Choroidal melanoma is a primary intraocular malignant tumor common in adults. Enucleation of the eye is the conventional treatment for larger choroidal melanoma, but it is a disfigure procedure that causes severe physical and mental harm to the patient. Different from enucleation, local intraocular surgical resection, especially vitrectomy, has the potential to be used as an eye-preserving treatment for choroidal melanoma. After surgery, medium - and long-term intraocular tamponade is usually performed with expandable gas or silicone oil. However, the intumescent gas used for internal tamponade is usually inconvenient for the patient. Silicone oil requires additional removal procedures to avoid potential complications, such as increased intraocular pressure, cataracts, temporary vision loss, and long-term retinal toxicity. More importantly, cancer cells often invade the local lamellar sclera and easily remain at the edge of the resected tissue, leading to a high postoperative recurrence rate. Considering the complex ocular structural barrier and the low immunogenicity of choroidal melanoma, intravenous immune checkpoint inhibitors cannot achieve effective therapeutic effects in previous studies, while intraocular injection may cause many adverse effects, such as uveitis, endophthalmitis, and retinal detachment.
Recently, Professor Chen Qian's team of our Institute developed an artificial vitreous body (AVB) hydrogel to control the recurrence of choroidal melanoma, and at the same time, it can be used as an artificial vitreous body for long-term retention of visual function after vitrectomy. AVB hydrogel can be used to adjust the concentration and mixing ratio of two four-arm polyethylene glycol highly branching polymers (Tetra-PEG) to achieve the appearance and physical properties similar to natural vitreous, including rheological behavior, light transmittance, swelling rate, water content, density, etc. AVB hydrogel is a good intraocular implant that can replace natural vitreous. In the early stage of filling, AVB hydrogel acts as a drug reservoir to sequentially release chemotherapy drugs and immune checkpoint blockers to inhibit the recurrence of intraocular choroidal melanoma after surgery. In the late filling stage, after the drug is released, AVB hydrogel itself is used for long-term intraocular filling, which can preserve the normal structure and visual function of the affected eye. The results were published online in Science Advances (Sci. Adv. 2023, 9, eadh1582) on November 1, 2023. PhD student Muchao Chen is the first author of this paper.
Link to paper: https://www.science.org/doi/10.1126/sciadv.adh1582
Title: An immunotherapeutic artificial vitreous body hydrogel to control choroidal melanoma and preserve vision after vitrectomy
Author: Muchao Chen, Jiaying Hu, Huiqin Gao, Jingjing Shen, Ting Wei, Jing Yao, Yan Zhang, Ping Gu, Zhuang Liu, Qian Chen*
Editor: Guo Jia