Spontaneous incomplete avulsion of juxtafoveal retinal pigment epithelial hamartoma.
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Adult↗
Biomedical subjects
S Dithmar
Publications and source records attributed to S Dithmar.
Neoadjuvant interferon alfa-2b treatment in a murine model for metastatic ocular melanoma: a preliminary study.
OBJECTIVES: To investigate the treatment of metastasis from uveal melanoma and to test the effect of interferon (IFN) alfa-2b in a murine model. METHODS: The B16-LS9 tissue culture melanoma cells were inoculated into the posterior intraocular compartment of 3 groups of C57BL/6 mice. The inoculated eyes were enucleated at 9 days and the mice were euthanized at 26 days after inoculation; the site and number of metastases were determined using standard histologic techniques. Group 1 was the control group; group 2 was given 20,000 international units (IU) of IFN alfa-2b intramuscularly 12 hours before enucleation, and group 3 received daily injections of 20,000 IU of IFN alfa-2b intramuscularly starting 4 days before enucleation. RESULTS: Pulmonary metastases were detected in 57%, 33%, and 0% of groups 1, 2, and 3, respectively; hepatic micrometastases were detected only in group 1. These results showed a significant decrease in hepatic metastases in mice receiving IFN alfa-2b vs controls (P =.005). CONCLUSION: Treatment with IFN alfa-2b results in decreased hepatic metastases from intraocular melanoma in a murine model. Arch Ophthalmol. 2000;118:1085-1089
Animals↗
[Circumscribed choroidal granulomatous inflammation after perforating injury. A histopathological study of four eyes].
BACKGROUND: This study was performed to describe the clinicopathologic features of patients wo showed circumscribed choroidal granulomatous inflammation after trauma. METHODS: We examined histologically 4 eyes which had been enucleated within 4 weeks after treatment for perforating trauma. The second eyes of the patients were not affected. RESULTS: Four enucleated eyes with perforating injuries had focal uveal granulomatous inflammation of the posterior choroid. None of these eyes contained Dalen-Fuchs' nodules. One eye had a disrupted lens without lens-induced inflammation. All eyes exhibited choroidal ruptures. Foreign material could be detected in one of these eyes. CONCLUSIONS: Focal choroidal granulomatous inflammation may occur as a result of penetrating ocular trauma. The origin of this condition is unknown, although a foreign body reaction and choroidal rupture may be involved in the pathogenesis of the granulomatous inflammation.
Adult↗
[Late diagnosis of Morquio syndrome. Clinical histopathological findings in a rare mucopolysaccharidosis].
BACKGROUND: The Morquio syndrome is a rare autosomal-recessive mucopolysaccharidosis. The Morquio syndrome is characterized by a reduced activity of N-acetylgalactosamine-6-sulfate-sulfatase (type A), or beta-galactosidase (type B). This deficiency leads to a lysosomal storage disease with accumulation of keratan sulfate und chondroitin-6-sulfate in connective tissue, skeletal system und teeth. Consequently, abnormalities of the skeletal system, aortic valvular disease and dental abnormalities occur. Ophthalmologically, diffuse corneal opacification and alterations of the trabecular meshwork--occasionally leading to glaucoma--can be found. CASE REPORT: A 44-year-old woman asked for perforating corneal transplantation because of corneal clouding on both eyes. Besides, she suffered from dwarfism of unclear reason. The diffuse corneal clouding and the dwarfism suggested a systemic-metabolic disease. Thus, further radiologic and medical investigation was started. RESULTS: Radiologically, a kyphoscoliosis, a pectus carinatum, a luxation of both hips, and a gonarthrosis were recognized. Fibroblast culture of a skin biopsy showed reduced activity of N-acetyl-galactosamine-6-sulfate-sulfatase. This was the proof of Morquio syndrome type A. The explanted corneal button showed granules of acid mucopolysaccharides. Those were in the epithelial and endothelial cells and in the corneal stroma. CONCLUSIONS: To our knowledge, a Morquio syndrome has never been diagnosed with an adult and only after the ophthalmologist gave a hint. This can only be explained by the comparative mild expression of the disease in this patient. Diagnosis of Morquio syndrome is important because the frequent odontoid hypoplasia can lead to a deadly atlanto-axial instability, if not treated.
Adult↗
Mucoepidermoid carcinoma of an accessory lacrimal gland with orbital invasion.
PURPOSE: To report a case of mucoepidermoid carcinoma of an accessory lacrimal gland with orbital invasion. METHODS: The clinical history and pathologic findings of a patient with a left upper eyelid lesion were reviewed. RESULTS: The patient was evaluated and found to have an epithelial tumor arising in an accessory lacrimal gland. Special stains showed mucin production by individual tumor cells. The tumor was classified as mucoepidermoid carcinoma. CONCLUSIONS: Mucoepidermoid carcinoma may arise in accessory lacrimal glands and invade the orbit.
Biopsy↗
Histopathologic changes in retinoblastoma after chemoreduction.
PURPOSE: To report the histologic findings in the eyes of two patients with bilateral retinoblastoma who underwent chemoreduction therapy and enucleation of one eye. METHODS: Clinical histories were obtained for both patients. The enucleated eyes were routinely processed and sections were stained with hematoxylin and eosin. RESULTS: The first patient underwent two cycles of carboplatin, vincristine, and etoposide, and the second patient underwent one cycle of carboplatin, vincristine, and etoposide before enucleation. The eyes of both patients exhibited a clinical type 3 regression pattern. Histopathologic examination showed a gliotic mass with interspersed calcifications in one eye and necrotic tumor adjacent to histologically intact retinoblastoma in the other eye. CONCLUSION: Chemoreduction has variable effects on retinoblastoma and the clinical type 3 regression pattern has several histologic counterparts.
Antineoplastic Combined Chemotherapy Protocols↗
Intraocular melanoma spread to regional lymph nodes: report of two cases.
PURPOSE: To report two cases of regional lymphatic spread of primary uveal melanoma. METHODS: The clinical records of two patients who underwent enucleation for uveal melanoma and later developed regional lymph node metastases were reviewed. One of the two eyes was initially treated with proton beam irradiation. Histologic sections of the enucleated eyes and excised lymph nodes were examined. RESULTS: The melanomas arose in the choroid and ciliary body of the two patients and spread to regional lymph nodes 2 years after enucleation. The choroidal melanoma recurred after irradiation, diffusely infiltrated the uveal tract, and extended into the conjunctiva via an emissary canal. The ciliary body melanoma spread through the trabecular meshwork to the conjunctiva. CONCLUSIONS: Choroidal and ciliary body melanoma may rarely exhibit regional lymph node metastasis. This mode of metastasis may occur after extraocular spread and invasion of conjunctival lymphatics.
Adult↗
A new technique for implantation of tissue culture melanoma cells in a murine model of metastatic ocular melanoma.
The aim of this study was to compare the transcorneal and transconjunctival techniques for the implantation of intraocular melanoma cells and development of metastasis in a murine model. Groups of C57BL/6 mice were given either transconjunctival or transcorneal inoculations of 2.5 x 10(5)/2.5 microl tissue culture B16-LS9 melanoma cells into the intraocular posterior compartment (PC). The eyes were enucleated at 4-11 days post-inoculation and histologically examined. The mice were sacrificed 14 days after enucleation and necropsies were performed with histological evaluation for visceral metastases. Intraocular and extraocular tumour growth was present in all of the eyes inoculated via the transconjunctival route. Pulmonary metastases were found in this group if the eye was enucleated 7 or more days post-inoculation. The melanoma remained confined to the inside of the eye in the transcorneal group until day 7. Haematogenous metastases to the lung and liver developed from the intraocular melanoma in this group. Transcorneal inoculation of tissue culture melanoma cells into the murine PC provides a useful animal model for visceral metastasis of ocular melanoma.
Animals↗
Animal models of uveal melanoma.
Many attempts have been made to develop a suitable animal model to study more effectively the aetiology, pathogenesis, diagnosis and therapy of intraocular (uveal) melanoma. Uveal melanoma may spontaneously occur in some animals, including dogs, cats, horses, rats, mice, birds and fish. The histological features, metastatic behaviour and unpredictable nature of occurrence of these uncommon spontaneous tumours detract from their suitability as a model. Several methods have been developed to induce intraocular melanoma chemically or by radiation in laboratory animals. Some of these induced tumours resemble human uveal melanoma, although the majority originate from the retinal pigment epithelium. Uveal proliferations have been biologically induced by feline leukaemia/sarcoma virus and simian virus 40, although the presence of virus in tumour cells and extraocular tumours resulting from shed virus detract from the utility of this model. Inoculation of tissue culture hamster, murine or human melanoma cells into animal eyes has the advantage that the inoculation site and size of inoculum can be controlled. Disadvantages include the immune suppression necessary for tumour growth in some models as well as the fact that many of the melanoma cell lines are of cutaneous origin. Transgenic murine models have been developed using the promoter region of the tyrosinase gene to target expression of oncogenes in melanin-producing cells. Spontaneous intraocular pigmented tumours and distant metastases may occur, although many, if not all, of the intraocular tumours arise in the retinal pigment epithelium.
Animals↗
Ultrastructural changes in Bruch's membrane of apolipoprotein E-deficient mice.
PURPOSE: To examine the histologic and ultrastructural changes in Bruch's membrane (BM) in apolipoprotein E deficient [ApoE(-)] mice in comparison with age-matched control animals. METHODS: Two-month-old (group 1) and 8-month-old (group 2) normal control C57BL/6 mice and 2-month-old (group 3) and 8-month-old (group 4) ApoE(-) mice were studied. All groups of mice were fed a standard rodent diet. The mice were killed, serum lipid levels were determined, and the eyes were ultrastructurally examined using standard techniques to measure the thickness of BM. The area fraction of electron-lucent (EL) particles in BM was quantified using point-counting stereology. RESULTS: The serum cholesterol levels of the ApoE(-) mice were significantly higher than those of the control mice (P = 0.0001). There was a significant thickening and EL particle accumulation in BM associated with age in the control animals. Group 2 had a thicker BM and more EL particle accumulation than group 1 (P = 0.0410 for thickness; P = 0.0042 for particle accumulation). Age-related changes were not seen in ApoE(-) mice; thickness and accumulation were similar in groups 3 and 4 (P = 0.50, thickness; P approximately/= 1.0, accumulation). Significant thickening and accumulation were seen in young ApoE(-) mice (group 3) versus young control animals (group 1; P = 0.008, thickening; P < 0.0001, EL particle accumulation). Group 4 ApoE(-) mice did not have a thicker BM or more EL particles than group 2 control animals (P = 0.2910, thickness; P = 0.35, EL particle accumulation). "Membrane-bounded" material (material between two membranes) was present significantly more frequently in ApoE(-) mice. CONCLUSIONS: ApoE(-) mice exhibit accumulation of EL particles at an earlier age and have more membrane-bounded material in BM than control mice. This material has ultrastructural similarities to basal linear deposit, which accumulates in age-related maculopathy.
Animals↗
Conjunctival deposits as an initial manifestation of sarcoidosis.
PURPOSE: To report conjunctival deposits as an initial manifestation of sarcoidosis. METHODS: Case reports. RESULTS: Two patients with bilateral bulbar conjunctival white deposits underwent conjunctival biopsy. The biopsy specimens showed noncaseating granulomas with prominent Schaumann bodies. Serum angiotensin-converting enzyme levels were increased in both patients. The first patient had abnormal results of pulmonary function tests. Sarcoidosis was diagnosed in both patients. CONCLUSIONS: Conjunctival deposits may represent the initial clinical manifestation of sarcoidosis.
Adult↗
Multifocal intraocular malignant melanoma: report of two cases and review of the literature.
PURPOSE: To describe two eyes from two patients with multifocal primary intraocular melanoma. DESIGN: Two case reports. METHODS: The history and histologic findings in the enucleated eyes of two patients with multifocal intraocular melanoma are described in comparison to previously reported cases. MAIN OUTCOME MEASURES: Pathologic examination of enucleated eyes. RESULTS: One of the two eyes contained mixed cell type melanomas, and one eye contained spindle cell type melanomas. Examination of serial sections showed no continuity between the intraocular melanomas. There were no associated ocular or systemic conditions with the multifocal intraocular melanomas. CONCLUSIONS: Multifocal primary intraocular melanoma is rare. There is no known predisposing factor to this condition.
Aged↗
B16LS9 melanoma cells spread to the liver from the murine ocular posterior compartment (PC).
PURPOSE: To create a murine ocular melanoma model that consistently metastasizes to the liver. METHODS: Twelve-week-old C57BL6 mice (n=10) were inoculated in the posterior compartment (PC) of one eye with 5x10(5) tissue culture B16LS9 melanoma cells. The inoculated eyes were enucleated at two weeks and the mice were sacrificed with necropsies performed at four weeks post-inoculation. RESULTS: Melanoma grew and was confined to the eyes of all 10 mice. The melanoma hematogenously spread to the lungs in 9 of 10 mice and the liver in 8 of 10 mice. There was a positive correlation between pulmonary and liver metastasis (r=0.94). CONCLUSIONS: B16LS9 melanoma cells consistently hematogenously spread to the liver when implanted into C57BL6 mice eyes. The value of this model is unknown at this time since it is not known if the intrahepatic melanoma is capable of growing and killing the host.
Animals↗
Desmoplastic spindle-cell melanoma of the eyelid with orbital invasion.
PURPOSE: To describe the clinicopathologic features of a patient with a spindle-cell melanoma of the eyelid that exhibited orbital invasion. METHODS: Case report. RESULTS: A slowly enlarging mass developed in the eyelid of a 50-year-old woman. Excision of the mass showed desmoplastic spindle-cell melanoma. The tumor recurred in the orbit, and an exenteration was performed. A second recurrence 7 months later was treated with radiation therapy. CONCLUSIONS: There is a continuum of spindle-cell to desmoplastic melanoma. The prognosis of patients with orbital invasion of melanoma is poor, and adjuvant treatment including radiation and chemotherapy has little benefit.
Biopsy↗
[Hereditary benign intraepithelial dyskeratosis].
BACKGROUND: Hereditary benign intraepithelial dyskeratosis (HBID) is a rare autosomal dominant disorder with incomplete penetrance. It is characterized by bilateral limbal conjunctival plaques combined with similar changes in the oral mucosa. PATIENT: An 11-year-old African-American patient presented with bilateral chronic conjunctivitis, nasal and temporal limbal conjunctival plaques, and plaques of the oral mucosa, all of which resisted therapy. The onset of the symptoms was in early childhood. Conjunctival smears, allergy tests, blood samples and the internal examination were inconclusive. Histologically, the ocular lesions showed acanthosis, parakeratosis, hyperkeratosis and dyskeratosis. An infiltrate of chronic inflammatory cells was present beneath the intact epithelial basement membrane. CONCLUSIONS: The clinical and histological findings are characteristic of HBID. Symptoms usually start in early childhood and show a waxing and waning course. HBID was first seen among Haliwa Indians in North Carolina. In the meantime HBID has been described in other parts of the US and also in Europe. As these patients were not related to any of the Haliwa Indians, they are considered new mutations. Malignant changes of the conjunctival or oral lesions have not been reported.
Child↗
[Confocal scanning laser indocyanine green angiography of classical choroid neovascularization].
"Classic" choroidal neovascularization (CNV) has a relatively uniform appearance in fluorescein angiography. In contrast, indocyanine green (ICG) angiography shows variable features of well-defined CNV. We examined 31 classic CNV patients secondary to age-related macular degeneration using a confocal laser scanning ophthalmoscope (Heidelberg Retina Angiograph) in order to determine ICG characteristics of classic CNV. Vascular patterns (97%), a hypofluorescent rim (84%), a hyperfluorescent margin (42%), late ICG leakage (32%) and "feeder vessels" were identified in variable frequency. Some of the ICG characteristics may correlate with histological features of the membrane and reflect proliferative activity. Extrafoveal "feeder vessels" may be amenable to laser photocoagulation in the presence of subfoveal CNV.
Aged↗
[Simultaneous fluorescein and indocyanine green angiography with a confocal laser ophthalmoscope].
BACKGROUND: We report on our clinical experience with a recently developed confocal scanning laser ophthalmoscope for simultaneous fluorescein and indocyanine-green (ICG) angiography. MATERIALS AND METHODS: Following injection of fluorescein and ICG mixed in one syringe simultaneous confocal scanning laser fluorescein and ICG angiography were carried out using the Heidelberg Retina Angiograph (HRA). An argon laser (488 nm) and a diode laser beam (795 nm) from an external source were delivered via single-mode fibers. Emission was recorded between 500 and 650 nm and above 810 nm, respectively. Digital images were displayed simultaneously on a monitor during angiography. RESULTS: A total of 295 simultaneous angiograms in 268 patients with various retinal and choroidal diseases, including exudative age-related macular degeneration with occult and classic choroidal neovascularization, were obtained. High-contrast images during all phases of the angiography were obtained. Besides mild side effects in similar frequency known from individual injections, no additional toxic or allergic reactions from simultaneous injections of the two dyes were observed. CONCLUSIONS: Confocal laser scanning angiography allows for simultaneous fluorescein and ICG angiography. Compared with consecutive investigations using both dyes, simultaneous angiography requires only one injection, and offers identical digital frames. Simultaneous injection is not associated with additional side effects.
Aged↗
[Massive reactive gliosis of the retina].
BACKGROUND: Massive retinal gliosis is a rare, extreme form of a reactive glial cell proliferation and can cause difficulties in the differential diagnosis of intraocular tumors. PATIENT AND METHODS: A 33-year-old patient presented with a painful neovascular glaucoma and a solid intraocular mass. The left globe was subsequently enucleated. The fundus could not be visualized due to lens opacities and an incomplete occlusive membrane. The findings of the magnetic resonance imaging were compatible with an intraocular malignant choroidal melanoma. RESULTS: Histologically the intraocular tumor proved to be a massive retinal gliosis replacing all retinal layers. Immunohistological reactions were positive for GFAP ("glial fibrillary acidic protein"). There were many dilated vessels within the glial mass. CONCLUSIONS: Massive proliferations of glial cells represent secondary changes which are usually found in blind eyes with various underlying diseases. They can be confused with other intraocular tumors, particularly if the fundus cannot be visualized. Ultrasound-reflectivity and magnet resonance imaging findings of massive retinal gliosis may resemble a malignant choroidal melanoma.
Adult↗