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Open Angle Glaucoma: Treatment01:27

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In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
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Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
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Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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Management of choroidal metastases.

P Jardel1, W Sauerwein2, T Olivier3

  • 1Department of Radiation Oncology, University Hospital, 2 rue de la Milétrie, 86000 Poitiers, France.

Cancer Treatment Reviews
|December 3, 2014
PubMed
Summary

Choroidal metastases (CM) are common in cancer patients and often cause vision loss. Radiotherapy is effective for symptom relief and local control, though long-term outcomes require further study.

Keywords:
Breast cancerChoroidal metastasisLung cancerRadiotherapyTreatmentTumor responseVisual acuity

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Area of Science:

  • Ophthalmology
  • Oncology
  • Radiation Oncology

Background:

  • Choroidal metastases (CM) are the most frequent malignant intraocular tumors, affecting 4-12% of cancer patients.
  • CM can lead to significant visual deterioration and vary in presentation from disseminated to isolated disease.

Purpose of the Study:

  • To review the multidisciplinary management of choroidal metastases.
  • To discuss technical aspects of radiotherapy for CM.

Main Methods:

  • A systematic literature review was conducted from 1974 to 2014.

Main Results:

  • Breast and lung carcinomas are the most common primary tumors for CM.
  • External beam radiotherapy (30Gy/10fx or 40Gy/20fx) achieves 80% complete response and 57-89% visual acuity improvement.
  • Chemotherapy and targeted therapies show promising response rates.

Conclusions:

  • Radiotherapy offers rapid symptom relief, excellent local control, and functional outcomes for CM.
  • Long-term toxicity data is limited due to poor prognosis; further research on long-term outcomes is needed.
  • Systemic therapies may suit pauci-symptomatic cases, while radiotherapy is crucial for symptomatic CM; focalized radiation is an option for isolated CM in select patients.