This review describes a scheme for diagnosis of glaucoma in population based prevalence surveys. Cases are diagnosed on the grounds of both structural and functional evidence of glaucomatous optic neuropathy. The scheme also makes provision for diagnosing glaucoma in eyes with severe visual loss where formal field testing is impractical, and for blind eyes in which the optic disc cannot be seen because of media opacities.

https://bjo.bmj.com/content/bjophthalmol/86/2/238.full.pdf

The definition and classification of glaucoma in prevalence surveys

Tissue sections from aggressive human intraocular (uveal) and metastatic cutaneous melanomas generally lack evidence of significant necrosis and contain patterned networks of interconnected loops of extracellular matrix. The matrix that forms these loops or networks may be solid or hollow. Red blood cells have been detected within the hollow channel components of this patterned matrix histologically, and these vascular channel networks have been detected in human tumors angiographically. Endothelial cells were not identified within these matrix-embedded channels by light microscopy, by transmission electron microscopy, or by using an immunohistochemical panel of endothelial cell markers (Factor VIII-related antigen, Ulex, CD31, CD34, and KDR[Flk-1]). Highly invasive primary and metastatic human melanoma cells formed patterned solid and hollow matrix channels (seen in tissue sections of aggressive primary and metastatic human melanomas) in three-dimensional cultures containing Matrigel or dilute Type I collagen, without endothelial cells or fibroblasts. These tumor cell-generated patterned channels conducted dye, highlighting looping patterns visualized angiographically in human tumors. Neither normal melanocytes nor poorly invasive melanoma cells generated these patterned channels in vitro under identical culture conditions, even after the addition of conditioned medium from metastatic pattern-forming melanoma cells, soluble growth factors, or regimes of hypoxia. Highly invasive and metastatic human melanoma cells, but not poorly invasive melanoma cells, contracted and remodeled floating hydrated gels, providing a biomechanical explanation for the generation of microvessels in vitro. cDNA microarray analysis of highly invasive versus poorly invasive melanoma tumor cells confirmed a genetic reversion to a pluripotent embryonic-like genotype in the highly aggressive melanoma cells. These observations strongly suggest that aggressive melanoma cells may generate vascular channels that facilitate tumor perfusion independent of tumor angiogenesis.

Vascular Channel Formation by Human Melanoma Cells in Vivo and in Vitro: Vasculogenic Mimicry

Background Ocular trauma or disease may lead to severe corneal opacification and, consequently, severe loss of vision as a result of complete loss of corneal epithelial stem cells. Transplantation of autologous corneal stem-cell sources is an alternative to allograft transplantation and does not require immunosuppression, but it is not possible in many cases in which bilateral disease produces total corneal stem-cell deficiency in both eyes. We studied the use of autologous oral mucosal epithelial cells as a source of cells for the reconstruction of the corneal surface. Methods We harvested 3-by-3-mm specimens of oral mucosal tissue from four patients with bilateral total corneal stem-cell deficiencies. Tissue-engineered epithelial-cell sheets were fabricated ex vivo by culturing harvested cells for two weeks on temperature-responsive cell-culture surfaces with 3T3 feeder cells that had been treated with mitomycin C. After conjunctival fibrovascular tissue had been surgically removed from the ocular surfa...

https://www.nejm.org/doi/pdf/10.1056/NEJMoa040455

Corneal reconstruction with tissue-engineered cell sheets composed of autologous oral mucosal epithelium.

An Integrated Hypothesis That Considers Drusen as Biomarkers of Immune-Mediated Processes at the RPE-Bruch's Membrane Interface in Aging and Age-Related Macular Degeneration

https://oftalmologiarafaelcaiado.files.wordpress.com/2012/04/anchor-study.pdf

Ranibizumab versus Verteporfin Photodynamic Therapy for Neovascular Age-Related Macular Degeneration: Two-Year Results of the ANCHOR Study

Objective To investigate the prevalence of "masked" pseudoexfoliation (PEX) syndrome in eyes with circular posterior synechiae receiving antiglaucomatous therapy with miotics. Design Cross-sectional prospective study. Methods Twenty-eight eyes of 27 consecutive patients with circular posterior synechiae and a history of miotic drug use without previous intraocular surgery, inflammation, or trauma, and without conventional signs of PEX material in the anterior chamber were included in the study. All eyes were investigated by slitlamp biomicroscopy and gonioscopy of the anterior chamber before extracapsular cataract surgery for the presence of typical PEX-associated iris pigment epithelial changes, such as peripupillary atrophy and trabecular meshwork melanin granule deposition. The anterior chamber depth, lens thickness, and axial lengths of the eyes were measured by A-scan immersion sonography. The excised anterior lens capsules obtained during extracapsular cataract surgery were investigated for the presence of precapsular fibrillar PEX deposits by electron microscopy. Main Outcome Measure The prevalence of masked PEX syndrome in eyes with circular posterior synechiae receiving antiglaucomatous therapy with miotics. Results Transmission electron microscopy of unselected nonserial sections revealed a precapsular layer consisting of typical PEX fibers or microfibrils, which indicated early stages of PEX syndrome in 18 (64%) of 28 eyes with circular posterior synechiae. Melanin granules were frequently found adhering to the fibrillar layer. Eyes with precapsular fibrillar deposits showed significantly greater trabecular meshwork pigmentation than eyes without such deposits. Differences in age, lens thickness, axial length of the eye, anterior chamber depth, and degree of peripupillary atrophy were, however, not statistically significant between the groups with and without electron microscopic evidence of PEX deposits. Conclusions Circular posterior synechiae were more frequently associated with manifest or early stages of PEX syndrome. However, the formation of broad posterior synechiae in miosis prevented a definite clinical diagnosis based on the classic changes of the anterior lens capsule. In eyes with spontaneous or miotic-induced circular posterior synechiae without other obvious cause, the masked variant of PEX syndrome should always be considered.

"Masked" Pseudoexfoliation Syndrome in Unoperated Eyes With Circular Posterior Synechiae Clinical-Electron Microscopic Correlation

Wir berichten uber Erfahrungen bei der Therapie des malignen Melanoms der Konjunktiva bei primar erworbener Melanose mit Hilfe einer adjuvanten lokalen Mitomycin-C-Behandlung Zwischen 1998 und 2001 wurden13 Patienten mit lokaler Chemotherapie bei malignem Melanom (MM) der Konjunktiva behandelt Bei allen war das MM aus einer primar erworbenen Melanose (PEM) hervorgegangen Bei 7 Patienten lag ein Tumorstadium pT2 vor, bei 3 Stadium pT3 Bei 3 Patienten war das Lid in den malignen Prozess einbezogen (Stadium pT4) Die lokale Chemotherapie wurde nach inzisionaler Biopsie in 2 Zyklen zu je 14 Tagen mit 14-tagiger Pause durchgefuhrt Bei 4 Patienten wurde ein 3 Zyklus angeschlossen Eine Regression des Tumors wurde bei allen Patienten beobachtet Schwere okulare oder systemische Nebenwirkungen wurden nicht bemerkt Im Beobachtungszeitraum blieben 9 Patienten rezidivfrei, bei 3 kam es zu einem Rezidiv Bei diesen 3 Patienten war das Lid primar in den Tumorprozess eingeschlossen Die lokale Chemotherapie mit Mitomycin C stellt eine Bereicherung des therapeutischen Spektrums dar Wir halten die Kombination aus inzisionaler Biopsie mit chirurgischer Tumorvolumenreduktion und lokaler Mitomycin-C-Therapie fur eine gute Option, wenn das Tumorstadium pT3 nicht uberschritten wird

Therapie maligner Melanome der Konjunktiva bei primär erworbener Melanose (PEM) mit Mitomycin-C-0,02%-Augentropfen

Retinal vasculitis with proliferative retinopathy in a patient with evidence of Borrelia burgdorferi infection.

The size of the optic nerve head influences the prevalence of optic disk anomalies and diseases. The authors investigated whether this also holds true for retinal vessel occlusions. The optic disks of 140 patients with central or branch occlusions of the retinal veins and arteries were measured, using photographs of the optic disk and correcting the photographic enlargement by Littmann's method. There were no significant differences in size and shape (Mann-Whitney Test) between the disks thus studied and 457 nonselected optic nerve heads. The incidence of retinal vessel occlusions appears to be unrelated to the shape and size of the optic disk.

Retinale Gefäßverschlüsse sind unabhängig von der Papillengröße - Eine morphometrische Untersuchung von 140 Patienten

In two patients suffering from congenital oculodermal melanocytosis (nevus of Ota) orbital, osseous, meningeal, and cerebral manifestations are documented In a 38-year-old European with a nevus of Ota on the right side an ipsilateral orbital tumor was diagnosed and surgically removed The histological examination revealed a primary spindle shaped malignant melanoma of the orbit In addition, many benign melanocytes were found in the optic nerve, in the extraocular muscles, in the orbital fat tissue, and in the dura of the sphenoid In a 17-year-old Ethiopian with a nevus of Ota of the right side an increase in size of the pigmented process was observed during puberty in the orbital fat tissue, in the extraocular muscles, in the optic nerve, in the periorbital bones, in the temporal muscle, and in the cortex of the frontal brain lobe A deep excision from the lower eye lid revealed a histologically benign oculo-orbito-dermal melanocytosis An irradiation was performed because of growth again after segmental excision, however without success In the ipsilateral eye a secondary open-angle glaucoma was diagnosed In the nevus of Ota an involvement of the orbit and of the meningo-cerebral tissue must be considered

Gottfried O. H. Naumann

Papers

"Masked" Pseudoexfoliation Syndrome in Unoperated Eyes With Circular Posterior Synechiae Clinical-Electron Microscopic Correlation

Therapie maligner Melanome der Konjunktiva bei primär erworbener Melanose (PEM) mit Mitomycin-C-0,02%-Augentropfen

Retinal vasculitis with proliferative retinopathy in a patient with evidence of Borrelia burgdorferi infection.

Retinale Gefäßverschlüsse sind unabhängig von der Papillengröße - Eine morphometrische Untersuchung von 140 Patienten

[Orbital, osseous, meningeal and cerebral findings in oculodermal melanocytosis (nevus of Ota). Clinico-histopathologic correlation in 2 patients].