1/86. 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 = 1keywords = vision (Clic here for more details about this article) |
2/86. 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 = 0.5keywords = vision (Clic here for more details about this article) |
3/86. Bilateral diffuse choroidal hemangiomas with unilateral facial nevus flammeus in sturge-weber syndrome.PURPOSE: To report bilateral choroidal hemangiomas associated with unilateral facial nevus flammeus in sturge-weber syndrome. methods: Case report. RESULTS: A 6-year-old male with a left facial nevus flammeus and a history of a left cerebral angioma had been followed 2 years for increasing esotropia. Examination demonstrated bilateral diffuse choroidal hemangiomas with overlying exudative retinal detachments. After bilateral external beam radiotherapy, the retinal detachments resolved and vision improved. CONCLUSION: patients with Sturge-Weber syndrome and unilateral facial nevus flammeus may harbor bilateral choroidal hemangiomas. Clinical manifestations of the sturge-weber syndrome are characteristically unilateral and ipsilateral to the facial nevus flammeus. Bilateral choroidal hemangiomas associated with bilateral facial nevus flammeus are rare. 1,2 We report bilateral diffuse choroidal hemangiomas associated with unilateral facial nevus flammeus in sturge-weber syndrome.- - - - - - - - - - ranking = 0.5keywords = vision (Clic here for more details about this article) |
4/86. Bilateral choroidal metastases secondary to uterocervical carcinoma of the squamous cell type.PURPOSE: To report a patient with bilateral choroidal metastases secondary to uterocervical carcinoma of the squamous cell type. methods: Case report. RESULTS: A 55-year-old woman complained of visual field loss and decreasing vision. Seven months earlier, uterocervical carcinoma of the squamous cell type was diagnosed and treated with chemotherapy and irradiation. Serous retinal detachment and choroidal masses were present in both eyes. retinal detachment was lessened in both eyes after radiotherapy. The patient died of respiratory insufficiency 3 months after the appearance of choroidal metastases. At autopsy, there was no second cancer to cause the choroidal metastases. Tumor embolization was present in the choriocapillaries. CONCLUSION: Choroidal metastasis may develop from hematogenous spread of uterocervical squamous cell carcinoma.- - - - - - - - - - ranking = 0.5keywords = vision (Clic here for more details about this article) |
5/86. adenocarcinoma of the esophagus with choroidal metastasis.In this report, a case is presented of an adenocarcinoma in a Barrett's esophagus metastatic to the choroid. A 54-year-old woman presented with a rapidly progressive decrease of vision in the right eye 8 months after intentionally curative esophagectomy for an adenocarcinoma. Fundoscopy, ultrasonography, and magnetic resonance imaging findings were suggestive of a metastasis. The patient received palliative external beam irradiation to the right eye for visual restoration, but she died before any beneficial effect was achieved.- - - - - - - - - - ranking = 0.5keywords = vision (Clic here for more details about this article) |
6/86. Late choroidal metastasis secondary to papillary thyroid carcinoma.PURPOSE: To report a case of late choroidal metastasis from papillary thyroid carcinoma. methods: Interventional case report. A 43-year-old woman who had been treated for papillary thyroid carcinoma 30 years earlier presented for evaluation of vision loss in the left eye. Eight weeks before this presentation, an ophthalmologist had diagnosed a metastatic uveal mass in the left eye of the patient. The clinical record was retrospectively reviewed. Ocular sonography was performed to confirm the diagnosis of choroidal metastasis. RESULTS: The choroidal mass had the typical characteristics of a metastatic lesion. The patient was treated with a combination of brachytherapy and chemotherapy. CONCLUSION: Papillary thyroid carcinoma can metastasize to the choroid many years after the initial diagnosis.- - - - - - - - - - ranking = 0.5keywords = vision (Clic here for more details about this article) |
7/86. Choroidal hemangioma treated with photodynamic therapy using verteporfin.OBJECTIVE: To describe a new treatment for vision loss caused by subretinal fluid associated with circumscribed choroidal hemangioma. methods: Three patients were treated with photodynamic therapy using verteporfin for injection (Visudyne; QLT Phototherapeutics Inc, Vancouver, british columbia). All patients had pretreatment and posttreatment fluorescein angiography and ultrasonography. Treatment parameters used were verteporfin, 6 mg/m(2), and laser light at 689 nm delivered at 50 J/cm(2) with an intensity of 600 mW/cm(2) for 83 seconds. RESULTS: All patients had complete resolution of subretinal fluid within 2 weeks of treatment. fluorescein angiography performed 2 to 4 weeks after treatment showed absence of tumor leakage. All eyes had reduced tumor thickness or complete flattening. visual acuity was improved in each eye. Average follow-up was 5.3 months. No complications were noted. CONCLUSION: Photodynamic therapy with verteporfin is effective in eliminating subretinal fluid and improving vision in patients with circumscribed choroidal hemangioma.- - - - - - - - - - ranking = 1keywords = vision (Clic here for more details about this article) |
8/86. Optical coherence tomography in the diagnosis of subclinical serous detachment of the macula secondary to a choroidal nevus.We present a case in which optical coherence tomography (OCT) aided in the diagnosis of subretinal fluid (SRF) secondary to a choroidal nevus. A patient with a raised lesion above the left optic disc and distorted central vision was referred to our unit because of suspected choroidal melanoma. Fundus fluorescein angiography and slit-lamp investigation did not indicate any areas of SRF; however, OCT showed serous detachment in the macular area. The lesion was treated with laser photocoagulation and, when reviewed at four weeks post-treatment, repeat OCT scans showed that the area of SRF had cleared. In this case OCT was able to detect a subclinical serous detachment in the macula. This may have important implications in the monitoring of patients with small suspicious lesions.- - - - - - - - - - ranking = 0.5keywords = vision (Clic here for more details about this article) |
9/86. Complete remission of gestational choriocarcinoma with choroidal metastasis treated with systemic chemotherapy alone: case report and review of literature.BACKGROUND: Gestational choriocarcinoma is a malignant tumor that frequently metastasizes to the highly vascularized organs such as the lung, brain, and liver via hematogenous spread. However, this tumor rarely metastasizes to the eye and only a few cases of metastasis to the choroid have been reported. CASE: A 17-year-old woman presented with visual field defects, decreased vision, and increasing pain in her left eye. She had undergone evacuation of a complete hydatidiform mole 32 months prior to the presentation. Ophthalmologic evaluation revealed a metastatic choroidal tumor, and a CT scan showed a metastatic tumor in the left lung. The serum hCG level was elevated at 7780 mIU/ml. A clinical diagnosis of metastatic gestational choriocarcinoma involving the choroid and lung was made. The patient received 13 courses of combination chemotherapy, resulting in complete remission. radiotherapy and surgical treatment were unnecessary. CONCLUSION: This is a very rare case of the successful treatment of gestational choriocarcinoma metastatic to the choroid using systemic chemotherapy alone.- - - - - - - - - - ranking = 0.5keywords = vision (Clic here for more details about this article) |
10/86. A rapidly growing choroidal melanoma.PURPOSE: We describe a rapidly growing choroidal melanoma that failed to respond to consecutive globe-sparing treatments in an individual with ocular melanocytosis. DESIGN: Interventional case report. methods: A 53-year-old man with right ocular melanocytosis, decreased vision in the right eye, and right eye pain was referred for suspected choroidal melanoma. The lesion, which measured 2.4 mm x 6.6 mm x 6.0 mm, was treated with transpupillary thermotherapy on two occasions and with iodine-125 (I-125) plaque brachytherapy, both of which failed. Enucleation allowed histologic analysis. RESULTS: At enucleation, the choroidal melanoma in the right eye measured 13.6 mm x 16.5 mm x 16.9 mm, which demonstrated the most rapid growth and doubling time reported in a tumor of this type thus far. Pathologic analysis classified the tumor as a mixed-cell type. CONCLUSION: This case reiterates the association between ocular melanocytosis and choroidal melanoma, provides additional evidence that rapid growth and doubling time may be associated with transpupillary thermotherapy and I-125 plaque failure, and highlights the need to follow those tumors closely.- - - - - - - - - - ranking = 0.5keywords = vision (Clic here for more details about this article) |
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