Fundus Autofluorescence Change as an Early Indicator of Treatment Effect of Brachytherapy for Choroidal Melanomas

• Published in: Ocular oncology and pathology Vol. 5; no. 6; pp. 445 - 453
• Main Authors: Navaratnam, Jesintha, Bærland, Thomas P., Eide, Nils A., Faber, Rowan T., Rekstad, Bernt L., Vavvas, Demetrios G., Bragadóttir, Ragnheiður
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01-10-2019
• Subjects: Research Article; 106Ru plaque; Brachytherapy; Fundus autofluorescence; Choroidal melanoma; Ultra-widefieldfundus imaging
• ISSN: 2296-4681; 2296-4657
• DOI: 10.1159/000499403

Background: Early confirmation of the effect of brachytherapy for choroidal melanoma showing that tumour coverage is valuable. The irradiated retinal pigment epithelium (RPE) commonly develops atrophy. This study compares the fundus autofluorescence (AF) changes to the development of RPE atrophy following brachytherapy. Methods: Retrospective study of 19 patients treated with 106 Ru and 2 with 125 I plaques with either a 3- or 6-month follow-up period. Ultra-widefield (UW) composite colour and AF images were obtained with Optomap 200Tx and interpreted as complete, partial, or no RPE changes and complete or partial hyperautofluorescence, hypoautofluorescence, or isoautofluorescence. Results: At the 3-month follow-up, 9 of 13 patients (69%) (95% confidence interval [CI], 0.389–0.896) treated with 106 Ru plaques developed complete homogenous hyperautofluorescence surrounding the tumour, but only 1 of 13 (8%) (95% CI, 0.004–0.379) developed complete RPE atrophy at the same time point. Six patients in the 106 Ru plaque group had their first follow-up with UW imaging at 6 months. Four of them developed homogenous hyperautofluorescence and none developed complete RPE atrophy around the tumour. The 2 patients treated with 125 I did not demonstrate any clear RPE or AF changes. Conclusion: The effect of 106 Ru plaque treatment on fundus UW imaging is detected as homogenous and well-demarcated hyperautofluorescence before visible RPE atrophy.