1,720,968 research outputs found
Long-term outcome of transpupillary thermotherapy as primary treatment of selected choroidal melanoma
No full textActa Ophthalmol. 2009 Nov;87(7):789-92. Epub 2008 Sep 5.
Long-term outcome of transpupillary thermotherapy as primary treatment of selected choroidal melanoma.
Parrozzani R, Boccassini B, De Belvis V, Radin PP, Midena E.
SourceDepartment of Ophthalmology, University of Padova, Italy.
Abstract
PURPOSE: To evaluate prospectively, on a long-term range, the clinical outcomes of transpupillary thermotherapy (TTT) as primary treatment of selected choroidal melanoma.
METHODS: Seventy-seven eyes of 77 patients affected by small posterior choroidal melanoma were treated with TTT as a sole treatment, using an infrared diode laser at 810 nm according to a standard procedure. Follow-up was longer than 36 months.
RESULTS: Seventeen tumours (22%) were parapapillary (PP) and 60 tumours (78%) were non-parapapillary (NPP) in location. Mean follow-up was 55.2 ± 17.9 months in PP tumours and 44.3 ± 23.7 months in NPP tumours. Thirteen (76%) PP tumours and 55 (92%) NPP tumours regressed (P > 0.05). Nine tumours recurred: seven were retreated using Iodine-125 brachytherapy and two were enucleated (both parapapillary). Four patients (5%) developed liver metastasis and died during follow-up. Tumour thickness was found to be predictive of recurrence (odds ratio: 4.3). Complications were found in 20 eyes (26%): macular pucker in 11 (14%), macular oedema in three (4%), retinal vein occlusion in six (8%), vitreous and subretinal haemorrhage in two (3%) and neovascular glaucoma in three (4%). PP tumours had more local complications (but this was not statistically significant; P > 0.05). Complications appeared more frequently in tumours treated with more than one TTT session (P = 0.01), and time-risk to develop intraocular complications seems longer in the PP group, without reaching statistical significance (P = 0.07).
CONCLUSION: TTT may be a clinically effective method for conservative treatment of selected, non-parapapillary, small posterior choroidal melanoma.
PMID: 18778335 [PubMed - indexed for MEDLIN
Long-term choroidal vascular changes after iodine brachytherapy versus transpupillary thermotherapy for choroidal melanoma.
Full text linkLong-term choroidal vascular changes after iodine brachytherapy versus transpupillary thermotherapy for choroidal melanoma.
Pilotto E, Vujosevic S, De Belvis V, Parrozzani R, Boccassini B, Midena E.
SourceDepartment of Ophthalmology, University of Padova, Padova, Italy. [email protected]
Abstract
PURPOSE: To compare long-term choroidal vascular changes after iodine-125 brachytherapy (IBT) versus transpupillary thermotherapy (TTT) used as primary treatment of small choroidal melanoma.
METHODS: Ninety-five small choroidal melanomas were randomized: 49 eyes with TTT and 46 eyes with IBT alone. Fluorescein and indocyanine green angiography (ICGA) were performed at 3-month intervals during the first year, and every 6 months thereafter.
RESULTS: Mean follow-up was 56.2 months (range, 24-118 months; SD, 22.6). Tumor regressed in 45 (92%) TTT-treated vs 45 (98%) IBT-treated eyes (p=0.397). Four TTT-treated and one IBT-treated tumor recurred. Occlusion of choriocapillaris was present in all TTT and IBT cases. Closure of medium and large choroidal vessels was observed in 17 (35%) TTT-treated vs 44 (96%) IBT-treated eyes (p<0.001). Choroidal vascular remodeling was detected in 20 (41%) TTT-treated and 16 (35%) IBT-treated eyes (p=0.693). Retinochoroidal anastomosis was present in 4 of the 37 (11%) TTT-treated eyes with patency of medium and large choroidal vessels, but never observed in the IBT-treated eyes, and was associated with tumor recurrence. Among IBT-treated eyes, segments of choroidal vascular wall ICG staining and choroidal aneurysmal changes were detected in 30 (65%) and 7 (15%), respectively. These changes were never detected in TTT-treated cases (p<0.0001 and p=0.015, respectively).
CONCLUSIONS: The pattern of tumor choroidal vascular changes following IBT and TTT differs. TTT is less effective in closing all tumor vasculature. The role of long-term choroidal vascular remodeling observed after these two treatments needs longer follow-up.
PMID: 19551682 [PubMed - indexed for MEDLINE
Stage 4 diffuse lamellar keratitis after laser in situ keratomileusis Clinical, topographical, and pachymetry resolution 5 years later.
No full textIn March 1999, a 35-year-old woman had uneventful laser in situ keratomileusis in both eyes on the same day. Five days postoperatively, slitlamp biomicroscopy of the left eye showed an appearance similar to haze after photorefractive keratectomy, with greater density at the center and striae convergent toward the infiltrate (stage 4 diffuse lamellar keratitis [DLK]). The patient received treatment with dexamethasone 0.2% eyedrops every 2 hours. After 2 weeks, visual acuity was better and improvement was evident on topography, pachymetry, and slitlamp photography. The improvements were more marked at 6 months and 1 year. There was a progressive increment in corneal thickness and consequent improvement in corneal transparency, curvature, and regularity. This case, in which continuous morphologic adaptation of the cornea occurred, indicates that observation, rather than intervention, is a valid therapeutic option for stage 4 DLK
Reproducibility of Macular Thickness Measurements Using Cirrus SD-OCT in Neovascular Age-Related Macular Degeneration
No full textPURPOSE. To assess the test-retest variability of central and sectorial macular thickness measurements obtained by Cirrus HD-OCT (Carl Zeiss Meditec, Dublin, CA) in neovascular age-related macular degeneration (nAMD). METHODS. Macular thickness measurements of nine standard ETDRS subfields were obtained and analyzed. The repeatability of macular thickness measurements by Cirrus HD-OCT was assessed by examining the intrasession within subject standard deviation (Sw), coefficient of repeatability (CR), and coefficient of variation (CV), before and after eyes with retinal segmentation errors were excluded. RESULTS. Forty-nine nAMD eyes of 49 consecutive patients were included in the study. The CR for the central macular subfield was 42.4 mu m (10.5%) and ranged from 12.1 mu m (3.7%) for the outer nasal to 41.8 mu m (11.4%) for the inner nasal subfields. In a secondary analysis, eyes affected by erroneous detection of inner and outer retinal boundaries (6/49, 12.24%) were excluded. The revised coefficient of repeatability for the central macular subfield was 26.1 mu m (8.1%) and ranged from 10.3 mu m (3.8%) for the outer superior to 30.2 mu m (8.3%) for the inner nasal subfields. CONCLUSIONS. Overall, the test-retest variability of Cirrus HD-OCT is good for the central and sectorial macular subfields, with a low incidence of scan artifacts. (Invest Ophthalmol Vis Sci. 2010;51:4788 - 4791) DOI:10.1167/iovs.09-497
In vivo monosomy 3 detection of posterior uveal melanoma: 3-year follow-up
No full textAbstract
BACKGROUND: Monosomy 3 is a highly specific marker for poor prognosis in posterior uveal melanoma. Unfortunately, cytogenetic prognostication is limited to enucleated eyes or resected tumors. The aim of this study was to evaluate mid-term natural history and safety of in vivo detection of chromosome 3 status in posterior uveal melanomas undergoing plaque brachytherapy.
METHODS: A 25-gauge transscleral fine needle aspiration biopsy (FNAB) was performed in 32 eyes affected by posterior uveal melanoma undergoing plaque brachytherapy, just before applying the radioactive plaque. Sampled material underwent fluorescence in situ hybridization (FISH) with centromeric probes for chromosome 3. All patients had a follow-up of at least 36 months.
RESULTS: Mean follow-up was 47.1 +/- 8.5 months. Mean largest basal diameter and mean thickness of the tumors were 12.5 +/- 2.7 mm and 8 +/- 2.3 mm respectively. FNAB yielded sufficient material in 26 of 32 cases (81.2%). Adequacy of the sample ranged from 91.1% (ciliary body tumors) to 76.8% (choroidal tumors). Seventeen cases had monosomy 3 (65.3%). No correlation was found between monosomy 3 and tumor dimensions or location (ciliary body vs choroidal tumors). No early and mid-term local complications were documented. Seven patients (21.8%) died during follow-up: five (15.6%) of them died due to metastatic disease (all had monosomy 3 tumors).
CONCLUSIONS: Posterior uveal melanomas may be adequately and safely sampled, by intra-operative transscleral FNAB, to detect in vivo monosomy 3.
PMID: 17934749 [PubMed - indexed for MEDLINE
In vivo detection of monosomy 3 in eyes with medium-sized uveal melanoma using transscleral fine needle aspiration biopsy
No full textAbstract
PURPOSE: Cytogenetic prognostication of choroidal melanoma, particularly monosomy 3 detections, is limited to enucleated eyes or resected tumors. The authors developed an in vivo technique to detect monosomy 3 using transscleral fine needle aspiration biopsy (FNAB).
METHODS: Eight eyes with medium-sized choroidal melanoma were included in this prospective study. A 25-gauge transscleral FNAB was performed during surgical procedure for brachytherapy, just before applying the radioactive plaque over the tumor base. Sampled material underwent fluorescence in situ hybridization (FISH) with centromeric probes for chromosome 3. Follow-up was >12 months.
RESULTS: Transscleral FNAB yielded sufficient material in 7 of 8 eyes (87.5 %). Five of seven eyes had monosomy 3. No early or late complications were detected.
CONCLUSIONS: This study demonstrates that medium choroidal melanomas may be safely sampled by intraoperative transscleral FNAB to detect monosomy 3 in vivo.
PMID: 16761244 [PubMed - indexed for MEDLINE
The pathogenesis of retinal damage in blunt eye trauma: Finite element modeling
No full textThe hypothesis that blunt trauma shockwave propagation may cause macular and peripheral retinal lesions, regardless of the presence of vitreous, was investigated. The study was prompted by the observation of macular hole after an inadvertent BB shot in a previously vitrectomized eye. Numeric simulations were performed with explicit finite element code. Simple constitutive modeling for soft tissues was used, and model parameters were calibrated on available experimental data by means of a reverse-engineering approach. It was demonstrated that: vitreous traction may not be responsible for blunt trauma???associated retinal lesions and can actually damp shockwaves significantly; negative pressures associated with multiaxial strain and high strain rates can tear and detach the retina; differential retinal elasticity may explain the higher tendency toward tearing the macula and vitreous base
Primary Blast Injury to the Eye and Orbit: Finite Element Modeling
No full textPrimary Blast Injury (PBI) mostly affects air-filled organs although sporadically reported in fluid-filled organs including the eye. Purpose of present paper is to explain orbit blast injury mechanisms through Finite Element Modelling (FEM). Design: FEM mesh of eye, orbit and skull was generated. Pressure, strain and strain rates were calculated at the cornea, vitreous base, equator, macula, and orbit apex for pressures known to cause tympanic rupture, lung damage and 50% mortality chances. Results: Pressures within the orbit ranged between +0.25 and -1.4 MegaPascal (MPa) for TR, +3 and -1 MPa for LD and +20 and -6 MPa for 50M. Higher trinitrotoluene (TNT) quantity and closer explosion caused significantly higher pressures and impact angle significantly influenced pressure at all locations. Pressure waves reflected and amplified to create steady waves resonating within the orbit. Strain reached 20% along multiple axes and strain rates exceeded 30,000 sec -1 at all locations even for the least amount of TNT. Conclusion: Orbit pyramid-like shape with bony walls and the mechanical impedance mismatch between fluid-like content and anterior air-tissue interface determine pressure wave reflection and amplification. The resulting steady wave resonates within the orbit and can explain both macular holes and optic nerve damage after ocular PBI
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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