Visual acuity after proton beam therapy for uveal melanoma: development and validation of a prediction model

Proton beam therapy for uveal melanoma is linked to post-treatment vision impairment, and a Cox prediction model using baseline acuity plus dose achieves c-indices up to 0.761 internally.

• Why it matters: Dose–toxicity relationships for ocular proton therapy are not well quantified, limiting the ability to set treatment planning constraints and build NTCP models for vision outcomes.
• What they did: Patients with uveal melanoma treated at Holland PTC (2020–2023, n=135) and PSI (1987–2019, n=100) were analyzed; multivariable Cox models were trained on 2/3 of the combined data (n=156) and tested on a held-out set (n=79).
• The result: Internal discrimination was good (c-indices 0.760 for Snellen <0.1 and 0.761 for Snellen <0.3), while held-out performance was acceptable (0.657 and 0.689), with calibration insufficient only for Snellen <0.1.

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