Radioactive plaque therapy (brachytherapy) may be used as a salvage therapy after globe-conserving treatments have failed to destroy all of the viable tumor; this therapy also can be applied as the primary treatment in eyes with small to medium tumors. The most commonly used isotopes for this procedure are iodine 125 and ruthenium 106. The plaque radiotherapy technique is generally applicable for tumors less than 16 mm in basal diameter and less than 8 mm in apical thickness. Ultrasound-assisted localization of the tumor intraoperatively enhances local tumor control. Compared with EBRT, plaque radiotherapy is associated with a greater likelihood of radiation optic neuropathy or retinopathy but a substantially lower risk of radiation-induced cancer.
Excerpted from BCSC 2020-2021 series: Section 4 - Ophthalmic Pathology and Intraocular Tumors. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.