1/168. Radioactive phosphorus uptake testing of choroidal lesions. A report of two false-negative tests.Two false-negative results from 32P testing for histologically verified malignant melanomas of the choroid are reported. In the first case, a haemorrhagic choroidal detachment caused an increase in probe; additionally, the tumour was necrotic. Both factors are likely to have contributed to the false-negative result. A satisfactory explanation for the false-negative result in the second case was not determined, although it may have accurately reflected a period of minimal tumour activity, inasmuch as repeat 32P testing was strongly positive eight months later, when unequivocal evidence of tumour growth was present. An alternative explanation is that the orally administered 32P was incompletely absorbed. Since 32P testing is frequently accompanied by significant manipulation both in the manoeuvre associated with tumour localization and in that associated with the actual radioactive counting, it would seem desirable to perform indicated enucleation immediately after completion of the 32P testing. While the properly performed 32P test remains a valuable diagnostic test for helping to establish the presence or absence of malignancies of the posterior globe, it is important to guard against the tendency to underestimate careful clinical evaluation.- - - - - - - - - - ranking = 1keywords = detachment, posterior (Clic here for more details about this article) |
2/168. Clinical experience with presumed hemangioma of the choroid: radioactive phosphorus uptake studies as an aid in differential diagnosis.A total of 27 cases of choroidal hemangioma was evaluated with radioactive phosphorus uptake studies. In each case the diagnosis of malignant melanoma was initially entertained, but the 32P test was unequivocally negative in every instance. follow-up studies in every case have supported the clinical diagnosis. In 22 patients, the lesion was treated with photocoagulation, and in every treated case the serous macular detachment disappeared. The importance of early and correct clinical diagnosis is stressed, since these are salvageable and potentially useful seeing eyes.- - - - - - - - - - ranking = 0.99864685044438keywords = detachment (Clic here for more details about this article) |
3/168. Proton beam therapy for posterior pole circumscribed choroidal haemangioma.BACKGROUND: Macular and juxtapapillary circumscribed choroidal haemangiomas (CCH) have always posed a diagnostic and therapeutic challenge. Proton beam therapy has been advocated by Zografos and associates as optimal for treating these tumours in this critical region as charged particles have a highly localised and uniform dose distribution. patients: We present 3 cases of CCH treated with proton beam therapy. Two patients developed radiation optic neuropathy and maculopathy, and one had a persistent exudative macular detachment following treatment. CONCLUSION: Our experience with proton therapy of these tumours has been disappointing in preventing radiation optic neuropathy and maculopathy and offers little advantage over external irradiation. The majority of our patients with this condition are now treated with low-dose lens-sparing external beam radiotherapy or brachytherapy, which has encouraging visual results and is a far more cost-effective option.- - - - - - - - - - ranking = 1.0040594486669keywords = detachment, posterior (Clic here for more details about this article) |
4/168. Primary laser photocoagulation of "small" choroidal melanomas.PURPOSE: To evaluate primary laser photocoagulation of "small" posterior choroidal melanomas in eyes with good vision. METHOD: This study includes a case series comprising six patients treated with standard laser techniques for melanoma, which had a mean thickness of 3.1 mm (range 2.9-3.9 mm), largest basal diameter of 8.6 mm (mean, range 7.0-10.0 mm), and located 0.5-2 disk diameters from the fovea or 0.3-3 disk diameters from the optic nerve head. RESULTS: No metastatic death was observed in the follow-up period (range 3 1/2-7 1/2 years). Two local recurrences appeared, both were treated with plaques, one eye was later enucleated. Two additional cases were also treated with plaques. Only two of the irradiated eyes retained reading vision. CONCLUSION: Primary photocoagulation of "small" posterior choroidal melanomas with argon laser is not recommended.- - - - - - - - - - ranking = 0.0027062991112465keywords = posterior (Clic here for more details about this article) |
5/168. Extraocular extension of unrecognized choroidal melanoma simulating a primary optic nerve tumor: report of two cases.BACKGROUND: Orbital extraocular extension of choroidal melanoma is well known and is usually detected in eyes with medium and large tumors, but it is very rare with small melanomas. It is particularly unusual for choroidal melanomas of any size to invade the optic nerve or its meninges. DESIGN: Two case reports. PARTICIPANTS: Two patients with small, relatively inconspicuous juxtapapillary pigmented choroidal lesions were referred with the diagnosis of primary optic nerve tumor. Both demonstrated a large nodular tumor in the meninges of the optic nerve, immediately posterior to the globe. methods: Retrospective review of clinical records and histopathology. RESULTS: In both cases, orbital magnetic resonance imaging confirmed the presence of a hyperintense enhancing nodular mass near the anterior portion of the optic nerve, prompting optic nerve biopsy in one case. Subsequent fundus examination disclosed a small juxtapapillary pigmented choroidal lesion measuring 1.0 mm or less in thickness. These observations suggested that the optic nerve tumor might be nodular extraocular extension of a small choroidal melanoma. Modified enucleation was performed in both cases, and histopathologic examination revealed a nodule of malignant melanoma within the meninges that compressed the optic nerve and extended extraocularly from a small, relatively inapparent juxtapapillary choroidal melanoma. In both cases, the extraocular component was large and symptomatic, whereas the intraocular component was inconspicuous. CONCLUSIONS: Small juxtapapillary choroidal melanomas can exhibit prominent extension into the orbit. All patients with orbital tumors should have careful ophthalmoscopy.- - - - - - - - - - ranking = 0.0013531495556233keywords = posterior (Clic here for more details about this article) |
6/168. Transscleral choroidal biopsy in the diagnosis of choroidal lymphoma.A 57-year-old man with non-Hodgkin's B-cell lymphoma of the abdominal lymph nodes developed moderate cells in the anterior chamber and vitreous, choroidal infiltration, and total nonrhegmatogenous retinal detachment in both eyes while receiving chemotherapy. After a diagnostic vitrectomy in the left eye was nonrevealing, the patient was referred to the oncology service. Fine-needle aspiration biopsy of the choroidal infiltrate was not done because of poor visualization of the choroid through the turbid subretinal fluid. Transscleral choroidal biopsy was performed without complications and disclosed diffuse high-grade B-cell lymphoma and no signs of endogenous infection. Transscleral choroidal biopsy is a useful technique in eyes with choroidal infiltration, especially when hazy media prohibit fine needle biopsy.- - - - - - - - - - ranking = 0.99864685044438keywords = detachment (Clic here for more details about this article) |
7/168. brachytherapy of a choroidal melanoma using radioactive gold grains: a long-term follow-up study.PURPOSE: We used radioactive gold grains to treat a patient with choroidal malignant melanoma. Radioactive sources were placed into surgically constructed scleral pockets. The patient was followed up for six years after therapy to assess changes in the tumor, recurrence, and side effects. methods AND MATERIALS: A male patient presented with malignant melanoma arising from the choroidal membrane of the posterior pole of the left eyeball. We placed radioactive gold grains into surgically constructed scleral pockets adjacent to the tumor, arranged in a plane based on the Manchester's method. The patient was followed up for six years after treatment. RESULTS: The radiation dose was 120 Gy at the apex of the tumor, which slowly became smaller and completely disappeared at one year and 10 months after treatment. Tumor recurrence was not observed. radiation dose at the ipsilateral lens was 280 cGy. Side effects associated with therapy were a decrease in visual acuity secondary to retinal degeneration and atrophy, but his vision was correctable with suitable glasses. In addition, the visual field of the left eye was also restricted. Mild cataracts also developed in the ipsilateral eye after treatment. CONCLUSION: Although this therapeutic method is technically difficult compared with other methods, it permits the tumor to be treated without loss of the eye. This may significantly improve the patient's quality of life.- - - - - - - - - - ranking = 0.0013531495556233keywords = posterior (Clic here for more details about this article) |
8/168. iris mammillations as the only sign of ocular melanocytosis in a child with choroidal melanoma.An 8-year-old girl had visual loss in her left eye over 2 months. Ocular examination showed that visual acuity was counting fingers in the left eye. The left iris was moderately pigmented and thickened with numerous confluent, dome-shaped elevations on its surface, consistent with iris mammillations arising from ocular melanocytosis. There was total retinal detachment and an inferiorly located large amelanotic choroidal mass compressing the optic nerve. A specimen from a fine-needle aspiration biopsy showed spindle and epithelioid melanoma cells. The eye was enucleated. Pathologic examination showed that the bland melanocytes comprising the anterior border layer of iris formed focal aggregates, corresponding to the iris mammillations observed clinically. The uvea was diffusely thickened. Arising from the posterior choroid and obscuring the optic nerve head was a moderately pigmented spindle and epithelioid cell choroidal melanoma with diffuse lymphocytic infiltration and high mitotic activity. This case demonstrates that iris mammillations can be the initial manifestation of ocular melanocytosis in the absence of scleral pigmentation.- - - - - - - - - - ranking = 1keywords = detachment, posterior (Clic here for more details about this article) |
9/168. Long-term follow-up of giant nodular posterior scleritis simulating choroidal melanoma.A 41-year-old asymptomatic woman was referred for enucleation of a 7. 5-mm-thick intraocular tumor suspected to be choroidal melanoma. The clinical findings combined with imaging studies suggested instead a diagnosis of giant nodular posterior scleritis. A scleral biopsy was performed to confirm the diagnosis. After 12 years of observation, the lesion has remained stable and visual acuity has been preserved. Nodular posterior scleritis can present with no symptoms of pain, redness, or visual disturbance and can remain quiet for many years. It must be clinically differentiated from choroidal melanoma. Arch Ophthalmol. 2000;118:1290-1292- - - - - - - - - - ranking = 0.0081188973337396keywords = posterior (Clic here for more details about this article) |
10/168. Optical coherence tomography patterns of choroidal osteoma.PURPOSE: To determine the optical coherence tomographic images that are commonly observed in eyes with choroidal osteoma (choroidal ossification). methods: Three patients with choroidal osteoma were examined by optical coherence tomography. RESULTS: We found two optical coherence tomographic patterns in the eyes with choroidal osteoma. First, multiple tracks of high refractivity were present posterior to the tumor lesion. Second, thick and irregular plate-like, high-signal intensity areas were present in the choroid in the region of the tumor. CONCLUSIONS: Optical coherence tomography can be useful in the diagnosis of choroidal osteoma.- - - - - - - - - - ranking = 0.0013531495556233keywords = posterior (Clic here for more details about this article) |
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