Objective To observe the macular morphological changes of choroidal melanoma with coherence tomography (OCT) after plaque radiotherapy (PRT).Methods A total of 48 patients (48 eyes)with choroidal melanoma who underwent 125I PRT were enrolled in this study.All the patients were examined documenting OCT to get the image of macula.The macula of all the patients was not involved.The median visual acuity was 0.4±0.2,which ranged from 0.02 to 1.0.There were 18 eyes (37.5％) with retinal detachment,12 eyes (25.0 ％) with retinal pigment epithelium (RPE) changes,seven eyes (14.6 ％)with macular edema, epimacular membrane, detachment combined with edema, exudation and RPE changes,11 eyes (22.9％) with normal macular structure.The median follow-up time was (10.4 ±5.9)months,which ranged from one to 24 months.The tumor control situation and visual acuity were observed in follow-up period.The same equipment and methods of OCT were used to return visit in follow-up period.The macular morphological changes at the final visit and its relationship with PRT and visual acuity werecontrastively analyzed.Results All the patients had good control of tumor.The vision acuity improved in two eyes (4.2％),unchanged in 10 eyes (20.8％),and decreased in 36 eyes (75.0％).The differences of the visual acuity was statistically significant between before and after treatment (Z=-3.778,P＜0.05).There were 13 eyes (27.1％) with retinal detachment; nine eyes (18.8％) with RPE changes; 17 eyes (35.4％) with macular edema,detachment combined with edema,exudation and RPE changes; six eyes (12.5 ％) with proliferation,atrophy,detachment combined with edema,exudation and epimacular membrane;three eyes (6.3％) with normal macular structure.There were 15 patients (31.3％) with two or more abnormal macular morphology after PRT.Conclusions Retinal detachment,RPE changes,macular edema and exudation are common abnormal macular morphology after PRT.The incidence rate of abnormal macular morphology is increased.There are 31.3 ％ patients with two or more abnormal macular morphology.