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M A Saornil

Publications and source records attributed to M A Saornil.

At least 19 recordsLinked to original sources
PubMed2005

[Ocular hypertension as the principal indicator of onset of uveal melanoma].

PURPOSE: To present a series of patients with uveal melanoma masquerading as ocular hypertension. METHODS: Patients diagnosed with uveal melanoma were reviewed, selecting those cases with initial presentation as secondary unilateral glaucoma. Clinical and histopathological information useful for prognosis was examined, such as anterior border localization, size and shape of the tumor, associated ocular pathology, cell type and degree of extraocular extension. RESULTS: Seven patients out of a total of 160 diagnosed with melanoma presented with ocular hypertension (4.3% of the total). Six tumors were large, with only one of them being middle-size. All cases had an associated asymmetric cataract on the affected side. Four cases had neovascular glaucoma, two pseudo-phacolytic glaucoma and the remaining case had invasion of the anterior chamber angle. All cases were unresponsive to medical treatment for glaucoma, due to the unsuspected tumor they harbored. Visual acuity was lower than 0.1 in the affected eye in all patients. Only one case had extraocular extension. A histopathologic examination performed in six cases showed that 3 tumors had epithelioid cellularity and also 3 had varying degrees of extrascleral extension. CONCLUSIONS: In patients presenting with the association of unilateral glaucoma and asymmetric cataract, it is crucial to perform imaging studies, such as ultrasound, in order to rule out the presence of an intraocular tumor, and to achieve an early diagnosis, improving the patient's prognosis and the morbidity of treatments.

Aged↗
PubMed2004

[Ocular presentation in Wegener granulomatosis].

CASE REPORT: A 71 year-old female presented with bilateral conjunctivitis, scleritis and peripheral ulcerative keratitis. Ancillary tests showed presence of anti-neutrophil cytoplasmic antibodies, with diffuse granular cytoplasmic immunofluorescence staining (ANCAc). Conjunctival biopsy showed necrotizing vasculitis in small vessels. Diagnosis of Wegener Granulomatosis (WG) was established and upper respiratory affection detected. Treatment with megadoses of cyclophosphamide and corticoids was initiated and remission of the disease was obtained. DISCUSSION: WG is a potentially lethal systemic vasculitis in which ocular involvement may be the first clinical presentation. Scleritis and peripheral ulcerative keratitis indicate systemic involvement, highlighting the importance of prompt diagnosis and treatment.

Aged↗
PubMed2002

The need for continuous immunosuppression with cyclosporin A to maintain an experimental model of uveal melanoma.

We investigated the need for continuous immunosuppression to maintain experimental tumours derived from human uveal melanoma cells implanted in the choroid of pigmented rabbits. Two groups of pigmented rabbits immunosuppressed with cyclosporin A (CsA) were implanted with human uveal melanoma cells in the suprachoroidal space. After 5 weeks, CsA was discontinued in group 2. Animals were treated with prophylactic antibiotics and examined weekly for tumour growth, weight and secondary effects; blood urea nitrogen levels were measured every two weeks. Autopsies and histopathological studies were performed after death or euthanasia at the end of week 12. The difference between the groups in the development of ophthalmoscopic tumours was not statistically significant 5 weeks after implantation. Tumours in group 1 grew progressively throughout the experiment, whereas group 2 tumours showed marked regression 3-4 weeks after discontinuing CsA. Tumours in group 1 were significantly larger and had greater mitotic activity and showed more ciliary body, optic nerve and extrascleral invasion than tumours in group 2, which showed massive fibrosis, minimal mitotic activity and marked inflammatory cell infiltration. Continuous immunosuppression with CsA seems to be necessary to maintain tumour growth in this experimental model of uveal melanoma.

Animals↗
PubMed2002

[Ghost cell detection in vitreous cytology: clinico-pathological correlation].

PURPOSE: To determine the prevalence of detection of ghost cells (GCs) in vitreous hemorrhages (VHs) and correlate it with the development of ghost cell glaucoma. To compare our results with those previously reported. METHODS: Retrospective analysis of clinical records and vitreous cytology reports (cytospin and direct paraffin embedding) from patients undergoing vitrectomy for VH at Instituto Universitario de Oftalmobiología Aplicada and University Hospital, Valladolid, for the last 2 years. RESULTS: 76 VHs have been analysed; 45 corresponded to proliferative diabetic retinopathy and the remainder to several pathologies. GCs have been detected in 18 cases (25%) (4 out of 76 specimens were excluded): 14 were phakic and 4 pseudophakic. Most of 76 VHs lasted more than 2 months. No case of ghost cell glaucoma was detected, neither previously nor after vitrectomy. CONCLUSIONS: The frequency of detection of GCs in vitreous cytology may vary according to the cytologic technique. In contrast with the information previously reported, ghost cell glaucoma is an unfrequent disease, particularly after vitrectomy, probably because of a better removal of hemorrhagic debris from the vitreous cavity nowadays. Nevertheless, this diagnosis should not be overlooked.

Aqueous Humor↗
PubMed2001

Orbital intradiploic giant epidermoid cyst.

We report a case of an intradiploic epidermoid cyst of the lateral orbital wall that resulted in proptosis and downward displacement of the left eye. Computed tomography and magnetic resonance imaging revealed a bone-destroying mass involving the frontal, sphenoid, and zygomatic bones that extended into the orbit, temporalis, and anterior cranial fossa. Complete surgical removal was performed through a lateral orbitotomy. The lateral wall was reconstructed with a porous polyethylene sheet. The cyst has not recurred after 18 months of follow-up.

Adult↗
PubMed2001

Conjunctival biopsy in the diagnosis of ocular sarcoidosis.

Sarcoidosis is a multisystem granulomatous disease of unknown etiology that can affect almost every organ in the body, particularly the lungs, skin, eyes, and thoracic lymph nodes. A definitive diagnosis of sarcoidosis requires that a biopsy be performed. A specimen can be obtained from any affected ocular structure, including conjunctiva, lacrimal gland, eyelid skin, and orbit. Among them, conjunctival biopsy has been suggested as a sensible and safe procedure for confirming suspected sarcoidosis. We describe three patients in whom ocular symptoms were the sole initial manifestations of sarcoidosis and who were diagnosed based on the results of a conjunctival biopsy. We also discuss the efficacy of and indications for conjunctival biopsy.

Adolescent↗
PubMed2001

[Usefulness of conjunctival biopsy as diagnostic technique].

PURPOSE: The conjuctival biopsy is described as a useful technique in the diagnosis of some chronic conjunctivitis, with low specific signs and with poor response to the conventional treatment. Furthermore it is quite important in the diagnosis of conjunctival diseases with potential dangerous treatment. PATIENTS AND METHODS: Three clinical cases are described. Case 1: A 37 years old woman with a chronic lesion of conjuctiva and the suspicion of blepharoconjunctivitis. There was no improvement with treatment. Case 2: A 58 years old woman with a chronic conjunctivitis and follicular reaction. Case 3: A 66 years old man who suffers from a cicatricial conjunctivis in both eyes with corneal lesion in one eye. A conjunctival biopsy was perfomed and studied under light microscopy and immunohistochemistry. There is a description of the technique. RESULTS: The results of every clinical case are described. In the first case the biopsy established the diagnosis of conjunctival lymphoma. In the second, the biopsy showed the appearance of granulomas and a diagnosis of conjunctival sarcoidosis was performed. In the third case a diagnosis of ocular cicatricial pemphigoid was established. CONCLUSION: Conjunctival biopsy is a useful and effective technique in the diagnosis of chronic conjunctivitis.

Adult↗
PubMed2001

[Efficacy of direct paraffin embedding in cytological analysis of vitreous from proliferative vitreo-retinopathy (PVR)].

PURPOSE: To assess the efficacy of direct paraffin embedding in cytological analysis of vitreous samples in patients suffering from PVR, against the commonly used method for this purpose (cytospin). METHOD: Undiluted vitreous or vitreous fluids from 40 subsequent patients with PVR were collected and processed (samples collected from cassette at the end of aspiration line in final stage of vitrectomy process). 40 samples underwent cytospinning, 24 samples were paraffin embedded. Specimens were assessed by an expert ocular pathologist and tested samples were assigned to scoring and non scoring groups (where scoring means at least three cells per field in x60 magnification). RESULTS: All 24 paraffin embedding samples scored according to criteria while 36 of 40 cytospinned samples complied with scoring criteria. Differences were not statistically significant. Macrophages (87.5%) and pigmented cells (85%) were the most frequent findings. CONCLUSIONS: Direct paraffin embedding is useful for cytological studies in vitreous samples of PVR patients.

Humans↗
PubMed2001

[Comparison of different techniques for cytologic analysis of vitreous specimens].

PURPOSE: To assess the efficacy of four methods to study the cytology of vitreous samples, and to evaluate the most efficient for routine analysis and immunocytochemical staining. METHODS: Diluted and undiluted vitreous samples of 87 consecutive patients suffering vitreoretinal surgery for different diseases were analysed. The specimens were centrifugated and then processed through four different procedures: agar sandwich (29 cases), direct paraffin embedding (33 cases), cytospin preparations (82 cases) and cytoblock (8 cases). RESULTS: Evaluable material was obtained in: agar sandwich 18 out of 29 cases (62%), direct paraffin embedding 32 out of 33 cases (96.9%), cytospin 72 out of 82 cases (87.8%) and cytoblock 1 out of 8 cases (12.5%). CONCLUSIONS: Direct paraffin embedding and cytospin are the most efficient procedures for routine purposes. Agar sandwich technique seems to be useful for studying small pieces of tissue. Direct paraffin embedding and agar sandwich technique seems to be valuable for immunocytochemistry. After 8 cases processed with cytoblock, our experience did not show valuable results for processing vitreous samples.

Cytological Techniques↗
PubMed2000

Extramedullary plasmacytoma of the orbit.

PURPOSE: To report a case of extramedullary plasmacytoma of the orbit. METHODS: A 71-year-old patient presented with diplopia eyelid fullness and limitation of ocular motility in the left eye. Visual acuity was counting fingers, intraocular pressure 34 mmHg and fundus eye examination showed choroidal folds in the involved eye. RESULTS: CT scan showed a mass filling the superior and external left orbit without bone destruction. A biopsy was performed revealing that the tumour was composed of plasmacytoid cells positive with immunohistochemical stains for Kappa light chains and epithelial membrane antigen. Systemic work up was negative. The diagnosis of extramedullary orbital plasmacytoma was made. The patient was treated with external beam radiotherapy (40 Gy) and has remained disease free for four years (49 months). CONCLUSION: Extramedullary plasmacytomas of the orbit are extremely rare tumours. Accurate and early diagnosis is essential for the therapeutic approach. Extensive medical work up to rule out multiple myeloma or other malignant lymphoproliferative conditions involving the orbit is needed when the diagnosis of orbital extramedullary plasmacytoma is suspected because treatment and prognosis are very different.

Aged↗
PubMed2000

[Choroidal metastasis as first manifestation of tumor relapse].

CASE REPORT: A case of a 41-year-old woman diagnosed and treated six years ago for a ductal breast carcinoma is presented. The patient complained of blurred vision in the right eye and this symptom was the first manifestation of tumoral relapse. DISCUSSION: We emphasize a correct ophthalmological exploration of cancer patients for an early diagnosis of tumoral spread or relapse. This will allow a proper treatment which is expected to increase the life expectation of these patients.

Adult↗
PubMed1997

Histopathologic study of eyes after iodine I 125 episcleral plaque irradiation for uveal melanoma.

OBJECTIVES: To describe the histopathologic findings attributable to irradiation in eyes with uveal malignant melanoma treated with iodine I 125 brachytherapy and to compare these findings with those reviewed in a previous study that compared histopathologic findings in eyes enucleated after proton beam teletherapy with those seen in eyes in a nonirradiated control group. METHODS: The slides from 22 eyes with uveal melanoma that had undergone enucleation after the administration of 125I brachytherapy were studied. The histopathologic features of the tumor and the retina were graded. Results were compared with findings from a previously reported group of 47 proton beam-treated eyes and its control group. RESULTS: Patient age, time between irradiation and enucleation, and ciliary body involvement were similar for the 125I brachytherapy-treated group and the proton beam-treated group and its control group. This allows comparison of the histopathologic findings. Comparing the 125I brachytherapy- and proton beam-treated groups, most histopathologic features were similar with nominally statistically significant differences only for cell type, number of mitotic figures, and fibrous metaplasia of the retinal pigment epithelium adjacent to the tumor. CONCLUSIONS: Irradiation of uveal melanoma induces changes in the tumor and in the surrounding retina. Brachytherapy and charged particle therapy are the 2 principal methods of irradiation. This study demonstrates that similar changes are produced by 125I plaque irradiation and proton beam irradiation.

Adult↗
PubMed1997

The role of retinotomy in an experimental rabbit model of proliferative vitreoretinopathy.

PURPOSE: To create a model of proliferative vitreoretinopathy (PVR) using retinotomy with vitrectomy, cryotherapy, and platelet-rich plasma (PRP) injection, which more closely resembles the human pathophysiologic condition. METHODS: One hundred and twenty albino rabbits were divided into 10 groups of 12 rabbits each and underwent the following procedures: group 1, vitrectomy; group 2, cryotherapy; group 3, PRP intravitreous injection; group 4, retinotomy; group 5, retinotomy and vitrectomy; group 6, retinotomy and cryotherapy; group 7, retinotomy and PRP injection; group 8, retinotomy, vitrectomy, and cryotherapy; group 9, vitrectomy, cryotherapy, and PRP injection and group 10, retinotomy, vitrectomy, cryotherapy, and PRP injection. All animals underwent follow-up examinations with indirect ophthalmoscopy and fundus photography on days 1, 3, 7, 10, 14, 21, and 28 after the procedure(s). Retinal changes were categorized according to the classification of Fastenberg et al. At the end of the experiments, the eyes were enucleated, and examined under light and electron microscopy. RESULTS: No retinal detachments (RDs) were observed in groups 1, 2, 4, 5, 6, and 8. RDs of varying severity were observed in group 3 (n = 1), group 7 (n = 2), group 9 (n = 6), and group 10 (n = 12). Light and transmission electron microscopy confirmed the findings. CONCLUSIONS: Combining retinotomy with vitreous removal, cryotherapy, and PRP injection creates an efficient and different model of PVR that produced RD in 100% of rabbit eyes.

Animals↗
PubMed1997

Morphologic and immunocytochemical characterization of four human uveal cell lines (melanoma- and melanocytes-derived).

PURPOSE: To characterize three cell lines from human uveal melanomas and one ocular melanocyte cell line to study the specificity of several antigens in the malignant transformation of melanocytic uveal cells. METHODS: Light microscopy (LM), transmission electron microscopy (TEM), and immunocytochemical techniques were used in the characterization of OCM-1, SP 6.5, and MKT-BR human uveal melanoma cell lines and UW-1 normal melanocyte cell line from human uvea. Several monoclonal antibodies (MoAbs) S-100, HMB-45, MNF-116, PAL-M1, NK1/C-3, IND-1, and MAAMA were used. RESULTS: All cell lines showed an epithelioid/spindle morphology with occasional multinucleated cells, and nuclear pleomorphism. TEM showed intracytoplasmatic premelanosomes. Incubation with HMB-45 MoAb was positive in all cell lines. PAL-M2, NK1/C-3, MAAMA, and IND-1 MoAbs stainings were positive with variable intensity. MNF-116 MoAb showed negative staining in the four lines, and S-100 MoAb was also negative except for the UW-1 cell line. CONCLUSIONS: Human uveal melanoma cell lines OCM-1, SP 6.5, and MKT-BR and the ocular melanocyte cell line UW-1 exhibited maintenance of some structural and ultrastructural characteristics of melanocytic cells. All four MoAbs, PAL-M2, NK1/C3, IND-1, and MAAMA against cutaneous melanoma-associated antigens stained positively all melanoma cell lines as well as the melanocytic cell line, suggesting that in vitro proliferation of melanocytes could modify their antigenic expression.

Antibodies, Monoclonal↗
PubMed1997

Porcine model of proliferative vitreoretinopathy with platelets.

PURPOSE: To develop an experimental model of proliferative vitreoretinopathy (PVR) in the pig, and determine the efficacy of platelet-derived growth factor (PDGF) compared with different platelet plasma concentrates in its development. METHODS: Animals were divided into four groups of 12 pigs each. Group 1, 2, and 3 underwent four 3-mm-long retinotomies, a partial mechanical vitrectomy, and six transconjunctival retinal cryoapplications and were injected intravitreally with, respectively, 0.2 ml of platelet rich plasma, 0.2 ml of a solution containing 200 ng of porcine PDGF, and 0.2 ml of platelet concentrated plasma. Group 4 received only an intravitreal injection of 0.2 ml of porcine PDGF. RESULTS: In Group 1, retinal detachments (RDs) developed in six eyes (50%) (two eyes, total RDs; four, extensive RDs). In Group 2, focal RDs developed in six eyes (50%). In Group 3, 11 eyes (92%) developed Rds (six eyes, total RDs; three, extensive RDs, two, focal RDs). Group 4, did not develop lesions. Statistically significant differences were found between Group 3 and the other groups. Group 2 RDs were associated with the presence of vitreoretinal membranes but there were no signs of PVR. In Groups 1 and 3, signs of anterior PVR, posterior PVR, and retinal holes with rolled edges were observed. CONCLUSIONS: We have developed a model of PVR in the pig, the retina of which more closely resembles that of humans. Platelet plasma more effectively contributed to the development of an experimental model of porcine PVR than 200 ng of PDGF. The efficacy depends on the platelet concentration of the plasma. These results suggest that other growth factors and plasma components may interact synergistically with PDGF in the pathogenesis of PVR.

Animals↗
PubMed1997

An evaluation of tumour vascularity as a prognostic indicator in uveal melanoma.

Experimental and clinical evidence suggests that tumour angiogenesis plays a role in the tendency for certain neoplasms, including cutaneous melanomas, to metastasize. We evaluated whether tumour vasculature is associated with the rate of metastases in patients with melanoma of the choroid or ciliary body. The study was based on a group of 63 patients enucleated between 1976 and 1984 with paraffin-embedded tissue blocks available for sectioning and with known survival status as of December 1988. Vessel endothelial cells were highlighted with Ulex europaeus agglutinin I (UEA-I) conjugated with peroxidase. UEA-I-stained microvessels were counted at varying levels in the tumour (apex, centre and base) without knowledge of patient outcome. Patients with (n = 30) and without (n = 33) metastases had similar total vessel counts (P = 0.31). There was no evidence of greater vessel density in tumours that had metastasized, by level within the tumour. Similar results were obtained in multivariate analyses. Findings of this study suggest that tumour microvessel density is unrelated to patient survival in uveal melanoma.

Adult↗