Subject(s)
Carotenoids/analogs & derivatives , Retinal Diseases/chemically induced , Canthaxanthin , Carotenoids/adverse effects , Choroid , Fluorescein Angiography , Humans , Macula Lutea/pathology , Male , Middle Aged , Retinal Diseases/complications , Retinal Diseases/pathology , Uveal Diseases/complications , Uveal Diseases/pathologyABSTRACT
We have used intraocular sulphur hexafluoride or liquid silicone as an adjunct to vitreous surgery in the treatment of a non-randomised sequential series of 19 eyes with retinal detachment complicated by proliferative vitreoretinopathy. We have studied the surgical results and complications of these two tamponades and drawn preliminary conclusions on their use in retinal reattachment surgery. After a seven-month minimum follow-up 13 (68%) of the eyes have reattached retinas. Six (60%) of 10 eyes treated only with silicone have reattached retinas, and four (67%) of six eyes treated only with sulphur hexafluoride gas tamponade have reattached retinas. An additional three eyes treated initially with silicone oil subsequently developed retinal detachments; all were successfully reattached with sulphur hexafluoride tamponade after silicone oil removal. Intraoperative pneumatic retinal reattachment to assess relief of retinal traction combined with the production of widespread chorioretinal adhesions to wall off persistent anterior traction and detachment, as well as extended postoperative gas tamponade of the retina, appears to enhance the surgical results in retinal detachment complicated by proliferative vitreoretinopathy. Silicone oil tamponade of the retina appears to be useful in cases where retinal traction cannot be entirely relieved and in patients who are unable to tolerate the head positioning required for effective gas tamponade of the retina. A controlled clinical study recently begun will be required to define further the precise role of these methods of retinal tamponade.
Subject(s)
Fluorides , Retinal Detachment/surgery , Silicone Oils , Sulfur Hexafluoride , Vitreous Body/surgery , Adult , Combined Modality Therapy , Eye Diseases/complications , Eye Diseases/surgery , Female , Humans , Intraoperative Complications , Male , Postoperative Complications , Pressure , Recurrence , Retinal Detachment/complicationsABSTRACT
Eighty-two patients with choroidal melanomas were treated with helium ion charged particle irradiation. Seventy-eight of 82 patients have either remained stable or demonstrated tumor shrinkage. Forty-five of 46 patients followed for at least 1 year after therapy have demonstrated tumor regression with a mean tumor shrinkage of approximately 31%. No tumor-related mortality has been observed. The most effective method of choroidal melanoma management is unclear. Charged particle external beam irradiation may be more applicable and have less ocular morbidity than either radioactive plaques or photocoagulation.
Subject(s)
Choroid Neoplasms/radiotherapy , Helium/therapeutic use , Melanoma/radiotherapy , Radiation, Ionizing/therapeutic use , Adult , Aged , Eye/radiation effects , Follow-Up Studies , Humans , Middle Aged , Visual AcuityABSTRACT
Nine patients with choroidal melanomas were treated with helium ion charged particle irradiation. No patient demonstrated tumor enlargement, and most lesions followed for more than five months have demonstrated tumor shrinkage. The most effective method of choroidal melanoma management is unclear. Heavy charged particle irradiation may be more applicable and have less ocular morbidity associated with it in either radioactive plaques or photocoagulation.
Subject(s)
Choroid Neoplasms/radiotherapy , Helium/therapeutic use , Melanoma/radiotherapy , Adult , Alpha Particles , Choroid Neoplasms/diagnosis , Follow-Up Studies , Humans , Ions , Melanoma/diagnosis , Middle Aged , UltrasonographyABSTRACT
We prospectively studied 51 patients with choroidal melanomas in a masked manner to determine the accuracy of clinical, ultrasound, and fluorescein diagnosis as well as the accuracy of tumor size measurements. In patients with clear media, clinical diagnosis was the most accurate means of detecting a choroidal melanoma. There was excellent correlation between clinical, ultrasound, and pathology measurements of tumor size. In small melanomas, clinical examination was the most accurate means of measuring tumor diameter and ultrasound the most accurate method of measuring tumor height. Even with a trained ocular oncologist, there was a significant variability in tumor measurements on serial ophthalmoscopic examinations.
Subject(s)
Choroid Neoplasms/diagnosis , Melanoma/diagnosis , Choroid Neoplasms/pathology , Fluorescein Angiography , Fundus Oculi , Humans , Melanoma/pathology , Microscopy , Ophthalmoscopy , Prospective Studies , Research Design , Ultrasonography , Visual Field TestsABSTRACT
We treated a small series of patients with choroidal malanomas with radioactive cobalt plaques. To assess the effectiveness of radiation, we performed radioactive phosphorus (32P) uptake determinations before and after treatment. The 32P results did not tumor destruction. In five of seven patients with posterior pole melanomas, radiation retinopathy developed after treatment with resultant decrease in vision.
