Table of Contents - WOC 2012

WOC2012 Abstract Book
IS-ONC-SA 188 (3)
Proton Beam Radiotherapy
Gragoudas Evangelos (1)
1. Massachusetts Eye and Ear Infirmary
Ocular outcomes and survival experience after proton irradiation have been
ascertained in a large series of patients with uveal melanomatreated at the
Massachusetts Eye and Ear Infirmary. Endpoints evaluated included tumor
recurrence, melanoma-related mortality, vision loss, eye loss, and radiationinduced
complications. Cumulative rates of these outcomes have been
calculated and risk factors for these events have been identified. These data
may be utilized by the physician and patient to determine the best choice of
treatment.
IS-ONC-SA 188 (4)
Local Resection
Damato Bertil (1)
1. Royal Liverpool University Hospital
Local resection of uveal melanoma has long been performed for small, iris and
ciliary body melanomas, but excision of choroidal tumours is still undertaken
only in a few centres. Thanks to advances in endoresection and exoresection
it is now possible to conserve the eye and vision when other methods are not
possible. Delegates will observe videos of these procedures and learn of the
scope of resection, both as primary treatment and for management of the “toxic
tumour syndrome” after radiotherapy.
IS-ONC-SA 188 (5)
Predicting Metastatic Death
Coupland Sarah (1)
1. University of Liverpool
Background and Aim: More than 90% of intraocular melanomas involve the
choroid and about 50% cause fatal metastatic disease. Univariate analysis
provides only approximate survival estimates, relevant to large groups of
patients but not individuals. Our aim was to create a prognostic model that
combined pathological, clinical and genetic data, using imputation techniques
to compensate for missing information.
Methods: Survivorship was modeled using accelerated failure time models.
Non-linear transformations were carried out on the input variables to model
time-dependence. A Bayesian Regularization method was used to reduce
overfitting and n-fold cross-validation was deployed to assess the model›s
performance. Using data from 3653 patients, we generated two predictive
models; the first using clinical data only and the second using clinical and
laboratory data. The model›s outcome was all-cause mortality.
Results: Results showed that the c-index of discrimination was 0.75 (95% CI
0.74-0.76) for the clinical model and 0.79 (95% CI, 0.76-0.82) for the laboratory
model. Calibration assessed by calculating the Cox-Snell residuals showed
good correlation between predicted and observed mortality [Kolmogorov-
Smirnov statistic: 0.8774204, p-value: 0.699 for clinical model; Kolmogorov--
Smirnov statistic: 0.7980748, p-value: 0.8005 for the laboratory model. The null
hypothesis is equality to an absolutely continuous distribution uniform in (0,1)].
Conclusion: We conclude that our model provides reasonably reliable
prognosis relevant to individual patients with choroidal melanoma.
IS-ONC-SA 188 (6)
Detecting Metastasis
Kivelä Tero (1)
1. Finnish Ophthalmological Society
Early detection of metastatic uveal melanoma is important in order to improve
survival. Most patients develop first hepatic metastases. Annual liver function
tests and abdominal ultrasound will identify 60% and semiannual tests 90% of
metastases when still asymptomatic. Chest radiograms have a low yield and
are not recommended. Metastases are confirmed by core needle biopsies and
staged using magnetic resonance imaging. Serum markers like osteopontin
and melanoma inhibitory activity help in detecting metastases and in evaluating
their response to treatment.
194
IS-ONC-SA 188 (7)
Treating Metastatic Disease
Desjardins Laurence (1)
1. Institut Curie
Surgical resection of liver metastases is the only option to improve the median
survival rate. IVor IAH chemotherapy, chemoembolization or isolated hepatic
perfusion gives median OS around 12-15 months in small non controlled
studies. Randomized phase III trial 18021 of the EORTC Melanoma Group
studies intravenous versus intra-arterial fotemustine chemotherapy In vitro
data support evidence for angiogenesis in the growth and spread of uveal
melanoma; Identification of new targets as frequent activating mutations
in GNAQ might also constitute new therapeutic options in metastatic uveal
melanoma.
Glaucoma Imaging
Sat 18 Feb 10:30 - 12:00 Conference Room B2
IS-IMG-SA 189 (1)
Uses of UBM in Glaucoma Diagnosis and Management
Osman Essam (1)
1. King Saud University
Ultrasound Biomicroscopy is a high resolution imaging method with high
frequency ultrasound (50–100 MHz). Detailed observation of anterior and
posterior chamber anatomy, and a useful clinical assessment of glaucoma.
It’s excellent diagnostic tool for assessment of angle recess, iris thickness,
root of the iris morphology, ciliary body position. Diagnosis of anterior segment
pathology, Post-surgical procedures, as filtering surgeries is facilitated by UBM
through examination. Additionally it provides clear visualization of Schlemm’s
canal, such as viscocanalostomies and Schlemm canaloplasty.
IS-IMG-SA 189 (2)
Beware of OCT ‹Glaucoma›
Dueker David (1)
1. Medical College of Wisconsin
Glaucoma diagnosis relies on a characteristic pattern of optic nerve damage
and visual field change. Sensitive tests of nerve damage potentially offer the
earliest evidence of glaucoma. Ocular coherence tomography (OCT) is a
revolutionary imaging advance but evidence of glaucoma is somewhat indirect,
being based on retinal nerve fiber layer (RNFL) thickness. Natural anatomic
variation and other causes of RNFL loss may mimic glaucoma on OCT. False
positive diagnosis may initiate lifetime therapy with monetary and quality of life
consequences.
IS-IMG-SA 189 (3)
Evolving Parameters in Anterior Segment OCT for Glaucoma
Assessment and Management
Smith Scott (1)
1. Cleveland Clinic Abu Dhabi
Anterior segment OCT allows the rapid acquisition of high-resolution images of
the anterior segment that are useful in characterizing the anatomic relationships
between the cornea, iris, lens, and anterior chamber angle structures. Various
biometric parameters have been evaluated to determine anatomic features of
eyes with angle-closure. The wide range of parameters that have been studied
and their utility in the diagnosis of glaucoma will be discussed.
IS-IMG-SA 189 (4)
The Role of Anterior Segment OCT in my Practice
Salim Sarwat (1)
1. University of Tennessee
The anterior segment optical coherence tomography (AS-OCT) provides an
objective method to assess the anterior chamber angle. This technology allows
both qualitative and quantitative analysis of the drainage angle and has shown
potential in the detection and management of angle closure. The presentation
will focus on the potential benefits and limitations of AS-OCT when compared
with gonioscopy and ultrasound biomicroscopy. Various clinical cases will be
discussed to highlight its role in glaucoma practice.