[Adenocarcinoma of nonpigmented ciliary body epithelium (clinical cases)]. / Adenokartsinoma iz bespigmentnogo epiteliya tsiliarnogo tela (klinicheskie nablyudeniya).

The article presents two clinical cases of adenocarcinoma of nonpigmented epithelium of the ciliary body, which is a very rare malignant tumor of the organ of vision with distinctive features. Surgical treatment is necessary to verify this tumor and assess the degree of its aggressiveness in terms of the prognosis of the disease, with subsequent pathomorphological and immunohistochemical studies. The article also discusses the epidemiological aspects, morphological features, clinical manifestations of this pathological condition, as well as possible treatment options and features of follow-up monitoring of this group of patients.

[Doppler ultrasound in the assessment of blood supply to choroidal melanoma: parallels with contrast angiography and histography]. / Ul'trazvukovaya dopplerografiya v otsenke krovosnabzheniya melanomy khorioidei: paralleli s kontrastnoi angiografiei i gistografiei.

PURPOSE: Evaluation of blood supply to choroidal melanoma based on comparison of Doppler characteristics of blood flow with angiographic variant of angioarchitectonics and densitometric parameters of the tumor. MATERIAL AND METHODS: The study was performed in 135 patients (135 eyes) with choroidal melanoma. The initial prominence of the tumors varied from 0.6 to 15.2 mm (mean 5.07±3.58 mm), the diameter of the tumor base varied from 4.1 to 22 mm (mean 10.97±3.62 mm). Taking into account the biometric characteristics of choroidal melanoma, all patients were divided into 3 groups: «small¼ (n=49), «medium¼ (n=34) and «large¼ (n=52). In addition to standard diagnostic examination, the following instrumental methods for assessing the blood supply of choroidal melanoma were carried out: angiography with indocyanine green, optical coherence tomography angiography, ultrasound in color Doppler mapping mode, ultrasound histography. RESULTS: Comparative analysis of Doppler ultrasound and contrast angiography data in assessing the blood supply of choroidal melanoma established that the first angiographic type, presented by straight and parallel vessels (65%, p=0.037), is characteristic for hypovascular and avascular masses, the second type - for hypervascular choroidal melanomas, in which the new vessels can take the form of arches, loops and nets (68%, p=0.027). The study of densitometric characteristics in choroidal melanoma of various sizes indicates a natural decrease in the acoustic density of the tumor tissue with increase in the prominence of the mass, while there are significant differences in the acoustic density values in hypo/avascular (36.53±5.37 dB) and hypervascular variants (29.28±4.53 dB) of blood supply to tumor tissue. CONCLUSION: The obtained data on acoustic density of choroidal melanoma can be used in clinical practice for indirect assessment of the nature of blood supply to choroidal melanoma.

[Sarcoid granuloma of the iris (clinical cases and state of the problem)]. / Sarkoidoznaya granulema raduzhki (klinicheskie sluchai i sostoyanie problemy).

Granulomatous lesion of the iris has varying etiology, but in the differential diagnostic it should often be considered by sarcoidosis and tuberculosis damage. PURPOSE: To describe a clinical case of sarcoid lesion of the iris and provide an analysis of literature devoted to this problem in the context of its polyetiology. MATERIAL AND METHODS: The article describes one case of sarcoid granuloma of the iris in a young patient with a relapsing course of the disease. RESULTS: The presented clinical case demonstrates the need for differential diagnosis to clarify the causes of the disease and the possibility of recurrence involving appearance of a multifocal lesion. The article also reviews literature on this problem reflecting the polyetiological nature of granulomatous lesions of the iris, and argues the use of interventional diagnostic methods in the absence of extraocular pathology. CONCLUSION: Analysis of the clinical case and literature clearly demonstrates the need for differential diagnosis of granulomatous lesions of the iris.

[Indocyanine green angiography in the diagnostics of choroidal tumors]. / Angiografiya s indotsianinom zelenym v diagnostike novoobrazovanii khorioidei.

PURPOSE: To study the use of ultrasound color Doppler imaging and indocyanine green (ICG) angiography for identification of malignant vasculature of choroidal tumors. MATERIAL AND METHODS: The study included 46 patients (46 eyes) with tumors of the choroid: 19 men and 26 women aged 22 to 89 years, average age 53.2±17.1 years. All patients underwent indocyanine green angiography and Doppler ultrasound imaging. At the time of examination, thickness of the tumors ranged from 1.1 mm to 3.0 mm, and the base diameter from 4.0 mm to 13.0 mm. Choroidal melanoma was diagnosed in 27 patients, choroidal nevus in 10, choroidal hemangioma in 5, and choroidal metastasis in 4 patients. RESULTS: The results of indocyanine green angiography demonstrate that the pathological malignant vasculature was determined: nevi was diagnosed in 7 out of 10 patients, choroidal melanoma in 16 out of 27, metastasis in 2 out of 4, and hemangioma in none of the 5 patients. Pathological malignant vasculature was determined in most patients with choroidal melanoma (77.8%), in all patients with choroidal hemangioma and in 3 patients with choroidal metastases. Ultrasound imaging revealed malignant vasculature in 15 of 27 (56%) patients with choroidal melanoma, it could be identified in all patients with hemangioma in 2 patients and with choroidal metastases, and in none patients with choroidal nevi. CONCLUSIONS: Indocyanine green angiography helps verify malignant vasculature in 77.8% of patients with small and medium sized choroidal melanomas. Angioarchitecture of choroidal tumors visualized with indocyanine green angiography is characterized by variability of patterns, which should be taken into account in the differential diagnosis of various pathological diseases.

[Ocular sarcoidosis as a clinical manifestation of multiorgan involvement]. / Sarkoidoz organa zreniia kak klinicheskoe proiavlenie mul'tiorgannogo porazheniia.

Eye lesion in sarcoidosis is often the first and only sign of a disorder, which suggests a possible systemic disease. Currently sarcoidosis is considered a multisystemic granulomatous disease that requires multidisciplinary approach. PURPOSE: To study the prevalence and clinical aspects of sarcoidosis eyes based on the representative sample of patients diagnosed with extraocular nonspecific granulomatous disease. MATERIAL AND METHODS: The study included 417 patients with multi-organ sarcoidosis. Females prevailed in the study population (259 patients - 62.11%); average patient age was 43.5±3.5 years. RESULTS: Patients with systemic signs of sarcoidosis had an eye lesion in 7.7% of cases. Females (71.87%) at the age of 48.5±2.5 were diagnosed with sarcoidosis more often. Among the clinical forms of sarcoidosic eye lesion, anterior uveitis prevailed (59.37%), affection of the posterior uveal tract was observed less often (31.25%); the disease had chronically recurrent course in 53.12% of patients. Among rare disease forms, orbital granuloma was found in two patients, and one patient had sarcoidosis of the skin of the medial angle of the eye. CONCLUSION: Analysis of the clinical material revealed the occurrence rate of eye lesion in patients with systemic manifestations of sarcoidosis, and gave insight on the polymorphism of clinical signs of organ lesion in multiorgan and isolated granulomatous inflammation.