Influenz of networks in the ICG-angiography on post irradiation regression rate of uveal melanomas

98^th Annual Meeting DOG 2000

K 102

Influence of networks in the ICG angiography on post irradiation egression rate of uveal melanomas

U. C. Schaller¹, A. J. Mueller¹, D.-U. Bartsch², W. R. Freeman², A. Kampik¹

Introduction: The post irradiation regression rate of uveal melanomas is prognostically significant factor for the developement of metastases (Augsburger: Ophthalmology (1987) 94:1173-1177). Other predicting factors for metastases are histologic networks (Folberg: Ophthalmology; (1993) 100:1389-1398). We could already demonstrate that this histologic pattern are imageable with confocal ICG-angiography (Mueller: Graefe´s Arch Clin Exp Ophthalmol (1999) 237:448-456). Purpose of this study was to evaluate the influence of networks in the ICG on tumor regression rate.

Methods: We compared the post irradiation regression rate in percent in 20 patients one year after brachytherapy with networks in the indocyanine green angiography/ICGA and maximum apical tumor hight. The ICG angiography was performed before irradiation. 10 patient were irradiated with Ru-106 and 10 were irradiated with Id-125.

Results: The mean of maximum apical hight was 5.2 mm (Std Dev: 1.54; Ru-106: 5.6 mm (Std Dev: 0.96); Iod-125: 4.8 mm (Std Dev: 1.89)). In 11 (55%) patients (Ru-106: 5; Id-125: 6) we found networks in the preoperative ICG. The mean of the regression rate in tumors with networks was 51.3% (Std Dev: 14.71%) and 28.02% (Std Dev: 16.4%) in the group without networks. The difference between both groups was statistically significant (p=0.0036, student t-Test). There was no statistically significant difference of regression rate between the two groups of Ru-106 and Id-125 (p=0.079, student t-Test).

Discussion: Highly proliferative tumors are known to be more sensible for irradiation. This may be one reason that tumors with a rapid post-irradiation regression are the more agressive ones regarding later developement of metastases. Also networks are known as a strong sign for more agressive, metastasizing tumors. Our observation emphasize the prognostic value of networks in the ICGA to assess the risk for developing systemic metastatic disease. None

^{1Department of Ophthalmology, Ludwig-Maximilians-Universität, Mathildenstr. 8, 80336 Munich, Germany²Department of
Ophthalmology, Shiley Eye Center, UCSD, 9415 Campus Point Dr. 0946, La Jolla Ca
92093-0946, USA}

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