[Conjunctival melanoma at corneoscleral limbus on primary acquired melanosis. A case report]

[Nevi of conjunctiva as a risk factor of melanoma]

Conjunctival nevi are the most common tumors of this location. They are usually unilateral, although bilateral cases may also be met. As to clinical presentation, all nevi are divided into: stationary or progressive nevi, blue nevi, and primary acquired melanosis. Color changes are acceptable, if they occur during pregnancy or puberty. However, if postpubertal, such changes should be considered alarming, as to possible malignization. Histopathologically, nevi are composed of melanocyte clusters in the skin stroma next to the basal layer of the epidermis.

AIM

To analyze the significance of timely removal of conjunctival nevi for melanoma prevention.

MATERIAL AND METHODS

A total of 52 patients were examined during 2009-2013. Of them, 48 patients had nevi of the conjunctiva and/or lacrimal caruncle, 1 patient was diagnosed with caruncular melanoma and 3 other - with conjunctival melanoma.

RESULTS

Patients with stationary nevi are still being followed up. Of those who were surgically treated, none developed recurrence. Taking into account high metastatic activity of melanomas and that discovering metastases does not always happen together with diagnosing the primary lesion (often, years after treatment), the follow-up of melanoma patients must be lifelong.

CONCLUSION

Timely removal of progressive conjunctival nevi is able to prevent malignancy, of which the outcome may be very unfavorable.

[Patterns of ocular neurovascular reactions]

AIM

To examine factors and determinants of ocular neurovascular reactions (NVR).

MATERIAL AND METHODS

The study included 120 healthy participants of both sexes aged 20.9±0.6 years, who underwent a standard ophthalmic examination. Ocular microcirculation was recorded using laser Doppler flowmetry. Autonomic homeostasis and the intensity of slow-wave oscillations of hemodynamics were of interest. Autoregulation of cerebral blood flow was assessed by transcranial color-coded duplex scanning.

RESULTS

The dynamics of perfusion control mechanisms (myogenic and neurogenic) have been studied in the young healthy population of Krasnoyarsk. The role of the autonomic nervous system in initiating a particular type of ocular NVR has been identified. The authors have also determined the significance of the nitric oxide production intensity in different types of NVR.

CONCLUSION

The type of ocular NVR is determined by parameters of cerebral hemodynamics. Normotonic NVR is associated with effective autoregulation of cerebral blood flow, while hyper- and hypotonic types of reactions - with autoregulatory failure.