The Collaborative Ocular Melanoma Study (COMS)

Principal Investigator:  Paul Finger, M.D.

The New York Eye and Ear Infirmary participated as a clinical center for this nation- wide study evaluating treatment of intraocular (choroidal) melanoma. This study is supported by both the National Institute of Health and The National Eye Institute. This successful study found that 20GY of pre-operative radiation therapy prior to enucleation did not improve survival.

In addition, the medium-sized tumor trial completed enrollment. This study determined that iodine-125 plaque-irradiation was equivalent to enucleation (removal of the eye) for the prevention of metastatic choroidal melanoma at 5 and 10 years follow up.

Dr. Paul Finger, was a Principal Investigator of this study performed at The New York Eye and Ear Infirmary’s Ocular Tumor Service.

Palladium-103 Ophthalmic Plaque Radiation Therapy: Since 1990, Dr. Finger first used a new isotope (radionuclide) for the treatment of intraocular tumors. Multiple dosimetry studies have indicated that in most cases, Palladium-103 (Theragenics Corp. Norcross, Georgia) offers a more favorable dose distribution than other types of plaque radiation. So far, no comparative clinical studies have proved whether these differences will change the incidence of radiation associated complications.

Mitomycin C Eye Drops for Conjunctival Cancer: First used against conjunctival melanomas by Dr. Finger and his colleagues at The New York Eye and Ear Infirmary, mitomycin c chemotherapy eye drops are now being used for conjunctival cancers in centers around the world.

3 Dimensional Ultrasonography: Dr. Finger was the first ophthalmic oncologist to use 3D ultrasound to image radioactive eye-plaques while they were sewn beneath their intraocular tumors. This technique was used to confirm proper plaque placement. Further studies are being directed toward improving radiation dose calculations. We have used this technique to measure the actual distances between the radioactive seeds and the tumor. In vivo dosimetry should allow for more accurate radiotherapy.

Anti-VEGF Therapy for Radiation Retinopathy: In 2007, Dr. Finger published the first reported experience using Avastin for radiation retinopathy and optic neuropathy. Published in the American Journal of Ophthalmology, the Archives of Ophthalmology and the International Journal of Radiation Oncology, Biology, Physics, Dr. Finger showed that anti-VEGF therapy decreased the hemorrhage, exudate and fluid causing radiation-related loss of vision after cancer therapy.