Late Complications of Radiation Therapy in Uveal Melanoma

Plaque brachytherapy and other radiation treatments have become an increasingly popular option for primary treatment of uveal melanoma since the publication of results from the Collaborative Ocular Melanoma Study. Radiation therapy, however, can cause direct or indirect damage to important ocular structures outside of the tumor, especially to the lens, retina, and optic nerve. Recent advancements in plaque brachytherapy technology have allowed for the reduction of iatrogenic injury, though some radiation damage is still unavoidable and follow-up treatment options are limited. Before treating with plaque brachytherapy or other radiation options, physicians must evaluate tumor-and patient-level risk factors for extensive radiation damage and discuss the risks and benefits of such a treatment with patients. In the years following radiation therapy for uveal melanoma, patients should also be followed closely by an ophthalmologist to assess for the delayed onset of radiation damage.