1/74. Ultrasonographically guided injection of corticosteroids for the treatment of retroseptal capillary hemangiomas in infants.PURPOSE: Injection of corticosteroids is a well-documented and successful mode of treatment for periorbital capillary hemangiomas. Because of the greater potential risk involved with retrobulbar injections, no prior study has described this treatment for tumors located behind the orbital septum. Although retroseptal intraorbital capillary hemangiomas comprise only 7% of all adnexal capillary hemangiomas, complications such as optic nerve compression or astigmatism may necessitate treatment. methods: Three patients with deep orbital hemangiomas that caused vision-threatening complications were treated with intralesional injections of triamcinolone and betamethasone. Orbital injection was performed with use of real-time ultrasonographic guidance of the needle. This technique was valuable in providing continuous, accurate, and safe advancement of the needletip in the orbit to avoid the globe and orbital walls. ultrasonography also permitted precise placement of the needle tip within the tumor and visualization of the injected material. RESULTS: Significant improvement was demonstrated in all cases on the basis of both ultrasonographic measurements and regression of clinical manifestations such as astigmatism, chemosis, proptosis, and optic nerve pallor. No complications were noted. CONCLUSION: Intralesional injection of corticosteroids to treat retroseptal and retrobulbar capillary hemangiomas was found to be a safe and effective treatment modality in our patients. Positioning of the injecting needle was guided by ultrasonography.- - - - - - - - - - ranking = 1keywords = vision (Clic here for more details about this article) |
2/74. T-cell and T/natural killer-cell lymphomas involving ocular and ocular adnexal tissues: a clinicopathologic, immunohistochemical, and molecular study of seven cases.OBJECTIVE: Lymphomas of the eye and its adnexa are frequently of B lineage. This study aims to characterize the clinical and histopathologic features of the rare non-B-cell non-Hodgkin lymphomas (NHL) of these locations. DESIGN: Retrospective, noncomparative case series. PARTICIPANTS: Seven cases of T- and T/NK-cell lymphomas involving the ocular and ocular adnexal tissues. methods: A morphologic, immunohistochemical, and molecular analysis (polymerase chain reaction) of each of the tumors was undertaken. The lesions were classified according to the Revised European-American Lymphoma (REAL) classification. The clinical and follow-up data were collected. RESULTS: The patients included four women and three men ranging in age from 32 to 88 years (mean, 63 years). The presenting ophthalmic symptoms varied from a small nodule on the upper eyelid and conjunctival swellings to dramatic loss of vision associated with gross protrusion of the globe. Five of the cases presented were secondary manifestations of a systemic lymphoma in ocular tissues; two cases represented primary disease. Three cases were "peripheral T-cell lymphomas (PTCL), unspecified" with positivity for CD3, CD8, and betaF1 and negativity for CD56. Two cases were CD3 , CD30 , and CD56- and were classified as "anaplastic large-cell lymphomas of T-cell type" (T-ALCL). The remaining two cases showed an immunophenotype of CD3 , CD56 , and betaF1- and proved to contain Epstein-Barr virus (EBV) by in situ hybridization, consistent with "T/natural killer (NK)-cell lymphoma of nasal type." Clonal T-cell populations were shown in all three of the PTCLs by Southern blot (n = 1) and polymerase chain reaction (n = 2) for the T-cell receptor gamma and beta genes in one case of ALCL but not in the T/NK-cell lymphomas. Five patients died within 2 years; only two patients (one primary PTCL and one cutaneous T-ALCL) were disease free at 4 and 5 years' follow-up, respectively. CONCLUSION: This study shows that a heterogeneous group of T-cell lymphomas can involve the eye and its adnexal tissue. Most T-cell neoplasms are secondary manifestations of systemic disease and carry a poor prognosis. These findings, in conjunction with published data on ocular B-NHL, also indicate that immunophenotypic differentiation between T- and B-NHL in these locations is of clinical importance.- - - - - - - - - - ranking = 1keywords = vision (Clic here for more details about this article) |
3/74. Limbal papilloma with massive corneal extension.The authors report a case of limbal papilloma with extensive corneal involvement. The limbal lesion was excised completely, leaving a clear corneal bed. Histopathologically, the lesion was found to be a limbal papilloma. Massive superficial involvement of the cornea by papilloma is rare. Simple excision is effective in treating the condition with restoration of vision and cosmesis.- - - - - - - - - - ranking = 1keywords = vision (Clic here for more details about this article) |
4/74. Ocular-central nervous system lymphoma mimicking posterior scleritis with exudative retinal detachment.OBJECTIVE: We describe an unusual ocular presentation of ocular-central nervous system lymphoma in a young patient. DESIGN: Interventional case report and literature review. methods: A previously well 24-year-old white woman presented with left eye pain and reduced vision. Episcleral injection, globe tenderness, an afferent pupil defect, and exudative retinal detachment were present. Computed tomographic scan of the head and orbits demonstrated scleral thickening, retinal detachment, and no other abnormality. A provisional diagnosis of posterior scleritis with exudative retinal detachment was made. Investigation for underlying connective tissue diseases was negative. There was an initial prompt response to corticosteroid therapy. The patient's symptoms and signs then recurred, and a left third cranial nerve palsy developed. Systemic investigations including lumbar puncture ultimately led to the diagnosis of primary T-cell central nervous system (CNS) lymphoma. serologic tests for human immunodeficiency virus were negative. MAIN OUTCOME MEASURES AND RESULTS: The patient underwent orbital and cranial irradiation and intrathecal and systemic chemotherapy. Despite an initial response to treatment, she returned with a recurrence of the lymphoma in the anterior segment of the left eye. Her systemic disease progressed rapidly, and she died shortly thereafter. CONCLUSIONS: This patient's young age and initial presentation mimicking posterior scleritis with unilateral exudative retinal detachment, without evidence of vitreous involvement, are highly unusual for ocular involvement in primary CNS lymphoma. A review of the literature highlights the atypical nature of this presentation.- - - - - - - - - - ranking = 2keywords = vision (Clic here for more details about this article) |
5/74. Vascular anastomoses between the iris and persistent hyperplastic primary vitreous.Prominent radial iris blood vessels created small but definite pupillary notches in five children with persistent hyperplastic primary vitreous and persistence of the tunica vasculosa lentis. Detection of these abnormal iris vessels suggested the presence of persistent hyperplastic primary vitreous and related syndromes even when the diagnosis was obscured by the presence of an opaque lens. These vessels represented early developmental arrest and may have been associated with abnormal development of the macula and optic nerve. Surgical and amblyopia therapy, therefore, may not provide useful vision, and should be undertaken with caution.- - - - - - - - - - ranking = 1keywords = vision (Clic here for more details about this article) |
6/74. Cotton-wool spots associated with pancreatic carcinoma.BACKGROUND: Malignant tumors of different organs may cause changes in the eye. patients: A 62-year-old woman and a 47-year-old man who both had a metastasizing carcinoma of the pancreas suffered from visual disturbances. RESULTS: The 62-year-old woman experienced cloudy vision in her left eye. The 47-year-old man noticed a left visual deterioration. Both patients exhibited cotton-wool spots in both eyes. In addition, the man revealed a metastasis of the choroid in the right eye. The woman was treated with Gemcitabine (1999), and the man with 5 Fluo-uracil/Leukovorin (1997). The cotton-wool spots were reduced in size in the woman after treatment with Gemcitabine. The patients had no diabetes mellitus and no arterial hypertension. After termination of treatment, their general condition deteriorated and they died within a few weeks. CONCLUSION: Cotton-wool spots are unusual findings in the retina of a metastasizing carcinoma, suggesting the presence of a retinal ischemia. Therefore, early screening of patients with metastasizing pancreas carcinoma for retinal abnormalities may be important.- - - - - - - - - - ranking = 1keywords = vision (Clic here for more details about this article) |
7/74. anterior chamber infiltrates associated with systemic lymphoma: report of two cases and review of the literature.PURPOSE: To describe the clinicopathologic features of two patients with systemic lymphoma who developed anterior chamber (AC) infiltrates of lymphoma cells. DESIGN: Two case reports and literature review. methods: The clinical and pathologic findings in two patients with AC infiltrates secondary to systemic B-cell lymphoma are reviewed. MAIN OUTCOME MEASUREMENTS: Clinical observation and cytologic/flow cytometric examination of the infiltrate after AC aspiration. RESULTS: One patient presented with uveal infiltration, an exudative retinal detachment and an AC infiltrate. Systemic evaluation revealed a follicular lymphoma involving several groups of lymph nodes. The second patient with a known history of abdominal lymphoma was found to have blurred vision, photophobia and an AC infiltrate. Flow cytometric analysis of the AC infiltrate in both patients showed phenotypes consistent with the patients' systemic lymphomas. CONCLUSIONS: A pseudohypopyon in an adult may represent either the initial manifestation or a later complication of systemic lymphoma, similar to what has been reported in acute leukemia.- - - - - - - - - - ranking = 1keywords = vision (Clic here for more details about this article) |
8/74. Intrathecal chemotherapy for recurrent central nervous system intraocular lymphoma.PURPOSE: To report the use of intrathecal chemotherapy for two patients with recurrent central nervous system (CNS) intraocular lymphoma. DESIGN: Two interventional case reports. PARTICIPANTS: The clinical course of two patients with documented recurrent CNS intraocular lymphoma were retrospectively reviewed. INTERVENTION: Both patients had previously undergone external beam radiation therapy to the orbit and brain, as well as systemic methotrexate (MTX) and intrathecal cytarabine (Ara-C), for primary CNS intraocular lymphoma. Both patients developed recurrent CNS intraocular lymphoma and treatment involved intrathecal MTX and Ara-C delivered by means of an Ommaya reservoir. MAIN OUTCOME MEASURE: survival and resolution of intraocular lymphoma. RESULTS: Complete remission of the CNS intraocular lymphoma was seen in both patients. Both patients maintain reading visual acuity in at least one eye. Both patients remain disease free with lymphoma in remission for greater than 5 years after initial diagnosis. CONCLUSIONS: Intrathecal chemotherapy for recurrent CNS intraocular lymphoma seems to be effective in preserving vision and possibly increasing survival.- - - - - - - - - - ranking = 1keywords = vision (Clic here for more details about this article) |
9/74. Melanocytoma of the optic disc.Melanocytoma of the optic disc is a benign lesion. We report here a patient with melanocytoma who presented with gradual diminution of vision. On examination the left eye fundus showed a mass uniformly dark black in colour, on the optic disc occupying the superotemporal quadrant. The mass completely obscured the fluorescence on fluorescein angiography and was thus differentiated from malignant melanoma.- - - - - - - - - - ranking = 1keywords = vision (Clic here for more details about this article) |
10/74. Primary corneal myxoma.PURPOSE: To present the clinical and histopathological characteristics of a corneal myxoma. methods: A 36-year-old, white woman presented with blurred vision and a whitish opacity on the left cornea. Clinical examination revealed a whitish, non-tender, 5 x 9 mm superficial tumour on the cornea. The tumour was excised and examined microscopically. RESULTS: The tumour was composed of spindle-shaped cells in a myxomatous ground substance. Immunohistochemically, the tumour cells were positive for vimentin, muscle-specific antigen and smooth muscle antigen. The tumour was classified as a myxoma of the cornea. The origin of the tumour is discussed. CONCLUSION: This is the second reported case of a corneal myxoma without prior corneal disease.- - - - - - - - - - ranking = 1keywords = vision (Clic here for more details about this article) |
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