|Year : 1957 | Volume
| Issue : 4 | Page : 109-111
Results of beta ray therapy - reports of 85 cases
Department of Ophthalmology, Eye Infirmary, Medical College, Calcutta, India
|Date of Web Publication||9-May-2008|
Department of Ophthalmology, Eye Infirmary, Medical College, Calcutta
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sengupta M. Results of beta ray therapy - reports of 85 cases. Indian J Ophthalmol 1957;5:109-11
RADIOACTIVE substances emit alpha, beta and gamma rays and of them beta and gamma rays have the least penetrating power. Due to its low penetration the ionising effect is best marked in the superficial tissues and so beta rays are useful in their therapeutic action in superficial disorders of the eye. Beta irradiation have been reported (Sen 1954) to produce good results in vernal conjunctivities, recurrent pterygium, phlyctenular keratitis, rosacea keratitis, nodular episclerities, corneal vascularisation particularly after lime and other chemical burns, and papilloma and haemangioma of the conjunctiva or skin of the lid. In some other eye conditions like resistant chronic corneal ulcers (Mooren's ulcer, herpetic ulcer), sclerokeratitis Bowens disease, vascularised leucoma etc. beta therapy has been found to have some therapeutic action.
In ophthalmology beta irradiation is done by contact therapy from a surface applicator. The sources of beta ray in medical applicators are either radon or strontium go. Radon emits in addition to beta rays two per cent of gamma rays while strontium 90 emits beta rays as well as Yttrium go which in turn emits further beta rays. Strontium 90 does not emit the dangerous gamma rays, which are harmful to the intraocular structures particularly the lens. Therefore for ophthalmological work Strontium 90 Beta Ray applicator is suitable.
In the Eye Infirmary, Medical College, Calcutta Strontium go Beta Ray applicator is being used since 1954. The applicator has an output of 42 rep of beta rays per second and the diameter of the contact surface is about 12.7 m.m. The applicator is kept clean in its box and before use its contact surface is soaked in rectified spirit and wiped with sterile gauze to dry its surface. The patients' eyes are anaesthetised with one or two drops of per cent anethaine (Glaxo) solution and where necessary a speculum is inserted to retract the eye lids. Each course of therapy consists of exposures of 10 to 20 seconds twice per week till the total dosages are given. Upto December, 1956 altogether 85 eyes were treated with beta irradiation for various types of ocular diseases and their results are given below :-
Out of 85 eyes treated 55 eyes had vernal conjunctivitis, 15 treated for palpebral condition and 40 for bulbar condition. Vernal conjunctivities responds well with beta therapy and out of the two types bulbar type has better results. Symptoms disappear in 2-3 months time but the proliferative growths take some time to disappear. Palpebral type is more refractile and may require two or more exposures before complete disappearance. Seven out of 8 cases of recurrent pterygium following operation had good results with beta therapy. In the other case the progress of pterygium was checked in the short period of follow up and it is expected to give satisfactory result ultimately. Beta irradiation was also found to have beneficial effect in rosacea keratitis and phlyctenular keratitis with marked vascularisation though the number of cases was small. Beta ray therapy did not have any effect on 8 cases of Mooren's ulcer. It could neither check the progress of the ulcer nor alter the course of the disease. In corneal vascularisation beta therapy was effective . in 2 out of 8 cases. In 4 cases of long standing vascularisation of dense leucoma (corneal scar) beta therapy failed to obliterate the vessels. In i case of vascularised keratitis with Mantaux positive in 1 in 1000,000, beta irradiation not only failed but produced complications. In 3 cases of haemangioma of bulbar conjunctiva and in 1 case of haemangioma of skin of the lid the effect of beta therapy could not be assessed as the follow up period is too short.
Complications of beta irradiation.
Sixty two out of 85 cases had total dosage varying between 3200-4800 rep, twenty two cases had 6000 - 8000 rep and 1 case had 19,200 rep. Maximum period of follow up is 2 ˝ years. Therefore in this series the average dosage in large number of cases was not high and the follow up period was not long enough to evaluate the late effects of beta irradiation. However one case of corneal vascularisation with keratitis (where Mantaux test was strongly positive) requires special mention. After exposure with total dosage of 3200 rep as the condition did not show any improvement within 4 months locally cortisone 0.5 per cent drop was used for i week followed by a second course of beta radiation of 3200 rep. Immediately following the irradiation acute punctate corneal ulcer appeared in the central part of the cornea followed later on by the formation of a descemetocele. With the usual treatment the descemetocele healed up but the corneal vascularisation never disappeared. On the other hand limbal vessels showed telangiectatic dilatation. The only case which had total dosage of 19,200 rep was the palpebral type of vernal conjunctivitis. After irradiation there was scarring of the palpebral conjunctiva but even with such a high dosage all the follicles did not disappear.
| Discussion|| |
Results of beta radiation in vernal conjunctivitis, recurrent pterygium, rosacea keratitis, phlyctenular keratitis in the present series of cases confirm the good results already obtained by other workers. Mooren's ulcer and vascularised old leucoma failed to show any therapeutic effect. Complications of irradiation like telangiectasis keratinization of the conjunctiva, superficial punctate keratitis, corneal scarring, atrophy of the sclera, atrophy of the ciliary body with hypotony, iritis, iris atrophy, secondary glaucoma, radiational cataract etc. as described as late effects
| Summary|| |
Results of beta ray therapy on 85 eyes are described. Of them 55 eyes had vernal conjunctivitis, 8 recurrent pterygium, 8 Mooren's ulcer, 8 corneal vascularisation, 3 haemangioma of conjunctiva, 1 haemangioma of skin of the lid, I rosacea keratitis and 1 phlyctenular keratitis. One case had complication after beta radiation.
| Acknowledgment|| |
I take this opportunity to thank Mrs. Watumull of Watumull Foundation, Honolulu, Hawii, for presenting the Strontium 90 Beta Ray Applicator to the Eye Infirmary, Medical College, Calcutta.
| References|| |
Merriam, George, R., (1955), Arch. Ophthal, Vol. 53, No. 5, p. 708.
Sen, K. L., (1954), J. of I. M. A., Vol. XXIII No. 9, pp. 396-398.