BRACHYTHERAPY OF CHOROIDAL MELANOMAS LESS THAN 10 MM IN LARGEST BASAL DIAMETER Comparison of 10-mm and 15-mm Ruthenium Plaques.

Abstract Purpose To compare tumor control, vision, and complications between patients with a choroidal melanoma Design Retrospective comparative case series Participants One hundred sixty-four consecutive patients with a choroidal melanoma Methods Diagnosis was based on growth or high-risk characteristics. The apical dose was 100-120 Gy aiming to deliver ≥250 Gy to the sclera. Plaque positioning was retrospectively modeled. An increase ≥0.3 mm in thickness and ≥0.5 mm in LBD indicated local recurrence. Outcomes were compared with cumulative incidence analysis and Cox regression. Median follow-up time for patients still alive was 8.4 years. Main Outcome Measures Recurrence rate, low vision, blindness, radiation maculopathy and optic neuropathy. Results Melanomas treated with the 10-mm plaque were smaller (median thickness, 1.9 vs 2.6 mm; LBD 7.1 vs 8.6 mm), and located closer to foveola (median, 2.0 vs 2.8 mm) than those treated with the 15-mm plaque (P Conclusions The 10-mm ruthenium plaque contributes to better visual preservation, particularly with tumors close to fovea, without increase in local recurrence rate and, therefore, may be preferable to the 15-mm plaque.