Dr. Finger Named One Of America’s Top Doctors In 2016

Dr. Paul T. Finger has been named one of America’s top doctors in 2016.
castle connoly

Castle Connolly’s top doctors are nominated by their peers through an extensive survey process of thousands of American physicians. Each year, Castle Connolly receives nearly 100,000 nominations through this process. The organization’s research team screens medical education, training, board certifications, hospital appointments, disciplinary histories, and other information to determine the best doctors in America.

“Castle Connolly Top Doctors are highly sought after physician leaders in their communities and metropolitan areas. National Top Doctors are the top referred specialists that attract patients from wide geographical areas and across the country.”

This marks the ninth straight year Dr. Finger has received this prestigious honor.

Dr. Finger was also named among Castle Connolly’s Top Doctors for Cancer in 2016. He has earned inclusion in this list every year since its inception in 2006.

For the 14th straight year, Dr. Finger was named a Top Doctor in the New York metro area.

Inclusion among America’s top doctors reflects Dr. Finger’s commitment to his patients, and his passion for developing new and innovative eye cancer treatments.


Exenteration After Images


Enucleation After-Images


Cytology Slides


Conjunctival Tumors

 


Ciliary Body Tumors


Chemoreduction of Orbital Tumors

Note the large nodular basal cell carcinoma on the right lower eye lid and cheek prior to cis-platinum chemotherapy.
Note the large nodular basal cell carcinoma on the right lower eye lid and cheek prior to cis-platinum chemotherapy.

By Paul T. Finger, MD

Note the large nodular basal cell carcinoma on the right lower eye lid and cheek in the image below. It has pulled the eye lid out (cicatricial ectropion) and was found to invade the orbit on CT scan. Click on an image below to enlarge and see the full description:

The diagnosis was easily confirmed by taking a small wedge biopsy in the office. Then after a complete discussion of treatment options, this patient opted for intravenous chemotherapy rather than extensive surgery or radiation therapy. In this case, 3 courses of cis-platinum chemotherapy reduced the size of the tumor. Due to renal toxicity, the treatment was discontinued. Chemoreduction did not (in itself) cure this patient, but it did allow for local resection of the reduced sized-tumor. Under frozen section control, tumor-free margins were obtained.

For more information on the investigational technique we offer the following references.

References

  1. Luxenberg MN and Guthrie TH, Jr.. Chemotherapy of eyelid and periorbital tumors. Trans Am Ophthal Soc 1985;83:162-180.

    After 3 courses of treatment the tumor was noted to shrink and his ectropion diminished. Note the improvement in the CT appearance.
    After 3 courses of treatment the tumor was noted to shrink and his ectropion diminished. Note the improvement in the CT appearance.
  2. Luxenberg MN and Guthrie TH, Jr.. Chemotherapy of basal cell and squamous cell carcinoma of the eyelids and periorbital tumors. Ophthalmology 1996;93:504-510.
  3. Morley M, Finger PT, Perlin M, Weiselberg LR, DeBlasio DS. Cis-Platinum Chemotherapy for Ocular Basal Cell Carcinoma. The British Journal of Ophthalmology, 1991, 75, 407-410.

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Laser Photocoagulation For Radiation Retinopathy

By Paul T. Finger, MD

Dr. Finger uses laser photocoagulation to prevent radiation related retinopathy, maculopathy, and loss of vision. As published in the British Journal of Ophthalmology, Drs. Finger and Kurli found that eyes with posterior choroidal melanomas were more likely to develop sight-threatening radiation retinopathy. In that series, 50 patients were treated with sector scatter laser photocoagulation to clinically evident radiation retinopathy. A second group of patients (considered to be “high risk” to develop radiation retinopathy) were also treated with laser.

In this study, laser photocoagulation improved radiation retinopathy in 29 (64.4%) of the 45 patients treated after the onset of radiation retinopathy (17 with only retinopathy, 10 with a combination of retinopathy and maculopathy, and two with only maculopathy). Of the 16 patients who received laser treatment before clinical evidence of retinopathy, only 1 developed radiation maculopathy and two retinopathy without maculopathy (all three responded to additional laser photocoagulation).
None of the patients in the prophylactic laser group lost more than three lines of vision as a result of maculopathy.

Conclusions

Sector scatter argon laser photocoagulation can be used to induce regression of radiation retinopathy. Though early treatment of radiation retinopathy appears to be more effective, a more long term and prospective randomized study should be performed.

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18FDG PET/CT SUV: A Noninvasive Biomarker For the Risk of Metastasis from Choroidal Melanoma

By Paul T. Finger, MD

In a research study, Dr. Finger compared the intensity of radioactive glucose uptake [from positron emmission tomography (PET)] to clinical, ultrasound, and pathology features of choroidal melanomas evaluated by FDG positron emission tomography / computed tomography (PET/CT). Ultrasound was used to measure tumor size, evaluate tumor shape and intrinsic vascularity (blood flow). Histopathology and immunohistochemical evaluations of tumor cell-type, necrosis, glycogen-content, vascularity and extrascleral extension were performed.

Selecting out the highest 6 PET/CT standardized uptake values [(SUV) > or = to 4.0] melanomas, patients were (on average) 10 years older. in general, higher SUV tumors had larger basal dimensions, were epithelioid-cell type, were centered anterior to the equator, contained enlarged blood vessels (>150 microns in diameter), and had formed extrascleral extension.

This study suggests that PET/CT imaging offered a physiologic assessment of glucose metabolism within choroidal melanomas. Increased FDG PET/CT SUV ( > or = to 4.0) was positively correlated to known clinical, pathology, and ultrasound features linked to metastatic potential of choroidal melanoma.

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Patient Stories

"Very well treated by Dr. Finger. He explained everything I needed to know about my issue with detail and attention, putting me at ease and giving me confidence to handle this problem for the rest of my life.”
N.N.

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