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Hötte GJ, Kolijn PM, de Bie M, de Keizer ROB, Medici M, van der Weerd K, van Hagen PM, Paridaens D, Dik WA. Thyroid stimulating immunoglobulin concentration is associated with disease activity and predicts response to treatment with intravenous methylprednisolone in patients with Graves' orbitopathy. Front Endocrinol (Lausanne) 2024; 15:1340415. [PMID: 38577576 PMCID: PMC10993908 DOI: 10.3389/fendo.2024.1340415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 03/06/2024] [Indexed: 04/06/2024] Open
Abstract
Background Thyroid stimulating immunoglobulins (TSI) play a central role in the pathogenesis of Graves' orbitopathy (GO), while soluble interleukin-2 receptor (sIL-2R) is a marker for T-cell activity. We investigated TSI and sIL-2R levels in relation to thyroid function, disease activity and severity and response to treatment with intravenous methylprednisolone (IVMP) in patients with GO. Methods TSI (bridge-based TSI binding assay), sIL-2R, TSH and fT4 levels were measured in biobank serum samples from 111 GO patients (37 male, 74 female; mean age 49.2 years old) and 25 healthy controls (5 male, 20 female; mean age 39.8 years old). Clinical characteristics and response to treatment were retrospectively retrieved from patient files. Results Higher sIL-2R levels were observed in GO patients compared to controls (p < 0.001). sIL-2R correlated with fT4 (r = 0.26), TSH (r = -0.40) and TSI (r = 0.21). TSI and sIL-2R concentrations were higher in patients with active compared to inactive GO (p < 0.001 and p < 0.05, respectively). Both TSI and sIL-2R correlated with total clinical activity score (CAS; r = 0.33 and r = 0.28, respectively) and with several individual CAS items. Cut-off levels for predicting active GO were 2.62 IU/L for TSI (AUC = 0.71, sensitivity 69%, specificity 69%) and 428 IU/mL for sIL-2R (AUC = 0.64, sensitivity 62%, specificity 62%). In multivariate testing higher TSI (p < 0.01), higher age (p < 0.001) and longer disease duration (p < 0.01) were associated with disease activity. TSI levels were higher in patients with a poor IVMP response (p = 0.048), while sIL-2R levels did not differ between responders and non-responders. TSI cut-off for predicting IVMP response was 19.4 IU/L (AUC = 0.69, sensitivity 50%, specificity 91%). In multivariate analysis TSI was the only independent predictor of response to IVMP (p < 0.05). Conclusions High TSI levels are associated with active disease (cut-off 2.62 IU/L) and predict poor response to IVMP treatment (cut-off 19.4 IU/L) in GO. While sIL-2R correlates with disease activity, it is also related to thyroid function, making it less useful as an additional biomarker in GO.
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Affiliation(s)
- Gijsbert J. Hötte
- Department of Oculoplastic, Lacrimal & Orbital Surgery, Rotterdam Eye Hospital, Rotterdam, Netherlands
| | - P. Martijn Kolijn
- Laboratory Medical Immunology, Department of Immunology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Maaike de Bie
- Department of Oculoplastic, Lacrimal & Orbital Surgery, Rotterdam Eye Hospital, Rotterdam, Netherlands
- Laboratory Medical Immunology, Department of Immunology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Ronald O. B. de Keizer
- Department of Oculoplastic, Lacrimal & Orbital Surgery, Rotterdam Eye Hospital, Rotterdam, Netherlands
| | - Marco Medici
- Academic Center for Thyroid Diseases, Department of Internal Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Kim van der Weerd
- Department of Internal Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, Netherlands
| | - P. Martin van Hagen
- Laboratory Medical Immunology, Department of Immunology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Internal Medicine, Section Clinical Immunology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Dion Paridaens
- Department of Oculoplastic, Lacrimal & Orbital Surgery, Rotterdam Eye Hospital, Rotterdam, Netherlands
- Department of Ophthalmology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Willem A. Dik
- Laboratory Medical Immunology, Department of Immunology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
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Nguyen JQ, Drabarek W, Vaarwater J, Yavuzyigitoglu S, Verdijk RM, Paridaens D, Naus NC, de Klein A, Brosens E, Kiliç E. 8q Gain Has No Additional Predictive Value in SF3B1MUT Uveal Melanoma but Is Predictive for a Worse Prognosis in Patients with BAP1MUT Uveal Melanoma. Ophthalmol Sci 2024; 4:100413. [PMID: 38187129 PMCID: PMC10767501 DOI: 10.1016/j.xops.2023.100413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/03/2023] [Accepted: 10/11/2023] [Indexed: 01/09/2024]
Abstract
Purpose Gain of chromosome 8q has been associated with poor prognosis in uveal melanoma (UM), and an increase in the absolute number of 8q-copies correlated with an even shorter survival. Splicing factor 3b subunit 1 (SF3B1)-mutated (SF3B1MUT) tumors display structural chromosomal anomalies and frequently show a partial gain of chromosome 8qter. A recent subset of SF3B1MUT UM with early-onset metastases has been identified, prompting the investigation of the relationship between survival, 8q gain, and SF3B1MUT UM. Design Retrospective cohort study. Subjects Patients diagnosed with UM who underwent enucleation or received a biopsy at the Erasmus MC Cancer Institute or the Rotterdam Eye Hospital, The Netherlands were included. Methods Fifty-nine patients with SF3B1MUT tumors and 211 patients with BRCA1 associated protein 1 (BAP1)-mutated (BAP1MUT) tumors were included in this study. Copy number status and gene expression were assessed using either a single nucleotide polymorphism array, fluorescence in situ hybridization, and karyotyping, or a combination of these techniques. Disease-free survival was determined and a cut-off of 60 months was used to define early-onset metastatic disease. Main Outcome Measures Disease-free survival. Results Forty-eight patients with SF3B1MUT UM (81%) had chromosome 8q gain (3 copies, 78%; 4 copies, 22%). Kaplan-Meier analysis of SF3B1MUT UM did not indicate a difference in survival in patients with or without gain of 8q (P = 0.99). Furthermore, the number of 8q copies was not associated with survival when comparing early (P = 0.97) versus late (P = 0.23) metastases group. In contrast, the presence of 8q gain (86%) was correlated with a decreased survival in BAP1MUT UM (P = 0.013). Conclusions We did not find a correlation between 8q gain and early-onset metastasis in SF3B1MUT tumors. Gain of 8q has no additional predictive value in SF3B1MUT tumors. In contrast, 8q gain is predictive of a worse prognosis in patients with BAP1MUT tumors. Thus, gain of chromosome 8q has additional predictive value for BAP1MUT tumors, but not for SF3B1MUT tumors. Financial Disclosures The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Josephine Q.N. Nguyen
- Department of Ophthalmology, Erasmus MC Cancer Institute, Erasmus MC Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
- Department of Clinical Genetics, Erasmus MC Cancer Institute, Erasmus MC Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
| | - Wojtek Drabarek
- Department of Ophthalmology, Erasmus MC Cancer Institute, Erasmus MC Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
- Department of Clinical Genetics, Erasmus MC Cancer Institute, Erasmus MC Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
- Department of Ophthalmic Oncology, The Rotterdam Eye Hospital, 3011 BH, Rotterdam, The Netherlands
| | - Jolanda Vaarwater
- Department of Ophthalmology, Erasmus MC Cancer Institute, Erasmus MC Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
- Department of Clinical Genetics, Erasmus MC Cancer Institute, Erasmus MC Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
| | - Serdar Yavuzyigitoglu
- Department of Ophthalmology, Erasmus MC Cancer Institute, Erasmus MC Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
| | - Robert M. Verdijk
- Department of Pathology, Section Ophthalmic Pathology, Erasmus MC Cancer Institute, Erasmus MC Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
- Department of Pathology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Dion Paridaens
- Department of Ophthalmology, Erasmus MC Cancer Institute, Erasmus MC Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
- Department of Ophthalmic Oncology, The Rotterdam Eye Hospital, 3011 BH, Rotterdam, The Netherlands
| | - Nicole C. Naus
- Department of Ophthalmology, Erasmus MC Cancer Institute, Erasmus MC Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
| | - Annelies de Klein
- Department of Clinical Genetics, Erasmus MC Cancer Institute, Erasmus MC Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
| | - Erwin Brosens
- Department of Clinical Genetics, Erasmus MC Cancer Institute, Erasmus MC Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
| | - Emine Kiliç
- Department of Ophthalmology, Erasmus MC Cancer Institute, Erasmus MC Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
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Nivean PD, Madhivanan N, Kumaramanikavel G, Berendschot TTJM, Webers CAB, Paridaens D. Understanding the clinical and molecular basis of thyroid orbitopathy: a review of recent evidence. Hormones (Athens) 2024; 23:25-34. [PMID: 37910311 PMCID: PMC10847210 DOI: 10.1007/s42000-023-00498-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/10/2023] [Indexed: 11/03/2023]
Abstract
Thyroid eye disease (TED) is an autoimmune orbital inflammatory disease which ranges from mild to severe. Tissue remodeling, fibrosis and fat proliferation cause changes in the orbital tissues which can affect esthetics and visual function. In its severe form, it is sight threatening, debilitating, and disfiguring and may lead to social stigma, the embarrassment about which has an impact on the quality of life of those affected and the family members. The pathogenesis of TED, which is influenced by genetic, immunological, and environmental factors, is complex and not fully elucidated. However, it remains unknown what factors determine the severity of the disease. Recent research has revealed a number of diagnostic and prognostic biomarkers of this disease. In this overview of TED, we focus on new insights and perspectives regarding biological agents that may provide a basis for new treatment modalities.
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Affiliation(s)
- Pratheeba Devi Nivean
- M.N Eye Hospital, Chennai, India.
- Maastricht University, Maastricht, The Netherlands.
| | | | | | | | | | - Dion Paridaens
- Department of Ophthalmology, Erasmus Medical Centre, Rotterdam, The Netherlands
- Orbital Service, Rotterdam Eye Hospital, Rotterdam, The Netherlands
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Roohé SL, Helsen S, Paridaens D. Medial lacrimal sac excision versus conventional H-shaped lacrimal sac opening in external dacryocystorhinostomy: a comparative cohort study. Orbit 2024; 43:1-7. [PMID: 36700372 DOI: 10.1080/01676830.2023.2168017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/03/2023] [Indexed: 01/27/2023]
Abstract
PURPOSE The external dacryocystorhinostomy (Ex-DCR) is a reliable but surgically challenging procedure to overcome a nasolacrimal duct obstruction (NLDO). The aim of this study is to describe the outcomes of a modified technique of lacrimal sac opening and to compare it with the conventional Ex-DCR. METHODS This comparative cohort study included adult patients undergoing Ex-DCR for primary acquired NLDO by or under supervision of one surgeon. Group 1 (conventional Ex-DCR including H-shaped incision, anastomosis of the anterior mucosal flap to nasal mucosal flap and resection of the posterior sac flap) was compared with Group 2 (modified Ex-DCR including excision of the medial lacrimal sac and anastomosis of remaining anterior sac flap to nasal mucosal flap). Outcome measures included the success rate (defined as complete symptom relief or patent irrigation after three months), reoperation rate, redo-free survival within five years, and occurrence of postoperative bleeding and postoperative infection. RESULTS 138 patients were included. The success rates were 94.7% (54/57 cases) for Group 1 and 96.3% (78/81) for Group 2 (p-value = 0.658). The redo-rate was 5.3% (3/75) in Group 1 and 2.5% (2/81) in Group 2 (p = 0.331). Two-year redo-free survival probability estimates were 89.8% for Group 1 and 96.3% for Group 2, respectively. No complications occurred in Group 2, whereas in Group 1, one patient (1.8%) suffered from postoperative bleeding and one (1.8%) from postoperative infection. CONCLUSIONS This study showed that our modified Ex-DCR technique is equally efficacious compared with the conventional Ex-DCR technique in adult patients with NLDO.
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Affiliation(s)
- S L Roohé
- Department of Oculoplastic & Orbital Surgery, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - S Helsen
- Department of Oculoplastic & Orbital Surgery, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
- Department of Oculoplastic and Lacrimal Surgery, Oogkliniek Monica Hospital Deurne, Antwerp, Belgium
| | - D Paridaens
- Department of Oculoplastic & Orbital Surgery, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
- Department of Ophthalmology, Orbital Center, Erasmus University Medical Center, Rotterdam, The Netherlands
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5
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Bergmann MJ, de Keizer ROB, Paridaens D. Globe-sparing surgical treatment for periocular malignancies with anterior orbital invasion: a consecutive case series. Orbit 2023; 42:536-544. [PMID: 36617852 DOI: 10.1080/01676830.2022.2141803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 10/25/2022] [Indexed: 01/10/2023]
Abstract
PURPOSE Orbital exenteration of periocular tumors complicated by orbital invasion is a heavy burden for patients and leads to disfiguring cosmesis and loss of vision. Here, we report our experience with globe-sparing surgery in a series of patients with periocular malignancies other than basal cell carcinoma (BCC), all exhibiting anterior orbital invasion. METHODS In this consecutive case series, we examined medical records of all patients between 2000 and 2018 with periocular malignancies (other than BCC) invading the anterior orbit (without extraocular muscle or scleral invasion) treated by one orbital surgeon (DP). The main outcome measures included local recurrence, regional and distant metastasis, survival, and visual acuity. RESULTS Nine patients were identified. Of the non-BCC cancers invading the orbit, squamous cell carcinoma (SCC) (44.4%) was the most prevalent type in our series. Excision included the removal of visibly distinguishable tumor and a free clinical margin of up to 5 mm with histological confirmation of radicality of the invasive tumor component. Reconstruction was achieved by a variety of oculoplastic reconstructive procedures. At a mean follow-up of 70 months (range 11-177 months), 8 out of 9 patients were still alive. Recurrence occurred in two patients with conjunctival melanoma (CM), and they were again treated with wide excision. Postoperative visual acuity remained stable or improved. CONCLUSION This retrospective case series demonstrates that globe-sparing excisional surgery can be considered in selected cases of periocular malignancies other than BCC with anterior orbital invasion, thus avoiding cosmetic disfigurement and loss of vision due to orbital exenteration.
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Affiliation(s)
- Michael Jan Bergmann
- Department of Orbital Oculoplastic and Lacrimal Surgery, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Ronald Olaf Björn de Keizer
- Department of Orbital Oculoplastic and Lacrimal Surgery, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Dion Paridaens
- Department of Orbital Oculoplastic and Lacrimal Surgery, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
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van Ipenburg JA, van den Bosch QCC, Paridaens D, Dubbink HJ, Kiliç E, Naus N, Verdijk RM. ATRX Loss in the Development and Prognosis of Conjunctival Melanoma. Int J Mol Sci 2023; 24:12988. [PMID: 37629169 PMCID: PMC10454703 DOI: 10.3390/ijms241612988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/08/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023] Open
Abstract
Metastatic disease is linked to TERT promoter mutations in conjunctival melanomas (CM). Both TERT promoter and ATRX mutations are associated with faulty telomere maintenance. This study aimed to determine the prognostic value of ATRX loss in conjunctival melanocytic lesions. Eighty-six conjunctival melanocytic lesions from the Rotterdam Ocular Melanoma Study group were collected. ATRX status and TERT promoter status were determined using immunohistochemical staining and molecular diagnostics, respectively. None of the nevi (n = 16) and primary acquired melanosis (PAM) without atypia (n = 6) showed ATRX loss. ATRX loss was found in 2/5 PAM with atypia without CM and in 8/59 CM. No cases with a TERT promoter mutation (n = 26) showed ATRX loss. Eight/eleven metastatic CM harbored a TERT promoter mutation, two other metastatic CM showed ATRX loss and one metastatic case showed no TERT promoter/ATRX alterations. In conclusion ATRX loss and TERT promoter mutations are only found in (pre)malignant conjunctival melanocytic lesions, with most metastatic cases harboring one of these alterations, suggesting that both alterations are associated with adverse behavior. Similar to TERT promoter mutations, ATRX loss may be used as a diagnostic tool in determining whether a conjunctival melanocytic lesion is prone to having an adverse course.
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Affiliation(s)
- Jolique A. van Ipenburg
- Department of Pathology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
| | - Quincy C. C. van den Bosch
- Department of Ophthalmology, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Dion Paridaens
- Department of Ophthalmology, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
- Department of Ocular Oncology, The Rotterdam Eye Hospital, Schiedamse Vest 180, 3011 BH Rotterdam, The Netherlands
| | - Hendrikus J. Dubbink
- Department of Pathology, Section Ophthalmic Pathology, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Emine Kiliç
- Department of Ophthalmology, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Nicole Naus
- Department of Ophthalmology, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Robert M. Verdijk
- Department of Ocular Oncology, The Rotterdam Eye Hospital, Schiedamse Vest 180, 3011 BH Rotterdam, The Netherlands
- Department of Pathology, Section Ophthalmic Pathology, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
- Department of Pathology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
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Detiger SE, Hötte GJ, Verdijk RM, de Keizer ROB, van Hagen PM, van Laar JAM, Paridaens D. Adult orbital xanthogranuloma: long-term follow-up of treated cases. Eye (Lond) 2023; 37:2475-2481. [PMID: 36526862 PMCID: PMC10397269 DOI: 10.1038/s41433-022-02357-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 11/04/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Adult orbital xanthogranulomatous disease (AOXGD) is a group of rare disorders. Four subtypes are identified: adult-onset xanthogranuloma (AOX), adult-onset asthma and periocular xanthogranuloma (AAPOX), necrobiotic xanthogranuloma (NBX), and Erdheim-Chester disease (ECD). Therapy options vary and little is known about the long-term effect of the treatment. In this study, we will describe the clinical behaviour, effect of treatment, and long-term outcome in a consecutive series of patients with AOXGD. METHODS This is a descriptive, retrospective study with a long follow-up term of 21 patients with histologically proven AOXGD, treated between 1989 and 2021 in the Rotterdam Eye Hospital and Erasmus MC University Medical Center. RESULTS Twenty-one patients with histologically proven AOXGD were included. The follow-up ranged from 2-260 months (median of 67 months). Six of the nine patients with AOX were treated with surgery alone, with recurrence in two. Three received systemic therapy, with recurrence in one. All four patients with AAPOX received systemic treatment, the disease recurred in two. Two patients with NBX were treated with surgery alone, with recurrence in one. Four required additional therapy with recurrence in two. Both patients with ECD required systemic therapy. CONCLUSIONS Recognition of AOXGD is important, in particular, because of the potential severe systemic locations in the different subtypes. Surgical excision might be a sufficient therapy for patients with AOX. Patients with AAPOX, NBX, and ECD warrant systemic therapy. Currently, there is no conclusive evidence for a superior treatment strategy, but further studies are necessary to investigate treatment options.
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Affiliation(s)
- S E Detiger
- The Rotterdam Eye Hospital, Rotterdam, The Netherlands.
| | - G J Hötte
- The Rotterdam Eye Hospital, Department of Oculoplastic, Orbital and Lacrimal Surgery, Rotterdam, The Netherlands
| | - R M Verdijk
- The Rotterdam Eye Hospital, Rotterdam, The Netherlands
- Department of Pathology, Section of Ophthalmic Pathology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - R O B de Keizer
- The Rotterdam Eye Hospital, Department of Oculoplastic, Orbital and Lacrimal Surgery, Rotterdam, The Netherlands
- Department of Ophthalmology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - P M van Hagen
- Departments of Internal Medicine and Immunology, section Clinical Immunology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - J A M van Laar
- Departments of Internal Medicine and Immunology, section Clinical Immunology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - D Paridaens
- The Rotterdam Eye Hospital, Department of Oculoplastic, Orbital and Lacrimal Surgery, Rotterdam, The Netherlands
- Department of Ophthalmology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
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Gishti O, de Keizer ROB, Detiger SE, van Rij C, Slagter C, Paridaens D. Radiation optic neuropathy and retinopathy in patients with presumed benign intraorbital tumours treated with fractionated stereotactic radiotherapy. Eye (Lond) 2023; 37:2470-2474. [PMID: 36513859 PMCID: PMC10397216 DOI: 10.1038/s41433-022-02356-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 11/19/2022] [Accepted: 12/02/2022] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To assess the long-term effects of fractionated stereotactic radiotherapy (fSRT) for the treatment of (presumed) benign intraorbital tumours on visual acuity, visual fields, globe and eyelid position, and complications including radiation retinopathy and deviations of retinal nerve fibre layer (RNFL) on OCT. METHODS Multi-centre retrospective follow-up study of a consecutive series of 25 patients treated in the Rotterdam Orbital Center (collaboration between Erasmus Medical Center and Rotterdam Eye Hospital) between 2002 and 2018. Data on the dose of fSRT, visual acuity, Humphrey field analyser (HFA) perimetry, globe and eyelid position were obtained from the medical records. RESULTS In this retrospective consecutive series of 25 patients with a median follow-up of 104 months (range 48-215 months), 80.0% of the patients had presumed optic nerve sheath meningioma and 20.0 % presumed cavernous haemangioma with signs suggestive of recent growth. In most patients, a better visual acuity and RNFL thickness were observed after stereotactic radiotherapy. Improvement of the visual field defects was observed after treatment, with a mean deviation of -14.98 dB (12.9 SD) before treatment versus -4.56 dB (10.8 SD) after treatment, respectively. Significant, but small changes in exophthalmometry values were observed with a mean of 14.92 mm (7.9 SD) versus 13.79 mm (7.3 SD) after treatment, respectively. Only 3 patients (15.0%) developed radiation retinopathy after stereotactic radiotherapy. All patients with radiation retinopathy had presumed optic nerve sheath meningioma. CONCLUSIONS Based on our results, fSRT is an effective treatment modality for this subset of orbital tumours with few complications and good long-term visual and cosmetic outcomes. FSRT is non-invasive and safer than surgery for lesions in the posterior orbit or around the optic nerve.
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Affiliation(s)
- O Gishti
- Rotterdam Eye Hospital, Rotterdam, The Netherlands.
- Department of Ophthalmology, Anna Hospital, Geldrop, The Netherlands.
| | | | - S E Detiger
- Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - C van Rij
- Department of Radiation Oncology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - C Slagter
- Department of Radiation Oncology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - D Paridaens
- Rotterdam Eye Hospital, Rotterdam, The Netherlands
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
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9
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de Bruyn DP, Bongaerts M, Bonte R, Vaarwater J, Meester-Smoor MA, Verdijk RM, Paridaens D, Naus NC, de Klein A, Ruijter GJG, Kiliç E, Brosens E. Uveal Melanoma Patients Have a Distinct Metabolic Phenotype in Peripheral Blood. Int J Mol Sci 2023; 24:ijms24065077. [PMID: 36982149 PMCID: PMC10049075 DOI: 10.3390/ijms24065077] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/01/2023] [Accepted: 03/04/2023] [Indexed: 03/09/2023] Open
Abstract
Uveal melanomas (UM) are detected earlier. Consequently, tumors are smaller, allowing for novel eye-preserving treatments. This reduces tumor tissue available for genomic profiling. Additionally, these small tumors can be hard to differentiate from nevi, creating the need for minimally invasive detection and prognostication. Metabolites show promise as minimally invasive detection by resembling the biological phenotype. In this pilot study, we determined metabolite patterns in the peripheral blood of UM patients (n = 113) and controls (n = 46) using untargeted metabolomics. Using a random forest classifier (RFC) and leave-one-out cross-validation, we confirmed discriminatory metabolite patterns in UM patients compared to controls with an area under the curve of the receiver operating characteristic of 0.99 in both positive and negative ion modes. The RFC and leave-one-out cross-validation did not reveal discriminatory metabolite patterns in high-risk versus low-risk of metastasizing in UM patients. Ten-time repeated analyses of the RFC and LOOCV using 50% randomly distributed samples showed similar results for UM patients versus controls and prognostic groups. Pathway analysis using annotated metabolites indicated dysregulation of several processes associated with malignancies. Consequently, minimally invasive metabolomics could potentially allow for screening as it distinguishes metabolite patterns that are putatively associated with oncogenic processes in the peripheral blood plasma of UM patients from controls at the time of diagnosis.
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Affiliation(s)
- Daniël P. de Bruyn
- Department of Ophthalmology, Erasmus MC, 3000 CA Rotterdam, The Netherlands
- Department of Clinical Genetics, Erasmus MC, 3000 CA Rotterdam, The Netherlands
- Erasmus MC Cancer Institute, Erasmus MC, 3000 CA Rotterdam, The Netherlands
| | - Michiel Bongaerts
- Department of Clinical Genetics, Erasmus MC, 3000 CA Rotterdam, The Netherlands
| | - Ramon Bonte
- Department of Clinical Genetics, Erasmus MC, 3000 CA Rotterdam, The Netherlands
| | - Jolanda Vaarwater
- Department of Ophthalmology, Erasmus MC, 3000 CA Rotterdam, The Netherlands
| | | | - Robert M. Verdijk
- The Rotterdam Eye Hospital, 3011 BH Rotterdam, The Netherlands
- Department of Pathology, Section Ophthalmic Pathology, Erasmus MC, 3000 CA Rotterdam, The Netherlands
- Department of Pathology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Dion Paridaens
- Department of Ophthalmology, Erasmus MC, 3000 CA Rotterdam, The Netherlands
- The Rotterdam Eye Hospital, 3011 BH Rotterdam, The Netherlands
| | - Nicole C. Naus
- Department of Ophthalmology, Erasmus MC, 3000 CA Rotterdam, The Netherlands
- Erasmus MC Cancer Institute, Erasmus MC, 3000 CA Rotterdam, The Netherlands
| | - Annelies de Klein
- Department of Clinical Genetics, Erasmus MC, 3000 CA Rotterdam, The Netherlands
- Erasmus MC Cancer Institute, Erasmus MC, 3000 CA Rotterdam, The Netherlands
| | | | - Emine Kiliç
- Department of Ophthalmology, Erasmus MC, 3000 CA Rotterdam, The Netherlands
- Erasmus MC Cancer Institute, Erasmus MC, 3000 CA Rotterdam, The Netherlands
| | - Erwin Brosens
- Department of Clinical Genetics, Erasmus MC, 3000 CA Rotterdam, The Netherlands
- Erasmus MC Cancer Institute, Erasmus MC, 3000 CA Rotterdam, The Netherlands
- Correspondence:
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10
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Detiger SE, Paridaens D, van Hagen M, Karim F, van Laar JAM, Verdijk RM. Tissue IgG2/IgG4 Ratio as an Additional Tool to Distinguish IgG4-Related Disease From Other Fibroinflammatory Disorders. Appl Immunohistochem Mol Morphol 2022; 30:517-525. [PMID: 35652730 DOI: 10.1097/pai.0000000000001040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 05/07/2022] [Indexed: 11/25/2022]
Abstract
Interpretation of biopsies taken on suspicion of immunoglobulin (Ig)G4-related disease (IgG4-RD) may be hampered by uninterpretable immunohistochemical stains for IgG because of strong background signals. This study aims to determine the significance of tissue IgG2 positive plasma cell counts in IgG4-RD in comparison with non-IgG4-related inflammatory disorders. Descriptive, retrospective case-control study of 16 patients with IgG4-related orbital disease (IgG4-ROD) and 24 with extraorbital IgG4-RD. Histopathology and serology of this group was compared with 16 patients with orbital non-IgG4-related disorders and 22 patients with extraorbital non-IgG4-related disorders. The mean tissue IgG2/IgG4 ratio was 0.16 in IgG4-ROD and 0.27 in extraorbital IgG4-RD and far below 1 in 98% of patients. This was significantly lower compared with the non-IgG4-related disorders that showed a mean tissue IgG2/IgG4 ratio of 1.98 in the orbital and 2.20 in the extraorbital group (range: 0.20 to 10, P <0.05). In 74% of tissue samples an IgG2/IgG4 ratio >1 was seen. The tissue IgG2/IgG ratio was significantly lower in IgG4-RD compared with non-IgG4-related inflammatory disorders. Serum IgG2 concentration was not abnormal in patients with IgG4-RD. A significantly lower tissue IgG2/IgG4 and IgG2/IgG ratio was observed in IgG4-RD, compared with non-IgG4-related inflammatory disorders. Additional immunohistochemical staining for IgG2 positive plasma cells can be helpful in the diagnosis of IgG4-RD. Especially in cases with uninterpretable IgG staining, a well-recognized problem that may give rise to a failed interpretation of the biopsy.
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Affiliation(s)
| | - Dion Paridaens
- Department of Oculoplastic, Orbital and Lacrimal Surgery, The Rotterdam Eye Hospital, Rotterdam
- Department of Ophthalmology
| | - Martin van Hagen
- Departments of Internal Medicine and Immunology, Section Clinical Immunology
| | - Faiz Karim
- Department of Internal Medicine, Groene Hart Hospital, Gouda, The Netherlands
| | - Jan A M van Laar
- Departments of Internal Medicine and Immunology, Section Clinical Immunology
| | - Robert M Verdijk
- Rotterdam Eye Hospital
- Department of Pathology, Section Ophthalmic Pathology, Erasmus MC University Medical Center Rotterdam, Rotterdam
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11
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van den Bosch QCC, Nguyen JQN, Brands T, van den Bosch TPP, Verdijk RM, Paridaens D, Naus NC, de Klein A, Kiliç E, Brosens E. FOXD1 Is a Transcription Factor Important for Uveal Melanocyte Development and Associated with High-Risk Uveal Melanoma. Cancers (Basel) 2022; 14:cancers14153668. [PMID: 35954332 PMCID: PMC9367502 DOI: 10.3390/cancers14153668] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/12/2022] [Accepted: 07/22/2022] [Indexed: 11/27/2022] Open
Abstract
Simple Summary Despite successful treatment of primary uveal melanoma (UM), metastases still occur in approximately 50% of the patients. Unfortunately, little is known about the mechanism behind metastasized UM. By reanalyzing publicly available single-cell RNA sequencing data of embryonic zebrafish larvae and validating the results with UM data, we have identified five transcription regulators of interest: ELL2, KDM5B, REXO4, RBFOX2 and FOXD1. The most significant finding is FOXD1, which is nearly exclusively expressed in high-risk UM and is associated with poor survival. FOXD1 is a novel gene which could be involved in the metastatic capability of UM. Elucidating its function and role in metastatic UM could help to understand and develop treatment for UM. Abstract Uveal melanoma (UM) is a deadly ocular malignancy, originating from uveal melanocytes. Although much is known regarding prognostication in UM, the exact mechanism of metastasis is mostly unknown. Metastatic tumor cells are known to express a more stem-like RNA profile which is seen often in cell-specific embryonic development to induce tumor progression. Here, we identified novel transcription regulators by reanalyzing publicly available single cell RNA sequencing experiments. We identified five transcription regulators of interest: ELL2, KDM5B, REXO4, RBFOX2 and FOXD1. Our most significant finding is FOXD1, as this gene is nearly exclusively expressed in high-risk UM and its expression is associated with a poor prognosis. Even within the BAP1-mutated UM, the expression of FOXD1 is correlated with poor survival. FOXD1 is a novel factor which could potentially be involved in the metastatic capacity of high-risk UM. Elucidating the function of FOXD1 in UM could provide insight into the malignant transformation of uveal melanocytes, especially in high-risk UM.
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Affiliation(s)
- Quincy C. C. van den Bosch
- Department of Ophthalmology, Erasmus MC Cancer Center, Erasmus MC University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands; (Q.C.C.v.d.B.); (J.Q.N.N.); (T.B.); (N.C.N.)
- Department of Clinical Genetics, Erasmus MC Cancer Center, Erasmus MC University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands;
| | - Josephine Q. N. Nguyen
- Department of Ophthalmology, Erasmus MC Cancer Center, Erasmus MC University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands; (Q.C.C.v.d.B.); (J.Q.N.N.); (T.B.); (N.C.N.)
- Department of Clinical Genetics, Erasmus MC Cancer Center, Erasmus MC University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands;
| | - Tom Brands
- Department of Ophthalmology, Erasmus MC Cancer Center, Erasmus MC University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands; (Q.C.C.v.d.B.); (J.Q.N.N.); (T.B.); (N.C.N.)
- Department of Clinical Genetics, Erasmus MC Cancer Center, Erasmus MC University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands;
| | - Thierry P. P. van den Bosch
- Department of Pathology, Section Ophthalmic Pathology, Erasmus MC Cancer Institute, Erasmus MC University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands; (T.P.P.v.d.B.); (R.M.V.)
| | - Robert M. Verdijk
- Department of Pathology, Section Ophthalmic Pathology, Erasmus MC Cancer Institute, Erasmus MC University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands; (T.P.P.v.d.B.); (R.M.V.)
- Department of Pathology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Dion Paridaens
- The Rotterdam Eye Hospital, 3011 BH Rotterdam, The Netherlands;
| | - Nicole C. Naus
- Department of Ophthalmology, Erasmus MC Cancer Center, Erasmus MC University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands; (Q.C.C.v.d.B.); (J.Q.N.N.); (T.B.); (N.C.N.)
| | - Annelies de Klein
- Department of Clinical Genetics, Erasmus MC Cancer Center, Erasmus MC University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands;
| | - Emine Kiliç
- Department of Ophthalmology, Erasmus MC Cancer Center, Erasmus MC University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands; (Q.C.C.v.d.B.); (J.Q.N.N.); (T.B.); (N.C.N.)
- Correspondence: (E.K.); (E.B.); Tel.: +31-107030683 (E.B.)
| | - Erwin Brosens
- Department of Clinical Genetics, Erasmus MC Cancer Center, Erasmus MC University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands;
- Correspondence: (E.K.); (E.B.); Tel.: +31-107030683 (E.B.)
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12
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Kovacic H, Wubbels RJ, Paridaens D. Efficacy of tarsoconjunctivomullerectomy in adults with acquired aponeurogenic blepharoptosis: a large single-surgeon case-series. Orbit 2022; 42:262-268. [PMID: 35815460 DOI: 10.1080/01676830.2022.2092155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE To evaluate the reoperation rate and symmetry after uni- or bilateral tarsoconjunctivomullerectomy (TCM) in a large, consecutive series of adult patients suffering from mild to moderate acquired aponeurogenic blepharoptosis. METHODS Patients who underwent TCM because of mild to moderate acquired aponeurogenic blepharoptosis between January 2005 and September 2016 were analysed. Main outcome was reoperation rate. Secondary outcomes were eyelid symmetry and the effects of uni- or bilateral surgery, and in unilateral cases contralateral ptosis surgery. MRD-1 (Margin to Reflex Distance) similarity within 1 mm and contour of the eyelid were used for grading eyelid symmetry. RESULTS We analysed the data of 243 patients, of whom 178 underwent unilateral, and 65 bilateral TCM. Previous ptosis surgery of the same eyelid had been performed (by another surgeon) in 44 patients. Reoperation was performed in four patients after unilateral (2.2%) and in 1 patient after bilateral surgery (1.5%) (p = 1.00). After unilateral surgery, contralateral ptosis surgery due to increased contralateral ptosis was performed in 16 patients (9.0%). We found no difference in reoperation rate between patients in whom ptosis surgery had been performed previously versus primary surgery (p = .22). Symmetry was good in 44%, acceptable in 44% and poor in 12% of the patients. CONCLUSIONS After TCM, the reoperation rate was about 2% with good or acceptable eyelid symmetry in most cases. There was no difference in reoperation results between uni- and bilateral cases. However, if we include secondary ptosis surgery of the contralateral eyelid in unilateral cases, results were better after bilateral surgery.
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Affiliation(s)
- Hrvoje Kovacic
- Oculoplastic Service, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - René J Wubbels
- Rotterdam Ophthalmic Institute, Rotterdam, The Netherlands
| | - Dion Paridaens
- Oculoplastic Service, The Rotterdam Eye Hospital, Rotterdam, The Netherlands.,Erasmus Medical Center, Rotterdam, The Netherlands
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13
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Meijer N, de Bruyn DP, de Klein A, Paridaens D, Verdijk RM, Berendschot TTM, Brosens E, Jager MJ, Kiliç E. High C-Reactive Protein Levels Are Related to Better Survival in Patients with Uveal Melanoma. Ophthalmology Science 2022; 2:100117. [PMID: 36249686 PMCID: PMC9560527 DOI: 10.1016/j.xops.2022.100117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/05/2022] [Accepted: 01/18/2022] [Indexed: 01/04/2023]
Abstract
Purpose To determine whether peripheral blood leukocyte numbers and serum markers of inflammation can be used to predict which patients with primary uveal melanoma will develop metastasis. Design Retrospective study. Participants Medical records of patients with uveal melanoma (UM) who received treatment for primary UM between February 1992 and December 2020 at the Erasmus University Medical Center (Rotterdam, The Netherlands) and the Rotterdam Eye Hospital (Rotterdam, The Netherlands) were reviewed. Methods Inclusion criteria were the presence of a melanoma of the choroid or ciliary body and the availability of data from peripheral blood samples taken before treatment of the melanoma. Data including patient demographics, C-reactive protein (CRP) levels; erythrocyte sedimentation rate (ESR); number of leukocytes, neutrophils, monocytes, and lymphocytes; and histopathologic findings were obtained from medical records. Neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) were calculated. Main Outcome Measures Metastasis-free survival. Results Of the 807 patients with UM, serum and leukocyte data were available for 183 of them at the time of primary tumor treatment. In the total group, no correlation was found between ESR before treatment; the number of leukocytes; percentages of neutrophils, monocytes, and lymphocytes; or NLR or LMR values and any of the clinical characteristics or metastasis-free survival. Among patients who underwent enucleation, those with negative BAP1 findings showed significantly lower numbers of leukocytes (P < 0.05). In the entire cohort, a significant association was found between high CRP levels and longer metastasis-free survival (MFS; P = 0.049). Conclusions The total blood leukocyte number was related to loss of BAP1 staining in patients who underwent enucleation, with lower leukocyte counts correlating with absent BAP1 staining. Higher CRP levels were associated with a longer MFS in the entire cohort. Neither the NLR nor the LMR is a good predictor for metastasis developing in patients with UM.
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Affiliation(s)
- Nikki Meijer
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Ophthalmology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Daniël P. de Bruyn
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Annelies de Klein
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Dion Paridaens
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Ocular Oncology, Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Robert M. Verdijk
- Department of Ocular Oncology, Rotterdam Eye Hospital, Rotterdam, The Netherlands
- Department of Pathology, Erasmus Medical Center, Rotterdam, and Leiden University Medical Center, Leiden, The Netherlands
| | - Tos T.J. M. Berendschot
- Department of Ophthalmology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Erwin Brosens
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Martine J. Jager
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
- Correspondence: Martine J. Jager, MD, PhD, Department of Ophthalmology, Leiden University Medical Center, P. O. Box 9600, 2300 RC Leiden, The Netherlands.
| | - Emine Kiliç
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands
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14
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Detiger SE, Paridaens D, Verdijk RM, van Laar JAM, Dammers R, Monserez DA, Nagtegaal AP. Vision loss caused by immunoglobulin G4-related disease of the skull base complicated by a mucocele of the sphenoid sinus. Int Forum Allergy Rhinol 2022; 12:1216-1220. [PMID: 35294105 PMCID: PMC9543375 DOI: 10.1002/alr.22993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 02/20/2022] [Accepted: 02/28/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Immunoglobulin G4-related disease (IgG4-RD) is a fibro-inflammatory disorder and manifestation in de paranasal and sphenoid sinus is well recognized. In this patient, IgG4-RD presented in an unusual manner with vision loss due to mucocele formation in the sphenoid sinus. CASE DESCRIPTION A 19-year-old man, with an unremarkable medical history, was referred with decreased vision in the left eye, headaches, and a sharp pain in the left orbit and ear. Compression of the left optic nerve due to a large mucocele caused papillary edema and emergency endoscopic marsupialization of the mucocele was performed. When the vision decreased again, a more extensive decompressing sphenoidotomy was performed. Histopathology showed IgG4-RD. Despite dexamethasone, the lesion expanded to the anterior skull base and the patient required repeat endoscopic surgery. After 3 months, a decrease in smell and vision warranted for a fourth extensive endoscopic decompressing surgery, complicated by a cerebrospinal fluid leak. Prednisone and later rituximab were commenced. Unfortunately, the patient reported a complete loss of vision after 4 months of rituximab due to increased mass effect on the optic nerve. An extensive combined craniofacial-endoscopic surgery was performed to remove the entire mucocele and to prevent further contralateral and intracranial progression. Methylprednisolone monthly was commenced to prevent further complications. DISCUSSION This case illustrates that in therapy-resistant sino-orbital IgG4-RD, extensive surgery might be necessary at an earlier stage. It may even be the only option to prevent irreversible damage to the surrounding tissues. A multidisciplinary approach in the management of sino-orbital IgG4-RD is therefore warranted.
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Affiliation(s)
| | - Dion Paridaens
- The Rotterdam Eye Hospital, Department of Oculoplastic, Orbital and Lacrimal Surgery, Rotterdam, The Netherlands.,Department of Ophthalmology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Robert M Verdijk
- The Rotterdam Eye Hospital, Rotterdam, The Netherlands.,Department of Pathology, Section Ophthalmic Pathology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jan A M van Laar
- Departments of Internal Medicine and Immunology, Section Clinical Immunology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Ruben Dammers
- Department of Neurosurgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Dominiek A Monserez
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - A Paul Nagtegaal
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
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15
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de Bruyn DP, Beasley AB, Verdijk RM, van Poppelen NM, Paridaens D, de Keizer ROB, Naus NC, Gray ES, de Klein A, Brosens E, Kiliç E. Is Tissue Still the Issue? The Promise of Liquid Biopsy in Uveal Melanoma. Biomedicines 2022; 10:biomedicines10020506. [PMID: 35203714 PMCID: PMC8962331 DOI: 10.3390/biomedicines10020506] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 12/18/2022] Open
Abstract
Uveal melanoma (UM) is the second most frequent type of melanoma. Therapeutic options for UM favor minimally invasive techniques such as irradiation for vision preservation. As a consequence, no tumor material is obtained. Without available tissue, molecular analyses for gene expression, mutation or copy number analysis cannot be performed. Thus, proper patient stratification is impossible and patients’ uncertainty about their prognosis rises. Minimally invasive techniques have been studied for prognostication in UM. Blood-based biomarker analysis has become more common in recent years; however, no clinically standardized protocol exists. This review summarizes insights in biomarker analysis, addressing new insights in circulating tumor cells, circulating tumor DNA, extracellular vesicles, proteomics, and metabolomics. Additionally, medical imaging can play a significant role in staging, surveillance, and prognostication of UM and is addressed in this review. We propose that combining multiple minimally invasive modalities using tumor biomarkers should be the way forward and warrant more attention in the coming years.
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Affiliation(s)
- Daniël P. de Bruyn
- Department of Ophthalmology, Erasmus MC Rotterdam, 3000 CA Rotterdam, The Netherlands; (D.P.d.B.); (N.M.v.P.); (D.P.); (N.C.N.)
- Department of Clinical Genetics, Erasmus MC Rotterdam, 3000 CA Rotterdam, The Netherlands; (A.d.K.); (E.B.)
- Erasmus MC Cancer Institute, 3000 CA Rotterdam, The Netherlands
| | - Aaron B. Beasley
- Centre for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia; (A.B.B.); (E.S.G.)
| | - Robert M. Verdijk
- The Rotterdam Eye Hospital, 3011 BH Rotterdam, The Netherlands; (R.M.V.); (R.O.B.d.K.)
- Department of Pathology, Section Ophthalmic Pathology, Erasmus MC Rotterdam, 3000 CA Rotterdam, The Netherlands
- Department of Pathology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Natasha M. van Poppelen
- Department of Ophthalmology, Erasmus MC Rotterdam, 3000 CA Rotterdam, The Netherlands; (D.P.d.B.); (N.M.v.P.); (D.P.); (N.C.N.)
- Department of Clinical Genetics, Erasmus MC Rotterdam, 3000 CA Rotterdam, The Netherlands; (A.d.K.); (E.B.)
- Erasmus MC Cancer Institute, 3000 CA Rotterdam, The Netherlands
| | - Dion Paridaens
- Department of Ophthalmology, Erasmus MC Rotterdam, 3000 CA Rotterdam, The Netherlands; (D.P.d.B.); (N.M.v.P.); (D.P.); (N.C.N.)
- The Rotterdam Eye Hospital, 3011 BH Rotterdam, The Netherlands; (R.M.V.); (R.O.B.d.K.)
| | | | - Nicole C. Naus
- Department of Ophthalmology, Erasmus MC Rotterdam, 3000 CA Rotterdam, The Netherlands; (D.P.d.B.); (N.M.v.P.); (D.P.); (N.C.N.)
- Erasmus MC Cancer Institute, 3000 CA Rotterdam, The Netherlands
| | - Elin S. Gray
- Centre for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia; (A.B.B.); (E.S.G.)
| | - Annelies de Klein
- Department of Clinical Genetics, Erasmus MC Rotterdam, 3000 CA Rotterdam, The Netherlands; (A.d.K.); (E.B.)
- Erasmus MC Cancer Institute, 3000 CA Rotterdam, The Netherlands
| | - Erwin Brosens
- Department of Clinical Genetics, Erasmus MC Rotterdam, 3000 CA Rotterdam, The Netherlands; (A.d.K.); (E.B.)
- Erasmus MC Cancer Institute, 3000 CA Rotterdam, The Netherlands
| | - Emine Kiliç
- Department of Ophthalmology, Erasmus MC Rotterdam, 3000 CA Rotterdam, The Netherlands; (D.P.d.B.); (N.M.v.P.); (D.P.); (N.C.N.)
- Erasmus MC Cancer Institute, 3000 CA Rotterdam, The Netherlands
- Correspondence: ; Tel.: +31-107030683
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16
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Drabarek W, van Riet J, Nguyen JQN, Smit KN, van Poppelen NM, Jansen R, Medico-Salsench E, Vaarwater J, Magielsen FJ, Brands T, Eussen B, van den Bosch TPP, Verdijk RM, Naus NC, Paridaens D, de Klein A, Brosens E, van de Werken HJG, Kilic E. Identification of Early-Onset Metastasis in SF3B1 Mutated Uveal Melanoma. Cancers (Basel) 2022; 14:cancers14030846. [PMID: 35159112 PMCID: PMC8834136 DOI: 10.3390/cancers14030846] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 12/31/2022] Open
Abstract
Simple Summary This study describes clinical and genetic characteristics of the largest aggregated cohort of Splicing Factor 3 Subunit B1 (SF3B1)-mutated Uveal Melanoma (UM) in the literature (n = 146). Missense mutations in the spliceosome gene SF3B1 result in an altered splice site recognition and aberrant mRNA transcripts. The SF3B1-mutated UM show early- and late-onset of metastatic disease for which, currently, no distinguishing biomarkers exist. Using a cutoff of 60 months for stratification, we found that a largest basal tumor diameter was more prevalent in the early-onset metastatic disease group. Furthermore, using differential gene expression and the detection of aberrant transcripts, we found that the expression of alpha/beta-Hydrolase domain containing 6 (ABHD6) is associated with early-onset metastatic SF3B1 and aberrant transcripts that are associated with early-onset SF3B1-mutated UM. Our results provide more accurate prognostication and targets for future functional studies in an effort to elucidate pathogenesis of SF3B1-mutated UM. Abstract Approximately 25% of all uveal melanoma (UM) contain driver mutations in the gene encoding the spliceosome factor SF3B1, and whilst patients with such SF3B1 mutations generally have an intermediate risk on developing metastatic disease, a third of these patients develop early metastasis within 5 years after diagnosis. We therefore investigated whether clinical and/or genetic variables could be indicative of short progression-free survival (PFS < 60 months) or long PFS (PFS ≥ 60 months) for SF3B1-mutated (SF3B1mut) UM patients. We collected 146 SF3B1mut UM from our Rotterdam Ocular Melanoma Studygroup (ROMS) database and external published datasets. After stratification of all SF3B1mut UM using short PFS vs. long PFS, only largest tumor diameter (LTD) was significantly larger (mean: 17.7 mm (±2.8 SD) in the short PFS SF3B1mut group vs. the long PFS group (mean: 14.7 (±3.7 SD, p = 0.001). Combined ROMS and The Cancer Genome Atlas (TCGA) transcriptomic data were evaluated, and we identified SF3B1mut-specific canonical transcripts (e.g., a low expression of ABHD6 indicative for early-onset metastatic disease) or distinct expression of SF3B1mut UM aberrant transcripts, indicative of early- or late-onset or no metastatic SF3B1mut UM.
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Affiliation(s)
- Wojtek Drabarek
- Department of Ophthalmology, Erasmus MC Cancer Institute, Erasmus MC, 3000 CA Rotterdam, The Netherlands; (W.D.); (J.Q.N.N.); (K.N.S.); (N.M.v.P.); (J.V.); (T.B.); (N.C.N.); (D.P.)
- Department of Clinical Genetics, Erasmus MC Cancer Institute, Erasmus MC, 3000 CA Rotterdam, The Netherlands; (E.M.-S.); (F.J.M.); (B.E.); (A.d.K.); (E.B.)
| | - Job van Riet
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus MC, 3000 CA Rotterdam, The Netherlands;
- Cancer Computational Biology Center, Erasmus MC Cancer Institute, University Medical Center, 3000 CA, Rotterdam, The Netherlands;
- Department of Urology, Erasmus MC Cancer Institute, University Medical Center, 3000 CA Rotterdam, The Netherlands
| | - Josephine Q. N. Nguyen
- Department of Ophthalmology, Erasmus MC Cancer Institute, Erasmus MC, 3000 CA Rotterdam, The Netherlands; (W.D.); (J.Q.N.N.); (K.N.S.); (N.M.v.P.); (J.V.); (T.B.); (N.C.N.); (D.P.)
- Department of Clinical Genetics, Erasmus MC Cancer Institute, Erasmus MC, 3000 CA Rotterdam, The Netherlands; (E.M.-S.); (F.J.M.); (B.E.); (A.d.K.); (E.B.)
| | - Kyra N. Smit
- Department of Ophthalmology, Erasmus MC Cancer Institute, Erasmus MC, 3000 CA Rotterdam, The Netherlands; (W.D.); (J.Q.N.N.); (K.N.S.); (N.M.v.P.); (J.V.); (T.B.); (N.C.N.); (D.P.)
- Department of Clinical Genetics, Erasmus MC Cancer Institute, Erasmus MC, 3000 CA Rotterdam, The Netherlands; (E.M.-S.); (F.J.M.); (B.E.); (A.d.K.); (E.B.)
| | - Natasha M. van Poppelen
- Department of Ophthalmology, Erasmus MC Cancer Institute, Erasmus MC, 3000 CA Rotterdam, The Netherlands; (W.D.); (J.Q.N.N.); (K.N.S.); (N.M.v.P.); (J.V.); (T.B.); (N.C.N.); (D.P.)
- Department of Clinical Genetics, Erasmus MC Cancer Institute, Erasmus MC, 3000 CA Rotterdam, The Netherlands; (E.M.-S.); (F.J.M.); (B.E.); (A.d.K.); (E.B.)
| | - Rick Jansen
- Cancer Computational Biology Center, Erasmus MC Cancer Institute, University Medical Center, 3000 CA, Rotterdam, The Netherlands;
- Department of Urology, Erasmus MC Cancer Institute, University Medical Center, 3000 CA Rotterdam, The Netherlands
| | - Eva Medico-Salsench
- Department of Clinical Genetics, Erasmus MC Cancer Institute, Erasmus MC, 3000 CA Rotterdam, The Netherlands; (E.M.-S.); (F.J.M.); (B.E.); (A.d.K.); (E.B.)
| | - Jolanda Vaarwater
- Department of Ophthalmology, Erasmus MC Cancer Institute, Erasmus MC, 3000 CA Rotterdam, The Netherlands; (W.D.); (J.Q.N.N.); (K.N.S.); (N.M.v.P.); (J.V.); (T.B.); (N.C.N.); (D.P.)
| | - Frank J. Magielsen
- Department of Clinical Genetics, Erasmus MC Cancer Institute, Erasmus MC, 3000 CA Rotterdam, The Netherlands; (E.M.-S.); (F.J.M.); (B.E.); (A.d.K.); (E.B.)
| | - Tom Brands
- Department of Ophthalmology, Erasmus MC Cancer Institute, Erasmus MC, 3000 CA Rotterdam, The Netherlands; (W.D.); (J.Q.N.N.); (K.N.S.); (N.M.v.P.); (J.V.); (T.B.); (N.C.N.); (D.P.)
- Department of Clinical Genetics, Erasmus MC Cancer Institute, Erasmus MC, 3000 CA Rotterdam, The Netherlands; (E.M.-S.); (F.J.M.); (B.E.); (A.d.K.); (E.B.)
| | - Bert Eussen
- Department of Clinical Genetics, Erasmus MC Cancer Institute, Erasmus MC, 3000 CA Rotterdam, The Netherlands; (E.M.-S.); (F.J.M.); (B.E.); (A.d.K.); (E.B.)
| | - Thierry. P. P. van den Bosch
- Department of Pathology, Section Ophthalmic Pathology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands; (T.P.P.v.d.B.); (R.M.V.)
| | - Robert M. Verdijk
- Department of Pathology, Section Ophthalmic Pathology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands; (T.P.P.v.d.B.); (R.M.V.)
- The Rotterdam Eye Hospital, 3011 BH Rotterdam, The Netherlands
| | - Nicole C. Naus
- Department of Ophthalmology, Erasmus MC Cancer Institute, Erasmus MC, 3000 CA Rotterdam, The Netherlands; (W.D.); (J.Q.N.N.); (K.N.S.); (N.M.v.P.); (J.V.); (T.B.); (N.C.N.); (D.P.)
| | - Dion Paridaens
- Department of Ophthalmology, Erasmus MC Cancer Institute, Erasmus MC, 3000 CA Rotterdam, The Netherlands; (W.D.); (J.Q.N.N.); (K.N.S.); (N.M.v.P.); (J.V.); (T.B.); (N.C.N.); (D.P.)
- The Rotterdam Eye Hospital, 3011 BH Rotterdam, The Netherlands
| | - Annelies de Klein
- Department of Clinical Genetics, Erasmus MC Cancer Institute, Erasmus MC, 3000 CA Rotterdam, The Netherlands; (E.M.-S.); (F.J.M.); (B.E.); (A.d.K.); (E.B.)
| | - Erwin Brosens
- Department of Clinical Genetics, Erasmus MC Cancer Institute, Erasmus MC, 3000 CA Rotterdam, The Netherlands; (E.M.-S.); (F.J.M.); (B.E.); (A.d.K.); (E.B.)
| | - Harmen J. G. van de Werken
- Cancer Computational Biology Center, Erasmus MC Cancer Institute, University Medical Center, 3000 CA, Rotterdam, The Netherlands;
- Department of Urology, Erasmus MC Cancer Institute, University Medical Center, 3000 CA Rotterdam, The Netherlands
- Department of Immunology, Erasmus MC Cancer Institute, University Medical Center, 3000 CA Rotterdam, The Netherlands
- Correspondence: (H.J.G.v.d.W.); (E.K.); Tel.: +31-107044467 (H.J.G.v.d.W.); +31-107044272 (E.K.)
| | - Emine Kilic
- Department of Ophthalmology, Erasmus MC Cancer Institute, Erasmus MC, 3000 CA Rotterdam, The Netherlands; (W.D.); (J.Q.N.N.); (K.N.S.); (N.M.v.P.); (J.V.); (T.B.); (N.C.N.); (D.P.)
- Correspondence: (H.J.G.v.d.W.); (E.K.); Tel.: +31-107044467 (H.J.G.v.d.W.); +31-107044272 (E.K.)
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17
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In 't Veld EH, Keizer R, Post N, Versteeg J, Verdijk R, Naus N, Relyveld G, Crijns M, Smith M, Grünhagen D, Wakkee M, Paridaens D, Zavrakidis I, Mooyaart A, van Akkooi A, Strauss D, Verhoef C, Wouters M, Hayes A, van Houdt W. Outcome after treatment for sebaceous carcinoma: A multicenter study. J Surg Oncol 2022; 125:730-735. [PMID: 34990031 PMCID: PMC9306786 DOI: 10.1002/jso.26774] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 10/15/2021] [Accepted: 10/15/2021] [Indexed: 11/24/2022]
Abstract
Background Sebaceous carcinoma (SC) is a rare malignant tumour whereby, comprehensive long‐term data are scarce. This study aimed to assess the outcome of patients treated with resection for SC. Methods Patients treated at four tertiary centres were included. Cumulative incidence curves were calculated for recurrences. Results A total of 100 patients (57 males, 57%) were included with 103 SCs. The median age was 72 (range, 15–95) years with a median follow‐up of 52 (interquartile range [IQR], 24‐93) months. Most SCs were located (peri)ocular (49.5%). Of all SCs, 17 locally recurred (16.5%) with a median time to recurrence of 19 (IQR, 8–29) months. The cumulative incidence probability for recurrence was statistically higher for (peri)ocular tumours (p = 0.005), and for positive resection margins (p = 0.001). Two patients presented with lymph node metastases and additional seven patients (8.7%) developed lymph node metastases during follow‐up with a median time to metastases of 8 (IQR, 0.5–28) months. Three patients had concurrent in‐transit metastases and one patient also developed liver and bone metastases during follow‐up. Conclusion SC is a rare, yet locally aggressive tumour. Positive resection margins and (peri)ocular SCs are more frequently associated with local recurrence. SC infrequently presents with locoregional or distant metastases.
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Affiliation(s)
- Eva Huis In 't Veld
- Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Ronald Keizer
- Department of Ocular Oncology, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Nicoline Post
- Department of Dermatology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jeroen Versteeg
- Department of Ocular Oncology, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Robert Verdijk
- Department of Pathology, Section Ophthalmic Pathology, Erasmus Medical Centre, Rotterdam, The Netherlands.,Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Nicole Naus
- Department of Ophthalmology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Germaine Relyveld
- Department of Dermatology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Marianne Crijns
- Department of Dermatology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Myles Smith
- Sarcoma and Skin Unit, Department of Academic Surgery, Royal Marsden NHS Trust, London, UK
| | - Dirk Grünhagen
- Department of Surgical Oncology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Marlies Wakkee
- Department of Dermatology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Dion Paridaens
- Department of Ocular Oncology, The Rotterdam Eye Hospital, Rotterdam, The Netherlands.,Department of Ophthalmology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Ioannis Zavrakidis
- Department of Epidemiology and Biostatistics, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Antien Mooyaart
- Department of Pathology, Section Ophthalmic Pathology, Erasmus Medical Centre, Rotterdam, The Netherlands.,Department of Pathology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Alexander van Akkooi
- Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Dirk Strauss
- Sarcoma and Skin Unit, Department of Academic Surgery, Royal Marsden NHS Trust, London, UK
| | - Cornelis Verhoef
- Department of Surgical Oncology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Michel Wouters
- Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Andrew Hayes
- Sarcoma and Skin Unit, Department of Academic Surgery, Royal Marsden NHS Trust, London, UK
| | - Winan van Houdt
- Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
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18
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Ionescu IC, Trotsenburg PAS, Paridaens D, Tanck M, Mooij CF, Cagienard E, Kalmann R, Pakdel F, Meeren S, Saeed P. Pediatric Graves' orbitopathy: a multicentre study. Acta Ophthalmol 2021; 100:e1340-e1348. [PMID: 34951116 DOI: 10.1111/aos.15084] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 12/07/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE Graves' orbitopathy (GO) is a rare condition in children often considered to be a less severe condition than at an older age. The aim of our study was to analyse if there are any factors that distinguish paediatric from adult GO in order to provide guidelines for assessing and managing paediatric GO. METHODS Study design is a multicentre retrospective observational case series; 115 paediatric patients diagnosed with GO who visited our university medical centres in the Netherlands and Iran between 2003 and 2019 were submitted for complete ophthalmological examinations, serological testing and/or orbital imaging. Main outcome measures focussed on the natural course and clinical picture as well as medical and surgical treatment in paediatric GO. RESULTS Clinical findings included proptosis (n = 97; 84.3%), eyelid retraction (n = 77; 67%) and diplopia (n = 13; 11.3%). Ninety-two patients (80%) presented with mild disease, 21 (18.3%) with moderate-severe disease and two (1.7%) with severe GO. Five patients (4.3%) underwent intravenous glucocorticoids and 25 patients underwent orbital decompression surgery. Strabismus surgery due to primary involvement of extraocular muscles was performed in two patients (1.7%). Overall, rehabilitative surgical treatment was planned in 31 patients (26.9%) with inactive disease. Two patients experienced reactivation of the disease. CONCLUSION Despite the fact that paediatric and adult GO are considered two separate entities, they might be the same disease with two different clinical phenotypes. Paediatric GO population presents with a comparable clinical picture regarding both soft tissue involvement and proptosis, which may require surgical intervention. Proptosis was present in the majority of paediatric GO patients. Orbital decompression was performed in 21.7% of patients.
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Affiliation(s)
- Ioana C. Ionescu
- Department of Ophthalmology Orbital Center Amsterdam University Medical Centers University of Amsterdam Amsterdam The Netherlands
| | - Paul A. S. Trotsenburg
- Department of Pediatric Endocrinology Emma Children’s Hospital Amsterdam University Medical Centers University of Amsterdam Amsterdam The Netherlands
| | - Dion Paridaens
- Orbital Center Rotterdam (The Rotterdam Eye Hospital & Erasmus Medical Center Rotterdam) Rotterdam The Netherlands
| | - Michael Tanck
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics Amsterdam Public Health Amsterdam University Medical Centers University of Amsterdam Amsterdam The Netherlands
| | - Christiaan F. Mooij
- Department of Pediatric Endocrinology Emma Children’s Hospital Amsterdam University Medical Centers University of Amsterdam Amsterdam The Netherlands
| | - Eliane Cagienard
- Department of Ophthalmology Orbital Center Amsterdam University Medical Centers University of Amsterdam Amsterdam The Netherlands
| | - Rachel Kalmann
- Department of Ophthalmology University Medical Center Utrecht Utrecht The Netherlands
| | - Farzad Pakdel
- Ophthalmic Plastic and Reconstructive Surgery Department Farabi Hospital Tehran University of Medical Sciences Tehran Iran
| | - Stijn Meeren
- Department of Ophthalmology Leiden University Medical Center Leiden The Netherlands
| | - Peerooz Saeed
- Department of Ophthalmology Orbital Center Amsterdam University Medical Centers University of Amsterdam Amsterdam The Netherlands
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Detiger SE, Kremer TM, A.S.H. Dalm V, de Keizer RO, Wubbels RJ, Metselaar J, van Hagen PM, Peeters RP, Paridaens D. A pilot study on the use of prednisolone-encapsulated liposomes for the treatment of moderate-to-severe Graves' orbitopathy with reduced systemic steroid exposure. Acta Ophthalmol 2021; 99:797-804. [PMID: 33423386 DOI: 10.1111/aos.14751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 11/29/2020] [Accepted: 12/07/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE To demonstrate that long-circulating PEGylated liposomal prednisolone is a safe and effective therapy in patients with active moderate-to-severe Graves' orbitopathy. METHODS Open-label, proof-of-concept, multicentre pilot study. Ten patients with moderate-to-severe Graves's orbitopathy, who were euthyroid for at least three months. Long-circulating PEGylated liposomal prednisolone 150 mg was administered intravenously twice, with 2-week interval. Total follow-up was 12 months, with visits at baseline, week 2, 6, 13, 26 and 52. Physical, laboratory and ophthalmological examinations were performed. Response to treatment was defined as a reduction in Clinical Activity Score by ≥2 points; palpebral aperture by ≥3 mm; soft tissue signs by ≥2 grades; exophthalmos by ≥2 mm; and motility by >8 degrees or improvement in diplopia score. A response was sustained when equally observed at weeks 6 and 13. RESULTS One patient achieved a sustained response according to the predetermined definition. All patients showed a decrease in Clinical Activity Score after one infusion, with a mean decrease of two points. The Clinical Activity Score was ≤1 at week 52 for all patients. Improvement was also observed in the soft tissue signs. Most of the adverse events were mild and of a transient nature. Two patients required further treatment with intravenous methylprednisolone. CONCLUSION This pilot study showed a positive effect of long-circulating PEGylated liposomal prednisolone on the Clinical Activity Score in patients with moderate-to-severe Graves's orbitopathy, resulting in fewer hospital visits and possibly less glucocorticoid-related side-effects.
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Affiliation(s)
| | | | - Virgil A.S.H. Dalm
- Department of Internal Medicine Division of Clinical Immunology & Department of Immunology Erasmus University Medical Center Rotterdam Rotterdam the Netherlands
| | - Ronald O.B. de Keizer
- The Rotterdam Eye Hospital Division of Oculoplastic, Orbital and Lacrimal Surgery Rotterdam the Netherlands
| | - Rene J. Wubbels
- The Rotterdam Ophthalmic Institute Rotterdam the Netherlands
| | - J.M. Metselaar
- Institute for Experimental Molecular Imaging, RWTH Aachen University Clinic, Forckenbeckstrasse 55, 52074 Aachen, Germany
| | - P. Martin van Hagen
- Department of Internal Medicine Division of Clinical Immunology & Department of Immunology Erasmus University Medical Center Rotterdam Rotterdam the Netherlands
| | - Robin P. Peeters
- Department of Internal Medicine Division of Endocrinology Erasmus University Medical Center Rotterdam Rotterdam the Netherlands
| | - Dion Paridaens
- The Rotterdam Eye Hospital Division of Oculoplastic, Orbital and Lacrimal Surgery Rotterdam the Netherlands
- Department of Ophthalmology Erasmus Medical Center Rotterdam Rotterdam the Netherlands
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20
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Roohé SL, Gan IM, van der Weerd K, Lopuhaä B, Verdijk RM, Paridaens D. Diplopia as the First Sign of Gastric Carcinoma. Case Rep Ophthalmol 2021; 12:870-874. [PMID: 34950013 PMCID: PMC8647119 DOI: 10.1159/000519953] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 09/25/2021] [Indexed: 11/19/2022] Open
Abstract
Orbital metastasis may be the initial manifestation of a malignancy of unknown origin. The primary locations of orbital metastasis are usually the lung, prostate, gastrointestinal tract, skin, kidney, eye, or thyroid gland. Metastasis of gastric carcinoma to an extraocular eye muscle is extremely rare. A solitary thickening in an extraocular eye muscle with no inflammatory features is suspect for a tumor. Symptoms such as diplopia, proptosis, ptosis, vision loss, or pain may be associated with an orbital malignancy. Our patient, a 67-year-old man known with radically resected prostate cancer, presented with complaints of vertigo with a tendency to fall, headache, and diplopia when looking to the right. As a coincidental finding, swelling of the rectus lateralis muscle of the left eye was observed on imaging. Extensive additional investigations showed that a gastric carcinoma with intraorbital and leptomeningeal metastasis was the cause. In conclusion, a solitary thickened extraocular eye muscle should be recognized in time and examined further.
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Affiliation(s)
- Suzanna L. Roohé
- Department of Oculoplastic and Orbital Surgery, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Ivan M. Gan
- Department of Ophthalmology, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
| | - Kim van der Weerd
- Department of Internal Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
| | - Boaz Lopuhaä
- Department of Pathology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Robert M. Verdijk
- Department of Pathology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Dion Paridaens
- Department of Oculoplastic and Orbital Surgery, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
- *Dion Paridaens,
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21
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Yavuzyigitoglu S, Tang MCY, Jansen M, Geul KW, Dwarkasing RS, Vaarwater J, Drabarek W, Verdijk RM, Paridaens D, Naus NC, Brosens E, de Klein A, Kilic E. Radiological Patterns of Uveal Melanoma Liver Metastases in Correlation to Genetic Status. Cancers (Basel) 2021; 13:cancers13215316. [PMID: 34771480 PMCID: PMC8582397 DOI: 10.3390/cancers13215316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 10/15/2021] [Indexed: 11/16/2022] Open
Abstract
This study reports the role played by the mutation status of Uveal Melanoma (UM) in relation to hepatic metastatic patterns as seen on imaging modalities. Radiological images were obtained from 123 patients treated at the Erasmus Medical Center Rotterdam or the Rotterdam Eye Hospital. Radiological images were derived from either computed tomography or magnetic resonance imaging. Hepatic metastatic patterns were classified by counting the number of metastases found in the liver. Miliary metastatic pattern (innumerable small metastases in the entire liver) was analyzed separately. Mutation status was determined in 85 patients. Median disease-free survival (DFS) and survival with metastases differed significantly between each of the metastatic patterns (respectively, p = 0.009, p < 0.001), both in favor of patients with less hepatic metastases. The mutation status of the primary tumor was not correlated with any hepatic tumor profiles (p = 0.296). Of the patients who had a solitary metastasis (n = 18), 11 originated from a primary BAP1-mutated tumors and one from a primary SF3B1-mutated tumor. Of the patients who had a miliary metastasis pattern (n = 24), 17 had a primary BAP1-mutated tumor and two had a primary SF3B1-mutated tumor. Chromosome 8p loss was significantly more in patients with more metastases (p = 0.045). Moreover, the primary UMs of patients with miliary metastases harbored more chromosome 8p and 1p loss, compared to patients with single solitary metastasis (p = 0.035 and p = 0.026, respectively). In conclusion, our study shows that there is an inverse correlation of the number of metastasis with the DFS and metastasized survival, indicating separate growth patterns. We also revealed that the number and type of metastases is irrelevant to the prognostic mutation status of the tumor, showing that both BAP1- and SF3B1-mutated UM can result in solitary and miliary metastases, indicating that other processes lay ground to the different metastatic patterns.
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Affiliation(s)
- Serdar Yavuzyigitoglu
- Department of Ophthalmology, Erasmus Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands; (S.Y.); (M.C.Y.T.); (M.J.); (J.V.); (W.D.); (D.P.); (N.C.N.)
- Department of Clinical Genetics, Erasmus Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands; (E.B.); (A.d.K.)
| | - Michael C. Y. Tang
- Department of Ophthalmology, Erasmus Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands; (S.Y.); (M.C.Y.T.); (M.J.); (J.V.); (W.D.); (D.P.); (N.C.N.)
| | - Miguel Jansen
- Department of Ophthalmology, Erasmus Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands; (S.Y.); (M.C.Y.T.); (M.J.); (J.V.); (W.D.); (D.P.); (N.C.N.)
| | - Kaspar W. Geul
- Department of Internal Medicine, Sint Franciscus Gasthuis Rotterdam, 3045 PM Rotterdam, The Netherlands;
| | - Roy S. Dwarkasing
- Department of Radiology, Erasmus Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands;
| | - Jolanda Vaarwater
- Department of Ophthalmology, Erasmus Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands; (S.Y.); (M.C.Y.T.); (M.J.); (J.V.); (W.D.); (D.P.); (N.C.N.)
- Department of Clinical Genetics, Erasmus Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands; (E.B.); (A.d.K.)
| | - Wojtek Drabarek
- Department of Ophthalmology, Erasmus Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands; (S.Y.); (M.C.Y.T.); (M.J.); (J.V.); (W.D.); (D.P.); (N.C.N.)
- Department of Clinical Genetics, Erasmus Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands; (E.B.); (A.d.K.)
| | - Robert M. Verdijk
- Department of Pathology, Erasmus Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands;
| | - Dion Paridaens
- Department of Ophthalmology, Erasmus Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands; (S.Y.); (M.C.Y.T.); (M.J.); (J.V.); (W.D.); (D.P.); (N.C.N.)
- The Rotterdam Eye Hospital, 3011 BH Rotterdam, The Netherlands
| | - Nicole C. Naus
- Department of Ophthalmology, Erasmus Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands; (S.Y.); (M.C.Y.T.); (M.J.); (J.V.); (W.D.); (D.P.); (N.C.N.)
| | - Erwin Brosens
- Department of Clinical Genetics, Erasmus Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands; (E.B.); (A.d.K.)
| | - Annelies de Klein
- Department of Clinical Genetics, Erasmus Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands; (E.B.); (A.d.K.)
| | - Emine Kilic
- Department of Ophthalmology, Erasmus Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands; (S.Y.); (M.C.Y.T.); (M.J.); (J.V.); (W.D.); (D.P.); (N.C.N.)
- Correspondence:
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van Beek JGM, van Rij CM, Baart SJ, Yavuzyigitoglu S, Bergmann MJ, Paridaens D, Naus NC, Kiliç E. Fractionated stereotactic radiotherapy for uveal melanoma: Long-term outcome and control rates. Acta Ophthalmol 2021; 100:511-519. [PMID: 34529346 PMCID: PMC9544756 DOI: 10.1111/aos.15029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 08/07/2021] [Accepted: 08/31/2021] [Indexed: 11/29/2022]
Abstract
Purpose The aim of our study is to evaluate local tumour control rates, radiation side‐effects, visual preservation and disease‐free survival (DFS) of uveal melanoma (UM) patients treated with fractionated stereotactic radiotherapy (fSRT). Methods A retrospective study of UM patients, who were treated with fSRT (N = 189), was performed by the Rotterdam Ocular Melanoma Study group (ROMS), the Netherlands, between 1999 and 2014 with a follow‐up of at least 5 years. Results The 1‐, 3‐, 5‐, 10‐ and 15‐year local tumour control rates were as follows: 99.4%, 92.8%, 92.2%, 89.3% and 89.3%, respectively. Cataract (67.8%) was the most common side‐effect of fSRT followed by retinopathy (35.1%), maculopathy (23.8%), vitreous haemorrhage (20.1%), neovascular glaucoma (NVG) (20.0%) and optic neuropathy (12.4%). Patients with anterior located UMs developed cataract more frequently (p = 0.047, multivariable analysis). By multivariable analysis, significant factors for secondary enucleation were tumour recurrence (p < 0.001) and NVG (p < 0.001). In multivariable analysis, risk factors for a worse DFS were larger UM (p = 0.024) and tumours with subretinal fluid (SRF) at baseline (p = 0.038). The 5‐year DFS was 77.0% and the best corrected visual acuity decreased significantly after treatment. After 5 years, 22.0% of patients and after 10 years 17.6% of patients had a visual acuity of ≤0.3 logMAR. Conclusion Fractionated stereotactic radiotherapy is a good treatment option for small‐, medium‐ and large‐sized tumours with 5‐year local tumour control of 92.2%. After 5 years, 22.0% of the patients had a good vision. Independently of tumour location, the visual acuity decreased significantly after treatment. Overall, the 5‐year DFS was 77.0%.
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Affiliation(s)
- Jackelien G. M. van Beek
- Department of Ophthalmology Erasmus University Medical Centre Rotterdam The Netherlands
- Department of Ophthalmology Ikazia Hospital Rotterdam The Netherlands
- ‘Oog op Zuid’ Eye Clinic Rotterdam The Netherlands
| | - Caroline M. van Rij
- Department of Radiotherapy Erasmus University Medical Centre Rotterdam The Netherlands
| | - Sara J. Baart
- Department of Biostatistics Erasmus University Medical Centre Rotterdam The Netherlands
| | - Serdar Yavuzyigitoglu
- Department of Ophthalmology Erasmus University Medical Centre Rotterdam The Netherlands
| | - Michael J. Bergmann
- Department of Ophthalmology Albert Schweitzer Hospital Dordrecht The Netherlands
| | - Dion Paridaens
- Department of Ophthalmology Erasmus University Medical Centre Rotterdam The Netherlands
- Oculoplastic and Orbital surgery Rotterdam Eye Hospital Rotterdam The Netherlands
| | - Nicole C. Naus
- Department of Ophthalmology Erasmus University Medical Centre Rotterdam The Netherlands
| | - Emine Kiliç
- Department of Ophthalmology Erasmus University Medical Centre Rotterdam The Netherlands
- Department of Clinical Genetics Erasmus University Medical Centre Rotterdam The Netherlands
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de Jongh FW, Pouwels S, Weenen C, van den Bosch WA, Paridaens D. Medial Canthal Reconstruction of Skin Defects With Full-Thickness Skin Grafts. Dermatol Surg 2021; 47:1135-1137. [PMID: 34397548 DOI: 10.1097/dss.0000000000002973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Frank W de Jongh
- Oculoplastic & Orbital Service, The Rotterdam Eye Hospital, Rotterdam, the Netherlands
| | - Sjaak Pouwels
- Department of Surgery, Haaglanden Medical Center, The Hague, the Netherlands
| | - Christien Weenen
- Oculoplastic & Orbital Service, The Rotterdam Eye Hospital, Rotterdam, the Netherlands
| | | | - Dion Paridaens
- Oculoplastic & Orbital Service, The Rotterdam Eye Hospital, Rotterdam, the Netherlands
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Pinas D, O.B. De Keizer R, Wubbels RJ, den Bosch WA, Paridaens D. Results of surgical correction of upper eyelid retraction in Graves' Orbitopathy. Acta Ophthalmol 2021; 99:e608-e613. [PMID: 32930505 DOI: 10.1111/aos.14622] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 07/26/2020] [Accepted: 08/01/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Anterior levator disinsertion/reinsertion and Müllerectomy (ALDM) is generally performed to correct upper eyelid retraction in patients with Graves' orbitopathy (GO). We studied the outcome of this procedure and its correlation with clinical parameters. PATIENTS AND METHODS Retrospective analysis of results of ALDM in 305 consecutive euthyroid patients with burnt-out GO treated in our hospital between 1 January 2000 and 1 January 2016. From the patient files, we recorded data on age, gender, laterality of surgery, smoking history and previous interventions. For outcome analysis, we used a qualitative scoring system with subdivision into three categories (good (MRD-1 of 4-5 mm, smooth upper eyelid contour and left-right difference of < 1 mm); acceptable (MRD-1 of 3-<4 or> 5-6 mm), smooth upper eyelid contour and left-right difference of < 2 mm; poor: if none of the above criteria was met). We analysed the outcome per eyelid as well as per patient. RESULTS Of the 305 patients (471 eyelids), 166 underwent bilateral and 139 unilateral surgery. Regarding eyelids, the outcome of surgery was good in 71.6% (337/471) acceptable in 15.7% (74/471) and poor in 12.7% (60/471). Regarding patients, the outcome was good in 64.3% (196/305), acceptable in 15.7% (48/305) and poor in 20% (61/305). Concerning bilateral and unilateral surgery, the outcome was good in 60.8% (101/166) and acceptable in 16.9% (28/166) of patients after bilateral surgery, and good in 68.3% (95/139) and acceptable in 14.4% (20/139) of the patients after unilateral surgery (p = 0.17). Reoperation was performed in 16% (75 of 471) of eyelids and in 22 % (66 of 305) of patients. After secondary surgery, the cumulative success percentage was good in 78.6% (370/471) of eyelids and in 79% (241/305) of patients. We found no relation between surgical outcome and any other studied parameter, such as age, gender, smoking history and previous intervention such as extraocular muscle surgery and/or orbital decompression. CONCLUSION Correction of upper eyelid retraction yields a good result in 64.3% of patients and 71.6% of eyelids. With one additional procedure, the procedure proved was successful in 79% of patients and eyelids. We found no relation between the outcome of surgery and any other parameter, such as previous disease severity, previous interventions or smoking history. For comparative analysis, we recommend to report the outcome per patient rather than per eyelid.
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Affiliation(s)
- Dianta Pinas
- Department of Oculoplastic & Orbital Surgery the Rotterdam Eye Hospital Rotterdam The Netherlands
| | - Ronald O.B. De Keizer
- Department of Oculoplastic & Orbital Surgery the Rotterdam Eye Hospital Rotterdam The Netherlands
- Rotterdam Ophthalmic Institute The Rotterdam Eye Hospital Rotterdam The Netherlands
| | - Rene J. Wubbels
- Rotterdam Ophthalmic Institute The Rotterdam Eye Hospital Rotterdam The Netherlands
| | - Willem A. den Bosch
- Department of Oculoplastic & Orbital Surgery the Rotterdam Eye Hospital Rotterdam The Netherlands
- Rotterdam Ophthalmic Institute The Rotterdam Eye Hospital Rotterdam The Netherlands
| | - Dion Paridaens
- Department of Oculoplastic & Orbital Surgery the Rotterdam Eye Hospital Rotterdam The Netherlands
- Rotterdam Ophthalmic Institute The Rotterdam Eye Hospital Rotterdam The Netherlands
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van Poppelen NM, van Ipenburg JA, van den Bosch Q, Vaarwater J, Brands T, Eussen B, Magielsen F, Dubbink HJ, Paridaens D, Brosens E, Naus N, de Klein A, Kiliç E, Verdijk RM. Molecular Genetics of Conjunctival Melanoma and Prognostic Value of TERT Promoter Mutation Analysis. Int J Mol Sci 2021; 22:ijms22115784. [PMID: 34071371 PMCID: PMC8198138 DOI: 10.3390/ijms22115784] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 12/16/2022] Open
Abstract
The aim of this study was exploration of the genetic background of conjunctival melanoma (CM) and correlation with recurrent and metastatic disease. Twenty-eight CM from the Rotterdam Ocular Melanoma Study group were collected and DNA was isolated from the formalin-fixed paraffin embedded tissue. Targeted next-generation sequencing was performed using a panel covering GNAQ, GNA11, EIF1AX, BAP1, BRAF, NRAS, c-KIT, PTEN, SF3B1, and TERT genes. Recurrences and metastasis were present in eight (29%) and nine (32%) CM cases, respectively. TERT promoter mutations were most common (54%), but BRAF (46%), NRAS (21%), BAP1 (18%), PTEN (14%), c-KIT (7%), and SF3B1 (4%) mutations were also observed. No mutations in GNAQ, GNA11, and EIF1AX were found. None of the mutations was significantly associated with recurrent disease. Presence of a TERT promoter mutation was associated with metastatic disease (p-value = 0.008). Based on our molecular findings, CM comprises a separate entity within melanoma, although there are overlapping molecular features with uveal melanoma, such as the presence of BAP1 and SF3B1 mutations. This warrants careful interpretation of molecular data, in the light of clinical findings. About three quarter of CM contain drug-targetable mutations, and TERT promoter mutations are correlated to metastatic disease in CM.
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Affiliation(s)
- Natasha M. van Poppelen
- Department of Ophthalmology, Erasmus MC University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (N.M.v.P.); (J.V.); (T.B.); (B.E.); (D.P.); (N.N.); (E.K.)
- Department of Clinical Genetics, Erasmus MC University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (F.M.); (E.B.); (A.d.K.)
| | - Jolique A. van Ipenburg
- Department of Pathology, Section Ophthalmic Pathology, Erasmus MC University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (J.A.v.I.); (Q.v.d.B.); (H.J.D.)
- Department of Pathology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
| | - Quincy van den Bosch
- Department of Pathology, Section Ophthalmic Pathology, Erasmus MC University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (J.A.v.I.); (Q.v.d.B.); (H.J.D.)
| | - Jolanda Vaarwater
- Department of Ophthalmology, Erasmus MC University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (N.M.v.P.); (J.V.); (T.B.); (B.E.); (D.P.); (N.N.); (E.K.)
- Department of Clinical Genetics, Erasmus MC University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (F.M.); (E.B.); (A.d.K.)
| | - Tom Brands
- Department of Ophthalmology, Erasmus MC University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (N.M.v.P.); (J.V.); (T.B.); (B.E.); (D.P.); (N.N.); (E.K.)
- Department of Clinical Genetics, Erasmus MC University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (F.M.); (E.B.); (A.d.K.)
| | - Bert Eussen
- Department of Ophthalmology, Erasmus MC University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (N.M.v.P.); (J.V.); (T.B.); (B.E.); (D.P.); (N.N.); (E.K.)
- Department of Clinical Genetics, Erasmus MC University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (F.M.); (E.B.); (A.d.K.)
| | - Frank Magielsen
- Department of Clinical Genetics, Erasmus MC University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (F.M.); (E.B.); (A.d.K.)
| | - Hendrikus J. Dubbink
- Department of Pathology, Section Ophthalmic Pathology, Erasmus MC University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (J.A.v.I.); (Q.v.d.B.); (H.J.D.)
| | - Dion Paridaens
- Department of Ophthalmology, Erasmus MC University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (N.M.v.P.); (J.V.); (T.B.); (B.E.); (D.P.); (N.N.); (E.K.)
- Department of Ocular Oncology, The Rotterdam Eye Hospital, Schiedamse Vest 180, 3011 BH Rotterdam, The Netherlands
| | - Erwin Brosens
- Department of Clinical Genetics, Erasmus MC University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (F.M.); (E.B.); (A.d.K.)
| | - Nicole Naus
- Department of Ophthalmology, Erasmus MC University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (N.M.v.P.); (J.V.); (T.B.); (B.E.); (D.P.); (N.N.); (E.K.)
| | - Annelies de Klein
- Department of Clinical Genetics, Erasmus MC University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (F.M.); (E.B.); (A.d.K.)
| | - Emine Kiliç
- Department of Ophthalmology, Erasmus MC University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (N.M.v.P.); (J.V.); (T.B.); (B.E.); (D.P.); (N.N.); (E.K.)
| | - Robert M. Verdijk
- Department of Pathology, Section Ophthalmic Pathology, Erasmus MC University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (J.A.v.I.); (Q.v.d.B.); (H.J.D.)
- Department of Ocular Oncology, The Rotterdam Eye Hospital, Schiedamse Vest 180, 3011 BH Rotterdam, The Netherlands
- Department of Pathology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
- Correspondence:
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26
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van Poppelen NM, de Bruyn DP, Bicer T, Verdijk R, Naus N, Mensink H, Paridaens D, de Klein A, Brosens E, Kiliҫ E. Genetics of Ocular Melanoma: Insights into Genetics, Inheritance and Testing. Int J Mol Sci 2020; 22:E336. [PMID: 33396957 PMCID: PMC7795687 DOI: 10.3390/ijms22010336] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/04/2020] [Accepted: 12/24/2020] [Indexed: 12/18/2022] Open
Abstract
Ocular melanoma consists of posterior uveal melanoma, iris melanoma and conjunctival melanoma. These malignancies derive from melanocytes in the uveal tract or conjunctiva. The genetic profiles of these different entities differ from each other. In uveal melanoma, GNAQ and GNA11 gene mutations are frequently found and prognosis is based on mutation status of BAP1, SF3B1 and EIF1AX genes. Iris melanoma, also originating from the uvea, has similarities to the genetic makeups of both posterior uveal melanoma (UM) and conjunctival melanoma since mutations in GNAQ and GNA11 are less common and genes involved in conjunctival melanoma such as BRAF have been described. The genetic spectrum of conjunctival melanoma, however, includes frequent mutations in the BRAF, NRAS and TERT promoter genes, which are found in cutaneous melanoma as well. The BRAF status of the tumor is not correlated to prognosis, whereas the TERT promoter gene mutations are. Clinical presentation, histopathological characteristics and copy number alterations are associated with survival in ocular melanoma. Tissue material is needed to classify ocular melanoma in the different subgroups, which creates a need for the use of noninvasive techniques to prognosticate patients who underwent eye preserving treatment.
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Affiliation(s)
- Natasha M. van Poppelen
- Department of Ophthalmology, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands; (N.M.v.P.); (D.P.d.B.); (T.B.); (N.N.); (D.P.)
- Department of Clinical Genetics, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands; (A.d.K.); (E.B.)
| | - Daniël P. de Bruyn
- Department of Ophthalmology, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands; (N.M.v.P.); (D.P.d.B.); (T.B.); (N.N.); (D.P.)
- Department of Clinical Genetics, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands; (A.d.K.); (E.B.)
| | - Tolga Bicer
- Department of Ophthalmology, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands; (N.M.v.P.); (D.P.d.B.); (T.B.); (N.N.); (D.P.)
- Department of Ophthalmology, University of Health Sciences Diskapi Training and Research Hospital, Ankara 06330, Turkey
| | - Rob Verdijk
- Department of Pathology, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands;
- Department of Pathology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Nicole Naus
- Department of Ophthalmology, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands; (N.M.v.P.); (D.P.d.B.); (T.B.); (N.N.); (D.P.)
| | - Hanneke Mensink
- Department of Ophthalmic Oncology, The Rotterdam Eye Hospital, 3011 BH Rotterdam, The Netherlands;
| | - Dion Paridaens
- Department of Ophthalmology, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands; (N.M.v.P.); (D.P.d.B.); (T.B.); (N.N.); (D.P.)
- Department of Ophthalmic Oncology, The Rotterdam Eye Hospital, 3011 BH Rotterdam, The Netherlands;
| | - Annelies de Klein
- Department of Clinical Genetics, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands; (A.d.K.); (E.B.)
| | - Erwin Brosens
- Department of Clinical Genetics, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands; (A.d.K.); (E.B.)
| | - Emine Kiliҫ
- Department of Ophthalmology, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands; (N.M.v.P.); (D.P.d.B.); (T.B.); (N.N.); (D.P.)
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27
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van Ipenburg JA, Naus NC, Dubbink HJ, van Ginderdeuren R, Missotten GS, Paridaens D, Verdijk RM. Prognostic value of TERT promoter mutations in conjunctival melanomas in addition to clinicopathological features. Br J Ophthalmol 2020; 105:1454-1461. [PMID: 33127831 DOI: 10.1136/bjophthalmol-2020-317405] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/29/2020] [Accepted: 10/08/2020] [Indexed: 12/23/2022]
Abstract
AIMS To evaluate the prognostic value of clinical, histopathological and molecular features and to relate different treatment modalities to clinical outcome in conjunctival melanomas (CM). METHODS Retrospective review of clinical, histopathological and BRAF V600E and telomerase reverse transcriptase (TERT) promoter mutation status and treatment modalities, correlated to recurrence and metastasis in 79 patients with CM, diagnosed between 1987 and 2015 in three tertiary referral centres in the Netherlands and Belgium. RESULTS Out of 78 evaluable patients, recurrences occurred in 16 patients and metastasis in 12 patients (median follow-up time 35 months (0-260 months)). Tumour thickness >2 mm, pT status, the presence of epithelioid cells, ulceration and mitoses was significantly correlated with metastasis (p value 0.046, 0.01, 0.02, 0.001 and 0.003, respectively). Furthermore, CM frequently harbour BRAF V600E and TERT promoter mutations (29% and 43%, respectively). TERT promoter mutations were correlated to shorter metastasis-free survival (p value 0.002). No significant correlation was found for clinical parameters and metastatic disease. Palpebral, forniceal and caruncular melanomas were more prone to develop recurrences (p value: 0.03). Most CM were treated with excision with adjuvant therapy. CONCLUSION In line with the recommendations in the Eighth Edition of the American Joint Committee on Cancer Staging for CM, the pathology report should include information about pT status, tumour thickness, presence of epithelioid cells, ulceration and mitoses. Furthermore, information about the presence of a TERT promoter mutation and BRAF V600E mutation is of interest for therapeutic decision making. The presence of a TERT promoter mutation is correlated to metastatic disease.
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Affiliation(s)
| | - N C Naus
- Ophthalmology, Erasmus MC, Medical Centre, Rotterdam, Netherlands
| | - H J Dubbink
- Erasmus Medical Center, Rotterdam, Zuid-Holland,Netherlands
| | - R van Ginderdeuren
- Department of Ophthalmology and Pathology, University Hospital Leuven, Leuven, Belgium
| | - G S Missotten
- Ophthalmology, KU Leuven University Hospitals Leuven Gasthuisberg Campus Hospital Pharmacy, Leuven, Flanders, Belgium
| | - D Paridaens
- Rotterdam Eye Hospital, Rotterdam, Netherlands
| | - R M Verdijk
- Pathology, Erasmus University Medical Center, Rotterdam, Netherlands /
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28
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Quaranta-Leoni FM, Paridaens D, Verity D. European Society of Ophthalmic Plastic and Reconstructive Surgery (ESOPRS) recommendations for oculoplastic surgeons during the COVID-19 pandemic: a hallenge for the future. Orbit 2020; 39:460-462. [PMID: 32808834 DOI: 10.1080/01676830.2020.1808022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In March 2020, at the outset of the current pandemic, ESOPRS issued detailed advice on the appropriate procedures that practicing oculoplastic surgeons should consider to limit the transmission of COVID-19, with this information updated in April 2020. This paper highlights the threat to training opportunities for future generations of oculoplastic surgeons, adjustments in healthcare delivery, modifications of scientific activity, and the possible role of telemedicine in oculoplastics.
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Affiliation(s)
- Francesco M Quaranta-Leoni
- Oftalmoplastica Roma , Rome, Italy.,Orbital and Adnexal Service, Villa Tiberia Hospital - GVM Care & Research , Rome, Italy
| | - Dion Paridaens
- Oculoplastic, Lacrimal & Orbital Service, Rotterdam Eye Hospital , Rotterdam, Netherlands.,Department of Ophthalmology, Erasmus Medical Center , Rotterdam, Netherlands
| | - David Verity
- Adnexal Service, Moorfields Eye Hospital , London, UK
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Abstract
Cellular angiofibroma is a benign mesenchymal tumor most commonly located in the distal genital tract of both men and women. Although extragenital locations have been reported rarely, this is the first report of cellular angiofibroma of the orbit. A 58-year-old man presented with a mass in the left superomedial orbit since 2 years. Magnetic resonance imaging showed a well-demarcated lesion with a homogeneous intermediate signal intensity on both T1- and T2-weighted images, homogeneous contrast enhancement and high signal intensity on diffusion-weighted images. Complete excision was performed through a medial upper eyelid crease incision. Histopathology showed a vascular CD34-positive and STAT6-negative spindle cell tumor with monoallelic loss of FOXO1, indicating cellular angiofibroma.
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Affiliation(s)
- G J Hötte
- Department of Oculoplastic, Orbital and Lacrimal Surgery, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - R M Verdijk
- Department of Oculoplastic, Orbital and Lacrimal Surgery, The Rotterdam Eye Hospital, Rotterdam, The Netherlands.,Department of Pathology, Section Ophthalmic Pathology, Erasmus MC, University Medical Center Rotterdam, The Netherlands
| | - M Gardeniers
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, The Netherlands
| | - D Paridaens
- Department of Oculoplastic, Orbital and Lacrimal Surgery, The Rotterdam Eye Hospital, Rotterdam, The Netherlands.,Department of Ophthalmology, Orbital Service, Erasmus MC, University Medical Center Rotterdam, The Netherlands
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Hötte GJ, Meijer N, Verdijk RM, Paridaens D. Accelerated growth of orbital schwannomas during pregnancy does not correlate with sex hormone- or growth factor receptor status. Orbit 2020; 40:120-126. [PMID: 32264727 DOI: 10.1080/01676830.2020.1747498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Purpose: Until now, three cases of growth of an orbital schwannoma during pregnancy have been published. We aim to provide additional insight in the effect of pregnancy on orbital schwannomas. Methods: We present two additional cases of accelerated growth of orbital schwannomas during pregnancy and investigate receptor expression profiles for estrogen, progesterone, androgen, VEGF, EGF, FGF, PDGF-Rβ and ki-67 in the two pregnant cases and six non-pregnant cases. Results: Case 1: A 26-year-old woman developed unilateral exophthalmos during pregnancy, with normal visual acuity and ocular motility. During a subsequent pregnancy, again the exophthalmos progressed. MRI showed a mass suggestive of schwannoma. After delivery, resection of the lesion was performed through an anterior approach. Pathology confirmed schwannoma. The expression profile was positive for estrogen- and FGF receptors and ki-67, but negative for progesterone-, androgen- and other growth factor receptors. Case 2: A 24-year-old woman presented with diplopia and unilateral pain during pregnancy. She had normal visual acuity, but a mild exophthalmos and elevation deficit. MRI revealed an extraconal mass suggestive of schwannoma. After delivery, resection was performed through an anterior approach. Pathology confirmed the diagnosis. The expression profile was positive for ki-67, but negative for sex hormone- and growth factor receptors. In the six non-pregnant cases the expression profiles varied, with only one subject showing a strong expression of estrogen-, progesterone- and androgen receptors. Conclusions: Orbital schwannomas can experience growth during pregnancy. The underlying mechanism remains unclear as hormone- and growth factor expression profiles show no correlation to the pregnant state.
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Affiliation(s)
- G J Hötte
- Department of Oculoplastic, Orbital and Lacrimal Surgery, the Rotterdam Eye Hospital , Rotterdam, The Netherlands
| | - N Meijer
- Department of Oculoplastic, Orbital and Lacrimal Surgery, the Rotterdam Eye Hospital , Rotterdam, The Netherlands
| | - R M Verdijk
- Department of Oculoplastic, Orbital and Lacrimal Surgery, the Rotterdam Eye Hospital , Rotterdam, The Netherlands.,Department of Pathology, Section Ophthalmic Pathology, Erasmus MC University Medical Center Rotterdam , Rotterdam, The Netherlands
| | - D Paridaens
- Department of Oculoplastic, Orbital and Lacrimal Surgery, the Rotterdam Eye Hospital , Rotterdam, The Netherlands.,Department of Ophthalmology, Orbital Service, Erasmus MC University Medical Center Rotterdam , Rotterdam, The Netherlands.,Oculoplastic & Orbital Service, ELZA Clinic , Zurich, Switzerland
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31
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van Ipenburg JA, Gillis, Ing AJ, Dorssers LC, van den Bosch QC, van Ginderdeuren R, Missotten GS, Naus N, Paridaens D, Looijenga LH, Verdijk RM. MicroRNA Profiling in Benign and Malignant Conjunctival Melanocytic Lesions. Ophthalmology 2020; 127:432-434. [DOI: 10.1016/j.ophtha.2019.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/04/2019] [Accepted: 10/07/2019] [Indexed: 12/16/2022] Open
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32
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van Ipenburg JA, Damman J, Paridaens D, Verdijk RM. Histopathological and Molecular Features of a Conjunctival Caruncular Deep Penetrating Nevus. Ocul Oncol Pathol 2020; 6:293-296. [PMID: 33005620 DOI: 10.1159/000504966] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 11/21/2019] [Indexed: 11/19/2022] Open
Abstract
We describe the first presentation of a deep penetrating nevus (DPN) on the lacrimal caruncle. This lesion was seen in an 18-year-old woman presenting with hemorrhage of a long-standing pigmented mass on the caruncle. Histology showed a combined melanocytic neoplasm that consisted of two different melanocytic components. The differential diagnosis, based on histological examination, was a conventional melanocytic nevus, a Spitz nevus, or a combined melanocytic nevus. On the molecular level, one of the components revealed a mutation in the CTNNB1 gene encoding the β-catenin protein, while both components harbored a BRAF V600E mutation, without molecular features of a malignant melanocytic lesion. This presentation of a DPN of the lacrimal caruncle emphasizes the similarities of the caruncle with the skin.
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Affiliation(s)
- Jolique A van Ipenburg
- Section of Ophthalmic Pathology, Department of Pathology, Erasmus MC - University Medical Center, Rotterdam, The Netherlands
| | - Jeffrey Damman
- Section of Ophthalmic Pathology, Department of Pathology, Erasmus MC - University Medical Center, Rotterdam, The Netherlands
| | - Dion Paridaens
- The Rotterdam Eye Hospital, Rotterdam, The Netherlands.,Department of Ophthalmology, Erasmus MC - University Medical Center, Rotterdam, The Netherlands
| | - Robert M Verdijk
- Section of Ophthalmic Pathology, Department of Pathology, Erasmus MC - University Medical Center, Rotterdam, The Netherlands.,The Rotterdam Eye Hospital, Rotterdam, The Netherlands.,Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
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33
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Virakul S, Somparn P, Pisitkun T, van der Spek PJ, Dalm VASH, Paridaens D, van Hagen PM, Hirankarn N, Palaga T, Dik WA. Integrative Analysis of Proteomics and DNA Methylation in Orbital Fibroblasts From Graves' Ophthalmopathy. Front Endocrinol (Lausanne) 2020; 11:619989. [PMID: 33658982 PMCID: PMC7919747 DOI: 10.3389/fendo.2020.619989] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 12/21/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Graves' ophthalmopathy (GO) is a frequent extrathyroidal complication of Graves' hyperthyroidism. Orbital fibroblasts contribute to both orbital tissue inflammation and remodeling in GO, and as such are crucial cellular elements in active GO and inactive GO. However, so far it is largely unknown whether GO disease progression is associated with functional reprogramming of the orbital fibroblast effector function. Therefore, the aim of this study was to compare both the proteome and global DNA methylation patterns between orbital fibroblasts isolated from active GO, inactive GO and healthy controls. METHODS Orbital fibroblasts from inactive GO (n=5), active GO (n=4) and controls (n=5) were cultured and total protein and DNA was isolated. Labelled and fractionated proteins were analyzed with a liquid chromatography tandem-mass spectrometer (LC-MS/MS). Data are available via ProteomeXchange with identifier PXD022257. Furthermore, bisulphite-treated DNA was analyzed for methylation pattern with the Illumina Infinium Human Methylation 450K beadchip. In addition, RNA was isolated from the orbital fibroblasts for real-time quantitative (RQ)-PCR. Network and pathway analyses were performed. RESULTS Orbital fibroblasts from active GO displayed overexpression of proteins that are typically involved in inflammation, cellular proliferation, hyaluronan synthesis and adipogenesis, while various proteins associated with extracellular matrix (ECM) biology and fibrotic disease, were typically overexpressed in orbital fibroblasts from inactive GO. Moreover, orbital fibroblasts from active GO displayed hypermethylation of genes that linked to inflammation and hypomethylated genes that linked to adipogenesis and autoimmunity. Further analysis revealed networks that contained molecules to which both hypermethylated and hypomethylated genes were linked, including NF-κB, ERK1/2, Alp, RNA polymerase II, Akt and IFNα. In addition, NF-κB, Akt and IFNα were also identified in networks that were derived from the differentially expressed proteins. Generally, poor correlation between protein expression, DNA methylation and mRNA expression was observed. CONCLUSIONS Both the proteomics and DNA methylation data support that orbital fibroblasts from active GO are involved in inflammation, adipogenesis, and glycosaminoglycan production, while orbital fibroblasts from inactive disease are more skewed towards an active role in extracellular matrix remodeling. This switch in orbital fibroblast effector function may have therapeutic implications and further studies into the underlying mechanism are thus warranted.
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Affiliation(s)
- Sita Virakul
- Department of Microbiology, Faculty of Science, Chulalongkorn University, Bangkok, Thailand
| | - Poorichaya Somparn
- Center of Excellence in Systems Biology, Research affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Translational Research in Inflammation and Immunology Research Unit (TRIRU), Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Trairak Pisitkun
- Center of Excellence in Systems Biology, Research affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Peter J. van der Spek
- Department of Bioinformatics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Virgil A. S. H. Dalm
- Department of Immunology, Laboratory Medical Immunology, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Internal Medicine, Division of Clinical Immunology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Dion Paridaens
- Rotterdam Eye Hospital, Rotterdam, Netherlands
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands
| | - P. Martin van Hagen
- Department of Immunology, Laboratory Medical Immunology, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Internal Medicine, Division of Clinical Immunology, Erasmus University Medical Center, Rotterdam, Netherlands
- Rotterdam Eye Hospital, Rotterdam, Netherlands
| | - Nattiya Hirankarn
- Center of Excellence in Immunology and Immune Mediated Diseases, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Tanapat Palaga
- Department of Microbiology, Faculty of Science, Chulalongkorn University, Bangkok, Thailand
| | - Willem A. Dik
- Department of Immunology, Laboratory Medical Immunology, Erasmus University Medical Center, Rotterdam, Netherlands
- *Correspondence: Willem A. Dik,
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van Ipenburg JA, de Waard NE, Naus NC, Jager MJ, Paridaens D, Verdijk RM. Chemokine Receptor Expression Pattern Correlates to Progression of Conjunctival Melanocytic Lesions. Invest Ophthalmol Vis Sci 2019; 60:2950-2957. [PMID: 31305861 DOI: 10.1167/iovs.19-27162] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Chemokines play a role in the progression and metastatic spread of both cutaneous and uveal melanomas. The aim of this study was to examine the prognostic value of expression of chemokine receptors CCR7, CXCR4, and CCR10 in conjunctival melanocytic lesions. Methods In total, 44 conjunctival nevi, 21 cases of primary acquired melanosis (PAM) with atypia and 35 conjunctival melanomas, were included. After immunohistochemical staining for CCR7, CXCR4, and CCR10 the immunoreactive score (IRS) was determined. The findings were correlated for association with melanoma and development of metastasis. For mechanistic evaluation, we used a mouse melanoma metastasis model using two human conjunctival melanoma cell lines, CM2005.1 and CRMM1. Results All tested chemokines showed a significantly higher expression in conjunctival melanoma than conjunctival nevi. There was a statistically significant difference between the IRS in nevi and PAM with atypia for nuclear IRS in CCR10 (P = 0.03) and both nuclear and cytoplasmic IRS in CXCR4 (P < 0.01 and P = 0.03, respectively); this was also true evaluating the groups PAM with atypia and melanoma all together (P < 0.01). Furthermore, a trend for lower IRS was seen in cases of melanoma without metastasis, with a suggestive pattern of a higher IRS in cases that did develop metastases, supported for CXCR4 using the mouse melanoma metastasis model. Conclusions Expression of specific chemokines changes during the progression and metastatic spread of conjunctival melanocytic lesions. Differential chemokine profiles may hold prognostic value for patients with conjunctival melanomas and might be considered as a therapeutic target.
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Affiliation(s)
| | - Nadine E de Waard
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Nicole C Naus
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Martine J Jager
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Dion Paridaens
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands.,The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Robert M Verdijk
- Department of Pathology, Erasmus University Medical Center, Rotterdam, The Netherlands.,The Rotterdam Eye Hospital, Rotterdam, The Netherlands.,Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
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Detiger SE, Karim F, Monserez D, Verdijk R, van Hagen M, Paridaens D, van Laar J. IgG4-Related Disease of Skull Base: Case Series of 3 Patients with Headache. World Neurosurg 2019; 134:536-539. [PMID: 31669684 DOI: 10.1016/j.wneu.2019.10.111] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/17/2019] [Accepted: 10/18/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND IgG4-related disease (IgG4-RD) is an immune-mediated, systemic, fibroinflammatory disease. IgG4-RD may manifest in almost every part of the human body. Here, we describe 3 patients with a skull base manifestation of IgG4-RD that mimicked malignancy. CASE DESCRIPTION Patient 1, a 73-year-old male, presented with a mass in the left nasopharynx and clivus. Patient 2, a 73-year-old male, presented with a mass in the left petrous bone and clivus with involvement of the left jaw joint. Patient 3, a 50-year-old male, presented with a lytic lesion of the clivus and sphenoid bone. All patients complained of headache and hearing loss. Serum IgG4 was normal, and imaging did not show systemic manifestation. Histology established the diagnosis of IgG4-RD. Two patients were treated successfully with prednisolone, hydroxychloroquine, and radiotherapy. One patient is monitored without treatment. CONCLUSIONS The described cases emphasize the broad clinical spectrum of IgG4-RD. The diagnostic workup may be challenging, and serum IgG4 may be normal, as demonstrated in these cases. Careful histopathologic examination of the tissues remains essential. Timely diagnosis of IgG4-RD is important to prevent secondary organ damage in patients with active disease.
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Affiliation(s)
| | - Faiz Karim
- Department of Internal Medicine and Immunology, Section Clinical Immunology, Erasmus MC, GD Rotterdam, The Netherlands; Department of Internal Medicine, Groene Hart Hospital, Gouda, The Netherlands
| | - Dominiek Monserez
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, GD Rotterdam, The Netherlands
| | - Robert Verdijk
- Department of Pathology, Section Ophthalmic Pathology, Erasmus MC, GD Rotterdam, The Netherlands
| | - Martin van Hagen
- Department of Internal Medicine and Immunology, Section Clinical Immunology, Erasmus MC, GD Rotterdam, The Netherlands
| | - Dion Paridaens
- The Rotterdam Eye Hospital, BH Rotterdam, The Netherlands; Department of Ophthalmology, Erasmus MC, GD Rotterdam, The Netherlands
| | - Jan van Laar
- Department of Internal Medicine and Immunology, Section Clinical Immunology, Erasmus MC, GD Rotterdam, The Netherlands
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Hötte GJ, Koudstaal MJ, Verdijk RM, Titulaer MJ, Claes JFHM, Strabbing EM, van der Lugt A, Paridaens D. Intracranial actinomycosis of odontogenic origin masquerading as auto-immune orbital myositis: a fatal case and review of the literature. BMC Infect Dis 2019; 19:763. [PMID: 31477035 PMCID: PMC6720412 DOI: 10.1186/s12879-019-4408-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 08/25/2019] [Indexed: 11/13/2022] Open
Abstract
Background Actinomycetes can rarely cause intracranial infection and may cause a variety of complications. We describe a fatal case of intracranial and intra-orbital actinomycosis of odontogenic origin with a unique presentation and route of dissemination. Also, we provide a review of the current literature. Case presentation A 58-year-old man presented with diplopia and progressive pain behind his left eye. Six weeks earlier he had undergone a dental extraction, followed by clindamycin treatment for a presumed maxillary infection. The diplopia responded to steroids but recurred after cessation. The diplopia was thought to result from myositis of the left medial rectus muscle, possibly related to a defect in the lamina papyracea. During exploration there was no abnormal tissue for biopsy. The medial wall was reconstructed and the myositis responded again to steroids. Within weeks a myositis on the right side occurred, with CT evidence of muscle swelling. Several months later he presented with right hemiparesis and dysarthria. Despite treatment the patient deteriorated, developed extensive intracranial hemorrhage, and died. Autopsy showed bacterial aggregates suggestive of actinomycotic meningoencephalitis with septic thromboembolism. Retrospectively, imaging studies showed abnormalities in the left infratemporal fossa and skull base and bilateral cavernous sinus. Conclusions In conclusion, intracranial actinomycosis is difficult to diagnose, with potentially fatal outcome. An accurate diagnosis can often only be established by means of histology and biopsy should be performed whenever feasible. This is the first report of actinomycotic orbital involvement of odontogenic origin, presenting initially as bilateral orbital myositis rather than as orbital abscess. Infection from the upper left jaw extended to the left infratemporal fossa, skull base and meninges and subsequently to the cavernous sinus and the orbits. Electronic supplementary material The online version of this article (10.1186/s12879-019-4408-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- G J Hötte
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands. .,Department of Orbital Oculoplastic and Lacrimal Surgery, The Rotterdam Eye Hospital, PO box 70030, 3000 LM, Rotterdam, The Netherlands.
| | - M J Koudstaal
- Department of Oral and Maxillofacial Surgery, Erasmus Medical Center, Rotterdam, The Netherlands
| | - R M Verdijk
- Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - M J Titulaer
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - J F H M Claes
- Department of Neurology, Franciscus Gasthuis and Vlietland, Rotterdam, The Netherlands
| | - E M Strabbing
- Department of Oral and Maxillofacial Surgery, Erasmus Medical Center, Rotterdam, The Netherlands
| | - A van der Lugt
- Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - D Paridaens
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Orbital Oculoplastic and Lacrimal Surgery, The Rotterdam Eye Hospital, PO box 70030, 3000 LM, Rotterdam, The Netherlands
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Drabarek W, Yavuzyigitoglu S, Obulkasim A, van Riet J, Smit KN, van Poppelen NM, Vaarwater J, Brands T, Eussen B, Verdijk RM, Naus NC, Mensink HW, Paridaens D, Boersma E, van de Werken HJG, Kilic E, de Klein A. Multi-Modality Analysis Improves Survival Prediction in Enucleated Uveal Melanoma Patients. ACTA ACUST UNITED AC 2019; 60:3595-3605. [DOI: 10.1167/iovs.18-24818] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Wojtek Drabarek
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Serdar Yavuzyigitoglu
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Askar Obulkasim
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Pediatric Oncology/Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Job van Riet
- Cancer Computational Biology Center, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Kyra N. Smit
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Natasha M. van Poppelen
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jolanda Vaarwater
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Tom Brands
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Bert Eussen
- Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Robert M. Verdijk
- Department of Pathology, Section Ophthalmic Pathology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
- The Rotterdam Eye Hospital, Rotterdam, The Netherlands
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Nicole C. Naus
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Dion Paridaens
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
- The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Eric Boersma
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Harmen J. G. van de Werken
- Cancer Computational Biology Center, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Emine Kilic
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Annelies de Klein
- Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
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Detiger SE, Karim AF, Verdijk RM, van Hagen PM, van Laar JAM, Paridaens D. The treatment outcomes in IgG4-related orbital disease: a systematic review of the literature. Acta Ophthalmol 2019; 97:451-459. [PMID: 30734497 DOI: 10.1111/aos.14048] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 01/12/2019] [Indexed: 12/14/2022]
Abstract
IgG4-related disease (IgG4-RD) is an immune-mediated systemic fibro inflammatory disease. Treatment of IgG4-related orbital disease (IgG4-ROD) is often indicated to relieve the symptoms and to prevent complications. For IgG4-ROD, no international formal treatment guidelines are available and the optimal treatment strategy is uncertain. In this systematic review, we describe the efficacy of conventional and biologic disease-modifying antirheumatic drugs (DMARDs) in IgG4-ROD. A systematic search of Embase, Medline, Web-of-Science, PubMed publisher, Cochrane and Google Scholar was performed for treatment outcomes in IgG4-ROD. Relevant articles on treatment of IgG4-ROD were retrieved to last date of inclusion 3 January 2018. The following inclusion criteria were used: articles in English or English translation, studies evaluating the use of DMARDs (conventional and biologic) in the treatment of IgG4-ROD. Meta-analysis and review articles were excluded. A final selection after full-text evaluation was made by independent reviewers, based on treatment of IgG4-ROD with DMARDs and the availability of treatment outcomes. With this systematic review, we identified 35 studies and case reports/series on IgG4-ROD, describing 95 patients, treated with conventional and/or biologic DMARDs. The success of conventional DMARDs varies between 36% and 75% in patients with IgG4-ROD, while rituximab is successful in the majority (93%) of the patients. Based on this systematic review, rituximab is the most effective DMARD in IgG4-ROD, while the efficacy of conventional DMARDs is limited. We propose early initiation of rituximab in case of refractory and organ- or life-threatening disease.
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Affiliation(s)
| | - A. Faiz Karim
- Departments of Internal Medicine and Immunology Section Clinical Immunology Erasmus MC Rotterdam the Netherlands
- Department of Internal Medicine Groene Hart Hospital Gouda the Netherlands
| | - Robert M. Verdijk
- Department of Pathology Section Ophthalmic Pathology Erasmus MC Rotterdam the Netherlands
| | - P. Martin van Hagen
- Departments of Internal Medicine and Immunology Section Clinical Immunology Erasmus MC Rotterdam the Netherlands
| | - Jan A. M. van Laar
- Departments of Internal Medicine and Immunology Section Clinical Immunology Erasmus MC Rotterdam the Netherlands
| | - Dion Paridaens
- The Rotterdam Eye Hospital Rotterdam the Netherlands
- Department of Ophthalmology Erasmus MC Rotterdam the Netherlands
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Mol I, Paridaens D. Efficacy of lateral eyelid-block excision with canthoplasty and full-thickness skin grafting in lower eyelid cicatricial ectropion. Acta Ophthalmol 2019; 97:e657-e661. [PMID: 30390376 PMCID: PMC6619400 DOI: 10.1111/aos.13958] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 09/27/2018] [Indexed: 11/30/2022]
Abstract
Purpose To report on the outcomes of our preferred surgical technique for the correction of lower eyelid cicatricial ectropion Methods We conducted a retrospective, nonrandomized, interventional analysis of a consecutive case series of patients with cicatricial lower lid ectropion treated with adhesiolysis, lateral eyelid‐block excision with canthoplasty and full‐thickness skin grafting. Donor sites included the ipsi‐ or contralateral upper eyelid and pre‐ or retroauricular skin. All patients were treated by one of our oculoplastic surgeons in the period from January 2005 to January 2017 in the Rotterdam Eye Hospital/Focus Clinic Rotterdam. We assessed postoperative lower eyelid apposition, the occurrence of intra‐ and postoperative complications and the reoperation rate. Results We included 38 eyelids of 32 patients, of whom 17 were male and 15 were female. The minimal postoperative follow‐up was 3 months. A total of 27 of 38 eyelids showed good postoperative apposition. Skin graft donor sites were the ipsi‐ or contralateral upper eyelid (47% and 16%, respectively) and the pre‐ or retroauricular skin (26% and 11%, respectively). No intraoperative complications occurred, but one patient developed a transient allergic contact dermatitis in the early postoperative phase. Two of 38 eyelids (two of 32 patients) required another surgical intervention (block excision) for residual or recurrent ectropion, with favourable outcomes. There was 100% viability of the skin grafts. Conclusion Repair of lower eyelid ectropion with lateral block excision, canthoplasty and full‐thickness skin grafting is an effective procedure with minimal donor site morbidity, excellent graft survival rates and a low reoperation rate.
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Affiliation(s)
- Ilse Mol
- Department of Ophthalmology Erasmus Medical Center Rotterdam The Netherlands
- Department of Oculoplastic and Orbital Surgery Rotterdam Eye Hospital Rotterdam The Netherlands
| | - Dion Paridaens
- Department of Oculoplastic and Orbital Surgery Rotterdam Eye Hospital Rotterdam The Netherlands
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40
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Schrijver B, Kooiman MA, Kasteleijn E, van Holten-Neelen C, Virakul S, Paridaens D, Peeters RP, van Hagen PM, Dalm VASH, Dik WA. Basic Fibroblast Growth Factor Induces Adipogenesis in Orbital Fibroblasts: Implications for the Pathogenesis of Graves' Orbitopathy. Thyroid 2019; 29:395-404. [PMID: 30724135 DOI: 10.1089/thy.2018.0544] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Basic fibroblast growth factor (bFGF) has been implicated in the pathogenesis of Graves' orbitopathy (GO). It stimulates several processes, including hyaluronan synthesis, involved in orbital tissue volume expansion and may act synergistically with platelet-derived growth factor (PDGF)-BB. PDGF-BB is known to stimulate adipogenesis in orbital fibroblasts, but the effect of bFGF on adipogenesis in orbital fibroblasts is so far unknown. This study was conducted to determine whether (i) bFGF induces adipogenesis in orbital fibroblasts, (ii) bFGF and PDGF-BB together exert an additive or synergistic effect on adipogenesis, and (iii) treatment directed at bFGF- and PDGF-BB signaling may potentially be of interest for the treatment of GO. METHODS Orbital fibroblasts from GO patients and controls were cultured in adipocyte differentiation medium with or without bFGF and/or PDGF-BB at different concentrations. Adipogenesis was determined by Oil Red O staining and messenger RNA expression of the late adipocyte differentiation markers cell death-inducing DFFA-like effector C (CIDEC) and adiponectin (ADIPOQ). To demonstrate involvement of FGF-receptor and PDGF-receptor signaling, experiments were also conducted in the presence of dasatinib (inhibitor of PDGF-receptor) or nintedanib (inhibitor of PDGF-receptor and FGF-receptor). RESULTS bFGF significantly stimulated adipogenesis by orbital fibroblasts, as shown by increased Oil Red O staining and CIDEC and ADIPOQ expression after 14 days of differentiation. Furthermore, an additive effect of bFGF/PDGF-BB co-stimulation on adipogenesis was observed at the lowest concentration (12.5 ng/mL) of the growth factors tested. Nintedanib completely inhibited bFGF-, PDGF-BB-, and bFGF/PDGF-BB-induced adipogenesis, while dasatinib only fully abrogated PDGF-BB-induced adipogenesis. CONCLUSION bFGF induces adipogenesis in orbital fibroblasts and as such may contribute to GO. The additive effect of bFGF and PDGF-BB on adipogenesis, along with the observed inhibitory effects of dasatinib and nintedanib, point at independent receptor-mediated effects. This supports the hypothesis that multi-target directed therapy might be more efficient in the treatment of GO.
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Affiliation(s)
- Benjamin Schrijver
- 1 Department of Immunology, Laboratory Medical Immunology; Rotterdam, The Netherlands
| | - Merel A Kooiman
- 1 Department of Immunology, Laboratory Medical Immunology; Rotterdam, The Netherlands
| | - Esmee Kasteleijn
- 1 Department of Immunology, Laboratory Medical Immunology; Rotterdam, The Netherlands
| | | | - Sita Virakul
- 2 Department of Microbiology, Faculty of Science, Chulalongkorn University, Bangkok, Thailand
| | - Dion Paridaens
- 4 Academic Center for Thyroid Diseases; Rotterdam, The Netherlands
- 3 Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Robin P Peeters
- 4 Academic Center for Thyroid Diseases; Rotterdam, The Netherlands
- 5 Department of Internal Medicine; Erasmus MC, Rotterdam, The Netherlands
| | - P Martin van Hagen
- 1 Department of Immunology, Laboratory Medical Immunology; Rotterdam, The Netherlands
- 4 Academic Center for Thyroid Diseases; Rotterdam, The Netherlands
- 5 Department of Internal Medicine; Erasmus MC, Rotterdam, The Netherlands
| | - Virgil A S H Dalm
- 1 Department of Immunology, Laboratory Medical Immunology; Rotterdam, The Netherlands
- 4 Academic Center for Thyroid Diseases; Rotterdam, The Netherlands
- 5 Department of Internal Medicine; Erasmus MC, Rotterdam, The Netherlands
| | - Willem A Dik
- 1 Department of Immunology, Laboratory Medical Immunology; Rotterdam, The Netherlands
- 4 Academic Center for Thyroid Diseases; Rotterdam, The Netherlands
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Lai A Fat NNJ, Paridaens D, van den Bosch WA. Surgical correction of involutional lower lid entropion with lateral canthal eyelid block excision and imbrication of the capsulopalpebral ligament using non-buried non-resorbable imbricating sutures versus buried resorbable imbricating sutures. Orbit 2019; 38:7-12. [PMID: 29498554 DOI: 10.1080/01676830.2018.1446538] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 02/19/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE To compare the results of surgical correction of involutional lower eyelid entropion using either buried resorbable imbricating sutures or non-buried non-resorbable sutures that were removed after five to seven days. METHODS Retrospective analysis of a two-surgeon series. Analysis of the charts of patients surgically treated for involutional lower eyelid entropion between January 2011 and December 2014 with a minimum follow-up of 12 months. MAIN OUTCOME MEASURES Recurrence rate, postoperative complications. RESULTS We included 281 eyelids of 240 patients. Of these, 89 eyelids had been treated with buried resorbable imbricating sutures (surgeon WvdB) and 192 with non-buried non-resorbable sutures (surgeon DP). Of the 281 eyelids, 77 eyelids had undergone previous entropion surgery. In the buried resorbable suture group (group R), the mean follow-up was 30 months (range 12 to 61 months) versus 39 months (range 14 to 60 months) in the non-buried non-resorbable group (group NR) (p = 0.07). With a follow-up of up to 18 months, the recurrence rate was 2.2% in group R and 4.2% in group NR (p = 0.73). With a similar follow-up, the recurrence rate was 3.9% after primary surgery versus 2.6% in recurrent cases (p = 0.73). Minor postoperative complications and side-effects were seen in 5.3% (15/281). CONCLUSION We found no difference in the recurrence rate between the use of buried resorbable imbricating sutures and non-buried non-resorbable sutures and between primary versus recurrent cases. We conclude that we can safely use buried resorbable imbricating sutures in involutional entropion. It yields comparable results and omits the need for suture removal.
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Affiliation(s)
- Nathalie N J Lai A Fat
- a Department of Oculoplastic and Orbital Surgery , The Rotterdam Eye Hospital , Rotterdam , the Netherlands
| | - Dion Paridaens
- a Department of Oculoplastic and Orbital Surgery , The Rotterdam Eye Hospital , Rotterdam , the Netherlands
| | - Willem A van den Bosch
- a Department of Oculoplastic and Orbital Surgery , The Rotterdam Eye Hospital , Rotterdam , the Netherlands
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Affiliation(s)
| | | | | | - Rene J. Wubbels
- The Rotterdam Ophthalmic Institute; Rotterdam The Netherlands
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43
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de Keizer ROB, Kozdras G, Wubbels R, Van den Bosch WA, Paridaens D. Retrospective study in 608 cases on the rate of surgical site infections after orbital surgery without prophylactic systemic antibiotics. Br J Ophthalmol 2018; 103:1466-1468. [DOI: 10.1136/bjophthalmol-2018-312232] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 11/21/2018] [Accepted: 11/26/2018] [Indexed: 11/04/2022]
Abstract
ObjectiveTo determine postoperative surgical site infection (SSI) rates in three separate patient groups who underwent orbital surgery without prophylactic systemic antibiotics.Study designSingle-centre retrospective descriptive case series.Study populationWe studied the notes of 639 consecutive patients who had undergone orbital surgery in our hospital from 2009 through 2013. All patients belonged to either of three groups: (1) clean orbital surgery (n=226); (2) clean orbital surgery with implant (n=290); (3) clean-contaminated surgery (n=92). Thirty-one patients were excluded.ResultsOf the total of 608 patients, without systemic antibiotic prophylaxis, only five were diagnosed with SSI 5/608 (0.82%): 1/226 in the ‘clean’ group, 3/290 in the ‘clean-with-implant’ group and 1/92 in the ‘clean-contaminated’ group. All five patients with SSI were effectively treated with antibiotics.ConclusionIn this study ‘clean’, ‘clean-with-implant’ and ‘clean-contaminated’ orbital surgery was safely performed without prophylactic antibiotics. Where postoperative infection did occur, the patients were effectively treated with systemic antibiotics. We suggest to restrict the administration of systemic antibiotic prophylaxis in orbital surgery.
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44
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van Beek JG, Buitendijk GH, Timman R, Muller K, Luyten GP, Paridaens D, Naus NC, Kiliç E. Quality of life: fractionated stereotactic radiotherapy versus enucleation treatment in uveal melanoma patients. Acta Ophthalmol 2018; 96:841-848. [PMID: 30284368 DOI: 10.1111/aos.13823] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 04/13/2018] [Indexed: 12/17/2022]
Abstract
PURPOSE To report the quality of life and visual functioning in uveal melanoma patients treated with enucleation or fractionated stereotactic radiation therapy (fSRT). METHODS Uveal melanoma (UM) patients treated with fSRT (n = 65) or enucleation (n = 48) participated in this prospective study. Questionnaires to measure anxiety (State-Trait Anxiety Inventory), subjective distress (Impact of Event Scale) and quality of life (EORTC-QLQ-C30 and National Eye Institute Visual Function Questionnaire (VFQ-25)) were obtained before treatment and 2, 6, 12, 24, 36 and 48 months after treatment. RESULTS Less peripheral vision was observed until 3 years (p = 0.026) posttreatment in enucleated patients compared to irradiated patients. From 2 months until 3 years posttreatment irradiated patients increase in role functioning-score (p = 0.005), while enucleated patients decrease in score (p = 0.012). Regardless of their treatment, for all patients we measured a reduction in physical functioning (p = 0.035), insomnia (p < 0.001) and in state anxiety from pretreatment until 2 years posttreatment (p < 0.001). An increase in pain overall (p = 0.023) and in emotional functioning is observed 1 year posttreatment (p < 0.001). At baseline, patients with metastases (independent of their treatment) have more subjective distress (p = 0.037) than patients without metastases. The mean 'global health score' overall, without effect of time, was 76.4 (SD: 13.6). CONCLUSION Enucleated patients had more difficulty working or performing household tasks 2 months posttreatment compared to irradiated patients. Enucleated patients had diminished peripheral vision until 3 years compared to irradiated patients. Overall quality of life is not significantly different between both treatment groups.
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Affiliation(s)
- Jackelien G.M. van Beek
- Department of Ophthalmology; Erasmus University Medical Centre; Rotterdam the Netherlands
- Department of Ophthalmology; Albert Schweitzer Hospital; Dordrecht the Netherlands
| | - Gabrielle H.S. Buitendijk
- Department of Ophthalmology; Erasmus University Medical Centre; Rotterdam the Netherlands
- Department of Epidemiology; Erasmus University Medical Centre; Rotterdam the Netherlands
| | - Reinier Timman
- Department of Psychiatry; section of Medical Psychology and Psychotherapy; Erasmus University Medical Centre; Rotterdam the Netherlands
| | - Karin Muller
- Department of Radiotherapy; Radiotherapy group; Deventer the Netherlands
| | - Gregorius P.M. Luyten
- Department of Ophthalmology; Leiden University Medical Centre; Leiden the Netherlands
| | | | - Nicole C. Naus
- Department of Ophthalmology; Erasmus University Medical Centre; Rotterdam the Netherlands
| | - Emine Kiliç
- Department of Ophthalmology; Erasmus University Medical Centre; Rotterdam the Netherlands
- Department of Clinical Genetics; Erasmus University Medical Centre; Rotterdam the Netherlands
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45
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Detiger SE, Karim AF, van Laar JAM, Paridaens D, Verdijk RM. The histological absence of IgG4 positive plasma cells in juvenile xanthogranuloma; comments on 'Systemic juvenile xanthogranuloma: a case report and brief review'. Clin Exp Dermatol 2018; 44:91-92. [PMID: 30240020 DOI: 10.1111/ced.13745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2018] [Indexed: 11/29/2022]
Affiliation(s)
- S E Detiger
- The Rotterdam Eye Hospital, Schiedamse Vest 180, 3011 BH, Rotterdam, The Netherlands
| | - A F Karim
- Departments of Internal Medicine and Immunology, Section of Clinical Immunology, Erasmus MC, Rotterdam, The Netherlands.,Department of Internal Medicine, Groene Hart Hospital, Gouda, The Netherlands
| | - J A M van Laar
- Departments of Internal Medicine and Immunology, Section of Clinical Immunology, Erasmus MC, Rotterdam, The Netherlands
| | - D Paridaens
- The Rotterdam Eye Hospital, Schiedamse Vest 180, 3011 BH, Rotterdam, The Netherlands
| | - R M Verdijk
- The Rotterdam Eye Hospital, Schiedamse Vest 180, 3011 BH, Rotterdam, The Netherlands.,Department of Pathology, Section of Ophthalmic Pathology, Erasmus MC, Rotterdam, The Netherlands
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46
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Frimmel S, de Faber JT, Wubbels RJ, Kniestedt C, Paridaens D. Type, severity, management and outcome of ocular and adnexal firework-related injuries: the Rotterdam experience. Acta Ophthalmol 2018. [PMID: 29536639 DOI: 10.1111/aos.13711] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE To study the type, severity, management and outcome of firework-related adnexal and ocular injuries during New Year's Eve festivities. METHODS A retrospective analysis of 123 injured patients (143 eyes) treated at the Rotterdam Eye Hospital between 2009 and 2013. All ages were included and analysed according to age, gender, active participant or bystander, laterality, location, dimension and severity of injury. Outcome parameter was the final best-corrected visual acuity. RESULTS The mean age was 22 ± 13 years with 87% males and 53% bystanders. 52% were ≤18 years. There was a higher number of female than male bystanders (63% versus 51%, p = 0.30). 50% of the eyes sustained mild, 13% moderate and 37% severe trauma. Adults suffered more from severe injuries compared to children (42% versus 31%). The most frequent intervention was gunpowder removal (20%), followed by traumatic cataract surgery (12%) and amniotic membrane grafting (8%). 76% of patients were followed over 1 year. At the end of follow-up, 88 (61.5%) eyes had recovered fully, while 55 (38.5%) eyes suffered from persistent complications with reduced vision ≤0.8 in 30% of injured eyes. 15 patients (12%, 10 adults, five children) were considered legally blind (vision ≤0.1). Three (2%) eyes were subject to evisceration. CONCLUSION Every year, around New Year's Eve 30-45 victims were referred to the Rotterdam Eye Hospital; 50% sustained moderate-to-severe trauma. In severe firework injuries, patients required multiple treatments that may not prevent permanent blindness and/or functional/cosmetic disfigurement. The majority was bystander and younger than 18 years.
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Affiliation(s)
- Sonja Frimmel
- The Rotterdam Eye Hospital; Rotterdam The Netherlands
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47
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Karim AF, Bansie RD, Rombach SM, Paridaens D, Verdijk RM, van Hagen PM, Van Laar JAM. The treatment outcomes in IgG4-related disease. Neth J Med 2018; 76:275-285. [PMID: 30152392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION IgG4-related disease (IgG4-RD) is an emerging systemic inflammatory disease involving nearly all organs eventually leading to fibrosis. Prompt and adequate treatment to prevent irreversible organ damage is therefore pivotal. To evaluate the treatment outcomes, we studied a well-defined cohort of patients with IgG4-RD. METHOD 32 patients with histologically confirmed IgG4-RD diagnosed between 1999 and April 2017 were included and reviewed for demographic and clinical characteristics. The response to treatment with glucocorticoids, disease modifying antirheumatic drugs, rituximab and other therapeutic interventions were evaluated. RESULTS Glucocorticoids as well as rituximab appeared successful therapeutic drugs leading to clinical remission (complete or partial remission) in all patients. Recurrences, however, were frequently seen (62% versus 100%, respectively). Diseases modifying antirheumatic drugs (DMARDs), including azathioprine, methotrexate and mycophenolate mofetil were effective in less than half of the cases. A minority of patients was treated with alternative treatments including hydroxychloroquine, thalidomide and infliximab which all appeared effective. Surgical intervention and radiotherapy in local disease seemed to induce clinical remission and were associated with low recurrence rates. CONCLUSION Glucocorticoids and rituximab induce substantial responses as well as primary surgical intervention and radiotherapy, while the efficacy of DMARDs is limited. Based on the few data available, hydroxychloroquine, infliximab and thalidomide may be promising treatment options for second or third line strategies.
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Affiliation(s)
- A F Karim
- Department of Internal Medicine, section Clinical Immunology, Erasmus University Medical Center, Rotterdam, the Netherlands
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48
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van Poppelen NM, Yavuzyigitoglu S, Smit KN, Vaarwater J, Eussen B, Brands T, Paridaens D, Kiliç E, de Klein A. Chromosomal rearrangements in uveal melanoma: Chromothripsis. Genes Chromosomes Cancer 2018; 57:452-458. [PMID: 29726589 PMCID: PMC6175119 DOI: 10.1002/gcc.4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 04/26/2018] [Accepted: 04/28/2018] [Indexed: 12/22/2022] Open
Abstract
Uveal melanoma (UM) is the most common primary intraocular malignancy in the Western world. Recurrent mutations in GNAQ, GNA11, CYSLTR2, PLCB4, BAP1, EIF1AX, and SF3B1 are described as well as non-random chromosomal aberrations. Chromothripsis is a rare event in which chromosomes are shattered and rearranged and has been reported in a variety of cancers including UM. SNP arrays of 249 UM from patients who underwent enucleation, biopsy or endoresection were reviewed for the presence of chromothripsis. Chromothripsis was defined as ten or more breakpoints per chromosome involved. Genetic analysis of GNAQ, GNA11, BAP1, SF3B1, and EIF1AX was conducted using Sanger and next-generation sequencing. In addition, immunohistochemistry for BAP1 was performed. Chromothripsis was detected in 7 out of 249 tumors and the affected chromosomes were chromosomes 3, 5, 6, 8, 12, and 13. The mean total of fragments per chromosome was 39.8 (range 12-116). In 1 UM, chromothripsis was present in 2 different chromosomes. GNAQ, GNA11 or CYSLTR2 mutations were present in 6 of these tumors and 5 tumors harbored a BAP1 mutation and/or lacked BAP1 protein expression by immunohistochemistry. Four of these tumors metastasized and for the fifth only short follow-up data are available. One of these metastatic tumors harbored an SF3B1 mutation. No EIF1AX mutations were detected in any of the tumors. To conclude, chromothripsis is a rare event in UM, occurring in 2.8% of samples and without significant association with mutations in any of the common UM driver genes.
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Affiliation(s)
- Natasha M van Poppelen
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Serdar Yavuzyigitoglu
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Kyra N Smit
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jolanda Vaarwater
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Bert Eussen
- Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Tom Brands
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Emine Kiliç
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Annelies de Klein
- Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
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Axmann S, Paridaens D. Anterior surface breakdown and implant extrusion following secondary alloplastic orbital implantation surgery. Acta Ophthalmol 2018; 96:310-313. [PMID: 29220117 DOI: 10.1111/aos.13611] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 08/26/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Secondary orbital implantation surgery can be complex due to scarring of the orbital tissues and can be complicated by implant exposure and extrusion. PURPOSE To evaluate the incidence and risk factors of implant exposure and extrusion following secondary alloplastic orbital implantation surgery in anophthalmic patients. METHODS Retrospective analysis of a consecutive series of patients who underwent secondary placement of an alloplastic orbital implant by one surgeon between 2001 and 2016 in the Rotterdam Eye Hospital. OUTCOME PARAMETERS implant exposure or extrusion. Other complications. RESULTS Sixty-three patients underwent secondary orbital placement of scleral-wrapped acrylic (60) or silicone (three) spherical implants. A subset of 25 patients had undergone earlier secondary orbital implant placement (by other surgeons) with exposure/extrusion necessitating additional implant surgery. Two patients were excluded due to lack of follow-up (<3 months). Mean age was 49 years (range: 1-84.5 years). The mean follow-up was 4.1 years (range: 0.25-13, 6 years). Implant exposure or extrusion occurred in six of 18 (33%) patients in whom no muscle had been reattached during secondary orbital implantation and in five of 43 (12%) patients in whom the extraocular recti muscles had been attached, but the follow-up time was shorter for the latter group. Surgical treatment for implant exposure/extrusion was required in eleven of 61 patients (18%). Other complications included postoperative volume deficiency despite optimal prosthesis (five of 61, 8%), inclusion cysts (four of 61, 7%) and conjunctivitis sicca (two of 61, 3%). Seven of 61 (11%) patients required fornix deepening and seven (11%) blepharoptosis correction. CONCLUSION Secondary orbital implantation of sclera-wrapped alloplastic implants was complicated by implant extrusion or exposure in 12% of cases in which the extraocular muscles were attached to the implant.
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Affiliation(s)
- Shadi Axmann
- Oculoplastic & Orbital Service; The Rotterdam Eye Hospital; Rotterdam the Netherlands
| | - Dion Paridaens
- Oculoplastic & Orbital Service; The Rotterdam Eye Hospital; Rotterdam the Netherlands
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50
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Smit KN, van Poppelen NM, Vaarwater J, Verdijk R, van Marion R, Kalirai H, Coupland SE, Thornton S, Farquhar N, Dubbink HJ, Paridaens D, de Klein A, Kiliç E. Combined mutation and copy-number variation detection by targeted next-generation sequencing in uveal melanoma. Mod Pathol 2018; 31:763-771. [PMID: 29327717 DOI: 10.1038/modpathol.2017.187] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 10/19/2017] [Accepted: 10/19/2017] [Indexed: 11/09/2022]
Abstract
Uveal melanoma is a highly aggressive cancer of the eye, in which nearly 50% of the patients die from metastasis. It is the most common type of primary eye cancer in adults. Chromosome and mutation status have been shown to correlate with the disease-free survival. Loss of chromosome 3 and inactivating mutations in BAP1, which is located on chromosome 3, are strongly associated with 'high-risk' tumors that metastasize early. Other genes often involved in uveal melanoma are SF3B1 and EIF1AX, which are found to be mutated in intermediate- and low-risk tumors, respectively. To obtain genetic information of all genes in one test, we developed a targeted sequencing method that can detect mutations in uveal melanoma genes and chromosomal anomalies in chromosome 1, 3, and 8. With as little as 10 ng DNA, we obtained enough coverage on all genes to detect mutations, such as substitutions, deletions, and insertions. These results were validated with Sanger sequencing in 28 samples. In >90% of the cases, the BAP1 mutation status corresponded to the BAP1 immunohistochemistry. The results obtained in the Ion Torrent single-nucleotide polymorphism assay were confirmed with several other techniques, such as fluorescence in situ hybridization, multiplex ligation-dependent probe amplification, and Illumina SNP array. By validating our assay in 27 formalin-fixed paraffin-embedded and 43 fresh uveal melanomas, we show that mutations and chromosome status can reliably be obtained using targeted next-generation sequencing. Implementing this technique as a diagnostic pathology application for uveal melanoma will allow prediction of the patients' metastatic risk and potentially assess eligibility for new therapies.
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Affiliation(s)
- Kyra N Smit
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Natasha M van Poppelen
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jolanda Vaarwater
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Robert Verdijk
- Department of Pathology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Ronald van Marion
- Department of Pathology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Helen Kalirai
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | - Sarah E Coupland
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | - Sophie Thornton
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | - Neil Farquhar
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | - Hendrikus-Jan Dubbink
- Department of Pathology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Annelies de Klein
- Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Emine Kiliç
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
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