Dr. Ann Musika Completes ECF Fellowship

From Uganda to Israel, and Back Home Again

Hailing from Kampala, Uganda, Dr. Ann Musika has completed her 6-month ophthalmic oncology fellowship training sponsored by the Eye Cancer Foundation.

From Left: Dr. Ann Musika, Dr. Alezam, Dr. Didi Fabian, and Dr. Vicktoria Vishnevska-Dai

For the past six months, Dr. Musika has trained at Sheba Medical Centre at the Goldschleger Eye Institute under supervision of the director of the ocular oncology unit, Dr. Vicktoria Dai. Her training included all aspects of eye cancer care––from diagnosis, to treatment, to intravitreal injections for radiation retinopathy. Additionally, she took part in various research studies at Goldschleger’s ophthalmology department.

The Eye Cancer Foundation places an emphasis world-class training as well as practical and applicable training. So while Dr. Musika learned all aspects of eye cancer treatment practiced at Goldschleger’s, she specifically focused on treatments and techniques that would be just as readily available to her in Kampala.

Dr. Ann Musika (second from the left) alongside Senior ocular oncologists (Presenters) with after the ocular oncology training at the University of Sienna Italy on December 6th-7th, 2018

“It is with great pleasure that I express my sincere gratitude

to you for the great support that you offered me…all this wouldn’t have been possible without your generous support. The knowledge and skills acquired from this training I hope to apply to improve the quality of care for our ocular oncology patients in my nation. I am forever grateful.”

Prior to Dr. Musika, there were no fellowship-trained eye cancer specialists in Uganda. Consequently, patients with eye cancer suffered not only from their disease, but also from a lack of specialized care. However, now upon the completion of her training, Dr. Musika intends to return to Uganda and provide her nation with much-needed specialty care.

 

To Learn More about the Eye Cancer Foundation, its mission, and fellowship opportunities, visit the website at www.eyecancercure.com.


Day 3: Live From the ISOO 2019!

Day 3 at the ISOO: Melanoma, Other Intraocular Cancers, and Basic Retinoblastoma Science

Every two years, eye cancer specialists worldwide convene at the International Society of Ocular Oncology Conference in order to review latest research and encourage international collaboration within the field of ophthalmic oncology.

For details on the ISOO Biennial Conference, read more here.


Dr. Puneet Jain presenting his iris varix poster

Dr. Puneet Jain returned to give us some insight on iris varix by presenting his paper Iris varix: 10-year experience with 28 eyes, published alongside Dr. Paul Finger during his Eye Cancer Foundation fellowship. The study began with the intention to more clearly define iris varix, consistent characteristics, imaging findings, and note any consistent change that might occur with observation. The results showed that iris varix is “primarily located in the inferotemporal quadrant, not associated with dysmorphic pupillary findings, progression, secondary glaucoma, or malignancy.” Essentially, “iris varices were benign vasculopathies with no associated ocular or vision-related morbidity.”


Dr. Ekaterina Semenova’s poster presentation

Why are some cases naturally suppressed by the immune system? Dr. Ekaterina Semenova raised the question, noting five cases in which choroidal melanoma in the patient had spontaneously regressed in her paper Spontaneously Regressed and Apparently Dormant Choroidal Melanomas, also published alongside Dr. Finger. She opened up discussion to the audience, though consensus was that this would be an interesting topic for future research in order to determine the cause. Now that such cases have been documented, we have this data to look back on and, hopefully, make additions to.


Dr. Abhilasha Maheshwari (left) and Dr. Paul Finger (right) after another successful poster presentation!

Finger’s Slotted Plaques was recognized in Dr. Abhilasha Maheshwari presentation, A 12-Year Study of Slotted Eye Plaque Radiation for Choroidal Melanoma: Near, Touching, or Surrounding the Optic Nerve. Over a decade’s worth of data was analyzed and slotted plaques were found to be very effective and resulted in good patient outcomed for patients whose tumor lies close to the optic nerve. These plaques offer more proper positioning of the plaque, allowing radiation to the entire melanoma plus a 2-3 mm margin. Dr. Maheshwari concluded that even after 12 years, “slotted plaque radiation therapy resulted in high rates of local tumor control and vision and eye retention.”


That’s all for today’s ECF highlights! Day 4 will be fully dedicated to retinoblastoma. Stay tuned!

 

To help sponsor fellowships and fellow research, donate to The Eye Cancer Foundation at www.eyecancercure.com/donate.


Day 1: Live From the ISOO 2019!

Day 1 at the ISOO: International Collaboration & Eye Cancer Care Worldwide

Every two years, eye cancer specialists worldwide convene at the International Society of Ocular Oncology Conference in order to review latest research and encourage international collaboration within the field of ophthalmic oncology.

For details on the ISOO Biennial Conference, read more here.

International Collaboration

The day began with a few talks instigating discussion on how to approach international, collaborative efforts, and how to improve on how we currently approach international cooperation. How do we get over international boundaries and laws restricting data-sharing, and varying laws surrounding research across countries? Much is yet to be done, though discussion is expected to continue as specialists from all over the world have convened at this conference.

Read on how Dr. Finger encourages international cooperation here.

What Do We Register and Why?

Featured ECF Fellow: Dr. Puneet Jain

Dr. Puneet Jain, on Registering Conjunctival Melanoma
Dr. Paul Finger (left) and ECF fellow Dr. Puneet Jain (right) immediately after his debut lecture.

Registries were a huge topic of discussion today. What is possible to be registered, what details should we include within the registry, how do avoid duplicate cases within separate registries, and how do we apply this to international cooperation? Among other points of discussion, however, it was unanimous that functional registries would assist greatly both with research and patient outcomes. The New York Eye Cancer Center’s recently graduated fellow, Dr. Puneet Jain, spoke particularly on the registering of conjunctival melanoma. His research with Dr. Finger evidenced the accuracy of the AJCC’s TMN classification for predicting metastasis.

 

Developing Worldwide Retinoblastoma Care

Dr. Brenda Gallie credits the Eye Cancer Foundation for research support.
Dr. Brenda Gallie credits the Eye Cancer Foundation for research support.

 

 

 

 

 

 

 

 

 

Dr. Brenda Gallie discussed the development of retinoblastoma care worldwide. She noted the growing importance of genetic testing, stating a case in which laser treatment was sufficient enough to control the disease. She briefly mentioned project DepictRB as a way to display anonymized patient data, and offered the audience a demo of the program.

Conclusion

The day concluded with unanimous agreement that worldwide collaboration within the field of eye cancer needs to continue and needs to improve. With enhanced cooperation and worldwide registries, the

amount of shared data will assist greatly in advancement of research, diagnosis, and patient outcomes.

Tomorrow we cover ocular melanoma in great detail. Stay tuned, out fellows and Dr. Finger will be informing us with their expertise!

ISOO 2019 Day 1 Complete!

The ECF Establishes the First Eye Pathologist in Jordan

Prior to involvement of The Eye Cancer Foundation (ECF), Jordan had no practicing eye cancer specialists. We trained Dr. Yacoub Yousef and he established the first eye cancer referral center at The King Hussein Cancer Center in Amman. After years of building this center, Dr. Yousef has trained many eye cancer specialists for the surrounding countries and has offered life and vision-sparing treatments for patients throughout the Middle East. Finally, with a place to go, patients requiring eye treatment inundated these hospitals. With more and more patients needing eye cancer services, Jordan and the Middle East needed a specialist in eye pathology.

In response to this need, The ECF supported Dr. Jakub Khzouz’s fellowship in ophthalmic pathology and oncology with Dr. Sarah Coupland at the Royal Liverpool Hospital in Liverpool, England. Dr. Khzouz has so far spent one year learning modern methods of ophthalmic pathology (adult and pediatric), as well as the diagnosis and treatment of eye cancers.  

Dr. Khzouz reports that his exposure to Eye and general Pathology with Dr. Coupland at  Liverpool Hospital’s pathology laboratory was significantly different from his prior experience in Jordan. He learned that eye cancer specimens should be handled by trained eye pathology specialists. “Proper sample grossing and detailed reporting are important for staging and aid management,”says Dr. Khzouz. He intends to reassess prior pathology reports, stating that “once back in Jordan, my first project will be to review all the retinoblastoma cases archived in our pathology laboratory, independently report and stage them according to the latest 8th edition AJCC-TNM system, and then compare that with the original reports.” Such will be important for research purposes, as well as defining the impact and importance of fellowship-training with respect to complicated pathologies.

Our fellows have even greater plans for the future of eye cancer treatment in Jordan. Dr. Khzouz intends topartner with the first eye cancer specialist in Jordan, ECF Fellow Dr. Yacoub Yousef. “I have discussed with my colleague Yacoub, and by working together we will improve the quality of the King Hussein Ocular Tumor Service and reach out to other laboratories and countries to perform molecular and genetic testing for eye cancer patients.”

Through our fellowship programs, The Eye Cancer Foundation has sought to provide unserved and underserved countries with the best quality fellowship education and training from some of the most experienced specialists in the world. We motivate our fellows to bring new techniques and advancements to their home countries so that access to optimal eye cancer treatment becomes universal. We will continue to support our fellows, Dr. Yousef and Dr. Khzouz and now offer Jordan two fellowship-trained eye cancer specialists who are dedicated to saving sight, saving life and “paying it forward” by teaching fellows from other middle eastern countries.

However, our goal is not yet complete. Many more countries are in great need, and we hope to place at least one eye cancer specialist in each country. Click here to donate to our cause.

 


New ECF Graduates Bring Their Skills to Egypt and India

Saving the Underserved in Egypt and India…

We at The Eye Cancer Foundation are pleased to celebrate the graduation of our two most recent recent fellows: Dr. Puneet Jain from India and Dr. Moanes Morkos from Egypt. In traditional ECF manner, both fellows return to their country with goals to care for eye cancer patients, advocate for patients, improve treatment and training. They will present their ECF sponsored research work at eye meetings in their countries and around the world.

Having successfully completed their training, Dr. Jain and Dr. Morkos now join the ranks of over forty fellows trained and sponsored by the ECF. Not only have we reached the goal of our 2020 Campaign––to train 20 eye cancer specialists in 20 unserved and underserved countries by the year 2020––we have doubled it.

With the support of our donors, we have taken on and answered many previously unsolved questions about eye tumor diagnosis and treatment  this year. We hope that this momentum does not decline, but rather accelerate, and bring us to a future where ocular melanoma, retinoblastoma and eye cancer deaths do not exist.

To become a patron, simply give a gift to The Eye Cancer Foundation. You can sponsor fellows like Dr. Jain and Dr. Morkos, buy prosthetic eyes for retinoblastoma children, or aid in any of our numerous goals for a clearer, brighter future.

Next stop: the rest of the world!

Donate Now!


ECF Fellow Presents: How to Save Eyes in Cairo, Egypt

Dr. Abhilasha Maheshwari (above) presents ECF research at Ophthalmic Oncology Meet

November 22nd Cairo, Egypt:

November 22nd Cairo, Egypt: Physician scholars came together for The 2nd Middle East Ophthalmic Oncology & Pediatric Retina Meeting. Organized by Dr. Ihab Othman, the meeting fostered discussion of various topics in ocular oncology.

The Eye Cancer Foundation (ECF) fellow, Dr. Abhilasha Maheshwari, shared recent findings of ECF supported research. She first presented her research with her mentor and ECF-chair Dr. Paul T. Finger. The article, titled Regression Patterns of Choroidal Melanoma After Palladium-103 (103Pd) Plaque Brachytherapy, shows how choroidal melanomas regress after 103Pd plaque radiation therapy.  Initially discovered as effective ocular cancer treatment by Dr. Finger in 1990, 103-Pd ophthalmic plaques have since been scientifically proven to be more gentle and effective than its precursor, 125-I. [See our results after 103Pd plaque therapy for choroidal melanomas on our website!] Results showed the tumors became darker, decreased in thickness, and there was a reduction or complete elimination of the tumor vascularity.

Dr. Maheshwari continued her presentation on choroidal melanoma by discussing patients whose tumors were located very close to the optic nerve. This talk, “A 12-Year Study of Slotted Palladium-103 (103Pd) Radiation Therapy for Choroidal Melanoma: Near, Touching, or Surrounding the Optic Nerve, discusses how using specially designed plaques created by Dr. Finger, even melanomas that surround the optic nerve can be treated with eye and vision sparing radiation therapy (instead of removing the eye). Dr. Maheshwari’s results showed > 98% tumor control, while most had relative preservation their sight and eye.

The Eye Cancer Foundation takes great pride supporting research that improves patient care. Our fellows are given travel grants to spread the word around the world. As we spread knowledge of these unique findings and improved treatments, we also spread hope for those who would alternatively lose both sight and life.

 


 

To donate to the ECF and help sponsor fellowships, research, and cancer treatments, click here!

Read Dr. Finger and Dr. Chagule’s paper here.

Read Dr. Finger and Dr. Maheshwari’s paper here.


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.


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