Options for management of intra ocular tumors

Gopal, Lingam

doi:10.4103/0301-4738.156913

Cited by 6 publications

(5 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In oncology practice, enucleation is routinely performed for the management of malignant intraocular tumors with an aim for complete tumor control [1][2][3][4][5][6][7][8][9][10][11][12]. To achieve this end, it sometimes entails the removal of an additional and adequate length of the optic nerve, excision of any adherent conjunctiva and tenon's fascia to the underlying tumor, or sacrificing a part of the orbital tissue, and this is termed as extended enucleation.…”

Section: Overview and Indications Of Enucleationmentioning

confidence: 99%

“…Enucleation for ciliochoroidal melanoma as a primary treatment is indicated in very large tumors (>18 mm in diameter and >10 mm in thickness) which are not amenable to plaque radiotherapy (Table 12.1) [5,6]. Choroidal melanomas with optic nerve invasion are also an indication for enucleation [7]. Enucleation may be necessary in recurrent posterior melanoma, which has not responded favorably to radiation treatment [5,6].…”

Section: Overview and Indications Of Enucleationmentioning

confidence: 99%

“…In a long-term analysis of 144 patients with iris melanoma treated by plaque radiotherapy, Shields et al noted that glaucoma was present at the initial visit in 40% of cases, and by Kaplan-Meier estimate at 7 years, enucleation was necessary in 12% [11]. Enucleation is sometimes necessary in other conditions including medulloepithelioma, intraocular extension of conjunctival squamous cell carcinoma, and blind painful eyes harboring large benign or malignant intraocular tumors (Table 12.1) [7,12]. In a two-institutional study of 41 eyes with medulloepithelioma, 26 eyes (63%) required enucleation, and it was mainly indicated in larger tumors (n = 21), and in smaller tumors that failed to respond to conservative treatment (n = 5) [12].…”

Section: Overview and Indications Of Enucleationmentioning

confidence: 99%

See 2 more Smart Citations

Enucleation and Exenteration

Honavar

Rao

2019

Surgical Ophthalmic Oncology

View full text Add to dashboard Cite

Enucleation and exenteration for the management of intraocular and orbital malignancies, respectively, was the standard treatment of care before the advent of radiotherapy and chemotherapy. Over the past few decades, enhanced knowledge on the biology of the tumors, advances in the histopathologic and cytological techniques, use of various diagnostic modalities for an early and a more precise diagnosis, implementation of protocol-based management, and use of multimodal treatment including chemotherapy, radiotherapy, immunotherapy, and conservative surgeries, have greatly contributed to the reduction in the need for enucleation and exenteration. This paradigm shift toward less radical treatment has brought about a refinement in the absolute indications for enucleation and exenteration.

show abstract

Section: Overview and Indications Of Enucleationmentioning

confidence: 99%

Section: Overview and Indications Of Enucleationmentioning

confidence: 99%

Section: Overview and Indications Of Enucleationmentioning

confidence: 99%

See 1 more Smart Citation

Enucleation and Exenteration

Honavar

Rao

2019

Surgical Ophthalmic Oncology

View full text Add to dashboard Cite

show abstract

“…Understanding intraocular tumors and their ocular complications are factors determining their response to treatment and practical management [13][14][15]. Appropriate diagnostic tools are essential for the early detection and management of ocular cancer.…”

Section: Introductionmentioning

confidence: 99%

Imaging techniques for ocular neoplasia

Amiri¹,

Heidari²,

Jafari³

et al. 2022

Med Hypothesis Discov Innov Optom

View full text Add to dashboard Cite

Background: Novel ocular imaging modalities have greatly impacted the diagnosis and management of different types of ocular neoplasia. In this narrative review, we summarize the practical features of popular and novel imaging modalities for ocular tumors. Methods: Four databases, including PubMed/MEDLINE, Web of Science, Scopus, and Google Scholar, were searched from January 1, 2000 to August 31, 2022. Articles reporting different imaging modalities for diagnosing or monitoring treatment responses of ocular tumors were extracted using various combinations of the following keywords: ocular neoplasia, positron emission tomography or PET, single-photon emission computed tomography or SPECT, optical coherence tomography or OCT, OCT angiography or OCTA, computed tomography or CT, ultrasonography or US, ultrasound biomicroscopy or UBM, and magnetic resonance imaging or MRI. Results: Various ocular imaging modalities had different accuracies as adjunctive tools for detecting or managing ocular tumors. Anterior ultra-high-resolution optical coherence tomography (OCT) could be used to evaluate images with < 5-µm resolution. OCT angiography provided deeper insight into retinal vascular changes associated with the malignant transformation of choroidal melanoma. OCT in children altered the diagnosis of suspicious retinoblastoma in 3% of the cases and treatment plan in 11% of the cases. While positron-emission tomography (PET)/computed tomography (CT) allowed the detection of metastatic lesions of choroidal melanoma by full-body scanning, single-photon emission CT was more sensitive compared to PET in detecting choroidal melanoma. Ultrasound biomicroscopy, with an accuracy exceeding 92.5%, could detect retinal calcification in lesions measuring 2–3 mm. Magnetic resonance imaging (MRI) had better contrast compared to ultrasound biomicroscopy and higher sensitivity compared to CT in detecting post-laminar optic nerve invasion. However, MRI had a lower spatial resolution compared to OCT. Further development of imaging modalities and their application in drug development would improve the treatment of ocular tumors. Conclusions: Although diagnosing ocular tumors depend on clinical characteristics, innovations in ocular imaging have enabled early diagnosis and timely, appropriate management of ocular neoplasia, which are conducive to favorable visual outcomes and increased life expectancy. Further systematic reviews and meta-analyses of primary studies focusing on a specific imaging modality in ocular neoplasia could precisely determine the diagnostic accuracy of each imaging modality to better guide eye practitioners with efficient diagnostic or therapeutic approaches for these sight- or life-threatening entities. Imaging modalities may play a major role in drug development in the future.

show abstract

“…It is most the common primary cancer of eye in adults that arises in the iris, ciliary body or choroid. The current treatment options include surgical enucleation, trans pupillary thermotherapy, cryotherapy, proton therapy, brachytherapy, and stereotactic radiosurgery (Lingam 2015). The goals of the treatment are to prevent further growth of the tumor, preserve vision, and reduce the risk of metastases.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of ceramic marker for the treatment of ocular melanoma with proton therapy

Saini

Bowen

James

et al. 2017

Biomed. Phys. Eng. Express

View full text Add to dashboard Cite

BioMarc Secure TM , a fiducial marker with ceramic core (zirconium oxide) and carbon coating, was evaluated for use in the localization and alignment of ocular melanoma targets using proton pencil beam scanning (PBS). Measurements and Monte Carlo (MC) simulations were performed to estimate the dose attenuation behind the marker. Imaging tests were performed to evaluate the visibility of marker for x-ray based alignment. An anthropomorphic phantom with implanted fiducial marker was scanned to obtain two-dimensional kilo-voltage (kV) x-ray and threedimensional computed tomographic (CT) images. For dose shadow measurements, an in-house phantom was constructed using solid water, Styrofoam and EBT3 gafchromic film. Dose attenuation behind the marker was measured at multiple depths and for three cardinal orientations: parallel, perpendicular, and transverse. The measurements were performed at the proton pencil beam gantry at the Seattle Cancer Care Alliance Proton Therapy center. A beam model for pencil beam gantry was created in the validated MC simulation toolkit GATE (GEANT4 Applications for Tomographic Emission). MC simulations were set up to mimic the measurement geometry and dose attenuation behind the marker was studied for a single layer PBS beam. Additional simulations were performed in water using the clinical relevant spread out Bragg peak (SOBP) beam. Qualitative analysis of the planar kV images showed excellent visibility of marker. Reconstruction artifacts in the form of light and dark streaks were present on the CT images. The film and MC simulations showed significant dose attenuation behind the marker that worsened when marker was placed close to the distal edge. Dose shadows of up to 45% and range loss of up to 1.1 mm were seen behind the marker. The transverse marker orientation in the clinical SOBP beam showed dose reduction of up to 61% and range pull-back of 2.4 mm. The dose attenuation was found to be a function of marker orientation and location within the SOBP. The analysis showed that small volumes behind the marker can see severe under-dosing. This effect should be taken into account during the planning of treatment. Comparing the results of this study to published results for tantalum marker, the BioMarc Secure marker was found to be inferior due to its greater dose attenuation and extended dose shadow on larger underlying volume. Furthermore, its bigger physical size may mean more discomfort to patient.

show abstract

Options for management of intra ocular tumors

Cited by 6 publications

References 30 publications

Enucleation and Exenteration

Enucleation and Exenteration

Imaging techniques for ocular neoplasia

Evaluation of ceramic marker for the treatment of ocular melanoma with proton therapy

Contact Info

Product

Resources

About