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Anguita R, Chou HD, Raval VR, Bajpai V, Ferro Desideri L, Bernardi E, Hussain RN, Kim M, Fung AT, Williams BK, Di Nicola M, Sagoo MS, da Cruz L, Damato B, Kiilgaard JF. Managing vitreoretinal complications in uveal melanoma: Surgical treatment and practical considerations. Semin Ophthalmol 2024:1-10. [PMID: 39194361 DOI: 10.1080/08820538.2024.2381774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 07/09/2024] [Accepted: 07/15/2024] [Indexed: 08/29/2024]
Abstract
BACKGROUND In the past few decades, the primary management for uveal melanoma has evolved from enucleation to eye-preserving treatments. However, despite achieving a high rate of local tumour control, complications following eye-preserving treatments still occur and are partly responsible for functional loss and secondary enucleation. METHODS A literature review by a broad international panel. RESULTS We summarised the current literature on utilizing vitreoretinal (VR) surgery for managing the complications of uveal melanoma. We also provided insights from the authors' personal experience and practical recommendations for clinical care. CONCLUSIONS With the advancement of VR instruments and surgical techniques and the combination of VR and ocular oncology knowledge ("Onco-VR"), it is now possible to manage or even prevent complications such as vitreous haemorrhage, retinal detachment, and toxic tumour syndrome.
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Affiliation(s)
- Rodrigo Anguita
- Department of Ophthalmology, Inselspital, University Hospital of Bern, Bern, Switzerland
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
| | - Hung-Da Chou
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
- Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Vishal R Raval
- Vitreoretina and ocular oncology, Anant Bajaj Retina Institute, L V Prasad Eye Institute, Hyderabad, India
| | - Vidhi Bajpai
- Vitreoretina and ocular oncology, Anant Bajaj Retina Institute, L V Prasad Eye Institute, Hyderabad, India
| | - Lorenzo Ferro Desideri
- Department of Ophthalmology, Inselspital, University Hospital of Bern, Bern, Switzerland
| | - Enrico Bernardi
- Department of Ophthalmology, Inselspital, University Hospital of Bern, Bern, Switzerland
| | - Rumana N Hussain
- Liverpool Ocular Oncology Service, St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
| | - Min Kim
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Adrian T Fung
- Westmead and Central (Save Sight Institute) Clinical Schools, Specialty of Clinical Ophthalmology and Eye Health, University of Sydney, Sydney, Australia
- Department of Ophthalmology, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Basil K Williams
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Maura Di Nicola
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Mandeep S Sagoo
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
| | - Lyndon da Cruz
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
| | - Bertil Damato
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
| | - Jens Folke Kiilgaard
- Department of Ophthalmology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
- Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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Hrbacek J, Kacperek A, Beenakker JWM, Mortimer L, Denker A, Mazal A, Shih HA, Dendale R, Slopsema R, Heufelder J, Mishra KK. PTCOG Ocular Statement: Expert Summary of Current Practices and Future Developments in Ocular Proton Therapy. Int J Radiat Oncol Biol Phys 2024:S0360-3016(24)00748-X. [PMID: 38971383 DOI: 10.1016/j.ijrobp.2024.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 05/08/2024] [Accepted: 06/18/2024] [Indexed: 07/08/2024]
Abstract
Although rare cancers, ocular tumors are a threat to vision, quality of life, and potentially life expectancy of a patient. Ocular proton therapy (OPT) is a powerful tool for successfully treating this disease. The Particle Therapy Co-Operative Ocular Group) formulated an Evidence and Expert-Based Executive Summary of Current Practices and Future Developments in OPT: comparative dosimetric and clinical analysis with the different OPT systems is essential to set up planning guidelines, implement best practices, and establish benchmarks for eye preservation, vision, and quality of life measures. Contemporary prospective trials in select subsets of patients (eg, tumors near the optic disc and/or macula) may allow for dosimetric and clinical analysis between different radiation modalities and beamline systems to evaluate differences in radiation delivery and penumbra, and resultant tumor control, normal tissue complication rates, and overall clinical cost-effectiveness. To date, the combination of multimodal imaging (fundus photography, ultrasound, etc), ophthalmologist assessment, and clip surgery with radiation planning have been keys to successful treatment. Increased use of three-dimensional imaging (computed tomography/magnetic resonance imaging) is anticipated although its spatial resolution might be a limiting factor (eg, detection of flat diffuse tumor parts). Commercially produced ocular treatment-planning systems are under development and their future use is expected to expand across OPT centers. Future continuity of OPT will depend on the following: (1) maintaining and upgrading existing older dedicated low-energy facilities, (2) maintaining shared, degraded beamlines at large proton therapy centers, and (3) developing adapted gantry beams of sufficient quality to maintain the clinical benefits of sharp beam conformity. Option (1) potentially offers the sharpest beams, minimizing impact on healthy tissues, whereas (2) and (3) potentially offer the advantage of substantial long-term technical support and development as well as the introduction of new approaches. Significant patient throughputs and close cooperation between medical physics, ophthalmology, and radiation therapy, underpinned by mutual understanding, is crucial for a successful OPT service.
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Affiliation(s)
- Jan Hrbacek
- Center for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland.
| | | | - Jan-Willem M Beenakker
- Department of Ophthalmology, Leiden University Medical Center, Leiden, Netherlands; Department of Radiology, C.J. Gorter MRI Center, Leiden University Medical Center, Leiden, Netherlands; Department of Radiation Oncology, Leiden University Medical Center, Leiden, Netherlands; HollandPTC, Delft, Netherlands
| | - Linda Mortimer
- Medical Physics Department, The Clatterbridge Cancer Centre NHS Foundation Trust, Birkenhead, United Kingdom
| | - Andrea Denker
- Helmholtz-Zentrum Berlin für Materialien und Energie, Proton Therapy (BE-APT), Berlin, Germany
| | - Alejandro Mazal
- Medical Physics Service, Centro de Protonterapia Quironsalud, Madrid, Spain
| | - Helen A Shih
- Harvard Medical School, Boston, Massachusetts; Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Remi Dendale
- Institut Curie Protontherapy Center, Orsay, France
| | - Roelf Slopsema
- Department of Radiation Oncology, Emory Proton Therapy Center, Atlanta, Georgia
| | - Jens Heufelder
- Department of Ophthalmology, Charité - Universitätsmedizin Berlin, BerlinProtonen am HZB, Berlin, Germany
| | - Kavita K Mishra
- Proton Ocular Radiation Therapy Program, Department of Radiation Oncology, Osher Center for Integrative Health, Osher Foundation Endowed Chair in Clinical Programs in Integrative Health, University of California San Francisco, San Francisco, California
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Synoradzki KJ, Paduszyńska N, Solnik M, Toro MD, Bilmin K, Bylina E, Rutkowski P, Yousef YA, Bucolo C, Zweifel SA, Reibaldi M, Fiedorowicz M, Czarnecka AM. From Molecular Biology to Novel Immunotherapies and Nanomedicine in Uveal Melanoma. Curr Oncol 2024; 31:778-800. [PMID: 38392052 PMCID: PMC10887618 DOI: 10.3390/curroncol31020058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/09/2023] [Accepted: 12/19/2023] [Indexed: 02/24/2024] Open
Abstract
Molecular biology studies of uveal melanoma have resulted in the development of novel immunotherapy approaches including tebentafusp-a T cell-redirecting bispecific fusion protein. More biomarkers are currently being studied. As a result, combined immunotherapy is being developed as well as immunotherapy with bifunctional checkpoint inhibitory T cell engagers and natural killer cells. Current trials cover tumor-infiltrating lymphocytes (TIL), vaccination with IKKb-matured dendritic cells, or autologous dendritic cells loaded with autologous tumor RNA. Another potential approach to treat UM could be based on T cell receptor engineering rather than antibody modification. Immune-mobilizing monoclonal T cell receptors (TCR) against cancer, called ImmTAC TM molecules, represent such an approach. Moreover, nanomedicine, especially miRNA approaches, are promising for future trials. Finally, theranostic radiopharmaceuticals enabling diagnosis and therapy with the same molecule bring hope to this research.
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Affiliation(s)
- Kamil J. Synoradzki
- Environmental Laboratory of Pharmacological and Toxicological Research, Mossakowski Medical Research Institute, Polish Academy of Sciences, 5 Pawinskiego Str., 02-106 Warsaw, Poland;
| | - Natalia Paduszyńska
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland; (N.P.); (M.S.)
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 5 Roentgen Str., 02-781 Warsaw, Poland; (E.B.); (P.R.)
| | - Malgorzata Solnik
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland; (N.P.); (M.S.)
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 5 Roentgen Str., 02-781 Warsaw, Poland; (E.B.); (P.R.)
| | - Mario Damiano Toro
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 1 Chmielna Str., 20-079 Lublin, Poland;
- Eye Clinic, Public Health Department, Federico II University, Via Pansini 5, 80131 Naples, Italy
| | - Krzysztof Bilmin
- Research and Development Centre Novasome Sp. z o.o., 51-423 Wrocław, Poland;
| | - Elżbieta Bylina
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 5 Roentgen Str., 02-781 Warsaw, Poland; (E.B.); (P.R.)
- Department of Clinical Trials, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 5 Roentgen Str., 02-781 Warsaw, Poland; (E.B.); (P.R.)
| | - Yacoub A. Yousef
- Department of Surgery (Ophthalmology), King Hussein Cancer Centre, Amman 11941, Jordan;
| | - Claudio Bucolo
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia 97, 95123 Catania, Italy;
| | - Sandrine Anne Zweifel
- Department of Ophthalmology, University Hospital Zurich, 8091 Zurich, Switzerland;
- Faculty of Human Medicine, University of Zurich, 8032 Zurich, Switzerland
| | - Michele Reibaldi
- Department of Surgical Sciences, Eye Clinic Section, Citta della Salute e della Scienza, Turin University, 10122 Turin, Italy;
| | - Michal Fiedorowicz
- Small Animal Magnetic Resonance Imaging Laboratory, Mossakowski Medical Research Institute, Polish Academy of Sciences, 5 Pawinskiego Str., 02-106 Warsaw, Poland
| | - Anna M. Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 5 Roentgen Str., 02-781 Warsaw, Poland; (E.B.); (P.R.)
- Department of Experimental Pharmacology, Mossakowski Medical Research Institute, Polish Academy of Sciences, 5 Pawinskiego Str., 02-106 Warsaw, Poland
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Banou L, Tsani Z, Arvanitogiannis K, Pavlaki M, Dastiridou A, Androudi S. Radiotherapy in Uveal Melanoma: A Review of Ocular Complications. Curr Oncol 2023; 30:6374-6396. [PMID: 37504330 PMCID: PMC10378371 DOI: 10.3390/curroncol30070470] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/20/2023] [Accepted: 07/01/2023] [Indexed: 07/29/2023] Open
Abstract
Uveal melanoma represents the most prevalent form of primary malignant intraocular tumor in adults. Historically, enucleation was considered the gold-standard approach in the treatment of uveal melanoma. Currently, radiotherapy is the most commonly used therapy, aiming at a better quality of life. However, radiotherapy can result in several ocular complications, some of which may be vision-threatening. Radiation-induced dry eye, scleral necrosis, cataract, rubeosis iridis, neovascular glaucoma, radiation retinopathy, maculopathy, and optic neuropathy are the most common complications. This article aims to summarize the current literature regarding the ocular complications after radiotherapy, as well as their clinical features, risk factors, and management strategies. A thorough understanding of these issues is crucial for ophthalmologists and oncologists to provide optimal patient care, improve visual outcomes, and minimize long-term complications.
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Affiliation(s)
- Lamprini Banou
- Department of Ophthalmology, University of Thessaly, 41110 Larissa, Greece
| | - Zoi Tsani
- Department of Ophthalmology, University of Thessaly, 41110 Larissa, Greece
| | | | - Maria Pavlaki
- Department of Ophthalmology, University of Thessaly, 41110 Larissa, Greece
| | - Anna Dastiridou
- Department of Ophthalmology, University of Thessaly, 41110 Larissa, Greece
| | - Sofia Androudi
- Department of Ophthalmology, University of Thessaly, 41110 Larissa, Greece
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Bai H, Bosch JJ, Heindl LM. Current management of uveal melanoma: A review. Clin Exp Ophthalmol 2023. [PMID: 37076276 DOI: 10.1111/ceo.14214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 02/12/2023] [Accepted: 02/13/2023] [Indexed: 04/21/2023]
Abstract
Uveal melanoma is the most frequent primary intraocular cancer in adulthood and is mostly localised to the choroid. It can be treated using radiation therapy, laser therapy, local resection and enucleation, with the best results achieved by combining these procedures. However, up to half of patients develop metastatic disease. There are no efficacious treatment methods for patients in advanced stage or with metastasis. In recent years, several novel treatment modalities aimed at improving tumour control and reducing adverse events have emerged. This review summarises current clinical treatment methods and new therapeutic perspectives for uveal melanoma.
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Affiliation(s)
- Haixia Bai
- Eye Center, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Jacobus J Bosch
- Centre for Human Drug Research, Leiden, Netherlands
- Leiden University Medical Center, Leiden, Netherlands
| | - Ludwig M Heindl
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
- Center for Integrated Oncology (CIO) Aachen-Bonn-Cologne-Duesseldorf, Cologne, Germany
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Guberina M, Sokolenko E, Guberina N, Dalbah S, Pöttgen C, Lübcke W, Indenkämpen F, Lachmuth M, Flühs D, Chen Y, Hoffmann C, Deuschl C, Jabbarli L, Fiorentzis M, Foerster A, Rating P, Ebenau M, Grunewald T, Bechrakis N, Stuschke M. Feasibility, Method and Early Outcome of Image-Guided Volumetric Modulated Arc Radiosurgery Followed by Resection for AJCC Stage IIA–IIIB High-Risk Large Intraocular Melanoma. Cancers (Basel) 2022; 14:cancers14194729. [PMID: 36230660 PMCID: PMC9562629 DOI: 10.3390/cancers14194729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/19/2022] [Accepted: 09/25/2022] [Indexed: 11/28/2022] Open
Abstract
Simple Summary The aim of this trial was to define one optimal contemporary treatment procedure for large intraocular melanoma. Radiosurgery is a highly effective treatment in cancer. In this trial, all consecutive patients with large intraocular melanoma treated with multimodality treatment, comprising 4D image-guided volumetric modulated arc radiosurgery procedure followed by resection, were evaluated. In the short-term follow-up there was no clinical toxicity due to external beam radiation therapy, and no local tumor recurrence. In 98% of the cases, the eye bulb could be maintained with partial residual visual acuity in the mean follow-up of 18 months. The outcome estimates one optimal treatment procedure for high-risk, large intraocular melanoma, with excellent results in the first follow-up. Abstract The main objective of this prospective observational study was the characterization of the feasibility and early outcome of image-guided (IG) volumetric modulated arc (VMAT) radiosurgery (SRS) followed by resection for patients with large intraocular melanoma. Our study included consecutive patients with unfavorable-risk melanoma, enrolled in an ophthalmic oncology center. IG-VMAT-SRS was applied by high-resolution 4D image guidance and monitoring. Current stereotactic technique parameters were evaluated for comparison. Side effects and eye function, based on a 5-point CTC assessment score, were quantified. In patients with tumors located more than 0.7–1 mm apart from the optic nerve, partial to complete volume-sparing of the optic nerve head could be achieved. In 95.5% of this subgroup, the vitality of the optic nerve and vision could be preserved by the multimodality-treatment approach (mean follow-up: 18 months (7.5–36 months)). The advanced technology of stereotactic radiotherapy demonstrated the achievability of steep dose gradients around the high-dose volume, with 4D-IG-VMAT dose application. These results enforce IG-VMAT-SRS followed by resection as one of the major therapeutic options for patients with large intraocular melanoma. The combination of 4D-IG high-precision SRS and resection provides an effective treatment for large intraocular melanoma, with few side effects, and enables an eye bulb and even vision preserving modus operandi.
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Affiliation(s)
- Maja Guberina
- Department of Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Hufeland Str. 55, 45147 Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Hufeland Str. 55, 45147 Essen, Germany
- Correspondence: ; Tel.: +49-201-723-2321
| | - Ekaterina Sokolenko
- Department of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, Hufeland Str. 55, 45147 Essen, Germany
| | - Nika Guberina
- Department of Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Hufeland Str. 55, 45147 Essen, Germany
| | - Sami Dalbah
- Department of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, Hufeland Str. 55, 45147 Essen, Germany
| | - Christoph Pöttgen
- Department of Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Hufeland Str. 55, 45147 Essen, Germany
| | - Wolfgang Lübcke
- Department of Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Hufeland Str. 55, 45147 Essen, Germany
| | - Frank Indenkämpen
- Department of Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Hufeland Str. 55, 45147 Essen, Germany
| | - Manfred Lachmuth
- Department of Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Hufeland Str. 55, 45147 Essen, Germany
| | - Dirk Flühs
- Department of Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Hufeland Str. 55, 45147 Essen, Germany
| | - Ying Chen
- Department of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, Hufeland Str. 55, 45147 Essen, Germany
| | - Christian Hoffmann
- Department of Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Hufeland Str. 55, 45147 Essen, Germany
| | - Cornelius Deuschl
- Institute of Diagnostic, Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Leyla Jabbarli
- Department of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, Hufeland Str. 55, 45147 Essen, Germany
| | - Miltiadis Fiorentzis
- Department of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, Hufeland Str. 55, 45147 Essen, Germany
| | - Andreas Foerster
- Department of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, Hufeland Str. 55, 45147 Essen, Germany
| | - Philipp Rating
- Department of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, Hufeland Str. 55, 45147 Essen, Germany
| | - Melanie Ebenau
- Department of Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Hufeland Str. 55, 45147 Essen, Germany
| | - Tobias Grunewald
- Department of Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Hufeland Str. 55, 45147 Essen, Germany
| | - Nikolaos Bechrakis
- Department of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, Hufeland Str. 55, 45147 Essen, Germany
| | - Martin Stuschke
- Department of Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Hufeland Str. 55, 45147 Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Hufeland Str. 55, 45147 Essen, Germany
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Retinal and Corneal Changes Associated with Intraocular Silicone Oil Tamponade. J Clin Med 2022; 11:jcm11175234. [PMID: 36079165 PMCID: PMC9457190 DOI: 10.3390/jcm11175234] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/13/2022] [Accepted: 09/01/2022] [Indexed: 12/22/2022] Open
Abstract
Silicone oils (SO) are used as long-term intraocular tamponades and have an irreplaceable role in vitreoretinal surgery. They can, however, be associated with multiple and potentially severe complications, involving different ocular tissues, in particular retina and cornea. Recent advances in ophthalmic imaging have allowed the precise characterization of retinal and corneal microstructural changes, at a subclinical level. This detailed analysis of SO-related retinal and corneal changes has improved our understanding of their pathogenesis and offer the potential for optimized monitoring and management of patients with SO-filled eyes. This review aims to provide clinicians and ophthalmic scientists with an updated and comprehensive overview of the corneal and retinal changes associated with SO tamponade.
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Hamza HS, Elnahry AG. Short-term perfluorocarbon liquid tamponade in choroidal melanoma endoresection. Int J Retina Vitreous 2022; 8:46. [PMID: 35794652 PMCID: PMC9258178 DOI: 10.1186/s40942-022-00395-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 06/27/2022] [Indexed: 11/10/2022] Open
Abstract
Purpose To report the use of short-term perfluorocarbon liquid (ST-PFCL) tamponade following choroidal melanoma endoresection. Methods Patients with medium to large choroidal melanomas not amenable to primary Ruthenium-106 brachytherapy underwent choroidal melanoma endoresection following gamma knife radiosurgery. During surgery, a complete vitrectomy was performed followed by PFCL injection, then a retinectomy with endoresection of the melanoma and underlying choroid was done. Complete PFCL filling was then achieved, and laser barrage surrounding the retinectomy was done. A Ruthenium-106 plaque was then inserted. Postoperatively, supine positioning was maintained for three days followed by plaque and PFCL removal with silicone oil injection. Several months later, silicone oil was removed. Results Four eyes of 4 patients underwent endoresection with ST-PFCL tamponade. Mean height of tumor was 8.6 ± 0.85 mm, while mean maximal basal diameter was 11.5 ± 1.1 mm. Mean preoperative logMAR best corrected visual acuity (BCVA) was 1.76 ± 0.18. All patients underwent preoperative gamma knife radiosurgery and postoperative brachytherapy. There were no major intraoperative or postoperative complications. All patients underwent silicone oil injection with PFCL/plaque removal after 3 days, while silicone oil was removed after 4 ± 1.2 months. Mean postoperative logMAR BCVA 3 months following oil removal was 0.89 ± 0.22 (p = 0.02). Mean follow-up duration was 17 ± 2.8 months. No patient developed local tumor recurrence, distant metastases, or vitreoretinal complications by final visit. Conclusion ST-PFCL tamponade may reduce the risk of intraoperative and postoperative complications associated with choroidal melanoma endoresection. Supplementary Information The online version contains supplementary material available at 10.1186/s40942-022-00395-z.
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