Herein, we have assembled a noninclusive table of representative case series with >100 treated patients (Table 5). Select observations derived from Table 5 include that the radionuclides 125I and 106Ru are best represented, and on average, the data are more than 10 years old. Note that a mean of 341 patients was reported per center, average follow-up was 4.5 years and tumor size reporting lacks AJCC or UICC standardization. With respect to treatment, the mean and median prescription dose were 83 and 80 Gy, respectively (range, 70–100 Gy). Similarly, reported and 5-year local control

rates averaged Selleckchem BTK inhibitor 89.5% (range, 69.9–97.9%). However, there exist no data to allow a meta-analysis comparing relative tumor size and location.

In general, there exists no information concerning cases lost to follow-up. Note that the median rates of metastasis are quite similar except for series reporting on larger tumors (48). Vorinostat clinical trial Finally, visual acuity results vary widely. Visual acuity outcomes are difficult to compare, in that they depend on many factors including but not limited to preexisting exudative retinal detachments, subfoveal tumor position, radiation dose to critical structures, cataract onset, cataract repair, secondary vitreous hemorrhage, radiation maculopathy, optic neuropathy, and the availability of antivascular endothelial growth factor (anti-VEGF) treatment. Clearly, this outcome analysis supports the need for more uniform data collection and reporting among eye cancer specialists. Ophthalmic brachytherapy complications have been related to both radiation and patient-specific factors. These include total dose, dose rate, dose volume, dose to critical structures, tumor size, location, and the biologically variable responses to irradiation. The ABS-OOTF survey indicates (Level 1 Consensus) that there exists no increased risk associated

with radiation cataract removal [62] and [117]. However, almost all centers recommended waiting until 6–12 months after brachytherapy. Radiation induces a progressive vasculopathy caused by loss of pericytes and endothelial PLEK2 cells (118). Clinical findings include transudation of intravascular components (blood, serum, and lipids) and small vessel closure (cotton wool spots). First retinal findings include hemorrhages, edema, and cotton wool infarcts. However, it is the earlier onset radiation macular edema causes reversible vision loss. Later, small vessel closure leads to ischemia, neovascularization, and irreversible atrophy. Variations of this process are also seen in the optic disc and iris. The ABS-OOTF concur (Level 2 Consensus) that untreated radiation maculopathy and optic neuropathy typically result in poor visual acuity. The prognosis for vision diminishes with vasculopathy of the macula, optic nerve, vitreous hemorrhage, and neovascular glaucoma.