Brachytherapy of Choroidal Melanomas Less Than 10 mm in Largest Basal Diameter Comparison of 10-mm and 15-mm Ruthenium Plaques

Purpose: To compare tumor control, vision, and complications between patients with a choroidal melanoma of Design: Retrospective, comparative case series. Participants: One hundred sixty-four consecutive patients with a choroidal melanoma of Methods: Diagnosis was based on growth or high-risk characteristics. The apical dose was 100 to 120 Gy aiming to deliver >= 250 Gy to the sclera. Plaque positioning was modeled retrospectively. An increase of >= 0.3 mm in thickness and >= 0.5 mm in LBD indicated local recurrence. Outcomes were compared with cumulative incidence analysis and Cox regression. Median follow-up time for patients still alive was 8.4 years. Main Outcome Measures: Recurrence rate, low vision, blindness, radiation maculopathy, and optic neuropathy. Results: Melanomas treated with the 10-mm plaque were smaller (median thickness, 1.9 mm vs. 2.6 mm; LBD, 7.1 mm vs. 8.6 mm) and located closer to foveola (median, 2.0 mm vs. 2.8 mm) than those treated with the 15-mm plaque (P