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  • Title: [Value of angiography in the surveillance of choroid melanoma treated by cobalt disk].
    Author: Desjardins L, Haye C, Oguz V.
    Journal: J Fr Ophtalmol; 1989; 12(6-7):427-30. PubMed ID: 2699885.
    Abstract:
    Conservative management of choroidal melanoma by radioactive plaques or protonbeam is widely used since 1968. The treatment of these tumors at Curie Institute has been done with cobalt plaques since 1968. Indications were first monophthalmic patients but are now much wide. We have been treating since 1981 all patients with tumor diameter less than 17 mm and tumor height less than 12 mm. The technic includes general anesthesia to place the disc with localisation of the tumor by transillumination or by indirect ophthalmoscopy. A dose of 70 to 90 grays is delivered to the apex of the tumor. We report two cases of patients treated by cobalt 60 plaque for choroïdal melanoma. The first patient has a 5 mm high choroïdal melanoma temporal to the macula. After treatment by cobalt plaque, he showed no echographic changes but angiograms revealed an hypofluorescent zone in the central part of the tumor. The second patient has an 8 mm tumor that after plaque showed only angiographic changes. Evolution after treatment of choroïdal melanoma by radioactive plaque is variable. Echographic changes are very low and it is frequent to observe no modification in the height of the tumor for a long time for this reason, repeated angiograms can be very useful in the follow up of these patients. They frequently show hypofluorescent spot in the central part of a tumor that was hyperfluorescent before treatment. Sometimes there is diffuse lowering of the fluorescence. We think that these modifications of fluorescence can be due to diminution of the vascularisation of the tumor or may be to central necrosis of the tumor.(ABSTRACT TRUNCATED AT 250 WORDS)
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