Biomedical subjects
Publications and source records attributed to K Bujara.
A patient with a malignant melanoma of the choroid was treated at first successfully with the 106Ru beta ray applicator. Because new tumor growth could not be ruled out, the eye was enucleated 2 1/2 years after radiotherapy. The histopathologic examination revealed, however, a complete tumor cell necrosis.
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We describe two sibs with DIDMOAD-Syndrome, a 19-year-old girl with diabetes mellitus (type I), optic atrophy, inner-ear deafness, and atonia of the urinary tract, and her 5-year-old brother with diabetes mellitus (type I) and optic atrophy. Studies of red blood cell insulin receptors revealed a normal number of receptors per cell and normal affinity to insulin. The syndrome represents an autosomal recessively inherited type of diabetes mellitus, which remains often undiagnozed since most of the symptoms except diabetes mellitus and optic atrophy occur with varying expressivity. An atonia of the efferent urinary tract often with fatal complications is present in 46% of all patients with this syndrome reported in the literature and is unfortunately not included in the acronym DIDMOAD.
Necrotic foci within the iris and ciliary body were present in 104 eyes examined at the histopathological laboratory of the University Eye Clinic, Hamburg. Three different aetiological mechanisms were found: 1) Vascular acute glaucoma, diminished arterial supply, or radiogenic occlusive vasculitis can lead to ischaemic infarction. 2) Inflammatory: direct contact with the noxious agent can lead to cell death, either via liberation of toxines and enzymes--usually bacterial--or due to direct cytotoxic effect, in case of viruses. Both can further cause cell death via immunological mechanisms. Intraocular suppurative bacterial infections predominate in this group. 3) Traumatic and operative: tissue damage is caused by mechanical or thermal injury. Besides accidental trauma, uveal necrosis also occurs frequently after surgical coagulation or dialysis of the ciliary body for glaucoma. The sequelae of iris and ciliary body necrosis depend on the extent of the damage. Small necrotic areas are followed by scarring, which has no injurious consequences on visual function. Widespread necrosis, on the other hand, is complicated by immediate atrophia bulbi or secondary angle-closure glaucoma with or without rubeosis iridis.
In a review of 474 malignant melanomas of the posterior uvea the incidence of totally necrotic tumors was 3.6% and of partially necrotic, 5.7%. Longer time intervals to appearance of first symptoms and enucleation, secondary glaucoma, and inflammatory exophthalmos were significantly more frequent in necrotic malignant melanomas (P less than 0.01). Histopathological examination also revealed that necrotic tumors more often had secondary angle-closure glaucoma, rubeosis iridis, cellular inflammatory infiltrates, and extraocular extension when compared to non-necrotic tumors (P less than 0.01).
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Barraquer-silk (8 x 0) and Polyglactin 910 (8 x 0) were histologically examined in corneo-scleral incisions of rabbit eyes. Wound healing using both suture materials was complete after two weeks, as observed by light microscopy. Barraquer-silk excited more cellular reaction than Polyglactin 910. Absorption of Polyglactin 910 suture began 18 days after surgery whilst Barraquer-silk did not begin to absorb until 42 days had passed.
The refractive status of 100 eyes were measured by three ophthalmologists utilizing retinoscopy under non-cycloplegic and cycloplegic conditions. The statistical analysis of the results was done by multiple regression. The retinoscopic measurements of sphere and cylinder of the three examiners show smaller differences under cycloplegic than under non-cycloplegic conditions. The largest differences in the measurements of axis were found in cases of small cylinder power. Especially in children and in patients with strabismus, the authors feel that measurements of the refractive state have to be carried out under cycloplegia.
Epibulbar osteomas are benign tumors which are usually present at birth. Up to now 39 cases have been described in the literature. In the last three years 4 further cases have been found in the Freiburg, Hamburg, Marburg, and Munich University Eye Clinics. Epibulbar osteomas probably occur more often than is generally believed. The clinical and histological findings in respect of these tumors are discussed.
A 64-year-old patient with a spindle-cell melanoma of the iris, which was removed by iridocyclectomy and tectonic corneal graft, developed 5 years later a recurrence of the tumor. The histology of the primary tumor showed a spindle-cell melanoma, the recurrence a mixed-cell melanoma. Such recurrences are rare.
Report of a 71-year-old woman with acute closed-angle glaucoma. Echography shows an intraocular tumor of the choroid, and the histological diagnosis is necrotic malignant melanoma of the choroid. The clinical, echographical and histological findings are discussed.
The clinical, fluorescein angiographical and histopathological findings of a mucous-producing adenoma apparently arising from the iris pigment epithelium is reported, and the differential diagnosis is discussed. Benign epitheliomas of the iris pigment epithelium are exceedingly rare and are usually heavily pigmented tumors. This appears to be the second documented case of a nonpigmented benign epithelioma of the iris.
By histological examination of 42 caruncle tumors we found 5 oncocytomas. All the patients were women older than 63 years. The clinical and histological findings are described and the pathogenesis of these tumors discussed.