July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Trends in radiation practices for female ocular oncologists in North America
Author Affiliations & Notes
  • Sona Shah
    USC Roksi Eye Institute, University of Southern California, Los Angeles, California, United States
  • Zelia M Correa
    University of Cincinnati, Cincinnati, Ohio, United States
  • Amy C Schefler
    Retina Consultants of Houston, Houston, Texas, United States
  • Kaitlin Kogachi
    USC Roksi Eye Institute, University of Southern California, Los Angeles, California, United States
  • Mary E Aronow
    Massachussetts Eye Sand Ear Infirmary, Harvard Medical School, Boston, California, United States
  • Sonia Callejo
    Montreal University, Montreal, Quebec, Canada
  • Shelley Day
    Austin Retina Associates, Austin, Texas, United States
  • Katherine Paton
    University of British Columbia, Vancouver, British Columbia, Canada
  • Isabella Phan
    Kaiser Permanente, San Francisco, California, United States
  • Carol L Shields
    Ocular Oncology Service, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Alison Skalet
    Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States
  • Richard Jennelle
    Department of Radiation Oncology, Los Angeles, California, United States
  • Jesse L Berry
    USC Roksi Eye Institute, University of Southern California, Los Angeles, California, United States
    Children’s Hospital Los Angeles, Los Angeles, California, United States
  • Footnotes
    Commercial Relationships   Sona Shah, None; Zelia Correa, None; Amy Schefler, None; Kaitlin Kogachi, None; Mary Aronow, None; Sonia Callejo, None; Shelley Day, None; Katherine Paton, None; Isabella Phan, None; Carol Shields, None; Alison Skalet, None; Richard Jennelle, None; Jesse Berry, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 3623. doi:
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      Sona Shah, Zelia M Correa, Amy C Schefler, Kaitlin Kogachi, Mary E Aronow, Sonia Callejo, Shelley Day, Katherine Paton, Isabella Phan, Carol L Shields, Alison Skalet, Richard Jennelle, Jesse L Berry; Trends in radiation practices for female ocular oncologists in North America. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3623.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : Ocular oncologists who perform plaque brachytherapy are exposed to radiation. This exposure may be more worrisome for female surgeons, particularly during pregnancy. We conducted a survey study to examine the exposure of female ocular oncologists to radiation, consequent levels of concern, and precautionary risk modifications.

Methods : Twelve female ocular oncologists regularly performing plaque brachytherapy in North America were identified by their registration in the International Society of Ocular Oncology. Ten completed the anonymous Qualtrics survey of 17 questions regarding safety training at their institutions, radiation exposure, and precautions during pregnancy. They also ranked their consequent anxiety levels regarding fertility.

Results : Demographics and responses are shown in Table 1. Eight participants (80%) report monitoring their yearly radiation exposure; four report doses ranging from <1 to 20 mSv, while the other four had exposure reports of ‘minimal’ per their institution. Two participants (20%) report their radiation exposure was not being monitored. Nine report using a non-active plaque to prepare for plaque implantation. Five (50%) report using no lead protection during surgery.
Of the 7 women who experienced pregnancy, six continued to perform plaque brachytherapy treatments while pregnant; one stopped. Five increased their protective practices during pregnancy. Participants rated their anxiety regarding fertility on a scale from zero to ten; the average reported anxiety was 2.7 (SD, 2.2).

Conclusions : This survey study corroborates prior oncology literature that radiation exposure to surgeons during plaque brachytherapy is minimal. Nonetheless there remains some anxiety regarding exposure risk. Many women continued to perform brachytherapy during pregnancy with appropriately increased precautions. The NCRP sets the maximum total body radiation exposure at 50mSv/year, with more stringent rates for pregnant women. The female ocular oncologists who completed the survey all reported exposure rates less than 20mSv. We additionally found high variability in routine exposure monitoring, utilized protective measures, and required training amongst this group of ocular oncologists. Improved education and clearer pregnancy guidelines regarding radiation exposure may help equip female surgeons with optimal understanding of needed precautions.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.


Table 1. Demographics and Responses of Survey Participants

Table 1. Demographics and Responses of Survey Participants


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