AVATAR: Analysis for Visual Acuity Prediction After Eye Interventional Radiotherapy

Abstract

Aim: The aim of this study was to detect clinical factors predictive of loss of visual acuity after treatment in order to develop a predictive model to help identify patients at risk of visual loss.

Patients and methods: This was a retrospective review of patients who underwent interventional radiotherapy (brachytherapy) with ¹⁰⁶Ru plaque for primary uveal melanoma. A predictive nomogram for visual acuity loss at 3 years from treatment was developed.

Results: A total of 152 patients were selected for the study. The actuarial probability of conservation of 20/40 vision or better was 0.74 at 1 year, 0.59 at 3 years, and 0.54 at 5 years after treatment. Factors positively correlated with loss of visual acuity included: age at start of treatment (p=0.004) and longitudinal basal diameter (p=0.057), while distance of the posterior margin of the tumor from the foveola was inversely correlated (p=0.0007).

Conclusion: We identified risk factors affecting visual function and developed a predictive model and decision support tool (AVATAR nomogram).

Keywords: 106Ru; Plaque brachytherapy; interventional radiotherapy; nomogram; prediction model; uveal melanoma; visual acuity.