Radial optic neurotomy for ischaemic central vein occlusion.

BACKGROUND/AIMS: Ischaemic central retinal vein occlusion (CRVO) accounts for 20-50% of all CRVO. No treatment has been proved to be effective. The efficacy of radial optic neurotomy (RON) was evaluated in eyes with ischaemic CRVO. METHODS: 10 patients with ischaemic CRVO underwent RON. After pars plana vitrectomy, a microvitreoretinal blade was used to incise the scleral ring, cribriform plate, and adjacent sclera at the nasal edge of the optic disc. Best corrected visual acuity (BCVA), intraocular pressure (IOP), fluorescein angiography (FA), multifocal electroretinography (mfERG), and optical coherence tomography (OCT) were measured preoperatively and at 1, 3, and 6 months postoperatively. RESULTS: No visual improvement was noted in the eyes that underwent RON. FA and mfERG showed no increase in retinal perfusion or retinal function postoperatively. Mean macular central thickness changed from 841 (SD 170) mum preoperatively to 162 (SD 34) microm at the sixth postoperative month. One patient had retinal central artery perforation intraoperatively. One patient developed neovascular glaucoma. CONCLUSION: RON in ischaemic CRVO did not improve visual function (by mfERG) or visual acuity although macular thickness did improve. This technique may be associated with potential risks. Randomised studies are needed to corroborate these results.

[Clinical-pathologic characteristics of uveal melanoma in Mexican patients under thirty years old]. / Características clínico-patológicas del melanoma uveal en pacientes mexicanos menores de 30 años de edad.

PURPOSE: To analyze the clinicopathologic characteristics of uveal melanoma in Mexican patients under thirty years old. METHODS: We reviewed the cases from the Service of Ophthalmic Pathology with histopathologic diagnosis of uveal melanoma from 1957 to March 2002. The data analyzed were: age, gender, affected eye, clinical diagnosis, size, cellular type, mitotic index, lymphocytic infiltrate, vascular pattern, necrosis, vascular and/or intraocular invasion and orbital extension. RESULTS: We reviewed 122 cases diagnosed with uveal melanoma, and 14 patients were younger than 30 years old (11.4%). The mean age was 21.7 years, with female preponderance. Preoperative clinical diagnoses were uveal melanoma in 92.8%, most of the cases originated from choroid. The most frequent cellular type was spindle cells and 3 and 4 Folberg's vascular patterns. CONCLUSIONS: Our results suggest that the clinicians should consider uveal melanoma more frequently as another differential diagnosis in patients under thirty years with an intraocular tumor. The histological characteristics found have been correlated with a better prognosis.

Características clínico-patológicas del melanoma uveal en pacientes mexicanos menores de 30 años de edad / Clinical-Pathologic characteristics of uveal melanoma in mexican patients under thirty years old

Objetivo: Determinar las características clínicopatológicas del melanoma uveal en pacientes mexicanos menores de treinta años. Métodos: Se revisaron los casos del Servicio de Patología Oftálmica con diagnóstico histopatológico de melanoma uveal de 1957 a marzo de 2002. Se analizaron: edad, sexo, ojo afectado, diagnóstico clínico, tamaño, tipo celular, índice mitótico, infiltrado linfocitario, patrón vascular, necrosis, invasión vascular y/o de estructuras intraoculares así como extensión orbitaria. Resultados: De 122 casos con diagnóstico de melanoma uveal, 14 correspondieron a pacientes menores de 30 años (11,4%). La edad promedio fue de 21,7 años, con predominio en mujeres. El diagnóstico clínico preoperatorio fue melanoma uveal en un 92,85 %, originándose en coroides en la mayoría de los casos. El tipo celular más frecuente fue el de células fusiformes, con predominio de los patrones vasculares 3 y 4 de Folberg. Conclusiones: Nuestros resultados sugieren que los clínicos deben considerar el melanoma uveal como un diagnóstico diferencial más en pacientes menores de 30 años con un tumor intraocular. Las características histológicas observadas se han correlacionado con un mejor pronóstico(AU)

Purpose: To analyze the clinicopathologic characteristics of uveal melanoma in Mexican patients under thirty years old. Methods: We reviewed the cases from the Service of Ophthalmic Pathology with histopathologic diagnosis of uveal melanoma from 1957 to March 2002. The data analyzed were: age, gender, affected eye, clinical diagnosis, size, cellular type, mitotic index, lymphocytic infiltrate, vascular pattern, necrosis, vascular and/or intraocular invasion and orbital extension. Results: We reviewed 122 cases diagnosed with uveal melanoma, and 14 patients were younger than 30 years old (11.4%). The mean age was 21.7 years, with female preponderance. Preoperative clinical diagnoses were uveal melanoma in 92.8%, most of the cases originated from choroid. The most frequent cellular type was spindle cells and 3 and 4 Folberg´s vascular patterns. Conclusions: Our results suggest that the clinicians should consider uveal melanoma more frequently as another differential diagnosis in patients under thirty years with an intraocular tumor. The histological characteristics found have been correlated with a better prognosis(AU)