Diseño de una base de datos informatizada para la gestión clínica y básica del melanoma uveal / Design of computerised database for clinical and basic management of uveal melanoma

Propósito: El melanoma uveal es el tumor intraocular primario más frecuente en la edad adulta. El objetivo de este trabajo es mostrar cómo se ha construido una base de datos informatizada con aplicaciones, tanto clínicas como de investigación concretas, a un grupo extenso de pacientes diagnosticados de melanoma de la úvea. Métodos: Para el diseño de la base de datos se realizó una selección de categorías, atributos y valores basándose en las clasificaciones y parámetros dados por diferentes autores en artículos que han tenido gran relevancia en el campo del melanoma uveal en los últimos años. Resultados: La base de datos cuenta en la actualidad con más de 250 registros de pacientes, con información específica sobre su clínica, diagnóstico, tratamiento y evolución. Nos permite realizar búsquedas sobre cualquier parámetro del registro y hacer estudios estadísticos de estos de una forma rápida y sencilla. Conclusión: Los modelos de bases de datos se han convertido en un arma fundamental para la práctica clínica, pues constituyen una forma eficaz tanto de almacenamiento como de recopilación y búsqueda selectiva de información. A la hora de realizar una base de datos es muy importante la definición de una estrategia común y el uso de un idioma normalizado (AU)

Purpose: The uveal melanoma is the most common primary intraocular tumour in adults. The objective of this work is to show how a computerised database has been formed with specific applications, for clinical and research use, to an extensive group of patients diagnosed with uveal melanoma. Method: For the design of the database a selection of categories, attributes and values was created based on the classifications and parameters given by various authors of articles which have had great relevance in the field of uveal melanoma in recent years. Results: The database has over 250 patient entries with specific information on their clinical history, diagnosis, treatment and progress. It enables us to search any parameter of the entry and make quick and simple statistical studies of them. Conclusion: The database models have been transformed into a basic tool for clinical practice, as they are an efficient way of storing, compiling and selective searching of information. When creating a database it is very important to define a common strategy and the use of a standard language (AU)

[Design of computerised database for clinical and basic management of uveal melanoma]. / Diseño de una base de datos informatizada para la gestión clínica y básica del melanoma uveal.

PURPOSE: The uveal melanoma is the most common primary intraocular tumour in adults. The objective of this work is to show how a computerised database has been formed with specific applications, for clinical and research use, to an extensive group of patients diagnosed with uveal melanoma. METHOD: For the design of the database a selection of categories, attributes and values was created based on the classifications and parameters given by various authors of articles which have had great relevance in the field of uveal melanoma in recent years. RESULTS: The database has over 250 patient entries with specific information on their clinical history, diagnosis, treatment and progress. It enables us to search any parameter of the entry and make quick and simple statistical studies of them. CONCLUSION: The database models have been transformed into a basic tool for clinical practice, as they are an efficient way of storing, compiling and selective searching of information. When creating a database it is very important to define a common strategy and the use of a standard language.

[Ultrasound diagnosis in vasoproliferative tumours of the ocular fundus]. / Diagnóstico ecográfico de los tumores vasoproliferativos del fondo de ojo.

OBJECTIVE: The aim of this work is to describe the ultrasound features in vasoproliferative tumours of the ocular fundus (VPTOF). METHODS: The medical records corresponding to eight patients were retrospectively studied. Clinical data from the complete ophthalmologic examination and ultrasonographic findings were analysed. RESULTS: Nodular masses affecting either the retina or both the retina and the choroid were found. The surface contour of the tumour was regular in 5, and irregular in 3 cases. In terms of dimensions (mm/ SD), the average major base was 7.14/2.56; the minor base 6.74/2.48 and the height 2.38/1.26. Internal structure was always solid and irregular and reflectivity was mostly medium to high in 6 eyes. Angle kappa was not present in any case. No vascularity signs were detected. CONCLUSION: According to the results it is suggested that when a differential diagnosis of VPTOF is carried out, not only should ophthalmoscopic signs be studied, but an ultrasound examination should also be done.

Diagnóstico ecográfico de los tumores vasoproliferativos del fondo de ojo / Ultrasound diagnosis in vasoproliferative tumours of the ocular fundus

Objetivo: Describir las características ecográficas en los tumores vasoproliferativos del fondode ojo (TVPFO).Métodos: Se estudiaron retrospectivamente las historias clínicas correspondientes a8 pacientes afectados de TVPFO. Se analizaron los datos correspondientes a la exploraciónoftalmológica completa y a la exploración ecográfica.Resultados: Se encontraron masas nodulares afectando a la retina o bien a la retina y la coroides.La superficie tumoral era regular en 5 casos e irregular en los 3 restantes. La media de lasdimensiones fue (mm/DE): base mayor, 7,14/2,56; base menor, 6,74/2,48 y altura 2,38/1,26. Laestructura interna fue siempre sólida e irregular y la reflectividad era media-alta en 6 casos.No se detectó ni ángulo kappa ni vascularidad interna en ningún caso.Conclusión: De acuerdo con los resultados obtenidos se propone que tanto el diagnósticocomo el diagnóstico diferencial de los TVPFO deben ser llevados a cabo no solo con laoftalmoscopia sino también con la exploración ecográfica(AU)

Objective: The aim of this work is to describe the ultrasound features in vasoproliferativetumours of the ocular fundus (VPTOF).Methods: The medical records corresponding to eight patients were retrospectively studied.Clinical data from the complete ophthalmologic examination and ultrasonographic findingswere analysed.Results: Nodular masses affecting either the retina or both the retina and the choroid werefound. The surface contour of the tumour was regular in 5, and irregular in 3 cases. In termsof dimensions (mm/ SD), the average major base was 7.14/2.56; the minor base 6.74/2.48 andthe height 2.38/1.26. Internal structure was always solid and irregular and reflectivity was mostly medium to high in 6 eyes. Angle kappa was not present in any case. No vascularitysigns were detected.Conclusion: According to the results it is suggested that when a differential diagnosis ofVPTOF is carried out, not only should ophthalmoscopic signs be studied, but an ultrasoundexamination should also be done(AU)

[Quality of life in patients with choroidal melanoma]. / Calidad de vida en pacientes con melanoma de coroides.

PURPOSE: To determine whether iodine 125 brachytherapy or enucleation is better for quality of life in patients treated for choroidal melanoma. PATIENTS AND METHODS: Sixty-five patients with choroidal melanoma were treated with a modified version of VF-14 iodine 125 brachytherapy, enucleation or both. Results of this treatment were then statistically analyzed. RESULTS: Statistically significant differences were found between visual acuity in the affected eye and binocular vision (initial and final), with an important decline after the treatment. The global medial score in the VF questionnaire decreased in a statistically significant manner after the treatment. CONCLUSION: We can confirm that patients treated with brachytherapy had better health-related quality of life than those who had their eye enucleated and were more likely to have higher (better) scores on the VF questionnaire items. On the other hand, the binocular vision and time after the treatment correlated with the quality of life in long-term follow-up.

Efficacy of subconjunctival cyclosporin-containing microspheres on keratoplasty rejection in the rabbit.

BACKGROUND: The purpose of this study was to evaluate microspheres of PLGA containing cyclosporin (CsA) as a subconjunctival drug delivery system and to test their efficacy in the prevention of corneal allograft rejection in the rabbit. METHODS: Rabbits were injected subconjunctivally with a solution of CsA (CsA-AR) (20 animals) or a microsphere suspension of CsA (CsA-MP) (20 animals), with equivalent drug concentrations (15 mg/ml). The concentration of CsA in the aqueous, cornea and blood was measured by radioimmunoassay at different times thereafter. In other rabbits, 40 allogeneic grafts were performed. Animals were divided into four groups that received the following subconjunctival treatments: group 1: AR solution (solvents of CsA-AR solution); group 2: CsA-AR solution; group 3: MP suspension (empty microspheres); group 4: CsA-MP suspension. RESULTS: Mean corneal levels of CsA were 1174+/-830, 918+/-179, 972+/-580, 268+/-182 and 243+/-162 ng/ml at 12, 24 and 48 h and 7 and 14 days after the injection of CsA-AR. For the CsA-MP suspension, corneal concentrations were 1195+/-321, 234+/-147 and 88+/-77 ng/ml at 12, 24 and 48 h but subsequently dropped to undetectable levels. Blood and aqueous levels were undetectable. Treatment with CsA significantly improved the survival time and survival rate of grafts in the CsA-treated groups (2, 4) over grafts in non-CsA-treated groups (1, 3). There was no significant difference in the graft survival curve between groups 2 and 4. CONCLUSION: CsA-containing microspheres might be a promising formulation in the prevention of corneal graft rejection. Since the levels of CsA in blood were undetectable, this treatment might avoid the problems associated with systemic side effects.

Dynamic register in ocular ultrasonography: combining A- and B-scan techniques.

We present the results obtained after studying two groups of patients with dynamic register techniques, using A-scan, standardised A-scan following Ossoinig's procedure and B-scan. One group comprised 50 patients with retinal detachment and proliferative vitreoretinopathy while the other consisted of 15 patients with choroidal melanoma. In the group of patients with retinal detachment and proliferative vitreoretinopathy 90% of cases demonstrated waves with 100% amplitude on A-scan when the ultrasound beam was directed perpendicularly over the detached retina. Likewise in these same 90% of cases we observed a small split in the wave peak during the after movements. Conversely on B-scan 80% of these patients with retinal detachment and proliferative retinopathy showed retinal mobility. In the group of patients with choroidal melanoma rapid spontaneous movements were detected in the internal echoes on A-scan and standardised A-scan. Moreover in 3 of the 15 cases (those of greatest size) movement could also be detected on B-scan.

Granular cell tumor of the eye (myoblastoma): ultrastructural and immunohistochemical studies.

The clinical and pathological characteristics of a myoblastoma of the orbital are described. The tumor presented as a painless hard mass in the left orbit of a 56-year-old caucasian male, causing diplopia and hypertrophy of the left eye in the primary visual position. Light microscopy studies revealed a typical granular cell tumor with PAS-positive intracytoplasmic granules. Immunoperoxidase studies showed positivity for S-100 protein and desmin. Electron microscopy studies showed numerous intracellular myelin degenerative bodies. The patient developed an epidermoid cyst at the site of initial surgery, but has no signs of local or distant disease two years after initial treatment.