1
|
How to Manage a Patient with Ocular Metastases? Biomedicines 2022; 10:biomedicines10123044. [PMID: 36551800 PMCID: PMC9775125 DOI: 10.3390/biomedicines10123044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/15/2022] [Accepted: 11/18/2022] [Indexed: 11/29/2022] Open
Abstract
Ocular metastases are the most frequent ocular malignant tumors; their prevalence is estimated around 5-10% and is even higher in patients with breast or lung cancer. They represent various clinical situations, but they share the same hierarchical multidisciplinary therapeutic challenge with respect to the way systemic and local therapies should be selected in combination or sequentially in the personalized medical history of a patient. The challenges include tumor control, eye preservation, and the minimization of iatrogenic damage to sensitive tissues surrounding the tumor in order to preserve vision. These aims should further contribute to maintaining quality of life in patients with metastases. Many patients with choroidal metastases have systemic molecular treatment for their primary tumor. However, secondary resistance to systemic treatment is common and may ultimately be associated with cancer relapse, even after an initial response. Therefore, it makes sense to propose local treatment concomitantly or after systemic therapy to provide a more sustainable response. The aim of this review is to present current therapeutic strategies in ocular metastases and discuss how to tailor the treatment to a specific patient.
Collapse
|
2
|
Photodynamic therapy for the treatment of choroidal metastases. Retina 2022; 42:1176-1183. [DOI: 10.1097/iae.0000000000003433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
3
|
Carobeli LR, Meirelles LEDF, Damke GMZF, Damke E, de Souza MVF, Mari NL, Mashiba KH, Shinobu-Mesquita CS, Souza RP, da Silva VRS, Gonçalves RS, Caetano W, Consolaro MEL. Phthalocyanine and Its Formulations: A Promising Photosensitizer for Cervical Cancer Phototherapy. Pharmaceutics 2021; 13:pharmaceutics13122057. [PMID: 34959339 PMCID: PMC8705941 DOI: 10.3390/pharmaceutics13122057] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 12/13/2022] Open
Abstract
Cervical cancer is one of the most common causes of cancer-related deaths in women worldwide. Despite advances in current therapies, women with advanced or recurrent disease present poor prognosis. Photodynamic therapy (PDT) has emerged as an effective therapeutic alternative to treat oncological diseases such as cervical cancer. Phthalocyanines (Pcs) are considered good photosensitizers (PS) for PDT, although most of them present high levels of aggregation and are lipophilic. Despite many investigations and encouraging results, Pcs have not been approved as PS for PDT of invasive cervical cancer yet. This review presents an overview on the pathophysiology of cervical cancer and summarizes the most recent developments on the physicochemical properties of Pcs and biological results obtained both in vitro in tumor-bearing mice and in clinical tests reported in the last five years. Current evidence indicates that Pcs have potential as pharmaceutical agents for anti-cervical cancer therapy. The authors firmly believe that Pc-based formulations could emerge as a privileged scaffold for the establishment of lead compounds for PDT against different types of cervical cancer.
Collapse
Affiliation(s)
- Lucimara R. Carobeli
- Department of Clinical Analysis and Biomedicine, Universidade Estadual de Maringá, Maringá 87020-900, PR, Brazil; (L.R.C.); (L.E.d.F.M.); (G.M.Z.F.D.); (E.D.); (M.V.F.d.S.); (N.L.M.); (K.H.M.); (C.S.S.-M.); (R.P.S.); (V.R.S.d.S.)
| | - Lyvia E. de F. Meirelles
- Department of Clinical Analysis and Biomedicine, Universidade Estadual de Maringá, Maringá 87020-900, PR, Brazil; (L.R.C.); (L.E.d.F.M.); (G.M.Z.F.D.); (E.D.); (M.V.F.d.S.); (N.L.M.); (K.H.M.); (C.S.S.-M.); (R.P.S.); (V.R.S.d.S.)
| | - Gabrielle M. Z. F. Damke
- Department of Clinical Analysis and Biomedicine, Universidade Estadual de Maringá, Maringá 87020-900, PR, Brazil; (L.R.C.); (L.E.d.F.M.); (G.M.Z.F.D.); (E.D.); (M.V.F.d.S.); (N.L.M.); (K.H.M.); (C.S.S.-M.); (R.P.S.); (V.R.S.d.S.)
| | - Edilson Damke
- Department of Clinical Analysis and Biomedicine, Universidade Estadual de Maringá, Maringá 87020-900, PR, Brazil; (L.R.C.); (L.E.d.F.M.); (G.M.Z.F.D.); (E.D.); (M.V.F.d.S.); (N.L.M.); (K.H.M.); (C.S.S.-M.); (R.P.S.); (V.R.S.d.S.)
| | - Maria V. F. de Souza
- Department of Clinical Analysis and Biomedicine, Universidade Estadual de Maringá, Maringá 87020-900, PR, Brazil; (L.R.C.); (L.E.d.F.M.); (G.M.Z.F.D.); (E.D.); (M.V.F.d.S.); (N.L.M.); (K.H.M.); (C.S.S.-M.); (R.P.S.); (V.R.S.d.S.)
| | - Natália L. Mari
- Department of Clinical Analysis and Biomedicine, Universidade Estadual de Maringá, Maringá 87020-900, PR, Brazil; (L.R.C.); (L.E.d.F.M.); (G.M.Z.F.D.); (E.D.); (M.V.F.d.S.); (N.L.M.); (K.H.M.); (C.S.S.-M.); (R.P.S.); (V.R.S.d.S.)
| | - Kayane H. Mashiba
- Department of Clinical Analysis and Biomedicine, Universidade Estadual de Maringá, Maringá 87020-900, PR, Brazil; (L.R.C.); (L.E.d.F.M.); (G.M.Z.F.D.); (E.D.); (M.V.F.d.S.); (N.L.M.); (K.H.M.); (C.S.S.-M.); (R.P.S.); (V.R.S.d.S.)
| | - Cristiane S. Shinobu-Mesquita
- Department of Clinical Analysis and Biomedicine, Universidade Estadual de Maringá, Maringá 87020-900, PR, Brazil; (L.R.C.); (L.E.d.F.M.); (G.M.Z.F.D.); (E.D.); (M.V.F.d.S.); (N.L.M.); (K.H.M.); (C.S.S.-M.); (R.P.S.); (V.R.S.d.S.)
| | - Raquel P. Souza
- Department of Clinical Analysis and Biomedicine, Universidade Estadual de Maringá, Maringá 87020-900, PR, Brazil; (L.R.C.); (L.E.d.F.M.); (G.M.Z.F.D.); (E.D.); (M.V.F.d.S.); (N.L.M.); (K.H.M.); (C.S.S.-M.); (R.P.S.); (V.R.S.d.S.)
| | - Vânia R. S. da Silva
- Department of Clinical Analysis and Biomedicine, Universidade Estadual de Maringá, Maringá 87020-900, PR, Brazil; (L.R.C.); (L.E.d.F.M.); (G.M.Z.F.D.); (E.D.); (M.V.F.d.S.); (N.L.M.); (K.H.M.); (C.S.S.-M.); (R.P.S.); (V.R.S.d.S.)
| | - Renato S. Gonçalves
- Department of Chemistry, Universidade Estadual de Maringá, Maringá 87020-900, PR, Brazil; (R.S.G.); (W.C.)
| | - Wilker Caetano
- Department of Chemistry, Universidade Estadual de Maringá, Maringá 87020-900, PR, Brazil; (R.S.G.); (W.C.)
| | - Márcia E. L. Consolaro
- Department of Clinical Analysis and Biomedicine, Universidade Estadual de Maringá, Maringá 87020-900, PR, Brazil; (L.R.C.); (L.E.d.F.M.); (G.M.Z.F.D.); (E.D.); (M.V.F.d.S.); (N.L.M.); (K.H.M.); (C.S.S.-M.); (R.P.S.); (V.R.S.d.S.)
- Correspondence: ; Tel.: +55-44-3011-5455
| |
Collapse
|
4
|
Choroidal metastasis as initial presentation of aggressive medullary thyroid carcinoma with widespread mediastinal, brain, pituitary, bone, lung, and liver metastasis: Case report and literature review. Int J Surg Case Rep 2021; 87:106419. [PMID: 34597971 PMCID: PMC8488480 DOI: 10.1016/j.ijscr.2021.106419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/09/2021] [Accepted: 09/13/2021] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Medullary thyroid carcinoma (MTC) is a neuroendocrine tumor that originates from the parafollicular C cells of the thyroid gland. MTC can be due to sporadic or hereditary causes due to gain of function germ line mutations in the RET proto-oncogene. MTC presenting as ocular symptoms due to choroidal mass is rare with bad prognosis. PRESENTATION OF CASE A 38-year-old Sudanese male presented to Hamad General Hospital, complaining of sudden painless decrease of vision of the right eye of 3 weeks duration. After investigations using imaging methods, the patient was discovered to have metastatic MTC that presented as choroidal mass and metastasized to his lung, bone, brain, pituitary, liver and mediastinum. DISCUSSION In terms of investigations, serum levels of calcitonin have superior diagnostic accuracy. Our patient undertook diagnostic imaging including ultrasonography, fine needle aspiration and computerized tomography (CT) scan and/or MRI imaging. He undertook total thyroidectomy and left neck dissection followed by stereotactic radiosurgery for the right orbit and pituitary. He then received systemic anti-RET therapy (Selpercatinib). At 5 months follow up there was dramatic drop in CEA from 888 μg/L to 164 μg/L, and calcitonin from >585.2 pmol/L to 354 pmol/L. CONCLUSION Choroidal metastasis as initial presentation of MTC is extremely rare and challenging to diagnose. Surgeons need a high index of suspicion when ocular symptoms accompany a neck mass or thyroid-related symptoms. MTC has a progressive course with involvement of blood vessels and neck lymph nodes. Choroidal metastasis of MTC is challenging to manage.
Collapse
|
5
|
Current Indications for Photodynamic Therapy in Retina and Ocular Oncology. CURRENT OPHTHALMOLOGY REPORTS 2021. [DOI: 10.1007/s40135-021-00272-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|
6
|
Yeung AM, Wells JR, Grossniklaus HE. Secondary ocular malignancies: A review. Clin Exp Ophthalmol 2021; 49:161-168. [PMID: 33426794 DOI: 10.1111/ceo.13889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/08/2020] [Accepted: 11/13/2020] [Indexed: 01/23/2023]
Abstract
Secondary ocular malignancies most commonly spread to the choroid. Previously, the prognosis was poor however, with newer treatments including immunotherapy, patient's life expectancy have increased. It is therefore, important that ophthalmologists diagnose this condition in a timely manner and offer treatment to maximize visual potential and refer them on to oncology colleagues in order to optimize their systemic treatment for their primary cancer.
Collapse
Affiliation(s)
- Aaron M Yeung
- Ocular Oncology & Ophthalmic Pathology, Emory Eye Center, Atlanta, Georgia, USA
| | - Jill R Wells
- Ocular Oncology & Ophthalmic Pathology, Emory Eye Center, Atlanta, Georgia, USA
| | - Hans E Grossniklaus
- Ocular Oncology & Ophthalmic Pathology, Emory Eye Center, Atlanta, Georgia, USA
| |
Collapse
|
7
|
Choroidal metastases: case report and review. JOURNAL OF RADIOTHERAPY IN PRACTICE 2020. [DOI: 10.1017/s1460396920001090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractIntroduction:Choroidal metastases are the most frequent intraocular secondary tumours, with a prevalence of 2–7% according to the literature. Our aim was to review a clinical case of choroidal metastasis.We present a case of a 63-year-old male patient diagnosed in 2018 with lung adenocarcinoma cT4N0M1. The patient had three metastases in the brain, which were successfully treated with radiosurgery (RS). The patient was treated with chemotherapy with pemetrexed–cisplatin schedule. Five months after diagnosis, the patient presented with decreased vision in the right eye. After ophthalmologic evaluation, he was diagnosed with a right choroidal metastasis, which was treated with external beam radiotherapy with 20 Gy in five fractions, resulting in improved visual acuity and a complete clinical and radiological response.The patient took part in a clinical trial that continued with systemic chemotherapy. Twenty-two months after radiotherapy to the eye, the patient has good visual acuity without any side effects.Conclusions:Choroidal metastasis treated with radiotherapy achieves good local control, with limited side effects, allowing an improvement in visual acuity and consequently, an improvement in the patient´s quality of life.
Collapse
|
8
|
Keshwani K, Roelofs KA, Hay G, Lewis R, Plowman N. Treating Choroidal Metastases and Improving Vision with Osimertinib in EGFR T790M-Mutated Lung Adenocarcinoma: A Case Report and Review of the Literature. Ocul Oncol Pathol 2020; 7:26-30. [PMID: 33796513 DOI: 10.1159/000510602] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/31/2020] [Indexed: 11/19/2022] Open
Abstract
A 41-year-old never-smoking female was diagnosed with epidermal growth factor receptor (EGFR)-mutated T2bN3M1b lung adenocarcinoma with axillary lymph nodes. She complained of blurred vision in the left eye (2/60) and was subsequently found to have a left choroidal metastasis. Treatment with tyrosine kinase inhibitor (TKI) erlotinib was started, and after 1 year of disease stability, she developed unsteadiness and worsening visual disturbance (1/60). Brain imaging showed 24 new brain metastases, which were treated with Gamma Knife stereotactic radiosurgery. An enlarging axillary lymph node was biopsied, which identified the T790M mutation, and she commenced the novel TKI osimertinib. Three weeks later, her choroidal lesion had regressed from 3.1 mm to 2.2 mm, and after 2 months of osimertinib, her visual acuity had improved to 6/9. At the last follow-up 8 months after initiation of osimertinib, her choroidal metastasis remains stable, and visual acuity has improved to 6/6. Evidence suggests that osimertinib's efficacy in treating cerebral metastases is superior to that of chemotherapy and other EGFR-TKIs (gefitinib and erlotinib); however, the literature is sparse with regards to the use of osimertinib for the treatment of intraocular disease. In this case, the need for intense daily radiation treatment with its associated toxicities was negated, and as such we propose that osimertinib may be a promising treatment for choroidal metastasis secondary to EGFR-mutated lung adenocarcinoma.
Collapse
Affiliation(s)
- Karim Keshwani
- Barts Cancer Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Kelsey A Roelofs
- Moorfields Eye Hospital Department of Ocular Oncology, London, United Kingdom
| | - Gordon Hay
- Moorfields Eye Hospital Department of Ocular Oncology, UCL Institute of Ophthalmology and Barts Health NHS Trust, London, United Kingdom
| | - Rachel Lewis
- Barts Cancer Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Nick Plowman
- Barts Cancer Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom
| |
Collapse
|
9
|
Local and Systemic Management of Uveal Metastasis. Int Ophthalmol Clin 2020; 60:13-26. [PMID: 33093314 DOI: 10.1097/iio.0000000000000332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
10
|
Lee KE, Yeo JH, Kim YJ, Kim JG, Yoon YH, Kwon DH, Cho YH, Lee JY. Short-term Effect of Gamma Knife Radiosurgery for a Choroidal Tumor. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2020. [DOI: 10.3341/jkos.2020.61.10.1156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
11
|
Mazloumi M, Dalvin LA, Abtahi SH, Yavari N, Yaghy A, Mashayekhi A, Shields JA, Shields CL. Photodynamic Therapy in Ocular Oncology. J Ophthalmic Vis Res 2020; 15:547-558. [PMID: 33133446 PMCID: PMC7591845 DOI: 10.18502/jovr.v15i4.7793] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/07/2020] [Indexed: 01/10/2023] Open
Abstract
Over the past two decades, we have witnessed the increasing use of photodynamic therapy (PDT) in the field of ocular oncology. Based on a review of the literature and our own experience, we herein review the role of PDT for the management of intraocular tumors. The discussion includes two main topics. First, we discuss the application of PDT for benign tumors, including circumscribed choroidal hemangioma, choroidal osteoma, retinal astrocytoma, retinal capillary hemangioma (retinal hemangioblastoma), and retinal vasoproliferative tumor. Second, we assess the role of PDT for malignant tumors, including choroidal melanoma and choroidal metastasis.
Collapse
Affiliation(s)
- Mehdi Mazloumi
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, USA
| | | | - Seyed-Hossein Abtahi
- Isfahan Eye Research Center, Feiz Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Negin Yavari
- Department of Cardiovascular Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Antonio Yaghy
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, USA
| | - Arman Mashayekhi
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, USA
| | - Jerry A Shields
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, USA
| | - Carol L Shields
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, USA
| |
Collapse
|
12
|
Long-term Outcomes of Small Pigmented Choroidal Melanoma Treated with Primary Photodynamic Therapy. Ophthalmol Retina 2020; 5:468-478. [PMID: 32890790 DOI: 10.1016/j.oret.2020.08.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 11/21/2022]
Abstract
PURPOSE To report the long-term outcomes of patients with small, pigmented, posteriorly located choroidal melanoma undergoing primary treatment using photodynamic therapy (PDT) with verteporfin at the London Ocular Oncology Service. DESIGN Retrospective, interventional, consecutive case series. PARTICIPANTS All patients undergoing primary treatment using PDT with verteporfin from April 2014 to December 2015 and followed until December 2019. METHODS This is a long-term follow-up study of the same cohort of patients previously reported by our group in 2017 and 2018. MAIN OUTCOME MEASURES Local tumor control, visual outcomes, and metastasis-free survival. RESULTS Twenty-six patients were included with a mean (± standard deviation) age and tumor thickness of 62 ± 14 years and 1.3 ± 0.5 mm, respectively. Tumors were posteriorly located (mean distance to optic nerve and fovea = 2.0 ± 2.2 mm and 1.6 ± 1.5 mm, respectively), and the majority were fully pigmented (73%). Overall, patients were followed for a median (interquartile range [IQR], range) of 49.5 (15.3, 7.0-66.0) months from first PDT to last follow-up. Over the course of this study, 14 of 26 (54%) have developed a local recurrence at a median of 20.0 months (20.5, 4.7-60.9 months). The most common pattern of recurrence was an isolated increase in basal dimensions (9/14; 64%). Median (IQR) final logarithm of the minimum angle of resolution visual acuity of the whole cohort was 0.2 (0.5). The only statistically significant difference in baseline and outcome characteristics between treatment failures and nonfailures was the distance to the fovea (median [IQR], 0.5 [1.3] vs. 2.5 [2.8]; P = 0.002) and final logarithm of the minimum angle of resolution visual acuity (median [IQR], 0.50 [0.80] vs. 0.00 [0.14]; P = 0.002), respectively. CONCLUSIONS Although treatment of small pigmented posterior choroidal melanoma with PDT effectively preserves visual acuity, 5-year treatment-success calculated by Kaplan-Meier analysis was only 38.4%. Recurrences after PDT tend to occur along the tumor edges, often with minimal increase in thickness. Given the substantial risk of treatment failure, primary PDT with vertepofrin is recommended in exceptional cases of choroidal melanoma, for which other treatments with greater tumor control are not a feasible option.
Collapse
|
13
|
Cui X, Zhu J, Wu X, Yang S, Yao X, Zhu W, Xu P, Chen X. Hematoporphyrin monomethyl ether-mediated photodynamic therapy inhibits the growth of keloid graft by promoting fibroblast apoptosis and reducing vessel formation. Photochem Photobiol Sci 2020; 19:114-125. [PMID: 31934700 DOI: 10.1039/c9pp00311h] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Photodynamic therapy (PDT) has been shown to significantly inhibit fibroblast activity. However, the effect of PDT mediated by the photosensitizer hematoporphyrin monomethyl ether (HMME) on keloids is not known well. The aim of our study was to examine the efficacy of HMME-PDT in cellular and animal models of keloids. Keloid fibroblasts (KFbs) were isolated from human keloid specimens and the proliferation, invasion, and migration of KFbs after HMME-PDT treatment was examined in vitro. Apoptosis in cells was measured by flow cytometry. Cysteinyl aspartate specific proteinase 3 (Caspase3) expression was determined by immunofluorescence staining and western blot. HMME-PDT inhibited KFbs proliferation, invasion, migration, increased apoptosis rate and enhanced caspase3 and cleaved caspase3 expression. The keloid graft transplantation was performed by using nude mice. The growth of the graft was monitored every third day. Interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) mRNA expression were detected by quantitative real time PCR. It was observed that HMME-PDT attenuated graft growth and reduced vessel density in the keloid grafts. However, HMME-PDT did not alter IL-6 and TNF-α mRNA expression in the keloid grafts. Moreover, HMME-PDT suppressed transforming growth-β1 (TGF-β1) and small phenotype and Drosophila Mothers Against Decapentaplegic 3 (Smad3) expression in both KFbs and keloid grafts. Collectively, the evidence suggests that HMME-PDT inhibits the growth of the keloid graft by promoting the apoptosis of fibroblasts and reducing vessel formation of the keloid graft.
Collapse
Affiliation(s)
- Xiaomei Cui
- Department of Medical Cosmetology, Department of Dermatology, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Jing Zhu
- Department of Dermatology, Wuxi People's Hospital, Wuxi, 214000, China
| | - Xiaoyan Wu
- Department of Medical Cosmetology, Department of Dermatology, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Shengju Yang
- Department of Medical Cosmetology, Department of Dermatology, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Xiaodong Yao
- Department of Medical Cosmetology, Department of Dermatology, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Wenyan Zhu
- Department of Medical Cosmetology, Department of Dermatology, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Pan Xu
- Department of Medical Cosmetology, Department of Dermatology, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Xiaodong Chen
- Department of Medical Cosmetology, Department of Dermatology, Affiliated Hospital of Nantong University, Nantong, 226001, China.
| |
Collapse
|
14
|
Shields CL, Khoo CTL, Mazloumi M, Mashayekhi A, Shields JA. Photodynamic Therapy for Choroidal Metastasis Tumor Control and Visual Outcomes in 58 Cases: The 2019 Burnier International Ocular Pathology Society Lecture. Ophthalmol Retina 2020; 4:310-319. [PMID: 31953111 DOI: 10.1016/j.oret.2019.10.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 10/21/2019] [Accepted: 10/21/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE To determine outcomes after photodynamic therapy (PDT) for choroidal metastasis. DESIGN Retrospective interventional case series. PARTICIPANTS Forty-three patients with 40 eyes harboring 58 choroidal metastases. METHODS Treatment with standard fluence PDT using verteporfin. MAIN OUTCOME MEASURES Tumor control and visual outcomes. RESULTS The primary cancer originated in the lung (n = 17 [39%]), breast (n = 16 [37%]), kidney (n = 3 [8%]), thyroid (n = 2 [6%]), and other sites (n = 5 [10%]). The mean patient age at entry was 61 years. Ocular symptoms included decreased visual acuity (n = 23 [53%]), visual field defect (n = 2 [5%]), floaters (n = 7 [16%]), flashes (n = 3 [7%]), and asymptomatic (n = 8 [19%]). The median entering visual acuity (Snellen equivalent) was 20/40. The median tumor diameter was 5.0 mm, and median thickness by ultrasonography was 2.0 mm. The median distance to the optic disc was 3.0 mm, and that to the foveola was 2.0 mm. Of the 43 patients, 35 maintained follow-up (40 eyes, 45 tumors), and PDT achieved tumor control with 1 session (n = 32 tumors [71%]) or 2 sessions (n = 3 tumors [7%]) and failed to achieve regression (n = 10 tumors [22%]). The 10 metastases for which treatment failed were managed further with plaque radiotherapy (n = 3), proton beam radiotherapy (n = 1), external beam radiotherapy (n = 1), systemic chemotherapy (n = 4), and observation (patient preference; n = 1). A comparison of clinical features for tumor control (PDT alone vs. PDT plus additional therapy) revealed those controlled with PDT alone were more likely to be adenocarcinoma (73% vs. 30%; P = 0.02) and those eyes were more like to achieve final visual acuity of 20/20 to 20/40 (66% vs. 30%; P = 0.03), with better median final Snellen visual acuity (20/30 vs. 20/70; not significant). Primary cancer site or ocular tumor features (size, location, color, shape, related subretinal fluid) did not impact tumor control. In the entire group of 40 eyes, visual acuity improved or remained stable in 28 (70%) and decreased in 12 (30%), related to subfoveal scar, persistent subretinal fluid, reactive exudation, radiation maculopathy, and brain metastasis. At last follow-up (mean, 20 months), of the entering 43 patients, 9 (21%) were alive and 34 (79%) had died of systemic metastasis. CONCLUSIONS Photodynamic therapy with verteporfin is an effective outpatient method for small to medium choroidal metastatic tumors, providing tumor control in 78% of eyes and visual outcome of 20/20 to 20/40 in 66% of eyes.
Collapse
Affiliation(s)
- Carol L Shields
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.
| | - Chloe T L Khoo
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Mehdi Mazloumi
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Arman Mashayekhi
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jerry A Shields
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
| |
Collapse
|
15
|
Photodynamic Therapy of Presumed Choroidal Metastasis Secondary to Colorectal Carcinoma: Literature Review. Case Rep Ophthalmol Med 2020; 2020:6490535. [PMID: 32099706 PMCID: PMC7016402 DOI: 10.1155/2020/6490535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 08/01/2019] [Accepted: 11/29/2019] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer may yield metastasis to the choroid. Its management may be challenging, since there is no consensus about treatment. We describe a case of a 70-year-old male with colon cancer who complained of worsening visual acuity of his better-seeing eye to 20/40 secondary to a nonpigmented choroidal mass of medium reflectivity under the inferior temporal arcade and neurosensory foveal detachment. Besides systemic chemotherapy, local treatment with verteporfin photodynamic therapy (vPDT) was performed. After one month, visual acuity improved to 20/25 and subretinal fluid faded. In conclusion, vPDT may be a useful adjuvant treatment modality for choroidal metastasis secondary to colorectal cancer.
Collapse
|
16
|
Wu SQ, Li QS, Zhang Y, Zhu LW. Spontaneous rupture of the eyeball due to choroidal metastasis of gastric carcinoma: A case report. Medicine (Baltimore) 2019; 98:e17441. [PMID: 31577766 PMCID: PMC6783159 DOI: 10.1097/md.0000000000017441] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
RATIONALE Although metastatic tumor is the most common intraocular malignancy, choroidal metastasis from gastric cancer is relatively rare. We present the exact course of a spontaneous rupture of the eyeball with choroidal metastasis from gastric carcinoma (GC) and the applied surgical interventions. PATIENT CONCERNS A 59-year-old male presented with pain and vision loss on his left eye for 6 months. He was diagnosed with GC, for which he received systemic chemotherapy for a year. DIAGNOSES Preoperative B-scan, color fundus photography, computed tomography, and magnetic resonance imaging showed a choroidal tumor in his left eye. The spontaneous rupture of the corneoscleral limbus from 2 to 5 o'clock, combined secondary glaucoma, exudative retinal detachment and choroidal detachment were found. INTERVENTIONS The ruptured corneoscleral limbus was sutured and the orbit was lavaged with 0.4% cisplatin during the enucleation. OUTCOMES Histopathology confirmed high homology of the choroidal metastasis and GC. He survived for 2 months after surgery, without pain or orbital neoplasms. LESSONS Choroidal metastasis from GC rapidly progressed to spontaneous rupture of the eyeball. Careful eyeball enucleation followed by orbital lavage with chemotherapeutics may reduce metastasis risk beyond the eyeball. Additional therapeutic interventions should be considered in patients resistant to single systemic chemotherapy.
Collapse
|
17
|
Jiang Y, Xu C, Leung W, Lin M, Cai X, Guo H, Zhang J, Yang F. Role of Exosomes in Photodynamic Anticancer Therapy. Curr Med Chem 2019; 27:6815-6824. [PMID: 31533597 DOI: 10.2174/0929867326666190918122221] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 07/05/2019] [Accepted: 07/26/2019] [Indexed: 12/24/2022]
Abstract
Photodynamic Therapy (PDT) is a promising alternative treatment for malignancies based on photochemical reaction induced by Photosensitizers (PS) under light irradiation. Recent studies show that PDT caused the abundant release of exosomes from tumor tissues. It is well-known that exosomes as carriers play an important role in cell-cell communication through transporting many kinds of bioactive molecules (e.g. lipids, proteins, mRNA, miRNA and lncRNA). Therefore, to explore the role of exosomes in photodynamic anticancer therapy has been attracting significant attention. In the present paper, we will briefly introduce the basic principle of PDT and exosomes, and focus on discussing the role of exosomes in photodynamic anticancer therapy, to further enrich and boost the development of PDT.
Collapse
Affiliation(s)
- Yuan Jiang
- Key Laboratory of Molecular Target and Clinical Pharmacology, State Key Laboratory of Respiratory Disease,
School of Pharmaceutical Science & Fifth Affiliated Hospital, Guangzhou Medical University,
Guangzhou, Guangdong 511436, China,Department of Rehabilitation Medicine, the First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, China
| | - Chuanshan Xu
- Key Laboratory of Molecular Target and Clinical Pharmacology, State Key Laboratory of Respiratory Disease,
School of Pharmaceutical Science & Fifth Affiliated Hospital, Guangzhou Medical University,
Guangzhou, Guangdong 511436, China
| | - Wingnang Leung
- Division of Chinese Medicine, School of Professional and Continuing Education, The University of Hong Kong, Hong Kong
| | - Mei Lin
- Key Laboratory of Molecular Target and Clinical Pharmacology, State Key Laboratory of Respiratory Disease,
School of Pharmaceutical Science & Fifth Affiliated Hospital, Guangzhou Medical University,
Guangzhou, Guangdong 511436, China
| | - Xiaowen Cai
- Key Laboratory of Molecular Target and Clinical Pharmacology, State Key Laboratory of Respiratory Disease,
School of Pharmaceutical Science & Fifth Affiliated Hospital, Guangzhou Medical University,
Guangzhou, Guangdong 511436, China
| | - Huanhuan Guo
- Key Laboratory of Molecular Target and Clinical Pharmacology, State Key Laboratory of Respiratory Disease,
School of Pharmaceutical Science & Fifth Affiliated Hospital, Guangzhou Medical University,
Guangzhou, Guangdong 511436, China
| | - Jiyong Zhang
- Shenzhen Maternity and Child Health Care Hospital, Shenzhen 518017, China
| | - Fanwen Yang
- Department of Biomedical Engineering, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou, Guangdong 511436, China
| |
Collapse
|
18
|
Zhou R, Reichstein D. Photodynamic Therapy with Verteporfin for Choroidal Metastasis Refractory to Radiotherapy. Case Rep Oncol 2019; 12:861-865. [PMID: 31824280 DOI: 10.1159/000502226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 07/16/2019] [Indexed: 11/19/2022] Open
Abstract
A 54-year old female with longstanding metastatic breast cancer was referred for management of choroidal metastases. She was first treated with external beam radiotherapy and experienced some response before later suffering progression of her eye disease. We then treated her using full fluence Photodynamic therapy (PDT) with Verteporfin, which resulted in regression of her lesions until she passed away due to other illnesses. This is the first documented successful application of PDT for choroidal metastasis from a primary breast cancer refractory to external beam radiotherapy.
Collapse
Affiliation(s)
- Raymond Zhou
- Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | | |
Collapse
|
19
|
Mathis T, Jardel P, Loria O, Delaunay B, Nguyen AM, Lanza F, Mosci C, Caujolle JP, Kodjikian L, Thariat J. New concepts in the diagnosis and management of choroidal metastases. Prog Retin Eye Res 2018; 68:144-176. [PMID: 30240895 DOI: 10.1016/j.preteyeres.2018.09.003] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Revised: 09/04/2018] [Accepted: 09/07/2018] [Indexed: 12/17/2022]
Abstract
The most frequent site of ocular metastasis is the choroid. The occurrence of choroidal metastases has increased steadily due to the longer survival of metastatic patients and the improvement of diagnostic tools. Fundoscopy, ultrasonography, and fluorescein angiography are now complemented by indocyanine green angiography and optical coherence tomography. Choroidal tumor biopsy may also confirm the metastatic nature of the tumor and help to determine the site of the primary malignancy. There is currently no consensus on the treatment strategy. Most patients have a limited life expectancy and for these complex treatments are generally not recommended. However, recent advances in systemic therapy have significantly improved survival of certain patients who may benefit from an aggressive ocular approach that could preserve vision. Although external beam radiation therapy is the most widely used treatment, more advanced forms of radiotherapy that are associated with fewer side effects can be proposed in select cases. In patients with a shorter life expectancy, systemic therapies such as those targeting oncogenic drivers, or immunotherapy can induce a regression of the choroidal metastases, and may be sufficient to temporarily decrease visual symptoms. However, they often acquire resistance to systemic treatment and ocular relapse usually requires radiotherapy for durable control. Less invasive office-based treatments, such as photodynamic therapy and intravitreal injection of anti-VEGF, may also help to preserve vision while reducing time spent in medical settings for patients in palliative care. The aim of this review is to summarize the current knowledge on choroidal metastases, with emphasis on the most recent findings in epidemiology, pathogenesis, diagnosis and treatment.
Collapse
Affiliation(s)
- Thibaud Mathis
- Department of Ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, 69317, Lyon, France; UMR-CNRS 5510 Matéis, 69100, Villeurbane, France
| | - Pauline Jardel
- Department of Radiation Oncology, Chicoutimi Hospital, Saguenay, QC, Canada
| | - Olivier Loria
- Department of Ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, 69317, Lyon, France
| | - Benoit Delaunay
- Department of Ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, 69317, Lyon, France
| | - Anh-Minh Nguyen
- Department of Ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, 69317, Lyon, France
| | - Francesco Lanza
- Department of Ophthalmology, Ocular Oncology Center, E.O. Ospedali Galliera, Genoa, Italy
| | - Carlo Mosci
- Department of Ophthalmology, Ocular Oncology Center, E.O. Ospedali Galliera, Genoa, Italy
| | | | - Laurent Kodjikian
- Department of Ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, 69317, Lyon, France; UMR-CNRS 5510 Matéis, 69100, Villeurbane, France
| | - Juliette Thariat
- Department of Radiation Therapy, Centre François Baclesse - ARCHADE, Unicaen - Normandie University, 14000, Caen, France.
| |
Collapse
|
20
|
Selby LD, Stiefel HC, Skalet AH, Cardenal MS, Bhavsar KV, Winges KM. Vision Loss from Choroidal and Pituitary Metastases Secondary to Renal Cell Carcinoma: A Case Report. Neuroophthalmology 2018; 42:391-398. [PMID: 30524492 DOI: 10.1080/01658107.2018.1454479] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 03/04/2018] [Accepted: 03/15/2018] [Indexed: 10/28/2022] Open
Abstract
A 62-year-old male with a history of metastatic clear cell renal cell carcinoma (ccRCC) presented with decreased vision to 20/50 in the left eye. Fundus examination revealed an elevated, amelanotic mass lesion in the superotemporal macula, without involvement of the central macula by subretinal fluid or tumour. Given incongruity between the fundus findings and the degree of visual impairment, visual field testing was obtained, revealing a bitemporal hemianopia. Magnetic resonance imaging demonstrated optic chiasm compression by a pituitary mass, which had previously been overlooked on computed tomography imaging. Biopsy confirmed metastatic ccRCC to the pituitary, which presented simultaneously with the presumed choroidal metastasis.
Collapse
Affiliation(s)
- Laura D Selby
- School of Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Hillary C Stiefel
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA.,Oregon Eye Specialists, Newberg, Oregon, USA
| | - Alison H Skalet
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA.,Department of Radiation Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Molly S Cardenal
- Department of Optometry, VA Portland Health Care System, Portland, Oregon, USA
| | - Kavita V Bhavsar
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA.,Department of Ophthalmology, VA Portland Health Care System, Portland, Oregon, USA
| | - Kimberly M Winges
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA.,Department of Ophthalmology, VA Portland Health Care System, Portland, Oregon, USA.,Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA
| |
Collapse
|
21
|
Shi W, Yin Y, Wang Y, Zhang B, Tan P, Jiang T, Mei H, Deng J, Wang H, Guo T, Pang Z, Hu Y. A tissue factor-cascade-targeted strategy to tumor vasculature: a combination of EGFP-EGF1 conjugation nanoparticles with photodynamic therapy. Oncotarget 2018; 8:32212-32227. [PMID: 27793028 PMCID: PMC5458279 DOI: 10.18632/oncotarget.12922] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 10/22/2016] [Indexed: 02/03/2023] Open
Abstract
Tumor requires tumor vasculature to supply oxygen and nutrients so as to support its continued growth, as well as provide a main route for metastatic spread. In this study, a TF-cascade-targeted strategy aiming to disrupt tumor blood vessels was developed by combination of TF-targeted HMME-loaded drug delivery system and PDT. PDT is a promising new modality in the treatment of cancers, which employs the interaction between a tumor-localizing photosensitizer and light of an appropriate wavelength to bring about ROS-induced cell death. In vitro results showed that protein EGFP-EGF1modification could significantly contribute to the uptake of nanoparticles by TF over-expressed BCECs. In vivo multispectral fluorescent imaging, the EGFP-EGF1 conjugated nanoparticles showed significantly higher accumulation in tumor tissues than non-conjugated ones. Tumor tissue slides further presented that EGFP-EGF1 conjugated nanoparticles showed significantly higher accumulation in tumor vasculature than non-conjugated ones. In vitro study demonstrated that PDT increased TF expression of BCECs. In vivo imaging, ex vivo imaging and tumor tissue slides showed that PDT further contribute EGFP-EGF1-NP accumulation in tumor. These promising results indicated that PDT enhanced EGFP-EGF1modified PEG-PLGA nanoparticle accumulation in tumor vaculature. Considering that EGFP-EGF1 conjugation enhanced nanoparticles uptake by TF over-expressed endothelium and PDT increased endothelium TF expression. We conclude that PDT triggered a TF cascade targeted effect. A combination of both EGFP-EGF1 modification and PDT provided a positive feed-back target effect to tumor vessels and might have a great potential for tumor therapy.
Collapse
Affiliation(s)
- Wei Shi
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China.,Targeted Biotherapy Key Laboratory of Ministry of Education, Wuhan, Hubei, China
| | - Yanxue Yin
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China.,Targeted Biotherapy Key Laboratory of Ministry of Education, Wuhan, Hubei, China
| | - Yao Wang
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Bo Zhang
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China.,Targeted Biotherapy Key Laboratory of Ministry of Education, Wuhan, Hubei, China
| | - Pei Tan
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China.,Targeted Biotherapy Key Laboratory of Ministry of Education, Wuhan, Hubei, China
| | - Ting Jiang
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China.,Targeted Biotherapy Key Laboratory of Ministry of Education, Wuhan, Hubei, China
| | - Heng Mei
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China.,Targeted Biotherapy Key Laboratory of Ministry of Education, Wuhan, Hubei, China
| | - Jun Deng
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China.,Targeted Biotherapy Key Laboratory of Ministry of Education, Wuhan, Hubei, China
| | - Huafang Wang
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China.,Targeted Biotherapy Key Laboratory of Ministry of Education, Wuhan, Hubei, China
| | - Tao Guo
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China.,Targeted Biotherapy Key Laboratory of Ministry of Education, Wuhan, Hubei, China
| | - Zhiqing Pang
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Yu Hu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China.,Targeted Biotherapy Key Laboratory of Ministry of Education, Wuhan, Hubei, China
| |
Collapse
|
22
|
Photodynamic Therapy in Ocular Oncology. Biomedicines 2018; 6:biomedicines6010017. [PMID: 29414877 PMCID: PMC5874674 DOI: 10.3390/biomedicines6010017] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 01/08/2018] [Accepted: 01/30/2018] [Indexed: 01/15/2023] Open
Abstract
Although introduced for the treatment of maculopathies, photodynamic therapy (PDT) is now largely used in some eye cancers treatment. The selective tissue damage with PDT is achieved by sequestration of the photosensitizer in the target tissue and focal activation of the photosensitizer by low energy directed light. In this way, it is possible to achieve the destruction of the tumor tissue by safeguarding the surrounding healthy structures. Our study describes the clinical uses and efficacy of photodynamic therapy in ocular oncology.
Collapse
|
23
|
Rundle P. Photodynamic Therapy for Eye Cancer. Biomedicines 2017; 5:biomedicines5040069. [PMID: 29292745 PMCID: PMC5744093 DOI: 10.3390/biomedicines5040069] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 11/26/2017] [Accepted: 12/04/2017] [Indexed: 12/28/2022] Open
Abstract
Photodynamic therapy is well-established as a treatment for a number of conditions in ophthalmology, principally in the field of medical retina, but less so in ocular oncology. Cancer of the eye is rare, the commonest lesions to affect the globe being choroidal melanoma (as a primary malignancy) and choroidal metastases (a secondary malignancy). The mainstay of treatment of such lesions remains radiotherapy in various forms, however, photodynamic therapy does have a useful role to play in the management of such patients. In this article, I hope to review the current indications, treatment regimes, and the risks and benefits of photodynamic therapy (PDT) as a treatment for eye cancer.
Collapse
Affiliation(s)
- Paul Rundle
- Ocular Oncology Service, Royal Hallamshire Hospital, Sheffield S10 2JF, UK.
| |
Collapse
|
24
|
Chen Y, Hu Y. Photodynamic Therapy for an iris metastasis from pulmonary adenocarcinoma. Photodiagnosis Photodyn Ther 2017; 20:246-247. [DOI: 10.1016/j.pdpdt.2017.10.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 10/12/2017] [Accepted: 10/16/2017] [Indexed: 11/15/2022]
|
25
|
Failure of ocular photodynamic therapy for secondary choroidal metastasis: a case report and literature review. Oncotarget 2017; 8:95030-95035. [PMID: 29212288 PMCID: PMC5706934 DOI: 10.18632/oncotarget.21847] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 10/05/2017] [Indexed: 12/25/2022] Open
Abstract
The choroid is the most common site for intraocular metastatic disease. Photodynamic therapy (PDT) can effectively destroy malignant tissue and induce anti-tumor activity. Recent publications support its use as an effective therapy for the treatment of choroidal metastases, especially in the subfoveal region, resulting in subsequent vision preservation or improvement. Here, we introduce a case of choroidal metastasis, secondary to primary lung cancer. The progression of choroidal metastasis after PDT was followed up using spectral domain optical coherence tomography with point-to-point follow-up. Unfortunately, both the choroidal metastasis and serous retinal detachment increased after PDT. Since the mechanism underlying the therapeutic effect of PDT on choroidal metastasis is still not fully understood, deeper investigations into its safety, underlying molecular mechanisms, and treatment effects are critical for further PDT clinical usage in intraocular choroidal metastases.
Collapse
|
26
|
Oh JH, Ko SJ, Yang YS, Choi CW. A Case of Choroidal Metastasis Caused by Lung Cancer. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2017. [DOI: 10.3341/jkos.2017.58.1.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jae Hyun Oh
- Department of Ophthalmology, Wonkwang University School of Medicine, Iksan, Korea
- Institute of Wonkwang Medical Science, Wonkwang University, Iksan, Korea
| | - Sang Jun Ko
- Department of Ophthalmology, Wonkwang University School of Medicine, Iksan, Korea
- Institute of Wonkwang Medical Science, Wonkwang University, Iksan, Korea
| | - Yun Sik Yang
- Department of Ophthalmology, Wonkwang University School of Medicine, Iksan, Korea
- Institute of Wonkwang Medical Science, Wonkwang University, Iksan, Korea
| | - Chang Wook Choi
- Department of Ophthalmology, Wonkwang University School of Medicine, Iksan, Korea
- Institute of Wonkwang Medical Science, Wonkwang University, Iksan, Korea
| |
Collapse
|