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Patients, physicians and technology interact to advance future treatments in ocular oncology
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NEW YORK — Treatment of retinoblastoma has come a long way since the American Ophthalmological Society first met in 1864, with smartphones now playing a role in patients’ hands, according to Carol L. Shields, MD.
Speaking at the 150th anniversary meeting of the AOS here, Shields said, “I can imagine at the AOS 100th meeting, if someone said you could take a picture with your telephone, that would have been thought to be crazy.” But, smartphone cameras are being used to take fundus photos, she said, even at the patient level, with patients’ families having access to such technology.
“At the doctor level with regard to retinoblastoma, we have excellent chemotherapies,” Shields said, adding that worldwide access to existing therapies is needed and physicians in developing countries need training in how to use them.
However, future treatments will be less toxic and will move beyond chemotherapy, she said.
“At the genetics level, we know how to remove the gene — engineer the gene — out of the family genome using preimplantation genetic diagnosis,” Shields said.
Regarding the future of melanoma, “In a nutshell, it’s down to the patient level, the doctor level and a molecular pathway level,” Shields said. “At the patient level, we need to educate families about the importance of annual eye care. … Again, I think smartphone technology is going to play a role in detection at the patient level.”
At the physician level, all ophthalmologists need to know how to detect melanoma early, Shields said.
“And at the molecular pathway level, we are understanding the molecular mistakes that lead to the development of melanoma,” she said. “There are multiple mutations along the way that lead to the development of a nevus, then the transformation of a nevus into a melanoma.”
By understanding the pathway, drugs can be developed to block progression of metastatic disease at points along the pathway.
Disclosure: Shields has no relevant financial disclosures.