The Amazon Ocular Oncology Center: The first three years / Centro de Oncologia Ocular do Amazonas: primeiros três anos

ABSTRACT Purpose: To evaluate the first three years of The Amazon Ocular Oncology Center, the first ocular cancer center in the North of Brazil. Methods: Here, we report patient information including patients' age, gender, diagnosis, treatment, and city of origin. Results: Two hundred and twenty-one patients were included on this study: 160 (72%) patients came from the city of Manaus, 52 (24%) from other cities in Amazonas, and 9 (4%) from other states. Of the 221 patients, 150 (68%) were afflicted with benign lesions and the remaining 71 (32%) had malignant lesions. Benign diagnosis included pterygium, chalazium, conjunctival nevus, and papilloma, cataract, and retinal detachment. Of the malignant cases, squamous cell carcinoma (SCC) of the conjunctiva was the most frequent with 43 cases (60%). Other diagnoses included choroidal melanoma (8 cases, 11%), retinoblastoma (7 cases, 9%), lymphomas (5 cases, 7%), basal cell carcinomas of the eyelid (4 cases, 5%), conjunctival melanoma (2 cases, 2%), and Kaposi sarcomas (1 case, 1%). Of the 43 patients with SCC, the mean age was 62 years old, and 30 (69%) were male; 29 patients (67%) were treated with an excisional biopsy, and 14 (33%) were treated with neoadjuvant topic chemotherapy, followed by surgery.

RESUMO Objetivo: Reportar sobre os primeiros três anos do Centro de Oncologia Ocular do Amazonas, primeiro centro de oncologia ocular na região Norte do Brasil. Métodos: Relatamos informações de diagnóstico, idade, sexo, tratamento e cidade de origem dos pacientes atendidos nos 3 primeiros anos. Resultados: Identificamos 221 pacientes, dos quais 160 (72%) eram da cidade de Manaus, 52 (24%) de outras cidades do Amazonas e 9 (4%) de outros estados. Dos 221 casos, 150 (68%) eram lesões benignas e 71 (32%) malignas. Lesões benignas incluíram pterígio, calázio, nevus e papiloma de conjuntiva, catarata e descolamento de retina. Das lesões malignas a mais comum foi o carcinoma escamoso de conjuntiva com 43 casos (60%). Outros diagnósticos incluíram melanoma de coróide (8 casos, 11%), retinoblastoma (7 casos, 9%), linfomas (5 casos, 7%), carcinoma da pálpebra (4 casos, 5%), melanoma da conjunctiva (2 casos, 2%) e sarcoma de Kaposi (1 caso, 1%). Dentre os CEC de conjuntiva, a idade media foi de 62 anos e 30 pacientes (69%) eram do sexo masculino. Vinte e nove casos (67%) foram tratados com biópsia excisional e 14 (33%) com quimioterapia tópica neoadjuvante seguida de cirurgia.

The Amazon Ocular Oncology Center: The first three years.

PURPOSE: To evaluate the first three years of The Amazon Ocular Oncology Center, the first ocular cancer center in the North of Brazil. METHODS: Here, we report patient information including patients' age, gender, diagnosis, treatment, and city of origin. RESULTS: Two hundred and twenty-one patients were included on this study: 160 (72%) patients came from the city of Manaus, 52 (24%) from other cities in Amazonas, and 9 (4%) from other states. Of the 221 patients, 150 (68%) were afflicted with benign lesions and the remaining 71 (32%) had malignant lesions. Benign diagnosis included pterygium, chalazium, conjunctival nevus, and papilloma, cataract, and retinal detachment. Of the malignant cases, squamous cell carcinoma (SCC) of the conjunctiva was the most frequent with 43 cases (60%). Other diagnoses included choroidal melanoma (8 cases, 11%), retinoblastoma (7 cases, 9%), lymphomas (5 cases, 7%), basal cell carcinomas of the eyelid (4 cases, 5%), conjunctival melanoma (2 cases, 2%), and Kaposi sarcomas (1 case, 1%). Of the 43 patients with SCC, the mean age was 62 years old, and 30 (69%) were male; 29 patients (67%) were treated with an excisional biopsy, and 14 (33%) were treated with neoadjuvant topic chemotherapy, followed by surgery.

Novel treatment of papillomatous conjunctival lesions using pattern scanning laser photocoagulation: 1-Year results.

PURPOSE: To evaluate the safety and 1-year effect of pattern scanning laser photocoagulation treatment for pedunculated papillomatous and sessile conjunctival lesions in a low-resource setting with extremely limited operating room access. METHODS: Adult patients with clinical diagnosis of conjunctival papilloma underwent complete ophthalmologic exam including anterior segment photography. After topical anesthesia and toluidine blue 1% instillation, the lesion was treated by pattern scanning photocoagulation using a duration time that varied from 20 to 100 ms and power from 600 to 1800 mW, treating the entire lesion surface with a 2 mm margin. Patients were examined weekly for a month then monthly and underwent retreatment as necessary. RESULTS: Six patients and seven eyes that had clinically significant non-malignant pedunculated or sessile papillomatous lesions were treated. All lesions responded to treatment, with complete resolution after an average of 2.3 sessions. Procedures were well tolerated with only minor mild discomfort persisting up to two days post-treatment. Patients were followed for a mean follow-up time of 13 months with no recurrences reported. CONCLUSION: Short-term results of the pattern scanning laser photocoagulation approach, with toluidine blue for papillomatous conjunctival lesions are favorable with a 100% success rate in this cohort. This rate is comparable to surgical excision. This novel strategy proved to be a less resource intensive alternative that not only could demonstrate its usefulness in settings with chronic operating room shortages, but also in recurrent cases. Longer follow-ups with a larger sample size and cost-analysis are necessary to confirm our findings.