{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T10:29:06Z","timestamp":1785234546998,"version":"3.55.0"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T00:00:00Z","timestamp":1620086400000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Exper Ophthalmology"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Radiation\u2010induced scleral necrosis (RISN) is a rare, but a serious complication of brachytherapy for uveal melanoma. We aimed at analysing the incidence, timing and risk factors associated with development of RISN in a large institutional series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All consecutive cases with brachytherapy for uveal melanoma treated by the Departments of Ophthalmology and Radiotherapy at University Hospital Essen between 1999 and 2016 were eligible. Development of RISN during the post\u2010treatment follow\u2010up was recorded. A 1:2 propensity score matched case\u2013control study was performed for the evaluation of the prognostic value of different tumour\u2010 and treatment\u2010associated parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>RISN was documented in 115 (2.9%) of 3960 patients with uveal melanoma included in the final analysis, and occurred at the mean 30.3\u00a0months (range: 1.26\u2013226\u2009months) after brachytherapy. In the whole cohort, younger age (<jats:italic>p<\/jats:italic>\u00a0=\u20090.042), plaque type (<jats:italic>p<\/jats:italic>\u00a0=\u20090.001) and ciliary body involvement (<jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.0001) were independently associated with the RISN occurrence. In the case\u2013control study, multivariable weighted proportional hazard analysis discovered the association of the following additional tumour\u2010 and treatment\u2010associated characteristics with RISN: posterior tumour margin anterior to equatorial region (<jats:italic>p<\/jats:italic>\u00a0=\u20090.0003), extraocular tumour extension (<jats:italic>p<\/jats:italic>\u00a0=\u2009&lt;0.0001), scleral contact dose (<jats:italic>p<\/jats:italic>\u00a0=\u2009&lt;0.0001), conjunctival dehiscence after therapy (<jats:italic>p<\/jats:italic>\u00a0=\u20090.0001), disinsertion of the superior rectus muscle (<jats:italic>p<\/jats:italic>\u00a0=\u20090.001) and the glaucoma medication (<jats:italic>p<\/jats:italic>\u00a0=\u20090.014).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study confirms RISN as a rare complication, which might occur even years later after the brachytherapy for uveal melanoma. Alongside with scleral dose five other tumour and therapy related factors predict the risk of RISN after brachytherapy for uveal melanoma were established.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ceo.13928","type":"journal-article","created":{"date-parts":[[2021,4,18]],"date-time":"2021-04-18T04:31:09Z","timestamp":1618720269000},"page":"357-367","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Scleral necrosis after brachytherapy for uveal melanoma: Analysis of risk factors"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7370-5077","authenticated-orcid":false,"given":"Leyla","family":"Jabbarli","sequence":"first","affiliation":[{"name":"Department of Ophthalmology University Hospital of Essen  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maja","family":"Guberina","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy University Hospital of Essen  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Biewald","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University Hospital of Essen  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Fl\u00fchs","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy University Hospital of Essen  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nika","family":"Guberina","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology and Neuroradiology University Hospital Essen  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia H. 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