Ocular Oncology and Pathology最新文献

{"title":"Minimally Invasive Iris Melanoma Resection and Cataract Surgery.","authors":"Maria Chiara Rivolta, Kristoffer Nissen, Carsten Faber, Steffen Heegaard, Per Riise, Yağmur Seda Yeşiltaş, Annapurna Singh, Arun D Singh, Mette Marie Bagger, Jens Folke Kiilgaard","doi":"10.1159/000553634","DOIUrl":"10.1159/000553634","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to compare the outcomes of minimally invasive iris melanoma resection (MIMR) with or without combined cataract surgery (CS) in patients with circumscribed iris melanoma, with the goal of developing evidence-based guidance for surgical management.</p><p><strong>Methods: </strong>This retrospective, multicenter case series included 89 patients treated at Copenhagen University Hospital (Denmark) and Cole Eye Institute, Cleveland Clinic (USA). Danish patients underwent combined MIMR and CS with iris diaphragm, while US patients underwent MIMR only. Outcomes included visual acuity, anterior chamber stability, induced astigmatism, cataract progression, and surgical complications. Tumor-related outcomes were tumor size, local recurrence, and development of metastasis. Statistical analyses were performed using R, with <i>p</i> < 0.05 considered significant.</p><p><strong>Results: </strong>Median age and follow-up differed between cohorts: 76 years and 13 months (range, 12-38) in the Danish cohort, compared with 58 years and 47 months (range, 1-145) in the American cohort (<i>p</i> < 0.001). All tumors were classified as AJCC T1. Visual acuity improved significantly after combined MIMR + CS (mean change -0.15 logMAR, <i>p</i> = 0.005) and decreased slightly after MIMR alone (+0.06 logMAR, <i>p</i> = 0.004). Combined surgery induced a small but significant increase in median corneal astigmatism (-0.45 D, <i>p</i> < 0.001), while standalone MIMR did not result in significant refractive change. Cataract progression after MIMR necessitated surgery in 16% of cases over a median follow-up of 47 months (range, 1-145 months). Complications were infrequent and manageable, with no sustained hypotony or intraoperative hyphema. Stable anterior segment anatomy enabled effective iris reconstruction in both approaches. The median tumor size was 1 clock hour (range, 0.25-3.5). Tumor recurrence occurred in 3 cases (3.4%); all recurrences were T1a lesions and occurred in the MIMR-only cohort. No metastatic events were observed during follow-up.</p><p><strong>Conclusions: </strong>Both standalone and combined MIMR demonstrated excellent safety, with low complication rates (<5%). No metastatic events were observed, and tumor recurrence occurred in only 3.4% of cases. In the combined MIMR + CS cohort, early visual recovery was superior, whereas standalone MIMR preserved lens status and induced minimal astigmatic change. These outcomes reflect distinct patient profiles - older cataractous versus younger phakic eyes - highlighting the importance of individualized surgical planning. Given its strong local control and low systemic risk, MIMR represents a safe and effective surgical option for localized iris melanoma, with combined procedures preferred when cataract coexists or is expected to progress.</p>","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National Coordinated Care and Translational Research Program for Uveal Melanoma Pilot: Infrastructure, Biobanking, and Challenges in Liquid Biopsy Implementation in a Latin American Country.","authors":"Santiago A Sepúlveda, César Luna, Eduardo Labbé, María E Mánquez, Eugenio Vinés, Rodolfo Garretón, Juan Carlos Roa, Alex Di Genova, Carol Moraga, Leslie C Cerpa, Leidy Muñoz, Francisca Saavedra, Miguel N Burnier, Julia V Burnier, Pablo Zoroquiain","doi":"10.1159/000553241","DOIUrl":"10.1159/000553241","url":null,"abstract":"<p><strong>Introduction: </strong>Uveal melanoma (UM) is a rare malignancy in Latin America (LA), where coordinated clinical and translational research initiatives remain limited. We evaluated the implementation of a national referral and biobanking program for UM in Chile and assessed the feasibility of liquid biopsy workflows in a middle-income healthcare setting.</p><p><strong>Methods: </strong>We established a coordinated national clinical and translational research program for UM in Chile, integrating centralized referral, standardized workflows, biobanking, and longitudinal sampling. Patients were prospectively recruited through a national referral network between 2021 and 2025. Both solid tissue and liquid biopsy biospecimens were processed under standardized protocols and assessed for downstream molecular analyses.</p><p><strong>Results: </strong>A total of 45 patients with UM were recruited nationwide. A total of 76 biospecimen sets were processed with complete pre-analytical traceability. Profiling of plasma-derived cell-free DNA showed characteristic fragment patterns. Formalin-fixed paraffin-embedded (FFPE)-derived tumor DNA and paired non-tumor (matched) DNA met quality thresholds for next-generation sequencing (NGS). However, in this pilot setting, circulating tumor DNA (ctDNA) quantities were insufficient to consistently recover the full spectrum of tumor-associated genomic alterations identified in matched FFPE samples through NGS.</p><p><strong>Conclusions: </strong>This study demonstrates the feasibility of implementing a coordinated national clinical and translational research framework for UM within a middle-income healthcare setting with heterogeneous access to specialized molecular infrastructure. While standardized biospecimen collection and liquid biopsy workflows can be successfully established, limitations related to ctDNA abundance and persistent disparities in geographic and financial access to specialized care remain. This national model provides a scalable foundation for future multicenter studies, prospective biomarker validation, and biomarker-driven and molecularly informed studies in LA UM populations.</p>","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structured Clinicopathologic Data as a Prerequisite for Generalizable AI in Ocular Oncology.","authors":"Henry Bair, Mak Djulbegovic","doi":"10.1159/000552138","DOIUrl":"10.1159/000552138","url":null,"abstract":"","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13282120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Delay and Risk of Orbital Exenteration in Periocular Sebaceous Carcinoma.","authors":"Grant M Welk, Caroline Y Yu, Rachel Israilevich, Lauren A Dalvin, Andrea A Tooley","doi":"10.1159/000553091","DOIUrl":"10.1159/000553091","url":null,"abstract":"<p><strong>Introduction: </strong>This single-institution study characterizes outcomes in periocular sebaceous carcinoma and evaluates whether treatment delay is associated with orbital exenteration.</p><p><strong>Methods: </strong>Retrospective case series of all patients diagnosed with primary periocular sebaceous carcinoma between January 1, 2000, and December 31, 2022, at a single academic institution. Clinical, histopathologic, treatment, and outcome data were analyzed. Association between time to treatment and orbital exenteration was assessed using logistic regression.</p><p><strong>Results: </strong>The study included 25 patients (median age 76.6 years). Prior misdiagnosis occurred in 21 (84%), most commonly as chalazia (<i>n</i> = 7) or blepharitis (<i>n</i> = 6). Most tumors were AJCC T1, with predominantly poor or moderate differentiation. Mean time from presentation-to-treatment was 5.67 months (range 0.26-28.52 months), with a subset experiencing prolonged delays. Most patients underwent wide local excision (52%) or Mohs surgery (32%), with 4 (16%) requiring exenteration. Each 3-month increase in time to treatment was associated with 16% greater odds of orbital exenteration (OR: 1.16, 95% CI: 1.01-1.38; <i>p</i> = 0.042). Demographic and socioeconomic variables were not associated with differences in delays or outcomes. Median follow-up was 43 months, during which visual acuity remained stable in non-exenterated patients (median logMAR change -0.125). Local tumor recurrence occurred in 4 (16%) at a median of 26.46 months. Overall survival was 54.2% at 10 years, with no deaths attributed to sebaceous carcinoma.</p><p><strong>Conclusion: </strong>Treatment delay was associated with increased odds of orbital exenteration and not with measured socioeconomic factors. These findings suggest a potential relationship between time-to-treatment and extent of surgical management, with possible implications for vision preservation and quality of life.</p>","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproducibility of Perfusion-Weighted and Diffusion-Weighted Magnetic Resonance Imaging in Patients with Ocular Tumours.","authors":"Pieter A M Janssen, Teresa A Ferreira, T H Khanh Vu, Jan-Willem M Beenakker, Lisa Klaassen","doi":"10.1159/000552801","DOIUrl":"10.1159/000552801","url":null,"abstract":"<p><strong>Introduction: </strong>Diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) can assess biological tumour characteristics of uveal melanoma (UM), the most common primary intraocular malignant tumour in adults. Recent studies propose that these techniques can aid in the differential diagnosis, provide prognostic information, and enable early assessment of treatment response following radiation therapy. However, it is important to determine the extent to which any observed differences can be attributable to true biological changes in the tumour rather than day-to-day physiological or measurement variations. Therefore, this study aimed to assess the reproducibility of ocular DWI and PWI measurements between two centres.</p><p><strong>Method: </strong>In this prospective study, 15 patients with UM were included. Each patient underwent two MRIs at two different centres with a mean interval of 28 days (range: 12-43 days). Apparent diffusion coefficient (ADC), relative peak intensity, and outflow percentage of the tumour were compared between the two timepoints. Mean absolute differences between the two timepoints were calculated.</p><p><strong>Results: </strong>Mean absolute differences between the two timepoints were 0.07 × 10^-3 mm²/s (95% CI, 0.04-0.11) for ADC, 0.11 (95% CI, 0.04-0.18) for relative peak intensity, and 6 (95% CI, 3-10) percentage points for outflow percentage.</p><p><strong>Conclusion: </strong>This study shows that DWI and PWI parameters demonstrate reproducibility in UM patients between two different centres, with variabilities smaller than differences typically observed in differential diagnosis or treatment response assessments.</p>","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13423369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug Rechallenge after Immune Checkpoint Inhibitor-Induced Inflammation and Optic Nerve Disorders.","authors":"Julia Canestraro, Rebecca F Silverman, David H Abramson, Jasmine H Francis","doi":"10.1159/000550281","DOIUrl":"10.1159/000550281","url":null,"abstract":"<p><strong>Introduction: </strong>The aims of the study were to investigate clinical characteristics and spectrum of immune checkpoint inhibitor optic nerve disorders (ICI-OND), including ICI-optic neuritis (ICI-ON), ICI-optic disc edema (ICI-OE), ICI-optic perineuritis, and ICI-panuveitis; to understand the breadth of management options; to investigate long-term outcomes of these patients; and, importantly, to tackle the question of outcomes following rechallenge of these potentially life-preserving drug regimens.</p><p><strong>Methods: </strong>Retrospective analysis, single-center tertiary cancer hospital. Thirty-seven eyes in twenty consecutive patients with ICI-OND treated at Memorial Sloan Kettering Cancer Center between June 16, 2019, and June 5, 2025, were included.</p><p><strong>Results: </strong>In 37 eyes with ICI-OND, the majority of patients had painless loss of vision (85%), bilateral involvement (70%), dyschromatopsia (59%), abnormal testing: visual field (79%), retinal nerve fiber layer optical coherence tomography (80%), and magnetic resonance imaging (56%). Time to diagnosis occurred following a median of 4.5 drug cycles and was shorter with combination ICI (two ICI's) versus monotherapy (one ICI). The 3 patients with pain all had concurrent intraocular inflammation. Following steroid treatment and ICI cessation, vision was improved in 84% of eyes, stable in 11%, and declined in 5%. Snellen lines regained was associated with baseline vision (<i>p</i> = 0.0002). Five patients were rechallenged, and we did not see nor detect recurrence of ICI-OND in 4 patients; 1 patient had recurrence which resolved with steroids and vision returned to baseline.</p><p><strong>Conclusions: </strong>In the majority of cases, ICI-OND occurs bilaterally with painless vision decline and color vision deficits. Cessation of drug along with initiation of systemic steroids can improve vision to 20/40 or better in at least one involved eye, and although we included a smaller subset of patients, we found that ICI can be rechallenged after completion of steroids, without documented recurrence of ICI-OND in most patients.</p>","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":" ","pages":"69-80"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12893765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146181272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extraocular Extension in Melanoma at an Ocular Oncology Unit in Buenos Aires.","authors":"Carolina Gentile, Maria Valentina Ranno, Stephany Loraine Lucia Salcedo Camargo, Lucila Tajtelbaum, Juan Ignacio Simunovich Garnero, Charbel Viñolo Chaca, Paola De la Iglesia Niveyro","doi":"10.1159/000551168","DOIUrl":"10.1159/000551168","url":null,"abstract":"<p><strong>Introduction: </strong>Extrascleral extension (EOE) of uveal melanoma is a known negative prognostic factor, more frequently observed in medium to large tumors. Although EOE is typically limited in size, extensive cases present significant challenges in treatment planning, and the optimal management approach remains controversial. This study aimed to estimate the incidence of EOE in patients with uveal melanoma and analyze the prognosis of patients treated at the Italian Hospital of Buenos Aires from 2007 to June 2024.</p><p><strong>Methods: </strong>We conducted an observational, analytical, retrospective cohort study from 2007 to June 2024. Patients with EOE at diagnosis or during follow-up were identified. Epidemiological characteristics, tumor dimensions, timing of EOE, metastasis occurrence, and survival data were analyzed.</p><p><strong>Results: </strong>A total of 181 patients diagnosed with uveal melanoma were included, of whom twelve (6.62%) presented EOE, and 54.5% were male. The mean age was 64.41 years (SD 14.39). Six patients (50%) had EOE at diagnosis (average tumor thickness 9.51 mm, average diameter 17.7 mm), while six developed it during follow-up. The median time to event was 31.5 months (range: 8-120 months). Among these 12 patients, three developed metastases within the first year after diagnosis and treatment.</p><p><strong>Conclusions: </strong>EOE is a poor prognostic factor and tends to occur in larger tumors. It may be present at diagnosis or appear years later, reinforcing the need for long-term surveillance. Early identification is crucial to ensure appropriate treatment.</p>","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":" ","pages":"128-136"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uveal Melanoma: Changing Paradigms of Treatment.","authors":"Sophie Piperno-Neumann","doi":"10.1159/000549994","DOIUrl":"10.1159/000549994","url":null,"abstract":"<p><strong>Background: </strong>Despite effective management of the primary tumor, up to 50% of patients with uveal melanoma develop metastases, with poor outcomes.</p><p><strong>Summary: </strong>In 2022, tebentafusp became the first approved systemic therapy to improve overall survival in metastatic UM. Tebentafusp is an immune-modulating bispecific fusion protein restricted to HLA A02:01, using a T-cell receptor targeting glycoprotein 100, a melanocyte lineage-specific antigen expressed on UM cells, capable of recruiting and activating polyclonal CD3 T cells. Reduction in circulating tumor DNA is associated with improved survival across all response categories and may serve as a surrogate biomarker to guide treatment decisions. Tebentafusp's mechanism of action and safety profile support combination trials with regional or systemic therapies and its evaluation in the ATOM adjuvant study for high-risk UM patients. As half of the patients are HLA A02:01 negative, alternative strategies are under investigation, including the protein kinase C inhibitor darovasertib in the NADOM neoadjuvant/adjuvant trial and in combination with crizotinib in metastatic UM. DYP688, a first-in-class PMEL17-targeting antibody-drug conjugate that inhibits GNAQ/11 signaling, has shown promise in metastatic UM and other GNAQ/11-mutant melanomas.</p><p><strong>Key message: </strong>The landscape of UM treatment is rapidly evolving following the identification of new targets and pathways such as PKC or PRAME. Combination of liver-directed therapies with personalized systemic immunotherapies or targeted agents in the metastatic disease, as well as the early use of systemic therapies in the primary tumor setting will refine treatment strategies in UM and suggest improved outcomes in the near future.</p>","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":" ","pages":"107-116"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal Imaging Features of Bilateral Diffuse Uveal Melanocytic Proliferation: A Systematic Review of 82 Patients.","authors":"Almila Sarıgül Sezenöz, Aslan Aykut, Buse Güneri Beşer, Sarinee Juntipwong, Bernadete Ayres, Hakan Demirci","doi":"10.1159/000550536","DOIUrl":"10.1159/000550536","url":null,"abstract":"<p><strong>Introduction: </strong>Bilateral diffuse uveal melanocytic proliferation (BDUMP) is a rare paraneoplastic syndrome characterized by proliferation of benign melanocytes throughout the uveal tract. Our purpose was to quantify the prevalence of multimodal imaging findings in BDUMP and identify features that most reliably characterize this rare paraneoplastic syndrome.</p><p><strong>Methods: </strong>We conducted a systematic review following PRISMA 2020 guidelines, searching PubMed/MEDLINE, Web of Science, and Embase through September 2025. We included case reports and series providing patient-level data on BDUMP with associated imaging. Prevalence rates were calculated using a documented denominator approach with 95% Wilson score confidence intervals.</p><p><strong>Results: </strong>Sixty-seven studies encompassing 82 patients were included. Median age was 67 years (range 35-88); 54.9% were female. Gynecologic (25.9%), gastrointestinal (22.2%), and lung (17.3%) cancers were most common. Optical coherence tomography revealed retinal pigment epithelium irregularities in 91.8% and subretinal fluid in 90.2% of patients, exceeding the prevalence of classical orange-red patches on fundus photography (82.6%). Fundus autofluorescence showed alternating hypo/hyperautofluorescence in 76.6%. Choroidal thickening was present in 88.9% on ultrasonography. Bacillary layer detachment was identified in 16.4% of cases.</p><p><strong>Conclusion: </strong>OCT-based structural abnormalities are more consistently present than Gass's classical funduscopic signs. These quantitative data may assist earlier recognition of BDUMP and suggest that updated diagnostic criteria should incorporate multimodal imaging findings.</p>","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":" ","pages":"117-127"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12987679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intractable Elevated Intraocular Pressure during Plaque Brachytherapy for Posterior Choroidal Tumors: A Case Report.","authors":"Mohamed Belmouhand, Jens Folke Kiilgaard, Carsten Faber","doi":"10.1159/000550817","DOIUrl":"10.1159/000550817","url":null,"abstract":"<p><strong>Introduction: </strong>Uncontrolled elevated intraocular pressure (IOP) during brachytherapy for posterior choroidal tumors is unreported. We present 2 patients who both experienced intractable elevated IOP during plaque brachytherapy.</p><p><strong>Case presentation: </strong>Both patients experienced persistent elevated IOP unresponsive to all pressure-lowering agents following surgery that included transvitreal retinochoroidal biopsy and ruthenium-106 plaque application for posterior choroidal tumors in the superior quadrants. During plaque placement in patient 1, a large, dilated vortex vein was observed in the area where the plaque was to be placed. After plaque removal in both patients, IOP normalized without the need for additional pressure-lowering therapy.</p><p><strong>Conclusion: </strong>We hypothesize that the clinical presentation in both patients was primarily attributable to two factors: first, pre-existing venous congestion and, second, the application of a plaque, which obstructed a superior vortex vein. This left the remaining vortex veins unable to compensate for the obstruction, leading to intractable IOP during plaque brachytherapy.</p>","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":" ","pages":"103-106"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13008412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}