ABSTRACT
PURPOSE: To assess the difference in intraocular tumors height measurements intraoperatively before and after radioactive plaque application. METHODOLOGY: Twenty-four eyes of 24 patients with intraocular tumors, candidates for radioactive therapy, were included. Each tumor was measured at the same setting before and after plaque application independently by 3 sonographers, using a 20-MHz B-scan transducer. Mean pre-plaque and post-plaque measurements were calculated and recorded. An A-scan vector aided in identification of the inner and outer tumor surfaces. RESULTS: Each patient was examined independently three times by three experienced ultrasonographers within the same setting to assess interobserver variability. There was no statistically significant difference between the 3 examiners' readings, with P-value 0.99 for pre-plaque height and 0.97 for post-plaque height. Mean pre-plaque height was 5.16±2.11mm, while post-plaque height was 5.51±2.1mm (P-value 0.001). The Spearman correlation test showed that initial tumor height was negatively correlated with the difference between both heights, but with no statistical significance. CONCLUSION: Intraocular tumor height measurement differs significantly before and after plaque application. Use of the pre-plaque height is advised until further studies are performed to assess the effect of this difference on treatment outcomes.
Subject(s)
Brachytherapy , Melanoma , Uveal Neoplasms , Humans , Prospective Studies , Uveal Neoplasms/pathology , Eye/pathologyABSTRACT
BACKGROUND: Proliferative vitreoretinopathy (PVR) is one of the most important complications following vitreoretinal surgery. So far, surgical strategies have been the gold standard in treatment. Pharmacological approaches for prevention and treatment of PVR are under clinical investigation and intervene in different phases of the PVR cascade. METHODS: The relevant literature as well as own data and experience with PVR are discussed in this review article. The most important aspects of pharmacological approaches for PVR prophylaxis and treatment are explained. RESULTS: A prophylactic use of systemic prednisone administration as an anti-inflammatory substance showed contradictory results, while there was no additional benefit for intravitreal triamcinolone. Orally administered isotretinoin also seems to be able to minimize the formation of PVR after retinal reattachment surgery, whereas there was no improvement in the success rate in established PVR. Cell proliferation inhibitors have already been extensively studied. The combined intravitreal prophylactic approach of 5fluorouracil and low molecular weight heparin was recently further investigated in a multicenter, placebo-controlled study and showed a positive effect in some studies. New preclinical and experimental approaches include the inhibition of growth factors, modulation of integrin activity and the induction of apoptosis. CONCLUSION: Most clinical studies dealt with an anti-inflammatory or antiproliferative approach. So far, no pharmacological substance has been established for the treatment of PVR but there are promising approaches for prophylaxis.
