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Graefe's Archive for Clinical and Experimental Ophthalmology

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02.02.2023 | Oncology

Visual outcomes of macular melanocytic lesions after early or delayed proton beam therapy

verfasst von: Maxime Nhari, Juliette Thariat, Laurent Kodjikian, Samuel Chacun, Anh-Minh Nguyen, Laurence Rosier, Joël Herault, Julia Salleron, Thibaud Mathis

Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology | Ausgabe 7/2023

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Abstract

Purpose

During their initial management, some macular melanocytic lesions can be closely monitored to wait for a documented growth before advocating a treatment by irradiation. However, the visual outcomes of this strategy have not yet been assessed. This study compares the visual outcomes of macular melanocytic lesions that underwent delayed proton beam therapy (PBT) after an initial observation to those treated early.

Methods

A total of 162 patients with suspicious melanocytic lesions whose margins were located within 3 mm of the fovea were recruited from two French ocular oncology centers.

Results

Overall, 82 patients treated with PBT within 4 months after the initial visit (early PBT group) were compared to 24 patients treated with delayed PBT (delayed PBT group) and 56 patients not treated with PBT (observation group). Visual acuity was not significantly different between baseline and last visit in the observation group (p = 0.325). Between baseline and last visit, the median [IQR] loss in visual acuity was significant in both the early (0.7 [0.2; 1.8], p < 0.001) and the delayed (0.5 [0.2; 1.5], p < 0.001) PBT groups. After irradiation, there was no significant difference between the early and delayed PBT groups for visual loss (p = 0.575), diameter reduction (p = 0.190), and thickness lowering (p = 0.892). In multivariate analysis, history of diabetes mellitus and Bruch’s membrane rupture remained significantly associated with greater visual loss (p = 0.036 and p = 0.002, respectively).

Conclusion

For small lesions in which there is no clear diagnosis of malignant melanoma, an initial close monitoring to document tumor growth does not impact visual prognosis, despite the potential complications associated with the untreated tumor. However, the survival should remain the main outcome of the treatment of these lesions.

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Titel: Visual outcomes of macular melanocytic lesions after early or delayed proton beam therapy
verfasst von: Maxime Nhari
Juliette Thariat
Laurent Kodjikian
Samuel Chacun
Anh-Minh Nguyen
Laurence Rosier
Joël Herault
Julia Salleron
Thibaud Mathis
Publikationsdatum: 02.02.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology / Ausgabe 7/2023
Print ISSN: 0721-832X
Elektronische ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-023-05981-x

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Visual outcomes of macular melanocytic lesions after early or delayed proton beam therapy

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