Beta irradiation: new uses for an old treatment: a review

Kirwan, James; Constable, P H; Murdoch, Ian; Khaw, PT

doi:10.1038/sj.eye.6700306

Cited by 81 publications

(58 citation statements)

References 63 publications

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“…Historically, irradiation has been one of the first attempts of modern surgery to suppress the potential for recurrence in pterygium management (90,91). ß-irradiation, delivered through strontium-/yttrium-90 sources, effectively reduces cellular populations responsible for pterygium recurrence (92). However, its use is not innocuous and may be associated with serious complications, including visionthreatening endophthalmitis (16).…”

Section: Treatment Optionsmentioning

confidence: 99%

Pathogenetic mechanisms and treatment options for ophthalmic pterygium: Trends and perspectives (Review)

Detorakis

Spandidos²

2009

Int J Mol Med

152

103

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Abstract. Pterygium is a fibrovascular lesion of the ocular surface that can display an aggressive clinical behavior and, occasionally, threaten vision. Although there is no consensus on its pathogenesis, recent evidence suggests that it is a proliferative, rather than degenerative condition strongly correlated with exposure to ultraviolet radiation (UVR) of solar light. Molecular genetic alterations reported in association with pterygium include loss of heterozygosity (LOH), point mutations of proto-oncogenes, such as K-ras and alterations in the expression of tumor suppressor genes, such as p53 or p63. Other findings in pterygium include the frequent detection of HPV DNA, ocular surface changes such as the overexpression of various proteins, including defensins and phospolipases D, as well as the up-regulation of growth factors, such as bFGF or VEGF. Although pterygium management has traditionally involved surgery, often enhanced by the use of antimetabolites, recent advancements in the understanding of molecular and biochemical events underlying pterygium pathogenesis may enable the use of less invasive treatment methods.

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Section: Treatment Optionsmentioning

confidence: 99%

Pathogenetic mechanisms and treatment options for ophthalmic pterygium: Trends and perspectives (Review)

Detorakis

Spandidos²

2009

Int J Mol Med

152

103

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“…The calculated amount of radiation reaching the germinal epithelium of lenses in all trials was probably less than the minimum dosage reported to cause cataract (200 cGy) (27,28) . Radiation-induced cataract has a characteristic pattern of cortical opacity, starting at the site of application (29) , which was not observed in the patients of those studies.…”

Section: Discussionmentioning

confidence: 95%

Meta-analysis of beta radiation augmentation for trabeculectomy - results in distinct ethnic groups

Fendi

Arruda

Costa

et al. 2011

Arq. Bras. Oftalmol.

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RESUMO Objetivo: Realizar uma revisão sistemática com meta-análise sobre a eficácia da trabeculectomia (TREC), seguida ou não por irradiação beta (BRT/TREC) para o tratamento do glaucoma, em termos de controle da pressão intraocular (PIO) e de efeitos adversos citações, oito estudos (cinco coortes e três aleatorizados) foram identificados e apenas 3 RCT foram incluídos nesta meta-análise. Maiores reduções na PIO foram verificadas no braço de estudo da BRT, comparado com o braço controle (diferença média=1,68 mmHg, 95% CI= 0,61-2,68, P=0,002). A frequência de PIO pós-operatória não controlada (>21 mmHg) foi menor quando utilizada a BRT (BRT/TREC) em relação ao grupo controle (38/218 =17,4% versus 9/239 =3,8%;OR= 6,7 IC 95% 3,2 14,3, P<0,0001 ABSTRACTPurpose: To conduct a systematic review with meta-analysis on the efficacy of trabeculectomy (TREC) followed by beta irradiation (BRT/TREC) compared to TREC alone for glaucoma in terms of intraocular pressure (IOP) control and adverse effects of treatment in different ethnic groups. Methods: A meta-analysis of randomized controlled trials (RCT) was performed comparing adjunct BRT treatment for glaucoma with standard TREC after 12 months. The MEDLINE, EMBASE, LILACS, and Cochrane Library databases, Trial registers, bibliographic databases and recent studies of relevant journals were searched. Two reviewers independently reviewed relevant reports and the references from these reports were searched for additional trials, using guidelines set by QUOROM statement criteria. Results: Of a total of 1,350 citations, eight studies (five cohorts, three randomized) were identified and only 3 RCT were included in this meta-analysis. Higher IOP reductions were verified in the BRT arm compared to the control arm (mean difference=1.68 mmHg, 95% CI= 0.61-2.68, P=0.002). Uncontrolled postoperative IOP (>21 mmHg) was less frequent when BRT was used (BRT/ TREC arm) compared to the control arm (38/218=17.4% versus 9/239=3.8%; OR=6.7; 95% CI 3.2-14.3, P<0.0001). Although better IOP control was observed in all patients treated with adjuvant BRT, only Black patients displayed a significant difference (P=0.005). There were no significant differences between the BRT and control arms regarding loss of visual acuity, postoperative complications and necessity of cataract surgery. Conclusion: Adjunct BRT increases the success rate of TREC, with better results in non Caucasian patients, and does not influence the occurrence of postoperative complications.

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“…From a biological perspective, we previously considered that postoperative irradiation should be performed as soon as possible after surgery because the start of fibrogenesis could occur within hours of surgery [6,15,22].…”

Section: Discussionmentioning

confidence: 99%