Characteristics and Outcomes of 237 Juxtapapillary Choroidal Melanomas Treated with Iodine-125 Plaque Brachytherapy

ntroduction:Juxtapapillary uveal melanomas limit plaquebrachytherapy treatment using the standard 2 mmmargin and are often excluded from prospective studiesthus limiting data on outcomes and complications. Weretrospectively evaluated outcomes in this tumor pop-ulation following primary iodine-125 plaque brachyther-apy.Methods:We performed a retrospective review over30 years of patients treatedwith iodine-125 plaque bra-chytherapy for juxtapapillary uveal melanoma at a singlecenter.Results:Patients were white (97%), male (53.2%),62 years old (median age, median follow-up of 4.1 years),with right eye involvement (54.4%). At 1, 5, and 10 years,local recurrence was observed in 2.2%, 10%, and 24.6%,enucleation in 0.05%, 11.3%, and 22.1%, metastasis in1.3%, 6.7%, and 14.2%, and mortality in 1.8%, 14.9%, and32.8%, respectively. Median visual acuity declined fromLogMAR 0.1 to 2.0 at last visit. Radiation retinopathy andoptic neuropathy were seen in 54.9% and 46%, respec-tively, of patients by a median of 742 days (2.03 years) and1,011.5 days (2.77 years).Conclusions:Juxtapapillarymelanomas demonstrated higher rates of vision loss andlocal recurrence following plaque brachytherapy com-pared with other tumor configurations. Enucleation, dis-tant metastasis, and overall mortality were comparable tothose reported for non-juxtapapillary melanomas.(c) 2025 S. Karger AG, Basel