Relapsed acute myeloid leukemia presenting as conjunctival myeloid sarcoma: a case report.

BACKGROUND: Conjunctival myeloid sarcoma (MS) as an isolated presentation of acute myeloid leukemia (AML) relapse is rare. Here, we report a case of unilateral conjunctival MS revealed as a sign of AML relapse. CASE PRESENTATION: A 50-year-old man with a history of AML in remission visited our clinic presenting with a left conjunctival injection persisting for 1 month. Diffuse subconjunctival thickening with conjunctival vascular engorgement was observed. Ultrasound biomicroscopy revealed a hyper-reflective, thickened conjunctiva in his left eye. During the incisional biopsy, the lesion was strongly attached to the underlying sclera; histopathologic examination revealed infiltration of leukemic blasts. The relapse of AML was confirmed by a successive bone marrow biopsy. The ocular lesion disappeared after allogeneic peripheral blood stem cell transplantation (PBSCT) and concomitant salvage radiotherapy on the left eye. The patient has remained in remission for 3 years after allogeneic PBSCT. CONCLUSIONS: Incidental conjunctival lesions can indicate AML relapse in patients treated earlier for AML. An ophthalmologist may have a role in the early detection of AML when a patient presents with an atypical conjunctival lesion.

Measurement of lamina and prelaminar thicknesses of both eyes in patients with unilateral branch retinal vein occlusion.

PURPOSE: Thinning of the lamina cribrosa thickness (LCT) and prelaminar tissue thickness (PT) has been observed in patients with glaucoma, and branch retinal vein occlusion (BRVO) is reportedly related to glaucoma. To test the hypothesis that thinning of the LCT and PT occurs in patients with BRVO, we investigated possible correlations of the LCT and PT in BRVO-affected eyes and fellow eyes and compared these values with age-, sex-, and underlying disease-matched eyes. METHOD: The study included 50 patients (50 eyes) with unilateral BRVO and 35 control subjects (35 eyes). The LCT and PT were measured using the enhanced depth imaging mode of spectral-domain optical coherence tomography. RESULTS: The mean LCT and PT in BRVO-affected eyes (208.26 ± 33.36 and 155.70 ± 76.89 µm, respectively) were significantly thinner than those in the normal control eyes (260.41 ± 43.25 and 201.74 ± 74.97 µm, respectively) (P = 0.000 and P = 0.008, respectively). The mean LCT and PT in the fellow eyes (204.97 ± 37.57 and 147.06 ± 71.33 µm, respectively) were also statistically thinner than those in the control group (P = 0.000 and P = 0.004, respectively). CONCLUSIONS: The LCT and PT in BRVO-affected eyes and fellow eyes were thinner than those in eyes of normal control subjects. Thinning of the LCT and PT may be associated with BRVO as well as glaucoma, suggesting that the two diseases have the similar structural abnormalities in the lamina cribrosa and prelaminar tissues.

Effect of transverse conjunctival advancement flap surgery for primary pterygium.

OBJECTIVE: To introduce a new surgical technique, transverse conjunctival advancement flap, and to evaluate the efficacy and safety of the technique in primary pterygium surgery. DESIGN: Retrospective, noncomparative, interventional case-series analysis. PARTICIPANTS: Sixty-three eyes of 63 patients. METHODS: The patients with primary pterygium were treated with transverse conjunctival advancement flap technique. After excision of the pterygium head and the perilimbal part of the pterygium body (within 2 mm from the limbus), the bare sclera was covered with the transverse conjunctival advancement flap using the conjunctiva of the remaining posterior part of the pterygium body. The patients were followed up for more than 6 months. RESULTS: The mean age of patients was 64.9 ± 8.7 years (range 43-85 years), and the mean follow-up period was 9.8 ± 3.9 months (range 6-18 months). In all cases, surgery did not exceed 20 minutes. During the follow-up period, recurrence of the pterygium occurred in 1 (1.5%) of the 63 cases, with recurrence only in the conjunctiva. There was no occurrence of serious complications. CONCLUSIONS: The transverse conjunctival advancement flap technique may be considered a safe and effective method, with a low rate of pterygium recurrence, after primary pterygium excision.

Effects of two different doses of intravitreal bevacizumab on subfoveal choroidal thickness and retinal vessel diameter in branch retinal vein occlusion.

AIM: To investigate the effects of two different doses of intravitreal bevacizumab on subfoveal choroidal thickness (SFChT) and retinal vessel diameter in patients with branch retinal vein occlusion. METHODS: An interventional, restrospective study of 41 eyes of 41 patients who had completed 12mo of follow-up, divided into group 1 (1.25 mg of bevacizumab, 21 eyes of 21 patients) and group 2 (2.5 mg of bevacizumab, 20 eyes of 21 patients). Complete ophthalmic examination, fluorescein angiography, enhanced depth imaging optical coherence tomography and measurement of retinal vessel diameter with IVAN software were performed at baseline and follow-up. RESULTS: The SFChT changed from 279.1 (165-431) µm at baseline to 277.0 (149-413) µm at 12mo in group 1 (P=0.086), and from 301.4 (212-483) µm to 300.3 (199-514) µm in group 2 (P=0.076). The central retinal arteriolar equivalent (CRAE) changed from 128.8±11.2 µm at baseline to 134.5±8.4 µm at 12mo in group 1, and from 134.6±9.0 µm to 131.4±12.7 µm in group 2 (P=0.767). The central retinal venular equivalent (CRVE) changed from 204.1±24.4 µm at baseline to 196.3±28.2 µm at 12mo in group 1, and from 205.8±16.3 µm to 194.8±18.2 µm in group 2 (P=0.019). The mean central macular thickness (P<0.05) and average best-corrected visual acuity (BCVA; P<0.05) improved in both groups. CONCLUSION: Changes in the SFChT are not statistically significant and not different according to the doses of bevacizumab. The CRAE did not show significant change, however, the CRVE showed significant decrease regardless of the dose.