Background: The Severe Acute Respiratory Syndrome Coronavirus 2 (COVID-19) pandemic has limited patient access to outpatient care, prompting many clinicians to incorporate telemedicine in their practice. This study aims to explore the impact of the pandemic on the use of tele-ophthalmology in the Philippines. Methodology: A 30-item online survey on practices and attitudes related to teleophthalmology was sent to ophthalmologists and ophthalmologists-in-training all over the Philippines. Results: A total of 327 local ophthalmologists responded to the anonymous survey. Reported use of tele-ophthalmology increased from 53% to 90% (P < 0.001) at the time of the COVID-19 pandemic. Social media messaging was the most employed modality, utilized by 8 out of 10 tele-ophthalmology users. Respondents reported confidence in diagnosing gross conditions of the eye, and lack of confidence in diagnosing posterior pole conditions and orbital fractures. The majority (84%) believe that it can be adopted on a wider scale in the upcoming years. Conclusion: The pandemic catalyzed a nationwide increase in the utilization of teleophthalmology. The majority of respondents expressed willingness to continue incorporating tele-ophthalmology in their practice after the pandemic.
Animal models are crucial for the study of tumorigenesis and therapies in oncology research. Though rare, uveal melanoma (UM) is the most common intraocular tumor and remains one of the most lethal cancers. Given the limitations of studying human UM cells in vitro, animal models have emerged as excellent platforms to investigate disease onset, progression, and metastasis. Since Greene’s initial studies on hamster UM, researchers have dramatically improved the array of animal models. Animals with spontaneous tumors have largely been replaced by engrafted and genetically engineered models. Inoculation techniques continue to be refined and expanded. Newer methods for directed mutagenesis have formed transgenic models to reliably study primary tumorigenesis. Human UM cell lines have been used to generate rapidly growing xenografts. Most recently, patient-derived xenografts have emerged as models that closely mimic the behavior of human UM. Separate animal models to study metastatic UM have also been established. Despite the advancements, the prognosis has only recently improved for UM patients, especially in patients with metastases. There is a need to identify and evaluate new preclinical models. To accomplish this goal, it is important to understand the origin, methods, advantages, and disadvantages of current animal models. In this review, the authors present current and historic animal models for the experimental study of UM. The strengths and shortcomings of each model are discussed and potential future directions are explored.
Purpose: To report 6 cases of diffuse choroidal hemangioma in children treated with iodine-125 plaque brachytherapy at a single tertiary care center.Methods: Retrospective case series.Results: Six pediatric patients diagnosed with diffuse choroidal hemangioma were included in the study. Preplaque visual acuity ranged from 20/150 to no light perception. All patients had extensive serous retinal detachment at presentation. An iodine-125 radioactive plaque was placed on the affected eye to administer a dose of 34.2-42.1 Gy to the tumor apex over a median of 4 days. Tumor regression and subretinal fluid resolution were observed in all eyes within 17 months of treatment. Visual acuity improved in two patients. Radiation-induced cataract and subretinal fibrosis were documented in one case, and one patient developed radiation retinopathy. No patients developed neovascular glaucoma within the follow-up time of 12-65 months.Conclusion: Iodine-125 plaque radiotherapy is an effective option for diffuse choroidal hemangioma, although there is a risk for radiation-induced complications.
Purpose: To report a rare case of infusion port site tumor seeding of choroidal melanoma after pars plana vitrectomy-assisted biopsy and successful treatment with second plaque brachytherapy.Methods: Observational case report with clinical data and diagnostic images.Results: A 55-year-old White woman diagnosed with choroidal melanoma of the left eye was found to have a second intraocular tumor 30 months after plaque brachytherapy and pars plana vitrectomy-assisted tumor biopsy. The second melanoma developed at the 5 o'clock vitrectomy infusion port site. The tumor regressed after plaque brachytherapy, and the patient has not developed systemic metastasis 5 years after diagnosis of intraocular seeding.Conclusion: Intraocular seeding into the infusion port site, although rare, may be encountered after pars plana vitrectomy-assisted biopsy of choroidal melanoma.
Purpose: To describe two patients with intraocular lens (IOL) and lens capsule spread of iridociliary melanoma.
Methods: Two pseudophakic patients with iridociliary body melanoma that spread onto the surface of their IOL and remaining lens capsule were included. Their eyes were enucleated and the histopathologic features were evaluated.
Results: Case 1 was an 82-year-old woman with diffuse primary iridociliary melanoma affecting the iris, lens capsule, IOL surface, and ciliary body. Case 2 was a 68-year-old female who developed melanoma recurrence in the anterior segment after plaque brachytherapy for iridociliary melanoma. The melanoma in both cases grew as a pigmented membrane onto the surface of the IOL.
Conclusions: Intraocular lens and lens capsule spread of iridociliary melanoma can occur primarily or develop secondarily after plaque brachytherapy of a pseudophakic eye. Since the extent of the melanoma may be uncertain and there is a high likelihood of glaucoma, enucleation is a reasonable option.
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