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Berry DE, Grewal DS, Mruthyunjaya P. Conjunctival Dehiscence and Scleral Necrosis following Iodine-125 Plaque Brachytherapy for Uveal Melanoma: A Report of 3 Cases. Ocul Oncol Pathol. 2018;4(5):291-296doi: 10.1159/000481858.
Berry, D. E., Grewal, D. S., & Mruthyunjaya, P. (2018). Conjunctival Dehiscence and Scleral Necrosis following Iodine-125 Plaque Brachytherapy for Uveal Melanoma: A Report of 3 Cases. Ocular oncology and pathology, 4(5), 291-296. https://doi.org/10.1159/000481858
Berry, Duncan E, et al. "Conjunctival Dehiscence and Scleral Necrosis following Iodine-125 Plaque Brachytherapy for Uveal Melanoma: A Report of 3 Cases." Ocular oncology and pathology vol. 4,5 (2018): 291-296. doi: https://doi.org/10.1159/000481858
Berry DE, Grewal DS, Mruthyunjaya P. Conjunctival Dehiscence and Scleral Necrosis following Iodine-125 Plaque Brachytherapy for Uveal Melanoma: A Report of 3 Cases. Ocul Oncol Pathol. 2018 Sep;4(5):291-296. doi: 10.1159/000481858. Epub 2018 Feb 13. PMID: 30320099; PMCID: PMC6167656.
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Ocul Oncol Pathol. 2018 Sep;4(5):291-296. doi: 10.1159/000481858. Epub 2018 Feb 13.

Conjunctival Dehiscence and Scleral Necrosis following Iodine-125 Plaque Brachytherapy for Uveal Melanoma: A Report of 3 Cases.

Ocular oncology and pathology

Duncan E Berry, Dilraj S Grewal, Prithvi Mruthyunjaya

Affiliations

  1. Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina, USA.
  2. Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, California, USA.

PMID: 30320099 PMCID: PMC6167656 DOI: 10.1159/000481858

Abstract

BACKGROUND/AIMS: Plaque brachytherapy is currently the most common treatment for uveal melanoma and has many known potential complications. Here we present 3 cases of early conjunctival and scleral necrosis following iodine-125 plaque.

METHODS: This study was conducted as a retrospective case series.

RESULTS: We identified 3 cases of early conjunctival and scleral necrosis following iodine-125 plaque. All patients were managed conservatively with resolution of the necrosis.

CONCLUSIONS: While delayed corneoscleral necrosis following plaque brachytherapy has been previously reported, occurring many months to years after treatment, the 3 cases in this series presented within 2-6 weeks in the postoperative period. While we were unable to identify a specific etiology, we believe this represents a distinct clinical entity of post-brachytherapy cornea-scleral necrosis that is important to recognize. Possible causes include acute radiation toxicity, mechanical trauma, and/or conjunctival microinfection.

Keywords: Choroidal melanoma; Conjunctival dehiscence; Plaque brachytherapy; Uveal melanoma

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