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Cohort studyAmerican journal of ophthalmology · 2026

Early Peripapillary and Macular Microvascular Changes Following Ruthenium-106 Plaque Brachytherapy For Uveal Melanomas.

Mai A Abdelkader, Shaymaa H Salah, Salma F Al-Etr … Abdussalam M Abdullatif

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OphthalmologyCohort study

Peripapillary capillary density drops early after Ru-106 plaque brachytherapy for uveal melanoma.

Early Peripapillary and Macular Microvascular Changes Following Ruthenium-106 Plaque Brachytherapy For Uveal Melanomas.

Mai A Abdelkader … Abdussalam M Abdullatif

American journal of ophthalmology · 2026

Purpose

To evaluate early peripapillary and macular microvascular changes following ruthenium-106 (Ru-106) episcleral plaque brachytherapy for uveal melanoma using optical coherence tomography angiography (optical coherence tomography angiography).

Methods

SUBJECTS: Twenty-four eyes of 24 patients with extramacular uveal melanoma treated with Ru-106 plaque brachytherapy at Cairo University Ocular Oncology Service.

n = 24 patients

Results

Radial peripapillary capillary density fell significantly by 3 months, then held steady.

49.06%

RPC Baseline

44.95%

RPC 3 months

More results

Mean best-corrected visual acuity (BCVA) declined from 0.44 ± 0.30 logMAR at baseline to 0.78 ± 0.72 at 6 months (p = .028).

Tumor height decreased significantly (p < .001).

More results

By contrast, DCP density declined progressively and diffusely (45.17 ± 4.86% to 44.90 ± 4.87% at 3 months and 42.23 ± 3.68% at 6 months, p = .017), accompanied by significant foveal avascular zone enlargement (0.25 ± 0.12 to 0.34 ± 0.11 mm², p < .001).

“

Conclusion · 1 of 4

Ru-106 brachytherapy induces early, subclinical microvascular injury detecTable by optical coherence tomography angiography.

Conclusion · 2 of 4

radial peripapillary capillary changes are early and strongly correlate with optic nerve radiation dose and visual decline, SCP changes are localized, while DCP demonstrates progressive and generalized loss.

Conclusion · 3 of 4

Tumor location influenced injury patterns, reflecting differential radiation exposure.

Conclusion · 4 of 4

optical coherence tomography angiography may serve as a noninvasive biomarker for early detection and risk stratification of radiation-induced microvascular injury.

Post

Early Peripapillary and Macular Microvascular Changes Following Ruthenium-106 Plaque Brachytherapy For Uveal Melanomas.

Peripapillary capillary density drops early after Ru-106 plaque brachytherapy for uveal melanoma.

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