ABSTRACT
Objective To observe and evaluate the short-term therapeutic effect of intravitreal injection with topotecan for refractory vitreous seeding from retinoblastoma (RB).Methods Eleven patients (11 eyes) of RB with refractory vitreous seeding (received intravenous chemotherapy,intra-arterial chemotherapy,intravitreal melphalan,laser,cryotherapy and subsequently developed refractory viable vitreous seeds) were enrolled in this study.There were 6 males (6 eyes) and 5 females (5 eyes).The aged from 9 to 44 months,with the mean age of 26 months.According to International Intraocular Retinoblastoma Classification,11 eyes were initially classified as group E (3 eyes),D (6 eyes),B (1 eye) or A (1 eye).All patients were received intravitreal injection with topotecan.A total of 32 intravitreal topotecan injections were performed with a mean of 2.9 injections (median 3 injections;range 2-4 injections).The mean follow-up was 10 months.The safety and effectiveness of intravitreal injection with topotecan for refractory vitreous seeding from RB were observed.Results Complete regression of vitreous seeds was achieved in 11 of 11 eyes (100％),including complete disappearance in 9 eyes and fibrosis in 2 eyes.None of the patients needed enucleation and occured ocular or systemic complications in the follow-up period.Conclusion Intravitreal injection with topotecan for refractory vitreous seeds from RB is effective and safe.
ABSTRACT
Tumors of the Ocular Surface clinically manifest with a very wide spectrum and include several forms of epithelial, stromal, caruncular, and secondary tumors. As a group, these tumors are seen commonly in the clinical practice of a comprehensive ophthalmologist, cornea specialist, and an ocular oncologist. This review is aimed to discuss the common tumors of the ocular surface and emphasize on their clinical diagnosis and appropriate management.
ABSTRACT
Targeted therapy in retinoblastoma (RB) is widely accepted as the current management tool with an aim of increasing drug availability at the tumor location. Inevitably the effect is several times higher compared to systemic delivery of chemotherapeutic drugs and carries less systemic toxicity. Despite tremendous advancement in saving life, eye salvage in advanced RB especially with active vitreous seeds remains a challenge. The hypoxic environment of the vitreous and reduced vitreous concentration of the drugs delivered makes these tumor seeds resistant to chemotherapy. Direct delivery of chemotherapeutic drugs into the vitreous cavity aids to overcome these challenges and is progressively being accepted worldwide. However, intraocular procedure in RB was abandoned due to high risk of extraocular tumor dissemination. Recently, the forbidden therapeutic technique was re‑explored and modified for safe use. Although eye salvage rate has tremendously improved after intravitreal chemotherapy (IVitC), retinal toxicity, and vision salvage are yet to be validated. In our preliminary report of intravitreal melphalan in 11 eyes, we reported 100% eye salvage and 0% recurrence with an extended 15 months mean follow‑up. In this review, we analyzed published reports on IVitC in RB via PubMed, Medline, and conference proceedings citation index, electronic database search, without language restriction that included case series and reports of humans and experimental animal eyes with RB receiving IVitC.
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To review the features and prognosis of uveal melanoma in children. Methods: Retrospective case series. Of 122 children with uveal melanoma, there were 53 [43%] male and 69 [57%] female patients. In this group, the mean age at presentation was 15 years [median 16 years, range 3-20 years]. Age at presentation was 0 to 5 years in 4 [3%], 5.1 to 10 years in 14 [11%], 10.1 to 15 years in 43 [35%], and 15.1 to
ABSTRACT
Diabetes mellitus [DM] is a major public health problem in Yemen. The aim of this descriptive study is to determine the prevalence and risk factors of macrovascular complications among diabetic patients attending the medical ward at Al-Gamhouria Teaching Hospital during the period January 2005 to June 2006. Patients completed an interviewer-administered questionnaire, carried out by treating physicians, and underwent a complete medical assessment including measurement of height, weight, blood pressure and examination for evidence of macrovascular complications. A standard echocardiography was recorded and blood samples were taken to document fasting blood sugar, glycosylated hemoglobin [HbAic] and lipid profile. 198 of diabetic patients were studied, 108 [54.4%] of them were males and 90 [45.4%] were females, with a mean age of 57.63 years [SD +/- 12.86]. 65.6% of DM patients had evidence of macrovascular complications, 39.9% of patients had cardiovascular disease, 26.3% had cerebrovascular disease and 5.5% had peripheral vascular disease. About 57.7% of the study patients had hypertension. The study findings revealed that macrovascular complications in diabetic patients were more common among males, increased with age, with hypertension, and its prevalence increased steadily with duration of diabetes mellitus. Our data demonstrated that there is a significant association between hypertension and the presence of macrovascular complications among diabetic patients. However, a lack of correlation between macrovascular disease and glycemic control among diabetic patients was observed