"Diagnostic imaging enables us to select the most appropriate treatment for each tumour"

The Instituto de Microcirugía Ocular in Barcelona (IMO) is one of the leading centres in the field of ocular oncology.

We spoke to him to find out about the latest advances in the treatment of the most common tumours that affect the eyes.

What’s the most common eye tumour found in adults?
In terms of malignant tumours, the most common is choroidal melanoma, a very aggressive type of cancer that causes metastasis in the liver, so it is important to detect it early and treat it correctly. Regarding benign tumours, the most common is choroidal haemangioma. It is benign, as it does not cause metastasis or any risk to other organs in the body, but it does affect vision, because it tends to grow near the optic nerve.

And in children?
The most common malignant tumour is undoubtedly retinoblastoma. It is a tumour that can occur in the first months of life and is inherited in 50% of cases. It tends to affect both eyes and is very aggressive. It is estimated that one in every 15,000 newborn infants suffers from it, and it is treated with a combination of chemotherapy and radiotherapy.

How do you know if a baby is suffering from retinoblastoma?
The most obvious symptom is the appearance of a white spot in the infant’s pupil. Although this spot can be caused by various conditions, it is important to visit the ophthalmologist immediately. As a general rule, a pupil that is not completely black has some kind of problem.

What role does technology play in the successful treatment of these types of cancer?
Technology has advanced considerably in recent years and enables us to combat intraocular tumours with an ever-increasing success rate. To begin with, having diagnostic imaging technology like 3D ultrasound imaging, retinography, wide-field angiography and nuclear magnetic resonance enables us not only to perform precise and early diagnosis, but also to study the height, size, type, growth rate and specific location of the tumour in order to be able to select the most appropriate treatment.

Can technology be used in treatment as well?
Absolutely. Brachytherapy, which is used in the treatment of choroidal melanoma, uses ruthenium 106 or iodine 125 plates that have advanced greatly in recent years, so much so that today we can ensure that radiation does not affect other parts of the body other than the eye, minimising possible side effects. A similar case in point is endoresection, a microsurgery technique, which, when combined with radiotherapy, provides very good results.

What scope for innovation exists in this speciality?
At IMO, we have shown that it is possible to make innovations in ocular oncology techniques. We were pioneers in the use of brachytherapy with ruthenium. We have also carried out multicentre clinical studies that have demonstrated the effectiveness of photodynamic therapy for the treatment of choroidal haemangioma, which is the current treatment of choice for these tumours. I do, however, think that the future of the speciality lies in pharmacogenetics, in other words, the study of DNA and tumour tissue in order to be able to create drugs that can effectively attack only cancer cells.