Downloaded from bjo.bmj.com on October 5, 2014 - Published by group.bmj.com
PostScript reported by Beykin et al. Furthermore, our patient developed a superior maculaoff rhegmatogenous detachment 2 days after plaque removal, with a break corresponding to the site of plaque attachment. This contrasts with detachments developed at a mean of 50.1 months post brachytherapy in Beykin’s series (with the earliest at 3.5 months), all of which were assumed to relate to late exudative detachment, subretinal fibrosis, retinal thinning and atrophic holes. It is interesting that we did not encounter any ‘degenerative’ detachments of this nature, with our own seemingly similar case mix, management and follow-up. Beykin et al do not report their rates of vitrectomy for indications other than retinal detachment, but in keeping with other published series, vitreous haemorrhage was the most common indication for vitrectomy following plaque brachytherapy in our patients (7 eyes (1.57%)).2 3 One patient developed vitreous haemorrhage 5 weeks after removal of plaque, the remainder much later (mean 5.4 years (range 1.4–8.8 years)) and attributed to tumour necrosis or proliferative radiation retinopathy. During the same study period we also treated 43 cases of posterior uveal melanoma by local resection combined with ruthenium plaque, and 227 with proton beam therapy. Of those with resections, 7 required vitrectomy (4 (9.3%) for retinal detachment, 3 (7.0%) for nonclearing vitreal haemorrhage); 2 eyes (0.9%) developed a retinal detachment following proton beam therapy.
Received 5 December 2013 Accepted 7 December 2013 Published Online First 3 January 2014
▸ http://dx.doi.org/10.1136/bjophthalmol-2014-304970 Br J Ophthalmol 2014;98:571. doi:10.1136/bjophthalmol-2013-304749
REFERENCES 1
2
3
Beykin G, Pe’er J, Hemo Y, et al. Pars plana vitrectomy to repair retinal detachment following brachytherapy for uveal melanoma. Br J Ophthalmol 2013;97:1534–7. Bianciotto C, Shields CL, Pirondini C, et al. Vitreous haemorrhage after plaque radiotherapy for uveal melanoma. Retina 2012;32:1156–64. Foster WJ, Harbour JW, Holekamp NM, et al. Pars plana vitrectomy in eyes containing a treated posterior uveal melanoma. Am J Ophthalmol 2003;136:471–6.
Seen Nee Chia, Henry B Smith, Ewan G Kemp Department of Ophthalmology, Tennent Institute of Ophthalmology, Glasgow, UK
Comment on: ‘Pars plana vitrectomy to repair retinal detachment following brachytherapy for uveal melanoma’ We read with interest the study by Beykin et al1 which appears to show a much higher rate of late retinal detachment following brachytherapy for posterior uveal melanoma than was found during a recent review of our own service. Between 1998 and 2013, 445 eyes with posterior choroidal melanoma were treated with ruthenium-106 plaque brachytherapy in the Scottish Ocular Oncology Service, and only 1 eye (0.22%) developed a retinal detachment. This contrasts with 7 from 473 eyes (1.48%) Br J Ophthalmol April 2014 Vol 98 No 4
Correspondence to Dr Seen Nee Chia, Department of Ophthalmology, Tennent Institute of Ophthalmology, Glasgow G12 0YN, UK, [email protected] Contributors SNC: data collection and analysis, drafting of manuscript. HBS: data analysis, drafting and final approval of manuscript. EGK: critical review and final approval of manuscript. Competing interests None. Ethics approval Anonymous data were obtained from the mandatory oncology database maintained by the Scottish Ocular Oncology Service. Provenance and peer review Not commissioned; internally peer reviewed. Data sharing statement Mandatory dataset available for inspection.
To cite Chia SN, Smith HB, Kemp EG. Br J Ophthalmol 2014;98:571. 571
Downloaded from bjo.bmj.com on October 5, 2014 - Published by group.bmj.com
Comment on: 'Pars plana vitrectomy to repair retinal detachment following brachytherapy for uveal melanoma' Seen Nee Chia, Henry B Smith and Ewan G Kemp Br J Ophthalmol 2014 98: 571 originally published online January 3, 2014
doi: 10.1136/bjophthalmol-2013-304749
Updated information and services can be found at: http://bjo.bmj.com/content/98/4/571.1.full.html
These include:
References
This article cites 3 articles, 1 of which can be accessed free at: http://bjo.bmj.com/content/98/4/571.1.full.html#ref-list-1
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PostScript reported by Beykin et al. Furthermore, our patient developed a superior maculaoff rhegmatogenous detachment 2 days after plaque removal, with a break corresponding to the site of plaque attachment. This contrasts with detachments developed at a mean of 50.1 months post brachytherapy in Beykin’s series (with the earliest at 3.5 months), all of which were assumed to relate to late exudative detachment, subretinal fibrosis, retinal thinning and atrophic holes. It is interesting that we did not encounter any ‘degenerative’ detachments of this nature, with our own seemingly similar case mix, management and follow-up. Beykin et al do not report their rates of vitrectomy for indications other than retinal detachment, but in keeping with other published series, vitreous haemorrhage was the most common indication for vitrectomy following plaque brachytherapy in our patients (7 eyes (1.57%)).2 3 One patient developed vitreous haemorrhage 5 weeks after removal of plaque, the remainder much later (mean 5.4 years (range 1.4–8.8 years)) and attributed to tumour necrosis or proliferative radiation retinopathy. During the same study period we also treated 43 cases of posterior uveal melanoma by local resection combined with ruthenium plaque, and 227 with proton beam therapy. Of those with resections, 7 required vitrectomy (4 (9.3%) for retinal detachment, 3 (7.0%) for nonclearing vitreal haemorrhage); 2 eyes (0.9%) developed a retinal detachment following proton beam therapy.
Received 5 December 2013 Accepted 7 December 2013 Published Online First 3 January 2014
▸ http://dx.doi.org/10.1136/bjophthalmol-2014-304970 Br J Ophthalmol 2014;98:571. doi:10.1136/bjophthalmol-2013-304749
REFERENCES 1
2
3
Beykin G, Pe’er J, Hemo Y, et al. Pars plana vitrectomy to repair retinal detachment following brachytherapy for uveal melanoma. Br J Ophthalmol 2013;97:1534–7. Bianciotto C, Shields CL, Pirondini C, et al. Vitreous haemorrhage after plaque radiotherapy for uveal melanoma. Retina 2012;32:1156–64. Foster WJ, Harbour JW, Holekamp NM, et al. Pars plana vitrectomy in eyes containing a treated posterior uveal melanoma. Am J Ophthalmol 2003;136:471–6.
Seen Nee Chia, Henry B Smith, Ewan G Kemp Department of Ophthalmology, Tennent Institute of Ophthalmology, Glasgow, UK
Comment on: ‘Pars plana vitrectomy to repair retinal detachment following brachytherapy for uveal melanoma’ We read with interest the study by Beykin et al1 which appears to show a much higher rate of late retinal detachment following brachytherapy for posterior uveal melanoma than was found during a recent review of our own service. Between 1998 and 2013, 445 eyes with posterior choroidal melanoma were treated with ruthenium-106 plaque brachytherapy in the Scottish Ocular Oncology Service, and only 1 eye (0.22%) developed a retinal detachment. This contrasts with 7 from 473 eyes (1.48%) Br J Ophthalmol April 2014 Vol 98 No 4
Correspondence to Dr Seen Nee Chia, Department of Ophthalmology, Tennent Institute of Ophthalmology, Glasgow G12 0YN, UK, [email protected] Contributors SNC: data collection and analysis, drafting of manuscript. HBS: data analysis, drafting and final approval of manuscript. EGK: critical review and final approval of manuscript. Competing interests None. Ethics approval Anonymous data were obtained from the mandatory oncology database maintained by the Scottish Ocular Oncology Service. Provenance and peer review Not commissioned; internally peer reviewed. Data sharing statement Mandatory dataset available for inspection.
To cite Chia SN, Smith HB, Kemp EG. Br J Ophthalmol 2014;98:571. 571
Downloaded from bjo.bmj.com on October 5, 2014 - Published by group.bmj.com
Comment on: 'Pars plana vitrectomy to repair retinal detachment following brachytherapy for uveal melanoma' Seen Nee Chia, Henry B Smith and Ewan G Kemp Br J Ophthalmol 2014 98: 571 originally published online January 3, 2014
doi: 10.1136/bjophthalmol-2013-304749
Updated information and services can be found at: http://bjo.bmj.com/content/98/4/571.1.full.html
These include:
References
This article cites 3 articles, 1 of which can be accessed free at: http://bjo.bmj.com/content/98/4/571.1.full.html#ref-list-1
Email alerting service
Receive free email alerts when new articles cite this article. Sign up in the box at the top right corner of the online article.
Notes
To request permissions go to: http://group.bmj.com/group/rights-licensing/permissions
To order reprints go to: http://journals.bmj.com/cgi/reprintform
To subscribe to BMJ go to: http://group.bmj.com/subscribe/
