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C. Metz, T. Gkika, W. Sauerwein, N. Bornfeld (claudia.metz@uk-essen.de) 1. University Hosital of Essen, Department of Ophthalmology, Essen, Germany 2. University Hospital of Essen, Department of Radiation Oncology, Essen, Germany Purpose. Aim of this retrospective study is to analyze results of vitreoretinal surgery following a complicated course after plaque brachytherapy. Main focus of interest is the latency period between plaque brachytherapy and vitreoretinal surgery and the role of applied irradiation dosage. Methods. We present a retrospective analysis of vitreoretinal surgeries following brachytherapy of malignant uvea melanoma with Ruthenium, Iodine or Ruthenium/Iodine plaques between 1991 and 2011. Results. A total number of 172 pars-plana-vitrectomies (126 patients) could be analyzed. Major indications for vitrectomy were massive vitreous bleeding (53%), retinal detachment (27%) and macular pucker (5%). Silicone oil tamponade was necessary in 27% of the cases. Average sclera irradiation dose was 950 Gy. The time period for irradiation retinopathy to develop in terms of rubeosis iridis, vitreous bleeding, intraretinal bleeding and proliferations was averagely 434 days. We observed an amaurosis in 24 cases; 16 of those had been treated with Ruthenium/ Iodine or CCB plaques and six cases were observed in juxtapapillary tumours. Better functional results could be achieved in those eyes that needed to be treated due to retinal detachment than in eyes with vitreous bleeding. Conclusions. Frequent controls are necessary after plaque brachytherapy not only for tumour control, but also for early recognition of secondary complications like irradiation retinopathy and retinal detachment. In many cases of complicated retinal detachment preservation of eyes and their function could be achieved applying a temporary silicone oil tamponade. Financial disclosure. None 2230 UM 26 LONG-TERM RESULTS AFTER ENDORESECTION OF LARGE UVEAL MELANOMAS WITH PRETREATMENT BY SINGLE-DOSE STEREOTACTIC IRRADIATION AND ADJUVANT BRACHYTHERAPY E. Biewald, H. Lautner, M. Freistühler, M. Gök, W. Sauerwein, GA Horstmann, N. Bornfeld (eva.biewald@web.de) 1.University Hospital of Essen, Department of Ophthalmology, Essen, Germany 2.Gamma Knife Centre, Krefeld, Germany 3.University Hospital of Essen, Department of Radiation Oncology, Essen, Germany Purpose. The aim of this non-comparative, consecutive case series is to evaluate the long-term results after endoresection of large uveal melanomas in combination with pre-treatment with stereotactic gamma knife radiosurgery and adjuvant ruthenium brachytherapy in most cases. Methods. Between April 1999 and April 2010, 219 patients with large uveal melanomas underwent stereotactic radiosurgery followed by UVEAL MELANOMA Abstracts 104 endoresection of the tumour via a standard three-port vitrectomy including laser photocoagulation and silicone oil tamponade. 153 patients were treated with adjuvant ruthenium brachytherapy. Patients with a juxtapapillary melanoma or an only eye usually did not receive a plaque. The average tumour height was 9.3 mm. The minimum dose delivered to the tumour volume was 25 Gy. Results. The median follow-up time was 34 months, with a range from 10 years to 66 days. 48 patients showed a ciliary body involvement. Only 28 eyes (12.8%) with a mean tumour distance to the fovea of 4 mm went blind after 15 months on average. All in all 24 (10.95%) eyes were enucleated due to serious complications such as pain, phthitical globe or loss to tumour control. In 12 of these eyes the histopathological report found vital toumor cells. After 3,7 years on average 39 (17.8%) patients developed liver metastases. Local tumour recurrences were observed in 12 cases leading to an additional treatment with ruthenium or a transpupillary thermotherapy. Conclusions. Eyes with large uveal melanomas can be salvaged by stereotactic radiotherapy followed by endoresection. A fair residual visual acuity was maintained in serveral patients. Financial disclosure. None 1447 UM27 TREATMENT OF JUXTAPAPILLARY CHOROIDAL MELA- NOMA Maria Tsimpida, John Hungerford, Victoria M.L. Cohen (tsimpidam@yahoo.co.uk) The Ocular Oncology Service St. Bartholomew’s and Moorfield’s Eye Hospitals Purpose. To compare the efficacy of proton beam radiotherapy (PBRT) and Ruthenium-106 notched plaque radiotherapy with or without adjuvant transpupillary thermotherapy (TTT) for the treatment of juxtapapillary choroidal melanoma. Methods. Retrospective case notes analysis of all juxtapapillary choroidal melanomas treated in London from May 2005 to February 2011. Three treatment groups were identified: group 1 PBRT; group 2 notched plaque with adjuvant TTT; group 3 notched plaque. Data analysis was based on tumour dimensions, length of follow-up, tumour control, radiation related complications, loss of 2 or more lines of Snellen visual acuity and secondary enucleation rates. Results. All juxtapapillary melanomas were ≤2mm from the optic disc. The tumour dimensions were similar in all 3 groups. 93 melanomas were identified. 52 with more than a year follow-up were included in the study. Tumour control was 100% in the proton beam group, 91% in the notched plaque with TTT group and 80% in the notched plaque group. However radiation-related complications were much more severe in the proton beam group, as 91% of patients lost 2 or more lines of vision, compared to 43% of patients in the notched plaque group. The secondary enucleation rate of 9% was the same in all 3 groups. Conclusions. Juxtapapillary melanomas can be successfully treated using either proton beam or notched plaque combined with adjuvant TTT. However, vision is often sacrificed. Notched plaque alone provides reduced local tumour control but results in improved visual outcome.( word count: 245) Financial disclosure. None 2307 UM28 OPTIC NERVE DAMAGE AFTER IRRADIATION OF INTRAOCULAR TUMOURS
Evangelos S. Gragoudas, Anne Marie Lane, Ivana Kim (evangelos_gragoudas@meei.harvard.edu) Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA Purpose. To evaluate the tolerance of the intraocular optic nerve to different doses of proton irradiation. Methods. We evaluated 1121 patients with choroidal melanoma treated with protons in whom the optic nerve was exposed to doses between 3.5 Gy and 70 Gy. The relationship between radiation exposure and incidence of radiation papillopathy and optic atrophy (disc pallor and visual acuity of NLP) was assessed. Vision loss (worse than 20/200) due to radiation-induced damage to the optic nerve was evaluated in a subgroup of 171 patients with tumours 46.7 Gy). Conclusions. These data suggest that exposure of the optic nerve to radiation doses up to 47 Gy is well-tolerated, with visual loss only observed in patients who received higher doses (> 47 Gy). Financial disclosure. None 133 UM29 PROTON BEAM RADIOTHERAPY OF PARAPAPILLARY CHOROIDAL MELANOMA G.D. Willerding1, D. Cordini2, N.E. Bechrakis4, M.H. Foerster5, J. Heufelder2, A.M. Joussen1, N. Lakotka1, L. Moser3(gregor.willerding@charite.de) 1. Charité, BerlinProtonen am HZB, Berlin, Germany; 2. Charité, Augenklinik, Campus 1. Charité, Augenklinik, Campus Benjamin Franklin, Berlin, Germany; 2 Charité, BerlinProtonen am HZB, Berlin, Germany; 3 Charité, Klinik für Strahlentherapie, Campus Benjamin Franklin, Berlin, Germany; 4. Department of Ophthalmology, Medical University of Innsbruck, Innsbruck, Austria; 5.Department of Ophthalmology, DRK Kliniken Berlin - Westend, Berlin, Germany Purpose. To report the results of optic disc involvement in proton beam radiotherapy of posterior choroidal melanoma. Methods. Retrospective case series of patients without endoresection following radiation, where treatment planning has been done with EYEPLAN. 159 patients, who received a cumulative dose of 50-60 CGE to the optic disc during fractionated proton beam irradiation of choroidal melanoma between December 1998 and December 2005 were identified. Results. Radiation treatment controlled the tumour in 94 %. Medium follow-up was 64 (4 to 140) months. Mean visual acuity before radiotherapy was 0,3 and dropped to 0.05 and 0.04 after 3 and 5 years. Mean tumour thickness decreased from 3.7 to 2.5 and 2.1 after 3 and 5 years. Recurrences occured in 6%. Main complications were radiation optic neuropathy in 81% and vitreous bleeding in 30% irrespective of secondary treatment. Secondary enucleation was performed in 3%. UVEAL MELANOMA Abstracts 105 Metastasis developed in 15% during follow-up. Conclusions. Significant decrease in visual acuity develops after optic disc irradiation in proton beam therapy. Rates of tumour control and eye retention in this group of patients are favourable. Financial disclosure. None 1414 UM30 HEMODYNAMIC MODIFICATIONS OF THE RETINA AND THE CHOROÏD FOLLOWING PROTON BEAM IRRADIATION OF UVEAL MELANOMAS Leonidas Zografos, Ann Schalenbourg, Line Chamot, (leonidas. zografos@fa2.ch) Jules-Gonin Eye Hospital, Lausanne, Switzerland Purpose. To study the mechanisms of hemodynamic modifications of the retina and the choroïd following proton beam irradiation of uveal melanomas. Methods. Panoramic ICG and panoramic fluorescein angiography was performed with the Staurenghi contact lens and the HRA2 camera. 223cases of uveal melanomas, previously treated with proton beam irradiation. The main hemodynamic modifications of the choroïd and retina are: Partial choroïdal Ischemia 58%, vortex vein occlusion 49%, arterio venous communications between the posterior cilliary arteries and the vortex veins 29 %, localised retinal ischemia 54 %, diffuse retinal ischemia 18%, inferior retinal ischemia 22%. Results. Following laser coagulation a decrease of the vascular density of the choroïd was observed in all the cases associated to a decrease of the permeability of the previously observed arterio venous communications. Conclusions. Panoramic ICG and fluorescein angiography provide useful informations about the hemodynamic modifications of the retina and the choroïd following proton beam irradiation of uveal melanomas as well as after extensive laser coagulation witch allows to introduce valuable antivasoprolifératives strategies. Financial disclosure. None 2358 UM31 PERIOCULAR TRIAMCINOLONE FOR PREVENTION OF MACULAR EDEMA FOLLOWING PLAQUE RADIOTHER- APY OF UVEAL MELANOMA: THREE YEAR FOLLOW- UP Noel Horgan, Carol L. Shields, Melissa Murphy, Arman Mashayekhi, Pedro F. Salazar, Miguel A. Materin, Myra O’Regan, Jerry A. Shields (noelhorg@hotmail.com) Royal Victoria Eye and Ear Hospital, Dublin Wills Eye Institute, Philadelphia Trinity College, Dublin Purpose. To determine the efficacy and safety of periocular triamcinolone acetonide (40 mg) for the prevention of macular edema in patients undergoing plaque radiotherapy for uveal melanoma. Methods. A prospective randomized controlled clinical trial recruited nehundred and sixty-three patients with newly diagnosed uveal melanoma undergoing Iodine125 plaque radiotherapy . Fifty-five patients were randomized to the control group and 108 to the triamcinolone group.
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XV th NH City Hotel and Tower Boliv
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List of Congress Meetings of the In
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Table of Contents Welcome address K
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Keynote Lectures Lymphoma of the oc
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The venue for the Biannual Meeting
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Buenos Aires Downtown MAP 12 Venue
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MORNING 8.30-10.10 Papers (Moderato
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50 RES 26 USING THE GLYCOLYTIC INHI
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2226 RES 4 NOTCH SIGNALING PROMOTES
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a reduction in the number of living
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array further detected copy number
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615 RES 21 TRB2 AND SKP2 IN THE RET
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following treatment with 2-fluorode
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1909 Rb14 RESULTS OF PATIENTS WITH
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Posters Retinoblastoma 2006 RBp100
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120 RBp135 MANAGEMENT OF AN ECTOPIC
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After treatment, 10 patients lived
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Methods. Six cycles of carboplatin
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1940 RB15 PROTON THERAPY FOR RECURR
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4. Fluoroscopy for cannula placemen
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Methods. A retrospective chart revi
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Ruth A. Kleinerman1, Chu-ling Yu1,
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2006 RBp100 RETINOBLASTOMA ASSESSME
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months. Mean delay between beginnin
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not associated with severity of RB.
Page 54 and 55: Conclusions. During a ten-year peri
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Page 58 and 59: (follow-up 5 years). Two years afte
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Page 63 and 64: Uvea (Moderators: B. Damato, M. Sag
Page 65 and 66: Morning 8.30-9.00 Poster presentati
Page 67 and 68: 1621 EC1 EVALUATION OF THE “HEDGE
Page 69 and 70: Purpose. Ocular surface squamous ne
Page 71 and 72: (cargusale@yahoo.com) Oncology Serv
Page 73 and 74: of the tissues most commonly affect
Page 75 and 76: 2128 RF1 RETINOBLASTOMA David H. Ab
Page 77 and 78: Ocular Oncology Service, St Barthol
Page 79 and 80: Arturo Irarrazaval, Pablo Cazon, Os
Page 81 and 82: A CASE OF TEARING AND SWELLING OF T
Page 83 and 84: 1849 ECp101 FIVE CASES OF CARCINOMA
Page 85 and 86: patients. The isolated involvement
Page 87 and 88: exudative fluid from the hemangioma
Page 89: maximum of 7 rituximab injections.
Page 92 and 93: 153 UM14 PHENO-GENOTYPIC IDENTIFICA
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Page 96 and 97: 2253 UM1 PRELIMINARY STUDY OF VASCU
Page 98 and 99: Purpose. To determine the presence
Page 100 and 101: gene expression profile of melanocy
Page 102 and 103: the rarity of UM, timely completion
Page 106 and 107: Patients in the triamcinolone group
Page 108 and 109: 1350 Ump101 INDUCED EXPRESSION OF P
Page 110 and 111: Purpose. To report the Results of R
Page 112 and 113: 1547 Ump113 LONG-TERM OBSERVATIONS
Page 114 and 115: 2038 Ump119 VALUE OF DOPPLER ANALYS
Page 116: Methods. A total of 4070 patients w
Page 119: First authors Naseripour, Masood No
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