scholarly journals The Use of Strontium-90 Beta Radiotherapy as Adjuvant Treatment for Conjunctival Melanoma

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Victoria M. L. Cohen ◽  
Vasilios P. Papastefanou ◽  
S. Liu ◽  
Ian Stoker ◽  
John L. Hungerford
Keyword(s):  
Visual Acuity ◽  
Adjuvant Treatment ◽  
De Novo ◽  
Excisional Biopsy ◽  
Bulbar Conjunctiva ◽  
Conjunctival Melanoma ◽  
Strontium 90 ◽  
Eye Symptoms ◽  
Dry Eye Symptoms

Background/Aims. To report the safety and efficacy of strontium (Sr90) beta radiotherapy as adjuvant treatment for conjunctival melanoma.Methods. A retrospective cohort study was undertaken from 1999 to 2007 of all patients who underwent Sr90beta radiotherapy for incompletely excised conjunctival melanoma. Failure of treatment was defined as recurrence of a conjunctival melanoma at the same location following beta radiotherapy.Results. Twenty patients underwent Sr90beta radiotherapy for incompletely excised conjunctival melanoma. Median follow-up interval was 59 months (8–152). All patients had conjunctival melanoma involving the bulbar conjunctiva. Underlying diagnoses included PAM with atypia in 60% (12 of 20), PAM without atypia in 15% (3 of 20), and de novo conjunctival melanoma in 25% (5 of 20). Following Sr90beta radiotherapy, in 90% (18 out of 20) local control was achieved and visual acuity was not affected in any patient. Three patients (15%) had dry eye symptoms, episcleritis, and descemetcoele, respectively. No cataract or secondary glaucoma was reported.Conclusions. Sr90treatment is a very effective adjuvant treatment after excisional biopsy and cryotherapy for conjunctival melanoma with a local success rate of 90%. The treatment is not associated with significant side effects and visual acuity is not affected.

scholarly journals Dry eye syndrome and cataract surgery

2019 ◽  
Vol 72 (3-4) ◽  
pp. 105-109
Author(s):  
Stefan Brunet ◽  
Vladimir Canadanovic ◽  
Nikola Babic ◽  
Aleksandar Miljkovic ◽  
Sandra Jovanovic ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Dry Eye ◽  
Dry Eye Syndrome ◽  
Schirmer Test ◽  
Corrected Visual Acuity ◽  
Body Sensation ◽  
Eye Symptoms ◽  
Best Corrected Visual Acuity ◽  
Dry Eye Symptoms

Introduction. Dry eye syndrome has become a common problem after ocular surgeries with a significant impact on the quality of life. Many patients, who have undergone cataract surgery, postop?eratively developed dry eye symptoms. Dry eye syndrome is one of the risk factors associated with cataract surgery. Material and Methods. The prospective study included 80 patients. We recorded the self-reported dry eye symptoms, the values of Schirmer test, tear breakup time, and best corrected visual acuity preoperatively, as well as 7 days and 1 month after the surgery. Results. A total of 80 patients were included in the study, 45 (56.2%) females and 35 (43.8%) males. The mean age of patients was 61.5 years (SD ? 6.2, range 57 - 70 years). The best corrected visual acuity at the time of surgery was 0.4 or less in 70 patients (87.5%). Most patients reported a significant improvement in visual acuity after surgery; 68 (85%) eyes achieved a best corrected visual acuity of 0.5 or higher (median 0.7; range 0.5 - 1.0). The mean tear breaking time in cata?ract patients before surgery was 12.4 sec, 7 days after the surgery it was 8.2 sec (p < 0.05) and 1 moth after the surgery 11.1 sec. The majority of patients had mild (47.5%) and moderate (33.75%) Schirmer test values. Dry eye with wetting < 5 mm after 5 minutes was found in 16.2% of patients before cataract surgery; 7 days after the surgery (p < 0.05) it was found in 23.75% of patients and one month after surgery 11.1 sec. A foreign body sensation and watery eye were the most reported symptoms before cataract surgery. Seven days after the surgery foreign body sensation was present in 48.75% and watery eyes in 40% of patients. Conclusion. Significant increase in dry eye symptoms after cataract surgery was found with increasing age. Self reported dry eye problems are more common in patients with lower Schirmer test and best corrected visual acu?ity values before cataract surgery. Patients with concomitant dry eye disease require preoperative and postoperative treatment of dry eye to prevent aggravation of the existing symptoms that may affect the visual outcome after cataract surgery.

scholarly journals A Case of a Cavitary Iris Melanoma with Aqueous Cytological Modulation

2018 ◽  
Vol 5 (3) ◽  
pp. 171-175
Author(s):  
Lindsay A. McGrath ◽  
James F. Bacon ◽  
Paul Rundle ◽  
Ian G. Rennie ◽  
Hardeep Singh Mudhar
Keyword(s):  
Malignant Melanoma ◽  
Adjuvant Treatment ◽  
Small Proportion ◽  
Excisional Biopsy ◽  
Malignant Tumour ◽  
Iris Melanoma ◽  
Pigmented Lesion ◽  
Sudden Enlargement ◽  
Uveal Melanomas

Malignant melanoma is the most common primary malignant tumour of the iris, but represents a small proportion of all uveal melanomas. The authors describe a 34-year-old male with a pigmented lesion of the iris. The lesion remained stable for 7 years, but the patient re-presented after this time with sudden enlargement of the mass and hyphaema. Excisional biopsy confirmed cavitary melanoma of the iris. This is the first reported case of cavitation in a primary iris melanoma. The patient has not had any further adjuvant treatment and remains metastasis free at 5 years of follow-up.

scholarly journals Pregabalin Failed to Prevent Dry Eye Symptoms after Laser-Assisted in Situ Keratomileusis (LASIK) in a Randomized Pilot Study

2019 ◽  
Vol 8 (9) ◽  
pp. 1355 ◽  
Author(s):  
Anat Galor ◽  
Sneh Patel ◽  
Leslie R. Small ◽  
Adriana Rodriguez ◽  
Michael J. Venincasa ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Pilot Study ◽  
Dry Eye ◽  
Secondary Outcome ◽  
Final Visit ◽  
Post Surgery ◽  
Eye Symptoms ◽  
Dry Eye Symptoms

Purpose: Perioperative pregabalin administration has been found to reduce the risk of persistent pain after a variety of surgical procedures. However, this approach has not been tested in relation to eye surgery. As such, the purpose of this study was to evaluate whether perioperative pregabalin can reduce the presence of dry eye (DE) symptoms, including eye pain, six months after laser-assisted in situ keratomileusis (LASIK). Methods: Prospective, masked, randomized single-center pilot study. Patients were treated with either pregabalin (oral solution of pregabalin 150 mg twice daily, first dose prior to surgery, continued for a total of 28 doses over 14 days) or placebo solution. The primary outcome was dry eye symptoms as measured by the Dry Eye Questionnaire 5 (DEQ-5). Secondary outcome measures included pain-related eye symptoms. Results: In total, 43 individuals were enrolled in the study and randomized to pregabalin (n = 21) or placebo (n = 22). Of those, 42 individuals completed the final visit after six months of follow-up. Some differences were noted between the two groups at baseline, including a higher frequency of females in the pregabalin group. At 6-months, there were no significant differences in the percentage of patients with DE symptoms (DEQ5 ≥ 6, 57% vs. 33%, p = 0.14), DE symptom severity (DEQ5, 6.6 ± 5.0 vs. 4.5 ± 4.2, p = 0.14), ocular pain intensity (numerical rating scale, 1.10 ± 1.48 vs. 0.38 ± 0.97, p = 0.08), or neuropathic pain complaints (Neuropathic Pain Symptom Inventory-Eye, 2.81 ± 4.07 vs. 3.14 ± 5.85, p = 0.83) between the pregabalin and control groups. Ocular signs were likewise similar between the groups, and of note, did not correlate with DE symptoms. The strongest predictor of DE symptoms six months post-surgery was the presence of DE symptoms prior to surgery. Conclusions: Perioperative pregabalin did not reduce the frequency or severity of DE symptoms at a six month follow-up after LASIK in this small pilot study.

scholarly journals Conjunctival Melanoma in a Horse Treated by Tumor Resection and Cryotherapy

2018 ◽  
Vol 46 ◽  
pp. 4
Author(s):  
João Antonio Tadeu Pigatto ◽  
Eduarda Valim Borges De Vargas ◽  
Marcela Torikachvili ◽  
Luciane De Albuquerque ◽  
Maria Cristina Caldart Andrade ◽  
...  
Keyword(s):  
Liquid Nitrogen ◽  
Histopathological Examination ◽  
Tumor Resection ◽  
Clinical Signs ◽  
Surgical Excision ◽  
Excisional Biopsy ◽  
Postoperative Treatment ◽  
Bulbar Conjunctiva ◽  
Conjunctival Melanoma ◽  
Flunixin Meglumine

Background: Ocular melanoma is very rare compared to cutaneous melanoma in horses. Definitive diagnosis is made through histopathological examination and treatment options include surgical excision associated with cryotherapy, radiation therapy, and chemotherapy. In this report, we describe a case of conjunctival melanoma in a horse that has been treated successfully with surgical excision associated with cryotherapy.Case: A 15-year-old male Percheron male was referred to the Ophthalmology Veterinary Section of the Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil, with a history of a pigmented mass located on the lower eyelid of the left eye. Ophthalmologic examination revealed ocular discomfort, secretion and a pigmented mass in the left inferior bulbar conjunctiva. The dermatological examination revealed other melanomas in the perineal region. Complete blood count and serum chemistry profile were within normal ranges and prior to surgery the horse was treated with flunixin meglumine (1.1 mg/kg, IV, q 12 h). Sedation was performed with xylazine (0.4 mg/kg, IV) and detomidine hydrochloride(0.01 mg/kg, IV) and then the animal was placed in a retention trunk. The conjunctival mass was resected with a margin of safety. Liquid nitrogen was applied to the tumor site and the adjacent conjunctiva with a copper cryoprobe with one unit of liquid nitrogen. Histopathological examination revealed neoplastic cells containing pigmented melanocytes in the conjunctival submucosa, confirming the diagnosis of conjunctival melanoma. Postoperative treatment was performed with flunixin meglumine (1.1 mg/kg, IV, q 12 h) for 3 days and topical ophthalmic ointment containing neomycin, polymyxin B sulfate and dexamethasone twice daily for one week. Seven days after surgery, the lesion was healed. The patient was followed for 24 months after excision and there was no evidence of recurrence.Discussion: Older horses are considered more predisposed to melanoma development, possibly because of the proliferation of melanocytes as a manifestation of aging, and in addition, cutaneous melanomas are common in gray horses and rare in other horse colors. In this case, the horse was a 15-year-old Percheron horse with gray hair. In horses, there is only one case of conjunctival melanoma documented in the literature. In both cases, the ophthalmic examination revealed a large, raised, heavily pigmented mass protruding from the bulbar conjunctiva. The only difference is that in the present case the location of the mass was in the inferior bulbar conjunctiva and in the case cited in the literature. The mass was located in the bulbar conjunctiva under the lateral comer. In this case, the diagnosis of conjunctive melanoma was based on clinical signs and confirmed by histopathological examination. It was decided to perform an excisional biopsy for treatment and to confirm the diagnosis of conjunctival melanoma. The choice of treatment depends very much on the clinical presentation, that in this animal, despite the neoplasia being extended, it was located only in the conjunctiva without involvement of the sclera and the eyelid. Therefore the decision was made to perform an excisional biopsy associated with cryotherapy. The purpose of such adjuvant therapy is to kill all residual tumor cells and prevent the recurrence of malignant tumors. In the present case, the surgical wound was cured one week after surgery. The surgical procedure in the case reported was performed under local anesthesia and sedation with the horse standing. To make this decision, consideration should be given to patient health, anesthetic risk, and additional risks during recovery from general anesthesia. In this case, surgical excision of the mass associated with cryotherapy was effective in the treatment of conjunctival melanoma in a horse.Keywords: ocular, equine, melanocytic neoplasia, cryosurgery.

scholarly journals Conjunctival Leiomyosarcoma, a Rare Neoplasm Always Originating at the Limbus? Report of a New Case and Review of 11 Published Cases

2019 ◽  
Vol 5 (5) ◽  
pp. 333-339 ◽  
Author(s):  
V. De Groot ◽  
E. Verhelst ◽  
P.C.W. Hogendoorn ◽  
R.J.W. de Keizer
Keyword(s):  
Adjuvant Radiotherapy ◽  
Myogenic Differentiation ◽  
Distant Metastases ◽  
Excisional Biopsy ◽  
Complete Resection ◽  
Favorable Prognosis ◽  
Strontium 90 ◽  
Malignant Mesenchymal Tumor ◽  
Histopathological Investigation

Purpose of the Study: To describe the differential diagnosis and management of a rare conjunctival malignancy. Procedures: A 79-year-old man presented with a conjunctival mass at the limbus. Excisional biopsy revealed a malignant mesenchymal tumor with myogenic differentiation. Six months later, three suspect lesions developed at the border of the previous excision. Pathological diagnosis pointed to a leiomyosarcoma. Adjuvant radiotherapy with strontium-90 brachytherapy was applied. After 3 years, there was neither recurrence nor distant metastases. A literature review revealed 11 cases of conjunctival leiomyosarcoma. Results: All 12 cases seemed to originate at the limbal conjunctiva. Scleral invasion was found only in one patient with multiple previous resections. Corneal invasion was reported in two patients. Four patients had a globe-sparing resection. In two of them, margins were not tumor free and additional brachytherapy gave a tumor-free follow-up of 1 and 3 years. Four cases underwent an exenteration. Conclusion and Message: Primary conjunctival leiomyosarcoma is a rare tumor with a favorable prognosis due to early detection and consequently limited size. Diagnosis involves histopathological investigation including immunohistochemistry. If possible, complete resection has the best prognosis. Adjunctive radiotherapy can be effective when the margins are not free and should be considered.

scholarly journals Isolated corneal squamous cell carcinoma in a patient with unilateral dry eye symptoms

2014 ◽  
Vol 14 (1) ◽  
pp. 31-35
Author(s):  
Siamak Zarei Ganavati ◽  
Alireza Eslampoor ◽  
Mehdi Farzadnia ◽  
Jafari Habib
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Dry Eye ◽  
Squamous Cell ◽  
Excisional Biopsy ◽  
Corneal Injury ◽  
History Of ◽  
Eye Symptoms ◽  
Short Time ◽  
Dry Eye Symptoms

The aim of this study was to report a case of isolated corneal squamous cell carcinoma in a patient with unilateral dry eye symptoms. The case was a 48 years old man with history of thermal corneal injury on his left eye two years ago with decreased visual acuity and dry eye symptoms a short time after, which was treated with the diagnosis of dry eye and had no improvement in symptoms. Examination revealed hypertrophy of near total corneal epithelium, without limbal and conjunctival involvement. The surface of the lesion was irregular with punctate epithelial erosions. The patient was underwent excisional biopsy which was revealed severe corneal dysplasia (carcinoma in situ). After excision, the patient was treated with Fluorouracil and there was no sign of recurrence till the time of last follow-up examination. Dry eye symptoms were disappeared completely. We conclude that, in the case of unilateral chronic dry eye which was resistant to the treatment with signs of corneal epithelial involvement, isolated corneal neoplasia should be considered even without limbal or conjunctival involvement.

scholarly journals Pleomorphic lipoma of the bulbar conjunctiva

2018 ◽  
Vol 11 (1) ◽  
pp. e226548
Author(s):  
Emily Li ◽  
Jonathan Silbert ◽  
John Sinard
Keyword(s):  
Excisional Biopsy ◽  
Bulbar Conjunctiva ◽  
Histopathological Analysis ◽  
The Third ◽  
The Past ◽  
Pleomorphic Lipoma ◽  
The Right ◽  
Rare Diagnosis

A 55-year-old woman presented with a painless, pink mass of the right eye bulbar conjunctiva that had been gradually increasing in size for the past 10 years. Excisional biopsy with histopathological analysis revealed a rare diagnosis of pleomorphic lipoma. There was no recurrence at last follow-up evaluation 6 months postoperatively. To the best of our knowledge, this represents the third case of pleomorphic lipoma of the bulbar conjunctiva reported to date.

Eine Therapie mit Everolimus und reduziertem Ciclosporin kann das Krebsrisiko von Nierentransplantierten verringern* (Sponsor: Novartis Pharma GmbH, Nürnberg)

2017 ◽  
Vol 05 (01) ◽  
pp. 22-22
Keyword(s):  
New Zealand ◽  
De Novo

ZusammenfassungDie Verknüpfung der A2309-Studie mit dem Australia and New Zealand Dialysis and Transplant (ANZDATA) Register erlaubte ein Follow up von 7 Jahren. Die Autoren bezeichnen diese Analyse als die bisher überzeugendste Evidenz, dass eine Immunsuppression mit de novo Everolimus und reduziertem Ciclosporin langfristig mit einer geringeren Krebsinzidenz nach Nierentransplantation assoziiert ist als die Standardtherapie.

BioMime – A Sirolimus-eluting Coronary Stent System for the Treatment of Patients with De Novo Coronary Lesions – meriT-1 Report

2011 ◽  
Vol 6 (1) ◽  
pp. 39
Author(s):  
Keyword(s):  
Stent Thrombosis ◽  
Time Course ◽  
De Novo ◽  
Drug Eluting Stent ◽  
Cobalt Chromium ◽  
Cardiac Events ◽  
End Points ◽  
Safety And Efficacy ◽  
Binary Restenosis

Background:Since the first reported use of percutaneous transluminal coronary angioplasty, advances in the interventional cardiology arena have been fast paced. Developers and clinicians are adapting from the learning curve awarded by the time-course of drug-eluting stent (DES) evolution. BioMime™ sirolimus-eluting stent (SES) is a step towards biomimicry. The stent is built on a strut of ultra-low thickness (65μm), a cobalt–chromium platform using an intelligent hybrid of closed and open cells allowing for morphology-mediated expansion. It employs a well-known antiproliferative – sirolimus – that elutes from a known biodegradable copolymer formulation within 30 days. The resultant stent demonstrates almost 100% endothelialisation at 30 days in preclinical models.Methods:The meriT-1 was a prospective, single-arm, single-centre trial to evaluate the safety and efficacy of BioMime SES in 30 patients with a single de novo lesion in native coronary arteries. The primary safety and efficacy end-points were major adverse cardiac events (MACE) at 30 days and in-stent late lumen loss at eight months, as measured using quantitative coronary angiographic (QCA) method. Secondary safety and efficacy end-points included MACE at one and two years and angiographic binary restenosis at eight-month angiographic follow-up. Other end-points included the occurrence of stent thrombosis at acute, subacute, late and very late periods and the percentage of diameter stenosis by QCA.Results:No MACE were observed and the median in-stent late luminal loss in 20 (67%) subjects studied by QCA was 0.15mm, with 0% binary restenosis at eight-month follow-up. No stent thrombosis was observed up to one-year follow-up.Conclusions:In comparison to currently available DES, BioMime SES appears to have a considerable scientific basis for prevention of neointimal proliferation, restenosis and associated clinical events.

Assessment Of Dry Eye Symptoms And Quality Of Sleep In Engineering Students During The Covid-19 Pandemic

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1202-1207
Author(s):  
Pavithra S ◽  
Dheepak Sundar M
Keyword(s):  
Sleep Quality ◽  
Dry Eye ◽  
Screen Time ◽  
Engineering Students ◽  
Statistical Tests ◽  
Quality Of Sleep ◽  
Cross Sectional ◽  
Eye Symptoms ◽  
Dry Eye Symptoms

To assess dry eye symptoms (DES) and quality of sleep in engineering students during the Covid19 pandemic lockdown and also to assess the association between DES and sleep quality. A cross-sectional questionnaire-based study was carried out among 396 engineering students studying in Saveetha engineering college. The study tool used was a semi-structured google form questionnaire designed for assessing digital device usage, symptoms of dry eye disease and sleep pattern. Responses were analyzed using appropriate statistical tests. Overall 64.1% attained a score of more than 10, indicating the presence of DES. 70.2% of the study population used digital screens for more than 13 hours. A statistically significant association was found between increased screen time and presence of DES(p<0.05). 64.9% had a score of >18 indicating reduced sleep quality. About 77.1% of the students with DES had reduced sleep quality, and a significant association (p<0.01) was observed between the two. During the Covid19 pandemic lockdown, there appears to be rising prevalence of DES in student population, one of the reasons being increased screen time. The sleep quality was also found to be reduced, and a significant association was found between DES and sleep quality.

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