Radiation treatment methods in uveal melanoma

Abstract

Background: The most frequent primary ocular malignancy in the western world is the uveal melanoma. While it mainly affects Caucasians, it is extremely uncommon among non-Caucasians. Continuous improvement in therapies for local treatment has allowed sparing of the eye, although this approach apparently does not improve survival. The present review aimed to explain different radiotherapy (RT) methods and compare the pros and cons of each method, along with the main complications that may be encountered in the treatment of uveal melanoma.
 Methods: Relevant papers published in English between January 2010 and January 2021 were retrieved, reviewed, and screened. Four databases, including PubMed, MEDLINE, Google Scholar, and GeneCards, were searched for this purpose.
 Results: Forty-one relevant articles were identified. Based on the selected papers, we highlighted the advantages and disadvantages of the different RT methods that have allowed sparing of the eye, even though they have not, as yet, improved survival. We listed a detailed comparison between therapies that allow an educated choice among the different available RT methods.
 Conclusions: The choice of uveal melanoma management is determined by the location of the tumor and volume of the extraocular extent. At present, there is no gold standard for the management of all ocular melanomas, and each case should be approached individually. Therefore, classification is a valuable prognostic tool. Many cases in cT3-4 classification categories are treated by primary enucleation and conservative treatment follow-up, while in cT2 and most cT1 classifications (i.e., 3.1–6.0-mm tumor thickness), several forms of RT are used.
 Keywords: melanoma of the uvea, choroidal melanoma, radiation therapy, brachytherapy, radioisotope brachytherapy, proton beam therapy, classification

Epiretinal Membrane Impairs the Inner Retinal Layer in a Traction Force-Dependent Manner

“… 33 It is well known that glial cells 33 and hyalocytes 34 , 35 transform into myofibroblasts, which express α-SMA. 33 , 36 We previously reported that MDRF is a biomarker for estimating the retinal traction force due to ERM based on the physical properties of membranous structures under compressive stress. 37 , 38 , 39 However, the molecular background of the relationship between MDRF and the retinal traction force due to ERM is unknown.…”

Influence of ILM peeling on macular blood flow in patients with diabetic epiretinal membrane

“…In contrast, secondary ERM is more often associated with intraocular in ammation and/or retinal ischaemia, resulting in a large number of in ammatory factors in the vitreous cavity, such as nestin, nuclear protein Ki-67, and highly glycosylated type I transmembrane glycoproteins; in addition, the expression of cytokines such as interleukin-6 and 8 and monocyte chemotactic protein-1 is increased in the ERM compared to the idiopathic ERM [5][6]. Diabetic retinopathy is an important cause of secondary ERM [7].…”

Simple new technique for macular pucker peel without forceps

“…ERMs may be located peripherally and have little or not any impact on visual function (3). More commonly, they have central foveal or perifoveal localization leading to significant visual impairment and worsening the quality of life (4). The prevalence of ERM increases with age (5).…”

“…The prevalence of ERM increases with age (5). Most often, ERMs occur in individuals older than 50 years, approaching the incidence of 20% of the total population by the age of 70 years (4).…”