Research progress on the correlation between Helicobacter pylori and ocular diseases / 国际眼科杂志(Guoji Yanke Zazhi)

Helicobacter pylori is a common gram-negative bacterium, which is associated with a variety of gastroenteric diseases, such as gastritis, duodenal ulcer and gastric cancer. Recent studies suggested a potential role of Helicobacter pylori in the pathogenesis of common ocular diseases, such as central serous chorioretinopathy, glaucoma, anterior uveitis and ocular adnexal lymphoma. Helicobacter pylori might affect the pathophysiological process of ocular diseases through oxidative damage, circulatory disorders and immune injury. Some studies also suggested that eradication of Helicobacter pylori had certain effects on some ocular diseases. This review aims to summarize current evidence of the Helicobacter pylori in the pathogenesis of common ocular diseases, so as to encourage innovative approaches in the prevention and treatment of these ocular diseases.

Clinical pathological analysis of ocular adnexal lymphoma / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To study the incidence, clinical features and pathological types of ocular adnexal lymphoma(OAL), in order to improve the level of clinical diagnosis and treatment.<p>METHODS: There were 147 cases of OAL in West China Hospital from August 2005 to July 2013. We collected clinical data such as general conditions, clinical manifestations, clinical examination(imaging, pathology)results, treatment and prognosis for retrospective study.<p>RESULTS: This study consist of 147 patients with OAL, including 91 males(61.9%)and 56 females(38.1%); aged from 3.5 to 87 years old; the course of disease range from 20d to 10a; the most common location of disease is orbit(106/147).The most common clinical manifestations including ocular mass, eyelid swelling and exophthalmos. Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue were most common(112/147), it also had the best prognosis while diffuse large B-cell lymphoma, extranodal NK/T-cell lymphoma,nasal type showed the worst prognosis.<p>CONCLUSION: The pathological types of OAL were complex, which also had diverse location of disease and clinical manifestations. Immunohistochemically staining is an important basis for the differential diagnosis of OAL, and the prognosis of which is closely related to pathological type.

Clinical efficacy of radiotherapy for stage ⅠE Primary ocular adnexal mucosa associated lymphoid tissue lymphoma / 中华放射肿瘤学杂志

Objective To evaluate the dose response and prognosis of patients with stage ⅠE primary ocular adnexal mucosa associated lymphoid tissue lymphoma (POAml) treated with radiotherapy.Methods Clinical date of 93 patients (117 eyes) with stage ⅠE POAml treated from November 2003 to July 2015 were retrospectively analyzed.The dose response was evaluated by observing the ocular changes in exophthalmos.The survival rate was calculated by using the Kaplan-Meier survival analysis.The log-rank test and univariate analysis were used for prognostic analysis.Results For patients treated with a dose of ≥ 27 Gy,the response rate of exophthalmos was 69.0％(29/42).The median response dose was 7.2 Gy (5.4-19.8 Gy).For all patients,the local control rate was 100％.The 5-and 10-year overall survival (OS) rates were 92％ and 82％.The 5-and 10-year cause-specific survival (CSS) rates were equally 98％.The 5-and 10-year progression-free survival (PFS) rate were 90％ and 88％.The univariate prognostic analysis demonstrated that the International Prognostic Index (IPI) score and age were the prognostic factors of PFS rate (both P=0.04).Conclusions POAml is sensitive to radiation therapy.Radiotherapy alone can yield excellent local control and long-term survival in POAml patients.A prescription dosage of 18 Gy dose can obtain favorable clinical efficacy.

Expression of integrin-linked kinase (ILK) and Toll-like receptor (TLR-2) in ocular adnexal MALT lymphoma and the effects on patients' prognosis / 眼科新进展

Objective To investigate the expression of integrin-linked kinase (ILK) and Toll-like receptor (TLR-2) in ocular adnexal mucosa-associated lymphoid tissue (MALT) lymphoma and the effects on patients' outcomes.Methods Tissue specimens from 46 patients with MALT lymphoma were collected in this study.The expression of ILK and TLR-2 protein was detected by immunohistochemical methods,and the correlation of ILK and TLR-2 protein expression with clinicopathological features and patients' outcomes was analyzed.Results The positive rates of ILK and TLR-2 protein expression in tumor tissues were 67.4％ (31/46) and 71.7％ (33/46),respectively,which was related to the clinical stage of AnnArbor (P ＜ 0.05),rather than to sex,age and lesion location (all P ＞0.05).The survival of patients with ILK positive expression was less than that of ones with ILK negative expression [(21.5 ± 2.7)months vs.(29.2 ± 2.1) months] (P ＜ 0.05);meanwhile,the survival of patients with TLR-2 positive expression was less than that of ones with TLR-2 negative expression [(20.4 ±1.7) months v.(27.6 ± 2.3) months] (P ＜ 0.05).Conclusion ILK and TLR-2 are closely related to biological behavior of ocular adnexal MALT lymphoma,and combination detection of ILK and TLR-2 has a certain guiding value for diagnosis and prognosis.

Clinical presentation and treatment outcomes of primary ocular adnexal MALT lymphoma in Thailand

BACKGROUND: Primary ocular adnexal extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (POML) is the most common subtype of lymphoma involving the eyes in Thailand. We sought to assess the characteristics and treatment outcomes of patients with POML in Thailand. METHODS: We retrospectively reviewed patient data and included patients diagnosed with POML between January 2004 and December 2016 at Chiang Mai University Hospital and King Chulalongkorn Memorial Hospital, Thailand. We collected and analyzed patients' clinical characteristics and treatment outcomes. RESULTS: Among 146 patients with lymphoma involving the eyes, 121 (82%) were diagnosed with POML. Sixty-four (52.9%) were women with median age 58 (range, 22–86) years. The most common presenting symptom was orbital mass (71.1%). Common sites of origin were the orbit (46.3%) and lacrimal gland (34.7%). At presentation, 22.3% of patients had bilateral eye involvement. About half of patients had stage I disease (N=59, 56.2%) and 20% had stage IV. Most patients (73.3%) had a low-risk International Prognostic Index. Radiotherapy was the main treatment for patients with limited-stage disease (66.7% in stage I and 56.5% in stage II). The overall response rate was 100% with complete response rates 80%, 77.3%, and 64.7% for stages I, II, and IV, respectively. Five-year progression-free survival (PFS) and overall survival were 66.1% and 94.0%, respectively. For patients with limited-stage disease, radiotherapy significantly improved PFS compared with treatment not involving radiotherapy (5-year PFS 89.9% vs. 37.3%, P=0.01). CONCLUSION: We revealed that POML has good response to treatment, especially radiotherapy, with excellent long-term outcome.

Expression and meaning of MTDH and β-catenin in ocular adnexal lymphoma / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To investigate the expression of MTDH and β-catenin in ocular adnexal lymphoma lesions and its clinical significance. <p>METHODS: Resected specimens were collected from patients suffering from B-cell non-Hodgkin lymphoma(NHL)(<i>n</i>=40)and lymphadenosis(<i>n</i>=20)of ocular adnexal in Affiliated Hospital of Qingdao University from June 1995 to December 2015. Lymphadenosis of ocular adnexal was acted as the control group. PCR and immunohistochemistry were employed to examine the MTDH and β-catenin mRNA and protein expression respectively. The relationship between the MTDH and β-catenin protein expression level and the clinical pathological characteristics were analyzed. <p>RESULTS:The expression of mRNA and protein of MTDH and β-catenin in ocular adnexal lymphoma lesions were higher than that in control group(<i>P</i><0.05). The expression of MTDH and β-catenin proteins were related to pathologic type of tumors, but not related to age, gender or pathogenic site. With the increase of pathologic grade, MTDH and β-catenin labeling frequency increased gradually. And there was a positive correlation between MTDH and β-catenin(<i>r</i>=0.389, <i>P=</i>0.036). <p>CONCLUSION: Over expression of MTDH and β-catenin may play a significant role in the ocular adnexal lymphoma. The expression of MTDH and β-catenin has a positive relationship.

Comparison of Ocular Adnexal Mantle Cell Lymphoma and MALT Lymphoma

PURPOSE: Mantle cell lymphoma (MCL) is known to have systemic dissemination with poor prognosis, but very few cases have been reported in Korea. Therefore, we analyzed clinical features and prognosis of MCL by comparing 3 cases of ocular adnexal MCL and mucosa-associated lymphoid tissue (MALT) lymphoma. METHODS: The medical records of patients with ocular adnexal MALT lymphoma and MCL from Chungnam National University Hospital and Pusan National University Hospital from January 1999 to April 2014 were retrospectively reviewed. Immunohistochemical examination was selectively used to diagnose lymphoma subtypes. Systemic dissemination, treatment response, and recurrence were identified using radiological testing and bone marrow aspiration. RESULTS: This study included 39 patients with ocular and ocular adnexal MALT lymphoma and 1 patient with MCL from Chungnam National University Hospital and 53 patients with MALT lymphoma and 2 patients with MCL from Pusan National University Hospital. All 3 (100%) patients diagnosed with ocular adnexal MCL were over 60 years of age. However, 28 of 92 (30.4%) patients diagnosed with MALT lymphoma were over 60 years of age. In MALT lymphoma, 3 of 92 patients presented with systemic dissemination and most patients recovered with radiotherapy. Conversely, all 3 patients with MCL showed systemic dissemination and recurrence after radiotherapy or chemotherapy, therefore, additional chemotherapy was required. CONCLUSIONS: Contrary to MALT lymphoma, ocular and ocular adnexal MCL usually presented with systemic dissemination and complete remission was difficult even though many regimens of chemotherapy were attempted. Because MCL can be misdiagnosed as MALT lymphoma, careful evaluation should be performed.

Risk Potentiality of Frontline Radiotherapy Associated Cataract in Primary Ocular Adnexal Mucosa-associated Lymphoid Tissue Lymphoma

PURPOSE: To elucidate risk potentiality of frontline radiotherapy associated cataracts in primary ocular adnexal mucosa-associated lymphoid tissue lymphoma (OAML). METHODS: Data from eight consecutive patients of 41 total OAML patients who had undergone cataract surgery after frontline radiotherapy were analyzed. RESULTS: The median patient age was 46 years (range, 36 to 69 years). The median total radiation dose was 3,780 cGy (range, 3,060 to 4,500 cGy), and the mean duration from radiation irradiation to cataract surgery was 36.60 +/- 8.93 months. Preoperative lens opacification was primarily at the posterior lens subcapsule, and best-corrected visual acuity (BCVA) was 0.43 +/- 0.21. Patients underwent the phacoemulsification surgical procedure with posterior chamber intraocular lens insertion. The average BCVA improved to 0.90 +/- 0.14 after cataract surgery. Two patients underwent posterior continuous curvilinear capsulorhexis, and one had posterior capsule rupture. For posterior capsule opacification (PCO), three patients received Nd:YAG laser posterior capsulotomy after the initial surgery, and one patient is currently under consideration for laser posterior capsulotomy. CONCLUSIONS: Radiotherapy increased posterior subcapsule opacification at a relatively young age in primary OAML. Phacoemulsification was a manageable procedure without severe complications, and final visual outcomes were good. However, because after-cataracts progressed earlier than did senile cataracts, close follow-up should be considered for PCO management.

The Effect of Rituximab, Cyclophosphamide, Vincristine, and Prednisolone (R-CVP) Chemotherapy in Patients with Ocular Adnexal Extranodal Marginal Zone B Cell Lymphoma of the Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma

PURPOSE: To report the effectiveness of rituximab, cyclophosphamide, vincristine, and prednisolone (R-CVP) combination chemotherapy in patients with ocular adnexal mucosa-associated lymphoid tissue (MALT) lymphoma (OAML). METHODS: R-CVP chemotherapy was performed in 7 patients (8 eyes) with a confirmed histopathological diagnosis of OAML from January 2012 to December 2012. A total of 6 cycles were administered at a 3-4 week interval and 2 cycles of rituximab were added at the third week. Response evaluation was performed 3 times, with the first evaluation 3 weeks after the third cycle, the second 3 weeks after the sixth cycle, and the last after the second rituximab cycle. RESULTS: In all 7 patients (8 eyes) with R-CVP, symptoms were improved, and the mass was markedly resolved based on orbit CT and MRI scan at first response evaluation. Clinically complete remission (CR) was achieved in 6 patients and partial response (PR) in 1 patient. At final response assessment, there was no detectable mass on orbit CT or MRI. There were no severe infections or hematologic adverse effects including neutropenia or decreased immunoglobulin during the follow-up period. CONCLUSIONS: In OAML, R-CVP combination chemotherapy is considered an effective, safe and important therapeutic approach, reducing the limitations of classic localized radiotherapy and combination chemotherapy and improving the remission rate.

Clinical Study of Ocular Adnexal Extranodal Marginal Zone B-cell Lymphoma: From the Perspective of Dermatology / 대한피부과학회지

BACKGROUND: The ocular adnexal extranodal marginal zone B-cell lymphoma has been known as the 2nd most common extranodal marginal zone B-cell lymphoma, which presents as the dermatologic symptom and sign, such as orbital mass and swelling. However, the ocular adnexal extranodal marginal zone B-cell lymphoma has been few reported in the dermatologic literature. OBJECTIVE: We described the clinical and histopathological features of ocular adnexal extranodal marginal zone B-cell lymphoma from the perspective of dermatology. METHODS: Ninety-nine cases of ocular adnexal extranodal marginal zone B-cell lymphoma patients were included in this study, among the 352 patients, who were diagnosed with extranodal marginal zone B-cell lymphoma between March 1998 and February 2011. Their medical records and histopathologic slides were retrospectively reviewed. RESULTS: Among the 352 patient of extranodal marginal zone B-cell lymphoma, ocular adnexal extranodal marginal zone B-cell lymphoma occurred in 99 patients (28.1%). The ratio between male and female was 1:2, and the mean age was 50 years (range; 20~54 years). Ocular adnexal extranodal marginal zone B-cell lymphoma presented as orbital mass (39.1%), conjunctival injection (25.6%), orbital swelling (19.5%), and etc. In most patients, lesions were located in conjunctiva (63.8%) or orbit (14.5%). 76.7% of patients presented with Ann Arbor stage I disease. Relapses occurred in 8.4% of patients during the follow-up period. CONCLUSION: When dermatologists meet patients presenting with orbital mass and swelling, dermatologists consider the possibility of ocular adnexal extranodal marginal zone B-cell lymphoma and consultation with the ophthalmologists.

Linfomas de la órbita y anexos oculares: Correlación clínico patológica de 25 casos / Orbital and ocular adnexal lymphomas: Clinico-pathological correlation in 25 cases

Se evaluaron las características clínicas, histológicas y la evolución de una cohorte de pacientes con linfomas de la órbita y anexos oculares. Entre 1995 y 2008 se estudiaron 25 casos de linfomas de la órbita y anexos oculares en un centro oncológico de referencia. En cada caso se analizó el inmunofenotipo usando un panel de anticuerpos monoclonales (CD45, CD20, CD3, CD5, CD23, BCL2, BCL6, BCL10, Ki67, CD30, CD15, BCL1, Kappa, Lambda, CD138). Las lesiones fueron evaluadas utilizando el sistema de clasificación de linfomas (OMS, 2008). Se analizaron 23 linfomas primarios y dos secundarios. Los subtipos histológicos fueron: 16 linfomas B de la zona marginal asociados a las mucosas (MALT), cuatro linfomas difusos de células grandes B, dos linfomas foliculares y un paciente con linfoma Hodgkin. De los 25 casos estudiados, 22 presentaron estadios localizados. El linfoma MALT fue el subtipo más frecuente. En este estudio se observó enfermedad localizada en la mayoría de los casos y con baja progresión a distancia.

Clinical, histological features and outcome of a cohort of patients with orbital and adnexal lymphoproliferative tumors were evaluated. Twenty-five cases in an oncologic referral center from 1995 to 2008, were included in the study. Each case had detailed immunophenotypic analysis using a panel of monoclonal antibodies (CD45, CD20, CD3, CD5, CD23, BCL2, BCL6, BCL10, Ki67, CD30, CD15, BCL1, Kappa, Lambda, CD138). Lesions were classified by using WHO (2008) lymphomas classification. Twenty-three patients were found to have primary and two secondary lymphomas. Histological subtypes were: 16 patients with marginal zone B cell lymphoma of mucosa-associated lymphoid tissue (MALT) lymphoma, four diffuse large B cell lymphomas, two mantle cell lymphomas, two follicular lymphomas, and one Hodgkin lymphoma. Among the 25 patients studied, 22 had localized stage. Extranodal marginal zone lymphoma was the most frequent type of primary orbital and adnexal lymphoma. In this study localized disease was observed in most cases, and distant spread of the lymphomas was infrequent.

The Clinical Characteristics and Treatment Results of Ocular Adnexal Lymphoma

PURPOSE: To assess the clinical pattern, the histopathological findings, the response to treatments, the recurrence pattern and the prognosis of malignant lymphoma in the ocular adnexa. METHODS: This study was performed on 22 total eyes from 17 patients who were diagnosed with ocular adnexal malignant lymphoma. We retrospectively analyzed the medical records for patient information including the histological classification based on age, the gender of each patient, the symptoms and signs at the initial diagnosis, the presence of binocular invasion, the findings of the surgical biopsy, the clinical stage of each patient's tumor, and the treatment methods used and their effectiveness. The mean follow-up period was 24.8 months. RESULTS: The mean age of patients studied was 46.8 years old. Six females and 11 males were included in the study. Fifteen cases consisting of 20 total eyes represented extranodal marginal zone B cell lymphoma of mucosa-associated lymphoid tissue (MALT). Five of seven patients (71.4%) whose lymphoma occurred within the conjunctiva relapsed after irradiation or chemotherapy, and four of the relapsed patients were salvaged with further therapy. CONCLUSIONS: Extranodal marginal zone B cell lymphoma of mucosa-associated lymphoid tissue (MALT) constituted 88.2% of all lymphomas involving the ocular adnexa. Lymphoma in the ocular adnexa responded well to conventional treatment, but the recurrence rate of lymphoma in the conjunctiva was significantly high.

Lymphoscintigraphy of Eyeball and Ocular Adnexal Malignant Tumors

PURPOSE: To evaluate the usefulness of preoperative or postoperative lymphoscintigraphy for the identification of lymphatic drainage and sentinel lymph node in patients with eyeball and ocular adnexal malignant tumors. METHODS: Lymphoscintigraphy was performed preoperatively or postoperatively in 5 patients with biopsy proven primary eyeball or ocular adnexal malignant tumors. Patients underwent lymphoscintigraphy with 500 micro Ci of technetium-99m antimony trisulfide colloid in a volume of 0.1 ml. We injected intradermally either the outer 1/3 of the upper or lower lid, or the inner 1/3 of the upper or lower lid. Images were taken by Gamma camera and we checked lymphatic drainage and sentinel lymph nodes. RESULTS: Two patients with conjunctival malignant melanoma showed normal lymphatic drainage, but the other two patients had lymphatic drainage to the parotid and submandibular chain, and sentinel lymph nodes were noted as the parotid lymph node and the submandibular lymph node. The patients with sebaceous gland carcinoma injected in the outer 1/3 of the upper lid had submandibular lymphatic chain and the sentinel lymph node proved to be the submandibular lymph node. CONCLUSIONS: Lymphoscintigraphy demonstrated the lymphatic drainage system and successfully identified the sentinel lymph nodes. This should prove to be very helpful to evaluate metastasis of the eyeball and ocular adnexal malignant tumors by selective lymph node biopsy and to decide the degree of surgery.

Detecting chlamydia psittaci DNA in patients with ocular adnexal lymphomas / 重庆医科大学学报

Objective:To detect the chlamydia psittaci DNA in patients with ocular adnexal lymphomas,and find out the relationship between chlamydia psittaci infection and ocular adnexal lymphomas.Methods:Tissue samples from 36 patients with ocular adnexal lymphomas were collected,as well as samples from patients with benign lymph disease and patients with eye trauma as controls.Chlamydia psittaci DNA were detected by PCR.Results:The chlamydia psittaci DNA positive rates in patients with ocular adnexal lymphomas,benign lymph diseases and ocular trauma organizations were 47.2%,5.0%,0.0%(?2 = 24.578,P=0.000 1),respectively.The DNA positive rates in patients withⅠ A period were 52.0%,36.4% of Ⅱ A period(?2 =0.749,P=0.387).5,8-year survival rates of all the cases were 90.1%,78.5%,which were the same in Chlamydia psittaci DNA positive group and negative group(?2 = 0.163,P= 0.687).Conclusion:The incidence of ocular adnexal lymphomas may be related with Chlamydia psittaci infection.But there is no evidence of the relationship with Chlamydia psittaci infection and of the ocular adnexal lymphomas stage and prognosis.