[Risk factors of malignant melanoma of the choroid].
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A case of X-linked ocular albinism is reported. Characteristic Masson-Fontana positive and Dopa positive giant melanin granules were found in keratinocytes, melanocytes and upper dermis. Ultrastructurally the macromelanosome was composed of a dense core and a less dense surrounding mantle.
The purpose of the present investigation was to study the occurrence and degree of severity of the actinic cheilitis in a sample of 566 artisan fishermen of Valparaíso, Chile. The condition was found in 43% of the sample, the degree of severity was an 8% for the acute expression and a 35% for the chronic type of the disease. A direct relationship between the number of years spent on sun exposure and the degree of severity of the vermillion alterations was found, being the patients between 16 and 45 years old the group most severely involved, a finding similar to the data reported in the current literature. The prone complexion was the fair one: those fishermen with blond or red hair, blue or green eyes and fair skin showed both clinical and histopathologically early disturbances of degenerative nature in the collagenous component of the connective tissue and in the epithelial surface.
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Adequate pupillary dilation is often difficult to achieve in darkly pigmented persons when using standard dilating drops. To quantify the degree to which mild corneal disruption could enhance this dilation, we touched the cornea of one eye and then placed dilating drops in both eyes of darkly pigmented and lightly pigmented subjects. The touch was either standard Gold-mann applanation tonometry or corneal reflex testing using a cotton-tipped applicator. Pupil diameter was measured using a video infrared pupillometer. The mean difference in pupil diameter between the touched and the control eye at 30 min was six-fold greater in darkly pigmented, compared to lightly pigmented, subjects. Touching the cornea by the method described herein appears to be a safe, useful technique for routinely enhancing pharmacologic dilation of the pupil in persons who have dark irises.
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A 32-year-old man with Fuchs' heterochromic iridocyclitis is described, and a review of the pertinent medical literature is presented.
Topical application of the H2-histamine receptor agonist, dimaprit (S-[4-N,N-dimethylaminopropyl]isothiourea), produced eosinophil chemotaxis into the anterior segment of rabbit eyes only when an H2-antagonist was co-administered. Nordimaprit (S-[4-N,N-dimethylaminoethyl]isothiourea), a structural homologue of dimaprit that lacked activity at histamine receptors, produced eosinophil chemotaxis whether or not an H2-antagonist was co-administered. Onset of eosinophil chemotaxis began after 2 or more days of treatment, and was accompanied by corneal edema, opacification, and ocular inflammation. There was no concurrent eosinophilia in the peripheral blood or in the conjunctiva. The response occurred in pigmented and albino rabbit eyes, and was facilitated by prior co-administration of proparacaine eye drops. Another dimaprit homologue without activity at histamine receptors, homodimaprit (S-[4-N,N-dimethylaminobutyl]isothiourea), did not produce eosinophil chemotaxis when applied topically, nor did the H2-agonists impromidine, histamine, or 4-methylhistamine, whether co-administered with an H2-antagonist or not. It was concluded that dimaprit and nordimaprit produced a selective eosinophil chemotaxis unrelated to H1- and H2-histamine receptor activity. However, the H2-agonist activity of dimaprit appeared to inhibit this response unless neutralized by an H2-antagonist. Topical application of dimaprit with an H2-antagonist or nordimaprit alone may allow large numbers of non-degranulated eosinophils, free of other cell types, to be harvested from the aqueous humor.
Paredrine has been used as an adjunct to the cocaine test for Horner's syndrome; however, there are no controlled studies measuring pupillary responses in normal eyes. Twenty-five volunteers with normal eye examinations received 1% Paredrine in one eye, followed by serial photography to document the extent of pupillary dilation. Pupillary measurements were taken from the photographs to prevent identification of the patient, control or treated eye, or the time after instillation of the eye drops. Lighter irides dilated more rapidly, and some patients with dark irides showed little response. The control eye showed progressive pupillary constriction as its fellow eye became more dilated.
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Cataract removal with implantation of an intraocular lens (IOL) was performed in 36 cases of Fuchs' unilateral syndrome. --Intracapsular technique with anterior chamber IOL: 3 cases. --Extracapsular with IOL: 33 cases: Binkorst four loops sutured to the iris: 10 cases; posterior chamber in the sulcus: 12 cases; posterior chamber in the bag: 11 cases. The operative difficulties in such an indication consist in the constant hemorrhaging in the anterior chamber, the poor dilatation and the fragility of the zonule. Inflammatory reactions during the immediate post-operative follow up are frequently observed (22.2%) with pupillary deformations and Irvine Gass syndrome as complications. Glaucoma is a worrisome complication in its unusual frequency and by the poor results obtained by surgical treatment, but it does not seem to be directly related to the operation on the cataract. The complications which appear to relate directly to the implantation are represented above all by the risk in the long time, of lack of IOL transparency caused by the precipitates, and the aggravation of secondary vitreal disorders relating to recurrent cyclitis which is more frequent than in cases without implantation. The type of IOL implanted appears to have played no role on surgical results. Functional results were relatively good (83.3% having visual acuity superior or equal to 5/10). The restoration of satisfactory binocular vision justifies the risks of IOL implantation in cases of Fuchs' unilateral syndrome, but it is important to be forewarned of such an procedure risks.
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We studied the mydriatic and cycloplegic effect of a single dose of a combination of 0.5% cyclopentolate hydrochloride and 0.5% tropicamide in 20 healthy subjects with dark brown irides. The mean change in dilatation with the combination drop was 3.5 mm, compared with 0.6 mm with 1% cyclopentolate alone (p less than 0.001). In 92% of 26 eyes studied the difference in refraction between the combination drop and 1% atropine was +1.00 dioptre or less. The combination drop safely provided satisfactory mydriasis and cycloplegia in 20 minutes, allowing for rapid and accurate examination of these patients.
Cutaneous malignant melanoma is occurring in epidemic proportions in the United States. To provide a profile of persons at risk and the epidemiologic features of malignant melanoma, we reviewed the records of 325 patients with cutaneous malignant melanoma seen at the University of Colorado Health Sciences Center between 1973 and 1983. Most patients had fair skin, brown or blonde hair, blue or green eyes, and had difficulty in suntanning. The majority of melanomas (72%) developed in preexisting nevi. In women, melanomas were most common on the extremities, and in men they occurred most frequently on the trunk, head or neck. The most frequently noted depth of invasion was Clark's level IV. At diagnosis, most of the patients (77%) were at stage I. We conclude that malignant melanoma constitutes a major disease problem in the western United States that is largely preventable with appropriate physician and patient education.