Predictors of radio-induced visual impairment after radiosurgery for uveal melanoma

Abstract

We found clinical and dosimetric variables to clearly predict the risk of the main side effects after GKRS for UM. These results may provide dose constraints to critical structures, potentially able to reduce side effects. Constraining D1% to the optic nerve below 12-13Gy may result in a dramatic reduction of blindness risk, while reducing V20 of the posterior segment of the bulb could limit the neovascular glaucoma onset.

Ocular leukemic mass‐like relapse treated with CyberKnife stereotactic radiosurgery

“…Our patient experienced visual loss (from hand motion to no light perception) after SRT; previous reports have reported the considerable risk of visual loss for tumour lesions close to the optic nerve after SRT (Gigliotti et al. 2018; Cicinelli et al. 2021).…”

“…The risk of radio-induced complications, potentially leading to irreversible visual loss, should be anticipated in patients undergoing ocular radiotherapy. Our patient experienced visual loss (from hand motion to no light perception) after SRT; previous reports have reported the considerable risk of visual loss for tumour lesions close to the optic nerve after SRT (Gigliotti et al 2018;Cicinelli et al 2021).…”

Predictive factors of radio‐induced complications in 194 eyes undergoing gamma knife radiosurgery for uveal melanoma

“…Inclusion criteria were a clinical diagnosis of UM, age older than 18 years, treatment with GKR, availability of charts and imaging studies and follow-up of at least 6 months after GKR. Detailed GKR treatment protocol has been previously published (Gigliotti et al 2018). Exclusion criteria were ocular tumours different from UM and previous treatment other than GKR (such as transpupillary thermotherapy, brachytherapy or proton beam radiotherapy).…”

“…peripapillary tumours) carried a three-time greater risk of developing RP, in accordance with previous studies . Although higher radiation dose has been associated with lower risk of tumour recurrence , greater optic nerve damage should be expected (Gigliotti et al 2018;.…”

Optimizing radiosurgery with photons for ocular melanoma

“…However, the clinical need for optimization must be weighted against the efforts. Minor improvements might impact on toxicity, such as visual acuity [18] , [19] . A major advantage of DCA-IMRT is, that in contrast to most data from radiosurgery or SBRT, we can apply constraints according to ICRU Report 62 [20] .…”