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Título

GLAUCOMA AFTER TREATMENT WITH EPISCLERAL BRACHYTHERAPY: A RETROSPECTIVE STUDY AT THE HOSPITAL ITALIANO DE BUENOS AIRES (2000-2023)

Resumo

Introduction
Radiation therapy has emerged as a critical option in the management of intraocular melanoma. However, this approach is not without complications, including cataracts, radiation retinopathy, vitreous hemorrhage, and glaucoma. The incidence of secondary glaucoma after radiotherapy for uveal melanoma is 2-15%, with neovascular glaucoma (NVG) being the most common cause.

Objectives
Analyze the incidence and management of glaucoma following episcleral brachytherapy.

Methods
A retrospective observational study was conducted at the Ophthalmology Department of the Hospital Italiano de Buenos Aires, including patients who underwent episcleral brachytherapy and developed posterior glaucoma between 2000 and 2023. The classification was carried out according to the type of glaucoma (neovascular, synechiae, u another type) and the treatment administered.

Results
Among 115 patients treated with episcleral plaque, 21 (18,26%) developed posterior glaucoma. The group had a mean age of 50.76 (SD ± 17.13) and 66.6% were women. The most common tumor for which brachytherapy was performed was choroidal melanoma with a total of 17 (80.95%). The majority exhibited neovascular glaucoma (52.38%), followed by other types of glaucoma (28.57%) and synechiae-related glaucoma (19.04%). The most frequently administered treatment was topical and/or oral medication (47.61%), followed by enucleation (23.80%), peripheral iridectomy (14.28%), transscleral cyclophotocoagulation (9.52%), and phacoemulsification (4.76%).

Conclusion
Our findings confirm that NVG is the predominant cause of secondary glaucoma post-brachytherapy, consistent with previous reports. In most cases, was effectively managed with conservative treatment. Currently there are protocols for the prevention of radiation retinopathy and neovascular glaucoma that have changed their incidence in recent years.

Referências Bibliográficas

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