Choroidal Melanoma Treated with Linear Accelerator-based Hypofractionated Stereotactic Radiotherapy: First Case of Globe Conservation in Uveal Melanoma from the Philippines

Objective: This is a case report of a 60-year-old woman with a juxtapapillary choroidal melanoma who underwent globe-sparing treatment using linear-accelerator (LINAC)-based hypofractionated stereotactic radiotherapy (FSRT). Methods: Clinical data, ophthalmologic findings, and imaging results were...

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Bibliographic Details
Main Authors: Raymund V. Tanchuling, MD, Andrei P. Martin, MD
Format: Article
Language:English
Published: Philippine Academy of Ophthalmology 2025-06-01
Series:Philippine Journal of Ophthalmology
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Online Access:https://paojournal.com/index.php/pjo/article/view/540
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Summary:Objective: This is a case report of a 60-year-old woman with a juxtapapillary choroidal melanoma who underwent globe-sparing treatment using linear-accelerator (LINAC)-based hypofractionated stereotactic radiotherapy (FSRT). Methods: Clinical data, ophthalmologic findings, and imaging results were obtained through retrospective chart review. Results: At three months and nine months post-treatment, tumor thickness decreased by 20.5% (from 13.00 mm to 10.34 mm) and 33.2% (to 8.69 mm), respectively. Partial resolution of subretinal fluid and vitreous hemorrhage was confirmed clinically and by B-scan. No metastatic spread was detected on liver ultrasound and chest radiography. Best-corrected visual acuity in the treated eye remained stable at hand motion. Radiation-induced dry eye was managed effectively with preservative-free sodium hyaluronate eye drops. Conclusion: LINAC-based hypofractionated FSRT achieved marked local control and tumor regression in this case of a medium-large, juxtapapillary choroidal melanoma, while preserving the globe and the baseline vision. In regions without access to plaque brachytherapy, this technique offers a practical, cost-efficient, and multidisciplinary approach to eye-conserving therapy.
ISSN:0031-7659