Visual outcomes of macular melanocytic lesions after early or delayed proton beam therapy - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Graefe's Archive for Clinical and Experimental Ophthalmology Année : 2023

Visual outcomes of macular melanocytic lesions after early or delayed proton beam therapy

Maxime Nhari
  • Fonction : Auteur
Laurent Kodjikian
  • Fonction : Auteur
Samuel Chacun
  • Fonction : Auteur
Anh-Minh Nguyen
  • Fonction : Auteur
Laurence Rosier
  • Fonction : Auteur
Joël Herault
  • Fonction : Auteur
Julia Salleron
  • Fonction : Auteur
Thibaud Mathis
  • Fonction : Auteur

Résumé

PurposeDuring their initial management, some macular melanocytic lesions can be closely monitored to wait for a documented growth before advocating a treatment by irradiation. However, the visual outcomes of this strategy have not yet been assessed. This study compares the visual outcomes of macular melanocytic lesions that underwent delayed proton beam therapy (PBT) after an initial observation to those treated early.MethodsA total of 162 patients with suspicious melanocytic lesions whose margins were located within 3 mm of the fovea were recruited from two French ocular oncology centers.ResultsOverall, 82 patients treated with PBT within 4 months after the initial visit (early PBT group) were compared to 24 patients treated with delayed PBT (delayed PBT group) and 56 patients not treated with PBT (observation group). Visual acuity was not significantly different between baseline and last visit in the observation group (p = 0.325). Between baseline and last visit, the median [IQR] loss in visual acuity was significant in both the early (0.7 [0.2; 1.8], p < 0.001) and the delayed (0.5 [0.2; 1.5], p < 0.001) PBT groups. After irradiation, there was no significant difference between the early and delayed PBT groups for visual loss (p = 0.575), diameter reduction (p = 0.190), and thickness lowering (p = 0.892). In multivariate analysis, history of diabetes mellitus and Bruch's membrane rupture remained significantly associated with greater visual loss (p = 0.036 and p = 0.002, respectively).ConclusionFor small lesions in which there is no clear diagnosis of malignant melanoma, an initial close monitoring to document tumor growth does not impact visual prognosis, despite the potential complications associated with the untreated tumor. However, the survival should remain the main outcome of the treatment of these lesions.
Fichier non déposé

Dates et versions

hal-04003990 , version 1 (24-02-2023)

Identifiants

Citer

Maxime Nhari, Juliette Thariat, Laurent Kodjikian, Samuel Chacun, Anh-Minh Nguyen, et al.. Visual outcomes of macular melanocytic lesions after early or delayed proton beam therapy. Graefe's Archive for Clinical and Experimental Ophthalmology, 2023, 261, pp.2049-2059. ⟨10.1007/s00417-023-05981-x⟩. ⟨hal-04003990⟩
15 Consultations
0 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More