The following article by Dr. Finger was originally published on Retinal Physician. Find it here.

Benjamin Franklin once wrote, “an ounce of prevention is worth a pound of cure.”¹ Although he was referring to fire prevention, this adage also applies to radiation maculopathy.

Over the years, I have relentlessly sought ways to decrease therapeutic radiation to the fovea and optic nerve. For example, in the 1980s, I studied adding intraocular microwave hyperthermia to lowered doses of plaque radiation therapy for the treatment of choroidal melanoma.²

In 1990, I published on the use of radio-opaque vitreous substitutes to act as an internal shield during plaque radiation therapy.³ This strategy is being pursued today with silicone oil.⁴

However, it was not until the mid-1990s that I discovered a simple, low-risk opportunity to improve plaque radiation therapy.^5–7 Compared to iodine-125, the use of lower-energy palladium-103 photons shifted the intraocular dose distribution.⁸ It increased the dose within the tumor, while decreasing irradiation of most normal ocular structures.⁹ Continue reading…