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PubMed2005

Body mass index extremes in a British adolescent gynecology clinic.

STUDY OBJECTIVE: To identify the prevalence of patients with BMI extremes (BMI>88% or < 2%) in our Adolescent Gynecology clinic and audit their weight management. DESIGN: Retrospective case series. SETTING: The Adolescent Gynecology Clinic of a British District General Hospital PARTICIPANTS: All patients aged 12-17 years when first seen in the Adolescent Gynecology clinic from 1997 to 2003. INTERVENTIONS: Retrospective data collection on biometry and weight management interventions. MAIN OUTCOME MEASURES: The percentage of obese (BMI>98(th) percentile for age), overweight (BMI 88(th)-98(th) percentile) and underweight (BMI < 2(nd) percentile) based on published percentile BMI curves for the UK adolescent population, the proportion of patients with extreme BMI that were offered intervention, the types of intervention offered, the proportion of patients whose BMI improved after the intervention, and the number of patients with BMI>88% among smokers were compared to non-smokers. RESULTS: Of the 125 patients 24% were obese, an additional 17% overweight and 1% underweight. The expected figures in the general population are 2%, 10% and 2% respectively (P < 0.001; test of a single proportion). Weight management intervention was offered to 47% of patients with extreme BMI. The BMI improved in 36% of the patients who were offered and 14% of patients who were not offered intervention (P=0.066; chi(2)). There was no statistically significant difference between smokers and non-smokers in the proportion of patients with BMI>88% (P=0.93; chi(2)). CONCLUSION: There is significantly increased prevalence of obese and overweight women among adolescent gynecological patients. The need for management of the BMI of these patients has not been always been recognized and treatment is not particularly effective. The results indicate a need for defined strategies and additional resources for obesity management.

Adolescent↗
PubMed2005

Overweight is gender-dependent in prenatal protein--calorie restricted adult rats acting on the blood pressure and the adverse cardiac remodeling.

UNLABELLED: Postnatal heart remodeling was studied in rats submitted to prenatal protein--calorie restriction (R). Offspring were divided in four groups: control male (CM) and female (CF) vs. restricted male (RM) and female (RF) and lived 120 days. The offspring blood pressure (BP) and biometry were periodically analyzed. In the euthanasia day, the left ventricular (LV) mass index, the cardiomyocyte nuclei profile number (N[cmn]) (disector method), the cross-sectional cardiomyocyte area (A[cm]) and the stereology for intramyocardial arteries (ima) were estimated. Interactions between gender and prenatal nutritional conditions were tested with the two-way ANOVA. RM animals showed higher BP and greater body mass and smaller LV mass index than the other groups. N[cmn] and stereology parameters of ima were smaller, and A[cm] was greater in the R groups rats than in the C groups rats; these structural changes were only dependent of the prenatal nutritional condition but not gender-dependent. IN CONCLUSION: hypertension and body and cardiac growth were influenced by the interaction between gender and prenatal nutritional conditions, while cardiac remodeling seems to be only programmed by the adverse intrauterine environment.

Algorithms↗
PubMed2006

Enhancing intraocular lens outcome precision: an evaluation of axial length determinations, keratometry, and IOL formulas.

Accurate biometry and intraocular lens (IOL) calculations have consequence in patient satisfaction and depend on correct determination of eye length, IOL position, refractive power of the cornea, and selection of the proper IOL formula. Familiarity with these variables will make it easier to achieve precise results in both the intact eyes and eyes that have had previous surgeries, including keratorefractive procedures. This articles provide practical tips and methods to avoid refractive surprises.

Cornea↗
PubMed2004

The axial length/disc area ratio in anisometropic hyperopic amblyopia: a hypothesis for decreased unilateral vision associated with hyperopic anisometropia.

OBJECTIVE: Hyperopic anisometropia is a risk factor for amblyopia. Disc areas and axial lengths are reduced in amblyopic eyes. This study's aim was to investigate the differences in the relative size of the optic disc in 5 groups of eyes: (1) normal right eyes; (2) smaller eyes of nonamblyopic, anisometropic, bilateral hyperopes; (3) larger eyes of nonamblyopic, anisometropic, bilateral hyperopes; (4) fellow (nonamblyopic) eyes of eyes of amblyopic, anisometropic, bilateral hyperopes; and (5) amblyopic eyes of bilateral hyperopic anisometropes. To determine the relative size of the discs, the relationships of axial length to disc area in the above groups were evaluated. DESIGN: Case-control study. PARTICIPANTS: Nine hundred twenty-seven records from the author's private practice, which included axial length measurements and optic disc photographs or digital images, were analyzed to form the 5 groups above. METHODS: Disc areas were measured using objective techniques developed by Bengtsson and Krakau. Axial lengths were determined by ultrasound biometry or with a Zeiss IOL Master. MAIN OUTCOME MEASURES: Optic disc areas, corrected for magnification, axial lengths, and a derived ratio, axial length/disc area (AXL/DA). RESULTS: The AXL/DA for the amblyopic eyes (group 5) was significantly greater than that of all of the other groups, indicating that amblyopic eyes have discs that are both absolutely smaller and, when adjusted for eyes' size, relatively smaller than those of nonamblyopic eyes. CONCLUSION: The relatively small size of the discs of amblyopic eyes points to an organic as opposed to a functional amblyopia in these patients.

Adolescent↗
PubMed2005

Nomogram-based intraocular lens power adjustment after myopic photorefractive keratectomy and LASIK: a new approach.

PURPOSE: (1) To evaluate the accuracy of nomogram-based adjustment of intraocular lens (IOL) power to achieve a desired refractive target after cataract surgery in postmyopic LASIK and photorefractive keratectomy (PRK) eyes and (2) to compare the accuracy of the nomogram-based method with the clinical history method. DESIGN: Multicenter, retrospective, interventional, noncomparative case series. SUBJECTS: Fourteen patients (19 eyes) after myopic LASIK or PRK with visually significant cataracts. INTERVENTION: All eyes underwent cataract extraction and posterior chamber intraocular lens implantation. In each case, IOL power was determined with standard keratometry and biometry. Power adjustment was made by use of a theoretical nomogram followed by implantation. MAIN OUTCOME MEASURES: (1) Final refraction and spherical equivalent after cataract surgery and (2) deviation of the final spherical equivalent from the refractive target. RESULTS: After cataract extraction, by use of nomogram adjustment, 63.2% of eyes were within 0.5 D of the intended spherical equivalent, 84.2% were within 1.0 diopter of the intended spherical equivalent, and 100% were within 1.5 D of the intended spherical equivalent. The clinical history method was accurate in predicting the correct IOL power in 37.5% of cases, regardless of whether spectacle or corneal plane refraction was used. CONCLUSIONS: (1) Given the change in spherical equivalent induced by myopic LASIK/PRK, IOL power can be adjusted accurately to avoid undercorrection without the need for the prerefractive surgery corneal power. (2) The nomogram-based method was more accurate than the clinical history method.

Adult↗
PubMed2006

Angle closure in highly myopic eyes.

PURPOSE: Patients with angle-closure glaucoma and high myopia are uncommon. We evaluated the clinical characteristics of all patients with angle closure and high myopia in our database and propose possible mechanisms for angle closure in these atypical patients. DESIGN: Retrospective noncomparative case series. PARTICIPANTS: Our database of 17938 patients was searched for patients with myopia of spherical equivalent of more than -6.0 diopters and angle closure. Data recorded included age at time of initial consultation, gender, slit-lamp examination results, gonioscopy results, biometric parameters, ultrasound biomicroscopy results (from 1993 onward), clinical diagnosis, and therapy. RESULTS: Twenty patients (11 females, 9 males) were identified. Mean age at the time of consultation was 52.9+/-19.3 years. Angle-closure diagnoses included primary pupillary block (9 patients), pupillary block in an eye with keratoconus (1 patient), pupillary block secondary to a pupillary membrane associated with retinopathy of prematurity (1 patient), plateau iris configuration and syndrome (3 patients), phacomorphic glaucoma in Weill-Marchesani syndrome (2 patients), malignant glaucoma secondary to a scleral buckle (2 patients), miotic-induced angle closure (1 patient), and Marfan syndrome (1 patient). CONCLUSIONS: Angle closure can occur in eyes with high myopia. Causes of angle closure other than relative pupillary block are more common than in the general angle-closure glaucoma population. Careful gonioscopy accompanied by biometry and ultrasound biomicroscopy can lead to the correct diagnosis and individualized management in these eyes.

Adult↗
PubMed2005

Teratogenic effects of diphenyl diselenide in Wistar rats.

Diphenyl diselenide is an organoselenium compound with potential therapeutic use. The present study evaluates the effects of single maternal subcutaneous injection of 50 and 100mg/kg diphenyl diselenide [(PhSe)2] at gestational days (GD) 6, 10 or 17 in Wistar rats. The highest dose of (PhSe2 was also administered at GD 7-12. External and internal fetal soft-tissue examination was performed at GD 20. No mortality was observed in fetuses or dams at any (PhSe)2 treatment group. Neither did exposure to (PhSe)2 cause significant changes to fetal body weight, organ weight, or fetal size when administered at GD 6-8, 10-12 or 17. Exposure to 100mg/kg (PhSe)2 at GD 9 produced significant changes in fetal biometry (crown-rump (CR) length) and body weight. No significant increase in the proportion of fetuses with external visible abnormalities was observed in groups exposed to (PhSe)2. Skeletal anomalies were observed in fetuses in the GD 9-11 treatment groups and included incomplete ossification of cranial bones, misshapen and incomplete ossification of sternebrae, reduced sternebrae number, wavy and extra ribs, incomplete ossification of fore and hindpaw bones and incomplete ossification of sacral and caudal bones. We conclude that maternal administration of (PhSe)2 during GD 7-12 led to increased incidences of these skeletal variations or anomalies, but did not cause externally visible malformations in rat fetuses.

Abnormalities, Drug-Induced↗
PubMedDate not supplied

Phakic intraocular lenses.

An analytical review of the data available in the field of phakic intraocular lens implantation was conducted. Particular attention was paid to the more critical issues of intraocular lens sizing and safety guidelines. A comprehensive, competitive analysis of different implantation sites, intraocular lens model designs, and safety guidelines has been included. Specialized biometry techniques, such as very high frequency ultrasound and Scheimpflug imaging, have been reviewed, and a critical review of commercial claims regarding intraocular lens technologies has been included. Clinical studies of phakic intraocular lenses demonstrate increasing promise for the correction of refractive errors not amenable to mainstream excimer laser refractive surgery. The main issues currently revolve around adequate lens design (VHF ultrasound study suggests that custom-design and sizing may be the most effective and safest approach for every phakic IOL model), because these devices will be required to remain physiologically inert and anatomically compatible with internal ocular structures and relations for several decades. The possibility of safe removing or exchanging the IOL should remain a feasible option over time. It is of utmost importance that we continue to critically evaluate current encouraging short-term outcomes, which are being extrapolated to the longer term by ongoing high resolution imaging and monitoring of the anatomical and functional relations of implanted phakic IOLs.

Humans↗
PubMed2006

Diphenyl ditelluride effect on embryo/fetal development in mice: interspecies differences.

It is well established that diphenyl ditelluride, (PhTe)(2), is a potent teratogen in rats, however, little is known about its effects on embryo/fetal development in mice. The present study was undertaken to investigate whether any differences exist on embryo/fetal development of mice exposed to (PhTe)(2) during distinctive periods of gestation compared to rats. Dams were treated subcutaneously (s.c.) with 0.12 or 60.0 mg/kg (PhTe)(2) on gestational day (GD) 4, 8 or 14. Cesarean section was performed on GD18 and external and skeletal alterations were examined. The lower dose did not affect any parameter evaluated in mouse fetuses. The maternal body weight for 60 mg/kg (PhTe)(2) groups, at all periods studied, was not affected. Maternal liver and spleen weights were increased at GD8. At GD14, maternal relative weight of kidney was also increased. A significant reduction in the number of implantation sites at GD4 was found. At GD4 and GD14, there was a reduction in the fetal weight and biometry. A few signs of reduced ossification in sternebrae and limbs were observed at GD14 in (PhTe)(2) group. In conclusion, (PhTe)(2) was not toxic to dams and affected some fetal endpoints only at the dose about 500-fold higher than the dose that was teratogenic in rats, suggesting a different developmental toxicity induced by (PhTe)(2) among species. Thus, the mice were less susceptible to toxic effects induced by (PhTe)(2) than were rats.

Animals↗
PubMed2003

Prenatal assessment of normal fetal humerus volume by three-dimensional ultrasound.

Because fetal humerus dysplasia is associated with a variety of congenital syndromes, prenatal assessment of the fetal humerus growth is very important. The fetal humerus volume is one of the indexes in evaluating the humerus growth, but it has never been studied by 3-D ultrasound (US) in utero. To establish a normal reference chart of the fetal humerus volume for clinical use, we undertook a prospective and cross-sectional study using 3-D US to assess the fetal humerus volume in normal pregnancy. A total of 216 singleton fetuses that ranged between 20 and 40 weeks of gestation and fit the criteria of normal pregnancies were included in this study. Our results showed that the fetal humerus volume is highly correlated with the gestational age (GA). Using GA as the independent variable and the humerus volume as the dependent variable, the best-fit regression equation was humerus volume (mL) = 0.0044GA(2) - 0.0841GA + 0.6874 (r = 0.97, n = 216, p < 0.0001). For clinical use, a chart of normal growth centiles of the fetal humerus volume was then established based on this equation. In addition, the common indexes of fetal biometry, such as biparietal diameter, occipitofrontal diameter, head circumference, abdominal circumference, femur length and estimated fetal weight, were all highly correlated with the humerus volume (all p < 0.0001). In conclusion, our data of the fetal humerus volume assessed by 3-D US can serve as a useful reference in evaluating the fetal humerus growth during normal gestation.

Adult↗
PubMed1987

A sonographic screening method for Down syndrome.

We describe a potential screening method for the second trimester detection of the fetus with Down syndrome by the use of standard sonographic biometry. Retrospective assessment of the biparietal diameter, femur length, and biparietal diameter/femur length ratio in 55 fetuses with Down syndrome and 544 control fetuses was performed at two medical centers. Adequate numbers of cases and controls were available to permit statistically significant comparisons between the groups at 15 to 23 weeks' gestation. Fetuses with Down syndrome displayed no statistically significant differences in the cephalic index or the biparietal diameter compared with controls at a given gestational age. Significant femur length shortening was observed, but the greatest statistical difference was noted for the biparietal diameter/femur length ratio. This ratio was found to decrease with gestational age in the normal population and was consistently elevated in the Down syndrome population (compared with control) throughout the second trimester. With a cutoff value of 1.5 SD above the normal population mean for the biparietal diameter/femur length ratio, 50% to 70% of fetuses with Down syndrome could be identified in 6% of the total population (p less than 0.0001). This preliminary study suggests that the biparietal diameter/femur length ratio may prove superior to current Down syndrome screening methods and, as a third independent variable, may significantly enhance the sensitivity and specificity of combined maternal age/maternal serum alpha-fetoprotein screening modalities.

Down Syndrome↗
PubMed1998

Doppler velocimetry determined redistribution of fetal blood flow: correlation with growth restriction in diamniotic monochorionic and dizygotic twins.

OBJECTIVE: Our purpose was to study fetal growth and blood flow distribution in diamniotic monochorionic compared with dizygotic (diamniotic dichorionic) twins by use of Doppler velocimetry of the umbilical artery and middle cerebral artery. STUDY DESIGN: Study candidates were divided into group A, consisting of 33 pairs (66 fetuses) of diamniotic monochorionic twins, and group B, 50 pairs (100 fetuses) of diamniotic dichorionic twins. Diamniotic monochorionic placentation was confirmed by microscopic placental examination for group A. Diamniotic dichorionic placentation was ensured for group B by selecting only twins with different-sex pairs (dizygotic twins). Targeted ultrasonography with biometry was performed in each twin, and Doppler recordings of the umbilical artery and middle cerebral artery were obtained. Waveforms were analyzed and the systolic/diastolic ratio, the resistance index, and a measure of blood flow redistribution (brain-sparing effect), the cerebral/placental ratio, was calculated for each fetus. Growth status at birth was assessed by the number of small-for-gestational-age infants (< or = 10th percentile), low-birth-weight infants (< or = 25th percentile), and percent of growth discordance between twins. Intertwin differences were assessed by delta values (value of larger twin minus value of smaller twin). RESULTS: Diamniotic monochorionic compared with dizygotic twins demonstrated a significantly greater probability of blood flow redistribution. For the study population as a whole, the brain-sparing effect was noted in 67% of small-for-gestational-age babies and only 7% of non-small-for-gestational-age infants (p < or = 0.001). For the diamniotic monochorionic pregnancies blood flow redistribution occurred in 6 of 10 small-for-gestational-age infants (60%) and 6 of 46 non-small-for-gestational-age infants (13%). In the diamniotic monochorionic group small-for-gestational-age compared with non-small-for-gestational-age infants were more likely to show blood flow redistribution, which was the result of significantly decreased resistance in the middle cerebral artery and significantly increased resistance in the umbilical artery. Small-for-gestational-age infants (< or = 10th percentile) occurred much less frequently in the dizygotic group. Two of two small-for-gestational-age infants in the dizygotic group showed blood flow redistribution. Although the extremes of birth weight were more common in the diamniotic monochorionic group, both groups had relatively large numbers of small babies with birth weights in the lower 25th percentile (50.0% for diamniotic monochorionic and 44.0% for dizygotic twins, not significant). However, 42.3% (11/26) of diamniotic monochorionic twins who were in the low-birth-weight group showed blood flow redistribution compared with only 3.3% (1/30) whose birth weights were > or = 25th percentile (p < or = 0.001). In the dizygotic twins 10% of lower-birth-weight infants redistributed blood flow compared with 1% in the higher-birth-weight group, a nonsignificant difference. Diamniotic monochorionic compared with dizygotic twins were delivered earlier (32.9 weeks vs 34.8 weeks, p < or = 0.001), were smaller (1832 gm vs 2304 gm, p < or = 0.001), showed higher birth weight discordance (29.8% vs 14%, p < or = 0.05), and had greater numbers (19.7% vs 2.3%, p < or = 0.01) of infants at < or = 10th percentile birth weight. CONCLUSIONS: Diamniotic monochorionic twins from the lower-birth-weight groups more often show blood flow redistribution compared with dizygotic twins of similar low birth weights. Placental vascular connections and the attendant hemodynamic changes in the fetuses of diamniotic monochorionic twins probably account for this difference. Brain-sparing events occur commonly without clinical twin transfusion syndrome in this group. These findings have implications for management.

Amnion↗
PubMed1998

Prenatal prediction of neonatal outcome in the extremely low-birth-weight infant.

OBJECTIVE: Our goal was to identify prenatally available parameters that correlate with neonatal outcome and could be used for predicting such outcome in the extremely low-birth-weight pregnancy. STUDY DESIGN: From 1990 through 1995, obstetric and neonatal data of live-born nonanomalous singleton infants with birth weights between 400 and 1000 gm were reviewed. Only cases in which ultrasonographic biometry, including biparietal diameter, abdominal circumference, and femur length, was performed < or =3 days before delivery were included. Overall survival (defined as alive at discharge) and survival without specific severe neonatal morbidities (namely, retinopathy of prematurity [stage 3 or 4], intraventricular hemorrhage [grade 3 or 4], periventricular leukomalacia, chronic lung disease, and deafness) were ascertained. The best combination of prenatal parameters for the prediction of overall survival and survival without severe morbidity was determined by backward stepwise logistic regression analyses. RESULTS: The most significant prenatal predictors of overall survival were the obstetric estimate of gestational age and the abdominal circumference (chi2 = 11.8036, p = 0.0006 and chi2 = 8.1862, p < 0.005, respectively). Survival without severe morbidity was also predicted by the same combination of parameters (chi2 = 21.9079, p = 0.0001 and chi2 = 6.538, p = 0.01, respectively). The estimated fetal weight was not a significant independent predictor of either category of outcome (chi2 = 0.1249, p = 0.72 and chi2 = 0.0361, p = 0.85, respectively). On the basis of the regression formulas, curves displaying the probabilities of overall survival and survival without severe morbidity with any combination of gestational age and abdominal circumference were developed. CONCLUSION: The combination of gestational age and the abdominal circumference measurements appears to be superior to any combination that included estimated fetal weight data for predicting neonatal outcome in the neonates weighing < or =1000 gm. We developed a mechanism for predicting neonatal outcome in this weight category on the basis of prenatally available parameters. This information could prove useful for both parental counseling and obstetric decision making.

Anthropometry↗
PubMed1996

Results following secondary intraocular lens implantation in children.

BACKGROUND: Placement of a secondary intraocular lens (IOL) in a child may be considered in children with congenital monocular cataracts who have had complete opacities removed early in life and who later become contact lens intolerant, in eyes that have received trauma which precluded placement of a primary IOL, and in young adults who have bilateral aphakia who become resistant to use of contact lenses or spectacles. METHODS: Clinical records of all children in our practice who received a secondary IOL between January 1988 and December 1994 were reviewed. Indications, biometry, type of procedures, preoperative and postoperative acuity, refractive error, binocular status, and complications were studied. RESULTS: During the 7-year period, 242 cataract operations were performed. Fifty-nine eyes received a lens implant, and 28 of these were secondary implants. There was a mean interval between the initial cataract operation and the procedure for the secondary implant of 77 months. The mean follow-up was 35 months (range, 3 to 71) for the 28 eyes that received a secondary implant. Two received anterior chamber implants. Eight eyes had insufficient capsular support for an IOL. Six implants were placed in the posterior chamber and required suture fixation to the sclera. Twenty of 28 eyes had a measurable improvement in visual acuity. Only 1 eye had a decrease in visual acuity of 2 lines. Fifteen patients (54%) had a final refraction within 1.50 diopters of the fellow eye, and 75% were within 3.00 diopters. During the follow-up period, 2 eyes developed glaucoma. One had a transient pressure elevation, and the second has required 2 filtration procedures. Three patients required a Nd: YAG capsulotomy. Six patients demonstrated Worth fusion at distance and near, but only 3 patients demonstrated 200 seconds of arc or better stereo acuity. CONCLUSION: Placement of contemporary-style, secondary intraocular lenses in children and young adults appears to provide a safe and effective alternative for correction of aphakia in children who become contact lens or spectacle-intolerant.

Adolescent↗
PubMed1996

Increase in iris-lens contact after laser iridotomy for pupillary block angle closure.

PURPOSE: To quantitate changes in anterior ocular segment anatomy after laser iridotomy for pupillary block angle closure. METHODS: We prospectively performed ultrasound biomicroscopy and A-scan biometry in 13 eyes of 13 consecutive untreated patients with relative pupillary block and appositional angle closure, without peripheral anterior synechiae on indentation gonioscopy. A radial, perpendicular image in the horizontal temporal meridian was obtained with ultrasound biomicroscopy before and one week after laser iridotomy in each eye. RESULTS: Mean age of the 13 patients was 69.3 +/- 1.8 (S.E.) years, mean refractive error was +1.37 +/- 0.39 diopters, and mean axial length was 22.54 +/- 0.20 mm. In 13 eyes, before and after laser iridotomy measurements of angle-opening distance (0.11 +/- 0.02 vs. 0.18 +/- 0.02 mm) (P = .0004; paired t test), angle aperture (8.3 +/- 1.3 vs 18.6 +/- 2.8 degrees) (P = .0003) and iris-lens contact distance (0.58 +/- 0.06 vs 1.18 +/- 0.14 mm) (P = .0003) were greater postoperatively, but anterior chamber depth was unchanged (P = .7). CONCLUSIONS: Flattening of the iris after laser iridotomy for pupillary block causes an increase in iris-lens contact. The change in angle configuration after iridotomy results more from an alteration in aqueous pressure gradients across the iris rather than from posterior lens movement.

Aged↗
PubMed1993

Follow-up of angle-closure glaucoma suspects.

One hundred twenty-nine patients thought to be at risk for developing angle-closure glaucoma underwent a baseline examination, which included gonioscopy, refraction, anterior chamber pachymetry, ultrasound biometry, and an angle-closure provocative test. Patients were then followed up with no treatment. Mean follow-up was 2.7 years with a range up to six years. Twenty-five patients developed angle closure in at least one eye during the follow-up period, but in most (17 of the 25 patients), the angle closure was nonacute (that is, no clinical signs or symptoms and no increase in intraocular pressure). None of the test factors studied showed a high sensitivity or positive predictive accuracy in detecting the eyes that later developed angle closure.

Adult↗
PubMed1990

Correlations of acoustic tissue typing of malignant melanoma and histopathologic features as a predictor of death.

Forty-six eyes with uveal melanoma were scanned with a computerized diagnostic ultrasound system before enucleation, and light microscope sections were obtained. Tumors were characterized by ultrasonically measured dimensions and power spectrum analysis, which provided information not available in conventional A- or B-scan ultrasonography. Histopathologic features, including cell clustering pattern, cell type, pigmentation, vascularity, and necrosis, were quantified. Statistically significant correlations were found between parameters derived from the power spectrum and histologic characteristics. Patients were followed up for up to ten years with 14 deaths occurring because of metastases. Using a Cox relative risk model with histopathologic data, a risk model comprising pigmentation and cell type (P less than .0001) was obtained. Using ultrasonic characteristics, a model comprising tumor volume and scatterer concentration (P = .0062) was obtained. The results suggest that ultrasonic tissue characterization and three-dimensional biometry may provide improved in vivo prognostic indicators for uveal melanoma.

Eye Enucleation↗