seen in treated choroidal melanoma,
choroidal metastasis, circumscribed choroidal hemangioma, posterior
scleritis, and choroidal hemorrhage. OCT-EDI successfully imaged the
tumors up to 1.5 mm in thickness.
Conclusions. OCT-EDI is helpful in imaging of choroidal tumors up to 1.5 mm
in thickness. It might be used in the differential diagnosis and follow-up of
these tumors.
Financial disclosure. None
114
1608 Ump121
HISTOPATHOLOGIC FINDINGS IN EYES WITH
CHOROIDAL MELANOMA TREATED WITH
BEVACIZUMAB FOR RADIATION RETINOPATHY
Hans E. Grossniklaus1, Martina C. Herwig1, 2, Weiqing Gao1 (ophtheg@
emory.edu)
1. Emory University School of Medicine, Atlanta, Georgia USA and 2.
University of Bonn, Bonn, Germany
Purpose. To describe the histopathological findings in two choroidal
melanoma eyes treated with intravitreal bevacizumab for radiation
retinopathy due to brachytherapy.
Methods. The clinical course of two patients with choroidal
melanoma who received intravitreal bevacizumab injections for
radiation retinopathy following brachytherapy was evaluated. After
enucleation for tumor recurrence (case 1) and secondary glaucoma
(case 2), the eyes were routinely processed, stained with H&E and
PAS, and immunostained for HMB45, VEGF, Ki67, CD31, and CD105.
Results. An increased amount of fibrosis within the tumor and peritumoral
tissue was found in both eyes in addition to the degenerative
changes of radiation retinopathy. HMB45 and VEGF were expressed
in both uveal melanomas, the latter particularly in macrophages.
Proliferative activity measured by the Ki67 index and angiogenesis
indicated by CD105+ vascular channels were related to tumor activity.
Conclusions. Bevacizumab injections for radiation retinopathy
seem to expedite fibrotic changes within uveal melanoma and the
peri-tumoral tissue including the choroid and the overlying retina.
Detection of tumor recurrence may be impaired by these bevacizumab
induced changes leading to a delay until adequate treatment.
Financial disclosure. None
64 Ump122
TREATMENT OF RADIATION MACULOPATHY WITH
INTRAVITREAL INJECTION OF BEVACIZUMAB
Mosci Carlo, Francesca Nasciuti, Francesco Baldo Lanza
(carlo.mosci@galliera.it)
Ocular Oncology Center, Galliera Hospital, Genova, Italy
Purpose. To evaluate the safety and efficacy of intravitreal injection
of bevacizumab as a treatment option for radiation maculopathy
secondary to proton beam radiotherapy.
Methods. Prospective case series of five patients affected by
intraocular melanoma who developed radiation maculopathy after
treatment with proton beam.
Three intravitreal injections of bevacizumab (0.5 ml) were given,
with an interval of one month between injections. The main outcome
measures were visual acuity measured with ETDRS acuity chart,
macular function with microperimetry test and optical coherence
tomography.
Results. The pre-injection visual acuity ranged from 46 to 13 with an
average of 33 letters.
The pre-injection central macular thickness measured by optical
coherence tomography ranged from 321 m to 605 m with an average
of 445 m. Three months after the first injection, the average visual
acuity was 35 and the average thickness 418; after 6 months these
numbers were 39 and 387, respectively. Microperimetry confirmed
the improvement in visual function at six months.