gms | German Medical Science

So far no common classification exists to compare different types of intraocular tumor regression and the severity of side effects after globe preserving tumor therapies. The goal of this paper was to establish a simple classification for tumor regression (following radiotherapeutic guidelines) and a classification for side effects whereby the visual function was correlated with morphologic radiogenic fundus changes.

For the sake of simplicity a 4 level graduation was selected, which as a red thread pulls itself through the entire classification. At our patient collective after Gamma Knife radio surgery uniform parameters of tumor regression were applied (1. total tumor regression, 2. partial tumor regression, 3. growth stop, 4. recurrance) The side effects were classified in 1. mild, 2. moderate, 3. severe and 4. very severe.

The visual function as a central parameter was correlated with the morphologic changes of the optic nerve, macula, lens and retina. The reading ability of the patient was classified again into 4 groups (reading ability, reading ability with visual aids, orientating vision, and (practical) blindness). The morphologic radiogenic changes in the eye were correlated with the central visual acuity , the visual field and the reading ability of the patient.

With this simple classification our results of a high dose and a low dose Gamma Knife radiosurgery could be compared , classified and correlated to daily abilities of the patient. In the nearby future this classification is going to be expanded to other therapies like transpupillary thermo therapy (TTT) or Ruthenium 106 brachytherapy. It now offers the possibility of accomplishing studies regarding globe preserving therapies according to Good Clinical Practise (GCP).