Two Extensive ECF-Sponsored Studies Presented at the AAOOP Annual Meeting

The New York Eye Cancer Center and the Eye Cancer Foundation were quite actively represented at the 2017 American Association of Ophthalmic Oncologists and Pathologists (AAOOP) Annual Meeting. The meeting was held on Friday, November 10, 2017 at the Hampton Inn & Suites Convention Center, located in the vibrant city of New Orleans, Louisiana, and was attended by Dr. Paul Finger as well as notable ECF-ICO Fellowship alumni, Dr. Sonal Chaugule, Dr. Ekatrina Semenova, and Dr. Abhilasha Maheshwari.

At the conference, Dr. Chaugule gave an oral presentation titled Adjuvant intravitreal triamcinolone acetate (ITA) for radiation maculopathy (RM) recalcitrant to high-dose intravitreal bevacizumab. This research was supported by the Eye Cancer Foundation and conducted at the New York Eye Cancer Center, where Dr. Chaugule worked alongside Dr. Richard Kaplan (ophthalmologist) and Dr. Paul T. Finger. She is pictured speaking on this paper at AAOOP below:

Now, what are ITA, RM, and Bevacizumab? Often, patients undergoing eye plaque radiation in order to treat their cancerous tumor can be subject  to vision-impairing radiation side-effects, or radiation maculopathy (RM), as a result of treatment. Intravitreal anti-VEGF therapy (which is otherwise commonly used to treat macular degeneration) such as Bevacizumab (Avastin), Lucentis, and Eyelea, are used to prolong the effects of radiation maculopathy. Itravitreal triamcinolone acetate (ITA) is a steroid used in conjunction with this anti-VEGF therapy to treat swelling that occurs in the affected eye, called macular edema.

The paper aims to evaluate the effects of using ITA for the treatment of RM in patients with choroidal melanoma after plaque radiotherapy. Eight choroidal melanoma patients undergoing this treatment were studied, having ITA treatment at 4-16 week intervals in addition to continued injections of Avastin. Results found that after starting ITA, vision was stable or improved for patients, leading to the conclusion that ITA can be used as a supplement to decrease macular edema (swelling) and preserve vision in choroidal melanoma patients with RM.

The evaluation of ITA steroids as valuable treatment for RM is not to be underestimated. It provides a new treatment option for patients experiencing loss of vision due to radiation therapy, patients whose loss of vision can no longer be controlled with maximum, standard anti-VEGF therapy. To read more on the findings of this paper and its effect on eye cancer patients, click here. And to read this paper in full, published in the British Journal of Ophthalmology, click here.

Dr. Abhilasha Maheshwari had separately presented ECF-supported research — a 12-year study evaluating patients with slotted, low energy photon eye plaque radiation therapy. The purpose? To measure the efficacy of this treatment for eye cancer patients, especially those who have tumors located near, touching, or surrounding the optic disc (a critical area that allows for  vision) were treated. Forty six patients of these eye cancer patients were treated with eye plaque radiation therapy, using seeds of the chemical isotope Palladium-103 to radiate the affected eye. Over the next 12 years, these patients were monitored for any changes to tumor thickness, visual acuity, and whether or not the cancer had reoccured or metastasized. Results found that the local control rate (i.e, total tumor destruction) was 95.6%, and lead to the conclusion that Slotted Eye Plaque Radiation Therapy is indeed an efficient method of treatment for eye cancer patients.  To read the paper, published in the American Journal of Ophthalmology, click here.

But the AAO updates do not end here! Stay tuned for upcoming information on even more presentations at AAO 2017 by ECF alumni.


Oblique (Angled) Injection Technique Improves the Delivery of Avastin Treatment

Intravitreal (IVT) injections are the most common surgical procedure in ophthalmology practice today. In fact, it is projected that millions of these injections are given each year in the United States. Ocular oncologists use intravitreal injections to treat such conditions as cystoid macular edema (CME), radiation retinopathy, and neovascularization. But did you know that the technique of delivering the injection can influence the effectiveness and safety of treatment?

Following IVT injection, some medication can actually egress or leave the eye through the port of entry, thus delivering less medication than what the physician intended. This can lead to under-treatment of the disease. The perfect IVT injection delivers an exact amount of medication with the least risk to vision and the eye.

Mehta and Finger used a technique of oblique (or angled) IVT injection in an effort to minimize the amount of medication leaving the eye. IVT injection was delivered at a 30-45 degree angle and compared to the standard technique of using a perpendicular (orthogonal) angle.

The researchers found that the angled IVT injection technique had a significantly higher mean intraocular pressure immediately after the injection. This finding suggests that angled injections are self-sealing and more of the drug is staying in the eye. Thus, the angled technique delivers a more accurate dose as well as prevents intraocular infection by closing a potential entry for pathogens.

The Figure below shows how the angled technique may allow for better retention of the drug within the eye following injection:

Through PubMed, you are able to read the published scientific article that explains this in detail here. To stay tuned on all the latest in eye cancer research, please keep our website, eyecancer.com, in your bookmarks!


Eye Injections 101

An intraocular injection (i.e., an injection made directly into the eye) may sound intimidating, uncommon, and dangerous. But did you know that intraocular injections are one of the most common surgical procedures practiced today in the United States? These injections are used mostly to treat macular degeneration, a deterioration of the sensitive, central portion of the retina (the macula) that makes it the leading cause of vision loss in Americans, more than cataracts and glaucoma combined (American Macular Degeneration Foundation). In 2005, Dr. Paul T. Finger discovered that these intraocular injections can be used towards another effect: in the vision-sparing treatment of radiation retinopathy.

Radiation retinopathy, or neuropathy, occurs as a side effect of the radiation used to treat orbital tumors or melanoma. When radiated, the retina and optic nerve may be progressively damaged over time, which can lead to permanent loss of vision if left untreated. Thus, intraocular injections of ANTI-VEGF therapy, such as Avastin or Eyelea, can help to suppress this retina and optic nerve damage caused by radiation treatment.

At The New York Eye Cancer Center, we aim to provide you with the best possible information regarding intraocular injections to ease any misgivings. We are constantly monitoring our patients who have undergone treatment to watch for signs of radiation retinopathy, and if injections of ANTI-VEGF therapy are required. For these patients, we have published a video that provides all necessary information regarding their expected injections, and what they can expect before, during, and after therapy. We stress, particularly, that treating radiation retinopathy is similar to the concept of treating hypertension (high blood pressure) or diabetes; the drugs administered will diminish the damage for these long-term medical conditions.

You can watch this video below at your convenience:

Eye Injection: Intraocular Injection at The New York Eye Cancer Center from Paul T Finger on Vimeo.

We have more upcoming videos available for public viewing at The New York Eye Cancer, so kindly consider keeping eyecancer.com in your bookmarks to stay tuned for them!


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.

Read More

REQUEST AN APPOINTMENT

  • This field is for validation purposes and should be left unchanged.

CONNECT AND SHARE