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Paul T. Finger - One of the best experts on this subject based on the ideXlab platform.
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laser photocoagulation for Radiation Retinopathy after ophthalmic plaque Radiation therapy
British Journal of Ophthalmology, 2005Co-Authors: Paul T. Finger, M KurliAbstract:Aim: To evaluate the use of scatter laser photocoagulation to prevent Radiation related Retinopathy, maculopathy, and loss of vision. Methods: This was an interventional case series. 66 eyes with posterior choroidal melanomas treated by ophthalmic plaque Radiation therapy were reported. Of these patients, 50 were selected because they developed Radiation Retinopathy; 45 of these were treated with sector scatter laser photocoagulation to regress clinically evident Radiation Retinopathy. 16 additional patients (considered to be “high risk” to develop Radiation Retinopathy) were also treated. Results: Radiation Retinopathy was noted to appear at a mean interval of 26 months following plaque treatment. Laser photocoagulation regressed Radiation Retinopathy in 29 (64.4%) of the 45 patients treated after the onset of Radiation Retinopathy (17 with only Retinopathy, 10 with a combination of Retinopathy and maculopathy, and two with only maculopathy). Of the 16 patients who received laser treatment before clinical evidence of Retinopathy, one developed Radiation maculopathy and two Retinopathy without maculopathy (all three responded to additional laser photocoagulation). In the 45 patient group, vision loss of more than three lines was attributable to Radiation maculopathy in seven (15.5%). None of the patients in the prophylactic laser group lost more than three lines of vision as a result of maculopathy. Conclusion: Sector scatter argon laser photocoagulation induced regression of Radiation Retinopathy. Though early treatment of Radiation Retinopathy appears to be more effective, a more long term and prospective randomised study will be needed to prove efficacy.
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authors ’ affiliations Correspondence to:
2004Co-Authors: P T Finger, Paul T. Finger, M Kurli, The NewAbstract:photocoagulation for Radiation Retinopathy after ophthalmic plaque Radiation therap
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plaque Radiation therapy for malignant melanoma of the iris and ciliary body
American Journal of Ophthalmology, 2001Co-Authors: Paul T. FingerAbstract:Abstract PURPOSE: To report on plaque Radiation therapy for malignant melanomas involving the iris and ciliary body. METHODS: Twenty-two eyes (22 patients) with anterior uveal melanomas were treated with 103 Pd ophthalmic plaque Radiation therapy. Transillumination and ultrasonography were used to evaluate ciliary body involvement and posterior iris extension. Plaques were placed onto the cornea to treat the anterior tumor margins. The targeted-zone included the tumor and a 2 to 3 mm tumor-free margin. After plaque removal, patients were examined at 1 day, 7 days, 4 weeks, and then every 3 to 6 months thereafter. Systemic evaluations for possible metastatic disease were performed every 6 months. RESULTS: After plaque Radiation therapy, the melanomas decreased in thickness (mean 47%) in all 22 eyes, and no secondary enucleation was performed. One patient died of metastatic melanoma 5 years after Radiation therapy. Despite anterior plaque placement that covered portions of the cornea, no epiphora, eyelash loss, or visually significant corneal opacities were noted. Whereas 15 of 21 phakic eyes (71%) developed secondary cataract, no eyes developed ischemic or neovascular Radiation maculopathy. Four eyes were noted to have glaucoma before treatment, and two developed it after irRadiation. Twenty of 22 eyes (91%) were within 2 lines of their pretreatment visual acuity. After Radiation, the mean ± SD follow-up was 56 ± 34.4 months (range, 9 to 117 months). CONCLUSIONS: Plaque radiotherapy of melanomas involving the iris and ciliary body resulted in excellent local control with preservation of vision. Although there was high incidence of secondary cataracts, 103 Pd plaque Radiation therapy resulted in no visually significant corneal opacity or Radiation Retinopathy.
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ophthalmic plaque radiotherapy for age related macular degeneration associated with subretinal neovascularization
American Journal of Ophthalmology, 1999Co-Authors: Paul T. Finger, Anthony M Berson, Andrzej SzechterAbstract:Abstract PURPOSE: To evaluate ophthalmic plaque radiotherapy for the treatment of subretinal neovascularization associated with age-related macular degeneration. METHODS: In a prospective phase I clinical trial, we treated 23 patients (23 eyes) with ophthalmic plaque radiotherapy for subfoveal exudative macular degeneration. Palladium 103 ophthalmic plaque brachytherapy was delivered to a retinal apex dose of 1,250 to 2,362 cGy (rad). Early Treatment Diabetic Retinopathy Study type visual acuity determinations, ophthalmic examinations, and angiography were performed before and after treatment. Clinical evaluations were performed in a nonrandomized and unmasked fashion. RESULTS: Patients were followed up for a mean (±SD) of 19 ± 10.7 months (range, 3 to 37 months). Six months after Radiation therapy, three (16%) of 19 eyes had lost 3 or more lines of best-corrected visual acuity; 12 months after Radiation therapy, four eyes (31% of 13 eyes), and 24 months after Radiation therapy, only two (22% of nine eyes) lost 3 or more lines of visual acuity. No eye suffered sudden irreversible loss of central vision. No Radiation Retinopathy, optic neuropathy, or cataract could be attributed to radiotherapy within this follow-up period. CONCLUSION: Ophthalmic plaque radiotherapy can be used to treat neovascular age-related macular degeneration. In contrast to external beam radiotherapy, ophthalmic plaque radiotherapy is a unilateral treatment, which allows a larger dose to be delivered to the macula with less irRadiation of normal ocular structures. We have found no sight-limiting complications at the doses, dose rates, and follow-up evaluated in this study.
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long term results of iodine 125 irRadiation of uveal melanoma
Ophthalmology, 1992Co-Authors: Samuel Packer, Scott H Stoller, Martin Lesser, Francine S Mandel, Paul T. FingerAbstract:The authors report on 64 of the first 65 patients treated with iodine 125. The mean follow-up was 64.9 months. After treatment, 29 patients (45.3%) retained visual acuity of 20/100 or better, and 18 patients (28.1%) retained visual acuity within two lines of visual acuity before irRadiation. Eleven patients (17.2%) died of metastasis, and 5 patients (7.8%) had local recurrence. Cataract developed in 29 (45.3%) patients; keratitis developed in only 2 (3.1 %) patients, and dry eye developed in none. Neovascular glaucoma developed in 7 (10.9%) patients, and 15 (23.4%) patients had Radiation Retinopathy. Eleven patients (17.2%) required enucleation for either tumor growth or neovascular glaucoma. These results show the increasing number of Radiation complications seen with long-term observation and the frequently seen adverse visual outcome.
Antonia M Joussen - One of the best experts on this subject based on the ideXlab platform.
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predictive risk factors for Radiation Retinopathy and optic neuropathy after proton beam therapy for uveal melanoma
Graefes Archive for Clinical and Experimental Ophthalmology, 2016Co-Authors: Ira Seibel, Dino Cordini, Jens Heufelder, A Hager, Aline I Riechardt, Johanna Tillner, Anja M Davids, Matus Rehak, Antonia M JoussenAbstract:Purpose This study was performed in order to evaluate the incidence of Radiation Retinopathy and optic neuropathy occurring after proton beam therapy for uveal melanoma.
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long term 4 years results of choroidal hemangioma treated with proton beam irRadiation
Graefes Archive for Clinical and Experimental Ophthalmology, 2014Co-Authors: A Zeisberg, Ira Seibel, Dino Cordini, N Lakotka, G Willerding, L Moser, Jens Heufelder, Antonia M JoussenAbstract:The aim of this retrospective study was to determine the efficacy of proton beam irRadiation in choroidal hemangioma in a long-term follow-up. A total dose of 20 Cobalt Gray equivalent (CGE) was administered to 50 eyes of 50 patients from September 1998 to September 2010. All treated patients presented with a symptomatic tumor. Nine patients were pre-treated by photodynamic therapy (PDT). Visual outcome, tumor regression, and complications resulting from Radiation were investigated. The mean follow-up was 55.4 months (range 13–132). Tumor thickness decreased in all patients. Retinal re-attachment was achieved without evidence of tumor leakage. Visual acuity improved by two lines after one year in 43.4 % of patients and after two years in 36.8 % of patients. During the 55.4 months of long-term follow-up the visual acuity improved from 6/15 to 6/12 after proton therapy. Twenty-three patients (46.0 %) developed Radiation Retinopathy. According to the Finger classification of 2004, 21 patients (42.0 %) showed a stage 1 or 2 (functionally not relevant) Retinopathy, and two patients (4.0 %) presented a stage 3 or 4 (functionally relevant) Retinopathy. Further complications included sicca syndrome in nine cases, cataract formation in 10 cases, and Radiation optic neuropathy in four cases. Proton therapy with 20 CGE is an efficient primary therapy in choroidal hemangioma and is very effective as a secondary treatment after PDT.
Jens Heufelder - One of the best experts on this subject based on the ideXlab platform.
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predictive risk factors for Radiation Retinopathy and optic neuropathy after proton beam therapy for uveal melanoma
Graefes Archive for Clinical and Experimental Ophthalmology, 2016Co-Authors: Ira Seibel, Dino Cordini, Jens Heufelder, A Hager, Aline I Riechardt, Johanna Tillner, Anja M Davids, Matus Rehak, Antonia M JoussenAbstract:Purpose This study was performed in order to evaluate the incidence of Radiation Retinopathy and optic neuropathy occurring after proton beam therapy for uveal melanoma.
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long term 4 years results of choroidal hemangioma treated with proton beam irRadiation
Graefes Archive for Clinical and Experimental Ophthalmology, 2014Co-Authors: A Zeisberg, Ira Seibel, Dino Cordini, N Lakotka, G Willerding, L Moser, Jens Heufelder, Antonia M JoussenAbstract:The aim of this retrospective study was to determine the efficacy of proton beam irRadiation in choroidal hemangioma in a long-term follow-up. A total dose of 20 Cobalt Gray equivalent (CGE) was administered to 50 eyes of 50 patients from September 1998 to September 2010. All treated patients presented with a symptomatic tumor. Nine patients were pre-treated by photodynamic therapy (PDT). Visual outcome, tumor regression, and complications resulting from Radiation were investigated. The mean follow-up was 55.4 months (range 13–132). Tumor thickness decreased in all patients. Retinal re-attachment was achieved without evidence of tumor leakage. Visual acuity improved by two lines after one year in 43.4 % of patients and after two years in 36.8 % of patients. During the 55.4 months of long-term follow-up the visual acuity improved from 6/15 to 6/12 after proton therapy. Twenty-three patients (46.0 %) developed Radiation Retinopathy. According to the Finger classification of 2004, 21 patients (42.0 %) showed a stage 1 or 2 (functionally not relevant) Retinopathy, and two patients (4.0 %) presented a stage 3 or 4 (functionally relevant) Retinopathy. Further complications included sicca syndrome in nine cases, cataract formation in 10 cases, and Radiation optic neuropathy in four cases. Proton therapy with 20 CGE is an efficient primary therapy in choroidal hemangioma and is very effective as a secondary treatment after PDT.
Dino Cordini - One of the best experts on this subject based on the ideXlab platform.
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predictive risk factors for Radiation Retinopathy and optic neuropathy after proton beam therapy for uveal melanoma
Graefes Archive for Clinical and Experimental Ophthalmology, 2016Co-Authors: Ira Seibel, Dino Cordini, Jens Heufelder, A Hager, Aline I Riechardt, Johanna Tillner, Anja M Davids, Matus Rehak, Antonia M JoussenAbstract:Purpose This study was performed in order to evaluate the incidence of Radiation Retinopathy and optic neuropathy occurring after proton beam therapy for uveal melanoma.
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long term 4 years results of choroidal hemangioma treated with proton beam irRadiation
Graefes Archive for Clinical and Experimental Ophthalmology, 2014Co-Authors: A Zeisberg, Ira Seibel, Dino Cordini, N Lakotka, G Willerding, L Moser, Jens Heufelder, Antonia M JoussenAbstract:The aim of this retrospective study was to determine the efficacy of proton beam irRadiation in choroidal hemangioma in a long-term follow-up. A total dose of 20 Cobalt Gray equivalent (CGE) was administered to 50 eyes of 50 patients from September 1998 to September 2010. All treated patients presented with a symptomatic tumor. Nine patients were pre-treated by photodynamic therapy (PDT). Visual outcome, tumor regression, and complications resulting from Radiation were investigated. The mean follow-up was 55.4 months (range 13–132). Tumor thickness decreased in all patients. Retinal re-attachment was achieved without evidence of tumor leakage. Visual acuity improved by two lines after one year in 43.4 % of patients and after two years in 36.8 % of patients. During the 55.4 months of long-term follow-up the visual acuity improved from 6/15 to 6/12 after proton therapy. Twenty-three patients (46.0 %) developed Radiation Retinopathy. According to the Finger classification of 2004, 21 patients (42.0 %) showed a stage 1 or 2 (functionally not relevant) Retinopathy, and two patients (4.0 %) presented a stage 3 or 4 (functionally relevant) Retinopathy. Further complications included sicca syndrome in nine cases, cataract formation in 10 cases, and Radiation optic neuropathy in four cases. Proton therapy with 20 CGE is an efficient primary therapy in choroidal hemangioma and is very effective as a secondary treatment after PDT.
Ira Seibel - One of the best experts on this subject based on the ideXlab platform.
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predictive risk factors for Radiation Retinopathy and optic neuropathy after proton beam therapy for uveal melanoma
Graefes Archive for Clinical and Experimental Ophthalmology, 2016Co-Authors: Ira Seibel, Dino Cordini, Jens Heufelder, A Hager, Aline I Riechardt, Johanna Tillner, Anja M Davids, Matus Rehak, Antonia M JoussenAbstract:Purpose This study was performed in order to evaluate the incidence of Radiation Retinopathy and optic neuropathy occurring after proton beam therapy for uveal melanoma.
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long term 4 years results of choroidal hemangioma treated with proton beam irRadiation
Graefes Archive for Clinical and Experimental Ophthalmology, 2014Co-Authors: A Zeisberg, Ira Seibel, Dino Cordini, N Lakotka, G Willerding, L Moser, Jens Heufelder, Antonia M JoussenAbstract:The aim of this retrospective study was to determine the efficacy of proton beam irRadiation in choroidal hemangioma in a long-term follow-up. A total dose of 20 Cobalt Gray equivalent (CGE) was administered to 50 eyes of 50 patients from September 1998 to September 2010. All treated patients presented with a symptomatic tumor. Nine patients were pre-treated by photodynamic therapy (PDT). Visual outcome, tumor regression, and complications resulting from Radiation were investigated. The mean follow-up was 55.4 months (range 13–132). Tumor thickness decreased in all patients. Retinal re-attachment was achieved without evidence of tumor leakage. Visual acuity improved by two lines after one year in 43.4 % of patients and after two years in 36.8 % of patients. During the 55.4 months of long-term follow-up the visual acuity improved from 6/15 to 6/12 after proton therapy. Twenty-three patients (46.0 %) developed Radiation Retinopathy. According to the Finger classification of 2004, 21 patients (42.0 %) showed a stage 1 or 2 (functionally not relevant) Retinopathy, and two patients (4.0 %) presented a stage 3 or 4 (functionally relevant) Retinopathy. Further complications included sicca syndrome in nine cases, cataract formation in 10 cases, and Radiation optic neuropathy in four cases. Proton therapy with 20 CGE is an efficient primary therapy in choroidal hemangioma and is very effective as a secondary treatment after PDT.
