ABSTRACT
Uveal melanomas are the most common malignant tumors of the eye. With modern molecular biological diagnostic methods, such as chromosome 3 typing and gene expression analysis, these tumors can be categorized into highly aggressive (monosomy 3, class II) and less aggressive forms. This molecular biological stratification is primarily important for determining the risk of these tumors as no therapy is currently available that is able to prevent or delay metastases. A randomized study of patients with a poor prognosis (monosomy 3) is currently being carried out in order to determine whether a cancer vaccine prepared from autologous (patient's own) dendritic cells and uveal melanoma RNA can prevent or delay progression and further metastases of this extremely aggressive form of cancer. Inclusion in the uveal melanoma study, which hopes to provide a potential therapeutic option for patients, is only possible if patients are referred to an institution that is able to manufacture and provide this vaccination before the patient is operated on or treated with radiation. Untreated tumor material is necessary for producing the vaccine on an individualized patient basis.
Subject(s)
Cancer Vaccines/therapeutic use , Dendritic Cells/immunology , Melanoma/immunology , Melanoma/therapy , Uveal Neoplasms/immunology , Uveal Neoplasms/therapy , Adult , Aged , Female , Humans , Immunotherapy/methods , Male , Melanoma/diagnosis , Middle Aged , RNA, Neoplasm/immunology , Treatment Outcome , Uveal Neoplasms/diagnosisABSTRACT
BACKGROUND: There is currently no effective therapy for retinal artery branch occlusion (RABO). Transluminal Nd:YAG embolectomy (TYE) was developed to achieve rapid reperfusion; however, it is still a subject of controversy. A Nd:YAG laser is focused on the occluded vessel, the vessel wall is ruptured and the embolism dislocates to the vitreous humor through the opening in the artery. METHOD: We retrospectively examined the results of five patients treated with TYE. RESULTS: The age of the patients was 26-75 years (mean age 58 years, median 68 years). Initial visual acuity was hand movements to 1.0 and all patients had visual field defects. Treatment was performed between 4 and 30 h from the onset of symptoms. Visual acuity improved markedly in two cases the next day (hand movements to 0.8 and 0.4 to 1.0) and final visual acuity was between 0.8 and 1.25. All treatments led to vitreous hemorrhage but only one patient required surgical treatment. The range of follow-up was 4-42 months. CONCLUSIONS: The results are in accordance with those published in the literature. It can be concluded that TYE is a fast, easy and readily available method that should be taken into account especially in cases with low initial visual acuity.
