Ciliary body melanoma: a special challenge

Although there is little doubt that the delayed recognition of ciliary body melanoma has a bearing on patient management and ultimate survival, the most compelling issues that face the clinician treating this neoplasm relate to the metastatic patterns and mechanisms of the disease. Several aspects of diagnosis and management of this tumour provide a unique challenge to the clinician. Ciliary body melanoma can remain clinically inapparent to the patient as well as to the clinician during its formative period. In management, tumour characteristics, including anterior and posterior margins, are more readily visualized with ultrasound biomicroscopy (UBM) than with other imaging techniques. UBM can provide valuable information when considering intervention, including biopsy, resection or plaque radiotherapy. Management depends on tumour size, intraocular involvement, patient preference and the presence or absence of systemic manifestations.     

Ciliary body melanoma with optic nerve invasion.

A case of melanoma of the ciliary body is presented. Initially the patient was diagnosed and treated for uveitis, but following CT scanning and ultrasound a tumour was detected and the eye enucleated. Histopathologically it was found that the tumour had invaded the optic nerve head, apparently via Cloquet's canal.     

Early ocular hypertension after cataract extraction

The intraocular pressure (IOP) course during the first postoperative month was measured with Goldmann applanation tonometry in 93 eyes. The patients include 30 eyes of intracapsular cataract extraction (ICCE), 32 eyes of extracapsular cataract extraction (ECCE) and 31 eyes of ECCE combined with posterior chamber intraocular lens (PC-IOL) implantation. The preoperative average IOP was 13.30 +/- 3.24 mmHg in 93 eyes. The first day after cataract extraction was 25.33 +/- 8.18 mmHg and 59 eyes (63.44%) had an IOP higher than 23 mmHg. On the second day it was 16.03 +/- 7.54 mmHg. On the third day it was 14.69 +/- 5.45 mmHg. On the seventh day it was 13.32 +/- 3.44 mmHg and only 2 eyes (2.14%) IOP was higher than 23 mmHg. The first postoperative month average IOP was 12.93 +/- 1.31 mmHg and it was above 23 mmHg in only one eye. When compared with preoperation a significant increase in IOP was found postoperatively. But on the seventh day and after the first month there was no significant difference (P greater than 0.05). The IOP rise among ICCE group, ECCE group and PC-IOL group did not differ significantly.     

Rosai-Dorfman disease manifesting as an epibulbar ocular tumour

The authors report a rare case of extranodal Rosai-Dorfman disease without systemic involvement. A 14-year-old girl presented with a slowly progressive, non-tender, well-circumscribed, perilimbal nodule in the right eye. Excisional biopsy was performed and histopathologic and immunohistochemical analysis established the diagnosis. Systemic evaluation revealed no other masses. After complete excision of the epibulbar lesion, the patient is asymptomatic and remains on regular follow up with no signs of recurrence. Rosai-Dorfman disease is an infrequent, benign histiocytic disorder that can rarely manifest as an exclusive extranodal mass. We report a case of solitary epibulbar Rosai-Dorfman disease, successfully treated with complete surgical excision of the lesion.     

Ciliary body tumor and cataract: local resection combined with phacoemulsification.

A 57-year-old man developed a ciliary body mass, clinically diagnosed as malignant melanoma of the ciliary body, that produced a cataract in the right eye. Treatment was cataract surgery with sclerouvectomy performed simultaneously. Pathohistologic examination revealed an acquired adenoma of the nonpigmented ciliary epithelium. The clinicopathologic features and treatment of this tumor are discussed.     

Ciliary body melanoma in a black patient: a case report

Uveal melanomas are rare in the black population. We report the case of an 81-year-old black man who presented a ciliary body melanoma of the left eye. Ophthalmological examination revealed a mass arising from the ciliary body and choroid. Diagnosis of ciliary body melanoma, made from clinical examination and ocular ultrasound, may be difficult in some cases due to its similarity to other eye tumors. Uveal melanomas mainly affect Caucasians but they are not unknown in blacks.     

Uveal melanoma presenting as cataract and staphyloma

Blind eyes can harbor a choroidal melanoma. We report a case of uveal melanoma presenting as staphyloma and complicated cataract in a 45-year-old female. The left eye was blind for six months. She underwent comprehensive ocular examination but fundus examination was precluded due to total cataract. The ultrasound of the eye showed a large mass filling the superior, nasal and inferonasal vitreous cavity with high surface reflectivity and low to moderate internal reflectivity. Magnetic resonance imaging (MRI) confirmed the diagnosis of choroidal melanoma. The patient underwent extended enucleation and histopathology was consistent with uveal melanoma.     

先天性无虹膜症青光眼白内障手术后眼压持续升高

【摘要】 一例11岁男孩,6个月时因双眼先天性无虹膜症、青光眼而行双眼小梁切除术,10岁时行超声乳化晶状体吸出人工晶状体植入术。术后6个月非接触眼压32、34 mm Hg,超声测量中央角膜厚度（CCT）：右眼850、左眼827 μm。眼底C/D 0.2。此患者需要继续治疗吗？（眼科,2012,21：234-238）     

Pattern electroretinogram as a function of spatial frequency in ocular hypertension and early glaucoma

Pattern electroretinograms (PERGs) in response to 8.3 Hz alternating gratings (16.6 rev/sec) of different spatial frequencies were recorded in normal subjects as well as in patients affected by early glaucoma and ocular hypertension. In normal subjects the PERG response is spatially tuned, with a maximum at about 1.5 cycles/deg and attenuation at higher and lower spatial frequencies. In all cases of early glaucoma and in the great majority of cases of ocular hypertension the PERG was reduced, as compared with that of normal subjects, mainly in the medium range of spatial frequencies (at which the PERG has its maximal amplitude).     

Primary ocular lymphoma manifesting as anterior uveitis. Apropos of a case

We report the case of a primitive ocular lymphoma occurring in a 48 year old patient. Non-Hodgkin's lymphomas are usually found in ocular localizations, and are often associated with a lymphomatous cerebral affection. The most frequent mode of presentation of these rare intra ocular tumors is usually posterior uveitis with chorioretinal lesions, and must be suspected for every long-standing chronic uveitis, especially posterior ones. The diagnosis can only be based on histological or cytological analysis. Our patient presented a primary ocular lymphoma which was initially revealed by an anterior uveitis and had evolved into a panuveitis that was resistant to treatment. The initial checkup of this uveitis remained negative and did not allow for an etiological diagnosis. The eye came less operational, hypertonic crisis became more frequent and controlled less and less by the treatment, therefore the patient had to be enucleated in order to establish a diagnosis and for therapeutic reasons. The histology revealed the existence of a NK lymphoma.