By Paul T. Finger, MD
Ophthalmic plaque brachytherapy has become the most common eye-sparing technique for the treatment of intraocular tumors. Eye plaques are constructed by affixing radioactive seeds within a gold, metallic, bowl-shaped carrier.
Then the radioactive eye plaque is sewn to the wall of the eye underneath the intraocular tumor. It is left in place for several days during which the tumor is sterilized by the radiation.
Small diode lights can be attached to ophthalmic plaques in order to improve their localization beneath their intraocular tumors and to allow photo-documentation of plaque position. With the lights turned on, we could see that the plaques were in position as to cover the intraocular tumor.
In most centers, radiation therapy has been able to destroy choroidal melanomas in over 92% of cases. Unfortunately, at least 8% of tumors have been found to regrow within 5 years of treatment. These failures of local control are thought to be due to radiation resistant tumors and to suboptimal placement of the eye-plaque (using standard transillumination techniques). This is evidenced by more failures occurring in treatment of small tumors near the optic nerve. These cases are difficult or impossible to visualize with standard transillumination or ultrasound techniques. Diode-light transillumination was invented to improve localization of eye plaques beneath these small posterior tumors.
References
- Finger PT, Iezzi R, Romero J, Rosen RB, Szechter A, Hegde H. Plaque-Mounted Diode-Light Transillumination For Localization around Intraocular Tumors. The Archives of Ophthalmology 1999:117:179-183.
- Finger PT, Iezzi R, Esteveo ML, Szechter A, Rosen RB, Berson A. Diode-Light Transillumination for Ophthalmic Plaque Localization around Juxtapapillary Choroidal Melanomas. The International Journal of Radiation Oncology, Biology, Physics 44:887-890, 1999.
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