Some observations on the treatment of ischemic optic neuropathy

We examined the efficacy of the treatment with steroids, vasodilators, and vitamins B1, B6, and B12 in 23 cases of anterior ischemic optic neuropathy treated at the Athens University Eye Clinic. We stress the necessity of an extended medication for 2 to 3 months, depending upon the improvement of visual acuity. Good results were achieved in 14 of the 23 patients.     

The prognostic value of visual evoked response latency in the treatment of amblyopia caused by strabismus

Visual evoked response alterations and especially P100 latency were studied in 60 patents with amblyopia caused by strabismus. Patients were divided in two groups according to the mode of fixation of the strabismic eye. Group A included patients with eccentric fixation, and group B, patients with central fixation of the strabismic eye. In all cases visual evoked responses were recorded before and after a 6-month period during which the patients had full-time occlusion of the sound eye. In case with eccentric fixation of the strabismic eye, P100 latency was more abnormal than in cases with central fixation. In cases where latencies are clearly abnormal before treatment, the prognosis is poor and the results after occlusion of the sound eye are unstable. In contrast, in the cases with normal or nearly normal visual evoked response latencies, the prognosis is better, and these eyes show satisfactory improvement of visual acuity.     

Some clinical aspects concerning microtropia.

The present study is concerned with the specific nature and the multiformity of microtropia, which is characterized by unilateral convergent small angle (under 10delta) strabismus with amblyopia and abnormal retinal correspondence. Three types of microtropia may be distinguished: Type I: Showing a positive cover test, amblyopia and abnormal retinal correspondence. Type II: Showing in addition to the above, heterophoria. Type III: Showing a negative cover test, a positive 4delta base-out prism test, amblyopia due to anisometropia, eccentric fixation and harmonious abnormal retinal correspondence, where the angle of anomaly is equal to the angle to eccentricity. For the prevention of microtropia all children aged under 4 and irrespective of the presence of any symptoms should undergo an eye examination. At a more advanced age the diagnosis of this clinical entity is of importance chiefly from a prognostic point of view, because it permits us to avoid futile efforts at correcting visual acuity by means of covering up to sound eye.     

Favorable outcome of Ewing sarcoma family tumors to multiagent intensive preoperative chemotherapy: a single institution experience

BACKGROUND: Aim of our study was to evaluate the efficacy of multiagent intensive preoperative chemotherapy in patients with Ewing sarcoma family tumors (ESFT), in order to succeed a better percentage of necrosis before surgical resection. PROCEDURE: Eighteen patients with ESFT were treated with the same multiagent intensive preoperative protocol. 5/18 patients had bone Ewings sarcoma (EWS) and 13/18 had peripheral primitive neuroectodermal tumor (PNET). None had metastases at diagnosis. Chemotherapy consisted of 5 or 6 cycles with vincristine, cisplatin, cyclophosphamide, and Adriamycin, followed by 12 cycles of vincristine, cyclophosphamide, and actinomycin-D. Five patients with EWS underwent total resection after 5-6 cycles of preoperative chemotherapy and prosthetic replacement was performed in two of them. In 3/13 patients with PNET the tumor was resected at diagnosis and in 1/13 after 5 cycles of chemotherapy, while 9/13 patients received chemotherapy only and/or radiotherapy. RESULTS: In patients with EWS, the histologic specimens of the resected tumors showed that tissue necrosis was 100% in four patients and 95% in one patient. The good histologic response reflects the effectiveness of this regimen in all ESFT. No patient had topical recurrence or developed metastatic disease during follow-up period (2-13 years, mean time 7.4 years). All patients had the scheduled cycles without delays or dose reductions. There were no major side effects of chemotherapy. CONCLUSIONS: The intensive chemotherapy schedule, comprising of 5-6 cycles preoperatively, seems to maximize the percentage of tumor necrosis, thus improving outcome. Our study implies that this combined therapy may improve the prognosis of ESFT.     

Contrast sensitivity in amblyopia: the fellow eye of untreated and successfully treated amblyopes.

PURPOSE: We sought to investigate contrast sensitivity on the fellow eyes of amblyopic and successfully treated amblyopic subjects. METHODS: Contrast sensitivity was tested monocularly on both eyes of 48 amblyopic patients (mean age, 11.51 years) and of 22 successfully treated amblyopic subjects (visual acuity 20/20 in each eye; mean age, 11.22 years). Inclusion criteria were visual acuity in the amblyopic eye 20/40 or better (mild amblyopia) and 20/20 or better in the fellow eye, steady fixation, no signs of congenital, latent or manifest/latent nystagmus on clinical examination. Twenty normal subjects (20 eyes) were used as age-matched controls. RESULTS: Contrast sensitivity functions from the fellow eye of the 48 amblyopic patients, even those who had never been treated with occlusion therapy before, were significantly decreased (P < 0.001) compared with control subjects. Both the previously amblyopic and the fellow eye of the 22 "cured" amblyopic subjects demonstrated significantly lower values (P < 0.001) compared with control patients. CONCLUSIONS: We suggest that the nonamblyopic, "normal" eye of amblyopic patients behaves abnormally when evaluated for contrast sensitivity functions. Neither the previously amblyopic nor the fellow eyes of successfully treated subjects were comparable with controls. Occlusion therapy may not be implicated for depressed contrast sensitivity of the fellow eye in amblyopia. The assessment of contrast sensitivity can provide important information on the visual function and the influence of occlusion therapy in amblyopia.     

Breast cancer metastasis suppressor-1 promoter methylation in cell-free DNA provides prognostic information in non-small cell lung cancer

Background:

Breast-cancer metastasis suppressor 1 (BRMS1) gene encodes for a predominantly nuclear protein that differentially regulates the expression of multiple genes, leading to suppression of metastasis without blocking orthotropic tumour growth. The aim of the present study was to evaluate for the first time the prognostic significance of BRMS1 promoter methylation in cell-free DNA (cfDNA) circulating in plasma of non-small cell lung cancer (NSCLC) patients. Towards this goal, we examined the methylation status of BRMS1 promoter in NSCLC tissues, matched adjacent non-cancerous tissues and corresponding cfDNA as well as in an independent cohort of patients with advanced NSCLC and healthy individuals.

Methods:

Methylation of BRMS1 promoter was examined in 57 NSCLC tumours and adjacent non-cancerous tissues, in cfDNA isolated from 48 corresponding plasma samples, in cfDNA isolated from plasma of 74 patients with advanced NSCLC and 24 healthy individuals.

Results:

The BRMS1 promoter was highly methylated both in operable NSCLC primary tissues (59.6%) and in corresponding cfDNA (47.9%) but not in cfDNA from healthy individuals (0%), while it was also highly methylated in cfDNA from advanced NSCLC patients (63.5%). In operable NSCLC, Kaplan–Meier estimates were significantly different in favour of patients with non-methylated BRMS1 promoter in cfDNA, concerning both disease-free interval (DFI) (P=0.048) and overall survival (OS) (P=0.007). In advanced NSCLC, OS was significantly different in favour of patients with non-methylated BRMS1 promoter in their cfDNA (P=0.003). Multivariate analysis confirmed that BRMS1 promoter methylation has a statistical significant influence both on operable NSCLC patients'' DFI time and OS and on advanced NSCLC patients'' PFS and OS.

Conclusions:

Methylation of BRMS1 promoter in cfDNA isolated from plasma of NSCLC patients provides important prognostic information and merits to be further evaluated as a circulating tumour biomarker.     

Effects of mycophenolate mofetil vs cyclosporine administration on graft survival and function after islet allotransplantation in diabetic rats

AIM: To develop an experimental model of islet allotran-splantation in diabetic rats and to determine the positive or adverse effects of MMF as a single agent. METHODS: Thirty-six male Wistar rats and 18 male Lewis rats were used as recipients and donors respectively. Diabetes was induced by the use of streptozotocin (60 mg/kg) intraperitoneally. Unpurified islets were isolated using the collagenase digestion technique and transplanted into the splenic parenchyma. The recipients were randomly assigned to one of the following three groups: group A (control group) had no immunosuppression; group B received cyclosporine (CsA) (5 mg/kg); group C received mycophenolate mofetil (MMF) (20 mg/kg). The animals were killed on the 12~(th) d. Blood and grafted tissues were obtained for laboratory and histological assessment. RESULTS: Median allograft survival was significantly higher in the two therapy groups than that in the controls (10 and 12 d for CsA and MMF respectively vs 0 d for the control group, P＜0.01). No difference in allograft survival between the CsA and MMF groups was found. However, MMF had less renal and hepatic toxicity and allowed weight gain. CONCLUSION: Monotherapy with MMF for immunosuppression was safe in an experimental model of islet allotransplantation and was equally effective with cyclosporine, with less toxicity.     

Some clinical aspects concerning diplopia after retinal detachment surgery with cryopexy and episcleral silastic sponge (author's transl)]

The aetiology of diplopia following retinal detachment surgery after the Lincoff-Custodis method is examined. Of 140 patients operated, 16 (i.e. 11.4%) developed diplopia. The authors believe that this diplopia is due to a fixation of the eyeball at the point of the silastic sponge placement. As responsible factors, which depend on the manner of sponge fixation and the size of the sponge, they regard: Alteration of the bulb curvature, shortening of the Tenon's capsule placed over the sponge, and changes in the conditions of muscular action.