[Choroidal melanoma treated by protontherapy: anatomical and functional results at Strasbourg University Medical...

To report anatomical and functional results of choroidal melanoma treated by protontherapy between 2001 and 2011 and to compare these with data reported in the literature.

The present study is a retrospective review of the charts of patients presenting with choroidal melanoma, managed at Strasbourg University Medical Center between 2001 and 2011, and receiving protontherapy. Visual acuity and a complete ophthalmologic examination, including intraocular pressure, dilated fundus exam, and ultrasonography with measurement of the major diameter of the tumor, were performed prior to treatment and at various follow-up visits (every six months for five years, then once a year for ten years). The rates and timing of local complications (cataract, rubeosis, retinal detachment, neovascular glaucoma and secondary enucleation) and systemic complications (metastasis) are also reported.

Seventy charts were included. Mean age of the treated population was 61.4 ± 15.2 years. Male/female ratio was 1.06. Mean visual acuity, 0.55 ± 0.6 (20/67) on presentation, decreased progressively from month 42. Mean tumor thickness was 5.8 ± 2.8mm and major diameter 11.2 ± 2.9 mm. Decreased tumor thickness was noted beginning at month 12 of follow-up (Anova, P<0.0001), while major diameter remained unchanged over time (P>0.05). The risk of complications (retinal detachment, rubeosis, neovascular glaucoma) was greater between the second and third year. Mean 5-year survival was 87.5%. The rate of secondary enucleation was 8.5%.

Protontherapy most often allows for preservation of the globe. Visual loss, often significant and permanent, is frequent.