Program Book

2253 UM1
PRELIMINARY STUDY OF VASCULAR FLOW IN CHOR-
OIDAL TUMORS AND PSEUDOTUMORS
C.M. Gentile, M. Faria Dovasio , Lucila Tajtelbaum, Atilio Lombardi , J.
Oscar Croxatto (carolina.gentile@gmail.com)
Hospital Italiano de Buenos Aires, Argentina
Purpose. The aim of this study was to describe and analyze the
hemodynamic findings pre and post treatment in choroidal melanocytic
tumors and in pseudotumors using high resolution doppler color and
spectral ultrasound.
Methods. Twenty six patients (aged ranged from 38 and 86 years- old)
with presumed
diagnosis of choroidal tumour or pseudotumors were included. The
B-Scan
and Doppler ultrasound images were obtained with ESAOTE My Lab 70
vision,
Italia equipment. Intralesional vascularization and spectral doppler
analysis from intratumoral vascular region and from tumoral base was
performed using values of flow velocity in systole and diastole, and
resistive index (systolic-diastolic/systolic, RI).
Results. Vascular flow with low resistive index was observed in patients
with untreated choroidal melanoma. After therapy, the intratumoral
vascularization decreased and increased the RI. In three patients with
treated melanomas, intratumoral vascularization in association with
tumoral growing was observed. There was no tumoral vascularization
in patients with choroidal nevus except for the base (choroid). Doppler
ultrasound in patients with media opacity and presumed diagnosis
of choroidal haematoma versus melanoma, revealed absence of
intralesional vascularization and it showed presence of vascularization
only on its base (choroidal vessels).
Conclusions. Doppler color and spectral ultrasound is a non invasive
and useful clinical technique which may be used in differential
diagnosis between choroidal haematoma and advanced melanoma in
patients with media opacity. It could be used as an additional tool for
the differential diagnosis of choroidal nevus and melanoma and for
evaluation of effectiveness in patients with choroidal melanoma after
conservative therapy.
Financial disclosure. None
622 UM2
AUSTRALIA AND NEW ZEALAND STUDY OF PDT IN
CHOROIDAL AMELANOTIC MELANOMA (ANZSOPI-
CAM) - TWO YEAR RESULTS
William Glasson, William G. Campbell, Sid Finnigan, Michael Giblin,
Peter Hadden, Timothy Isaacs, John D. McKenzie, James Muecke, Tanya
M. Pejnovic. (glasson@terraceeyecentre.com.au)
Dr William G. Campbell is the principal investigator, other authors are
co-investigators.
Purpose. ANZSOPICAM is an investigator-initiated prospective
multicentre clinical trial of photodynamic therapy in choroidal amelanotic
melanoma. This paper summarises the first two years’’ results.
Methods. Patients presenting with posteriorly-located amelanotic
melanoma were recruited into the study. After full ocular and systemic
assessment photodynamic therapy was applied with the Zeiss Visulas
laser, using verteporfin as the photosensitiser. PDT was repeated at
UVEAL MELANOMA
Abstracts
96
three monthly intervals intil the melanoma had completely regressed.
Results. 31 patients were recruited in the first two years. Complete
regression of the melanoma has been achieved in 19 patients to date;
eight after just one treatment, five following two treatments, five
required three sessions of PDT, whilst in one patient four treatments
were necessary. The tumour in the remaining 12 patients demonstrated
a response to PDT; of these 10 are still undergoing treatment, one was
lost to follow-up and one, an 85 year old male, died of an unrelated
condition three months after his initial PDT. Vision has remained stable
or improved in all but three patients. Three participants developed
small, local recurrences that responded favourably to a further session
of PDT. So far no evidence of systemic metastatic disease has been
found in any patients.
Conclusions. The results of this study to date indicate PDT is effective
in causing regression of amelanotic melanoma, in the majority of cases
without compromising vision. The study is ongoing.
Financial disclosure. None
1618 UM3
PHOTODYNAMIC THERAPY AS ADJUVANT TREAT-
MENT FOR AMELANOTIC CHOROIDAL MELANOMA
DEBULKING
Maria A. Blasi, Monica M. Pagliara, Andrea Scupola, Carmela G. Caputo,
Emilio Balestrazzi (mariaantonietta.blasi@rm.unicatt.it)
Department of Ophthalmology, Catholic University, Rome, Italy
Purpose. To evaluate the efficacy of photodynamic therapy (PDT) as adjuvant
treatment to reduce tumour thickness before brachytherapy for amelanotic
choroidal melanoma.
Methods. Patients and Methods: Fourteen patients with amelanotic choroidal
melanoma were recruited. Inclusion criterion was diagnosis of amelanotic
choroidal melanoma based on ophthalmoscopy, ultrasonography (US),
fluorescein angiography (FA), and ICGA. All patients underwent PDT treatment
using verteporfin infused intravenously at a dose of 6mg/m2body surface
area. Five minutes after infusion, a 689nm laser was applied with a light dose
of 100 J/cm 2 at an irradiance of 600mW/cm2 over an interval of 166 seconds.
One month after PDT all patients underwent brachytherapy.
Results. One month after PDT treatment US showed reduction of tumour
height in 9 patients (64.28%) (Group A), stable thickness in 3 patients (
21.42%) (Group B) and minimal increase in thickness in 2 patients (14.28%)
(Group C). The mean tumour thickness was 5.39mm at baseline, with a
mean reduction of 25.33% in Group A; 4.60mm and no reduction in Group
B; 2.63mm with a mean increase of 6.08% in Group C. In Group A, the mean
dose of irradiation to macula and optic nerve calculated at baseline was 76.61
and 54.2 Gy, after PDT it was 43.44 and 35.05 Gy, with a decrease of 43.3%
and 35.3% respectively.
Conclusions. The goal of treatment for uveal melanoma is to achieve local
tumour control while minimizing damage to macula and optic nerve. Use of
PDT as adjuvant therapy in order to reduce tumour thickness and consequently
brachytherapy toxic effects is encouraging.
Financial disclosure. None
1413 UM4
MACROPHAGE INFILTRATION IN PREVIOUSLY-IRRA-
DIATED UVEAL MELANOMA
M.J. Jager, THK Vu, IHG Bronkhorst, M Versluis, M Marinkovic, SG van
Duinen, GPM Luyten (m.j.jager@lumc.nl)