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Published on: October 18, 2011
Limbal Stem Cell Preservation During Proton Beam Irradiation for Diffuse Iris Melanoma
Arun D Singh1, William J Dupps, Charles V Biscotti
1*Department of Ophthalmic Oncology, Cole Eye Institute, Cleveland Clinic, Cleveland, OH; †Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH; Departments of ‡Anatomic Pathology; and §Radiation Oncology, Cleveland Clinic, Cleveland, OH; ¶University of Pittsburgh School of Medicine/Ophthalmology and Swanson School of Engineering/Bioengineering; ∥Associates in Ophthalmology, Pittsburgh, PA; and **Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA.
Proton beam radiation successfully treated diffuse iris melanoma while preserving limbal stem cells. Stem cell transplantation after radiation promoted regeneration, maintaining corneal health and visual acuity.
Area of Science:
- Ophthalmology
- Oncology
- Regenerative Medicine
Background:
- Diffuse iris melanoma is a rare intraocular tumor.
- Proton beam radiation is a treatment option for localized tumors.
- Limbal stem cells are crucial for corneal health and regeneration.
Observation:
- A single case of diffuse iris melanoma treated with proton beam radiation (53 Gy).
- Limbal stem cells were harvested before radiation and replaced post-treatment.
- Regeneration of palisades of Vogt and limbal stem cells was monitored using optical coherence tomography.
Findings:
- At 24 months post-radiation, best-corrected visual acuity was 20/25 with a clear cornea.
- No signs of limbal stem cell dysfunction were observed.
- Clinical examinations confirmed local tumor control and no metastatic disease.
- Regeneration of palisade structures in the limbus was evident 21 months post-transplant.
Implications:
- Proton beam radiation can be a successful treatment for diffuse iris melanoma.
- Preemptive harvesting and post-radiation replacement of limbal stem cells can preserve corneal integrity.
- Optical coherence tomography is a valuable tool for documenting limbal stem cell regeneration.
