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Cohort studyCanadian journal of ophthalmology. Journal canadien d'ophtalmologie · 2026

Thirty-year visual acuity outcomes after plaque brachytherapy for posterior uveal melanoma.

Lauren A Dalvin, Gustav Stålhammar

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OphthalmologyCohort study

Only 4% of eyes retained useful vision (≥20/200) 30 years after plaque radiotherapy.

Thirty-year visual acuity outcomes after plaque brachytherapy for posterior uveal melanoma.

Lauren A Dalvin, Gustav Stålhammar

Canadian journal of ophthalmology. Journal canadien d'ophtalmologie · 2026

Purpose

To quantify 30-year visual-acuity outcomes after ruthenium 106 or iodine 125 plaque brachytherapy for posterior uveal melanoma and identify independent predictors of best-corrected visual acuity (BCVA) <20/200.

Methods

Were 1 785 consecutive patients treated at St.

n = 20 eyes

Results

fewer eyes kept reading-level vision three decades after treatment

sHR 3.57 (95% CI 2.43 to 5.23)

null 0

2.43

5.23

CI excludes the null - significant

More results

Mean visual acuity declined from 0.34 logMAR (20/44) at diagnosis to 0.82 logMAR (20/132) at the last follow-up.

Among eyes beginning with ≥20/40, corresponding probabilities were 73%, 52%, 26%, and 8%.

More results

Iodine 125 plaques (sHR [subdistribution hazard ratio]: 3.57 vs ruthenium 106; 95% CI: 2.43-5.23) independently predicted vision <20/200, while each additional millimetre of tumour-fovea distance was protective (sHR 0.90; 95% CI: 0.86-0.95).

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Conclusion · 1 of 2

Three decades after plaque brachytherapy, fewer than 1 in 20 eyes retained useful vision. Iodine 125 plaques and tumours abutting the macula carried the greatest risk.

Conclusion · 2 of 2

The fovea-isotope-thickness score may assist clinicians in counselling and selecting sight-preserving strategies.

Post

Thirty-year visual acuity outcomes after plaque brachytherapy for posterior uveal melanoma.

Only 4% of eyes retained useful vision (≥20/200) 30 years after plaque radiotherapy.

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