Kellner U, Bornfeld N, Foerster M H
FU Berlin, Klinikum Steglitz, Augenklinik und Poliklinik, Hindenburgdamm, Germany.
Graefes Arch Clin Exp Ophthalmol. 1993 May;231(5):267-70. doi: 10.1007/BF00919103.
In a prospective study the incidence of optic neuropathy following 106Ru/106Rh-brachytherapy of uveal melanomas was evaluated. Pattern visual evoked potentials (VECP) were measured before radiation and at regular follow-up intervals. Patients were grouped according to tumor location in peripheral melanomas with a central tumor margin of more than 60 degrees to the optic disc (n = 11) and central melanomas with a tumor within 15 degrees to the optic disc (n = 28). No patient with peripheral tumor had clinical signs of optic neuropathy or pathological VECPs after radiation. In patients with central melanomas clinical signs were seen in 5/28 (18%), but pathological VECPs developed in 14/28 (50%). The visual loss after radiation was greater in patients with pathological VECPs (P < 0.03). Radiation-induced optic nerve damage depends on tumor location and is more frequent than clinically expected.
在一项前瞻性研究中，评估了106Ru/106Rh近距离放射治疗葡萄膜黑色素瘤后视神经病变的发生率。在放疗前及定期随访时测量图形视觉诱发电位（VECP）。根据肿瘤位置将患者分组，外周黑色素瘤患者的肿瘤中心边缘与视盘夹角超过60度（n = 11），中心黑色素瘤患者的肿瘤位于视盘15度范围内（n = 28）。外周肿瘤患者放疗后均无视神经病变的临床体征或VECP异常。中心黑色素瘤患者中，5/28（18%）出现临床体征，但14/28（50%）出现VECP异常。VECP异常的患者放疗后的视力丧失更严重（P < 0.03）。放疗引起的视神经损伤取决于肿瘤位置，且比临床预期更常见。
