97th DOG Annual Meeting 1999
NEW DEVELOPMENTS IN THE TREATMENT OF INTRAOCULAR TUMORS: INFRARED LASER, BINUCLID OPHTHALMIC APPLICATORS, ENDORESECTION
N. Bornfeld1, M. H. Foerster2, A. Schüler1, J. Wening1, G. Anastassiou1
Complications in radiotherapy of intraocular tumors have induced the search for therapeutic alternatives.
Radiotherapy alone in the management of large uveal melanomas and juxtapapillary melanomas of the choroid has resulted in unfavorable results. Therapeutic alternatives include the combination of transpupillary infrared laser therapy with low dose radiotherapy, the enhancement of infrared laser therapy with dyes and endoresection in selected cases combined with one of the local treatment modalities. The use of binuclide ophthalmic plaques seems to be promising as a more favorable depth dose distribution can be achieved. Preliminary data suggest better results in terms of function and salvage of the tumor containing eye.
The treatment of retinoblastoma has changed considerably in the last 3 years. External beam radiotherapy increases the individual risk of secondary extraocular malignant tumors by six in patients with germinal rb1 mutations. New modalities avoiding external beam radiation include chemoreduction and the use of thermochemo-therapy. Using this multimodal procedure favorable local control rates can be achieved. Local recurrences and new tumors, however, are much more frequent resulting in more treatment sessions and more time consuming procedures.