PTERYGIUM

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Khushbu on Jul 30, 2012 Says :

very informative ppt on radiotherapy treatment of pterygium.

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Slide 1 :

PTERYGIUM:ROLE OF RADIOTHERAPY By: NIMESH DAHIMA

Slide 2 :

Take a look over anatomy of eye The ocular adnexa consist of structures including the eyelids, cilia, lacrimal glands, lacrimal drainage apparatus, and conjuctiva.

Slide 3 :

The eyeball is a spherical organ composed of three tunicae. The outer coat consists of the clear cornea on the front and the sclera, a fibrous hypocellular layer that occupies 90% of the posterior aspect of the globe. The uvea, or middle coat, is formed by the chroid, ciliary body and iris, all of which contain a high concentration of melaocytes as well as vessels. The innermost and sensory layer is the retina and its analogs. This coat extends from the oraserrata retinae anteriorly to the optic nerve posteriorly.

Slide 4 :

The vascular supply to the posterior half of the retina derives from the central retinal artery, which enters the globe through the optic nerve. The choroid is split into anterior ciliary and posterior ciliary arteries. The lens is suspended from the ciliary body and is located posterior to the iris..

Slide 5 :

The orbit is composed of seven bones: Frontal, Maxilla, Lacrimal, Palatine, Ethmoid, Sphenoid and Zygomatic. The bony orbit encloses the ocular globe, vessels, nerves, orbital fat, lacrimal gland, and ocular muscles: superior, inferior, medial, and lateral recti as well as superior and inferior oblique muscles that are inserted on the sclera

Slide 6 :

Benign Ocular Disease Radiation therapy is most commonly used for the treatment of malignant tumors, however since long time it has been applied to the eye globe or the orbit with the purpose of achieving control of selective benign processes.

Slide 7 :

PTERYGIUM Pterygium is a benign ocular growth of fibrovascular tissue on conjuctiva. Pterygium can cause irritation, erythema of the cornea, ma obstruct vision and become of cosmetic concer for a patient. Age 20-50 yrs Dry, Dusty and hot conditions: which can cause trauma to the corneal stem cells and cause slow decay of these cells, thich in turn allows overgrowth of thickened fibrovascular tissue at the limbus and onto the cornea.

Slide 8 :

The loss of corneal stem cells is most apparent at the horizontal limbal region where exposure to the environment is greatest. It is also theorized that ultraviolet light exposure may increase the risk of development of pterygium. Most frequently Medial/Nasal aspect of conjuctiva.

Slide 9 :

Primary treatment: SURGERY Complete surgical excision and replacement of loss stem cells by autograft is the surgery of choice. Recurrence rate after surgery alone are in range of 20% to 68%. Adjuvant treatment for pterygium can involve radiation therapy or topical chemotherapeutic agents to minimize regrowth of fibrovascular tissue.

Slide 10 :

In a prospective randomized study, 96 eyes with pterygium were operated on and received ß-radiation with a Strontium-90 (90Sr) eye applicator, or sham radiation within 24 hours of surgery. control rates were approximately 93.2% for the ß-radiation group verses 33.3% for the sham radiation group.

Slide 11 :

Single dose ß-radiation after surgery proved to be a simple, safe and effective treatment to reduce the risk of pterygium recurrence. Current surgical techniques have made the use of irradiation for pterygium sporadic and is only employed in selected cases.

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ROLE OF RADIOTHERAPY IN PTERYGIUM
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