Endoresection utilizing pars plana vitrectomy for benign and malignant intraocular tumors

Reichstein, David; Karan, Kayla

doi:10.1097/icu.0000000000000561

Cited by 7 publications

(8 citation statements)

References 45 publications

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“…A potential problem is the intraoperative dissemination of tumour cells that can lead to local recurrences, extraocular extension or increased risk of distant metastasis. Based on the literature, depending on the follow-up period, the risk of local dissemination of tumour cells may range up to 19% of patients [13,15,17,25,26,30,31]. In our study, we have not observed any local recurrences during a follow-up period.…”

Section: Discussionsupporting

confidence: 52%

“…According to the literature, the metastatic disease in patients undergoing endoresection for choroidal melanoma was observed in 1.9-15.5% of cases after a mean follow-up of 41-102.5 months [12,13,17,21,30]. However it is unclear whether metastatic disease is of the iatrogenic origin or is associated with the presence of circulating malignant cells which seeded liver before surgery [20,32,33].…”

Section: Discussionmentioning

confidence: 99%

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Prevention and treatment of the toxic tumour syndrome following primary proton beam therapy of choroidal melanomas

Kubicka‐Trząska¹,

Morawski²,

Markiewicz³

et al. 2020

Arch Med Sci Civil Dis

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The aim of this study was to evaluate the efficacy and safety of endoresection for choroidal melanoma to prevent and treat the toxic tumour syndrome (TTS). Material and methods: Thirteen patients who underwent primary proton beam therapy (PBRT) for choroidal melanoma followed by endoresection were evaluated. Main outcome measures were functional and anatomical results, surgical complications, rate of local recurrence, presence or absence of metastatic spread. Results: The median time of the follow-up period was 61.6 months. Six patients with clinical signs of TTS and seven with large tumours to prevent TTS underwent endoresection. Tumour thickness was 5.8 to 9.3 mm (mean: 7.6), the basal diameters were 10.6 to 15.0 mm (mean: 13.4). Preoperative best corrected visual acuity (BCVA) was 6/7.5 to counting fingers and the final BCVA was 6/15 to no light perception, and was better in those treated to prevent TTS (p = 0.01). The most universal early postoperative complication was bleeding from the scleral bed. The most common late postoperative complications were epiretinal membrane formation (30.8%), cystoid macular oedema (23.1%) and silicone oil-induced glaucoma (15.4%). Two (15.4%) patients developed phthisis bulbi, neither developed local recurrence. One patient developed liver metastases. Conclusions: Endoresection for choroidal melanoma is a safe and effective procedure with a high rate of local tumour control. The procedure appears to be useful in the prophylaxis and treatment of TTS after PBRT of choroidal melanoma.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Prevention and treatment of the toxic tumour syndrome following primary proton beam therapy of choroidal melanomas

Kubicka‐Trząska¹,

Morawski²,

Markiewicz³

et al. 2020

Arch Med Sci Civil Dis

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“…Radiotherapy can be administered in the form of brachytherapy, used as first choice treatment for smaller tumors, or proton beam radiotherapy and stereotactic radiosurgery, which are preferably used in medium and large tumors [3,6]. The surgical resection of the tumor is another viable option for selected patients with UM [7][8][9][10][11][12][13][14][15][16][17]. In consideration of the multiple treatment options currently available, treatment should be highly individualized depending on several factors related to the tumor itself, such as dimensions, location, involvement of the surrounding structures and activity, and other factors related to the patient including status of the fellow eye, age, general health, and psychological status.…”

Section: Introductionmentioning

confidence: 99%

“…It can be performed through a trans-scleral approach (exoresection) or through an internal approach utilizing pars plana vitrectomy (endoresection). Endoresection surgery has been utilized over the last three decades with promising results, but only the advances in vitreoretinal surgery technology made in recent years have significantly improved the technique [16,17]. In recent years, endoresection of the tumor utilizing pars plana vitrectomy combined with adjuvant ruthenium brachytherapy has proven to be an effective treatment for selected patients with large choroidal melanoma [12,17,31].…”

Section: Introductionmentioning

confidence: 99%

Anatomical and Functional Outcomes after Endoresection and Adjuvant Ruthenium Brachytherapy for Uveal Melanoma: A Single-Center Experience

Mazzini

Vicini

Leo

et al. 2023

Life

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Purpose: To evaluate the anatomical and functional outcomes of endoresection and adjuvant ruthenium (Ru)-106 brachytherapy for uveal melanoma (UM). Methods: Retrospective case series of 15 UM patients (15 eyes) treated at our center (Careggi University Hospital, Florence). Results: Six patients (40%) were male and nine were female (60%). The mean age of patients at the time of treatment was 61.6 years (±19.41). The mean BCVA at baseline was 20/50. In all cases UM originated from the choroid. The mean tumor thickness at baseline was 7.14 mm (±2.05), and the mean largest basal diameter was 11.2 mm (±1.92). A concurrent retinal detachment was diagnosed in 11 patients (73.3%). Two patients (13.3%) showed vitreous seeding at baseline. Eleven patients (73.3%) were treated with primary endoresection, while four patients (26.7%) were treated with a “salvage endoresection” after primary treatment failure (previous radiation treatment). The mean follow-up time was 28.9 months (±10.6). Thirteen out of fifteen patients were alive and showed no evidence of local recurrence or distance metastasis at the last follow-up visit. The treatment achieved local control of the disease in 14 out of 15 cases (93.3%). In one case, the patient underwent enucleation for disease recurrence. The overall survival rate at the end of the follow-up was 93.3%. The mean BCVA at last follow-up visit was 20/40. Treatment was well tolerated, without significant complications. Conclusions: Endoresection and adjuvant Ru-106 brachytherapy is a valuable conservative option for selected UM patients and can be used both as a primary treatment and as a salvage therapy. It can control melanoma and avoid enucleation, reduce radiation-related complications, and provide tumor tissue for chromosomal analysis and prognostic testing.

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“…Choroidal melanoma is one of the most common intraocular malignancies in adults and represents approximately 5% of all melanomas ( 32 ). Ophthalmectomy ( 33 ) and laser ablation ( 34 ) are common clinical therapeutic strategies for intraocular cancer. Although choroidal melanoma at an early stage can be successfully cured by ophthalmectomy, approximately 50% of patients with choroidal melanoma have liver metastasis and exhibit low survival rates (choroidal melanoma metastasis is shown in fig.…”

Section: Resultsmentioning

confidence: 99%

Eyedrop-based macromolecular ophthalmic drug delivery for ocular fundus disease treatment

et al. 2023

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Therapeutic antibodies are extensively used to treat fundus diseases by intravitreal injection, as eyedrop formulation has been rather challenging due to the presence of ocular barriers. Here, an innovative penetrating carrier was developed for antibody delivery in eyedrop formulations. We found that fluorocarbon-modified chitosan (FCS) would self-assemble with proteins to form nanocomplexes, which could effectively pass across the complicated ocular structure to reach the posterior eye segments in both mice and rabbits. In a choroidal melanoma–bearing mouse model, eyedrops containing FCS/anti-PDL1 could induce stronger antitumor immune responses than those triggered by intravenous injection of anti-PDL1. Moreover, in choroidal neovascularization–bearing mouse and rabbit models, FCS/anti-VEGFA eyedrops effectively inhibited vascular proliferation, achieving comparable therapeutic responses to those observed with intravitreal injection of anti-VEGFA. Our work presents an effective delivery carrier to treat fundus diseases using eyedrop of therapeutic proteins, which may enable at-home treatment of many eye diseases with great patient compliance.

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Endoresection utilizing pars plana vitrectomy for benign and malignant intraocular tumors

Cited by 7 publications

References 45 publications

Prevention and treatment of the toxic tumour syndrome following primary proton beam therapy of choroidal melanomas

Prevention and treatment of the toxic tumour syndrome following primary proton beam therapy of choroidal melanomas

Anatomical and Functional Outcomes after Endoresection and Adjuvant Ruthenium Brachytherapy for Uveal Melanoma: A Single-Center Experience

Eyedrop-based macromolecular ophthalmic drug delivery for ocular fundus disease treatment

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