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Anderson AN, Conley P, Klocke CD, Sengupta SK, Pang A, Farley HC, Gillingham AR, Dawson AD, Fan Y, Jones JA, Gibbs SL, Skalet AH, Wu G, Wong MH. Detection of neoplastic-immune hybrid cells with metastatic properties in uveal melanoma. Res Sq 2023:rs.3.rs-3694879. [PMID: 38106024 PMCID: PMC10723549 DOI: 10.21203/rs.3.rs-3694879/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Background Uveal melanoma is the most common non-cutaneous melanoma and is an intraocular malignancy affecting nearly 7,000 individuals per year worldwide. Of these, approximately 50% will progress to metastatic disease for which there are currently no effective therapies. Despite advances in molecular profiling and metastatic stratification of uveal melanoma tumors, little is known regarding their underlying biology of metastasis. Our group has identified a disseminated neoplastic cell population characterized by co-expression of immune and melanoma proteins, circulating hybrid cells (hybrids), in patients with uveal melanoma. Compared to circulating tumor cells, which lack expression of immune proteins, hybrids are detected at an increased prevalence in peripheral blood and can be used as a non-invasive biomarker to predict metastatic progression. Methods To ascertain mechanisms underlying enhanced hybrid cell dissemination we identified hybrid cells within primary uveal melanoma tumors using single cell RNA sequencing and evaluated their gene expression and predicted ligand-receptor interactions in relation to other melanoma and immune cells within the primary tumor. We then verified expression of upregulated hybrid pathways within patient-matched tumor and peripheral blood hybrids using cyclic immunofluorescence and quantified their protein expression relative to other non-hybrid tumor and disseminated tumor cells. Results Among the top upregulated genes and pathways in hybrid cells were those involved in enhanced cell motility and cytoskeletal rearrangement, immune evasion, and altered cellular metabolism. In patient-matched tumor and peripheral blood, we verified gene expression by examining concordant protein expression for each pathway category: TMSB10 (cell motility), CD74 (immune evasion) and GPX1 (metabolism). Both TMSB10 and GPX1 were expressed on significantly higher numbers of disseminated hybrid cells compared to circulating tumor cells, and CD74 and GPX1 were expressed on more disseminated hybrids than tumor-resident hybrids. Lastly, we identified that hybrid cells express ligand-receptor signaling pathways implicated in promoting metastasis including GAS6-AXL, CXCL12-CXCR4, LGALS9-P4HB and IGF1-IGFR1. Conclusion These findings highlight the importance of TMSB10, GPX1 and CD74 for successful hybrid cell dissemination and survival in circulation. Our results contribute to the understanding of uveal melanoma tumor progression and interactions between tumor cells and immune cells in the tumor microenvironment that may promote metastasis.
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Ni S, Nguyen TTP, Ng R, Woodward M, Ostmo S, Jia Y, Chiang MF, Huang D, Skalet AH, Campbell JP, Jian Y. Panretinal Optical Coherence Tomography. IEEE Trans Med Imaging 2023; 42:3219-3228. [PMID: 37216244 PMCID: PMC10615839 DOI: 10.1109/tmi.2023.3278269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
We introduce a new concept of panoramic retinal (panretinal) optical coherence tomography (OCT) imaging system with a 140° field of view (FOV). To achieve this unprecedented FOV, a contact imaging approach was used which enabled faster, more efficient, and quantitative retinal imaging with measurement of axial eye length. The utilization of the handheld panretinal OCT imaging system could allow earlier recognition of peripheral retinal disease and prevent permanent vision loss. In addition, adequate visualization of the peripheral retina has a great potential for better understanding disease mechanisms regarding the periphery. To the best of our knowledge, the panretinal OCT imaging system presented in this manuscript has the widest FOV among all the retina OCT imaging systems and offers significant values in both clinical ophthalmology and basic vision science.
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Anderson AN, Conley P, Klocke CD, Sengupta SK, Robinson TL, Fan Y, Jones JA, Gibbs SL, Skalet AH, Wu G, Wong MH. Analysis of uveal melanoma scRNA sequencing data identifies neoplastic-immune hybrid cells that exhibit metastatic potential. bioRxiv 2023:2023.10.24.563815. [PMID: 37961378 PMCID: PMC10634980 DOI: 10.1101/2023.10.24.563815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Uveal melanoma (UM) is the most common non-cutaneous melanoma and is an intraocular malignancy that affects nearly 7,000 individuals per year worldwide. Of these, nearly 50% will progress to metastatic disease for which there are currently no effective therapies. Despite advances in the molecular profiling and metastatic stratification of class 1 and 2 UM tumors, little is known regarding the underlying biology of UM metastasis. Our group has identified a disseminated tumor cell population characterized by co-expression of immune and melanoma proteins, (circulating hybrid cells (CHCs), in patients with UM. Compared to circulating tumor cells, CHCs are detected at an increased prevalence in peripheral blood and can be used as a non-invasive biomarker to predict metastatic progression. To identify mechanisms underlying enhanced hybrid cell dissemination we sought to identify hybrid cells within a primary UM single cell RNA-seq dataset. Using rigorous doublet discrimination approaches, we identified UM hybrids and evaluated their gene expression, predicted ligand-receptor status, and cell-cell communication state in relation to other melanoma and immune cells within the primary tumor. We identified several genes and pathways upregulated in hybrid cells, including those involved in enhancing cell motility and cytoskeleton rearrangement, evading immune detection, and altering cellular metabolism. In addition, we identified that hybrid cells express ligand-receptor signaling pathways implicated in promoting cancer metastasis including IGF1-IGFR1, GAS6-AXL, LGALS9-P4HB, APP-CD74 and CXCL12-CXCR4. These results contribute to our understanding of tumor progression and interactions between tumor cells and immune cells in the UM microenvironment that may promote metastasis.
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Yumang M, Yee C, Passo RM, Skalet AH. Increased Number and Severity of Open Globe Injuries during COVID-19 Stay-at-home Orders. Ophthalmic Epidemiol 2023; 30:532-536. [PMID: 36748947 DOI: 10.1080/09286586.2023.2174558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 10/11/2022] [Accepted: 01/25/2023] [Indexed: 02/08/2023]
Abstract
PURPOSE To evaluate the occurrence and outcome of open globe injury during state-mandated COVID-19 stay-at-home orders compared to historical averages at a tertiary medical center in Portland, Oregon. METHODS Open globe injury between January 1, 2015 and December 31, 2020 was identified using relevant procedure codes. The number of injuries, mechanism of trauma, and short-term outcomes of globes repaired during the study period of March 23, 2020 to July 6, 2020 when stay-at-home orders were in effect were compared to a cohort from the same 15-week time frame in 2015-2019. We also evaluated injuries occurring throughout 2020 as compared to the prior 5 years. RESULTS 263 consecutive open globe injuries were identified between January 2015 and December 2020. While Oregon's stay-at-home orders were in effect, we observed a significant increase in the number of open globe injuries treated compared to the prior 5 years (p = .004). Twenty-four cases identified during the study period represent a 2-fold increase over the 2015-2019 average of 11.8 globe repairs during the same 15-week time period. Visual acuity < 20/200 at 6 months (p = .008) and secondary enucleation (p < .001) were more frequent during stay-at-home orders, and severity of injury as calculated by the Ocular Trauma Scores (OTS) was higher. Time-to-repair was similar between the two cohorts. CONCLUSION At our center, there was an increased number and severity of open globe injury during the period of mandatory COVID-19 stay-at-home orders. Visual acuity outcomes and risk for secondary enucleation were poorer compared to the reference cohort.Abbreviations: Ocular Trauma Score (OTS), Open globe injury (OGI), Emergency department (ED), Oregon Health and Science University (OHSU).
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Affiliation(s)
- Marika Yumang
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland, USA
| | - Claudine Yee
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland, USA
| | - Ross M Passo
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland, USA
| | - Alison H Skalet
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, USA
- Department of Radiation Medicine, Oregon Health & Science University, Portland, USA
- Department of Dermatology, Oregon Health & Science University, Portland, USA
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5
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Weis E, Jiang J, Skalet AH, Shields CL, Crump RT. Psychometric Results of a New Patient-Reported Outcome Measure for Uveal Melanoma Post-Brachytherapy Treatment: The PROM-UM. Cancers (Basel) 2023; 15:4142. [PMID: 37627170 PMCID: PMC10453155 DOI: 10.3390/cancers15164142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/02/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
The objective of this study was to evaluate the psychometric properties of a new patient-reported outcome instrument intended for use with patients who have undergone brachytherapy for uveal melanoma (PROM-UM). Classical test theory and item response theory were used to evaluate the performance of individual items and domains. A convenience sample of 439 participants who had undergone brachytherapy for uveal melanoma from one of three North American ocular oncology treatment centers were included in this cross-sectional study. Exploratory factor analysis identified three domains which were labelled "Symptom Impairment", "Worry", and "Discomfort". The acceptability of the instrument was supported by little missing data (range = 0.00-1.14%) and low maximum endorsement (range = 0.00-1.82%). Item-total (range = 0.68-0.85) and inter-item (range = 0.74-0.80) correlations indicated acceptable reliability. Discrimination and difficulty were assessed using item response theory. Items in all three domains indicated moderate to very high discrimination (range = 1.00-4.10). Two items in the Symptom Impairment domain were too difficult to measure. Response ranges in the other two domains demonstrated acceptable difficulty. These results from the study indicate that this new patient-reported outcome instrument can be used with patients treated with brachytherapy for uveal melanoma. Providers could use this instrument to help inform post-treatment management.
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Affiliation(s)
- Ezekiel Weis
- Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Jing Jiang
- Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Alison H. Skalet
- Departments of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Carol L. Shields
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107, USA;
| | - R. Trafford Crump
- Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
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6
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Jansen RW, de Bloeme CM, Cardoen L, Göricke S, van Elst S, Jessen JL, Ramasubramanian A, Skalet AH, Miller AK, Maeder P, Uner OE, Hubbard GB, Grossniklaus H, Boldt HC, Nichols KE, Brennan RC, Sen S, Sirin S, Brisse HJ, Galluzzi P, Dommering CJ, Castelijns JA, van der Valk P, Boellaard R, Dorsman J, Moll AC, de Jong MC, de Graaf P. MRI Features for Identifying MYCN-amplified RB1 Wild-type Retinoblastoma. Radiology 2023; 307:e222264. [PMID: 37191489 PMCID: PMC10315525 DOI: 10.1148/radiol.222264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 03/06/2023] [Accepted: 03/20/2023] [Indexed: 05/17/2023]
Abstract
Background MYCN-amplified RB1 wild-type (MYCNARB1+/+) retinoblastoma is a rare but clinically important subtype of retinoblastoma due to its aggressive character and relative resistance to typical therapeutic approaches. Because biopsy is not indicated in retinoblastoma, specific MRI features might be valuable to identify children with this genetic subtype. Purpose To define the MRI phenotype of MYCNARB1+/+ retinoblastoma and evaluate the ability of qualitative MRI features to help identify this specific genetic subtype. Materials and Methods In this retrospective, multicenter, case-control study, MRI scans in children with MYCNARB1+/+ retinoblastoma and age-matched children with RB1-/- subtype retinoblastoma were included (case-control ratio, 1:4; scans acquired from June 2001 to February 2021; scans collected from May 2018 to October 2021). Patients with histopathologically confirmed unilateral retinoblastoma, genetic testing (RB1/MYCN status), and MRI scans were included. Associations between radiologist-scored imaging features and diagnosis were assessed with the Fisher exact test or Fisher-Freeman-Halton test, and Bonferroni-corrected P values were calculated. Results A total of 110 patients from 10 retinoblastoma referral centers were included: 22 children with MYCNARB1+/+ retinoblastoma and 88 control children with RB1-/- retinoblastoma. Children in the MYCNARB1+/+ group had a median age of 7.0 months (IQR, 5.0-9.0 months) (13 boys), while children in the RB1-/- group had a median age of 9.0 months (IQR, 4.6-13.4 months) (46 boys). MYCNARB1+/+ retinoblastomas were typically peripherally located (in 10 of 17 children; specificity, 97%; P < .001) and exhibited plaque or pleomorphic shape (in 20 of 22 children; specificity, 51%; P = .011) with irregular margins (in 16 of 22 children; specificity, 70%; P = .008) and extensive retina folding with vitreous enclosure (specificity, 94%; P < .001). MYCNARB1+/+ retinoblastomas showed peritumoral hemorrhage (in 17 of 21 children; specificity, 88%; P < .001), subretinal hemorrhage with a fluid-fluid level (in eight of 22 children; specificity, 95%; P = .005), and strong anterior chamber enhancement (in 13 of 21 children; specificity, 80%; P = .008). Conclusion MYCNARB1+/+ retinoblastomas show distinct MRI features that could enable early identification of these tumors. This may improve patient selection for tailored treatment in the future. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Rollins in this issue.
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Affiliation(s)
- Robin W. Jansen
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Christiaan M. de Bloeme
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Liesbeth Cardoen
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Sophia Göricke
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Sabien van Elst
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Jaime Lyn Jessen
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Aparna Ramasubramanian
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Alison H. Skalet
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Audra K. Miller
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Philippe Maeder
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Ogul E. Uner
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - G. Baker Hubbard
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Hans Grossniklaus
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - H. Culver Boldt
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Kim E. Nichols
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Rachel C. Brennan
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Saugata Sen
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Selma Sirin
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Hervé J. Brisse
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Paolo Galluzzi
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Charlotte J. Dommering
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Jonas A. Castelijns
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Paul van der Valk
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Ronald Boellaard
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Josephine Dorsman
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Annette C. Moll
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Marcus C. de Jong
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Pim de Graaf
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
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7
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Altman MT, Staubach Z, Dunlap J, Zaki A, Skalet AH, Leonard J, Lin P. PSEUDOPANUVEITIS AS A HARBINGER FOR SYSTEMIC LEUKEMIA RECURRENCE. Retin Cases Brief Rep 2023; 17:117-119. [PMID: 34081042 PMCID: PMC10421638 DOI: 10.1097/icb.0000000000001172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe a patient with a history of pre-B-cell acute lymphoblastic leukemia in remission, who developed recurrent alternating intraocular leukemia manifesting with pseudohypopyon, uveal mass, and serous retinal detachment. In multiple instances, this constellation of ocular findings preceded systemic leukemia recurrence. METHOD Case report. RESULTS A 29-year-old man with a history of pre-B-cell acute lymphoblastic leukemia, in remission after a hematopoietic stem cell transplant, presented with pseudohypopyon, uveal lesions, and serous retinal detachment of the right eye. Comprehensive workup for infectious and inflammatory etiologies was unremarkable, and a bone marrow biopsy revealed systemic recurrence of leukemia. One year later, while again in remission, the patient developed a pseudohypopyon, uveal mass, and serous retinal detachment of the other eye. Repeat bone marrow biopsy showed impending leukemia relapse, which occurred 1 month later. Orbital radiation resulted in complete ocular resolution. CONCLUSION The constellation of pseudohypopyon, serous retinal detachment, and uveal mass (pseudopanuveitis) should be recognized as a harbinger for systemic pre-B ALL recurrence.
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Affiliation(s)
| | - Zane Staubach
- Department of Pathology, Oregon Health & Science University, Portland, Oregon
| | - Jennifer Dunlap
- Department of Pathology, Oregon Health & Science University, Portland, Oregon
| | - Amr Zaki
- Casey Eye Institute, Oregon Health & Science University
| | - Alison H. Skalet
- Casey Eye Institute, Oregon Health & Science University
- Department of Radiation Medicine, Oregon Health & Science University
- Department of Dermatology, Oregon Health & Science University
| | - Jessica Leonard
- Department of Hematology and Medical Oncology, Oregon Health & Science University
| | - Phoebe Lin
- Casey Eye Institute, Oregon Health & Science University
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8
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Uner OE, Aronow ME, Mruthyunjaya P, Materin MA, Stacey AW, Wilson M, Afshar A, Skalet AH. Uveal Melanoma and the IRIS® Registry (Intelligent Research in Sight): A Pilot Analysis and Future Directions. Ophthalmol Retina 2023; 7:284-286. [PMID: 36522810 DOI: 10.1016/j.oret.2022.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/15/2022] [Accepted: 10/25/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Ogul E Uner
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland, Oregon
| | - Mary E Aronow
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Prithvi Mruthyunjaya
- Department of Ophthalmology, Byers Eye Institute, Stanford School of Medicine, Palo Alto, California
| | - Miguel A Materin
- Department of Ophthalmology, Duke University Eye Center, Durham, North Carolina; Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina
| | - Andrew W Stacey
- Department of Ophthalmology, University of Washington, Seattle, Washington
| | - Matthew Wilson
- Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, Tennessee; Ocular Oncology Division, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Armin Afshar
- Ocular Oncology Service, Department of Ophthalmology, Wayne & Gladys Valley Center for Vision, University of California, San Francisco, San Francisco, California
| | - Alison H Skalet
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland, Oregon; Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon; Department of Radiation Medicine, Oregon Health & Science University, Portland, Oregon; Department of Dermatology, Oregon Health & Science University, Portland, Oregon.
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9
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Im DH, Pike S, Reid MW, Peng CC, Sirivolu S, Grossniklaus HE, Hubbard GB, Skalet AH, Bellsmith KN, Shields CL, Lally SE, Stacey AW, Reiser BJ, Nagiel A, Shah R, Xu L, Berry JL. A multicenter analysis of nucleic acid quantification using aqueous humor liquid biopsy in retinoblastoma – Implications for clinical testing. Ophthalmology Science 2023; 3:100289. [PMID: 37025945 PMCID: PMC10070901 DOI: 10.1016/j.xops.2023.100289] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/07/2023] [Accepted: 02/13/2023] [Indexed: 02/22/2023]
Abstract
Purpose Retinoblastoma (RB) is most often diagnosed with clinical features and not diagnosed with tumor biopsy. This study describes tumor-derived analyte concentrations from aqueous humor (AH) liquid biopsy and its use in clinical assays. Design Case series study. Participants Sixty-two RB eyes from 55 children and 14 control eyes from 12 children from 4 medical centers. Methods This study included 128 RB AH samples including: diagnostic (DX) samples, samples from eyes undergoing treatment (TX), samples after completing treatment (END), and during bevacizumab injection for radiation therapy after completing RB treatment (BEV). Fourteen-control AH were analyzed for unprocessed analytes (double-stranded DNA [dsDNA], single-stranded DNA [ssDNA], micro-RNA [miRNA], RNA, and protein) with Qubit fluorescence assays. Double-stranded DNA from 2 RB AH samples underwent low-pass whole-genome sequencing to detect somatic copy number alterations. Logistic regression was used to predict disease burden given analyte concentrations. Main Outcome Measures Unprocessed analyte (dsDNA, ssDNA, miRNA, RNA and protein) concentrations. Results Results revealed dsDNA, ssDNA, miRNA, and proteins, but not RNA, were quantifiable in most samples (up to 98%) with Qubit fluorescence assays. Median dsDNA concentration was significantly higher in DX (3.08 ng/μl) compared to TX (0.18 ng/μl; P < 0.0001) at an order of 17 times greater and 20 times greater than END samples (0.15 ng/μl; P = 0.001). Using logistic regression, nucleic acid concentrations were useful in predicting higher versus lower RB disease burden. Retinoblastoma somatic copy number alterations were identified in a TX, but not in a BEV sample, indicating the correlation with RB activity. Conclusions Aqueous humor liquid biopsy in RB is a high-yield source of dsDNA, ssDNA, miRNA, and protein. Diagnostic samples are most useful for RB 1 gene mutational analyses. Genomic analysis may be more informative of tumor activity status than quantification alone and can be performed even with smaller analyte concentrations obtained from TX samples. Financial Disclosures Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
- Deborah H. Im
- Department of Surgery, Division of Ophthalmology, The Vision Center at Children’s Hospital Los Angeles, Los Angeles, California
- USC Roski Eye Institute, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Sarah Pike
- Department of Surgery, Division of Ophthalmology, The Vision Center at Children’s Hospital Los Angeles, Los Angeles, California
- USC Roski Eye Institute, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Mark W. Reid
- Department of Surgery, Division of Ophthalmology, The Vision Center at Children’s Hospital Los Angeles, Los Angeles, California
| | - Chen-Ching Peng
- Department of Surgery, Division of Ophthalmology, The Vision Center at Children’s Hospital Los Angeles, Los Angeles, California
- USC Roski Eye Institute, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Shreya Sirivolu
- Department of Surgery, Division of Ophthalmology, The Vision Center at Children’s Hospital Los Angeles, Los Angeles, California
- USC Roski Eye Institute, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | | | - G. Baker Hubbard
- Emory Eye Center, Emory University School of Medicine, Atlanta, Georgia
| | - Alison H. Skalet
- Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, Oregon
| | - Kellyn N. Bellsmith
- Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, Oregon
| | - Carol L. Shields
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Sara E. Lally
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Andrew W. Stacey
- Division of Ophthalmology, Department of Ophthalmology, Seattle Children’s Hospital, University of Washington, Seattle, Washington
| | - Bibiana J. Reiser
- Department of Surgery, Division of Ophthalmology, The Vision Center at Children’s Hospital Los Angeles, Los Angeles, California
- USC Roski Eye Institute, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Aaron Nagiel
- Department of Surgery, Division of Ophthalmology, The Vision Center at Children’s Hospital Los Angeles, Los Angeles, California
- USC Roski Eye Institute, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Rachana Shah
- Cancer and Blood Disease Institute, Children’s Hospital Los Angeles, Los Angeles, California
| | - Liya Xu
- Department of Surgery, Division of Ophthalmology, The Vision Center at Children’s Hospital Los Angeles, Los Angeles, California
- USC Roski Eye Institute, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Jesse L. Berry
- Department of Surgery, Division of Ophthalmology, The Vision Center at Children’s Hospital Los Angeles, Los Angeles, California
- USC Roski Eye Institute, Keck School of Medicine of the University of Southern California, Los Angeles, California
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California
- The Saban Research Institute, Children’s Hospital Los Angeles, Los Angeles, California
- Correspondence: Jesse L. Berry, MD, Director of Ocular Oncology, Children’s Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027.
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Parappilly MS, Chin Y, Whalen RM, Anderson AN, Robinson TS, Strgar L, Sutton TL, Conley P, Klocke C, Gibbs SL, Chang YH, Wu G, Wong MH, Skalet AH. Circulating Neoplastic-Immune Hybrid Cells Predict Metastatic Progression in Uveal Melanoma. Cancers (Basel) 2022; 14:cancers14194617. [PMID: 36230539 PMCID: PMC9564048 DOI: 10.3390/cancers14194617] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/15/2022] [Accepted: 09/19/2022] [Indexed: 01/25/2023] Open
Abstract
Background: Uveal melanoma is an aggressive cancer with high metastatic risk. Recently, we identified a circulating cancer cell population that co-expresses neoplastic and leukocyte antigens, termed circulating hybrid cells (CHCs). In other cancers, CHCs are more numerous and better predict oncologic outcomes compared to circulating tumor cells (CTCs). We sought to investigate the potential of CHCs as a prognostic biomarker in uveal melanoma. Methods: We isolated peripheral blood monocular cells from uveal melanoma patients at the time of primary treatment and used antibodies against leukocyte and melanoma markers to identify and enumerate CHCs and CTCs by immunocytochemistry. Results: Using a multi-marker approach to capture the heterogeneous disseminated tumor cell population, detection of CHCs was highly sensitive in uveal melanoma patients regardless of disease stage. CHCs were detected in 100% of stage I-III uveal melanoma patients (entire cohort, n = 68), whereas CTCs were detected in 58.8% of patients. CHCs were detected at levels statically higher than CTCs across all stages (p = 0.05). Moreover, CHC levels, but not CTCs, predicted 3 year progression-free survival (p < 0.03) and overall survival (p < 0.04). Conclusion: CHCs are a novel and promising prognostic biomarker in uveal melanoma.
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Affiliation(s)
- Michael S. Parappilly
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, OR 97201, USA
| | - Yuki Chin
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, OR 97201, USA
| | - Riley M. Whalen
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, OR 97201, USA
| | - Ashley N. Anderson
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, OR 97201, USA
| | - Trinity S. Robinson
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, OR 97201, USA
| | - Luke Strgar
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97201, USA
- Department of Computational Biology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Thomas L. Sutton
- Department of Surgery, Oregon Health & Science University, Portland, OR 97239, USA
| | - Patrick Conley
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Christopher Klocke
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Summer L. Gibbs
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97201, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97201, USA
| | - Young Hwan Chang
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97201, USA
- Department of Computational Biology, Oregon Health & Science University, Portland, OR 97239, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97201, USA
| | - Guanming Wu
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR 97239, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97201, USA
| | - Melissa H. Wong
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, OR 97201, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97201, USA
- Correspondence: (M.H.W.); (A.H.S.)
| | - Alison H. Skalet
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97201, USA
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Correspondence: (M.H.W.); (A.H.S.)
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11
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Fabian ID, Abdallah E, Abdullahi SU, Abdulqader RA, Abdulrahaman AA, Abouelnaga S, Ademola-Popoola DS, Adio A, Afifi MA, Afshar AR, Aggarwal P, Aghaji AE, Ahmad A, Akib MNR, Akinsete A, Al Harby L, Al Mesfer S, Al Ani MH, Alarcón Portabella S, Al-Badri SAF, Alcasabas APA, Al-Dahmash SA, Alejos A, Alemany-Rubio E, Alfa Bio AI, Alfonso Carreras Y, Al-Haddad CE, Al-Hussaini HHY, Ali AM, Alia DB, Al-Jadiry MF, Al-Jumaily U, Alkatan HM, All-Eriksson C, Al-Mafrachi AARM, Almeida AA, Alsawidi KM, Al-Shaheen AASM, Al-Shammary EH, Amankwaa-Frempong D, Amiruddin PO, Armytasari I, Astbury NJ, Atalay HT, Ataseven E, Atchaneeyasakul LO, Atsiaya R, Autrata R, Balaguer J, Balayeva R, Barranco H, Bartoszek P, Bartuma K, Bascaran C, Bechrakis NE, Beck Popovic M, Begimkulova AS, Benmiloud S, Berete RC, Berry JL, Bhaduri A, Bhat S, Bhattacharyya A, Biewald EM, Binkley E, Blum S, Bobrova N, Boldt H, Bonanomi MTBC, Bouda GC, Bouguila H, Brennan RC, Brichard BG, Buaboonnam J, Budiongo A, Burton MJ, Calderón-Sotelo P, Calle Jara DA, Camuglia JE, Cano MR, Capra M, Caspi S, Cassoux N, Castela G, Castillo L, Català-Mora J, Cavieres I, Chandramohan A, Chantada GL, Chaudhry S, Chawla B, Chen W, Chiwanga FS, Chuluunbat T, Cieslik K, Clark A, Cockcroft RL, Comsa C, Correa Llano MG, Corson TW, Couitchere L, Cowan-Lyn KE, Csóka M, Dangboon W, Das A, Das P, Das S, Davanzo JM, Davidson A, De Francesco S, De Potter P, Quintero D K, Demirci H, Desjardins L, Díaz Coronado RY, Dimaras H, Dodgshun AJ, Donato Macedo CR, Dragomir MD, Du Y, Du Bruyn M, Du Plessis J, Dudeja G, Eerme K, Eka Sutyawan IW, El Kettani A, Elbahi AM, Elder JE, Elhaddad AM, Elhassan MMA, Elzembely MM, Ericksen C, Essuman VA, Evina TGA, Ezegwui IR, Fadoo Z, Fandiño AC, Faranoush M, Fasina O, Fernández DDPG, Fernández-Teijeiro A, Foster A, Frenkel S, Fu LD, Fuentes-Alabi SL, Garcia JL, García Aldana D, Garcia Pacheco HN, Geel JA, Ghassemi F, Girón AV, Goenz MA, Gold AS, Goldberg H, Gole GA, Gomel N, Gonzalez E, Gonzalez Perez G, González-Rodríguez L, Gorfine M, Graells J, Gregersen PA, Grigorovski NDAK, Guedenon KM, Gunasekera DS, Gündüz AK, Gupta H, Gupta S, Gupta V, Hadjistilianou T, Hamel P, Hamid SA, Hamzah N, Hansen ED, Harbour JW, Hartnett ME, Hasanreisoglu M, Muhammad H, Hassan S, Hassan S, Hautz W, Haydar H, Hederova S, Hessissen L, Hongeng S, Hordofa DF, Hubbard GB, Hummelen M, Husakova K, Hussein Al-Janabi AN, Ibanga A, Ida R, Ilic VR, Islamov Z, Jairaj V, Janjua T, Jeeva I, Ji X, Jo DH, Jones MM, Kabesha Amani TB, Kabore RL, Kaliki S, Kalinaki A, Kamsang P, Kantar M, Kapelushnik N, Kardava T, Kebudi R, Keomisy J, Kepak T, Ketteler P, Khan ZJ, Khaqan HA, Khetan V, Khodabande A, Khotenashvili Z, Kim JW, Kim JH, Kiratli H, Kivela TT, Klett A, Koç I, Kosh Komba Palet JE, Krivaitiene D, Kruger M, Kulvichit K, Kuntorini MW, Kyara A, Lam GC, Larson SA, Latinović S, Laurenti KD, Lavy Y, Lavric Groznik A, Leverant AA, Li C, Li K, Limbu B, Liu CH, Quah B, López JP, Lukamba RM, Luna-Fineman S, Lutfi D, Lysytsia L, Madgar S, Magrath GN, Mahajan A, Maitra P, Maka E, Makimbetov EK, Maktabi A, Maldonado C, Mallipatna A, Manudhane R, Manzhuova L, Martín-Begue N, Masud S, Matende IO, Mattosinho CCDS, Matua M, Mayet I, Mbumba FB, McKenzie JD, Mehrvar A, Mengesha AA, Menon V, Mercado GJV, Mets MB, Midena E, Miller A, Mishra DKC, Mndeme FG, Mohamedani AA, Mohammad MT, Moll AC, Montero MM, Moreira C, Mruthyunjaya P, Msina MS, Msukwa G, Mudaliar SS, Muma KIM, Munier FL, Murray TG, Musa KO, Mushtaq A, Musika AA, Mustak H, Mustapha T, Muyen OM, Myezo KH, Naidu G, Naidu N, Nair AG, Natarajan S, Naumenko L, Ndoye Roth PA, Nency YM, Neroev V, Ng Y, Nikitovic M, Nkanga ED, Nkumbe HE, Numbi MN, Nummi K, Nuruddin M, Nyaywa M, Nyirenda C, Obono-Obiang G, Oliver SCN, Oporto J, Ortega-Hernández M, Oscar AH, Ossandon D, Pagarra H, Paintsil V, Paiva L, Palanivelu MS, Papyan R, Parrozzani R, Pascual Morales CR, Paton KE, Pe'er J, Peralta Calvo J, Perić S, Pham CTM, Philbert R, Plager DA, Pochop P, Polania RA, Polyakov V, Ponce J, Qadir AO, Qayyum S, Qian J, Refaeli D, Rahman A, Rajkarnikar P, Ramanjulu R, Ramasubramanian A, Ramirez-Ortiz MA, Randhawa JK, Randrianarisoa HL, Raobela L, Rashid R, Reddy M, Renner LA, Reynders D, Ribadu D, Ritter-Sovinz P, Rogowska A, Rojanaporn D, Romero L, Roy SR, Saab RH, Saakyan S, Sabhan AH, Sagoo MS, Said AMA, Saiju R, Salas B, San Román Pacheco S, Sánchez GL, Sanchez Orozco AJ, Sayalith P, Scanlan TA, Schlüter S, Schwab C, Sedaghat A, Seth R, Sgroi M, Shah AS, Shakoor SA, Sharma MK, Sherief ST, Shields CL, Sia D, Siddiqui SN, Sidi cheikh S, Silva S, Singh AD, Singh U, Singha P, Sitorus RS, Skalet AH, Soebagjo HD, Sorochynska T, Ssali G, Stacey AW, Staffieri SE, Stahl ED, Steinberg DM, Stones DK, Strahlendorf C, Suarez MEC, Sultana S, Sun X, Superstein R, Supriyadi E, Surukrattanaskul S, Suzuki S, Svojgr K, Sylla F, Tamamyan G, Tan D, Tandili A, Tang J, Tarrillo Leiva FF, Tashvighi M, Tateshi B, Teh KH, Tehuteru ES, Teixeira LF, Tekavcic Pompe M, Thawaba ADM, Theophile T, Toledano H, Trang DL, Traoré F, Tripathy D, Tuncer S, Tyau-Tyau H, Umar AB, Unal E, Uner OE, Urbak SF, Ushakova TL, Usmanov RH, Valeina S, Valente P, van Hoefen Wijsard M, Vasquez Anchaya JK, Vaughan LO, Veleva-Krasteva NV, Verma N, Victor AA, Viksnins M, Villacís Chafla EG, Villegas VM, Vishnevskia-Dai V, Waddell K, Wali AH, Wang YZ, Wangtiraumnuay N, Wetter J, Widiarti W, Wilson MW, Wime ADC, Wiwatwongwana A, Wiwatwongwana D, Wolley Dod C, Wong ES, Wongwai P, Wu SQ, Xiang D, Xiao Y, Xu B, Xue K, Yaghy A, Yam JC, Yang H, Yanga JM, Yaqub MA, Yarovaya VA, Yarovoy AA, Ye H, Yee RI, Yousef YA, Yuliawati P, Zapata López AM, Zein E, Zhang Y, Zhilyaeva K, Zia N, Ziko OAO, Zondervan M, Bowman R. The Global Retinoblastoma Outcome Study: a prospective, cluster-based analysis of 4064 patients from 149 countries. The Lancet Global Health 2022; 10:e1128-e1140. [PMID: 35839812 PMCID: PMC9397647 DOI: 10.1016/s2214-109x(22)00250-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/06/2022] [Accepted: 05/23/2022] [Indexed: 02/01/2023] Open
Abstract
Background Retinoblastoma is the most common intraocular cancer worldwide. There is some evidence to suggest that major differences exist in treatment outcomes for children with retinoblastoma from different regions, but these differences have not been assessed on a global scale. We aimed to report 3-year outcomes for children with retinoblastoma globally and to investigate factors associated with survival. Methods We did a prospective cluster-based analysis of treatment-naive patients with retinoblastoma who were diagnosed between Jan 1, 2017, and Dec 31, 2017, then treated and followed up for 3 years. Patients were recruited from 260 specialised treatment centres worldwide. Data were obtained from participating centres on primary and additional treatments, duration of follow-up, metastasis, eye globe salvage, and survival outcome. We analysed time to death and time to enucleation with Cox regression models. Findings The cohort included 4064 children from 149 countries. The median age at diagnosis was 23·2 months (IQR 11·0–36·5). Extraocular tumour spread (cT4 of the cTNMH classification) at diagnosis was reported in five (0·8%) of 636 children from high-income countries, 55 (5·4%) of 1027 children from upper-middle-income countries, 342 (19·7%) of 1738 children from lower-middle-income countries, and 196 (42·9%) of 457 children from low-income countries. Enucleation surgery was available for all children and intravenous chemotherapy was available for 4014 (98·8%) of 4064 children. The 3-year survival rate was 99·5% (95% CI 98·8–100·0) for children from high-income countries, 91·2% (89·5–93·0) for children from upper-middle-income countries, 80·3% (78·3–82·3) for children from lower-middle-income countries, and 57·3% (52·1-63·0) for children from low-income countries. On analysis, independent factors for worse survival were residence in low-income countries compared to high-income countries (hazard ratio 16·67; 95% CI 4·76–50·00), cT4 advanced tumour compared to cT1 (8·98; 4·44–18·18), and older age at diagnosis in children up to 3 years (1·38 per year; 1·23–1·56). For children aged 3–7 years, the mortality risk decreased slightly (p=0·0104 for the change in slope). Interpretation This study, estimated to include approximately half of all new retinoblastoma cases worldwide in 2017, shows profound inequity in survival of children depending on the national income level of their country of residence. In high-income countries, death from retinoblastoma is rare, whereas in low-income countries estimated 3-year survival is just over 50%. Although essential treatments are available in nearly all countries, early diagnosis and treatment in low-income countries are key to improving survival outcomes. Funding Queen Elizabeth Diamond Jubilee Trust.
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Uner OE, Nanji AA, Skalet AH. Unilateral Intraocular Lens Implant Subluxation in an Adult. JAMA Ophthalmol 2022; 140:648-649. [PMID: 35420646 DOI: 10.1001/jamaophthalmol.2022.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Ogul E Uner
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland
| | - Afshan A Nanji
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland.,Knight Cancer Institute, Oregon Health & Science University, Portland
| | - Alison H Skalet
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland.,Knight Cancer Institute, Oregon Health & Science University, Portland.,Department of Radiation Medicine, Oregon Health & Science University, Portland.,Department of Dermatology, Oregon Health & Science University, Portland
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13
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Wu F, McGarrey MP, Geenen KR, Skalet AH, Guillot FH, Wilson JL, Shah AS, Gonzalez E, Thiele EA, Kim IK, Aronow ME. Treatment of Aggressive Retinal Astrocytic Hamartoma with Oral mTOR Inhibition. Ophthalmol Retina 2022; 6:411-420. [PMID: 35007768 DOI: 10.1016/j.oret.2022.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 12/28/2021] [Accepted: 01/04/2022] [Indexed: 12/22/2022]
Abstract
OBJECTIVE OR PURPOSE To describe the clinical course and outcomes of aggressive retinal astrocytic hamartoma (RAH) treated with oral mTOR inhibitors (mTORi). DESIGN Retrospective clinical case series. SUBJECTS, PARTICIPANTS, AND/OR CONTROLS Five patients with genetically confirmed TSC and visually significant RAH due to tumor growth or exudation. METHODS, INTERVENTION, OR TESTING Review of the electronic medical record in this retrospective clinical case series was performed to determine baseline and follow-up ophthalmologic examination characteristics along with ancillary imaging findings, in patients receiving off-label treatment with either oral sirolimus or everolimus for symptomatic RAH. MAIN OUTCOME MEASURES Visual acuity, change in tumor size, degree of exudation, and adverse effects of mTORi were evaluated. RESULTS The five patients in this series ranged in age from 8 months to 54 years. Four were treated with sirolimus, and one received everolimus. In all cases, tumor height was stable or decreased following treatment (median follow-up: 39 months, range 11-73 months). Exudation improved following treatment in all cases. In the 8-month-old infant, frequent upper respiratory tract infections prompted cessation of treatment. In one patient, the mTORi was temporarily held due to elevated liver enzymes. No other significant adverse effects were noted. CONCLUSIONS Sirolimus and everolimus should be considered in the management of vision-threatening RAH, particularly in the setting of exudative and rapidly growing tumors. Four out of five patients in this series tolerated oral mTORi and continued on therapy. There were no serious complications.
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Affiliation(s)
- Frances Wu
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA
| | - Mark P McGarrey
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA
| | - Kennedy R Geenen
- Herscot Center for Tuberous Sclerosis Complex, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Alison H Skalet
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland, OR; Department of Radiation Medicine, Oregon Health & Science University, Portland, OR; Department of Dermatology, Oregon Health & Science University, Portland, OR
| | - Florian H Guillot
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland, OR
| | - Jenny L Wilson
- Department of Pediatric Neurology, Oregon Health & Science University, Portland, OR
| | - Ankoor S Shah
- Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Efren Gonzalez
- Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Elizabeth A Thiele
- Herscot Center for Tuberous Sclerosis Complex, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Ivana K Kim
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA
| | - Mary E Aronow
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA.
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14
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Dietz MS, Sutton TL, Walker BS, Gast CE, Zarour L, Sengupta SK, Swain JR, Eng J, Parappilly M, Limbach K, Sattler A, Burlingame E, Chin Y, Gower A, Mira JLM, Sapre A, Chiu YJ, Clayburgh DR, Pommier SJ, Cetnar JP, Fischer JM, Jaboin JJ, Pommier RF, Sheppard BC, Tsikitis VL, Skalet AH, Mayo SC, Lopez CD, Gray JW, Mills GB, Mitri Z, Chang YH, Chin K, Wong MH. Relevance of circulating hybrid cells as a non-invasive biomarker for myriad solid tumors. Sci Rep 2021; 11:13630. [PMID: 34211050 PMCID: PMC8249418 DOI: 10.1038/s41598-021-93053-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 06/09/2021] [Indexed: 02/06/2023] Open
Abstract
Metastatic progression defines the final stages of tumor evolution and underlies the majority of cancer-related deaths. The heterogeneity in disseminated tumor cell populations capable of seeding and growing in distant organ sites contributes to the development of treatment resistant disease. We recently reported the identification of a novel tumor-derived cell population, circulating hybrid cells (CHCs), harboring attributes from both macrophages and neoplastic cells, including functional characteristics important to metastatic spread. These disseminated hybrids outnumber conventionally defined circulating tumor cells (CTCs) in cancer patients. It is unknown if CHCs represent a generalized cancer mechanism for cell dissemination, or if this population is relevant to the metastatic cascade. Herein, we detect CHCs in the peripheral blood of patients with cancer in myriad disease sites encompassing epithelial and non-epithelial malignancies. Further, we demonstrate that in vivo-derived hybrid cells harbor tumor-initiating capacity in murine cancer models and that CHCs from human breast cancer patients express stem cell antigens, features consistent with the potential to seed and grow at metastatic sites. Finally, we reveal heterogeneity of CHC phenotypes reflect key tumor features, including oncogenic mutations and functional protein expression. Importantly, this novel population of disseminated neoplastic cells opens a new area in cancer biology and renewed opportunity for battling metastatic disease.
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Affiliation(s)
- Matthew S Dietz
- Department of Pediatrics, Oregon Health & Science University (OHSU), Portland, OR, 97239, USA.,Department of Pediatrics, University of Utah, Salt Lake City, UT, 84113, USA
| | | | | | - Charles E Gast
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, 2720 S. Moody Ave., Mailcode KC-CDCB, Portland, OR, 97201, USA
| | - Luai Zarour
- Department of Surgery, OHSU, Portland, OR, 97239, USA.,Department of General Surgery, Legacy Medical Group, Gresham, OR, 97030, USA
| | - Sidharth K Sengupta
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, 2720 S. Moody Ave., Mailcode KC-CDCB, Portland, OR, 97201, USA
| | - John R Swain
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, 2720 S. Moody Ave., Mailcode KC-CDCB, Portland, OR, 97201, USA
| | - Jennifer Eng
- Department of Biomedical Engineering, OHSU, Portland, OR, 97239, USA
| | - Michael Parappilly
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, 2720 S. Moody Ave., Mailcode KC-CDCB, Portland, OR, 97201, USA
| | | | - Ariana Sattler
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, 2720 S. Moody Ave., Mailcode KC-CDCB, Portland, OR, 97201, USA
| | - Erik Burlingame
- Department of Biomedical Engineering, OHSU, Portland, OR, 97239, USA.,Computational Biology Program, OHSU, Portland, OR, 97239, USA
| | - Yuki Chin
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, 2720 S. Moody Ave., Mailcode KC-CDCB, Portland, OR, 97201, USA
| | - Austin Gower
- Cancer Early Detection Advanced Research Center, OHSU, Portland, OR, 97201, USA
| | - Jose L Montoya Mira
- Department of Biomedical Engineering, OHSU, Portland, OR, 97239, USA.,Cancer Early Detection Advanced Research Center, OHSU, Portland, OR, 97201, USA
| | - Ajay Sapre
- Cancer Early Detection Advanced Research Center, OHSU, Portland, OR, 97201, USA
| | - Yu-Jui Chiu
- Cancer Early Detection Advanced Research Center, OHSU, Portland, OR, 97201, USA
| | - Daniel R Clayburgh
- Department of Otolaryngology, OHSU, Portland, OR, 97239, USA.,Operative Care Division, Portland Veterans Affairs Medical Center, Portland, OR, 97239, USA.,The Knight Cancer Institute, OHSU, Portland, OR, 97201, USA
| | | | - Jeremy P Cetnar
- The Knight Cancer Institute, OHSU, Portland, OR, 97201, USA.,Department of Medicine, OHSU, Portland, OR, 97239, USA
| | - Jared M Fischer
- Cancer Early Detection Advanced Research Center, OHSU, Portland, OR, 97201, USA.,The Knight Cancer Institute, OHSU, Portland, OR, 97201, USA.,Department of Molecule and Medical Genetics, OHSU, Portland, OR, 97239, USA
| | - Jerry J Jaboin
- The Knight Cancer Institute, OHSU, Portland, OR, 97201, USA.,Department of Radiation Medicine, OHSU, Portland, OR, 97239, USA
| | - Rodney F Pommier
- Department of Surgery, OHSU, Portland, OR, 97239, USA.,The Knight Cancer Institute, OHSU, Portland, OR, 97201, USA
| | - Brett C Sheppard
- Department of Surgery, OHSU, Portland, OR, 97239, USA.,The Knight Cancer Institute, OHSU, Portland, OR, 97201, USA
| | | | - Alison H Skalet
- The Knight Cancer Institute, OHSU, Portland, OR, 97201, USA.,Casey Eye Institute, OHSU, Portland, OR, 97239, USA
| | - Skye C Mayo
- Department of Surgery, OHSU, Portland, OR, 97239, USA.,The Knight Cancer Institute, OHSU, Portland, OR, 97201, USA
| | - Charles D Lopez
- The Knight Cancer Institute, OHSU, Portland, OR, 97201, USA.,Department of Medicine, OHSU, Portland, OR, 97239, USA
| | - Joe W Gray
- Department of Biomedical Engineering, OHSU, Portland, OR, 97239, USA.,The Knight Cancer Institute, OHSU, Portland, OR, 97201, USA
| | - Gordon B Mills
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, 2720 S. Moody Ave., Mailcode KC-CDCB, Portland, OR, 97201, USA.,The Knight Cancer Institute, OHSU, Portland, OR, 97201, USA
| | - Zahi Mitri
- The Knight Cancer Institute, OHSU, Portland, OR, 97201, USA.,Department of Medicine, OHSU, Portland, OR, 97239, USA
| | - Young Hwan Chang
- Department of Biomedical Engineering, OHSU, Portland, OR, 97239, USA.,Computational Biology Program, OHSU, Portland, OR, 97239, USA.,The Knight Cancer Institute, OHSU, Portland, OR, 97201, USA
| | - Koei Chin
- Department of Biomedical Engineering, OHSU, Portland, OR, 97239, USA.,The Knight Cancer Institute, OHSU, Portland, OR, 97201, USA
| | - Melissa H Wong
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, 2720 S. Moody Ave., Mailcode KC-CDCB, Portland, OR, 97201, USA. .,The Knight Cancer Institute, OHSU, Portland, OR, 97201, USA.
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15
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Simonett JM, Skalet AH, Lujan BJ, Neuwelt EA, Ambady P, Lin P. Risk Factors and Disease Course for Blood-Brain Barrier Disruption-Associated Maculopathy. JAMA Ophthalmol 2021; 139:143-149. [PMID: 33270081 DOI: 10.1001/jamaophthalmol.2020.5329] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Importance Blood-brain barrier disruption (BBBD) is a systemic therapy for malignant central nervous system (CNS) tumors that has been linked to poorly understood pigmentary maculopathy. Objectives To examine the rate of and risk factors for the development of BBBD-associated maculopathy and to assess whether there can be visually significant progression after completion of systemic therapy. Design, Setting, and Participants In this retrospective case series, data from February 1, 2006, through December 31, 2019, were collected from patients treated with osmotic BBBD at a single tertiary referral center who had subsequent ophthalmic evaluation. Exposures Treatment with BBBD therapy for any malignant CNS tumor. Main Outcomes and Measures Rate and potential risk factors for developing BBBD-associated maculopathy and changes in visual acuity and retinal imaging characteristics after completion of BBBD therapy. Results Of 283 patients treated with BBBD and chemotherapy for a CNS malignant neoplasm, 68 (mean [SD] age, 46.0 [17.9] years; 25 [38.5%] female) had an ophthalmic examination after starting systemic therapy. After excluding 3 patients because of bilateral media opacities, pigmentary maculopathy was present in 32 of 65 patients (49.2%) treated with BBBD. The number of BBBD treatment sessions, but not age, CNS malignant cancer type, or systemic chemotherapy agent, was associated with maculopathy development (odds ratio, 1.30; 95% CI, 1.12-1.50; P = .001). After completion of BBBD therapy, progressive enlargement of geographic atrophy occurred in 5 eyes of 3 patients, and choroidal neovascularization developed in 1 eye. Conclusions and Relevance In this case series, an association was found between BBBD-related maculopathy and the number of BBBD treatment sessions, suggesting a dose-dependent effect. In some cases, maculopathy progression, including enlargement of geographic atrophy, occurred years after completion of systemic therapy. These findings may have important implications for patient education and ophthalmic monitoring.
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Affiliation(s)
- Joseph M Simonett
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland
| | - Alison H Skalet
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland
| | - Brandon J Lujan
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland
| | - Edward A Neuwelt
- Department of Neurology, Oregon Health & Science University, Portland
| | - Prakash Ambady
- Department of Neurology, Oregon Health & Science University, Portland
| | - Phoebe Lin
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland
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16
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Simonett JM, Ambady P, Neuwelt EA, Skalet AH, Lin P. Maculopathy Associated With Osmotic Blood- Brain Barrier Disruption and Chemotherapy in Patients With Primary CNS Lymphoma. Ophthalmic Surg Lasers Imaging Retina 2021; 51:S5-S12. [PMID: 32484895 DOI: 10.3928/23258160-20200108-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 02/10/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To describe the incidence, characteristics, and risk factors of a pigmentary maculopathy in patients with primary central nervous system (CNS) lymphoma treated with blood-brain barrier disruption (BBBD) therapy. PATIENTS AND METHODS This retrospective chart review included patients with biopsy-proven primary CNS lymphoma treated with or without BBBD therapy who underwent an ophthalmic examination after starting systemic treatment. Clinical data and all available retinal imaging were analyzed. RESULTS Fifty-eight patients met inclusion criteria. Twenty-one of 36 patients treated with BBBD therapy had a bilateral pigmentary maculopathy. None of the 22 patients treated with conventional chemotherapy had similar changes. Additional findings in patients treated with BBBD included geographic retinal pigment epithelium atrophy, subretinal fluid, and in one case, choroidal neovascularization. Some cases of maculopathy resulted in reduced visual acuity. The presence of a pigmentary maculopathy was associated with a higher number of BBBD treatment sessions (20.1 vs 13.3, P = .016), but not vitreoretinal lymphoma involvement or intravitreal methotrexate injections. CONCLUSION In this cohort, 58.3% of patients with primary CNS lymphoma treated with BBBD and chemotherapy were found to have a bilateral pigmentary maculopathy. This maculopathy can result in reduced visual acuity and is associated with the number of BBBD treatment sessions. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:S5-S12.].
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17
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Slaught C, Berry EG, Bacik L, Skalet AH, Anadiotis G, Tuohy T, Leachman SA. Clinical challenges in interpreting multiple pathogenic mutations in single patients. Hered Cancer Clin Pract 2021; 19:15. [PMID: 33541411 PMCID: PMC7863461 DOI: 10.1186/s13053-021-00172-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 01/25/2021] [Indexed: 01/13/2023] Open
Abstract
Background In the past two decades, genetic testing for cancer risk assessment has entered mainstream clinical practice due to the availability of low-cost panels of multiple cancer-associated genes. However, the clinical value of multiple-gene panels for cancer susceptibility is not well established, especially in cases where panel testing identifies more than one pathogenic variant. The risk for specific malignancies as a result of a mutated gene is complex and likely influenced by superimposed modifier variants and/or environmental effects. Recent data suggests that the combination of multiple pathogenic variants may be fewer than reported by chance, suggesting that some mutation combinations may be detrimental. Management of patients with “incidentally” discovered mutations can be particularly challenging, especially when established guidelines call for radical procedures (e.g. total gastrectomy in CDH1) in patients and families without a classic clinical history concerning for that cancer predisposition syndrome. Case presentation We present two cases, one of an individual and one of a family, with multiple pathogenic mutations detected by multi-gene panel testing to highlight challenges practitioners face in counseling patients about pathogenic variants and determining preventive and therapeutic interventions. Conclusions Ongoing investigation is needed to improve our understanding of inherited susceptibility to disease in general and cancer predisposition syndromes, as this information has the potential to lead to the development of more precise and patient-specific counseling and surveillance strategies. The real-world adoption of new or improved technologies into clinical practice frequently requires medical decision-making in the absence of established understanding of gene-gene interactions. In the meantime, practitioners must be prepared to apply a rationale based on currently available knowledge to clinical decision-making. Current practice is evolving to rely heavily on clinical concordance with personal and family history in making specific therapeutic decisions. Supplementary Information The online version contains supplementary material available at 10.1186/s13053-021-00172-3.
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Affiliation(s)
- Christa Slaught
- Department of Dermatology, Oregon Health & Science University, 3303 SW Bond Ave, Suite 16D, Portland, OR, 97239, USA
| | - Elizabeth G Berry
- Department of Dermatology, Oregon Health & Science University, 3303 SW Bond Ave, Suite 16D, Portland, OR, 97239, USA.
| | - Lindsay Bacik
- Department of Dermatology, Penn State Health, Hershey, USA
| | - Alison H Skalet
- Department of Dermatology, Oregon Health & Science University, 3303 SW Bond Ave, Suite 16D, Portland, OR, 97239, USA.,Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, USA.,Knight Cancer Institute, Oregon Health & Science University, Portland, USA.,Department of Radiation Medicine, Oregon Health & Science University, Portland, USA
| | - George Anadiotis
- Legacy Cancer Institute, Cancer Genetics Services, Legacy Health Systems, Portland, USA
| | - Therese Tuohy
- Legacy Cancer Institute, Cancer Genetics Services, Legacy Health Systems, Portland, USA
| | - Sancy A Leachman
- Department of Dermatology, Oregon Health & Science University, 3303 SW Bond Ave, Suite 16D, Portland, OR, 97239, USA.,Knight Cancer Institute, Oregon Health & Science University, Portland, USA
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18
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Fabian ID, Abdallah E, Abdullahi SU, Abdulqader RA, Adamou Boubacar S, Ademola-Popoola DS, Adio A, Afshar AR, Aggarwal P, Aghaji AE, Ahmad A, Akib MNR, Al Harby L, Al Ani MH, Alakbarova A, Portabella SA, Al-Badri SAF, Alcasabas APA, Al-Dahmash SA, Alejos A, Alemany-Rubio E, Alfa Bio AI, Alfonso Carreras Y, Al-Haddad C, Al-Hussaini HHY, Ali AM, Alia DB, Al-Jadiry MF, Al-Jumaily U, Alkatan HM, All-Eriksson C, Al-Mafrachi AARM, Almeida AA, Alsawidi KM, Al-Shaheen AASM, Al-Shammary EH, Amiruddin PO, Antonino R, Astbury NJ, Atalay HT, Atchaneeyasakul LO, Atsiaya R, Attaseth T, Aung TH, Ayala S, Baizakova B, Balaguer J, Balayeva R, Balwierz W, Barranco H, Bascaran C, Beck Popovic M, Benavides R, Benmiloud S, Bennani Guebessi N, Berete RC, Berry JL, Bhaduri A, Bhat S, Biddulph SJ, Biewald EM, Bobrova N, Boehme M, Boldt HC, Bonanomi MTBC, Bornfeld N, Bouda GC, Bouguila H, Boumedane A, Brennan RC, Brichard BG, Buaboonnam J, Calderón-Sotelo P, Calle Jara DA, Camuglia JE, Cano MR, Capra M, Cassoux N, Castela G, Castillo L, Català-Mora J, Chantada GL, Chaudhry S, Chaugule SS, Chauhan A, Chawla B, Chernodrinska VS, Chiwanga FS, Chuluunbat T, Cieslik K, Cockcroft RL, Comsa C, Correa ZM, Correa Llano MG, Corson TW, Cowan-Lyn KE, Csóka M, Cui X, Da Gama IV, Dangboon W, Das A, Das S, Davanzo JM, Davidson A, De Potter P, Delgado KQ, Demirci H, Desjardins L, Diaz Coronado RY, Dimaras H, Dodgshun AJ, Donaldson C, Donato Macedo CR, Dragomir MD, Du Y, Du Bruyn M, Edison KS, Eka Sutyawan IW, El Kettani A, Elbahi AM, Elder JE, Elgalaly D, Elhaddad AM, Elhassan MMA, Elzembely MM, Essuman VA, Evina TGA, Fadoo Z, Fandiño AC, Faranoush M, Fasina O, Fernández DDPG, Fernández-Teijeiro A, Foster A, Frenkel S, Fu LD, Fuentes-Alabi SL, Gallie BL, Gandiwa M, Garcia JL, García Aldana D, Gassant PY, Geel JA, Ghassemi F, Girón AV, Gizachew Z, Goenz MA, Gold AS, Goldberg-Lavid M, Gole GA, Gomel N, Gonzalez E, Gonzalez Perez G, González-Rodríguez L, Garcia Pacheco HN, Graells J, Green L, Gregersen PA, Grigorovski NDAK, Guedenon KM, Gunasekera DS, Gündüz AK, Gupta H, Gupta S, Hadjistilianou T, Hamel P, Hamid SA, Hamzah N, Hansen ED, Harbour JW, Hartnett ME, Hasanreisoglu M, Hassan S, Hassan S, Hederova S, Hernandez J, Hernandez LMC, Hessissen L, Hordofa DF, Huang LC, Hubbard GB, Hummlen M, Husakova K, Hussein Al-Janabi AN, Ida R, Ilic VR, Jairaj V, Jeeva I, Jenkinson H, Ji X, Jo DH, Johnson KP, Johnson WJ, Jones MM, Kabesha TBA, Kabore RL, Kaliki S, Kalinaki A, Kantar M, Kao LY, Kardava T, Kebudi R, Kepak T, Keren-Froim N, Khan ZJ, Khaqan HA, Khauv P, Kheir WJ, Khetan V, Khodabande A, Khotenashvili Z, Kim JW, Kim JH, Kiratli H, Kivelä TT, Klett A, Komba Palet JEK, Krivaitiene D, Kruger M, Kulvichit K, Kuntorini MW, Kyara A, Lachmann ES, Lam CPS, Lam GC, Larson SA, Latinovic S, Laurenti KD, Le BHA, Lecuona K, Leverant AA, Li C, Limbu B, Long QB, López JP, Lukamba RM, Lumbroso L, Luna-Fineman S, Lutfi D, Lysytsia L, Magrath GN, Mahajan A, Majeed AR, Maka E, Makan M, Makimbetov EK, Manda C, Martín Begue N, Mason L, Mason JO, Matende IO, Materin M, Mattosinho CCDS, Matua M, Mayet I, Mbumba FB, McKenzie JD, Medina-Sanson A, Mehrvar A, Mengesha AA, Menon V, Mercado GJVD, Mets MB, Midena E, Mishra DKC, Mndeme FG, Mohamedani AA, Mohammad MT, Moll AC, Montero MM, Morales RA, Moreira C, Mruthyunjaya P, Msina MS, Msukwa G, Mudaliar SS, Muma KI, Munier FL, Murgoi G, Murray TG, Musa KO, Mushtaq A, Mustak H, Muyen OM, Naidu G, Nair AG, Naumenko L, Ndoye Roth PA, Nency YM, Neroev V, Ngo H, Nieves RM, Nikitovic M, Nkanga ED, Nkumbe H, Nuruddin M, Nyaywa M, Obono-Obiang G, Oguego NC, Olechowski A, Oliver SCN, Osei-Bonsu P, Ossandon D, Paez-Escamilla MA, Pagarra H, Painter SL, Paintsil V, Paiva L, Pal BP, Palanivelu MS, Papyan R, Parrozzani R, Parulekar M, Pascual Morales CR, Paton KE, Pawinska-Wasikowska K, Pe'er J, Peña A, Peric S, Pham CTM, Philbert R, Plager DA, Pochop P, Polania RA, Polyakov VG, Pompe MT, Pons JJ, Prat D, Prom V, Purwanto I, Qadir AO, Qayyum S, Qian J, Rahman A, Rahman S, Rahmat J, Rajkarnikar P, Ramanjulu R, Ramasubramanian A, Ramirez-Ortiz MA, Raobela L, Rashid R, Reddy MA, Reich E, Renner LA, Reynders D, Ribadu D, Riheia MM, Ritter-Sovinz P, Rojanaporn D, Romero L, Roy SR, Saab RH, Saakyan S, Sabhan AH, Sagoo MS, Said AMA, Saiju R, Salas B, San Román Pacheco S, Sánchez GL, Sayalith P, Scanlan TA, Schefler AC, Schoeman J, Sedaghat A, Seregard S, Seth R, Shah AS, Shakoor SA, Sharma MK, Sherief ST, Shetye NG, Shields CL, Siddiqui SN, Sidi Cheikh S, Silva S, Singh AD, Singh N, Singh U, Singha P, Sitorus RS, Skalet AH, Soebagjo HD, Sorochynska T, Ssali G, Stacey AW, Staffieri SE, Stahl ED, Stathopoulos C, Stirn Kranjc B, Stones DK, Strahlendorf C, Suarez MEC, Sultana S, Sun X, Sundy M, Superstein R, Supriyadi E, Surukrattanaskul S, Suzuki S, Svojgr K, Sylla F, Tamamyan G, Tan D, Tandili A, Tarrillo Leiva FF, Tashvighi M, Tateshi B, Tehuteru ES, Teixeira LF, Teh KH, Theophile T, Toledano H, Trang DL, Traoré F, Trichaiyaporn S, Tuncer S, Tyau-Tyau H, Umar AB, Unal E, Uner OE, Urbak SF, Ushakova TL, Usmanov RH, Valeina S, van Hoefen Wijsard M, Varadisai A, Vasquez L, Vaughan LO, Veleva-Krasteva NV, Verma N, Victor AA, Viksnins M, Villacís Chafla EG, Vishnevskia-Dai V, Vora T, Wachtel AE, Wackernagel W, Waddell K, Wade PD, Wali AH, Wang YZ, Weiss A, Wilson MW, Wime ADC, Wiwatwongwana A, Wiwatwongwana D, Wolley Dod C, Wongwai P, Xiang D, Xiao Y, Yam JC, Yang H, Yanga JM, Yaqub MA, Yarovaya VA, Yarovoy AA, Ye H, Yousef YA, Yuliawati P, Zapata López AM, Zein E, Zhang C, Zhang Y, Zhao J, Zheng X, Zhilyaeva K, Zia N, Ziko OAO, Zondervan M, Bowman R. Global Retinoblastoma Presentation and Analysis by National Income Level. JAMA Oncol 2020; 6:685-695. [PMID: 32105305 PMCID: PMC7047856 DOI: 10.1001/jamaoncol.2019.6716] [Citation(s) in RCA: 144] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Importance Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs.
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Affiliation(s)
| | - Ido Didi Fabian
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel
| | - Elhassan Abdallah
- Ophthalmology Department of Rabat, Mohammed V University, Rabat, Morocco
| | | | | | | | | | - Adedayo Adio
- Department of Ophthalmology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
| | | | | | - Ada E Aghaji
- Department of Ophthalmology, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Alia Ahmad
- The Children's Hospital and the Institute of Child Health, Lahore, Pakistan
| | | | - Lamis Al Harby
- The Royal London Hospital, Barts Health NHS Trust, and Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | | | - Aygun Alakbarova
- Zarifa Aliyeva National Center of Ophthalmology, Baku, Azerbaijan
| | | | - Safaa A F Al-Badri
- Pediatric Oncology Unit, Children Welfare Teaching Hospital, College of Medicine, University of Baghdad, Baghdad, Iraq
| | | | | | - Amanda Alejos
- Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala
| | | | | | | | - Christiane Al-Haddad
- Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon
| | | | - Amany M Ali
- Pediatric Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Donjeta B Alia
- University Hospital Center Mother Theresa, Tirana, Albania
| | - Mazin F Al-Jadiry
- Pediatric Oncology Unit, Children Welfare Teaching Hospital, College of Medicine, University of Baghdad, Baghdad, Iraq
| | | | - Hind M Alkatan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | | | | | | | | | | | - Nicholas J Astbury
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Hatice T Atalay
- Department of Ophthalmology, School of Medicine, Gazi University, Ankara, Turkey
| | | | - Rose Atsiaya
- Lighthouse For Christ Eye Centre, Mombasa, Kenya
| | - Taweevat Attaseth
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Than H Aung
- Yangon Eye Hospital, University of Medicine 1, Yangon, Myanmar
| | | | - Baglan Baizakova
- Scientific Center of Pediatrics and Pediatric Surgery, Almaty, Kazakhstan
| | - Julia Balaguer
- Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - Walentyna Balwierz
- Institute of Pediatrics, Jagiellonian University Medical College, Children's University Hospital of Krakow, Krakow, Poland
| | - Honorio Barranco
- Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Covadonga Bascaran
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Maja Beck Popovic
- Pediatric Hematology-Oncology Unit, Lausanne University Hospital, Lausanne, Switzerland
| | - Raquel Benavides
- Hospital Nacional de Niños Dr Carlos Sáenz Herrera, San Jose, Costa Rica
| | - Sarra Benmiloud
- Department of Pediatric Oncology, University Hassan II Fès, Fez, Morocco
| | | | - Rokia C Berete
- Ophthalmologic Department of the Teaching Hospital of Treichville, Abidjan, Côte d'Ivoire
| | - Jesse L Berry
- Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles
| | | | - Sunil Bhat
- Department of Pediatric Hematology and Oncology, Narayana Health City, Bangalore, India
| | | | - Eva M Biewald
- Department of Ophthalmology, Essen University Hospital, University Duisburg-Essen, Essen, Germany
| | - Nadia Bobrova
- The Filatov Institute of Eye Diseases and Tissue Therapy, Odessa, Ukraine
| | - Marianna Boehme
- Department of Ophthalmology, Essen University Hospital, University Duisburg-Essen, Essen, Germany
| | - H C Boldt
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City
| | | | - Norbert Bornfeld
- Department of Ophthalmology, Essen University Hospital, University Duisburg-Essen, Essen, Germany
| | - Gabrielle C Bouda
- Centre Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso
| | - Hédi Bouguila
- Institut Hédi Raïs d'Ophtalmologie, Faculté de Médecine, Université Tunis El Manar, Tunis, Tunisia
| | - Amaria Boumedane
- Etablissement Hospitalière Spécialise Emir Abdelkader CEA Service d'Oncologie Pédiatrique, Oran, Algeria
| | - Rachel C Brennan
- Solid Tumor Division, Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | | | | | | | | | - Jayne E Camuglia
- Department of Ophthalmology, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Miriam R Cano
- Salud Ocular, Ministerio de Salud Publica, Asuncion, Paraguay
| | | | - Nathalie Cassoux
- Institut Curie, Université de Paris Medicine Paris V Descartes, Paris, France
| | - Guilherme Castela
- Centro Hospital Universitário de Coimbra, University of Coimbra, Coimbra, Portugal
| | | | | | - Guillermo L Chantada
- Hospital Sant Joan de Déu, Barcelona, Spain
- Hospital Garrahan, Buenos Aires, Argentina
- NationalScientific and Technical Research Council, CONICET, Buenos Aires, Argentina
| | - Shabana Chaudhry
- Paediatric Ophthalmology Department, Mayo Hospital and College of Allied Visual Sciences, King Edward Medical University, Lahore, Pakistan
| | - Sonal S Chaugule
- Department of Ophthalmic Plastic Surgery, Orbit and Ocular Oncology, PBMA's H. V. Desai Eye Hospital, Pune, Maharashtra, India
| | | | - Bhavna Chawla
- Ocular Oncology Service, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Violeta S Chernodrinska
- Eye Clinic, Department of Ophthalmology, University Hospital Alexandrovska, Medical University, Sofia, Sofia, Bulgaria
| | | | | | - Krzysztof Cieslik
- Department of Ophthalmology, The Children's Memorial Health Institute, Warsaw, Poland
| | | | - Codruta Comsa
- Institute of Oncology, Prof. Dr Al. Trestioreanu, Bucharest, Romania
| | - Zelia M Correa
- Wilmer Eye Institute, Johns Hopkins Medicine, Baltimore, Maryland, and University of Cincinnati College of Medicine, Cincinnati, Ohio
| | | | | | | | | | - Xuehao Cui
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Wantanee Dangboon
- Department of Ophthalmology, Songklanagarind Hospital, Prince of Songkla University, Songkla, Thailand
| | - Anirban Das
- Department of Pediatric Hematology-Oncology, Tata Medical Center, Kolkata, India
| | - Sima Das
- Ocular Oncology Services, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | | | - Alan Davidson
- Red Cross War Memorial Children's Hospital and the University of Cape Town, Cape Town, South Africa
| | | | | | - Hakan Demirci
- Department of Ophthalmology, Kellogg Eye Center, University of Michigan, Ann Arbor
| | | | | | - Helen Dimaras
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Andrew J Dodgshun
- Department of Paediatrics, University of Otago, Christchurch, Children's Haematology and Oncology Center, Christchurch Hospital, Christchurch, New Zealand
| | - Craig Donaldson
- The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | | | - Monica D Dragomir
- Institute of Oncology, Prof. Dr Al. Trestioreanu, Bucharest, Romania
| | - Yi Du
- Department of Ophthalmology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | | | - Kemala S Edison
- Ophthalmology Department, Dr M. Djamil General Hospital, Faculty of Medicine, Andalas University, West Sumatra, Indonesia
| | - I Wayan Eka Sutyawan
- Department of Ophthalmology, Faculty of Medicine, Udayana University, Sanglah Eye Hospital, Bali, Indonesia
| | - Asmaa El Kettani
- Center Hospitalier et Universitaire Ibn Rochd, Casablanca, Morocco
| | - Amal M Elbahi
- Tripoli Eye Hospital, University of Tripoli, Tripoli, Libya
| | - James E Elder
- Department of Ophthalmology, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia
| | - Dina Elgalaly
- Children's Cancer Hospital Egypt 57357, Cairo, Egypt
| | | | - Moawia M Ali Elhassan
- Department of Oncology, National Cancer Institute, University of Gezira, Wadi Madani, Sudan
| | - Mahmoud M Elzembely
- Pediatric Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Vera A Essuman
- Ophthalmology Unit, Department of Surgery, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
| | | | | | | | - Mohammad Faranoush
- Pediatric Growth and Development Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Rasool Akram Hospital, Tehran, Iran
| | - Oluyemi Fasina
- Department of Ophthalmology, University College Hospital, University of Ibadan, Ibadan, Nigeria
| | | | | | - Allen Foster
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Shahar Frenkel
- Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Soad L Fuentes-Alabi
- Pediatric Oncology Department, Benjamin Bloom National Children's Hospital, San Salvador, El Salvador
| | | | - Moira Gandiwa
- Lions Sight First Eye Hospital, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | | | | | | | - Jennifer A Geel
- Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - Fariba Ghassemi
- Retina and Vitreous Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ana V Girón
- Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala
| | - Zelalem Gizachew
- Department of Ophthalmology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Marco A Goenz
- Pediatric Oncology Department, Benjamin Bloom National Children's Hospital, San Salvador, El Salvador
| | - Aaron S Gold
- Murray Ocular Oncology and Retina, Miami, Florida
| | | | - Glen A Gole
- Department of Ophthalmology, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Nir Gomel
- Department of Ophthalmology, Sourasky Medical Center Tel Aviv, School of Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Efren Gonzalez
- Department of Ophthalmology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | | | - Henry N Garcia Pacheco
- Pediatric Oncology Unit, Instituto Regional de Enfermedades Neoplásicas del Sur, Arequipa, Perú
| | - Jaime Graells
- Unidad de Oncologia Ocular Hospital Oncologico Luis Razzetti, Caracas, Venezuela
| | - Liz Green
- IAM NOOR Eye Care Programme, Afghanistan
| | - Pernille A Gregersen
- Department of Clinical Genetics and Center for Rare Disorders, Aarhus University Hospital, Aarhus, Denmark
| | | | - Koffi M Guedenon
- Département de Pédiatrie, CHU Sylvanus Olympio, Université de Lomé, Lomé, Togo
| | | | - Ahmet K Gündüz
- Department of Ophthalmology, Ankara University School of Medicine, Ankara, Turkey
| | - Himika Gupta
- Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Sanjiv Gupta
- King George's Medical University, Lucknow, India
| | | | - Patrick Hamel
- Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montréal, Quebec, Canada
| | | | | | - Eric D Hansen
- John A. Moran Eye Center, University of Utah, Salt Lake City
| | - J William Harbour
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | | | - Murat Hasanreisoglu
- Department of Ophthalmology, School of Medicine, Gazi University, Ankara, Turkey
| | - Sadiq Hassan
- Aminu Kano Teaching Hospital, Bayero University, Kano, Nigeria
| | - Shadab Hassan
- Department of Pediatric Ophthalmology and Strabismus, Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan
| | | | - Jose Hernandez
- Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú
| | | | - Laila Hessissen
- Pediatric Hematology and Oncology Center, Mohammed V University, Rabat, Morocco
| | - Diriba F Hordofa
- Department of Pediatrics and Child Health, Jimma University Medical Center, Jimma, Ethiopia
| | - Laura C Huang
- Byers Eye Institute, Stanford University, Stanford, California
| | | | - Marlies Hummlen
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
| | | | | | - Russo Ida
- Bambino Gesù IRCCS Children's Hospital, Rome, Italy
| | - Vesna R Ilic
- Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | | | | | - Helen Jenkinson
- Eye Department, Birmingham Children's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
| | - Xunda Ji
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dong Hyun Jo
- Fight Against Angiogenesis-Related Blindness Laboratory, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | | | - William J Johnson
- Storm Eye Institute, Medical University of South Carolina, Charleston
| | - Michael M Jones
- The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | | | - Rolande L Kabore
- Centre Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso
| | - Swathi Kaliki
- Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, India
| | - Abubakar Kalinaki
- Department of Ophthalmology, Makerere University College of Health Sciences Kamplala, Uganda
| | - Mehmet Kantar
- Division of Pediatric Oncology, School of Medicine, Ege University, Izmir, Turkey
| | | | - Tamar Kardava
- Ophthalmology Department, Central Children's Hospital of Georgia, Tbilisi, Georgia
| | - Rejin Kebudi
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, Cerrahpaşa Faculty of Medicine and Oncology Institute, Istanbul University, Istanbul, Turkey
| | - Tomas Kepak
- St. Anne's University Hospital Brno, Masaryk University, and International Clinical Research Center/St Anna University Hospital, Brno, Czech Republic
| | | | | | - Hussain A Khaqan
- Department of Ophthalmology, Postgraduate Medical Institute, Ameer-Ud-Din Medical College, Lahore General Hospital, Lahore, Pakistan
| | - Phara Khauv
- Angkor Hospital for Children, Krong Siem Reap, Cambodia
| | - Wajiha J Kheir
- Duke Eye Center, Duke University Hospital, Durham, North Carolina
| | | | - Alireza Khodabande
- Retina and Vitreous Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Zaza Khotenashvili
- Ophthalmology Department, Central Children's Hospital of Georgia, Tbilisi, Georgia
| | - Jonathan W Kim
- Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles
| | - Jeong Hun Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hayyam Kiratli
- Ocular Oncology Service, Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Tero T Kivelä
- Ocular Oncology Service, Department of Ophthalmology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Artur Klett
- East Tallinn Central Hospital, Tallinn, Estonia
| | | | - Dalia Krivaitiene
- Children's Ophthalmology Department, Children's Hospital of Vilnius, University Hospital Santaros Clinic, Vilnius, Lithuania
| | - Mariana Kruger
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Kittisak Kulvichit
- Vitreo-Retina Research Unit, Department of Ophthalmology, Chulalongkorn University, Bangkok, Thailand
| | | | - Alice Kyara
- Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Eva S Lachmann
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carol P S Lam
- Hong Kong Eye Hospital, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Geoffrey C Lam
- Perth Children's Hospital, University of Western Australia, Perth, Western Australia, Australia
| | - Scott A Larson
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City
| | - Slobodanka Latinovic
- Clinical Center of Vojvodina, University Eye Clinic, Eye Research Foundation Vidar-Latinović, Novi Sad, Serbia
| | - Kelly D Laurenti
- Division of Ophthalmology, Feinberg School of Medicine, Northwestern University, and Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Bao Han A Le
- John A. Burns School of Medicine, University of Hawaii, Honolulu, and University of Southern California Roski Eye Institute, Los Angeles
| | - Karin Lecuona
- Division of Ophthalmology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | | | - Cairui Li
- Affiliated Hospital of Dali University, Dali City, China
| | - Ben Limbu
- Tilganga Institute of Ophthalmology, Kathmandu, Nepal
| | | | - Juan P López
- Ophthalmology Department, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Robert M Lukamba
- University Clinics of Lubumbashi, University of Lubumbashi, Lubumbashi, Democratic Rrepublic of Congo
| | | | - Sandra Luna-Fineman
- Pediatric Hematology/Oncology/Stem Cell Transplantation, Center for Global Health, Children's Hospital Colorado, University of Colorado, Aurora
| | - Delfitri Lutfi
- Department of Ophthalmology, Dr Soetomo General Hospital, Airlangga University, Surabaya, Indonesia
| | | | - George N Magrath
- Storm Eye Institute, Medical University of South Carolina, Charleston
| | - Amita Mahajan
- Pediatric Hematology-Oncology Unit, Apollo Center for Advanced Pediatrics, Indraprastha Apollo Hospital, New Delhi, India
| | | | - Erika Maka
- Semmelweis University, Budapest, Hungary
| | - Mayuri Makan
- Sekuru Kaguvi Eye Unit, Parirenyatwa Group of Hospitals, Harare, Zimbabwe
| | | | - Chatonda Manda
- Lions Sight First Eye Hospital, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Nieves Martín Begue
- Department of Pediatric Ophthalmology, Hospital Vall d'Hebron, Barcelona, Spain
| | | | | | | | - Miguel Materin
- Duke Eye Center, Duke University Hospital, Durham, North Carolina
| | | | - Marchelo Matua
- Ruharo Eye Centre, Ruharo Mission Hospital, Mbarara, Uganda
| | - Ismail Mayet
- University of the Witwatersrand, Johannesburg, South Africa
| | | | - John D McKenzie
- Department of Ophthalmology, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Ocular Oncology, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Aurora Medina-Sanson
- Department of Oncology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Azim Mehrvar
- MAHAK Hematology Oncology Research Center, Mahak Hospital, Tehran, Iran
| | | | | | | | - Marilyn B Mets
- Division of Ophthalmology, Feinberg School of Medicine, Northwestern University, and Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Edoardo Midena
- Department of Ophthalmology, University of Padova, Padova, Italy
| | | | | | - Ahmed A Mohamedani
- Department of Pathology, Faculty of Medicine, University of Gezira, Wad Medani, Sudan
| | | | - Annette C Moll
- Department of Ophthalmology, Amsterdam UMC, Amsterdam, the Netherlands
| | | | - Rosa A Morales
- Hospital Infantil Manuel de Jesús Rivera, Managua, Nicaragua
| | - Claude Moreira
- Service d'Oncologie Pédiatrique de l'Hôpital Aristide le Dantec, Dakar, Senegal
| | | | | | - Gerald Msukwa
- Lions Sight First Eye Hospital, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | | | | | - Francis L Munier
- Jules-Gonin Eye Hospital, Fondation Asile de Aveugles, University of Lausanne, Lausanne, Switzerland
| | - Gabriela Murgoi
- Institute of Oncology, Prof. Dr Al. Trestioreanu, Bucharest, Romania
| | | | - Kareem O Musa
- Department of Ophthalmology, Lagos University Teaching Hospital, College of Medicine of the University of Lagos, Lagos, Nigeria
| | - Asma Mushtaq
- The Children's Hospital and the Institute of Child Health, Lahore, Pakistan
| | - Hamzah Mustak
- Division of Ophthalmology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | | | - Gita Naidu
- University of the Witwatersrand, Johannesburg, South Africa
| | - Akshay Gopinathan Nair
- Aditya Jyot Eye Hospital, Mumbai, India
- Lokmanya Tilak Municipal General Hospital and Medical College, Mumbai, India
| | - Larisa Naumenko
- N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus
| | | | - Yetty M Nency
- Child Health Department, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
| | - Vladimir Neroev
- Moscow Helmholtz Research Institute of Eye Diseases, Moscow, Russia
| | - Hang Ngo
- Ho Chi Minh Eye Hospital, Ho Chi Minh, Vietnam
| | - Rosa M Nieves
- Hospital Infantil Dr Robert Reid Cabral, Santo Domingo, Dominican Republic
| | - Marina Nikitovic
- Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Elizabeth D Nkanga
- Department of Ophthalmology, Calabar Children's Eye Center, University of Calabar Teaching Hospital, Calabar Nigeria
| | - Henry Nkumbe
- Magrabi ICO Cameroon Eye Institute, Yaounde, Cameroon
| | - Murtuza Nuruddin
- Chittagong Eye Infirmary and Training Complex, Chittagong, Bangladesh
| | | | | | - Ngozi C Oguego
- Department of Ophthalmology, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Andrzej Olechowski
- Department of Ophthalmology, The Children's Memorial Health Institute, Warsaw, Poland
| | - Scott C N Oliver
- Sue Anschutz-Rodgers Eye Center, University of Colorado School of Medicine, Aurora
| | | | - Diego Ossandon
- Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile
| | | | | | - Sally L Painter
- Eye Department, Birmingham Children's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
| | | | - Luisa Paiva
- National Ophthalmological Institute of Angola, Luanda, Angola
| | - Bikramjit P Pal
- H M Diwan Eye Foundation, and Tata Medical Center, Kolkata, India
| | | | - Ruzanna Papyan
- Department of Oncology, Yerevan State Medical University, and Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after R. H. Yeolyan, Yerevan, Armenia
| | | | - Manoj Parulekar
- Eye Department, Birmingham Children's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
| | | | | | - Katarzyna Pawinska-Wasikowska
- Institute of Pediatrics, Jagiellonian University Medical College, Children's University Hospital of Krakow, Krakow, Poland
| | - Jacob Pe'er
- Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Sanja Peric
- University Hospital Center Zagreb, Zagreb, Croatia
| | - Chau T M Pham
- Vietnam National Institute of Ophthalmology, Ha Noi, Vietnam
| | - Remezo Philbert
- Centre Hospitalier Universitaire de Kamenge, Bujumbura, Burundi
| | | | - Pavel Pochop
- Department of Ophthalmology for Children and Adults, Second Faculty of Medicine, Charles University, and Motol University Hospital, Prague, Czech Republic
| | | | - Vladimir G Polyakov
- Head and Neck Tumors Department, SRI of Pediatric Oncology and Hematology, N.N. Blokhin Russian Cancer Research Center, Moscow, Russia
- Russian Medical Academy of Postgraduate Education, Moscow, Russia
| | - Manca T Pompe
- University Eye Hospital Ljubljana, University Medical Center Ljubljana, Ljubljana, Slovenia
| | | | - Daphna Prat
- The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel
| | | | - Ignatius Purwanto
- Sardjito Hospital, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | | | - Seema Qayyum
- The Children's Hospital and the Institute of Child Health, Lahore, Pakistan
| | - Jiang Qian
- Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
| | - Ardizal Rahman
- Ophthalmology Department, Dr M. Djamil General Hospital, Faculty of Medicine, Andalas University, West Sumatra, Indonesia
| | | | | | | | | | | | - Marco A Ramirez-Ortiz
- Department of Ophthalmology, Hospital Infantil de Mexico Federico Gómez, Mexico City, Mexico
| | - Léa Raobela
- Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona, Antananarivo, Madagascar
| | - Riffat Rashid
- Department of Oculoplasty and Ocular Oncology, Ispahani Islamia Eye Institute and Hospital, Dhaka, Bangladesh
| | - M Ashwin Reddy
- The Royal London Hospital, Barts Health NHS Trust, and Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Ehud Reich
- Department of Ophthalmology, Davidoff Center for Oncology, Rabin Medical Center, Sackler School of Medicine, Tel Aviv University, Israel
| | - Lorna A Renner
- School of Medicine and Dentistry, Korle-Bu Teaching Hospital, University of Ghana, Accra, Ghana
| | | | | | | | - Petra Ritter-Sovinz
- Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Duangnate Rojanaporn
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Livia Romero
- Unidad de Oncologia Ocular Hospital Oncologico Luis Razzetti, Caracas, Venezuela
| | - Soma R Roy
- Chittagong Eye Infirmary and Training Complex, Chittagong, Bangladesh
| | - Raya H Saab
- Children's Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Svetlana Saakyan
- Moscow Helmholtz Research Institute of Eye Diseases, Moscow, Russia
| | - Ahmed H Sabhan
- Pediatric Oncology Unit, Children Welfare Teaching Hospital, College of Medicine, University of Baghdad, Baghdad, Iraq
| | - Mandeep S Sagoo
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital, and UCL Institute of Ophthalmology and London Retinoblastoma Service, Royal London Hospital, London, United Kingdom
| | - Azza M A Said
- Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Rohit Saiju
- Tilganga Institute of Ophthalmology, Kathmandu, Nepal
| | - Beatriz Salas
- Hospital Dr Manuel Ascencio Villarroel, Cochabamba, Bolivia
| | | | | | | | | | | | | | - Ahad Sedaghat
- Department of Ophthalmology, Rasool Akram Hospital, Tehran, Iran
| | | | - Rachna Seth
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Ankoor S Shah
- Department of Ophthalmology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | | | - Sadik T Sherief
- Department of Ophthalmology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Carol L Shields
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Sorath Noorani Siddiqui
- Department of Pediatric Ophthalmology and Strabismus, Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan
| | - Sidi Sidi Cheikh
- Ophthalmology Department, Nouakchott Medical University, Nouakchott, Mauritania
| | - Sónia Silva
- Centro Hospital Universitário de Coimbra, University of Coimbra, Coimbra, Portugal
| | - Arun D Singh
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | | | - Usha Singh
- Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Penny Singha
- Department of Ophthalmology, Songklanagarind Hospital, Prince of Songkla University, Songkla, Thailand
| | - Rita S Sitorus
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, and Dr Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Alison H Skalet
- Casey Eye Institute, Oregon Health & Science University, Portland
| | - Hendrian D Soebagjo
- Department of Ophthalmology, Dr Soetomo General Hospital, Airlangga University, Surabaya, Indonesia
| | | | - Grace Ssali
- Mulago National Referral Hospital, Kampala, Uganda
| | - Andrew W Stacey
- Department of Ophthalmology, University of Washington, Seattle
| | - Sandra E Staffieri
- Department of Ophthalmology, Royal Children's Hospital, Parkville, Victoria, Australia
- Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia
| | - Erin D Stahl
- Children's Mercy Hospital, Kansas City, Missouri
| | - Christina Stathopoulos
- Jules-Gonin Eye Hospital, Fondation Asile de Aveugles, University of Lausanne, Lausanne, Switzerland
| | - Branka Stirn Kranjc
- University Eye Hospital Ljubljana, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - David K Stones
- Department of Paediatrics and Child Health, University of the Free State, Bloemfontein, South Africa
| | | | | | - Sadia Sultana
- Department of Oculoplasty and Ocular Oncology, Ispahani Islamia Eye Institute and Hospital, Dhaka, Bangladesh
| | - Xiantao Sun
- Henan Children's Hospital, Affiliated Children's Hospital of Zhengzhou University, Zhengzhou, China
| | - Meryl Sundy
- Casey Eye Institute, Oregon Health & Science University, Portland
| | - Rosanne Superstein
- Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montréal, Quebec, Canada
| | - Eddy Supriyadi
- Sardjito Hospital, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | | | - Shigenobu Suzuki
- Department of Ophthalmic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Karel Svojgr
- Department of Pediatric Hematology and Oncology, Second Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic
| | | | - Gevorg Tamamyan
- Department of Oncology, Yerevan State Medical University, and Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after R. H. Yeolyan, Yerevan, Armenia
| | - Deborah Tan
- Singapore National Eye Center, Singapore, Singapore
| | - Alketa Tandili
- University Hospital Center Mother Theresa, Tirana, Albania
| | | | - Maryam Tashvighi
- MAHAK Hematology Oncology Research Center, Mahak Hospital, Tehran, Iran
| | | | - Edi S Tehuteru
- National Cancer Center, Dharmais Cancer Hospital, Jakarta, Indonesia
| | - Luiz F Teixeira
- Pediatric Oncology Institute, Federal University of São Paulo, São Paulo, Brazil
- Ophthalmology Department, Federal University of São Paulo, São Paulo, Brazil
| | - Kok Hoi Teh
- Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | | | - Helen Toledano
- Department of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Doan L Trang
- Vietnam National Institute of Ophthalmology, Ha Noi, Vietnam
| | - Fousseyni Traoré
- Pediatric Oncology Service, Gabriel Toure Hospital, Bamako, Mali
| | | | - Samuray Tuncer
- Department of Ophthalmology, Faculty of Medicine, Ocular Oncology Service, Istanbul University, Istanbul, Turkey
| | | | - Ali B Umar
- Aminu Kano Teaching Hospital, Bayero University, Kano, Nigeria
| | - Emel Unal
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, Ankara University, Ankara, Turkey
| | | | - Steen F Urbak
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - Tatiana L Ushakova
- Head and Neck Tumors Department, SRI of Pediatric Oncology and Hematology, N.N. Blokhin Russian Cancer Research Center, Moscow, Russia
- Russian Medical Academy of Postgraduate Education, Moscow, Russia
| | | | | | | | - Adisai Varadisai
- Vitreo-Retina Research Unit, Department of Ophthalmology, Chulalongkorn University, Bangkok, Thailand
| | | | | | - Nevyana V Veleva-Krasteva
- Eye Clinic, Department of Ophthalmology, University Hospital Alexandrovska, Medical University, Sofia, Sofia, Bulgaria
| | | | - Andi A Victor
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, and Dr Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | | | | | - Vicktoria Vishnevskia-Dai
- The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel
| | | | | | | | - Keith Waddell
- Ruharo Eye Centre, Ruharo Mission Hospital, Mbarara, Uganda
| | | | | | - Yi-Zhuo Wang
- Department of Paediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Avery Weiss
- Department of Ophthalmology, University of Washington, Seattle
| | - Matthew W Wilson
- Department of Surgery, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Amelia D C Wime
- National Ophthalmological Institute of Angola, Luanda, Angola
| | | | | | | | - Phanthipha Wongwai
- Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Daoman Xiang
- Department of Pediatric Ophthalmology, Guangzhou Children's Hospital and Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | | | - Jason C Yam
- Hong Kong Eye Hospital, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Huasheng Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jenny M Yanga
- Service d'Ophtalmologie, Cliniques Universitaires de Kinshasa, Université de Kinshasa, Kinshasa, Democratic Republic of Congo
| | | | - Vera A Yarovaya
- S.Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia
| | - Andrey A Yarovoy
- S.Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia
| | - Huijing Ye
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | | | - Putu Yuliawati
- Department of Ophthalmology, Faculty of Medicine, Udayana University, Sanglah Eye Hospital, Bali, Indonesia
| | | | - Ekhtelbenina Zein
- Assistante Hospitalo Universitaire, Faculte de Medecine de Nouakchott Medecin Oncopediatre, Center National d'Oncologie, Nouakchott, Mauritania
| | - Chengyue Zhang
- Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Yi Zhang
- Department of Paediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Junyang Zhao
- Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Xiaoyu Zheng
- Department of Ophthalmology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | | | - Nida Zia
- The Indus Hospital, Karachi, Pakistan
| | - Othman A O Ziko
- Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Marcia Zondervan
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Richard Bowman
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Ophthalmology Department, Great Ormond Street Hospital, London, United Kingdom
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Skalet AH, Allen RC, Shields CL, Wilson MW, Mruthyunjaya P, Gombos DS. Considerations for the Management and Triage of Ocular Oncology Cases during the COVID-19 Pandemic. Ocul Oncol Pathol 2020; 6:1-4. [PMID: 32411697 PMCID: PMC7206351 DOI: 10.1159/000507734] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 04/03/2020] [Indexed: 11/29/2022] Open
Affiliation(s)
- Alison H Skalet
- Casey Eye Institute, Department of Ophthalmology, Oregon Health and Science University, Portland, Oregon, USA.,Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon, USA.,Department of Radiation Medicine, Oregon Health and Science University, Portland, Oregon, USA.,Department of Dermatology, Oregon Health and Science University, Portland, Oregon, USA
| | - Richard C Allen
- Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA.,Texas Children's Cancer Center, Baylor College of Medicine, Houston, Texas, USA
| | - Carol L Shields
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Matthew W Wilson
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.,Department of Surgery, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.,Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | | | - Dan S Gombos
- The Retinoblastoma Center of Houston, Houston, Texas, USA.,Texas Children's Cancer Center, Baylor College of Medicine, Houston, Texas, USA.,Section of Ophthalmology, Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas, USA
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20
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Binder C, Mruthyunjaya P, Schefler AC, Seider MI, Crilly R, Hung A, Meltsner S, Mowery Y, Kirsch DG, Teh BS, Jennelle RLS, Studenski MT, Liu W, Lee C, Hayman JA, Kastner B, Hadsell M, Skalet AH. Practice Patterns for the Treatment of Uveal Melanoma with Iodine-125 Plaque Brachytherapy: Ocular Oncology Study Consortium Report 5. Ocul Oncol Pathol 2019; 6:210-218. [PMID: 32509767 DOI: 10.1159/000504312] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/06/2019] [Indexed: 11/19/2022] Open
Abstract
Background Treatment planning for I-125 plaque therapy for uveal melanoma has advanced significantly since the Collaborative Ocular Melanoma Study trial, with more widely available image-guided planning and improved dosimetry. Objective We evaluated real-world practice patterns for I-125 plaque brachytherapy in the United States by studying practice patterns at centers that comprise the Ocular Oncology Study Consortium (OOSC). Methods The OOSC database and responses to a treatment practice survey were evaluated. The database contains treatment information from 9 institutions. Patients included in the database were treated between 2010 and 2014. The survey was conducted in 2018 and current treatment planning methods and prescriptions were queried. Results Examination of the OOSC database revealed that average doses to critical structures were highly consistent, with the exception of one institution. Survey responses indicated that most centers followed published guidelines regarding dose and prescription point. Dose rate ranged from 51 to 118 cGy/h. As of 2018, most institutions use pre-loaded plaques and fundus photographs and/or computed tomography or magnetic resonance imaging in planning. Conclusions While there were differences in dosimetric practices, overall agreement in plaque brachytherapy practices was high among OOSC institutions. Clinical margins and planning systems were similar among institutions, while prescription dose, dose rates, and dosimetry varied.
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Affiliation(s)
- Christina Binder
- Department of Radiation Medicine, Oregon Health and Science University, Portland, Oregon, USA
| | - Prithvi Mruthyunjaya
- Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, California, USA.,Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina, USA
| | | | - Michael I Seider
- The Permanente Medical Group, San Francisco, California, USA.,Department of Ophthalmology, University of California, San Francisco, California, USA
| | - Richard Crilly
- Department of Radiation Medicine, Oregon Health and Science University, Portland, Oregon, USA
| | - Arthur Hung
- Department of Radiation Medicine, Oregon Health and Science University, Portland, Oregon, USA
| | - Sheridan Meltsner
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina, USA
| | - Yvonne Mowery
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina, USA
| | - David G Kirsch
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina, USA
| | - Bin S Teh
- Department of Radiation Oncology, Houston Methodist Cancer Center, Houston, Texas, USA
| | - Richard L S Jennelle
- Department of Radiation Oncology, University of Southern California Medical Center, Los Angeles, California, USA
| | - Matthew T Studenski
- Department of Radiation Oncology/Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida, USA
| | - Wu Liu
- Department of Radiation Oncology, Stanford University, Palo Alto, California, USA.,Department of Therapeutic Radiology, Yale University and Yale-New haven Hospital, New Haven, Connecticut, USA
| | - Choonik Lee
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - James A Hayman
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Brian Kastner
- Radiation Oncology Centers, PC, Spectrum Health, Grand Rapids, Michigan, USA
| | - Michael Hadsell
- Department of Radiation Oncology, Porter Adventist, Centura Health, Denver, Colorado, USA
| | - Alison H Skalet
- Department of Radiation Medicine, Oregon Health and Science University, Portland, Oregon, USA.,Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, USA
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21
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Skalet AH, Liu L, Binder C, Miller AK, Crilly R, Hung AY, Wilson DJ, Huang D, Jia Y. Longitudinal Detection of Radiation-Induced Peripapillary and Macular Retinal Capillary Ischemia Using OCT Angiography. Ophthalmol Retina 2019; 4:320-326. [PMID: 31757690 DOI: 10.1016/j.oret.2019.10.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 10/02/2019] [Accepted: 10/03/2019] [Indexed: 01/06/2023]
Abstract
PURPOSE To study longitudinal changes in retinal capillary circulation in eyes treated with iodine 125 (I125) plaque brachytherapy for uveal melanoma using OCT angiography (OCTA). DESIGN Longitudinal prospective study of 21 patients undergoing treatment for uveal melanoma with I125 plaque brachytherapy. Eyes with melanoma were imaged with OCTA before treatment and at 12-month intervals until 2 years after brachytherapy. PARTICIPANTS After institutional review board approval, participants were enrolled prospectively from an academic ocular oncology clinic. METHODS Peripapillary (4.5 × 4.5-mm) and macular (3 × 3-mm) OCTA scans were acquired with AngioVue (Optovue, Inc, Fremont, CA). MAIN OUTCOME MEASURES The peripapillary nerve fiber layer plexus capillary density (NFLP_CD), macular superficial vascular complex vessel density (mSVC_VD), and foveal avascular zone (FAZ) area were calculated. RESULTS Before treatment, no significant difference was found in the NFLP_CD, mSVC_VD, or FAZ area between eyes with melanoma and normal fellow eyes. By 24 months, 11 eyes had developed clinical signs of radiation retinopathy, radiation optic neuropathy, or both. In treated eyes, the NFLP_CD (48.4±4.1%) was reduced at 12 months (46.7±5.0%; P = 0.04, Wilcoxon signed-rank test) and 24 months (44.5±6.1%; P < 0.001). Similarly, the mSVC_VD (48.4 2±3.6%) was reduced in treated eyes at 12 months (43.5±5.9%; P = 0.01) and 24 months (37.4±9.1%; P < 0.001). The FAZ area (0.26±0.11 mm2) increased in treated eyes at 12 months (0.35±0.22 mm2; P = 0.009) and 24 months (0.81±1.03 mm2; P = 0.001). When only eyes with clinically evident radiation changes were evaluated, the changes in NFLP_CD, mSVC_VD, and FAZ area were more pronounced. OCT angiography measurements correlated with both radiation dose and visual acuity. The mSVC_VD measured at 12 months was found to predict the development of clinically apparent radiation retinopathy within 1 year. CONCLUSIONS OCT angiography demonstrated early emergence of peripapillary and macular capillary vasculature changes after I125 plaque brachytherapy. OCT angiography provided a quantitative measurement of retinal capillary changes associated with ischemia that correlated with visual acuity and radiation dose and may predict future development of radiation-induced retinal toxicity.
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Affiliation(s)
- Alison H Skalet
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland, Oregon; Department of Radiation Medicine, Oregon Health & Science University, Portland, Oregon.
| | - Liang Liu
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland, Oregon
| | - Christina Binder
- Department of Radiation Medicine, Oregon Health & Science University, Portland, Oregon
| | - Audra K Miller
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland, Oregon
| | - Richard Crilly
- Department of Radiation Medicine, Oregon Health & Science University, Portland, Oregon
| | - Arthur Y Hung
- Department of Radiation Medicine, Oregon Health & Science University, Portland, Oregon
| | - David J Wilson
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland, Oregon
| | - David Huang
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland, Oregon
| | - Yali Jia
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland, Oregon
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22
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Lee HJ, Stacey A, Klesert TR, Wells C, Skalet AH, Bloch C, Fung A, Bowen SR, Wong TP, Shibata D, Halasz LM, Rengan R. Corneal Substructure Dosimetry Predicts Corneal Toxicity in Patients With Uveal Melanoma Treated With Proton Beam Therapy. Int J Radiat Oncol Biol Phys 2019; 104:374-382. [PMID: 30763658 DOI: 10.1016/j.ijrobp.2019.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 01/25/2019] [Accepted: 02/04/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE This study examines the relationship between dose to corneal substructures and incidence of corneal toxicity within 6 months of proton beam therapy (PBT) for uveal melanoma. We aim to develop clinically meaningful dose constraints that can be used to mitigate corneal toxicity. METHODS AND MATERIALS Ninety-two patients were treated with PBT between 2015 and 2017 and evaluated for grade 2+ (GR2+) intervention-requiring corneal toxicity in our prospectively maintained database. Most patients were treated with 50 Gy (relative biological effectiveness [RBE]) in 5 fractions, and all had complete six-month follow-up. Analyses included Mann-Whitney, χ2, Fisher exact, and receiver operating curve tests to identify risk factors for GR2+ toxicity. Bivariate logistic regression was used to identify independent dose-volume histogram (DVH) predictors of toxicity after adjustment for the most important clinical risk factor. RESULTS The 6-month PBT GR2+ corneal toxicity rate was 10.9%, with half of patients experiencing grade 2 toxicity and half experiencing grade 3 toxicity, with no grade 4 events. Patients with anterior chamber tumors had a higher risk (58.3%) for toxicity than those with posterior tumors (0%) or posterior tumors extending past the equator (25%, P < .0001). On univariate analysis, larger size according to Collaborative Ocular Melanoma Studies was associated with increased toxicity rate (P < .004). DVH analysis revealed that cutoffs of 58% for V25, 32% for V45, 51.8 Gy (RBE) for maximum dose, and 32 Gy (RBE) for mean dose to the cornea separated patients into groups experiencing and not experiencing toxicity with 90% sensitivity and ≥96% specificity. Bivariate logistic regression indicated that corneal V25, V45, and mean dose independently predicted for toxicity after adjusting for tumor location. CONCLUSIONS Patients receiving PBT for anterior uveal melanomas experience a high rate of GR2+ corneal toxicity because of increased corneal dose. Anterior location and corneal DVH parameters independently predict toxicity risk. We propose dosimetric constraints to facilitate treatment planning and toxicity mitigation.
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Affiliation(s)
- Howard J Lee
- Duke University School of Medicine, Durham, North Carolina.
| | - Andrew Stacey
- Department of Ophthalmology, University of Washington School of Medicine, Seattle, Washington
| | - Todd R Klesert
- Vitreoretinal Associates of Washington, Seattle, Washington
| | - Craig Wells
- Vitreoretinal Associates of Washington, Seattle, Washington
| | - Alison H Skalet
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon; Department of Radiation Medicine, Oregon Health and Science University, Portland, Oregon
| | - Charles Bloch
- Department of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington
| | - Angela Fung
- Seattle Cancer Care Alliance Proton Therapy Center, Seattle, Washington
| | - Stephen R Bowen
- Department of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington; Department of Radiology, University of Washington School of Medicine, Seattle, Washington
| | - Tony P Wong
- Seattle Cancer Care Alliance Proton Therapy Center, Seattle, Washington
| | - Dean Shibata
- Department of Radiology, University of Washington School of Medicine, Seattle, Washington
| | - Lia M Halasz
- Department of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington
| | - Ramesh Rengan
- Department of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington
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23
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Lu JE, Francis JH, Dunkel IJ, Shields CL, Yu MD, Berry JL, Kogachi K, Skalet AH, Miller AK, Santapuram PR, Daniels AB, Abramson DH. Metastases and death rates after primary enucleation of unilateral retinoblastoma in the USA 2007-2017. Br J Ophthalmol 2018; 103:1272-1277. [PMID: 30361279 DOI: 10.1136/bjophthalmol-2018-312915] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/07/2018] [Accepted: 10/11/2018] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIMS Enucleation for retinoblastoma is performed less often in the past decade due to increasingly widespread alternative therapies, but enucleation remains an important option. There is a paucity of reports on the current incidence of metastases and metastatic deaths in unilateral retinoblastoma from US centres. METHODS Retrospective chart review at five tertiary retinoblastoma centres in the USA for unilateral retinoblastoma patients treated with primary enucleation, 2007-2017, with >1 year of follow-up or treatment failure. RESULTS Among 228 patients (228 eyes), there were nine metastases (3.9%) and four deaths (1.7%). The Kaplan-Meier estimate at 5 years for metastasis-free survival was 96% (95% CI, 94% to 99 %), and for overall survival was 98% (95% CI 96% to 100%). All metastases were evident within 12 months. Histopathology revealed higher risk pathology (postlaminar optic nerve and/or massive choroidal invasion) in 62 of 228 eyes (27%). Of these higher risk eyes, 39 received adjuvant chemotherapy. There were four subsequent metastases in this higher risk pathology with adjuvant chemotherapy group, with three deaths. Of the nine overall with metastases, seven (78%) showed higher risk pathology. All metastatic patients were classified as Reese-Ellsworth V and International Classification of Retinoblastoma Groups D or E. Initial metastases presented as orbital invasion in seven of nine cases. CONCLUSIONS Primary enucleation for unilateral retinoblastoma results in a low rate of metastatic death, but is still associated with a 3.9% chance of metastases within a year of enucleation. Most but not all patients who developed metastases had higher risk histopathological findings.
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Affiliation(s)
- Jonathan E Lu
- Ophthalmic Oncology Service, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Jasmine H Francis
- Ophthalmic Oncology Service, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.,Department of Ophthalmology, Weill Cornell Medical College, New York City, New York, USA
| | - Ira J Dunkel
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York City, New York, USA
| | - Carol L Shields
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Michael D Yu
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Jesse L Berry
- Children's Hospital Los Angeles & the USC Roski Eye Institute, Keck Medical School of the University of Southern California, Los Angeles, California, USA
| | - Kaitlin Kogachi
- Children's Hospital Los Angeles & the USC Roski Eye Institute, Keck Medical School of the University of Southern California, Los Angeles, California, 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
| | - Audra K Miller
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA.,Department of Radiation Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Pranav R Santapuram
- Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Anthony B Daniels
- Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - David H Abramson
- Ophthalmic Oncology Service, Memorial Sloan Kettering Cancer Center, New York City, New York, USA .,Department of Ophthalmology, Weill Cornell Medical College, New York City, New York, USA
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24
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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25
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Shah SN, Kogachi K, Correa ZM, Schefler AC, Aronow ME, Callejo SA, Cebulla CM, Day-Ghafoori S, Francis JH, Lally S, McCannel TA, Paton KE, Phan IT, Pointdujour-Lim R, Ramasubramanian A, Rath P, Shields CL, Skalet AH, Wells JR, Jennelle RL, Berry JL. Trends in Radiation Practices for Female Ocular Oncologists in North America: A Collaborative Study of the International Society of Ocular Oncology. Ocul Oncol Pathol 2018; 5:54-59. [PMID: 30675478 DOI: 10.1159/000489219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 04/11/2018] [Indexed: 12/22/2022] Open
Abstract
Background The aim of this study was to determine the known radiation exposure, attitudes, and consequent risk modifications among female ocular oncologists in North America who routinely administer radioactive plaque brachytherapy treatment and are members of the International Society of Ocular Oncology. Methods Nineteen female ocular oncologists completed an anonymous 17-question radiation exposure survey. Results Eleven of the participants chose to routinely wear lead protection during surgery; 8 did not. Fifteen of 19 participants reported using an unloaded "nonactive" template to prepare for plaque implantation. During pregnancy, 11 of 13 participants continued to perform plaque brachytherapy. Eight of these 11 undertook measures to decrease radiation exposure self-reported as lead wear and other. The average reported anxiety regarding fertility was 2.1 (SD, 2.2) on a scale from 1 to 10. Conclusion This study corroborates prior literature that surgeons' exposure to radiation during plaque brachytherapy is minimal. Nonetheless, there remains some anxiety regarding exposure risk to women, due to potential effects on fertility and fetal health. We found variability in exposure monitoring, required training, and precautions during pregnancy amongst this group of surgeons. Improved education and clearer pregnancy guidelines may equip female ocular oncologists with optimal knowledge regarding risk of radiation exposure.
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Affiliation(s)
- Sona N Shah
- USC Roski Eye Institute, University of Southern California, Los Angeles, California, USA.,Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Kaitlin Kogachi
- USC Roski Eye Institute, University of Southern California, Los Angeles, California, USA.,Children's Hospital Los Angeles, Los Angeles, California, USA
| | | | | | - Mary E Aronow
- Massachusetts Eye and Ear, Retina Service, Harvard Medical School, Boston, Massachusetts, USA
| | | | | | | | - Jasmine H Francis
- Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Sara Lally
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Tara A McCannel
- University of California, Los Angeles, Los Angeles, California, USA
| | | | - Isabella T Phan
- Kaiser Permanente, Northern California, San Francisco, California, USA
| | | | | | - Pamela Rath
- Everett and Hurite Ophthalmic Association, Pittsburgh, Pennsylvania, USA
| | - Carol L Shields
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Alison H Skalet
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA.,Department of Radiation Oncology, Oregon Health & Science University, Portland, Oregon, USA
| | - Jill R Wells
- Emory Eye Center, Emory University, Atlanta, Georgia, USA
| | - Richard L Jennelle
- Department of Radiation Oncology, University of Southern California, Los Angeles, California, USA
| | - Jesse L Berry
- USC Roski Eye Institute, University of Southern California, Los Angeles, California, USA.,Children's Hospital Los Angeles, Los Angeles, California, USA
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26
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Kamihara J, Bourdeaut F, Foulkes WD, Molenaar JJ, Mossé YP, Nakagawara A, Parareda A, Scollon SR, Schneider KW, Skalet AH, States LJ, Walsh MF, Diller LR, Brodeur GM. Retinoblastoma and Neuroblastoma Predisposition and Surveillance. Clin Cancer Res 2018; 23:e98-e106. [PMID: 28674118 DOI: 10.1158/1078-0432.ccr-17-0652] [Citation(s) in RCA: 137] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 05/02/2017] [Accepted: 05/09/2017] [Indexed: 12/28/2022]
Abstract
Retinoblastoma (RB) is the most common intraocular malignancy in childhood. Approximately 40% of retinoblastomas are hereditary and due to germline mutations in the RB1 gene. Children with hereditary RB are also at risk for developing a midline intracranial tumor, most commonly pineoblastoma. We recommend intensive ocular screening for patients with germline RB1 mutations for retinoblastoma as well as neuroimaging for pineoblastoma surveillance. There is an approximately 20% risk of developing second primary cancers among individuals with hereditary RB, higher among those who received radiotherapy for their primary RB tumors. However, there is not yet a clear consensus on what, if any, screening protocol would be most appropriate and effective. Neuroblastoma (NB), an embryonal tumor of the sympathetic nervous system, accounts for 15% of pediatric cancer deaths. Prior studies suggest that about 2% of patients with NB have an underlying genetic predisposition that may have contributed to the development of NB. Germline mutations in ALK and PHOX2B account for most familial NB cases. However, other cancer predisposition syndromes, such as Li-Fraumeni syndrome, RASopathies, and others, may be associated with an increased risk for NB. No established protocols for NB surveillance currently exist. Here, we describe consensus recommendations on hereditary RB and NB from the AACR Childhood Cancer Predisposition Workshop. Clin Cancer Res; 23(13); e98-e106. ©2017 AACRSee all articles in the online-only CCR Pediatric Oncology Series.
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Affiliation(s)
- Junne Kamihara
- Dana-Farber Cancer Institute, Boston Children's Hospital, Boston, Massachusetts
| | | | - William D Foulkes
- Human Genetics, Medicine and Oncology, McGill University, Montreal, Québec, Canada
| | - Jan J Molenaar
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Yaël P Mossé
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - Andreu Parareda
- Sant Joan de Deu, Barcelona Children's Hospital, Barcelona, Catalonia, Spain
| | | | | | - Alison H Skalet
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon
| | - Lisa J States
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - Lisa R Diller
- Dana-Farber Cancer Institute, Boston Children's Hospital, Boston, Massachusetts
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27
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Skalet AH, Liu L, Binder C, Miller AK, Wang J, Wilson DJ, Crilly R, Thomas CR, Hung AY, Huang D, Jia Y. Quantitative OCT Angiography Evaluation of Peripapillary Retinal Circulation after Plaque Brachytherapy. Ophthalmol Retina 2018; 2:244-250. [PMID: 29732441 PMCID: PMC5932624 DOI: 10.1016/j.oret.2017.06.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To study peripapillary retinal capillary circulation in eyes treated with I-125 plaque brachytherapy for uveal melanoma using optical coherence tomography angiography (OCTA). DESIGN Cross-sectional study of 10 subjects imaged with OCTA prior to uveal melanoma treatment and 15 subjects imaged after development of radiation retinopathy and/or optic neuropathy. PARTICIPANTS Following IRB approval, subjects were enrolled from an academic ocular oncology clinical practice. All subjects had uveal melanoma in one eye and treatment with I-125 plaque brachytherapy was planned or had previously taken place. Patients with low vision at baseline and uncontrolled hypertension were excluded. In the post-treatment group, seven subjects were male and eight were female; age range 38 to 81 years. Visual acuities in the irradiated eyes ranged from 20/20 to counting fingers. Visual acuities in the untreated fellow eyes were 20/25 or better. METHODS Peripapillary retinal capillary circulation was measured by OCTA (Optovue, Inc). 4.5×4.5 mm optic disc scans were obtained. 10 subjects were imaged prior to brachytherapy treatment and 15 subjects were imaged after development of clinically apparent radiation retinopathy and/or radiation optic neuropathy post-brachytherapy. MAIN OUTCOME MEASURES The relationship of the peripapillary retinal capillary density (PPCD) as measured by OCTA to the calculated dose to the optic nerve (D50, the dose to 50% of the disc) and the LogMAR vision was evaluated. RESULTS No significant difference was seen in the PPCD as measured by OCTA when comparing the eye with melanoma to the fellow eye prior to brachytherapy; however the PPCD was significantly lower in treated eyes (52.9% +/- 22.4%) than in fellow eyes that did not receive radiation (73.3% +/- 13.7%, p = 0.004). There was an inverse linear correlation between D50 and the PPCD (Pearson's; r= -0.528, P=0.043) and between visual acuity and the PPCD (Pearson's; r= -0.564, P=0.028). CONCLUSIONS Among patients with clinically apparent radiation retinopathy and/or radiation optic neuropathy, PPCD was lower in the treated eye and correlated with the radiation dose to the optic nerve and the visual acuity. OCTA provides a measure of capillary changes following radiation, and may serve as a quantitative endpoint to address visual prognosis.
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Affiliation(s)
- Alison H. Skalet
- Casey Eye Institute, Oregon Health and Science University,
Portland
| | - Liang Liu
- Casey Eye Institute, Oregon Health and Science University,
Portland
| | - Christina Binder
- Department of Radiation Medicine, Oregon Health & Science
University, Portland
| | - Audra K. Miller
- Casey Eye Institute, Oregon Health and Science University,
Portland
| | - Jie Wang
- Casey Eye Institute, Oregon Health and Science University,
Portland
| | - David J. Wilson
- Casey Eye Institute, Oregon Health and Science University,
Portland
| | - Richard Crilly
- Department of Radiation Medicine, Oregon Health & Science
University, Portland
| | - Charles R. Thomas
- Department of Radiation Medicine, Oregon Health & Science
University, Portland
| | - Arthur Y. Hung
- Department of Radiation Medicine, Oregon Health & Science
University, Portland
| | - David Huang
- Casey Eye Institute, Oregon Health and Science University,
Portland
| | - Yali Jia
- Casey Eye Institute, Oregon Health and Science University,
Portland
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Nagarkatti-Gude N, Li Y, Huang D, Wilson DJ, Skalet AH. Optical coherence tomography angiography of a pigmented Fuchs' adenoma (age-related hyperplasia of the nonpigmented ciliary body epithelium) masquerading as a ciliary body melanoma. Am J Ophthalmol Case Rep 2018; 9:72-74. [PMID: 29468224 PMCID: PMC5786886 DOI: 10.1016/j.ajoc.2018.01.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 01/05/2018] [Accepted: 01/08/2018] [Indexed: 12/04/2022] Open
Abstract
Purpose To report a case of age-related hypertrophy of the nonpigmented ciliary epithelium (ARH-NPCE) clinically resembling a ciliary body melanoma and report the optical coherence tomography angiography (OCTA) findings associated with this lesion. Observations A 51-year-old male was referred for evaluation of a deeply pigmented ciliary body mass with extension through the iris root. Iridocyclectomy was performed due to concern for ciliary body melanoma. Histopathologic analysis was instead consistent with ARH-NPCE, also known as Fuchs' adenoma. Prior to surgery, OCTA images revealed abnormal vasculature in the area of the lesion. Vessels in the peripheral iris approaching the lesion appeared more tortuous and were non-radial as compared with normal iris vessels. The ciliary body mass itself could not be penetrated using an OCTA system operating at 1050 nm. Conclusions and importance ARH-NPCE may clinically resemble a pigmented ciliary body melanoma. This is the second case describing this clinical scenario, which may be more common than previously thought. Non-invasive imaging with OCTA revealed an abnormal peripheral iris vasculature pattern in the area of the iridociliary mass characterized by disorganized, tortuous, and non-radial vessels. Despite advances in longer wavelength OCTA systems, poor penetration of the ciliary body lesion precluded imaging of the intratumoral vessels in this location.
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Affiliation(s)
| | | | | | | | - Alison H. Skalet
- Corresponding author. Casey Eye Institute, Oregon Health and Science University, 3375 SW Terwilliger Blvd, Portland, OR, 97239, USA.Casey Eye InstituteOregon Health and Science University3375 SW Terwilliger BlvdPortlandOR97239USA
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Miller AK, Benage MJ, Wilson DJ, Skalet AH. Uveal Melanoma with Histopathologic Intratumoral Heterogeneity Associated with Gene Expression Profile Discordance. Ocul Oncol Pathol 2016; 3:156-160. [PMID: 28868288 DOI: 10.1159/000453616] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 11/15/2016] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To report a case of intratumoral gene expression profile discordance in a malignant uveal melanoma, associated with intratumoral heterogeneity based upon histopathologic features. METHODS The clinical history, fundus findings, imaging and histopathologic features, and DecisionDx-UM gene expression profile results (Castle Biosciences, Inc., Phoenix, AZ, USA) of the tumor were reviewed. RESULTS A trans-retinal fine-needle aspiration biopsy was performed for a thin, pigmented choroidal tumor in a 33-year-old man. Cells obtained from this biopsy were tested using the DecisionDx-UM gene expression profile test and the tumor was classified as class 1A. Cytology confirmed melanoma. The patient subsequently elected to undergo enucleation. On microscopic examination of the globe, the tumor was composed primarily of spindle B cells, but had a focal area composed of epithelioid cells. This portion of the tumor was subsequently tested and demonstrated a class 1B gene expression profile. CONCLUSION Intratumoral discordance in gene expression profile results has been described in uveal melanomas. Here we demonstrate that this discordance may be associated in some cases with intratumoral heterogeneity based upon histopathologic features.
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Affiliation(s)
- Audra K Miller
- Casey Eye Institute, Oregon Health and Science University, Portland, IA, USA
| | - Matthew J Benage
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA
| | - David J Wilson
- Casey Eye Institute, Oregon Health and Science University, Portland, IA, USA
| | - Alison H Skalet
- Casey Eye Institute, Oregon Health and Science University, Portland, IA, USA
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Skalet AH, Li Y, Lu CD, Jia Y, Lee B, Husvogt L, Maier A, Fujimoto JG, Thomas CR, Huang D. Optical Coherence Tomography Angiography Characteristics of Iris Melanocytic Tumors. Ophthalmology 2016; 124:197-204. [PMID: 27856029 DOI: 10.1016/j.ophtha.2016.10.003] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 10/04/2016] [Accepted: 10/05/2016] [Indexed: 01/27/2023] Open
Abstract
PURPOSE To evaluate tumor vasculature with optical coherence tomography angiography (OCTA) in malignant iris melanomas and benign iris lesions. DESIGN Cross-sectional observational clinical study. PARTICIPANTS Patients with iris lesions and healthy volunteers. METHODS Eyes were imaged using OCTA systems operating at 1050- and 840-nm wavelengths. Three-dimensional OCTA scans were acquired. Iris melanoma patients treated with radiation therapy were imaged again after I-125 plaque brachytherapy at 6 and 18 months. MAIN OUTCOME MEASURES OCT and OCTA images, qualitative evaluation of iris and tumor vasculature, and quantitative vessel density. RESULTS One eye each of 8 normal volunteers and 9 patients with iris melanomas or benign iris lesions, including freckles, nevi, and an iris pigment epithelial (IPE) cyst, were imaged. The normal iris has radially oriented vessels within the stroma on OCTA. Penetration of flow signal in normal iris depended on iris color, with best penetration seen in light to moderately pigmented irides. Iris melanomas demonstrated tortuous and disorganized intratumoral vasculature. In 2 eyes with nevi there was no increased vascularity; in another, fine vascular loops were noted near an area of ectropion uveae. Iris freckles and the IPE cyst did not have intrinsic vascularity. The vessel density was significantly higher within iris melanomas (34.5%±9.8%, P < 0.05) than in benign iris nevi (8.0%±1.4%) or normal irides (8.0%±1.2%). Tumor regression after radiation therapy for melanomas was associated with decreased vessel density. OCTA at 1050 nm provided better visualization of tumor vasculature and penetration through thicker tumors than at 840 nm. But in very thick tumors and highly pigmented lesions even 1050-nm OCTA could not visualize their full thickness. Interpretable OCTA images were obtained in 82% of participants in whom imaging was attempted. CONCLUSIONS This is the first demonstration of OCTA in iris tumors. OCTA may provide a dye-free, no-injection, cost-effective method for monitoring a variety of tumors, including iris melanocytic lesions, for growth and vascularity. This could be helpful in evaluating tumors for malignant transformation and response to treatment. Penetration of the OCT beam remains a limitation for highly pigmented tumors, as does the inability to image the entire iris in a single field.
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Affiliation(s)
- Alison H Skalet
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon
| | - Yan Li
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon
| | - Chen D Lu
- Electrical Engineering & Computer Science and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Yali Jia
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon
| | - ByungKun Lee
- Electrical Engineering & Computer Science and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Lennart Husvogt
- Electrical Engineering & Computer Science and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts; Pattern Recognition Lab and SAOT, University Erlangen Nuremberg, Erlangen, Germany
| | - Andreas Maier
- Pattern Recognition Lab and SAOT, University Erlangen Nuremberg, Erlangen, Germany
| | - James G Fujimoto
- Electrical Engineering & Computer Science and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Charles R Thomas
- Department of Radiation Medicine, Oregon Health and Science University, Portland, Oregon
| | - David Huang
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon.
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Lin W, Beardsley RM, Skalet AH, Wilson DJ, Rosenbaum JT, Lin P. Bilateral Idiopathic Solitary Granuloma of the Uveal Tract: Diagnosis and Treatment. ACTA ACUST UNITED AC 2016; 4. [PMID: 26779545 DOI: 10.4172/2324-8599.1000166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We present a case of sequential bilateral idiopathic solitary granuloma of the uveal tract in a 51 year-old woman, who underwent enucleation in one eye due to complications of this condition, but was then successfully treated in the contralateral eye with anti-tumor necrosis-alpha therapy followed shortly by intraocular steroids and a steroid-releasing implant. Her visual acuity at its worst was 20/200 due to vitreous haze and cystoid macular edema, but then stabilized after successful treatment with a final visual acuity of 20/25 in her only seeing eye at 1 year follow-up. This represents the first known biopsy-proven case of bilateral idiopathic solitary granuloma, which additionally, has responded favorably to treatment.
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Affiliation(s)
| | | | | | | | - James T Rosenbaum
- Devers Eye Institute-Legacy Health System, Portland, OR, USA; Casey Eye Institute-OHSU, Portland, OR, USA
| | - Phoebe Lin
- Casey Eye Institute-OHSU, Portland, OR, USA
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Affiliation(s)
| | - Alison H. Skalet
- Casey Eye Institute, Oregon Health & Science University, Portland
| | - Andreas K. Lauer
- Casey Eye Institute, Oregon Health & Science University, Portland
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Ausayakhun S, Skalet AH, Jirawison C, Ausayakhun S, Keenan JD, Khouri C, Nguyen K, Kalyani PS, Heiden D, Holland GN, Margolis TP. Accuracy and reliability of telemedicine for diagnosis of cytomegalovirus retinitis. Am J Ophthalmol 2011; 152:1053-1058.e1. [PMID: 21861977 DOI: 10.1016/j.ajo.2011.05.030] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Revised: 05/23/2011] [Accepted: 05/24/2011] [Indexed: 11/30/2022]
Abstract
PURPOSE To determine the feasibility of remote diagnostic screening for cytomegalovirus (CMV) retinitis among HIV patients in northern Thailand. DESIGN Prospective, observational cross-sectional study. METHODS One hundred eighty-two eyes from 94 consecutive patients with HIV seen in 2008 and 2009 at a tertiary university-based medical center were photographed using a digital retinal camera. Individual and composite images were uploaded to a secure web site. Three expert graders accessed the electronic images and graded each image for signs of CMV retinitis. Results of remote expert grading were compared with on-site patient examination by local expert ophthalmologists. RESULTS On-site ophthalmologists diagnosed CMV retinitis in 89 (48.9%) of 182 eyes. Trained ophthalmic photographers obtained digital retinal images for all 182 eyes. As compared with the on-site examinations, the sensitivity for detecting CMV retinitis by remote readers using composite retinal images ranged from 89% to 91%. The specificity for detecting CMV retinitis by remote readers ranged from 85% to 88%. Intrarater reliability was high, with each grader achieving a κ value of 0.93. Interrater reliability among the 3 graders also was high, with a κ value of 0.86. CONCLUSIONS Remote diagnostic screening for CMV retinitis among HIV-positive patients may prove to be a valuable tool in countries where the burden of HIV exceeds the capacity of the local eye care providers to screen for ocular opportunistic infections.
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Skalet AH, Cevallos V, Ayele B, Gebre T, Zhou Z, Jorgensen JH, Zerihun M, Habte D, Assefa Y, Emerson PM, Gaynor BD, Porco TC, Lietman TM, Keenan JD. Antibiotic selection pressure and macrolide resistance in nasopharyngeal Streptococcus pneumoniae: a cluster-randomized clinical trial. PLoS Med 2010; 7:e1000377. [PMID: 21179434 PMCID: PMC3001893 DOI: 10.1371/journal.pmed.1000377] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2010] [Accepted: 10/29/2010] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND It is widely thought that widespread antibiotic use selects for community antibiotic resistance, though this has been difficult to prove in the setting of a community-randomized clinical trial. In this study, we used a randomized clinical trial design to assess whether macrolide resistance was higher in communities treated with mass azithromycin for trachoma, compared to untreated control communities. METHODS AND FINDINGS In a cluster-randomized trial for trachoma control in Ethiopia, 12 communities were randomized to receive mass azithromycin treatment of children aged 1-10 years at months 0, 3, 6, and 9. Twelve control communities were randomized to receive no antibiotic treatments until the conclusion of the study. Nasopharyngeal swabs were collected from randomly selected children in the treated group at baseline and month 12, and in the control group at month 12. Antibiotic susceptibility testing was performed on Streptococcus pneumoniae isolated from the swabs using Etest strips. In the treated group, the mean prevalence of azithromycin resistance among all monitored children increased from 3.6% (95% confidence interval [CI] 0.8%-8.9%) at baseline, to 46.9% (37.5%-57.5%) at month 12 (p = 0.003). In control communities, azithromycin resistance was 9.2% (95% CI 6.7%-13.3%) at month 12, significantly lower than the treated group (p < 0.0001). Penicillin resistance was identified in 0.8% (95% CI 0%-4.2%) of isolates in the control group at 1 year, and in no isolates in the children-treated group at baseline or 1 year. CONCLUSIONS This cluster-randomized clinical trial demonstrated that compared to untreated control communities, nasopharyngeal pneumococcal resistance to macrolides was significantly higher in communities randomized to intensive azithromycin treatment. Mass azithromycin distributions were given more frequently than currently recommended by the World Health Organization's trachoma program. Azithromycin use in this setting did not select for resistance to penicillins, which remain the drug of choice for pneumococcal infections. TRIAL REGISTRATION www.ClinicalTrials.gov NCT00322972. Please see later in the article for the Editors' Summary.
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Affiliation(s)
- Alison H. Skalet
- Francis I. Proctor Foundation for Research in Opthalmology, University of California, San Francisco, San Francisco, California, United States of America
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States of America
| | - Vicky Cevallos
- Francis I. Proctor Foundation for Research in Opthalmology, University of California, San Francisco, San Francisco, California, United States of America
| | | | | | - Zhaoxia Zhou
- Francis I. Proctor Foundation for Research in Opthalmology, University of California, San Francisco, San Francisco, California, United States of America
| | - James H. Jorgensen
- University of Texas Health Sciences Center, San Antonio, Texas, United States of America
| | | | | | - Yared Assefa
- Department of Ophthalmology, University of Gondar, Ethiopia
| | - Paul M. Emerson
- The Carter Center, Atlanta, Georgia, United States of America
| | - Bruce D. Gaynor
- Francis I. Proctor Foundation for Research in Opthalmology, University of California, San Francisco, San Francisco, California, United States of America
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States of America
| | - Travis C. Porco
- Francis I. Proctor Foundation for Research in Opthalmology, University of California, San Francisco, San Francisco, California, United States of America
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States of America
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, California, United States of America
| | - Thomas M. Lietman
- Francis I. Proctor Foundation for Research in Opthalmology, University of California, San Francisco, San Francisco, California, United States of America
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States of America
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, California, United States of America
- Institute for Global Health, University of California, San Francisco, San Francisco, California, United States of America
| | - Jeremy D. Keenan
- Francis I. Proctor Foundation for Research in Opthalmology, University of California, San Francisco, San Francisco, California, United States of America
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States of America
- * E-mail:
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Skalet AH, Quinn GE, Ying GS, Gordillo L, Dodobara L, Cocker K, Fielder AR, Ells AL, Mills MD, Wilson C, Gilbert C. Telemedicine screening for retinopathy of prematurity in developing countries using digital retinal images: a feasibility project. J AAPOS 2008; 12:252-8. [PMID: 18289897 DOI: 10.1016/j.jaapos.2007.11.009] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2007] [Revised: 11/01/2007] [Accepted: 11/06/2007] [Indexed: 12/28/2022]
Abstract
PURPOSE To determine the feasibility in a middle-level human development country of onsite training, image collection, Internet transfer, and remote grading of digital retinal images from babies screened for retinopathy of prematurity (ROP). METHODS Two experienced nurses in a neonatal nursery in Lima, Peru, were trained to take posterior pole (30 degrees ) digital retinal images. Nurses obtained posterior pole retinal images from babies undergoing routine ROP screening and selected images for uploading via Internet for remote evaluation by five masked ROP experts. Results of gradings were compared with same-day clinical diagnostic examinations by an experienced ophthalmologist. Success rates for image acquisition and transfer for grading by expert readers were calculated. RESULTS Serial image sets from 26 of the 28 babies enrolled in this study were obtained; two babies were too unstable for imaging. Fifty-six of 58 (96.6%) imaging sessions were successful in obtaining retinal images. Three hundred thirty of 336 (98.2%) images obtained were successfully uploaded to an interactive database. Remote graders judged 93.6% to 97.3% of image sets suitable for ROP grading. Preliminary results indicate sensitivities for detection of serious ROP from 45.5% to 95.2% among individual readers, with specificities of 61.7% to 96.2% when images were gradable. CONCLUSIONS A telemedicine approach for ROP screening using digital retinal images obtained by nonophthalmologists is feasible in rapidly developing countries that lack ROP-trained ophthalmologists. If remote grading of digital images is validated as an effective method for identifying referral-warranted ROP (RW-ROP), images obtained by nonphysicians may provide a means of identifying babies who require a diagnostic examination by an ophthalmologist.
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Affiliation(s)
- Alison H Skalet
- Division of Pediatric Ophthalmology, The Children's Hospital of Philadelphia and Scheie Eye Institute, University of Pennsylvania Health System, Philadelphia, Pennsylvania 19104, USA
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Skalet AH, Isler JA, King LB, Harding HP, Ron D, Monroe JG. Rapid B cell receptor-induced unfolded protein response in nonsecretory B cells correlates with pro- versus antiapoptotic cell fate. J Biol Chem 2005; 280:39762-71. [PMID: 16188879 DOI: 10.1074/jbc.m502640200] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The adaptive unfolded protein response (UPR) is essential for the development of antibody-secreting plasma cells. B cells induced by lipopolysaccharide (LPS) to differentiate into plasma cells exhibit a nonclassical UPR reported to anticipate endoplasmic reticulum stress prior to immunoglobulin production. Here we demonstrate that activation of a physiologic UPR is not limited to cells undergoing secretory cell differentiation. We identify B cell receptor (BCR) signaling as an unexpected physiologic UPR trigger and demonstrate that in mature B cells, BCR stimulation induces a short lived UPR similar to the LPS-triggered nonclassical UPR. However, unlike LPS, BCR stimulation does not induce plasma cell differentiation. Furthermore, the BCR-induced UPR is not limited to cells in which BCR induces activation, since a UPR is also induced in transitional immature B cells that respond to BCR stimulation with a rapid apoptotic fate. This response involves sustained up-regulation of Chop mRNA indicative of a terminal UPR. Whereas sustained Chop expression correlates with the ultimate fate of the BCR-triggered B cell and not its developmental stage, Chop-/- B cells undergo apoptosis, indicating that CHOP is not required for this process. These studies establish a system whereby a terminal or adaptive UPR can be alternatively triggered by physiologic stimuli.
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MESH Headings
- Alleles
- Animals
- Apoptosis
- B-Lymphocytes/cytology
- B-Lymphocytes/metabolism
- Blotting, Western
- CD40 Antigens/biosynthesis
- Cell Differentiation
- Cell Lineage
- Cell Membrane/metabolism
- Cytoplasm/metabolism
- Endoplasmic Reticulum/metabolism
- Exons
- Genes, Reporter
- Immunoglobulins/metabolism
- Lipopolysaccharides/chemistry
- Mice
- Mice, Inbred BALB C
- Mice, Inbred C57BL
- Mice, Transgenic
- Microscopy, Electron
- Mutation
- Protein Denaturation
- Protein Folding
- RNA, Messenger/metabolism
- Receptors, Antigen, B-Cell/metabolism
- Receptors, Interleukin-4/metabolism
- Reverse Transcriptase Polymerase Chain Reaction
- Signal Transduction
- Time Factors
- Toll-Like Receptor 4/metabolism
- Transcription Factor CHOP/metabolism
- Up-Regulation
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Affiliation(s)
- Alison H Skalet
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA
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Abstract
Viral infection causes stress to the endoplasmic reticulum. The response to endoplasmic reticulum stress, known as the unfolded protein response (UPR), is designed to eliminate misfolded proteins and allow the cell to recover by attenuating translation and upregulating the expression of chaperones, degradation factors, and factors that regulate the cell's metabolic and redox environment. Some consequences of the UPR (e.g., expression of chaperones and regulation of the metabolism and redox environment) may be advantageous to the viral infection; however, translational attenuation would not. Thus, viruses may induce mechanisms which modulate the UPR, maintaining beneficial aspects and suppressing deleterious aspects. We demonstrate that human cytomegalovirus (HCMV) infection induces the UPR but specifically regulates the three branches of UPR signaling, PKR-like ER kinase (PERK), activating transcription factor 6 (ATF6), and inositol-requiring enzyme 1 (IRE-1), to favor viral replication. HCMV infection activated the eIF2alpha kinase PERK; however, the amount of phosphorylated eIF2alpha was limited and translation attenuation did not occur. Interestingly, translation of select mRNAs, which is dependent on eIF2alpha phosphorylation, did occur, including the transcription factor ATF4, which activates genes which may benefit the infection. The endoplasmic reticulum stress-induced activation of the transcription factor ATF6 was suppressed in HCMV-infected cells; however, specific chaperone genes, normally activated by ATF6, were activated by a virus-induced, ATF6-independent mechanism. Lastly, HCMV infection activated the IRE-1 pathway, as indicated by splicing of Xbp-1 mRNA. However, transcriptional activation of the XBP-1 target gene EDEM (ER degradation-enhancing alpha-mannosidase-like protein, a protein degradation factor) was inhibited. These results suggest that, although HCMV infection induces the unfolded protein response, it modifies the outcome to benefit viral replication.
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Affiliation(s)
- Jennifer A Isler
- Department of Cancer Biology, Abramson Family Cancer Research Institute, University of Pennsylvania, Philadelphia, USA
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