Plaque brachytherapy – Radiating positivity

Background: Plaque brachytherapy is an evolving, yet effective globe and vision-sparing modality for the treatment of intraocular tumors by transscleral irradiation of the tumor base with a radioactive implant. The American Brachytherapy Society (ABS) along with the collaboration of the international multicenter Ophthalmic Oncology Task Force (OOTF) was assembled to reach a consensus regarding establishing practice guidelines and setting standards of care for intraocular tumors. The advent of plaque brachytherapy has revolutionized the outcomes of intraocular tumors, thus ensuring globe salvage, reducing morbidity and mortality, and avoiding cosmetic disfigurement. A well-planned dosimetry for plaque brachytherapy results in achieving local tumor control and excellent prognosis. Purpose: This technique provides the advantage of focal radiation, thus eliminating the damage to the adjacent structures, minimal periorbital tissue damage, absence of cosmetic disfigurement owing to lack of retarded bone growth as seen in external beam radiotherapy. Thus, it reduces the risk of metastasis, and with the recent advances, it provides a shorter duration of treatment. Synopsis: In this video, we shall display the concept of plaque brachytherapy, the various types of plaques available, different radiations sources, planning dosimetry and calculations, target disease spectrum, surgical placement, and post-radiation outcomes in terms of local tumor control and prognosis. Highlights: This video highlights the history, basic principles and techniques of plaque brachytherapy and provides an understanding of its applications in the world of ocular oncology.

Angioceratoma conjuntival canino: relato de caso / Canine conjunctival angiokeratoma: case report

O angioceratoma é um tumor de origem vascular, semelhante ao hemangioma, que se diferencia deste por alterações histológicas epiteliais. A apresentação ocular do angioceratoma é pouco frequente em cães, sendo mais comum a ocorrência de hemangioma e hemangiossarcoma. Neste relato, é descrito o caso de um cão, macho, da raça Border Collie, que apresentava uma massa localizada, hiperêmica, bem vascularizada e protrusa, na região temporal da conjuntiva bulbar do olho direito (OD). Foi realizado exame oftalmológico completo e ultrassonografia ocular, tendo sido possível observar que a massa não envolvia outras estruturas oculares além da conjuntiva. Dessa forma, foi realizada a conjuntivectomia parcial, e o material foi encaminhado para análise histológica. O exame histopatológico foi conclusivo para um angioceratoma e mostrou que as margens da amostra estavam livres. O procedimento cirúrgico com margem de segurança foi eficiente no tratamento da neoplasia, sem recorrência até o momento do presente relato.(AU)

Angiokeratomas have been described as tumors of vascular origin, similar to hemangioma but with participation of adjacent epithelium and less frequent in dogs. In this case we have reported an adult, male, Border Collie dog presenting a localized and hyperemic mass with protrusion surface and well vascularized region of temporal bulbar conjunctiva of the right eye (OD). Complete ocular examination and ocular ultrasound have revealed no involvement of other ocular structures beyond the conjunctiva. A partial conjuntivectomy was surgically performed, tissue material sent for histological analysis and angiokeratoma diagnosis was accurately made. Surgical procedure with a safety tissue margin has shown adequate treatment efficiency, with no neoplasia recurrence to date.(AU)

Caracterización epidemiológica de la neoplasia intraepitelial de la conjuntiva en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer" / Epidemiological characterization of conjunctival intraepithelial neoplasia in "Ramón Pando Ferrer" Cuban Institute of Ophtalmology

OBJETIVO: identificar el patrón epidemiológico de la neoplasia intraepitelial de la conjuntiva en el Instituto Cubano de Oftalmología «Ramón Pando Ferrer¼ (2005-2010). MÉTODOS: se realizó un estudio descriptivo en 106 pacientes con neoplasia intraepitelial unilateral según edad, sexo, enfermedad ocular asociada y años de diagnóstico. Se calcularon porcentajes, tasa de incidencia y prevalencia proporcional y se estimó la tendencia por método gráfico. RESULTADOS: el 59,4 % perteneció al sexo femenino (n = 63); el 53,8 % (n = 57) se encontró en edades entre 30 y 39 años, seguido por ³ 60 años con 33 % (n = 35); el 18,9 % (n = 20) presentó enfermedad ocular asociada, donde el 60 % (n = 12) correspondió al pterigium. Hubo entre 34 % (n = 36), 31, 1 % (n = 33) y 30,2 % (n = 32) con NIC I, NIC II y NIC III respectivamente, y el 4,7 % (n = 5) con carcinoma in situ. La incidencia en el 2009 alcanzó 3,1 % (n = 34) y 85,8 % de prevalencia (n = 91), con tendencia lineal al incremento. CONCLUSIONES: se manifiesta tendencia al incremento de la enfermedad; por eso merece atención el estudio de los factores de riesgo como enfoque preventivo para reducir este comportamiento, si se parte del aumento de la expectativa de vida de la población cubana con tendencia al envejecimiento, pues la neoplasia intraepitelial de la conjuntiva es característica de personas en edad avanzada.

OBJECTIVE: to identify the epidemiological pattern of intraepithelial neoplasia of the conjunctiva in the «Ramón Pando Ferrer¼ Cuban Ophthalmology Institute (2005-2010). METHODS: a descriptive study was conducted in 106 patients with unilateral intraepithelial neoplasia by age, sex, associated eye disease and number of years since diagnosis. Percentages, incidence and proportional prevalence rates, and tendency by the graphic method were all estimated. RESULTS: in the study group, 59,4 % (n = 63) were females 53,8 % (n = 57) were 30-39 years old, followed by 33 % of ³ 60 years-olds (n = 35), 18,9 % (n = 20) had associated eye disease with 60 % (n = 12) affected by pterygium. There was 34 % (n = 36), 31,1 % (n = 33) and 30,2 % (n = 32) with CINI, CIN II and CIN III, respectively, and 4,7 % (n = 5) with in situ carcinoma. The incidence rate in 2009 was 3,1 % (n = 34) and 85,8 % prevalence rate (n = 91), with linear tendency to increase. CONCLUSIONS: this study showed increasing tendency of the disease, so it must be paid attention to the preventive approach-oriented study of the risk factors to reduce this tendency, taking into account the rise of the life expectancy of the Cuban population and their aging tendencies and the fact that the conjunctival intraepithelial neoplasia is characteristic of the elderly people.

Clinical Analysis of Benign Eyelid and Conjunctival Tumors

PURPOSE: To assess the occurrence and characteristics of benign eyelid and conjunctival tumors. METHODS: We histopathologically analyzed 80 consecutive cases of benign eyelid (56 cases) and conjunctival (24 cases) tumors between April 2000 and November 2002. All eyelid and conjunctival tumors were confirmed histopathologically. Age, sexual distribution, occurrence and location were analyzed. RESULTS: The mean ages were 42.32+/-16.27 SD in benign eyelid tumors, and 29.71+/-18.60 SD in benign conjunctival tumors. The sexual distribution revealed 23 males and 33 females in benign eyelid tumors, and 12 males and 12 females in benign conjunctival tumors. About the location, lower lid was most frequent site of benign eyelid tumors, responsible for 27 (48.2%) of the 56 cases, and medial conjunctiva was the most frequent site of benign conjunctival tumors, responsible for 14 (58.3%) of 24 cases. Shave biopsy was performed in eyelid margin tumors. Excisional biopsy was performed in other eyelid tumors and conjunctival tumors. The frequency of benign eyelid tumors was noted in this order: intradermal nevi 25 cases (44.6%), seborrheic keratoses 9 cases (16.1%), and compound nevi 6 cases (10.7%), and frequency of benign conjunctival tumors was noted in this order: compound nevi 7 cases (29.2%), and intradermal nevi 6 cases (25.0%). CONCLUSIONS: From the Results of this study, we hope that this report provides a basic source for diagnosis and therapy of the benign eyelid and conjunctival tumors.