OCULAR MELANOMA--DEVELOPMENT OF A PHOTODYNAMIC THERAPY

这项研究的长期目标是建立光动力疗法。 作为一种安全有效的眼科治疗方法 肿瘤。葡萄膜黑色素瘤是最常见的眼内恶性肿瘤， 与高转移率相关。迄今为止，尽管 治疗，无论是摘除眼球还是某种形式的放射治疗， 超过四分之一的患者会发生转移性疾病。预期寿命 转移的患者一般不到1年。 治疗葡萄膜黑色素瘤的理想替代疗法是 这将以最小的眼部发病率根除肿瘤细胞。 光动力疗法(PDT)是一种相对较新的实验手段。 治疗光线可及的肿瘤。这种方法提供了双重功能 对肿瘤组织的选择性是通过优先实现的 光敏剂染料在肿瘤组织内的滞留 照射范围限制在肿瘤部位。潜力 这种选择性靶向肿瘤细胞的方式使光动力疗法特别 在对结构完整性至关重要的解剖区域具有吸引力 维持生命功能。眼部黑色素瘤应该是一个理想的选择 光动力疗法的候选对象，因为它很容易通过 散开的瞳孔，可直接照射。 我们建立了一种色素脉络膜黑色素瘤的动物模型。 实验室和该模型下，各种生物分布 将对荷瘤眼中的光敏剂进行评估，以确定 哪种光敏剂染料更适合眼部黑色素瘤的PDT。 曾经脉络膜黑色素瘤内光敏剂的滞留模式 和周围组织被确定，光动力疗法在 色素性脉络膜黑色素瘤的破坏将被评估。黑色素瘤- 反应性抗体也将被评估其增强 将光敏剂输送到肿瘤部位。最后，一个 光敏剂血管造影术将被开发用于检测 荷瘤眼睛中的光敏剂。 一种有效的光动力疗法的发展 黑色素瘤细胞可以更有选择性地提高存活率并提供更好的 眼部黑色素瘤患者的视力结局。

The long-term-objective of this study is to establish photodynamic therapy as a safe and effective clinical modality for the treatment of ocular tumors. Uveal melanoma is the most common intraocular malignancy and is associated with a high incidence of metastases. To date, in spite of treatment, whether it is enucleation or some form of radiotherapy, metastatic disease occurs in over a quarter of patients. Life expectancy of patients with metastases is generally less than 1 year. An ideal alternative therapy for the treatment of uveal melanoma is one that would eradicate tumor cells with minimal ocular morbidity. Photodynamic therapy (PDT) is a relatively new and experimental means of treating tumors that are accessible to light. This approach offers dual selectivity for tumor tissue which is accomplished by the preferential retention of photosensitizer dye within the neoplastic tissue and restriction of the field of illumination to the tumor site. The potential of this modality to selectively target tumor cells makes PDT particularly attractive in anatomic regions where structural integrity is crucial for maintenance of vital functions. Ocular melanoma should be an ideal candidate for photodynamic therapy as it is easily visualized through dilated pupils and is accessible to direct illumination. An animal model of pigmented choroidal melanoma has been developed in our laboratory and with this model, biodistribution of various photosensitizers in the tumor-bearing eye will be evaluated to determine which photosensitizer dye is more suitable for PDT of ocular melanoma. Once the retention pattern of photosensitizers within choroidal melanomas and surrounding tissues is determined, the effectiveness of PDT in the destruction of pigmented choroidal melanomas will be evaluated. Melanoma- reactive antibodies will also be assessed for their potential to enhance the delivery of photosensitizers to the tumor site. Lastly, a photosensitizer angiography will be developed for the detection of photosensitizers in tumor-bearing eyes. The development of an effective photodynamic therapy that eradicates melanoma cells more selectively could enhance survival and provide better visual outcome for patients afflicted with ocular melanoma.