Purpose: A retrospective evaluation of effectiveness of brachytherapy or enucleation in treatment of rare form of uveal melanoma: ring melanoma.Material and methods: Analysis comprised 49 patients treated from 2000 to 2019 for ring melanoma involving ciliary body. In 15 patients, primary treatment consisted of brachytherapy ( 106 Ru or 125 I), whereas in 34 patients, eyeballs were enucleated. The evaluation concerned differences between analyzed groups relating to the clinical and histopathological features as well as overall survival, cancer-specific overall survival, and disease-free survival.Results: No significant differences between the analyzed groups were found with regards to clinical and histopathological features, apart from intra-ocular pressure (increased in the enucleation group). Kaplan-Meier analysis did not reveal any significant differences between the group treated with enucleation and the group undergoing brachytherapy, both with regards to overall survival (p = 0.325) and cancer-specific overall survival (p = 0.477). A significant difference was observed in disease-free survival (p = 0.009), which was significantly shorter in the group undergoing brachytherapy. In the analysis of parameters of the applied brachytherapy, no significant differences between patients with and without local recurrence were found. Mean observation period was 350.8 weeks (range, 24-996 weeks, SD = 231.6). A local recurrence occurred in 11 (22.4%) patients, including 3 (6.1%) in enucleation and 8 (16.3%) after brachytherapy groups. Metastasis developed in 11 (22.4%) cases after a mean follow-up of 133 weeks (33.25 months), range 3-655 weeks.Conclusions: Preliminary observations may suggest that brachytherapy in this rare form of uveal melanoma, such as ring melanoma involving the ciliary body, may be taken into consideration as a useful alternative to enucleation. However, the confirmation of such an approach requires a larger patients' group to be gathered, and also a longer follow-up period. This is especially important in patients with a good baseline visual acuity in the affected eye, or when the neoplasm is present in the remaining eye with vision.

Purpose: To perform a retrospective analysis of factors which might affect the occurrence of a relapse of uveal melanoma after 125 I brachytherapy. Material and methods: The analysis concerned 343 patients treated in the years 2001-2012. The effect on local recurrence of such factors as patient's sex, age, tumour size, shape, pigmentation, location, presence of orange pigment or petechiae on tumour surface, retinal detachment, and blood or dispersed pigment in vitreous body were studied. Additional analysis concerned physical properties of brachytherapy (total dose, irradiation dose applied to tumour apex and base and irradiation time). Two groups of patients were distinguished: with and without a relapse. The diagnostic criterion for the relapse was growth of the tumour base or height by 0.5 mm. Results: Local recurrence of the uveal melanoma was observed in 29 patients (8.5%). Recurrences occurred with significantly higher frequency (p < 0.001), when the anterior tumour edge involved the ciliary body. Patients' survival in relation to the moment the occurrence of the relapse was statistically significant for application time (p = 0.004) and tumour pigmentation (p = 0.010). The deaths of patients with a local relapse were most rare when brachytherapy lasted from 72 to 95.9 hours and most frequent in cases of brownish tumour pigmentation. Patient sex, tumour shape and size, presence of orange pigment, retinal detachment, petechiae and bleeding to vitreous body as well as the dose of irradiation to tumour top and base did not have any significant effect on relapse occurrence. Conclusions: Treatment of uveal melanomas with 125 I applicators allows for a high rate of positive local results. Nonetheless, the recurrence probability always exists. The involvement of the ciliary body could influence this. The survival depending on the time of relapse could be statistically significant for application time and dark-brown tumour pigmentation.

PurposeA study presents features of choroidal osteoma in Deep Range Imaging Optical Coherent Tomography (DRI‐OCT).MethodsWe analysed 5 cases with choroidal osteoma. All patiens were diagnosed, treated and follow‐up at the Ophthalmology and Ocular Oncology Department of University Hospital in Cracow during 2013 and 2015 years. Diagnosis of osteoma was established on basis of typical features found during fundus and ultrasonography examnations. Additionaly, DRI‐OCT was performed in all choroidal osteoma cases. Images were evaluated by four experienced physicians in using DRI‐OCT in differential diagnosis of intraocular tumors.ResultsIn all cases choroidal osteoma were observed smooth undulating tumor surface, multiple intralesional layers, sponge bone structure, transparency with visibility of sclero‐choroidal junction and presence of vessels.ConclusionsChoroidal osteoma is a rare, benign tumor presents mainly at posterior pole of eye globe in young woman. Especially it should be distinguish from amelanotic choroidal melanoma or metastatic tumors. In these controversial cases DRI‐OCT is very useful due to present very characteristic features of choroidal osteoma in this examination.

Purpose To report case series of coexistence of the non‐pigmented ciliary body epithelium adenoma and uveal melanoma in one eye. Methods Retrospective analysis of case series. Results In Department of Ophthalomology and Ocular Oncology in Cracow we have found 3 patients with coexistence of uveal melanoma and non‐pigmented ciliary body epithelium adenoma in some eye. All patients were treated because of diagnosis uveal melanoma . Non‐pigmented ciliary body epithelium adenoma was detected accidently in histopatological examination. Before histopatological test there were no suspicion of ciliary body adenoma. In 1 case melanoma was located in iris and in 2 cases in choroid. We performed iris melanoma excision in patient with iris melanoma. First patient with choroid melanoma were treated with brachytherapy and next with enucleation because of neovascular, secondary glaucoma . Second patient with choroidal melanoma in spite extraocular extention disagreed with enucleation in the beginning. But after I‐125 brachytherapy with excision of extraocular infiltration patient decided on enucleation. In histopathologycal examination choroidal melanoma and adenoma were detected. Conclusion Adenoma of non‐pigmented ciliary body epithelium is a very rare tumor. It is more rarely with coexistence with uveal melanoma in one eye.

Purpose Analysis of all cases choroidal melanoma treated with proton beam radiotherapy (PBRT) in 2011‐2013 in Krakow. Methods The retrospective analysis of 39 patients with choroidal melanoma treated with proton beam in Krakow in 2011‐2013 was performed. There were 20 (51%) women and 19 (49%) men in mean 53,7 years (24 ‐ 74). . The largest tumor diameter ranged from 4,6 mm to 16.2 mm, and tumor thickness from 1.4 mm to 10.3 mm. Treatment was delivered in 4 fractions on 4 consecutive days. All patients received the dose of 60 CGE (Cobalt Grey Equivalent) given to PTV (planning target volume). Results The tumour had regressed in 20 patients (51 %) and remained stable in 19 patients (49 %). The large tumours in 4 cases were removed during vitrectomy (endoresection). One tumor was excised with exoresection. In the case of 1 patient, despite intraocular tumour regression occurring the choroidal melanoma had spread multifocally into the orbit, which necessitated orbit exenteration. In this case tumor cells in scleral vessels were detected in histopathologycal examination. The results ensured that the eyeballs of 38 patients (99%) could be saved. Visual acuity improved in 5 cases, was stable in 21 and decreased in 14 patients The follow‐up period Conclusion Proton beam radiotherapy is an effective method for treating patients with choroidal melanoma. This method ensures an eyeball preservation rate of 99%, with the vision function of 67% patients being saved. Decreasing visual function was caused by choroidal melanomas location close to macula and/or optic nerve disc in our group it were in 19 (49%) cases.