[Exudative retinal detachment surgery. A prognostic++ parameter of malignant melanoma in brachytherapy?]

The purpose of this study was to compare the regression of the tumor-distant exudative detachment that accompanies malignant melanoma with regression of the tumor as a result of ruthenium-106 irradiation.

From 1994 until the beginning of 1996 we treated 28 patients with choroidal malignant melanoma with radioactive plaque therapy. Follow-up examinations were completed 3 and 6 weeks, 3, 6 and 12 months after therapy and finally at 1 year or half-year intervals. Twenty-three patients met the study requirements.

Initially, after irradiation there was an increase in the retinal detachment. In 15 patients (65%) we found rapid regression of the detachment, accompanied by distinct tumor regression (61%). One of these patients revealed only minor tumor regression in spite of regression of the exudative detachment. Three months after radiation, 8 patients showed no rapid regression of the exudative detachment. Two of these patients had to undergo a second irradiation and 2 were enucleated because of absent tumor regression. One patient died. Three patients showed an increase in the detachment, accompanied by tumor regression.

Rapid regression of the exudative detachment (> or = 50% of the preoperative detachment) approximately 3 months after irradiation seems to be of good prognostic value for tumor regression.