Cone photoreceptor abnormalities correlate with vision loss in a case of acute posterior multifocal placoid pigment epitheliopathy.

The authors report adaptive optics scanning laser ophthalmoscopy (AO-SLO) findings in a case of acute posterior multifocal placoid pigment epitheliopathy. The right eye showed an island of coarse, hyperreflective speckles surrounded by a dark annulus lacking cone cells, which were associated with reduced MP1 sensitivity and abnormal findings in other imaging modalities. Although dark lesions were also detected in the left eye, the correlated spectral-domain optical coherence tomography images were normal. AO-SLO allowed for the direct observation of retinal disruptions and the ability of this technology to detect abnormalities in the left eye demonstrates a superior ability for in-depth retinal imaging.

Overview of ocular complications in patients with electrical burns: an analysis of 102 cases across a 7-year period.

BACKGROUND: Ocular complications from electrical burns are uncommon. Thus far, there has been no systematic review on ocular electrical trauma with emphasis on patients' ophthalmic complications and visual symptoms. Herein, we retrospectively analyzed records of patients with electrical injuries to summarize the ophthalmic characteristics and explore their relationships with visual symptoms. METHODS: We collected the medical records of 102 patients who consulted from 557 electrical burn patients between 2004 and 2010. Ophthalmic, systemic and demographic factors associated with electrical burns were identified in the patient who underwent the ophthalmic consultations. Two sets of comparisons were used to determine the demographic and systemic factors that were related to ophthalmic complications and the subjective outcome of visual impairment. RESULTS: There were 53 eyes (29 patients) with ophthalmic complication were identified. Corneal epithelial erosion was the most common ocular electrical injury and the primary reason for subjective visual symptoms. Electrical burns affecting the head and neck were significantly related to subjective symptoms of visual disturbances. CONCLUSION: Present study indicates that earlier involvement of ophthalmologists in the case of any patient who has suffered a facial burn is advisable. Appropriate management would be helpful to prevent future complications and alleviate visual symptoms.

Dermolipoma surgery with rotational conjunctival flaps.

PURPOSE: To describe a useful technique of surgical resection of dermolipomas. METHODS: This is a retrospective, noncomparative and interventional case series. Sixteen eyes of 16 patients with dermolipomas and large areas of conjunctiva strongly adherent to the masses underwent surgical removal of the dermolipomas. The anterior portion of the mass, including closely adherent conjunctiva and pilosebaceous areas, was excised, and the conjunctival defects were covered with rotational conjunctival flaps from the superior or inferior bulbar conjunctiva. RESULTS: The mean follow-up time was 12.5 months (range, 6-47 months). The cosmetic outcome was satisfactory in all 16 patients. There were no cases of reappearance of the mass, symblepharon or significant scar formation during follow-up. One patient developed blepharoptosis and another showed limitation of medial gaze postoperatively. Both were resolved spontaneously within 3 months. There were no other significant complications. CONCLUSION: Rotational conjunctival flap is a useful technique of conjunctival reconstruction following removal of large dermolipomas and the overlying epithelium.

Expression of matrix metalloproteinase (MMP)-2, MMP-9, and tissue inhibitor of MMP (TIMP)-1 in conjunctival melanomas and clinical implications.

PURPOSE: To investigate the expression of matrix metalloproteinase (MMP)-2, MMP-9, and tissue inhibitor of matrix metalloproteinase (TIMP)-1 in conjunctival melanomas and their correlations with clinicopathologic parameters and prognosis. METHODS: Fourteen conjunctival melanoma tissue samples and nine conjunctival nevus tissue samples were stained immunohistochemically for MMP-2, MMP-9, and TIMP-1. Association of MMP-2, MMP-9, and TIMP-1 expression in melanoma tissues with clinical progression in terms of metastasis, recurrence, mitotic index, thickness, base diameter, and invasion depth was analyzed. RESULTS: In the melanoma group, 78.6% of samples showed a positive reaction for MMP-2, 85.7% for MMP-9, and 100% for TIMP-1. In the nevus group, 11.1% showed a positive reaction for MMP-2, 66.7% for MMP-9, and 100% for TIMP-1. MMP-2 expression was significantly more induced in conjunctival melanoma than in benign nevi (P = 0.002). In conjunctival melanoma, MMP-9 expression was higher in tumors >1.5 mm thick (P = 0.026) and TIMP-1 expression was higher in recurrent cases (P = 0.03). There was no significant correlation between the expression and metastasis during the follow-up period (mean, 5 years). CONCLUSION: MMP-2, MMP-9, and TIMP-1 were expressed in the majority of conjunctival melanomas, and MMP-2 might play a role in the development and clinical behavior of conjunctival melanoma.