The New York Eye and Ear Infirmary of Mount Sinai is celebrating 200 years of providing innovative, first-class care to patients with ocular diseases. At the core of the infirmary’s Ocular Oncology Service stands ECF Executive Director Paul T. Finger, MD, who doubles as the committee’s founding director.

The Eye Cancer Foundation has supported much of the research conducted by Dr. Finger in pioneering new methods of treating eye cancers. Since the service began at NYEE in 1989, several new treatment modalities have been adapted: the use of topical chemotherapy in treating conjunctival melanoma and primary acquired melanosis; Finger-Slotted eye plaques to improve local control in treating choroidal melanoma; anti-VEGF therapy in treating intraocular melanoma to lessen radiation damage; and much more.

The support of The Eye Cancer Foundation and the work of the New York Eye and Ear Infirmary has reshaped the face of eye cancer care around the world. The ECF looks forward to continuing its work of supporting research efforts with the end goal of improving patient care.

Read the full article here.

Drs. Garg and Finger created the first visual acuity prognosis based staging system for retina capillary hemangioma (CRH). It appeared in the May 2020 issue of  the Russian Ophthalmological Journal. Their study titled, “Visual Prognosis Based Staging for Retinal Capillary Hemangioma,” was derived from an analysis of the medical literature on Medline and PubMed. Thus, published medical evidence was collected and analyzed to create a staging system to determine the visual prognosis of eyes that are affected by retinal angiomatosis of Von-Hippel. Some of those same patients suffer from Von-Hippel Lindau disease (VHL), which is a genetic condition associated with benign and malignant tumors arising in multiple organs. The tumors seen in VHL include: hemangioblastomas, which are blood vessel tumors of the brain, spinal cord and eye as well as renal cell carcinoma. However, the most common manifestation of VHL is the retinal capillary hemangioblastoma (CRH). The average lifespan of VHL patients is 40 to 50 years. Treatment of CRH usually included observation, laser, cryotherapy, plaque brachytherapy and vitreoretinal surgery for larger CRHs and their complications. 

 

Dr. Finger and Dr. Garg performed a meta-analysis for the risk factors associated with vision loss at diagnosis. The current study provides an overview of visual prognosis, factors affecting, and a new staging system to prognosticate vision retention. Dr. Finger and Dr. Garg determined that age at onset of CRH, intraocular location, and multifocality were the most important predictors of vision loss. This new Garg-Finger staging system can thus be used by both patients and their ophthalmologists to decide on the timing of treatment and the possible outcomes.

Surgical Ophthalmic Oncology: A Collaborative Open Access Reference has been published by Springer Nature and is  available for download for free here! 

Five years ago, The First Eye Cancer Working Day was hosted by The Curie Institute in Paris, France. This was where the idea for the textbook was born, then called a  “Collaborative Open Access Surgical Textbook (COAST).” Recognizing that there were over 40 countries with NO eye cancer specialist, this “how to” book and video atlas was conceived to offer guidance for general ophthalmologists in those countries. 

Drs. Sonal Chaugule and Santosh Honavar, together with Dr. Finger moved this impressive project from conception to publication. The Eye Cancer Foundations’ support allowed the book to become public access and thus readable on any computer in the world. The International Council of Ophthalmology (ICO) has endorsed this work. All told, this book includes the hard work of more than 25 authors who are ophthalmic oncologists, ophthalmic plastic and reconstructive surgeons, vitreo-retinal surgeons, ocular pathologists, and radiation oncologists all from internationally renowned health care institutions. 

This textbook describes symptoms, diagnostic and treatment approaches for oncologic conditions. It covers indications, pre- and post-operative care, and surgical techniques that are required to manage the many types of eye cancer. There are also various illustrations to support reading and enhance the reader’s learning experience, making this a valuable and impressive resource for anyone interested in learning about eye cancer and how it is being treated. One can also find a meticulous approach to treating common and rare eye diseases complete with the key points that are required for performing the surgeries. This original concept book follows the goals of the International Council of Ophthalmology (ICO) in order to improve the quality of a patient’s life and eyesight by spreading  knowledge and improving the education of these diseases.

 

Dr. Finger finds the book available at the 2019 American Academy of Ophthalmology Meeting in San Francisco.

Barton Blackorby: You are the founding member of The New York Eye Cancer Foundation. Could you give some tips on how others can get involved in things like that and how you manage such a busy practice? 

Paul T. Finger: Back in 1998, I found myself leaving academic-based medicine and going into private practice. And when that happens, you realize that all the support from doing research and education disappears and you’re on your own. So I needed to start a foundation. First, I coopted actually some of my patients, found a lawyer, an investor, someone really good with patients, and put together the core of the board and together, we started the foundation. We applied for a 501c3 and then we were off and running. At first, it was to support ongoing research and soon we started doing other things, such as a website. At first, I put my FAQs on there so people would have a reference. And before long, we had a full online text and atlas. We were seeking questions from patients on what they wanted on the website and that was really an education. I went to Australia a couple of years ago, and some of the doctors said, “Oh thanks for having eyecancer.com because my patients go there and look at your images, discussions, and come back and talk to me about it.” It’s been a great resource. We get around 40,000 visits a month to eyecancer.com, then we have a new website: eyecancercure.com. 

But we didn’t stop there. Once we had more funding, The Eye Cancer Foundation went into international outreach. There are 40 countries that don’t even have an eye cancer specialist! So, we found doctors from those countries and started training them and sending them back. The most cost-effective way of doing this was to train them in other countries: we take – someone from say Uganda and train them in Israel or India (I think we have a fellow from Ethiopia going to India) and they’re learning cost-effective medicine, going back to their countries, and starting ocular tumor services. There are 7,000 children who die of retinoblastoma in the undeveloped world per year and we are trying to at least cut that in half and we can do that with early detection and prompt treatment. 

Barton Blackorby: Thank you very much for the information and inspiring us to do things in the future.

Paul T. Finger: I hope a lot of people start their own foundations. If you’re hands-on, don’t know exactly what you need to do, call us. The ECF was the first and is the most philanthropic foundation for eye cancer in the world. 

Pakistan is another country claimed by the Eye Cancer Foundation! Recently, Dr. Saima Amin graduated from her training sponsored by the Eye Cancer Foundation in Amman, Jordan at the King Hussain Cancer Center under the training of Dr. Yacoub Yousef. Of the hospital she worked, she notes that unfortunately in order to save their lives, “almost all retinoblastoma patients were getting enucleated (having their eye(s) removed)” and the burden of these patients was increasing every day. However, today she is the first fellowship trained ocular oncologist in Pakistan. 

During her fellowship, Dr. Amin was able to assist in several types of surgeries, including plaque surgery and the excision of tumors and biopsies from different sites. In addition, she witnessed the more complex cases of retinoblastoma, which truly helped in preparing her for the full spectrum of pediatric patients she may see in her home country’s hospital. Proudly, she states that she was “involved in every step – the examination, treatment, and decision making.” While honing her skills in a clinical setting, Dr. Amin was also able to practice scholarly research by writing a paper for an international journal under the guidance of Dr. Yousef. 

When Dr. Amin returned to her parent hospital, she said that she feels so much more confident in dealing with oncology cases, particularly retinoblastoma, where so many tumors can be treated without losing a patient’s sight or their eye(s) as a consequence. She is grateful to Dr. Finger and The Eye Cancer Foundation for allowing her intensive training to happen! 

Dr. Amin and supervisor, Dr. Yousef 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

                 Dr. Amin’s Farewell