Biomedical subjects

V M Elner

Publications and source records attributed to V M Elner.

At least 37 records · Page 2Linked to original sources

PubMed1997

Cell-associated human retinal pigment epithelium interleukin-8 and monocyte chemotactic protein-1: immunochemical and in-situ hybridization analyses.

Human retinal pigment epithelial (RPE) cells secrete chemokines, interleukin-8 (IL-8) and monocyte chemotactic protein-1 (MCP-1) in response to pro-inflammatory cytokines. In this study we (1) examined the efficiency of human RPE IL-8 and MCP-1 secretion, (2) determined the amount of neutrophil and monocyte chemotactic activity in human RPE cell conditioned media and cell extracts that is attributable to IL-8 and MCP-1, respectively, and (3) assessed the sensitivity of immunohistochemistry and in situ hybridization for detecting chemokine production by cytokine-stimulated human RPE cells. Conditioned media and extracts from human RPE cells stimulated with various physiologic concentrations of interleukin-1 beta (IL-1 beta) (0.2-20 ng ml-1), tumor necrosis factor (TNF-alpha) (0.2-20 ng ml-1) or interferon-gamma (IFN-gamma) (10-1000 U ml-1) were examined to compare secreted and cell associated levels of IL-8 and MCP-1 at various time points up to 24 hr. ELISA demonstrated that IL-8 and MCP-1 are both efficiently secreted by pro-inflammatory cytokine treated human RPE cells. Substantial dose- and time-dependent RPE secretion of IL-8 was observed following stimulation with IL-1 beta or TNF-alpha, but cell associated IL-8 was detectable only after high dose (20 ng ml-1) IL-1 beta stimulation and comprised less than 1% of the total IL-8 induced. Dose- and time-dependent RPE cell MCP-1 secretion was also observed following IL-1 beta > TNF-alpha > IFN-gamma stimulation, with an average of 4% of the total MCP-1 retained within RPE. Bioassays demonstrated neutrophil and monocyte chemotactic activity in conditioned media from stimulated RPE cells, but not in human RPE cell extracts. Inhibition of conditioned media-induced chemotaxis by specific anti-IL-8 or anti-MCP-1 antibodies demonstrated that IL-8 and MCP-1 were responsible for the majority of HRPE-derived neutrophil (> 60%) and monocyte (53-57%) chemotactic activity, respectively. Using in situ hybridization IL-8 mRNA was readily detected within IL-1 beta > TNF-alpha stimulated RPE cells and MCP-1 mRNA easily visualized within IL-1 beta > TNF-alpha > or IFN-gamma stimulated cells. Immunohistochemistry to detect IL-8 was positive only in RPE cells exposed to high dose IL-1 beta (20 ng ml-1) for 8 or 24 hr and was weak. Immunohistochemical staining for MCP-1 in RPE cells was more intense and was visualized within RPE cells stimulated with IL-beta, TNF-alpha, or IFN-gamma. This study demonstrates that: (1) RPE cells efficiently secrete IL-8 and MCP-1 upon stimulation with pro-inflammatory cytokines; (2) secreted IL-8 and MCP-1 account for the majority of human RPE neutrophil and monocyte chemotactic activity; (3) in situ hybridization readily detects IL-8 and MCP-1 mRNA in cytokine stimulated RPE cells; and (4) immunohistochemistry demonstrates cell-associated MCP-1 in cytokine stimulated RPE cells, but only minimal cell-associated IL-8.

Cells, Cultured↗

PubMed1997

Mucoepidermoid carcinoma of the caruncle.

PURPOSE: To report a case of mucoepidermoid carcinoma, a highly aggressive variant of conjunctival squamous cell carcinoma. METHODS: We examined and treated a 57-year-old man with mucoepidermoid carcinoma of the caruncle, a highly unusual site for this tumor. RESULTS: In the past, simple excision of this tumor has been followed by rapid recurrence. Our patient underwent wide surgical excision of the tumor and has shown no evidence of recurrence after 16 months of follow-up. CONCLUSION: Mucoepidermoid carcinoma may first manifest in the caruncle. Histologically verified, tumor-free surgical margins are necessary for complete excision.

Carcinoma, Mucoepidermoid↗

PubMed1997

Selective IL-10 inhibition of HLA-DR expression in IFN-gamma-stimulated human retinal pigment epithelial cells.

PURPOSE: Human RPE cells express HLA-DR antigens, bind leukocytes via ICAM-1, and secrete IL-8 and MCP-1, which attract and activate leukocytes. Since little is known concerning endogenous cytokines that may alter ocular immunologic and inflammatory mechanisms, we investigated whether IL-10, an immunosuppressive cytokine, modulates these HRPE features. METHODS: IL-10 effects on HLA-DR and ICAM-1 were examined by HRPE exposures to: (1) IFN-gamma (10-1000 U/ml) + IL-10 (1-100 U/ml) and (2) IL-10 pre-incubation followed by IFN-gamma + IL-10. Immunohistochemistry for HLA-DR and ICAM-1 was graded by masked observers. Flow cytometric analysis quantitated HRPE HLA-DR and ICAM-1. Effects of IL-10 on IL-1 beta (0.2 or 2 ng/ml)-, or TNF-alpha (0.2 or 2 ng/ml)-induced IL-8 and MCP-1 secretion and gene expression were assessed using enzyme-linked immunosorbent assay (ELISA) and Northern blot analysis. RESULTS: HLA-DR expression, detected by immunohistochemistry and flow cytometric analysis, showed dose-dependent increases to IFN-gamma. IL-10 pre-/co-incubation, but not co-incubation alone, markedly reduced HLA-DR expression, but did not modulate constitutive or IFN-gamma-induced ICAM-1. IL-10 alone did not induce MCP-1 or IL-8 secretion or steady-state mRNA expression, nor modulate IL-1 beta-, TNF-alpha- or IFN-gamma-induced IL-8 or MCP-1. CONCLUSIONS: This study suggests that HRPE HLA-DR antigens are selectively inhibited by IL-10, but the timing of IL-10 exposure may be crucial.

Chemokine CCL2↗

PubMed1997

Recurrent orbital malignant peripheral nerve sheath tumor 18 years after initial resection.

Malignant peripheral sheath tumor (malignant PNS tumor) is a rare, aggressive, and lethal orbital neoplasm that usually arises from sensory branches of the trigeminal nerve in adults. Malignant PNS tumor spreads along nerves to involve the brain, and most patients die within 5 years of clinical diagnosis. The clinical history and examination, imaging studies, surgical procedures, and pathologic specimens of a 23-year-old man with rapid, posttraumatic onset of left orbital proptosis and pain are reported. Biopsy specimens of the tumor were compared with specimens from the same orbit obtained 18 years previously. Histopathology of the left orbital tumor compared with that of an incomplete excision of a tumor 18 years previously in the same orbit revealed both to be malignant PNS tumor. The patient is alive without recurrence 8 months after orbital exenteration and 18 years after initial tumor presentation. This is the youngest age of occurrence and the longest documented survival of a patient with orbital malignant PNS tumor.

Adult↗

PubMed1997

Recurrent trichofolliculoma of the upper eyelid margin.

We report a woman who had a recurrent trichofolliculoma on the upper eyelid margin. Only three cases of this benign tumor on the eyelid have been reported, and no recurrence in this location had been noted in the literature. The lesion, present for 6 years, had been excised twice previously (3 and 4 years before), recurred, and had been injected with a steroid preparation 2 years earlier. Lashes, both normal-looking and immature, arose from the center area of this lesion, and telangiectatic vessels were on its surface. Full-thickness wedge resection was used to excise the lesion completely. Complete primary excision of trichofolliculoma is important, and local steroid preparations should not be used.

Adult↗

PubMed1997

Dexamethasone and cyclosporin A modulation of human retinal pigment epithelial cell monocyte chemotactic protein-1 and interleukin-8.

PURPOSE: To examine the modulation of interleukin-1 beta (IL-1 beta)- and tumor necrosis factor-alpha (TNF-alpha)-stimulated monocyte chemotactic protein-1 (MCP-1) and interleukin-8 (IL-8) secretion and transcription in human retinal pigment epithelial (HRPE) cells by dexamethasone (DEX) and cyclosporin A (CSA). METHODS: Cultured HRPE cells were stimulated with IL-1 beta (0.2 to 20 ng/ml) or TNF-alpha (0.2 to 20 ng/ml) for 8 or 24 hours without (control) and with DEX (10(-8) to 10(-6) M) or with CSA (0.3 to 30 ng/ml). Secreted levels of HRPE MCP-1 and IL-8 were measured in the media using enzyme-linked immunosorbent assay (ELISA). Both MCP-1 and IL-8 mRNA were analyzed by Northern blot. RESULTS: Although DEX (10(-8) to 10(-6) M) inhibited IL-1 beta-stimulated MCP-1 and IL-8 production, it did not inhibit TNF-alpha-stimulated chemokine secretion. In contrast, CSA significantly inhibited TNF-alpha-stimulated, but not IL-1 beta-stimulated, HRPE MCP-1 and IL-8 secretion. Both DEX and CSA inhibitions showed dose dependence. Northern blot analysis of HRPE steady state MCP-1 and IL-8 mRNA corroborated the ELISA measurements of secreted MCP-1 and IL-8. CONCLUSIONS: Although DEX and CSA inhibit HRPE MCP-1 and IL-8 secretion, this is dependent on whether the inducing inflammatory mediator is IL-1 beta or TNF-alpha. IL-1 beta-induced chemokine secretion is sensitive to DEX, whereas MCP-1 and IL-8 induced by TNF-alpha are inhibited by CSA. This information may be useful in explaining in vivo observations and in suggesting targeted clinical treatments and combinations of immunosuppressive agents.

Anti-Inflammatory Agents↗

PubMed1997

Human retinal pigment epithelial cell interleukin-8 and monocyte chemotactic protein-1 modulation by T-lymphocyte products.

PURPOSE: The purpose of the study was to examine the effect of T-lymphocyte products on human retinal pigment epithelial (HRPE) cell interleukin-8 (IL-8) and monocyte chemotactic protein-1 (MCP-1) secretion and gene expression. METHODS: HRPE cells were stimulated for 2, 4, 8, or 24 hours with 20% conditioned media (CM) from T-lymphocytes stimulated with CD3 or CD28 monoclonal antibodies (mAbs) or phorbol myristic acid. In some experiments, CM from CD3 mAb-stimulated T-lymphocytes was preincubated with neutralizing anti-(alpha)-tumor necrosis factor (TNF), alpha-interferon-gamma (IFN-gamma), or alpha-interleukin-1 (IL-1) mAb (control) to determine the contributions of each of these cytokines to HRPE chemokine induction by stimulated T-lymphocyte CM. HRPE cells were stimulated for 8 and 24 hours with IL-1 beta (0.2 to 20.0 ng/ml) (positive control), TNF-alpha (0.2 to 20.0 ng/ml) (positive control), IFN-gamma (1 to 1000 U/ml), IFN-gamma + IL-1 beta, IFN-gamma + TNF-alpha. Interleukin-2 (IL-2; 100 ng/ml) alone or in combination with IL-1 beta, TNF-alpha, or IFN-gamma also was tested. Enzyme-linked immunosorbent assay (ELISA) and Northern blot analyses were performed to determine secreted IL-8 and MCP-1 and their steady state mRNA expression, respectively. RESULTS: ELISA showed significant increases in HRPE IL-8 and MCP-1 secretion by CM from T-lymphocytes stimulated with CD3 or CD3 + CD28 mAb. Smaller, but significant, increases in IL-8 and MCP-1 resulted from CM phorbol myristic acid-stimulated T-lymphocytes. CM preincubated with neutralizing alpha-TNF or alpha-IFN-gamma mAb induced significantly less HRPE IL-8 and MCP-1, whereas preincubation of CM with neutralizing alpha-IL-1 mAb failed to inhibit CM-induced IL-8 or MCP-1. Northern blot analysis showed increased HRPE IL-8 and MCP-1 mRNA expression within 2 hours of stimulation and was maintained up to 24 hours. CM from T-lymphocytes stimulated with CD3 mAb or CD3 + CD28 mAb produced the greatest increases in IL-8 and MCP-1 mRNA. IFN-gamma induced dose-dependent increases in HRPE MCP-1, but not IL-8, IFN-gamma potentiated IL-1 beta and TNF-alpha-induced MCP-1 production, but showed little modulation of IL-1 beta and TNF-alpha-induced IL-8 production. IL-2 did not induce HRPE IL-8 or MCP-1, nor did it modulate the effects of the other cytokines. Northern blot analysis confirmed the ELISA results. CONCLUSIONS: T-lymphocyte secretions induce HRPE IL-8 and MCP-1 gene expression and secretion. TNF and IFN-gamma appear to be necessary components of T-lymphocyte CM for the induction of HRPE IL-8 and MCP-1. IFN-gamma alone induces HRPE MCP-1, albeit to a lesser extent than would IL-1 beta or TNF-alpha, and potentiates IL-1 beta- and TNF-alpha-induced HRPE MCP-1. IL-2 does not appear to modulate cytokine-induced HRPE IL-8 or MCP-1.

Antibodies, Monoclonal↗

PubMed1996

Angiosarcoma metastatic to the orbit.

Angiosarcoma is a rare malignant endothelial cell tumor. Few reports of primary orbital angiosarcoma exist in the literature. A 46-year-old woman had a 3-month history of progressive diplopia and right-sided exophthalmos. Magnetic resonance imaging showed a right intraconal mass, consistent with a cavernous hemangioma. Ultrasound examination showed a isolated mass with moderate vascularity, consistent with a metastatic lesion. Subtotal excision through a lateral orbitotomy was performed. Tissue was stained with hematoxylineosin, periodic acid-Schiff, and immunohistochemical stains for factor-VIII-related antigen and Ulex europaeus agglutinin I lectin. Lateral orbitotomy biopsy specimens showed an angiosarcoma, similar to a primary breast angiosarcoma that had been resected 2 years previously. The patient initially underwent orbital exenteration for her only known metastasis. Despite a multidisciplinary and aggressive approach to this tumor, the tumor recurred, and the patient died.

Breast Neoplasms↗

PubMed1996

Lateral extensions of the Müller muscle.

OBJECTIVES: To define the lateral extension of the Müller muscle and to elucidate its involvement in the development and surgical treatment of Graves (thyroid) eye disease. METHODS: Twelve lateral halves of orbits exenterated from patients with medial or posterior orbital neoplasms were fixed, embedded, and step sectioned at 250-microns intervals to produce histological sections. Gross anatomical dissections of human cadaver heads were also used to corroborate the histological findings. RESULTS: Histological analysis revealed that the Müller muscle extended laterally between the orbital and palpebral lobes of the lacrimal gland in all specimens. The smooth muscle fibers were found to interdigitate with lacrimal ducts passing from the orbital to palpebral lobe and to extend close to the ductal orifices at the conjunctival surface. Gross dissections confirmed that the Müller muscle accompanied the levator aponeurosis lateral extension, which is known to pass between the orbital and palpebral lobes of the lacrimal gland. CONCLUSIONS: Our anatomical findings suggest that the Müller muscle may contribute to the temporal flare frequently seen in eyelid retraction associated with thyroid eye disease. They may also explain the difficulty of treating lateral eyelid retraction in thyroid eye disease and indicate the need for new surgical approaches for severe lateral eyelid retraction.

Eye Enucleation↗

PubMed1996

Glycated serum albumin induces chemokine gene expression in human retinal pigment epithelial cells.

Chronic hyperglycemia is thought to be important in the development of diabetic neovascularization but the mechanisms involved remain poorly understood. Interleukin-8 (IL-8) is a leukocyte chemokine and activating agent with angiogenic properties that is present in diabetic vitreous and may play a role in diabetic vasculopathy. We studied IL-8 and monocyte chemotactic protein-1 (MCP-1) production by human retinal pigment epithelial (hRPE) cells exposed to glycated human serum albumin (GHSA). Enzyme-linked immunoassay GHSA (500 micrograms/mL)-treated hRPE cells secreted levels of IL-8 and MCP-1 detectable within 4 h and reached 26.0 +/- 1.3 and 42.2 0.4 ng/10(6) cells/mL after 24 h, respectively. Induction of IL-8 and MCP-1 by GHSA at concentrations ranging from 62.5 to 3,000 micrograms/mL exhibited dose-dependent kinetics. The GHSA-induced chemokine secretion by hRPE was almost completely inhibited by actinomycin D and cycloheximide, suggesting that de novo mRNA and protein synthesis are necessary for the GHSA-induced IL-8 and MCP-1 production. Northern blot analysis of GHSA-induced hRPE IL-8 and MCP-1 mRNA expression corresponded to the time- and dose-dependent increases measured by enzyme-linked immunosorbent assay. High concentrations of glucose (20 mM; 360 mg/dl) increased GHSA-induced hRPE IL-8 and MCP-1 secretion, whereas added insulin (0.5 ng/mL) inhibited IL-8 but not MCP-1 protein secretion and mRNA expression. GHSA also induced hRPE to secrete GRO-alpha, RANTES, and NAP-2 chemokines. GHSA induction of hRPE chemokines further suggests a role for the hRPE in leukocyte infiltration, vascular injury, and neovascularization.

Cells, Cultured↗

PubMed1996

Interleukin-7 (IL-7) induces retinal pigment epithelial cell MCP-1 and IL-8.

The neuroectodermally-derived retinal pigment epithelium (RPE) forms part of the blood-retina barrier where it is strategically-positioned to regulate leukocyte infiltration in retinal diseases. Activated human RPE cells possess several functions enabling them to perform this role including expression of HLA-DR antigens, production of intercellular adhesion molecule-1, and secretion of monocyte chemotactic protein-1 and interleukin-8. In this study, we examined the ability of interleukin-7 to induce RPE-derived monocyte chemotactic protein-1 and interleukin-8 and assessed the potentiating effects of interleukin-7 on interleukin-1 beta- and tumor necrosis factor-alpha-induced RPE monocyte chemotactic protein-1 and interleukin-8 production. Human RPE cells incubated with interleukin-7 (1-100 ng ml-1) for 24 hr secreted significant levels of antigenic RPE monocyte chemotactic protein-1 and interleukin-8 in a dose-dependent fashion interleukin-7 (P < 0.05). RPE costimulation with interleukin-7 and interleukin-1 beta (2 ng ml-1) or tumor necrosis factor-alpha (2 ng ml-1) resulted in additive increases (P < 0.05) in secreted monocyte chemotactic protein-1 and interleukin-8. Steady-state RPE monocyte chemotactic protein-1 mRNA was substantially increased by interleukin-7 (1-100 ng ml-1), while RPE interleukin-8 mRNA was mildly elevated by higher doses of interleukin-7 (10-100 ng ml-1). Time-dependent increases in RPE monocyte chemotactic protein-1 and interleukin-8 mRNA were noted. RPE monocyte chemotactic protein-1 mRNA peaked at 2 hr and decreased over 8 hr and 24 hr. Whereas, RPE interleukin-8 mRNA was perceptible at 2 hr, maximal at 8 hr, and reduced by 24 hr. Interleukin-7 potentiated interleukin-1 beta-induced monocyte chemotactic protein-1 and interleukin-8 steady-state mRNA expression at all interleukin-7 concentrations. Interleukin-7 potentiated tumor necrosis factor-alpha-induced RPE monocyte chemotactic protein-1 steady-state mRNA expression at all doses of interleukin-7 while only high dose interleukin-7 (100 ng ml-1) enhanced tumor necrosis factor-alpha-induced RPE interleukin-8 steady-state gene expression. Our data show that interleukin-7 is a primary stimulus of RPE monocyte chemotactic protein-1 and interleukin-8. This is one of the first reports demonstrating: (1) interleukin-7 induction of monocyte chemotactic protein-1 in any cell type, and (2) interleukin-7 induction of interleukin-8 in resident, tissue-based cells. These studies suggest that interleukin-7 potentiation of interleukin-1 beta and tumor necrosis factor-alpha-induced RPE monocyte chemotactic protein-1 and IL-8 may be important for the elicitation of leukocyte chemotaxins in diseased retinal tissue when only low ambient levels of individual pro-inflammatory cytokines are present.

Cells, Cultured↗

PubMed1996

Golf-related ocular injuries.

PURPOSE: To examine patient outcomes from golf-related ocular injuries. METHODS: Retrospective case review of patients treated at the University of Michigan during the six-year period from November 1989 to October 1995. RESULTS: Of nine injuries treated in the six-year period, six of the patients with ocular injuries from golfing required enucleation. Seven of the injuries were from golf balls, and remaining two were injuries from golf clubs. CONCLUSION: Although unpredictable and difficult to avoid, proper golf etiquette and safety may diminish the incidence of golf-related ocular injures.

Adolescent↗

PubMed1996

Differential expression of immunoreactive HLA-DR and ICAM-1 in human cultured orbital fibroblasts and orbital tissue.

Intercellular adhesion molecule-1 (ICAM-1) and class II major histocompatibility complex antigens (MHC II, HLA-DR), are two cell-surface ligands known to be critical to the initiation and propagation of immune-mediated inflammation. Their expression in tissue is induced by proinflammatory mediators, principally interferon-gamma, tumor necrosis factor-alpha, and interleukin-1 beta. We examined human orbital fibroblasts and intact human orbital tissue exposed to these mediators for the presence of immunoreactive ICAM-1 and HLA-DR antigen. These ligands were detectable on stimulated fibroblasts and on fibroblasts and vascular endothelium in samples of orbital fat and muscle. ICAM-1 reactivity was diffuse and occurred in response to all three proinflammatory mediators. In contrast, HLA-DR reactivity was intense but limited to fewer numbers of cells. Our results, demonstrating the differential expression of these two ligands, may help further to elucidate the underlying pathogenetic mechanisms involved in the initiation and perpetuation of immune-mediated orbital inflammatory diseases.

Adipose Tissue↗

PubMed1996

The integrin superfamily and the eye.

Integrins may have many different roles in the eye, from influencing ocular development, cell migration in wound healing or pathologic processes, and modulating inflammation and thrombosis in ocular tissue. With the variety of integrins expressed on ocular cells, great versatility and redundancy are afforded in integrin interactions. Elucidation of the functional roles of specific integrins may answer important questions regarding tumor invasion, metastasis, and ocular development. The roles of integrins in inflammation is a rapidly advancing field that soon may lead to anti-inflammatory pharmacologic agents. Potent integrin antagonists, such as cyclic RGD peptides isolated from viper venom, may prove to be useful as anti-inflammatory, anti-metastatic, or anti-thrombotic agents for the treatment of ocular disease.

Amino Acid Sequence↗

PubMed1995

Laser photocoagulation of the choroid through experimental subretinal hemorrhage.

OBJECTIVE: To study the differential abilities of diode infrared, krypton red, and argon blue-green laser energies to penetrate experimental subretinal hemorrhage and coagulate the underlying choroid. METHODS: Autologous, heparinized whole blood was injected beneath the neurosensory retina of pigmented rabbit eyes. After 30 to 60 minutes, confluent patches of moderate or severe diode, krypton, or argon laser burns were applied to adjacent healthy retina and continued into the region of the subretinal hematoma without varying the power setting or focal plane. Histopathologic evaluation of early lesions was performed in a masked fashion, and subretinal hemorrhage thickness was determined with computer-assisted image capture and analysis. RESULTS: Retina overlying treated subretinal hemorrhage showed no ophthalmoscopically visible signs of photocoagulation with diode energy, a faint gray reaction with krypton energy, and an intense white reaction with argon energy. Histopathologic analysis revealed photocoagulative inner choroidal damage beneath a mean (+/- SD) maximum blood thickness of 0.56 +/- 0.14 mm with severe diode burns, 0.42 +/- 0.09 mm with severe krypton burns, and 0.22 +/- 0.04 mm with severe argon burns. CONCLUSIONS: These data demonstrate that laser penetration of subretinal blood increases with longer wavelengths in vivo. Diode infrared laser energy is capable of penetrating subretinal blood to coagulate the choroid in the absence of ophthalmoscopically visible changes in the overlying retina.

Animals↗

PubMed1995

Inverted papillomas that invade the orbit.

We describe 10 patients with inverted papillomas (IPs), uncommon endophytic epithelial tumors that arose in the nose, paranasal sinuses, and lacrimal sac, that invaded the orbit; review the world literature on IP; and discuss treatment options. Patients ranged in age from 49 to 72 years (mean age, 62 years; median age, 66 years). Six patients were men and four were women. Presenting symptoms and signs included a medial canthal mass (n = 5), epiphora/lacrimal drainage obstruction (n = 3), inability to wear eyeglasses (n = 2), diplopia (n = 1), and painful dentures (n = 1). Histopathologic examination was performed in each patient and revealed all patients to have areas with malignant transformation: six patients with IPs that contained areas of squamous cell carcinoma and four with areas of transitional cell carcinoma in the tumor within the orbit. Eight of the patients with IPs had a recurrence after initial resection. In two patients, the IPs were completely excised and did not recur; yet, follow-up was short. Eight patients required orbital exenteration for local control of disease. Nevertheless, local spread of tumor through bone to brain occurred in three patients with orbital involvement. Indeed, IPs that invade the orbit have a high incidence of malignancy and are locally aggressive tumors. Treatment is difficult, and the recurrence rate is high. Early, wide excision of this aggressive tumor provides the best chance of cure.

Aged↗

PubMed1995

Visual outcome and ocular survival after penetrating trauma. A clinicopathologic study.

PURPOSE: Ocular trauma is a leading cause of blindness in the United States. This study was undertaken to identify clinical and histopathologic factors that predict ocular survival and final visual acuity after penetrating ocular trauma. METHODS: One hundred seventy-six cases of ruptured globe were reviewed. Factors analyzed included (1) initial visual acuity, (2) wound location, (3) wound length, (4) mechanism of injury (sharp, blunt, or missile), (5) presence of intraocular foreign body, (6) type of ocular wound (perforating versus nonperforating), (7) performance of vitrectomy, and (8) histopathologic features (n = 40). Data were analyzed using univariate and multivariate logistic regression analysis. RESULTS: Predictors of excellent final visual acuity (20/60 or better) were initial visual acuity of 20/200 or better, wound location anterior to the plane of insertion of the four rectus muscles, wound length 10 mm or less, and sharp mechanism of injury. In contrast, predictors of poor vision were initial visual acuity of light perception or no light perception, wounds extending posterior to rectus muscle insertion plane, would length greater than 10 mm, and blunt or missile injury. Vitrectomy did not improve final vision. Factors predicting enucleation were similar to those predicting poor vision; however, vitrectomy decreased the likelihood of enucleation. Histopathologic review showed fibrous ingrowth in 93% of eyes enucleated more than 14 days after injury, and none of those enucleated within 2 weeks. CONCLUSION: Significant predictive factors of final visual acuity after penetrating trauma include visual acuity, wound location and length, and mechanism of injury. Establishment of predictors of ocular survival and visual function may assist clinicians in selecting salvageable eyes for surgical repair.

Adolescent↗

PubMed1995

Cytokines in proliferative diabetic retinopathy and proliferative vitreoretinopathy.

We determined whether interleukin-8, monocyte chemotactic protein-1, and macrophage-colony stimulating factor are present in the vitreous of patients with proliferative diabetic retinopathy (PDR) or proliferative vitreoretinopathy (PVR). The levels of these cytokines were measured by specific enzyme-linked immunoassays in vitreous from 30 patients with PDR, 13 patients with PVR, and 26 control individuals, including 10 cadaver eyes and 16 patients with idiopathic macular holes, idiopathic macular puckers, vitreous hemorrhages, or uncomplicated retinal detachments. Detectable levels of interleukin-8 were found in 90% of vitreous samples of patients with PDR, 85% with PVR, and 58% of control samples. IL-8 was significantly increased in PDR (mean +/- SEM; 25.0 +/- 5.3 ng/ml; p = 0.01), but not in PVR (11.9 +/- 3.9 ng/ml; p = 0.50) compared to control human vitreous (8.5 +/- 2.5 2.5 ng/ml). MCP-1 was detected in 90% of vitreous samples of patients with PDR, 92% with PVR, and 81% of control samples. MCP-1 was significantly increased in PDR (6.2 +/- 0.9 ng/ml, p = 0.001) and PVR (7.7 +/- 2.5 ng/ml, p = 0.001) over the levels in control vitreous (1.2 +/- 0.2 ng/ml). M-CSF was detected in 94% of vitreous samples of patients with PDR, 88% with PVR, and 92% from control vitreous. M-CSF was significantly elevated in PDR (32.3 +/- 8.3 ng/ml, p = 0.03), but not in PVR (23.6 +/- 12.8 ng/ml, p = 0.4) compared to control (10.7 +/- 3.5 ng/ml). Our results suggest that IL-8, MCP-1, and M-CSF participate in the pathogenesis of PDR and PVR.

Chemokine CCL2↗