News and Information
Featured Stories
Dr. Miguel Materin Joins Yale as Director of Ocular Oncology
Miguel Materin, MD, joined Yale University School of Medicine on January 1, 2009 as Assistant Professor of Ophthalmology and Director of Ocular Oncology. Ocular oncology is a specialty that involves diagnosis and treatment of patients with ocular tumors, including benign and malignant tumors of the eye. Dr. Materin comes to Yale from Wills Eye Hospital at Thomas Jefferson University in Philadelphia, where he served as Director of Diagnostic Studies for the Ocular Oncology Service.
Dr. Miguel Materin
Dr. Materin’s goal, and the goal of the Ocular Oncology Section at Yale, is to improve the prognosis of these rare diseases in terms of life, conservation of the eye, and sight. “The most important thing I want people to know is that cancer of the eye is a rare disease, but once the tumor is found we can begin the treatment process; the key is to be diagnosed and treated correctly,” said Dr. Materin.
As a retinal specialist in Buenos Aires, where Dr. Materin received his medical degree, he received referrals of patients with tumors of the eye, both benign and malignant. Realizing there was a great need for the specialty he decided to pursue a fellowship in ocular oncology at Thomas Jefferson University. He is an internationally recognized ocular oncologist and has a special interest in ocular melanoma and retinoblastoma.
According to Dr. Materin, the most common benign intraocular tumor is a choroidal nevus, occurring in 6% of the Caucasian population, most typically in those with fair skin, hair, and eyes. The most common primary malignant tumor of the eye in adults is melanoma.
Malignant tumors of the eye are potentially life-threatening conditions that affect people without distinction of age, gender, or race. They can be either primary tumors that originate in the eye, or a tumor that has metastasized from somewhere else in the body. The most common cancers known to metastasize to the eye are breast and lung cancer.
Melanoma of the eye is often detected during a routine eye exam with no symptoms present, however symptoms can occur, including blurred vision, floaters, flashes, change in color of the iris, or a red, painful eye, among others. A complete eye exam, ultrasound, and sometimes a biopsy, are used to confirm a diagnosis.
When reviewing prognosis, there are three different topics to discuss: life prognosis, eye prognosis, and vision prognosis. In terms of life, there is a 30 to 40% chance for metastatic disease occurring from eye cancer; regarding the eye, most patients can conserve the eye with conservative treatments, and finally vision, these patients have a 50% chance of losing some vision, either due to the tumor or to the treatment.
Dr. Materin hopes to soon have a clinical trial available at Yale for melanoma of the eye in order to increase the survival of patients. Working with the Yale Department of Genetics in the area of Cytogenetics, and the section of Medical Oncology, Dr. Materin is in the process of conducting several DNA analyses of different chromosomes hoping to find a way to better determine the prognosis of patients with melanoma of the eye.
Retinoblastoma, the most common intraocular malignancy in children, is also at the center of one of Dr. Materin’s current projects. “There are new options for treatment of patients with retinoblastoma. We are working to provide our patients with the option of intra-arterial chemotherapy so systemic chemotherapy, external beam radiation, and enucleation could potentially be avoided. This would allow us to use high doses of chemotherapy, injected directly into the artery leading to the affected eye, hopefully reducing the risks for systemic complications,” said Dr. Materin. This treatment is currently being used at Memorial Sloan Kettering Cancer Center in New York with good results.
Retinoblastoma usually affects children during the first two years of life and can be both inherited, germ-line mutation, or non-inherited, somatic mutation. Dr. Materin explained that genetic testing for the RB1gene is available if a retinoblastoma is found. This is recommended due to the fact that a germ-line mutation affects all cells, and can increase the risk for 2nd and 3rd cancers later in life. Advancements in treatment for retinoblastoma during the latter half of the 20th century have increased the survival rate from nearly 0% to almost 95%.
Dr. Materin commented that Yale has provided him with all of the equipment needed to provide state-of-the-art care to his patients. “I am happy to have the opportunity to work at Yale and provide the best care possible to patients here,” said Dr. Materin. “The most important thing when we are dealing with cancer of the eye is saving the patient’s life. Next we concentrate on saving the eye and vision. In this field it is a constant fight for life, and sight.”