scholarly journals Diagnostic methods and therapeutic options of uveal melanoma with emphasis on MR imaging—Part II: treatment indications and complications

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Pietro Valerio Foti ◽  
Mario Travali ◽  
Renato Farina ◽  
Stefano Palmucci ◽  
Corrado Spatola ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Proton Beam ◽  
Uveal Melanoma ◽  
Diagnostic Methods ◽  
Therapeutic Options ◽  
Cytotoxic Action ◽  
Neoplastic Tissue ◽  
Pictorial Review ◽  
Treatment Indications ◽  
Uveal Melanomas

AbstractTherapy of uveal melanoma aims to preserve the eye and its function and to avoid metastatic dissemination. The treatment choice is difficult and must keep into account several factors; the therapeutic strategy of uveal melanoma should therefore be personalized, sometimes requiring to combine different treatment techniques. Nowadays globe-sparing radiotherapy techniques are often preferred to enucleation. Plaque brachytherapy, the most commonly used eye-preserving therapy, is suitable for small- and medium-sized uveal melanomas. Proton beam radiotherapy is indicated for tumours with noticeable size, challenging shape and location, but is more expensive and less available than brachytherapy. Enucleation is currently restricted to advanced tumours, uveal melanomas with orbital or optic nerve involvement, blind and painful eyes because of treatment-related complications (neovascular glaucoma, chronic inflammatory processes). The effect of proton beam therapy on neoplastic tissue is related to direct cytotoxic action of the radiations, impairment of neoplastic vascular supply and immunologic response. Complications after radiotherapy are frequent and numerous and mainly related to tumour thickness, radiation dose and distance between the tumour and optic nerve. The purpose of this pictorial review is to provide the radiologists with awareness about diagnostic methods and therapeutic options of uveal melanoma. In the present second section, we discuss the therapeutic management of uveal melanoma, describing the main ocular-conserving radiotherapic techniques. We subsequently present an overview of the effects of radiations on neoplastic tissue. Lastly, we review ocular complications following radiotherapy that should be evaluated by radiologists during follow-up MRI examinations.

scholarly journals Diagnostic methods and therapeutic options of uveal melanoma with emphasis on MR imaging—Part I: MR imaging with pathologic correlation and technical considerations

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Pietro Valerio Foti ◽  
Mario Travali ◽  
Renato Farina ◽  
Stefano Palmucci ◽  
Corrado Spatola ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Uveal Melanoma ◽  
Significant Role ◽  
Signal Intensity ◽  
Malignant Neoplasm ◽  
Diagnostic Methods ◽  
Therapeutic Options ◽  
Imaging Appearance ◽  
Pictorial Review ◽  
Uveal Melanomas

AbstractUveal melanoma is a malignant neoplasm that derives from pigmented melanocytes of the uvea and involves, in order of decreasing prevalence, the choroid, ciliary body and iris. Its prognosis is related to histopathologic and genetic features, tumor size and location, extraocular extension. The diagnosis is fundamentally based on clinical evaluation (ophthalmoscopy, biomicroscopy) and ultrasonography. MRI is useful in case of untransparent lens or subretinal effusion. Moreover, MRI has a significant role to confirm the diagnosis, in the evaluation of the local extent of the disease with implications for treatment planning, and in the follow-up after radiotherapy treatment. Uveal melanoma can show different morphologic features (lentiform, dome or mushroom shape) and often determines retinal detachment. MR appearance of uveal melanoma mainly depends on the melanin content. Uveal melanoma typically displays high signal intensity on T1-weighted images and low signal intensity on T2-weighted images. Nevertheless, imaging appearance may be variable based on the degree of pigmentation and the presence of areas of necrosis or cavitation. Differential diagnosis includes other uveal lesions. The radiologists and in particular MRI play a significant role in the clinical management of uveal melanoma. The purpose of this pictorial review is to provide the radiologists with awareness about diagnostic methods and therapeutic options of uveal melanoma. In the present first section we summarize the MR anatomy of the eye and describe ophthalmological and radiological imaging techniques to diagnose uveal melanomas, with emphasis on the role of MR imaging. Additionally, we review MR imaging appearance of uveal melanomas.

scholarly journals Importance of the length of excised optic nerve in enucleations for uveal melanoma

2006 ◽  
Vol 53 (3) ◽  
pp. 49-52
Author(s):  
A. Bobic-Radovanovic ◽  
Z. Vlatkovic
Keyword(s):  
Intraocular Pressure ◽  
Optic Nerve ◽  
Uveal Melanoma ◽  
Poor Vision ◽  
Nerve Invasion ◽  
Uveal Melanomas

The importance of a length of excised optic nerve in eyes enucleated for uveal melanoma isn't finally discussed. We analyzed 473 eyes enucleated for uveal melanoma between 1995. and 2004. at Institute of ophthalmology in Belgrade, 16 (3,7%) of which extended into the optic nerve or its meningeal sheaths. Peripapillary melanomas and large melanomas in eyes with increased intraocular pressure and poor vision were associated with optic nerve invasion. This tumors, as a rule, require an enucleation as a treatment of choice. Authors suggest that a long piece of optic nerve should be excised when eyes with uveal melanomas are enucleated. .

scholarly journals Histopathologic and MR Imaging Appearance of Spontaneous and Radiation-Induced Necrosis in Uveal Melanomas: Initial Results

Cancers ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 215
Author(s):  
Pietro Valerio Foti ◽  
Corrado Inì ◽  
Giuseppe Broggi ◽  
Renato Farina ◽  
Stefano Palmucci ◽  
...  
Keyword(s):  
Proton Beam ◽  
Signal Intensity ◽  
Final Analysis ◽  
Control Group ◽  
High Signal ◽  
Mri Findings ◽  
Neoplastic Tissue ◽  
Proton Beam Radiotherapy ◽  
Radiation Induced ◽  
Uveal Melanomas

Necrosis in uveal melanomas can be spontaneous or induced by radiotherapy. The purpose of our study was to compare the histopathologic and MRI findings of radiation-induced necrosis of a group of proton beam-irradiated uveal melanomas with those of spontaneous necrosis of a control group of patients undergoing primary enucleation. 11 uveal melanomas who had undergone proton beam radiotherapy, MRI and secondary enucleation, and a control group of 15 untreated uveal melanomas who had undergone MRI and primary enucleation were retrospectively identified. Within the irradiated and nonirradiated group, 7 and 6 eyes with histological evidence of necrosis respectively, were furtherly selected for the final analysis; the appearance of necrosis was assessed at histopathologic examination and MRI. Irradiated melanomas showed a higher degree of necrosis as compared with nonirradiated tumors. Irradiated and nonirradiated lesions differed based on the appearance and distribution of necrosis. Irradiated tumors showed large necrotic foci, sharply demarcated from the viable neoplastic tissue; nonirradiated tumors demonstrated small, distinct foci of necrosis. Radiation-induced necrosis, more pigmented than surrounding viable tumor, displayed high signal intensity on T1-weighted and low signal intensity on T2-weighted images. The hemorrhagic/coagulative necrosis, more prevalent in nonirradiated tumors (4 out of 6 vs. 1 out of 7 cases), appeared hyperintense on T2-weighted and hypointense on T1-weighted images. Our study boosts the capability to recognize radiation-induced alterations in uveal melanomas at MRI and may improve the accuracy of radiologists in the evaluation of follow-up MR examination after radiotherapy.

scholarly journals Development of new therapeutic options for the treatment of uveal melanoma

FEBS Journal ◽  
2021 ◽  
Author(s):  
Janney Z. Wang ◽  
Vivian Lin ◽  
Elsa Toumi ◽  
Ke Wang ◽  
Hong Zhu ◽  
...  
Keyword(s):  
Uveal Melanoma ◽  
Therapeutic Options

Tumor and Dosimetric Predictors of Long-Term Visual Outcomes After Proton Beam Therapy of Uveal Melanoma

2014 ◽  
Vol 90 (1) ◽  
pp. S305 ◽  
Author(s):  
A.L. Polishchuk ◽  
D.H. Char ◽  
V. Weinberg ◽  
I.K. Daftari ◽  
T.B. Cole ◽  
...  
Keyword(s):  
Proton Beam ◽  
Uveal Melanoma ◽  
Proton Beam Therapy ◽  
Visual Outcomes

scholarly journals MR Imaging–Pathologic Correlation of Uveal Melanomas Undergoing Secondary Enucleation after Proton Beam Radiotherapy

2021 ◽  
Vol 11 (9) ◽  
pp. 4310
Author(s):  
Pietro Valerio Foti ◽  
Corrado Inì ◽  
Mario Travali ◽  
Renato Farina ◽  
Stefano Palmucci ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Proton Beam ◽  
Uveal Melanoma ◽  
Vitreous Hemorrhage ◽  
Nerve Degeneration ◽  
Proton Beam Radiotherapy ◽  
Iris Neovascularization ◽  
Weighted Sequences ◽  
Histopathologic Findings ◽  
Optic Nerve Degeneration

Background: Currently, radiotherapy represents the most widely employed therapeutic option in patients with uveal melanoma. Although the effects of proton beam radiotherapy on uveal melanoma end ocular tissues have been histologically documented, their appearance at MR imaging is still poorly understood. The purpose of our study was to elucidate the magnetic resonance (MR) semiotics of radiotherapy-induced changes to neoplastic tissues and ocular structures in patients with uveal melanoma undergoing secondary enucleation after proton beam radiotherapy. Methods: Nine patients with uveal melanoma who had undergone proton beam radiotherapy, MR imaging, and subsequent secondary enucleation were retrospectively selected. The histopathologic findings evaluated for irradiated tumors were necrosis, fibrosis, and viable tumor, while the histopathologic findings evaluated for extratumoral ocular/periocular tissues were radiation-related intraocular inflammation, vitreous hemorrhage, optic nerve degeneration, iris neovascularization, and periocular fibrotic adhesions. On MR images, the appearance of the abovementioned histologic features was assessed on conventional and diffusion-weighted sequences. Results: T2-weighted sequences performed better in detecting radiation-induced necrosis, fibrosis, optic nerve degeneration, and periocular fibrotic adhesions. T1-weighted sequences were preferable for identifying cataracts, vitreous hemorrhage, and inflammatory complications. Contrast-enhanced T1-weighted sequences were irreplaceable in assessing iris neovascularization, and in confirming inflammatory complications. Conclusions: In the light of their increasing role in the multidisciplinary management of patients with uveal melanoma, radiologists should be aware of the MR appearance of the effects of radiotherapy on neoplastic and ocular tissue, in order to improve the accuracy of follow-up MR examinations.

Technical Considerations for Noncoplanar Proton-Beam Therapy of Patients with Tumors Proximal to the Optic Nerve

2009 ◽  
Vol 186 (1) ◽  
pp. 36-39 ◽  
Author(s):  
Masashi Mizumoto ◽  
Hidetsugu Nakayama ◽  
Mari Tokita ◽  
Shinji Sugahara ◽  
Haruko Hashii ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Proton Beam ◽  
Proton Beam Therapy ◽  
Technical Considerations

Uveal Melanoma Recurrence After Fractionated Proton Beam Therapy: Comparison of Survival in Patients Treated With Reirradiation or With Enucleation

2011 ◽  
Vol 79 (3) ◽  
pp. 842-846 ◽  
Author(s):  
Laura Marucci ◽  
Marek Ancukiewicz ◽  
Anne Marie Lane ◽  
John M. Collier ◽  
Evangelos S. Gragoudas ◽  
...  
Keyword(s):  
Proton Beam ◽  
Uveal Melanoma ◽  
Proton Beam Therapy

Combined corneal and optic nerve pathology

2021 ◽  
pp. 28-32
Author(s):  
M.R. Khabazova ◽  
◽  
E.E. Ioyleva ◽  
N.A. Gavrilova ◽  
N.S. Gadzhieva ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Corneal Dystrophy ◽  
Diagnostic Methods ◽  
Ophthalmological Examination ◽  
Rare Occurrence ◽  
Progressive Decrease ◽  
Optic Nerve Atrophy ◽  
Congenital Diseases ◽  
Optic Disc Drusen ◽  
Genetically Determined

A case with ophthalmological manifestations of two genetically determined diseases in one patient with a progressive decrease in visual functions is considered. The clinical picture and modern diagnostic methods necessary for the clinical diagnosis are reflected. The rare occurrence of combinations of congenital diseases of the cornea and optic nerve disc requires special attention during ophthalmological examination. Key words: corneal dystrophy, comorbidity, inherited diseases, optic nerve atrophy, optic disc drusen.

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