Ocular Oncology Center Pediatric and Adult

• Benign ocular tumors
• Primary Acquired Melanosis
• Iris Nevus
• Choroidal Nevus
• Vascular Tumors
• Uveal Tumors
• Choroidal Melanoma
• Ciliary Body Melanoma
• Iris Melanoma
• Choroidal Intraocular Lymphoma
• Ocular Metastases
• Ocular surface tumors
• Conjunctival Lymphoma
• Conjunctival Melanoma
• Conjunctival Intraepithelial Neoplasia
• Ocular Surface Squamous Neoplasia
• Rhabdomyosarcoma
• Retinoblastoma

Instructions for the patient

• Please do not drive to your appointment at our Center.
• The dilating drops you might need to receive during your visit to perform a detailed examination of the back of your eyes may blur your vision and increase your sensitivity to light for up to six hours.
• We recommend booking flexible travel arrangements to accommodate changes if you are travelling and live outside Athens.

What to bring to your appointment

• A list of your current medications.
• Distance glasses (if prescribed).
• Sunglasses (even if it’s not sunny, as they will help decrease the effects of the dilating drops).

In the case of an adult patient with ocular oncology conditions

After checking-in with our receptionist, your visit will continue with the following steps:

• A qualified Ocular Oncology Nurse will collect information about your general health, medical history, ocular history and any current medications you are taking.
• An Optometry specialist will perform a detailed check of your vision.
• A specialist Ocular Oncology Nurse will, if necessary, administer dilating drops to dilate your pupils so that a funduscopy with a detailed examination of the posterior segment of the eye can be performed.
• It may be necessary for Dr. Pefkianaki to follow up your examination with a diagnostic high-resolution and high-definition ultrasound examination of the posterior and/or anterior segment of your eye.
• An Ocular Oncology Diagnostic Imaging specialist may need to obtain optical coherence tomography images of the anterior and/or posterior segments of your eye, autofluorescence images, and images of the anterior and/or posterior segments of your eye.
• In some patient cases, you may need either Fluorescein Angiography, which depicts an additional vascular network that develops in malignant tumors as opposed to benign tumors, or Indocyanine Angiography ICGA.

In the case of a pediatric patient with ocular oncology conditions

Depending on the age of the child, it is possible that during the visit an ophthalmological examination under general anesthesia may need to be scheduled to thoroughly investigate and exclude or confirm certain ocular diseases.

During the examination under general anesthesia, it is also possible that the following diagnostic tests may need to be performed:

• Optical Coherence Tomography of the anterior and/or posterior segment of the eye with a Hand-Held LEICA Optical Tomography System, which our Center has and is the only one in Europe.
• Images of the anterior and/or posterior segment of the eye with the Retcam Envision diagnostic machine, which our Center has and is the only one in Greece.
• It may be necessary to perform a Fluorescein Angiography during the examination under general anesthesia. Fluorescein Angiography is a diagnostic test in which a special camera is used to capture certain images of the retina located at the posterior segment of the eye.

• Dr. Pefkianaki will discuss the findings and answer your questions.
• We will guide you through the diagnostic and treatment process.
• We provide instructions, leaflets, a note of findings, and a 24-hour telephone support line.
• Separate clinical days and operating rooms for adults and children.

• Gamma-Knife Radiosurgery

1. • High dose of radiation in one session, without recovery.
   • Applied for the treatment of ocular melanoma.

• Transpupillary Thermotherapy treatment with the possibility of large and small spots
  Semiconductor diode lasers that deliver true continuous wave infrared laser (810 nm) light for a variety of ocular conditions. Can be used in combination with other treatments in patients with choroidal melanoma.

• Treatment with 810 nm laser, via indirect ophthalmoscope. Adds the therapeutic potential of transpupillary retinal photocoagulation to the wide-angle diagnostic capabilities of a binocular indirect ophthalmoscope.
  One of the most important treatments, primary or adjunctive/combined, for children with Retinoblastoma.

• Green Patented MicroPulse Laser Therapy 532nm

In ocular oncology patients, laser retinal photocoagulation can be used in the case of radiation-induced retinopathy, to destroy or limit retinal ischemia caused by radiation in the eye, or to treat radiation-induced maculopathy.

• Green Laser administered through an ophthalmoscope
  The laser focuses on the blood vessels surrounding and feeding the tumor, achieving its destruction through heating. Its use alone or in combination with other treatments is effective in treating patients, adults or children, with benign or malignant ocular tumors
• Cryotherapy
  • Using a small metal probe that is cooled to very low temperatures, killing the cancer cells by freezing them.
  • Cryotherapy can be used as primary or adjunctive/combined therapy in patients with Retinoblastoma as well as in various types of Adult Ocular Tumors.
• Intravitreal chemotherapy
  A targeted treatment in patients with Retinoblastoma in which chemotherapeutic medications are injected directly to the affected area of the eye, into the vitreous humor, resulting in increased availability of the chemotherapeutic medication in the eye at a specific stage of Retinoblastoma.
• Intra-arterial chemotherapy
  • Administration of chemotherapy through an ophthalmic artery.
  • Reducing the need for eye removal.

• Intra-arterial chemotherapy
  The dose of chemotherapy is released into the ophthalmic artery. A targeted treatment in patients with Retinoblastoma in which chemotherapy drugs are administered locally through a thin catheter through the ophthalmic artery directly into the eye resulting in increased drug availability at the tumor site.
  This curative treatment has reduced the number of eye removals for retinoblastoma by half.

• Topical chemotherapy

1. • Use of eye drops to treat tumors on the surface of the eye.

• Enucleation

1. • Surgical removal of the eyeball.

• Orbital exenteration
• External beam radiotherapy

We provide genetic counseling and testing for prevention and treatment with gene analysis to better assess risk of ocular tumors, particularly retinoblastoma and choroidal melanoma.