British Journal of Ophthalmology最新文献

{"title":"Genome-wide association study of anterior uveitis","authors":"Fredrika Koskimäki, Oona Ahokas, Risto Kajanne, Krista-Roberta Saviauk, Abdelrahman Elnahas, Anu Reigo, Kadri Reis, Tõnu Esko, Priit Palta, Sanna Leinonen, Johannes Kettunen, Johanna Liinamaa, Minna K Karjalainen, Ville Saarela, Estonian Biobank Research Team Consortium","doi":"10.1136/bjo-2024-326037","DOIUrl":"https://doi.org/10.1136/bjo-2024-326037","url":null,"abstract":"Background/aims The purpose of this study is to define genetic factors associated with anterior uveitis through genome-wide association study (GWAS). Methods In this GWAS meta-analysis, we combined data from the FinnGen, Estonian Biobank and UK Biobank with a total of 12 205 anterior uveitis cases and 917 145 controls. We performed a phenome-wide association study (PheWAS) to investigate associations across phenotypes and traits. We also evaluated genetic correlations of anterior uveitis. Results We identified six anterior uveitis-associated loci. Genome-wide significant (p<5 × 10−8) associations were identified for the first time at three loci (innate immunity activator ( INAVA) , nucleotide-binding domain, leucine-rich repeat family, pyrin domain containing 3 and nitric oxide synthase 2). We detected associations at three loci previously reported to be associated with uveitis (endoplasmic reticulum aminopeptidase 1 ( ERAP1) , the trinucleotide repeat containing 18 ( TNRC18) and the HLA region) and also replicated associations at two loci previously associated with acute anterior uveitis ( IL23R and HDAC2-AS2 ). In PheWAS, we further detected that lead single nucleotide polymorphisms (SNPs) at three of the anterior uveitis-associated loci ( ERAP1 , INAVA and TNRC18 ) are associated with other immunity-related phenotypes, including ankylosing spondylitis and inflammatory bowel disease. Additionally, we detected a moderate genetic correlation between anterior uveitis and inflammatory bowel disease ( rg =0.39, p=8 × 10−5). Conclusion We identified six anterior uveitis-associated loci, including three novel loci with genome-wide significance. Our findings deepen our understanding of the genetic basis of anterior uveitis and the genetic connections between anterior uveitis and immune-related disorders, providing a foundation for further research and potential therapeutic interventions. Data are available upon reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"14 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142887475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CMV corneal endotheliitis","authors":"Vishal Jhanji","doi":"10.1136/bjo-2024-326866","DOIUrl":"https://doi.org/10.1136/bjo-2024-326866","url":null,"abstract":"When corneal endotheliitis was first reported by Khodadoust and Attarzadeh in 1982, it was thought to be caused by an autoimmune process.1 The clinical presentation was similar to corneal allograft rejection due to the presence of linear corneal keratic precipitates (KPs). PCR testing in a patient with a similar clinical presentation in Japan led to discovery of the herpes simplex virus.2 Later, Koizumi et al detected cytomegalovirus (CMV) DNA in a case of corneal endotheliitis.3 CMV endotheliitis is a unique entity. The pathogenesis of CMV corneal endotheliitis is unknown. The clinical presentation is characterised by KPs and local corneal oedema eventually leading to corneal endothelial cell damage and bullous keratopathy. The diagnosis is confirmed by the presence of CMV DNA in the anterior chamber. The …","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"120 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of cytomegalovirus corneal endotheliitis postcorneal transplantation","authors":"Mako Watanabe, Koji Kitazawa, Hideki Fukuoka, Koichi Wakimasu, Tsutomu Inatomi, Kengo Yoshii, Noriko Koizumi, Shigeru Kinoshita, Chie Sotozono","doi":"10.1136/bjo-2024-326055","DOIUrl":"https://doi.org/10.1136/bjo-2024-326055","url":null,"abstract":"Purpose This study was designed to investigate risk factors for the development of cytomegalovirus (CMV) corneal endotheliitis following corneal transplantation. Methods We retrospectively analysed 1225 corneal transplants for bullous keratopathy between 2011 and 2021. 31 cases who were administered the treatment of CMV corneal endotheliitis preoperatively were excluded, and 1194 cases were analysed for risk factors for the development of CMV corneal endotheliitis following corneal transplantation. Results Among 1194 cases, 15 cases (1.26%) occurred CMV corneal endotheliitis after corneal transplantation. Coin-shaped lesion or keratoprecipitates were observed in 100% of cases. Postoperatively, the mean onset of CMV corneal endotheliitis was 9.9±12.2 months, with 12 eyes (80.0%) within the first 12 months. Multivariate analysis adjusted for potential confounding factors revealed a gender (male, OR (8.42, 95% CI: 2.19 to 56.00), the previous history of anterior uveitis (OR: 25.31, 95% CI: 8.22 to 95.19) and the previous history of glaucoma (OR: 6.25, 95% CI: 1.17 to 115.90) were significantly associated with the development of postoperative CMV corneal endotheliitis. The maternal proportion Ryan multiple comparison tests revealed that dual previous history with glaucoma and anterior uveitis significantly enhanced the development of postoperative CMV corneal endotheliitis (p<0.001). Conclusions CMV corneal endotheliitis developed postcorneal transplantation with coin-shaped lesions. Careful postoperative follow-up, especially within the first 12 months after surgery, is necessary for patients with a history of glaucoma or anterior uveitis. Data are available upon reasonable request. The data that support the findings of this study are available from Kyoto Prefectural University of Medicine upon reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"82 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metastatic conjunctival melanoma: a multicentre international study","authors":"Puneet Jain, Paul T Finger, Maria Filì, Bertil Damato, Sarah E Coupland, Heinrich Heimann, Nihal Kenawy, Niels J Brouwer, Marina Marinkovic, Sjoerd van Duinen, Jean-Pierre Caujolle, Celia Maschi, Stefan Seregard, David E Pelayes, Martin Folgar, Yacoub Yousef, Hatem Krema, Brenda Gallie, Carlos Alberto Calle Vasquez","doi":"10.1136/bjo-2024-326043","DOIUrl":"https://doi.org/10.1136/bjo-2024-326043","url":null,"abstract":"Background To reveal clinical findings related to metastatic conjunctival melanoma. Methods 10 ophthalmic oncology centres (9 countries and 4 continents) shared data to create a large clinical case series. The main outcome measures were the incidence and cumulative risk of systemic metastasis, study mortality rates and Kaplan-Meier patient mortality after developing conjunctival melanoma metastasis. Results Of 288 patients, 29 developed metastasis. Five had metastasis at presentation, were American Joint Committee on Cancer (AJCC) cT3-category and exhibited tumour-surface ulceration. Four of five (80%) had melanotic tumours with plical and/or caruncular involvement and died within 1 year. One survived 21 months. In contrast, 24 developed metastases during follow-up (mean 4.6±3.2 years). Their primary tumours were cT1 (n=13/24, 54.1%), cT2 (n=6/24, 25%), cT3 (n=2/24, 8.3%) and 3 cTx (12.5%) at presentation. Death had occurred in 17 patients (n=17/24, 71%) by the end of the study. The cumulative risk of systemic metastasis after treatment was 0.4% (95% CI 0.6% to 2.9%) at 1 year, 8.6% (95% CI 5.1% to 14.3%) at 5 years and 22.3% (95% CI 14.5% to 33.5%) at 10 years. Each increase in AJCC cT category was associated with an 89% higher risk for metastasis (HR=1.89, p<0.001). Among all 29 patients who developed metastasis, those who presented with AJCC cT3 disease were at highest risk (p<0.001). Liver and lung (n=13 each) were the most reported metastatic sites. Conclusion Metastatic conjunctival melanoma was found in 10% of conjunctival melanoma patients. Tumour-specific characteristics including AJCC cT3-category, conjunctival location and surface ulceration were associated with metastatic risk. Survival durations were shorter for those presenting with metastasis. All data relevant to the study are included in the article or uploaded as online supplemental information.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"64 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142841621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optic nerve sheath enhancement on orbital MRI in giant cell arteritis.","authors":"Rebka K Ephrem, Suyash Mohan, Ryan Rebello, Rui Liang, Robert Kurtz, Jae W Song, Madhura A Tamhankar, Rennie L Rhee","doi":"10.1136/bjo-2024-326608","DOIUrl":"10.1136/bjo-2024-326608","url":null,"abstract":"<p><strong>Background: </strong>Differentiating arteritic anterior ischaemic optic neuropathy (A-AION) due to giant cell arteritis (GCA) from non-arteritic anterior ischaemic optic neuropathy (NA-AION) may pose a diagnostic challenge. Our study aimed to assess the use of standard orbital MRI in distinguishing ocular manifestations of GCA from NA-AION.</p><p><strong>Methods: </strong>This study included 25 consecutive patients (11 GCA, 14 NA-AION) who underwent contrast-enhanced orbital MRIs within 3 months of symptom onset. Two radiologists blinded to clinical data independently evaluated MRIs for the enhancement of the optic nerve sheath (ONS) and other orbital structures.</p><p><strong>Results: </strong>On orbital MRI, ONS enhancement of at least one eye was more common in patients with GCA than NA-AION (64% vs 14%, p=0.02). ONS enhancement on MRI was seen in patients with typical ophthalmologic exam findings of A-AION as well as in GCA patients with other features of ocular ischaemia (eg, retinal artery occlusion). Among patients with GCA, ONS enhancement was bilateral in six of seven cases even when visual symptoms and signs were unilateral.</p><p><strong>Conclusion: </strong>Patients with ocular GCA are more likely to have ONS enhancement on MRI compared with NA-AION. ONS enhancement was observed in (i) A-AION and other forms of ocular ischaemia, demonstrating the potential value of MRI in multiple orbital pathologies in GCA, and (ii) both the affected and unaffected eye, suggesting MRI may detect early subclinical ocular disease in GCA. These results highlight the potential value of adding orbital MRI to the diagnostic workup of ocular GCA.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognosis for patients with metastatic conjunctival melanoma","authors":"Bita Esmaeli","doi":"10.1136/bjo-2024-326271","DOIUrl":"https://doi.org/10.1136/bjo-2024-326271","url":null,"abstract":"Conjunctival melanoma is a rare ocular cancer, and despite recent advances in the early detection of metastasis and the availability of new drugs such as immune checkpoint inhibitors and Braf-directed targeted therapy that have demonstrated efficacy for the treatment of metastatic conjunctival melanoma,1 it remains a significant cause of morbidity and mortality worldwide. Jain et al report on 29 patients with metastatic conjunctival melanoma.2 These 29 patients represent about 10% of the 288 patients with conjunctival melanoma included in this retrospective review based on data pooled from 10 international centres from a wide geographic area of the world. ‘Metastasis’ is defined as ‘M1’ per the American Joint Commission on Cancer (AJCC) definition and as such only addresses distant (hematogenous) metastasis. In other words, the stated primary objective of the report is to focus on patients who developed hematogenous distant metastasis although the authors provide some information regarding nodal metastasis in the same group of patients. Among the 29 patients with systemic metastasis, five (17%) were found at the time of the initial presentation, while 24 (83%) were …","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"23 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142841232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of macular neovascularisation characteristics for photoreceptor integrity in nAMD: a prospective observational study.","authors":"Jiaxin Pu, Xuenan Zhuang, Miaoling Li, Xinlei Hao, Guiqin He, Yongyue Su, Yuhong Gan, Xiongze Zhang, Yuying Ji, Lan Mi, Yining Zhang, Ruijun Yang, Xuelin Chen, Feng Wen","doi":"10.1136/bjo-2024-326319","DOIUrl":"10.1136/bjo-2024-326319","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the relationship between characteristics of macular neovascularisation (MNV) and photoreceptor integrity in patients with neovascular age-related macular degeneration (nAMD).</p><p><strong>Methods: </strong>This prospective study enrolled treatment-naïve nAMD eyes and conducted a 3-month follow-up. 16 quantitative MNV features were evaluated using optical coherence tomography angiography, and the impaired areas of ellipsoid zone (EZ), external limiting membrane (ELM) and outer nuclear layer (ONL) were obtained using optical coherence tomography. Correlation and regression analyses assessed the relationships between MNV features and photoreceptor integrity.</p><p><strong>Results: </strong>110 nAMD eyes from 110 patients (73.64% men) were included. Baseline MNV characteristics, including MNV perimeter, maxFeret, minFeret, vessel area, total vessel length, total number of junctions and endpoints, and mean E lacunarity, were positively correlated with photoreceptor damage areas (r ranging from 0.227 to 0.558, p<0.05 for all). Meanwhile, vessel density negatively correlated with photoreceptor damage (r=-0.468 for EZ, -0.394 for ELM and -0.538 for ONL, all p<0.05). After the loading phase, the EZ prognosis was independently associated with baseline MNV minFeret (Std β=0.362, p=0.011) and mean E lacunarity (Std β=0.130, p=0.041). The prognosis for ELM was independently linked to baseline MNV minFeret (Std β=0.373, p=0.014), while no significant factors were found to influence ONL prognosis (p>0.05 for all).</p><p><strong>Conclusion: </strong>A strong correlation was observed between MNV features and photoreceptor integrity, with larger and more complex vascular networks associated with greater photoreceptor damage.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methotrexate versus conventional disease-modifying antirheumatic drugs in the treatment of non-anterior sarcoidosis-associated uveitis.","authors":"Mathilde Leclercq, Pascal Sève, Lucie Biard, Mathieu Vautier, Georgina Maalouf, Gaëlle Leroux, Fanny Domont, Adélaïde Toutée, Christine Fardeau, Thomas Sales de Gauzy, Sara Touhami, Laurent Kodjikian, Patrice Cacoub, Bahram Bodaghi, David Saadoun, Anne-Claire Desbois","doi":"10.1136/bjo-2024-325163","DOIUrl":"10.1136/bjo-2024-325163","url":null,"abstract":"<p><strong>Aims: </strong>To compare the safety and efficacy of methotrexate (MTX), mycophenolate mofetil (MMF) and azathioprine (AZA) in non-anterior sarcoidosis-associated uveitis.</p><p><strong>Methods: </strong>Retrospective study including non-anterior sarcoidosis-associated uveitis according to the revised International Workshop on Ocular Sarcoidosis criteria. The primary outcome was defined as the median time to relapse or occurrence of serious adverse events leading to treatment discontinuation.</p><p><strong>Results: </strong>58 patients with non-anterior sarcoidosis-associated uveitis (MTX (n=33), MMF (n=16) and AZA (n=9)) were included. The time to treatment failure (ie, primary outcome) after adjustment for corticosteroids dose and the presence of vasculitis was significantly higher with MTX (median time of 34.5 months with MTX (IQR: 11.8 -not reached) vs 8.4 months (3.1-22.9) with MMF and 16.8 months (8.0-90.1) with AZA (p=0.020)). The risk of relapse at 12 months was more than twice lower in MTX as compared with MMF (p=0.046). Low visual acuity at the last visit was significantly lower with MTX (4% vs 9% in MMF vs 57% in AZA group (p=0.008)). Regarding all 75 lines of treatment (MTX (n=39), MMF (n=24) and AZA (n=12)), MTX was more effective than MMF and AZA to obtain treatment response at 3 months (OR 10.85; 95% CI 1.13 to 104.6; p=0.039). Significant corticosteroid-sparing effect at 12 months (p=0.035) was only observed under MTX. Serious adverse events were observed in 6/39 (15%), 5/24 (21%) and 2/12 (17%) with MTX, MMF and AZA, respectively.</p><p><strong>Conclusion: </strong>In non-anterior sarcoidosis-associated uveitis, MTX seems to be more efficient compared with AZA and MMF and with an acceptable safety profile.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"34-40"},"PeriodicalIF":3.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment exit options for non-infectious uveitis registry: participant characteristics at 3 years.","authors":"David Julian Fink, Jennifer Dell, Carsten Heinz, Maximilian W M Wintergerst, Tobias Höller, Moritz Berger, Matthias Schmid, Karl Thomas Boden, Uwe Pleyer, Herbert Reitsamer, Christoph M E Deuter, Tibor K Lohmann, Robert P Finger","doi":"10.1136/bjo-2023-324927","DOIUrl":"10.1136/bjo-2023-324927","url":null,"abstract":"<p><strong>Purpose: </strong>The Treatment exit Options For non-infectious Uveitis (TOFU) registry documents disease courses for non-anterior non-infectious uveitis entities with and without treatment to generate more evidence for clinical management recommendations including treatment exit strategies. In this article, we present the participants' baseline characteristics after the first 3 years.</p><p><strong>Methods: </strong>TOFU is an observational, prospective registry and recruits patients ≥18 years of age with non-anterior non-infectious uveitis with or without a history of previous disease-modifying antirheumatic drugs (DMARDs) treatment. The data are collected in the electronic data capture software REDCap and include ophthalmological and general medical history as well as clinical findings.</p><p><strong>Results: </strong>Between 24.10.2019 and 27.12.2022, 628 patients were enrolled at 25 clinical sites in Germany and Austria. Patients with intermediate uveitis were most frequently included (n=252; 40.1%) followed by posterior uveitis (181; 28.8%), panuveitis (n=154; 24.5%) and retinal vasculitis (n=41, 6.5%). At baseline, 39.6% were treated with systemic corticosteroids, 22.3% with conventional synthetic (cs) DMARDs, 20.5% with biological (b) DMARDs and 3.6% with other systemic treatments. Average best corrected visual acuity (BCVA) was 0.69 decimal. Patients with panuveitis had the worst BCVA with 0.63 decimal. Overall, only 8 patients (1.3%) suffered from severe visual impairment.</p><p><strong>Conclusions: </strong>Less than half of participants required DMARD treatment at baseline, with csDMARDs used more frequently than bDMARDs. The presence of severe visual impairment was low, mostly affecting patients with panuveitis. These findings are in line with comparable monocentric cross-sectional studies of tertiary uveitis centres in Germany and will allow us to generate generalisable evidence in TOFU.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"27-33"},"PeriodicalIF":3.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Local tumour control and patient survival after ruthenium-106 brachytherapy for small choroidal melanoma.","authors":"Beatrice Gallo, Rohan Hussain, Ranaa Al-Jamal, Hagar Khalid, Ian Stoker, Gordon Hay, Amit K Arora, Peter W Szlosarek, Mandeep S Sagoo","doi":"10.1136/bjo-2023-324687","DOIUrl":"10.1136/bjo-2023-324687","url":null,"abstract":"<p><strong>Aim: </strong>To report local tumour control, metastasis and survival rates of patients with small choroidal melanoma (CM) after treatment with ruthenium-106 (Ru-106) plaque brachytherapy.</p><p><strong>Methods: </strong>Retrospective case series of 353 consecutive eyes with small CM (thickness ≤2.5 mm and largest basal diameter ≤16 mm) treated with Ru-106 brachytherapy at the London Ocular Oncology Service, between October 2004 and May 2019.</p><p><strong>Results: </strong>The final cohort included 310 eyes and tumour recurrence was observed in 52 (17%) eyes. Ocular retention rate was 96%. Metastatic disease and tumour-related death occurred in 18 (5.8%) and 12 (3.9%) patients, respectively. Metastases were diagnosed after a median of 54 (54±35; range 3.6-118) months from initial treatment. Kaplan-Meier estimates for tumour recurrence, melanoma-related metastases and survival were 17% (95% CI 13.3% to 22.9%), 4.8% (95% CI 2.6% to 8.5%) and 98% (95% CI 94.4% to 99.1%) at 5 years and 26% (95% CI 18.3% to 35.3%), 16% (95% CI 8.7% to 27.7%) and 92% (95% CI 84.5% to 95.7%) at 10 years, respectively. On multivariable analysis, factors predictive for tumour recurrence included juxtapapillary location, larger plaque and final tumour thickness, and for metastasis exudative retinal detachment.</p><p><strong>Conclusion: </strong>Small CMs treated with Ru-106 brachytherapy show recurrence and death rates of 17% and 2% at 5 years and 26% and 8% at 10 years. As small CMs have better prognosis than large tumours, early treatment is the key for better survival outcomes.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":"76-82"},"PeriodicalIF":3.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141533604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}