Purpose: Iris neovascularization (INV) and anterior chamber angle neovascularization after radiotherapy for uveal melanoma may lead to neovascular glaucoma and enucleation. However, neovascularization of the anterior ...Purpose: Iris neovascularization (INV) and anterior chamber angle neovascularization after radiotherapy for uveal melanoma may lead to neovascular glaucoma and enucleation. However, neovascularization of the anterior ocular segment may respond favorably to treatment with panretinal photocoagulation. The purpose of this study was to evaluate the frequency, interval to development, and predisposing factors of anterior ocular segment neovascularization following iodine 125 (I125)- brachytherapy for uveal melanoma. Design: Retrospective, interventional, consecutive case series. Participants: Sixty- five patients (65 eyes), consecutively treated with I125 brachytherapy for uveal melanoma from 1995 through 2000 and followed up after radiation therapy for 24 months or more. Methods: Clinical findings and ultrasonography characteristics as well as treatment parameters were analyzed. Main Outcome Measures: The frequency of INV was determined and the interval to development of INV as well as the predisposing factors were analyzed statistically. Results: In 15 of 65 eyes (23% ), INV was detected after I125 brachytherapy at a mean± standard deviation of 26.66± 11.63 months (median, 24 months; range, 9- 48 months). Risk factors displaying the stronger correlation with INV were greater maximal tumor height (P< 0.01), greater tumor vascularity (P< 0.01), and disinsertion of horizontal rectus muscles (P=0.01). Conclusions: After I125 brachytherapy for choroidal melanoma, INV developed in 23% of eyes and was correlated with larger tumor size, greater tumor vascularity, and disinsertion of a horizontal rectus muscle.展开更多
Purpose: To describe a case of conjunctival hyperaemia and proptosis of the ri ght eye. Methods: Three-dimensional computed tomography (CT) was performed to r eveal the size and position of a lesion of osseous density...Purpose: To describe a case of conjunctival hyperaemia and proptosis of the ri ght eye. Methods: Three-dimensional computed tomography (CT) was performed to r eveal the size and position of a lesion of osseous density extending into the ri ght orbit. The lesion was then excised using a right paranasal transcutaneous ap proach. Results: The pathology report suggested ethmoidal osteoma. The postopera tive course was uncomplicated and the lesion did not recur during a 5-year foll ow-up period. Repeated postoperative ophthalmic examinations revealed preservat ion of visual acuity and visual fields postoperatively. Discussion: Diagnosis is based on imaging studies, especially CT and three-dimen- sional CT scans. A three-dimensionalCT scan is critical in understanding the actual dimensions of the tumour and its relations with other structures. Surgica l removal is indicated in cases with orbital matrix compression and displacement . A transcutaneous paranasal approach allows for increased exposure of affected structures.展开更多
Aims: Ophthalmic pterygium is a potentially vision-threatening lesion of unkn own etiology, related to an exposure to solar light. Mutations to the ras genes are frequently observed in lesions related to an exposure t...Aims: Ophthalmic pterygium is a potentially vision-threatening lesion of unkn own etiology, related to an exposure to solar light. Mutations to the ras genes are frequently observed in lesions related to an exposure to solar light. The pr esent study aims at screening pterygia for mutations at codons 12 and 13 of the ras genes. Methods: In all, 50 pterygia were examined, together with respective blood samples and specimens of normal conjunctiva. A PCR reaction was performed to amplify sequences containing codons 12 and 13 of Ki-ras, H-ras, and N-ras. An RFLP analysis was then performed to detect point mutations at codon 12. The mutational status at codons 12 and 13 was further explored with sequencing of PC R products. Results: RFLP analysis revealed Ki-ras mutations at codon 12 in fiv e (10%) of pterygia, whereas H-ras or N-ras mutations were not observed. Sequ encing confirmed Ki-ras mutations at codon 12 and revealed absence of mutations at codon 13. The presence of Ki-ras mutations was significantly correlated wit h postoperative recurrence (P=0.02) and young age (P=0.04). Mutations were not o bserved in specimens of blood or normal conjunctiva for any of the genes examine d. Conclusions: The absence of Nras mutations is in agreement with previous repo rts concerning mucosal lesions. The detection of Ki-ras mutations and the assoc iation with postoperative recurrence implies a possible role of Ki-ras in the c linical profile of pterygium. The mechanism of Ki-ras mutations is unclear and could be independen t of the action of UV light.展开更多
Brain metastases from choroidal melanoma are rare and usually have a grave prognosis. A case of successfully treated late isolated brain metastasis from choroidal melanoma is described. A 35-year-old man presented wit...Brain metastases from choroidal melanoma are rare and usually have a grave prognosis. A case of successfully treated late isolated brain metastasis from choroidal melanoma is described. A 35-year-old man presented with epileptic seizures of recent origin, 9 years following enucleation for choroidal melanoma. Imaging studies revealed a lesion of the right frontal lobe that was surgically removed. Results of pathologic examination were compatible with metastatic choroidal melanoma. The patient is a symptomatic 5 years post-operatively. Late isolated brain metastases from uveal melanoma may be treatable by local resection. Close, lifelong follow-up is required to diagnose and aggressively treat metastatic disease.展开更多
文摘Purpose: Iris neovascularization (INV) and anterior chamber angle neovascularization after radiotherapy for uveal melanoma may lead to neovascular glaucoma and enucleation. However, neovascularization of the anterior ocular segment may respond favorably to treatment with panretinal photocoagulation. The purpose of this study was to evaluate the frequency, interval to development, and predisposing factors of anterior ocular segment neovascularization following iodine 125 (I125)- brachytherapy for uveal melanoma. Design: Retrospective, interventional, consecutive case series. Participants: Sixty- five patients (65 eyes), consecutively treated with I125 brachytherapy for uveal melanoma from 1995 through 2000 and followed up after radiation therapy for 24 months or more. Methods: Clinical findings and ultrasonography characteristics as well as treatment parameters were analyzed. Main Outcome Measures: The frequency of INV was determined and the interval to development of INV as well as the predisposing factors were analyzed statistically. Results: In 15 of 65 eyes (23% ), INV was detected after I125 brachytherapy at a mean± standard deviation of 26.66± 11.63 months (median, 24 months; range, 9- 48 months). Risk factors displaying the stronger correlation with INV were greater maximal tumor height (P< 0.01), greater tumor vascularity (P< 0.01), and disinsertion of horizontal rectus muscles (P=0.01). Conclusions: After I125 brachytherapy for choroidal melanoma, INV developed in 23% of eyes and was correlated with larger tumor size, greater tumor vascularity, and disinsertion of a horizontal rectus muscle.
文摘Purpose: To describe a case of conjunctival hyperaemia and proptosis of the ri ght eye. Methods: Three-dimensional computed tomography (CT) was performed to r eveal the size and position of a lesion of osseous density extending into the ri ght orbit. The lesion was then excised using a right paranasal transcutaneous ap proach. Results: The pathology report suggested ethmoidal osteoma. The postopera tive course was uncomplicated and the lesion did not recur during a 5-year foll ow-up period. Repeated postoperative ophthalmic examinations revealed preservat ion of visual acuity and visual fields postoperatively. Discussion: Diagnosis is based on imaging studies, especially CT and three-dimen- sional CT scans. A three-dimensionalCT scan is critical in understanding the actual dimensions of the tumour and its relations with other structures. Surgica l removal is indicated in cases with orbital matrix compression and displacement . A transcutaneous paranasal approach allows for increased exposure of affected structures.
文摘Aims: Ophthalmic pterygium is a potentially vision-threatening lesion of unkn own etiology, related to an exposure to solar light. Mutations to the ras genes are frequently observed in lesions related to an exposure to solar light. The pr esent study aims at screening pterygia for mutations at codons 12 and 13 of the ras genes. Methods: In all, 50 pterygia were examined, together with respective blood samples and specimens of normal conjunctiva. A PCR reaction was performed to amplify sequences containing codons 12 and 13 of Ki-ras, H-ras, and N-ras. An RFLP analysis was then performed to detect point mutations at codon 12. The mutational status at codons 12 and 13 was further explored with sequencing of PC R products. Results: RFLP analysis revealed Ki-ras mutations at codon 12 in fiv e (10%) of pterygia, whereas H-ras or N-ras mutations were not observed. Sequ encing confirmed Ki-ras mutations at codon 12 and revealed absence of mutations at codon 13. The presence of Ki-ras mutations was significantly correlated wit h postoperative recurrence (P=0.02) and young age (P=0.04). Mutations were not o bserved in specimens of blood or normal conjunctiva for any of the genes examine d. Conclusions: The absence of Nras mutations is in agreement with previous repo rts concerning mucosal lesions. The detection of Ki-ras mutations and the assoc iation with postoperative recurrence implies a possible role of Ki-ras in the c linical profile of pterygium. The mechanism of Ki-ras mutations is unclear and could be independen t of the action of UV light.
文摘Brain metastases from choroidal melanoma are rare and usually have a grave prognosis. A case of successfully treated late isolated brain metastasis from choroidal melanoma is described. A 35-year-old man presented with epileptic seizures of recent origin, 9 years following enucleation for choroidal melanoma. Imaging studies revealed a lesion of the right frontal lobe that was surgically removed. Results of pathologic examination were compatible with metastatic choroidal melanoma. The patient is a symptomatic 5 years post-operatively. Late isolated brain metastases from uveal melanoma may be treatable by local resection. Close, lifelong follow-up is required to diagnose and aggressively treat metastatic disease.
