Pub Date : 2024-03-01DOI: 10.1016/j.apjo.2024.100046
Kushal U. Agrawal, Matthew R. Barke, Lawrence Chiang, Roselind Ni, Rachel S. Kim, Qiang Zhang, Carol L. Shields
Purpose
To determine the correlation of Fitzpatrick Skin Type (FST) and iris color with tumor size (tumor thickness and basal diameter) in patients with uveal melanoma.
Design
Retrospective Cohort
Methods
Retrospective cohort from a single ocular oncology center of 823 patients with uveal melanoma and documented FST, iris color, and tumor size. Patients were classified by FST (type I, II, and III–V) and iris color (blue, green, and brown) on the basis of external facial photography. There were no FST type VI patients. Tumor thickness was classified into small [< 3 millimeter (mm)], medium (3.1–8.0 mm), or large (> 8.0 mm), and basal diameter into small (< 10 mm), medium (10.1–15 mm) or large (> 15 mm). The correlation of FST and iris color with tumor thickness and basal diameter was evaluated using the Kruskal-Wallis H test.
Results
The FST classification was type I (n = 92, 11%), type II (n = 643, 78%), or III–V (n = 88, 11%), and iris color was blue (n = 472, 57%), green (n = 102, 12%), or brown (n = 249, 30%). A comparison of FST revealed differences in mean tumor thickness (P = 0.04) and basal diameter (P = 0.006). Iris color showed no difference for mean tumor thickness (P = 0.41) or basal diameter (P = 0.48). There was a statistically significant difference with brown iris color relative to FST III–V for mean tumor thickness (P = 0.003) and basal diameter (P = 0.001) but no difference with blue or green iris color (P > 0.05).
Conclusions
Iris color alone showed no difference in tumor size, but those with brown iris color and FST type III–V demonstrated larger tumor thickness and basal diameter.
{"title":"Correlation of fitzpatrick skin type and iris color with tumor size in 823 patients with uveal melanoma","authors":"Kushal U. Agrawal, Matthew R. Barke, Lawrence Chiang, Roselind Ni, Rachel S. Kim, Qiang Zhang, Carol L. Shields","doi":"10.1016/j.apjo.2024.100046","DOIUrl":"10.1016/j.apjo.2024.100046","url":null,"abstract":"<div><h3>Purpose</h3><p>To determine the correlation of Fitzpatrick Skin Type (FST) and iris color with tumor size (tumor thickness and basal diameter) in patients with uveal melanoma.</p></div><div><h3>Design</h3><p>Retrospective Cohort</p></div><div><h3>Methods</h3><p>Retrospective cohort from a single ocular oncology center of 823 patients with uveal melanoma and documented FST, iris color, and tumor size. Patients were classified by FST (type I, II, and III–V) and iris color (blue, green, and brown) on the basis of external facial photography. There were no FST type VI patients. Tumor thickness was classified into small [< 3 millimeter (mm)], medium (3.1–8.0 mm), or large (> 8.0 mm), and basal diameter into small (< 10 mm), medium (10.1–15 mm) or large (> 15 mm). The correlation of FST and iris color with tumor thickness and basal diameter was evaluated using the Kruskal-Wallis H test.</p></div><div><h3>Results</h3><p>The FST classification was type I (n = 92, 11%), type II (n = 643, 78%), or III–V (n = 88, 11%), and iris color was blue (n = 472, 57%), green (n = 102, 12%), or brown (n = 249, 30%). A comparison of FST revealed differences in mean tumor thickness (<em>P</em> = 0.04) and basal diameter (<em>P</em> = 0.006). Iris color showed no difference for mean tumor thickness (<em>P</em> = 0.41) or basal diameter (<em>P</em> = 0.48). There was a statistically significant difference with brown iris color relative to FST III–V for mean tumor thickness (<em>P</em> = 0.003) and basal diameter (<em>P</em> = 0.001) but no difference with blue or green iris color (<em>P</em> > 0.05).</p></div><div><h3>Conclusions</h3><p>Iris color alone showed no difference in tumor size, but those with brown iris color and FST type III–V demonstrated larger tumor thickness and basal diameter.</p></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000306/pdfft?md5=706bc3e2d29bb003370b1e8f2b6e285c&pid=1-s2.0-S2162098924000306-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139696869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.apjo.2024.100048
L. Yamamoto-Rodríguez, D. Lorenzo, R. Mediavilla-Vallespín, JM Caminal
{"title":"Diffuse preretinal vitreous seeding as a recurrence of uveal melanoma","authors":"L. Yamamoto-Rodríguez, D. Lorenzo, R. Mediavilla-Vallespín, JM Caminal","doi":"10.1016/j.apjo.2024.100048","DOIUrl":"10.1016/j.apjo.2024.100048","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000434/pdfft?md5=ed8f1797b7dba785b37683d358e0add5&pid=1-s2.0-S2162098924000434-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140058578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2024-04-11DOI: 10.1097/APO.0000000000000610
Chul Hee Lee, Min Kim, Su-Jin Shin
{"title":"41 Gauge transvitreal fine-needle aspiration biopsy for intraocular tumors without vitrectomy.","authors":"Chul Hee Lee, Min Kim, Su-Jin Shin","doi":"10.1097/APO.0000000000000610","DOIUrl":"https://doi.org/10.1097/APO.0000000000000610","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140849299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.apjo.2024.100060
Maria Chiara Gelmi, Martine J. Jager
Uveal Melanoma (UM) is a rare disease, yet it is the most common primary intraocular malignancy in adult patients. Despite continuous advancements and research, the risk of metastasis remains high. It is possible to stratify patients according to their risk of metastases using a variety of known risk factors. Even though there is no gold standard for the prognostication of patients with uveal melanoma, it is becoming increasingly clear that combining histo-pathological, patient-related and molecular prognostic markers allows a more accurate prediction of the metastatic risk than by using one parameter. Primary UM in the eye are treated very effectively with eye-sparing radiation-based techniques or enucleation. However, it is not yet possible to prevent or treat metastases with the current therapeutic options. Nonetheless, the efforts to find new therapeutic targets continue and progress is being made, especially in the field of targeted therapy, as exemplified by the anti-gp100 bispecific molecule Tebentafusp. This review delves into the history of uveal melanoma, its incidence, presentation and diagnosis, the known prognostic factors and the treatment options, both for the primary tumour and for metastases. We show that different populations may have different risks for developing UM, and that each country should evaluate their own patients.
葡萄膜黑色素瘤(UM)是一种罕见疾病,但却是成年患者中最常见的原发性眼内恶性肿瘤。尽管研究在不断进步,但其转移风险仍然很高。利用各种已知的风险因素,可以根据转移风险对患者进行分层。尽管目前还没有葡萄膜黑色素瘤患者预后的金标准,但人们越来越清楚地认识到,将组织病理学、患者相关和分子预后标志物结合起来,比使用一种参数更能准确预测转移风险。眼部原发性 UM 可通过保眼放射技术或去核术得到非常有效的治疗。然而,目前的治疗方法还无法预防或治疗转移。尽管如此,寻找新治疗靶点的努力仍在继续,并且正在取得进展,尤其是在靶向治疗领域,抗gp100双特异性分子Tebentafusp就是一个很好的例子。本综述深入探讨了葡萄膜黑色素瘤的历史、发病率、表现和诊断、已知的预后因素以及原发肿瘤和转移瘤的治疗方案。我们指出,不同人群罹患葡萄膜黑色素瘤的风险可能不同,每个国家都应该对本国患者进行评估。
{"title":"Uveal melanoma: Current evidence on prognosis, treatment and potential developments","authors":"Maria Chiara Gelmi, Martine J. Jager","doi":"10.1016/j.apjo.2024.100060","DOIUrl":"https://doi.org/10.1016/j.apjo.2024.100060","url":null,"abstract":"<div><p>Uveal Melanoma (UM) is a rare disease, yet it is the most common primary intraocular malignancy in adult patients. Despite continuous advancements and research, the risk of metastasis remains high. It is possible to stratify patients according to their risk of metastases using a variety of known risk factors. Even though there is no gold standard for the prognostication of patients with uveal melanoma, it is becoming increasingly clear that combining histo-pathological, patient-related and molecular prognostic markers allows a more accurate prediction of the metastatic risk than by using one parameter. Primary UM in the eye are treated very effectively with eye-sparing radiation-based techniques or enucleation. However, it is not yet possible to prevent or treat metastases with the current therapeutic options. Nonetheless, the efforts to find new therapeutic targets continue and progress is being made, especially in the field of targeted therapy, as exemplified by the anti-gp100 bispecific molecule Tebentafusp. This review delves into the history of uveal melanoma, its incidence, presentation and diagnosis, the known prognostic factors and the treatment options, both for the primary tumour and for metastases. We show that different populations may have different risks for developing UM, and that each country should evaluate their own patients.</p></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000550/pdfft?md5=370aeec9463fd109397c6f3e37edc461&pid=1-s2.0-S2162098924000550-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140650963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.apjo.2024.100058
Min Zhou , Jieling Tang , Jiayan Fan , Xuyang Wen , Jianfeng Shen , Renbing Jia , Peiwei Chai , Xianqun Fan
Retinoblastoma, the primary ocular malignancy in pediatric patients, poses a substantial threat to mortality without prompt and effective management. The prognosis for survival and preservation of visual acuity hinges upon the disease severity at the time of initial diagnosis. Notably, retinoblastoma has played a crucial role in unraveling the genetic foundations of oncogenesis. The process of tumorigenesis commonly begins with the occurrence of biallelic mutation in the RB1 tumor suppressor gene, which is then followed by a cascade of genetic and epigenetic alterations that correspond to the clinical stage and pathological features of the tumor. The RB1 gene, recognized as a tumor suppressor, encodes the retinoblastoma protein, which plays a vital role in governing cellular replication through interactions with E2F transcription factors and chromatin remodeling proteins. The diagnosis and treatment of retinoblastoma necessitate consideration of numerous factors, including disease staging, germline mutation status, family psychosocial factors, and the resources available within the institution. This review has systematically compiled and categorized the latest developments in the diagnosis and treatment of retinoblastoma which enhanced the quality of care for this pediatric malignancy.
{"title":"Recent progress in retinoblastoma: Pathogenesis, presentation, diagnosis and management","authors":"Min Zhou , Jieling Tang , Jiayan Fan , Xuyang Wen , Jianfeng Shen , Renbing Jia , Peiwei Chai , Xianqun Fan","doi":"10.1016/j.apjo.2024.100058","DOIUrl":"https://doi.org/10.1016/j.apjo.2024.100058","url":null,"abstract":"<div><p>Retinoblastoma, the primary ocular malignancy in pediatric patients, poses a substantial threat to mortality without prompt and effective management. The prognosis for survival and preservation of visual acuity hinges upon the disease severity at the time of initial diagnosis. Notably, retinoblastoma has played a crucial role in unraveling the genetic foundations of oncogenesis. The process of tumorigenesis commonly begins with the occurrence of biallelic mutation in the <em>RB1</em> tumor suppressor gene, which is then followed by a cascade of genetic and epigenetic alterations that correspond to the clinical stage and pathological features of the tumor. The <em>RB1</em> gene, recognized as a tumor suppressor, encodes the retinoblastoma protein, which plays a vital role in governing cellular replication through interactions with E2F transcription factors and chromatin remodeling proteins. The diagnosis and treatment of retinoblastoma necessitate consideration of numerous factors, including disease staging, germline mutation status, family psychosocial factors, and the resources available within the institution. This review has systematically compiled and categorized the latest developments in the diagnosis and treatment of retinoblastoma which enhanced the quality of care for this pediatric malignancy.</p></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000537/pdfft?md5=4574acbfced6f750ba7b6fccc6269c2e&pid=1-s2.0-S2162098924000537-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140650964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Masquerade syndromes in uveitis are complex clinical conditions where non-inflammatory diseases mimic uveitic manifestations, often leading to diagnostic and therapeutic challenges. This review delves into the diverse spectrum of masquerade syndromes, categorizing them into neoplastic and non-neoplastic entities. We explore the prevalence of primary intraocular lymphoma, leukaemia, retinoblastoma, and other malignancies, as well as conditions like retinitis pigmentosa and endophthalmitis that can present as uveitis. Through detailed analysis of symptoms, diagnostic methods, and treatment approaches, the review emphasizes the importance of considering masquerade syndromes in differential diagnoses to prevent mismanagement. The synthesis of current knowledge aims to enhance clinicians' ability to discern these complex presentations, advocating for a multidisciplinary approach to diagnosis and care, thereby improving patient outcomes in cases of uveitic masquerade syndromes.
{"title":"Masquerade syndrome: A review of uveitic imposters","authors":"Parthopratim Dutta Majumder , Vikas Khetan , Jyotirmay Biswas","doi":"10.1016/j.apjo.2024.100054","DOIUrl":"https://doi.org/10.1016/j.apjo.2024.100054","url":null,"abstract":"<div><p>Masquerade syndromes in uveitis are complex clinical conditions where non-inflammatory diseases mimic uveitic manifestations, often leading to diagnostic and therapeutic challenges. This review delves into the diverse spectrum of masquerade syndromes, categorizing them into neoplastic and non-neoplastic entities. We explore the prevalence of primary intraocular lymphoma, leukaemia, retinoblastoma, and other malignancies, as well as conditions like retinitis pigmentosa and endophthalmitis that can present as uveitis. Through detailed analysis of symptoms, diagnostic methods, and treatment approaches, the review emphasizes the importance of considering masquerade syndromes in differential diagnoses to prevent mismanagement. The synthesis of current knowledge aims to enhance clinicians' ability to discern these complex presentations, advocating for a multidisciplinary approach to diagnosis and care, thereby improving patient outcomes in cases of uveitic masquerade syndromes.</p></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000495/pdfft?md5=bbd4d91674bf79215796aba4fab25779&pid=1-s2.0-S2162098924000495-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140650980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.apjo.2024.100059
Xianqun Fan , Martine J. Jager
{"title":"Navigating the spectrum: A comprehensive exploration of diverse ocular and orbital tumor entities","authors":"Xianqun Fan , Martine J. Jager","doi":"10.1016/j.apjo.2024.100059","DOIUrl":"https://doi.org/10.1016/j.apjo.2024.100059","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000549/pdfft?md5=d8d92ec3fdd8f7efaf9194745c4b897c&pid=1-s2.0-S2162098924000549-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140650962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.apjo.2024.100061
Thanaporn Kritfuangfoo , Duangnate Rojanaporn
Retinoblastoma stands as a paradigm of success in treating malignancies among pediatric patients. Over recent decades, the approach to managing retinoblastoma has evolved significantly, transitioning from the preservation of patients' lives to the preservation of eyes and vision while minimizing treatment-related complications. Chemotherapy, administered through diverse routes, has solidified its role as the cornerstone of retinoblastoma treatment. In addition to intravenous chemotherapy (IVC), alternative administration routes, including intraarterial (IAC), intravitreal, intracameral, and periocular delivery, have emerged as promising modalities for retinoblastoma management. Numerous studies have demonstrated outstanding outcomes, achieving nearly 100% salvage rates for eyes classified under groups A–C. However, for advanced intraocular retinoblastoma (groups D and E eyes), IAC appears to offer superior local control rates compared to IVC. Intravitreal injection of chemotherapeutic agents, when administered in a controlled and secure manner, holds promise in averting the need for enucleation and radiotherapy in advanced retinoblastoma cases presenting with vitreous seeds. The optimal chemotherapy strategy remains meticulously tailored based on numerous factors. This review provides a comprehensive update on chemotherapy across various routes, encompassing key considerations, dosages, administration methods, treatment outcomes, and potential complications. Furthermore, it explores emerging potential treatments and outlines future directions aimed at enhancing treatment outcomes.
视网膜母细胞瘤是治疗儿童恶性肿瘤的成功典范。近几十年来,治疗视网膜母细胞瘤的方法发生了显著变化,从保护患者生命过渡到保护眼睛和视力,同时最大限度地减少治疗相关并发症。通过不同途径进行的化疗已巩固了其作为视网膜母细胞瘤治疗基石的地位。除静脉化疗(IVC)外,其他给药途径,包括动脉内给药(IAC)、玻璃体内给药、巩膜内给药和眼周给药等,都已成为视网膜母细胞瘤治疗的有效方法。大量研究表明,A-C 组的治疗效果显著,挽救率接近 100%。然而,对于晚期眼内视网膜母细胞瘤(D 组和 E 组眼睛),IAC 的局部控制率似乎优于 IVC。在控制和安全的情况下进行玻璃体内注射化疗药物,有望避免对伴有玻璃体种子的晚期视网膜母细胞瘤病例进行去核手术和放射治疗。最佳化疗策略仍需根据众多因素精心定制。本综述全面介绍了各种途径化疗的最新情况,包括主要考虑因素、剂量、给药方法、治疗效果和潜在并发症。此外,它还探讨了新出现的潜在治疗方法,并概述了旨在提高治疗效果的未来方向。
{"title":"Update on chemotherapy modalities for retinoblastoma: Progress and challenges","authors":"Thanaporn Kritfuangfoo , Duangnate Rojanaporn","doi":"10.1016/j.apjo.2024.100061","DOIUrl":"https://doi.org/10.1016/j.apjo.2024.100061","url":null,"abstract":"<div><p>Retinoblastoma stands as a paradigm of success in treating malignancies among pediatric patients. Over recent decades, the approach to managing retinoblastoma has evolved significantly, transitioning from the preservation of patients' lives to the preservation of eyes and vision while minimizing treatment-related complications. Chemotherapy, administered through diverse routes, has solidified its role as the cornerstone of retinoblastoma treatment. In addition to intravenous chemotherapy (IVC), alternative administration routes, including intraarterial (IAC), intravitreal, intracameral, and periocular delivery, have emerged as promising modalities for retinoblastoma management. Numerous studies have demonstrated outstanding outcomes, achieving nearly 100% salvage rates for eyes classified under groups A–C. However, for advanced intraocular retinoblastoma (groups D and E eyes), IAC appears to offer superior local control rates compared to IVC. Intravitreal injection of chemotherapeutic agents, when administered in a controlled and secure manner, holds promise in averting the need for enucleation and radiotherapy in advanced retinoblastoma cases presenting with vitreous seeds. The optimal chemotherapy strategy remains meticulously tailored based on numerous factors. This review provides a comprehensive update on chemotherapy across various routes, encompassing key considerations, dosages, administration methods, treatment outcomes, and potential complications. Furthermore, it explores emerging potential treatments and outlines future directions aimed at enhancing treatment outcomes.</p></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000562/pdfft?md5=913c378222877e9710e848b97b7b7e99&pid=1-s2.0-S2162098924000562-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140650965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.apjo.2024.100055
Jasmine Yaowei Ge , Y.H. Loo , Anita S.Y. Chan
{"title":"Metastatic renal cell carcinoma masquerading as an endogenous endophthalmitis: Role of vitreous cytology","authors":"Jasmine Yaowei Ge , Y.H. Loo , Anita S.Y. Chan","doi":"10.1016/j.apjo.2024.100055","DOIUrl":"https://doi.org/10.1016/j.apjo.2024.100055","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000501/pdfft?md5=65b8cc05ceb3d1b8399821a37ddf81d7&pid=1-s2.0-S2162098924000501-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140650982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.apjo.2024.100052
Irwin Leventer , Hartej Singh , Bahram Pashaee , Christian D. Raimondo , Chenab K. Khakh , Jonathan L. Martin , Binod Acharya , Qiang Zhang , Sara E. Lally , Carol L. Shields
Importance
Ocular surface squamous neoplasia (OSSN) is a spectrum of malignancies that generally includes conjunctival intraepithelial neoplasia (CIN) and squamous cell carcinoma (SCC). OSSN can be treated with topical therapies including interferon α-2b (IFN), mitomycin C (MMC), or 5-fluorouracil 1% (5FU). Recently, due to unavailability of IFN and toxicity associated with MMC, therapy has shifted towards 5FU.
Objective
Herein, we compare the use of 5FU 1% as a primary versus (vs) secondary treatment regimen in eyes with moderate to extensive OSSN.
Design Setting and Participants
Retrospective cohort study of 73 consecutive patients with unilateral moderate to extensive OSSN treated at a single tertiary ocular oncology center from 2016 to 2023. Mean follow up time was 478.2 days overall, with 283.0 days for primary 5FU group and 860.3 days for secondary 5FU group.
Intervention
Topical 5FU 1% 4 times daily for 2 weeks with option for 2-weekly extension until tumor control, either as primary treatment or as secondary treatment to surgical resection, topical IFN or topical MMC, or cryotherapy.
Main Outcomes
Outcome measures included tumor response, need for additional surgery, complications, and visual outcomes.
Results
A comparison (primary vs secondary treatment) revealed no difference in mean tumor basal dimension (19.6 vs 17.2 mm, P = 0.46), thickness (3.7 vs 3.4 mm, P = 0.64), or tumor extent (4.4 vs 4.5 clock hours, P = 0.92). The primary treatment group showed greater complete tumor control (77% vs 38%, P = 0.04). Multivariable analysis comparison (primary vs secondary treatment) showed primary treatment more likely to achieve complete tumor control (P = 0.01). There was no difference in the complication rate from 5FU treatment between the groups. There was no difference in visual outcome, and no tumor-related metastasis (0%) or death (0%).
Conclusion and Relevance
Topical 5FU 1% is efficacious and safe as a primary or secondary treatment for moderate to extensive OSSN. Tumors treated with primary 5FU 1% demonstrated more complete resolution. In patients with moderate to extensive OSSN, primary treatment with topical 5FU 1% may be warranted.
{"title":"Topical 5-fluorouracil 1% for moderate to extensive ocular surface squamous neoplasia in 73 consecutive patients: Primary versus secondary treatment","authors":"Irwin Leventer , Hartej Singh , Bahram Pashaee , Christian D. Raimondo , Chenab K. Khakh , Jonathan L. Martin , Binod Acharya , Qiang Zhang , Sara E. Lally , Carol L. Shields","doi":"10.1016/j.apjo.2024.100052","DOIUrl":"10.1016/j.apjo.2024.100052","url":null,"abstract":"<div><h3>Importance</h3><p>Ocular surface squamous neoplasia (OSSN) is a spectrum of malignancies that generally includes conjunctival intraepithelial neoplasia (CIN) and squamous cell carcinoma (SCC). OSSN can be treated with topical therapies including interferon α-2b (IFN), mitomycin C (MMC), or 5-fluorouracil 1% (5FU). Recently, due to unavailability of IFN and toxicity associated with MMC, therapy has shifted towards 5FU.</p></div><div><h3>Objective</h3><p>Herein, we compare the use of 5FU 1% as a primary versus (vs) secondary treatment regimen in eyes with moderate to extensive OSSN.</p></div><div><h3>Design Setting and Participants</h3><p>Retrospective cohort study of 73 consecutive patients with unilateral moderate to extensive OSSN treated at a single tertiary ocular oncology center from 2016 to 2023. Mean follow up time was 478.2 days overall, with 283.0 days for primary 5FU group and 860.3 days for secondary 5FU group.</p></div><div><h3>Intervention</h3><p>Topical 5FU 1% 4 times daily for 2 weeks with option for 2-weekly extension until tumor control, either as primary treatment or as secondary treatment to surgical resection, topical IFN or topical MMC, or cryotherapy.</p></div><div><h3>Main Outcomes</h3><p>Outcome measures included tumor response, need for additional surgery, complications, and visual outcomes.</p></div><div><h3>Results</h3><p>A comparison (primary vs secondary treatment) revealed no difference in mean tumor basal dimension (19.6 vs 17.2 mm, <em>P</em> = 0.46), thickness (3.7 vs 3.4 mm, <em>P</em> = 0.64), or tumor extent (4.4 vs 4.5 clock hours, <em>P</em> = 0.92). The primary treatment group showed greater complete tumor control (77% vs 38%, <em>P</em> = 0.04). Multivariable analysis comparison (primary vs secondary treatment) showed primary treatment more likely to achieve complete tumor control (<em>P</em> = 0.01). There was no difference in the complication rate from 5FU treatment between the groups. There was no difference in visual outcome, and no tumor-related metastasis (0%) or death (0%).</p></div><div><h3>Conclusion and Relevance</h3><p>Topical 5FU 1% is efficacious and safe as a primary or secondary treatment for moderate to extensive OSSN. Tumors treated with primary 5FU 1% demonstrated more complete resolution. In patients with moderate to extensive OSSN, primary treatment with topical 5FU 1% may be warranted.</p></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000471/pdfft?md5=8252b5d4bb5e7c9034eb3aefa6fa446e&pid=1-s2.0-S2162098924000471-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140193172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}