ABSTRACT
In recent years several investigators have reached the conclusion that the prognosis of melanoma of the iris is related to the cell type of the tumor. Overall mortality ranges from 3.0-3.6%, but there is no correlation between the clinical manifestation of the tumor, its microscopic appearance, or the results of angiography. The clinical behavior of histologically benign tumors may be malignant, with penetration through the trabeculum into the ciliary body and sclera, and there may even be recurrence following excision of the tumor. We present 2 women, 20 and 59 years old, respectively, with melanoma of the iris with malignant behavior. However, in 1 of them the microscopic picture was completely benign, although the tumor had penetrated into the angle of the anterior chamber and had caused severe secondary glaucoma.
Subject(s)
Iris Diseases/pathology , Iris/pathology , Melanoma/pathology , Uveal Neoplasms/pathology , Adult , Female , Humans , Iris Diseases/classification , Melanoma/classification , Middle Aged , Nevus/classification , Nevus/pathology , Uveal Neoplasms/classificationABSTRACT
A patient with subdural hematoma and right amaurosis resulting from traumatic injury to the optic nerve developed papilledema in both eyes a few days after the trauma. This was interpreted as supplementary proof of the existence of axonal flow in the first weeks after occurrence of the optic axon lesion. In the amaurotic eye, the papilledema was less pronounced and disappeared more rapidly (after 3 weeks, as opposed to 6 weeks for the other eye). The nerve fiber layer disappeared between 4 and 6 weeks after the trauma.
Subject(s)
Blindness/etiology , Hematoma, Subdural/complications , Optic Nerve Injuries , Papilledema/etiology , Adult , Axonal Transport , Fundus Oculi , Humans , Intracranial Pressure , Male , Optic Nerve/physiopathologyABSTRACT
Serial narrow-band green-light fundus photographs documented the evolution of descending optic atrophy in a case of rapid bilateral blindness produced by a highly invasive osteogenic sarcoma of the base of the skull. Disappearance of the nerve fiber layer (NFL) was observed to take place between the sixth and 12th week after onset of blindness; thus, it is similar to the evolution of descending atrophy found to occur in clinical cases of blindness caused by traumatic involvement of the optic nerve. Parallel to the disappearance of the NFL there was an increase in optic nerve head excavation and a change in the appearance of the vessels on the disk surfaces.
Subject(s)
Optic Nerve Diseases/pathology , Osteosarcoma/pathology , Skull Neoplasms/pathology , Adult , Blindness/etiology , Blindness/pathology , Fundus Oculi , Humans , Male , Neoplasm Invasiveness , Osteosarcoma/complications , Skull Neoplasms/complicationsABSTRACT
Lack of fungiform papillae over the surface of the tongue is considered essential for the diagnosis of familial dysautonomia. We describe two cases with dysautonomia in which the diagnosis was delayed because numerous fungiform papillae were easily seen. Only a close inspection of the tongue with an ophthalmologic slit lamp revealed that each papilla was degenerated and atrophic. Lacking a clinical sine qua non or easily available diagnostic laboratory tests, fungiform papillae should be studied in detail to establish not only that their number is sufficient but also that their shape and structure are normal. The simple technique described enables confirmation of the diagnosis in children and newborns in whom familial dysautonomia is suspected.
Subject(s)
Dysautonomia, Familial/diagnosis , Infant, Newborn, Diseases/diagnosis , Taste Buds/abnormalities , Diagnostic Errors , Female , Humans , Infant, NewbornABSTRACT
Sixty-eight eyes with neovascular senile maculopathy involving the capillary free zone that were assigned randomly for red krypton laser photocoagulation were followed for two years and compared to 55 eyes with the same disease that were not treated. In the majority of the studied eyes there was a decline of visual acuity during the follow-up period. However, an increase in visual acuity was encountered in one third of treated eyes, but no increase in the untreated eyes. The extent of visual acuity deterioration was greater in the nontreated than in the treated eyes. Eyes that were treated when visual acuity was between 6/9-6/60 generally belonged to a better final visual acuity group than those eyes that were treated when visual acuity was less than 6/60. The technique of red krypton laser photocoagulation is described, the rationale for this treatment is discussed, and the results of the treatment are evaluated.
Subject(s)
Fovea Centralis/blood supply , Laser Therapy , Lasers/methods , Macula Lutea/blood supply , Neovascularization, Pathologic , Retinal Hemorrhage/surgery , Aged , Capillaries/surgery , Fluorescein Angiography , Humans , Middle Aged , Neovascularization, Pathologic/diagnostic imaging , Radiography , Visual AcuityABSTRACT
We used narrow-band (540-nm) green-light stereoscopic fundus photography to study the surface details of the peripapillary retina in 14 patients. Each photograph was divided into four areas; the papillomacular bundle, the upper arcuate bundle, the lower arcuate bundle, and the nasal sectorial fibers. We scored each area on a scale of 0 (normal) to 3 (total loss of nerve fiber layer), and compared these scores to those obtained by testing the corresponding visual fields. The scores were the same in 88 of 111 comparisons; the retinal scores were higher in 17 comparisons and the visual field scores were higher in six comparisons. This photographic technique makes the nerve fiber layer easier to see and evaluate and the detection of defects becomes less difficult.
