Szemészet, 2004 (141. évfolyam, 1-4. szám)

2004-06-01 / 2. szám

141. évfolyam (2004)

Diagnosis and therapy of tumours of the eye and surrounding tissues over the past 100 years, as reflected in papers in the Hungarian journal

of ophthalmology

Berta A.

University of Debrecen, Medical and Health Science Center, Dept, of Ophthalmology

Papers on ocular tumours published in the journal “Szemészet” (“Ophthalmology”) between 1904 and 2003 were evaluated from two aspects:

1. Quantitative: How many (and what proportion of) papers dealt with such tumours? What was the distribution for different tumour types?

2. Medical/historical: How have diagnostic/ therapeutic methods for Hungarian ophthalmo-oncological patients changed; and which were (and are) the most important treatment centres, and the specialists who contributed significant advances?

Despite some apparently missing volumes, we believe that our evaluation covers 98-99% of all “Szemészet” issues for the period. Society lectures were considered as papers if their text was published, even in shortened form; we identified a total of 3459 papers on all topics. Among these, 203 (5.9%) dealt with ocular tumours; a high proportion, considering the specialised nature of the subject. The distribution for various tumour types was: intraocular, 98 (48.3%); eyelid or facial, 46 (22.7%); orbital, 27 (13.3%); conjunctival, 23 (11.3%); corneal, 7 (3.4%); lachrymal gland, 2 (1.0%).

The papers were also analysed for three historical sub-periods. Most articles dealt with the management of injuries or with infectious eye diseases, the most common eye problems of the period. The highest number of all types of paper, and also by far the highest number and percentage of papers dealing with tumours, were published after the Second World War. The average numbers of all papers were: 1904-1914, 38.4 papers/year; 1914-1945, 28.2 papers/year; 1945-2003, 45.7 papers/year. The total numbers (and % of all papers in the sub-period) concerning ocular tumours were: 1904-1914, 16 (4.2%); 1914-1945, 7 (1.2%); 1945-2003, 180 (7.2%).

Though already in 1904 three important oncological papers were published (“Patients suffering from lid epithelioma treated with radium”; “Malignant rhabdomyoma of the orbit”; “Melanosarcoma of the conjunctiva”), ophthalmic oncology has since then made many advances. For tumours of the eyelid and face the most important surgical innovators were József Imre jun. (the arched or “Hungarian” plasty), László Blaskovics and Aladár Kettesy, who developed various lid operations, and István Csapody (the cavital or contracted-socket plasty). The Debrecen Eye Clinic and the 1st Department of Ophthalmology in Budapest are important centres where ophthalmic plastic-surgeries are performed at a high level. At these two clinics the school-creating activity of Magdolna Zajácz and the successful work of Olga Lukács deserve special mention.

In the early 1970s Béla Alberth reported his experiences with iridectomies and iridocyclectomies. The Ophthalmology Department of the National Institute for Neurosurgery (under László Remenár and subsequently Márta Hajda) is a centre for the management of orbital tumours, using modern diagnostic methods and eye-saving radical orbital operations. Remenár also performed pioneering work using radiotherapy and cryotherapy for retinoblastoma in children. In connection with radiotherapy of the surroundings of the eye we must also mention Iván Ródé (orthovolt Röntgen and cobalt therapy), working in the 1950s - 1960s, and András Bajcsay who more recently has treated patients using the linear accelerator. Brachytherapy of intraocular tumours with ruthenium applicators has been carried out in Hungary since 1986 at the Debrecen Eye Clinic (András Berta, Judit Damjanovich, Béla Alberth). Thermotherapy of chorioidea melanomas using the diode laser was first performed here by Bálint Kovács at the Pécs Eye Clinic.

4 June 2004

History of Hungarian ophthalmology II.