Clinical use of photodynamic therapy in ocular tumors

Çerman, Eren; Çekıç, Osman

doi:10.1016/j.survophthal.2015.05.004

Cited by 49 publications

(51 citation statements)

References 203 publications

(222 reference statements)

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“…A photosensitizer is administered via intravenous injection, which accumulates in tumor tissue and when activated with light at a specific wavelength causes tumor destruction by direct cytotoxic effect, causes destruction of peritumoral vasculature, and creates local inflammatory reaction resulting in increased autophagy. 70 Verteporfin 6 mg/m 2 is the most commonly used photosensitizer. Ten minutes after intravenous injection of verteporfin, 690 nm diode laser is delivered through a dilated pupil to the choroidal tumor surface.…”

Section: Photodynamic Thermotherapymentioning

confidence: 99%

Uveal melanoma: relatively rare but deadly cancer

Kaliki

Shields

2016

Eye

441

520

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Although it is a relatively rare disease, primarily found in the Caucasian population, uveal melanoma is the most common primary intraocular tumor in adults with a mean age-adjusted incidence of 5.1 cases per million per year. Tumors are located either in iris (4%), ciliary body (6%), or choroid (90%). The host susceptibility factors for uveal melanoma include fair skin, light eye color, inability to tan, ocular or oculodermal melanocytosis, cutaneous or iris or choroidal nevus, and BRCA1-associated protein 1 mutation. Currently, the most widely used first-line treatment options for this malignancy are resection, radiation therapy, and enucleation. There are two main types of radiation therapy: plaque brachytherapy (iodine-125, ruthenium-106, or palladium-103, or cobalt-60) and teletherapy (proton beam, helium ion, or stereotactic radiosurgery using cyber knife, gamma knife, or linear accelerator). The alternative to radiation is enucleation. Although these therapies achieve satisfactory local disease control, long-term survival rate for patients with uveal melanoma remains guarded, with risk for liver metastasis. There have been advances in early diagnosis over the past few years, and with the hope survival rates could improve as smaller tumors are treated. As in many other cancer indications, both early detection and early treatment could be critical for a positive long-term survival outcome in uveal melanoma. These observations call attention to an unmet medical need for the early treatment of small melanocytic lesions or small melanomas in the eye to achieve local disease control and vision preservation with the possibility to prevent metastases and improve overall patient survival.

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Section: Photodynamic Thermotherapymentioning

confidence: 99%

Uveal melanoma: relatively rare but deadly cancer

Kaliki

Shields

2016

Eye

441

520

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“…The earlier that treatment is implemented, the better the visual outcome for the patient 13 . Several treatment options are available presently, including argon laser photocoagulation, episcleral plaque radiation therapy, external beam radiotherapy, proton beam radiotherapy, TTT, PDT, and intravitreal anti-VEGF therapy 2, 3, 4, 6, 8, 9, 11, 12, 13, 14, 15. Enucleation is reserved for blind painful eyes after other therapies have failed.…”

Section: Resultsmentioning

confidence: 99%

“…One possible side effect is choroidal atrophy from repeated treatments. Overall, PDT is a safe and effective primary or secondary treatment for CCH 5, 14, 15…”

Section: Literature Reviewmentioning

confidence: 98%

Circumscribed choroidal hemangioma: A case report and literature review

Berry

Lucas

2017

Journal of Optometry

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Choroidal hemangioma is a rare congenital ocular tumor that can present as either circumscribed or diffuse. Circumscribed choroidal hemangioma (CCH) typically manifests as a red-orange mass within the posterior pole and appears similar to other ocular conditions, such as choroidal melanoma and choroidal metastasis. Proper diagnosis is crucial and is aided by the use of ancillary testing. CCH itself is benign but can cause secondary complications such as subretinal fluid accumulation and subsequent retinal detachment. If these conditions should arise, several treatment options are available.

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“…However, it has been speculated that PDT is ineffective for pigmented choroidal melanoma because pigment might block penetration of the laser,27–29 likely resulting with radial growth of the deeper undamaged malignant cells. From a mechanistic perspective, PDT with verteporfin is believed to cause damage to cellular components by the formation of free oxygen radicals,30 hence dependent on laser-tissue penetration. However, verteporfin may also have a role, independent of its activation by PDT, as an anticancer compound associated with the Hippo pathway 31.…”

Section: Discussionmentioning

confidence: 99%

“…PDT is considered generally a safe treatment modality, although some ocular complications were reported in association with its use, including transient visual disturbances, choroidal atrophy, vitreous haemorrhage, exudative retinal detachment30 and also a case of branch retinal artery occlusion 33. Although rare, patients should be informed of the possibility of sight-threatening complications which has immediate negative visual consequences.…”

Section: Discussionmentioning

confidence: 99%