Table 4.
Summary of studies on endoresection for uveal melanoma.
| Authors | Patients, n | Diameter, mm |
Thickness, mm | Follow-Up, mean | Survival | Enucleation | Recurrence | VA Pretreatment | VA Posttreatment | Complications |
|---|---|---|---|---|---|---|---|---|---|---|
| Kertes et al., 1998 [18] Case series retrospective No adjuvant BT |
32 | 8.0 (range 3–18) | 5.3 (flat to 12.0) | 40 | 9.4% (3 pts) died | 9.4% (3 pts) |
3.1% (1 pts) |
31.2% had VA ≥ 6/60; 56.3% between 6/120 and light perception, 12.5% NLP | VH (37.5%); cataract (25%); RD (9.3%); glaucoma (9.3%). | |
| Damato et al., 1998 [19] Retrospective case series Adjuvant BT selected pts |
52 | 8.2 (range 4.0–14.0) | 3.9 (1.5–10.1) | 20 | 0 | 10% | 0 | 90% eye retention | RD (16), cataract (25), ocular hypertension (14), phthisis (one), epiretinal membrane (one), VH (two), possible local tumour recurrence (eight), and endophthalmitis (one) | |
| Garcia-Arumi et al., 2001 [20] Retrospective case series Adjuvant BT selected pts |
25 | 12.1 (range, 8.9–14.8) | 10.6 (range, 9.1–12.8) | 31 (12–72) |
0 | 0 | 0 | Mean, 20/60 (range, 20/400 to 20/20) | Hand motions to 20/30 (mean, 20/100) | Hemorrhage at the scleral bed (100%), cataract (40%), ocular hypertension (32%), RD (16%), macular traction (16%), epiretinal macular proliferation (8%), branch vein occlusion (4%), and submacular hemorrhage (4%). |
| Bechrakis et al., 2006 [21] Retrospective case series Adjunctive Proton radiotherapy |
58 | 15.6 (11.1–21.6) |
Median: 8.8 (range, 7.0–14.5) |
Median 18 m (3.0–48) |
4% (2 mets) |
KM at 2 years was 8.4% | 2% (1 recurrence at 40 m) | 20/40 (range, 20/400–20/20) |
Median: 20/200 | KM at 2 years: Cataract: 46.6%; RD 32.1%; Macular hole 4.0%; Secondary glaucoma 2.6%; Phthisis 2.1%; Macular pucker 1.8%; Radiation retinopathy: 27.5%; radiation optic neuropathy: 29.4% |
| Karkhaneh et al., 2007 [22] Retrospective case series No adjuvant BT |
20 | 11.67 (range, 8.0–15.7) | 8.51 (range, 5.5–11) | 89.55 months (24–132) |
5% (1 pt) |
15% (3 pts) |
10% (2 pts) |
Mean, 20/100 (hand motions to 20/30) | No light perception to 20/30 | Cataract: 25%: RD: 15%; Bullous keratopathy: 10% |
| Garcia-Arumi et al., 2008 [23] Retrospective case series BT all pts |
38 | 9.9 (5–15) | 10.1(7.7–13.5) | Mean 70.63 (23 to 129) | 13% (3/23) 90.9% at 5 years (K-M) |
7.9% (3 pts) |
5.8% (2 pts) |
20/60 (‘‘hand-movements’’ to 20/20) | Mean 20/300 (‘‘no light perception’’ to 20/30) | Hemorrhage at the scleral bed: 100%; ocular hypertension: 31.5%; RD: 26%; epiretinal macular proliferation: 11%; post-radiation retinopathy: 5.2%; and subretinal neovascularisation: 5.2% at 2 years |
| Konstantinidis et al., 2014 [24] NO adjuvant BT |
71 | 9.5 (4.8–14.5) | 4.4 (0.9–11.1) | 49.2 m (range, 24 to 195.6 m) | 7% (5/71) 9% at 5 years and 10 years |
4% | 3% (2 pts) 3.7% at 10 years KM |
Better than 6/12 in 9 (13%) and better than 6/30 in 21 (31%) | Cataract (94%), transient ocular hypertension (10%), epiretinal membrane (13%) and moderate haemorrhage (3%); RD (22%). | |
| Garcia-Arumi J. et al., 2015 [25] 20 pat endoresection alone 21 pts BT |
41 | 9.9 (range, 5–15) | 9.8 (range, 7.7–13.5) | 102.5 (20–180) | 7.3% (3 pts) KM at 10 years 97.6% |
12..2% | 5 pts (12.2%) in the group endo alone |
20/100 (range, hand movement–20/20) | No light perception to 20/20, with mean 20/1625 | RD 28.9%; Phthisis bulbi 12.2%; PRP 9.8%; ERM 12.2%; CNVM 4.9%; Subretinal fibrosis 2.4%; Ocular hypertension 34.1%; VH 2.4%; CME 2.4%; corneal decompensation 2.4% |
| Biewald E et al., 2017 [26] Prior treatment with gamma and postop BT |
200 | 12 (range, 6.3–20) | 9.4 (range 6–14.8) | 32.3 months | 15.5% (31 /200) | 11% (22/200) |
5% (10 pts) |
13.4% the VA of 20/50 or better and 20/400 to 20/50 in 33.6% | Cataract surgery in 70%; pars plana vitrectomy revision surgery in 1.5%; use of an adjuvant ruthenium-106 plaque did not lower recurrence |
|
| Vidoris et al., 2017 [27] No adjuvant BT |
14 | 15.98 ± 4.76 (range: 4.3–23) | 6.05 ± 1.94 (range: 3.3–9.7) | Mean 54.5 (range: 12–60 m) | 7.1% (1 pt) | 0 | 0 | Between 20/60 and 20/200 (78.5%) | Macular bleeding (7.1%); elevated IOP (7.1%); RD (14.2%) | |
| Susskind et al., 2017 Adjuvant BT [28] |
35 | Mean 13.0 (8..4–17.6) |
Mean: 7.33 (range, 4.06–12.2) |
Mean: 65.7 (12 and 154) | 20% (7 pts) 92.0% 5 years and 57.9% 10 years KM |
22.9% (8 pts) 77.3% 5 years and 70.8% 10 years KM |
22.9% (8 pts) (22.7% at 5 years and 29.2% at 10 years (KM) |
Median 0.2 (2.3–0) LogMar | Median 2.0 (4.0–0.4) LogMar | Radiation retinopathy: 11.4%; CNV: 8.6%); pale optic disc (opticopathy): 31.4%; corneal decompensation: 8.6%; epiretinal membrane: 5.7%; RD PVR: 11.4%; macular hole: 2.8%; persistent corneal erosion: 2.8%; corneal band keratopathy: 5.7%; persistent hypotony: 5.7%. |
Abbreviations: CNV, choroidal neovascularization; IOP, intraocular pressure; RD, retinal detachment. CME: cystoid macular edema; CNVM: Choroidal neovascular membrane; ERM: epiretinal membrane; PRP: postradiation retinopathy; VH: vitreous hemorrhage; pts, patients.