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van Poppelen NM, Cassoux N, Turunen JA, Naus NC, Verdijk RM, Vaarwater J, Cohen V, Papastefanou VP, Kiratli H, Saakyan SV, Tsygankov AY, Rospond-Kubiak I, Mudhar HS, Salvi SM, Kiilgaard JF, Heegaard S, Moulin AP, Saornil MA, Garciá-Alvarez C, Fili M, Eide NA, Meyer P, Kivelä TT, de Klein A, Kilic E, Al-Jamal RT. The Pediatric and Young Adult Choroidal and Ciliary Body Melanoma Genetic Study, A Survey by the European Ophthalmic Oncology Group. Invest Ophthalmol Vis Sci 2024; 65:12. [PMID: 38573618 PMCID: PMC10996971 DOI: 10.1167/iovs.65.4.12] [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: 05/04/2023] [Accepted: 12/28/2023] [Indexed: 04/05/2024] Open
Abstract
Purpose To explore the genetic background of choroidal and ciliary body melanoma among children and young adults, with special focus on BAP1 germline variants in this age group. Methods Patients under the age of 25 and with confirmed choroidal or ciliary body melanoma were included in this retrospective, multicenter observational study. Nuclear BAP1 immunopositivity was used to evaluate the presence of functional BAP1 in the tumor. Next-generation sequencing using Ion Torrent platform was used to determine pathogenic variants of BAP1, EIF1AX, SF3B1, GNAQ and GNA11 and chromosome 3 status in the tumor or in DNA extracted from blood or saliva. Survival was analyzed using Kaplan-Meier estimates. Results The mean age at diagnosis was 17 years (range 5.0-24.8). A germline BAP1 pathogenic variant was identified in an 18-year-old patient, and a somatic variant, based mainly on immunohistochemistry, in 13 (42%) of 31 available specimens. One tumor had a somatic SF3B1 pathogenic variant. Disomy 3 and the absence of a BAP1 pathogenic variant in the tumor predicted the longest metastasis-free survival. Males showed longer metastasis-free survival than females (P = 0.018). Conclusions We did not find a stronger-than-average BAP1 germline predisposition for choroidal and ciliary body melanoma among children and young adults compared to adults. Males had a more favorable survival and disomy 3, and the absence of a BAP1 mutation in the tumor tissue predicted the most favorable metastasis-free survival. A BAP1 germline pathogenic variant was identified in one patient (1%), and a somatic variant based mainly on immunohistochemistry in 13 (42%).
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Affiliation(s)
- Natasha M. van Poppelen
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Nathalie Cassoux
- Department of Ophthalmology, Curie Institute, Université Paris Cité UFR Médecine, Paris, France
| | - Joni A. Turunen
- Ocular Oncology Service, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Eye Genetics Group, Folkhälsan Research Center, Helsinki, Finland
| | - Nicole C. Naus
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Robert M. Verdijk
- Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Pathology, Leiden Universital Medical Center, Leiden, The Netherlands
| | - Jolanda Vaarwater
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Victoria Cohen
- Ocular Oncology Service, Moorfields Eye Hospital, London, United Kingdom
| | | | - Hayyam Kiratli
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Svetlana V. Saakyan
- Department of Ophthalmology, Moscow Helmholtz Research Institute of Eye Diseases, Moscow, Russia
| | - Alexander Y. Tsygankov
- Department of Ophthalmology, Moscow Helmholtz Research Institute of Eye Diseases, Moscow, Russia
| | - Iwona Rospond-Kubiak
- Department of Ophthalmology, Poznan University of Medical Sciences, Poznán, Poland
| | - Hardeep S. Mudhar
- National Specialist Ophthalmic Pathology Service (NSOPS), Department of Histopathology, Royal Hallamshire Hospital, Sheffield, United Kingdom
| | - Sachin M. Salvi
- Sheffield Ocular Oncology Service, Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield, United Kingdom
| | - Jens F. Kiilgaard
- Department of Ophthalmology, University of Copenhagen, Copenhagen, Denmark
| | - Steffen Heegaard
- Department of Ophthalmology, University of Copenhagen, Copenhagen, Denmark
- Department of Pathology, University of Copenhagen, Copenhagen, Denmark
| | - Alexandre P. Moulin
- Department of Ophthalmology, Jules-Gonin Eye Hospital, Lausanne University, Lausanne, Switzerland
| | - Maria A. Saornil
- Department of Ophthalmology, Hospital Clinico Universitario de Valladolid, Valladolid, Spain
| | - Ciro Garciá-Alvarez
- Department of Ophthalmology, Hospital Clinico Universitario de Valladolid, Valladolid, Spain
| | - Maria Fili
- Department of Ophthalmology, St. Erik Eye Hospital, Stockholm, Sweden
| | - Nils A. Eide
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
| | - Peter Meyer
- Department of Ophthalmology, Basel University Hospital, Basel, Switzerland
| | - Tero T. Kivelä
- Ocular Oncology Service, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Annelies de Klein
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Emine Kilic
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Rana'a T. Al-Jamal
- Ocular Oncology Service, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Ocular Oncology Service, Moorfields Eye Hospital, London, United Kingdom
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2
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Wróblewska-Zierhoffer M, Paprzycka B, Kubiak A, Tomczyk Ł, Rospond-Kubiak I. Additional primary malignancies in a Polish cohort of uveal melanoma patients: a review of 644 patients with long-term follow-up. BMC Ophthalmol 2023; 23:506. [PMID: 38087265 PMCID: PMC10717148 DOI: 10.1186/s12886-023-03246-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: 06/25/2023] [Accepted: 11/26/2023] [Indexed: 12/18/2023] Open
Abstract
AIM To investigate the frequency and location of additional primary malignancies in a Polish cohort of uveal melanoma (UM) patients registered in a single centre database. MATERIAL AND METHOD Retrospective data analysis of patients treated for uveal melanoma at the Department of Ophthalmology, Poznań University of Medical Sciences, Poland between 1991 and 2017. Data on the diagnosis of the additional malignancies were obtained during the follow-up visits in our Department and/or from the Greater Poland Cancer Registry. The exclusion criteria comprised no confirmed follow-up or incomplete clinical entry data. RESULTS Among 644 UM patients registered in the database up to 2017, the additional malignancy was diagnosed in 126 (20%) patients: 71 men, 55 women at the median age of 67 years (range: 34-94). In 48 patients (38%), the additional malignancy occurred prior to the diagnosis of UM, in 73 (58%) patients - after it. The most common locations of second cancer were skin (20 cases / 15%), breast (17 cases / 13%) and lungs (15 cases / 12%). The median follow-up was 36 months (range: 3-242). 87 patients (69%) died by the study close, 32 (37%) of them due to metastatic disease from uveal melanoma, 41 (47%) due to another cancer. CONCLUSIONS The frequency of additional primary malignancies was higher in our cohort than reported by most of other groups. If there is a certain predisposition to a specific type of additional primary carcinoma in UM patients, the analysis of larger database is required.
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Affiliation(s)
- Marta Wróblewska-Zierhoffer
- Department of Ophthalmology, Poznań University of Medical Sciences, Poznań, Poland
- Polyclinic of Plastic and Ophthalmic Surgery, Kobylniki, Poland
| | - Barbara Paprzycka
- Department of Ophthalmology, Poznań District Hospital, Poznań, Poland
| | - Anna Kubiak
- Greater Poland Cancer Registry, Greater Poland Cancer Centre, Poznań, Poland
| | - Łukasz Tomczyk
- Department of Food Safety and Quality Management, Poznań University of Life Sciences, Poznań, Poland
| | - Iwona Rospond-Kubiak
- Department of Ophthalmology, Poznań University of Medical Sciences, Poznań, Poland.
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3
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Mularska W, Wróblewska-Zierhoffer M, Adamski W, Rospond-Kubiak I. Surgical outcomes of unwrapped acrylic orbital implants: A review of 192 patients. J Fr Ophtalmol 2023; 46:1149-1154. [PMID: 37679221 DOI: 10.1016/j.jfo.2023.03.021] [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: 01/02/2023] [Revised: 02/28/2023] [Accepted: 03/14/2023] [Indexed: 09/09/2023]
Abstract
PURPOSE The purpose of this study is to report the results in a series of acrylic orbital implant placements without the use of wrapping material. METHODS We retrospectively reviewed the records of the patients who underwent enucleation with acrylic orbital implant insertion without scleral wrapping at the Department of Ophthalmology, Poznań University of Medical Sciences, Poland, between 2013 and 2020. RESULTS There were 192 patients: 102 women and 90 men, mean age: 60 years (range: 13-90 years). In the majority of cases, the reason for enucleation was uveal melanoma (148 patients-77.1%), followed by secondary glaucoma in 22 patients (11.5%) and painful, phthisical eye in 16 (8.3%). The median follow-up was 23 months (range: 1-96 months). The stability of the implants was satisfactory in the majority of cases, and there were no cases of implant migration identified during the study period. We noted a total of 4 (2%) implant exposures. Other postoperative complaints included eyelid malposition-21 patients (11%), Tenon's capsule thinning (15 patients-7.8%) and post-enucleation eye socket syndrome (PEES)-7 patients (3.6%). The rate of postoperative complications was associated only with a history of previous ocular surgery (P=0.006). CONCLUSIONS The stability and functional outcomes of unwrapped acrylic orbital implants in this group of patients were satisfactory during the follow-up period.
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Affiliation(s)
- W Mularska
- Department of Ophthalmology, Poznań University of Medical Sciences, 84/82, Szamarzewskiego Street, 61-848 Poznań, Poland
| | - M Wróblewska-Zierhoffer
- Department of Ophthalmology, Poznań University of Medical Sciences, 84/82, Szamarzewskiego Street, 61-848 Poznań, Poland
| | - W Adamski
- Department of Ophthalmology, Poznań District Hospital, 7/19 Juraszów Street, 60-479 Poznań, Poland
| | - I Rospond-Kubiak
- Department of Ophthalmology, Poznań University of Medical Sciences, 84/82, Szamarzewskiego Street, 61-848 Poznań, Poland.
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4
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Zwolin´ska E, Główka L, Chicheł A, Rospond-Kubiak I. Ruthenium brachytherapy for iris melanoma. J Contemp Brachytherapy 2023; 15:344-349. [PMID: 38026074 PMCID: PMC10669923 DOI: 10.5114/jcb.2023.132401] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/15/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose The study aimed to review the long-term outcomes of ruthenium brachytherapy for iris and iridociliary melanoma. Material And Methods Medical records of patients who underwent ruthenium plaque treatment for iris and iridociliary melanoma at the Department of Ophthalmology, Poznań University of Medical Sciences, between 1999 and 2021 were retrospectively reviewed. Results We identified 24 patients, including 17 women and 7 men, with a median age of 61.5 years (range, 35-84 years). Median observation time before treatment was 3 months (range, 0-68 months). Nineteen (79%) patients received a treatment with 20 mm CCB plaque, 5 (21%) with 15 mm CCA plaque and 2 (8%) patients received total irradiation to the entire iridocorneal angle. Median follow-up was 67.5 months (range, 24-265 months). We noted one (4%) recurrence managed by irradiating the anterior segment. Twelve (50%) patients developed post-operative cataracts in a median time of 38 months following treatment, 5 (21%) required topical medications to control intraocular pressure, and one (4%) developed chronic macular edema (CME) that was managed with anti-VEGF therapy. Final visual acuity between 1.0 and 0.5 was observed for 16 (67%) patients, between 0.49-0.1 for 5 (21%) patients, and below 0.09 for 3 (12%) patients. Nine (37%) patients maintained final visual acuity stable; in 4 (17%) patients, it dropped more than 3 lines, and improved in 6 (25%) patients. Conclusions Ruthenium brachytherapy with standard applicators is an effective and safe way of treatment for iris and iridociliary melanoma. We observed no significant post-operative complications in a long-term observation.
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Affiliation(s)
- Emilia Zwolin´ska
- Department of Ophthalmology, Poznan´ University of Medical Sciences, Poznan´, Poland
| | - Lidia Główka
- Department of Ophthalmology, Poznan´ University of Medical Sciences, Poznan´, Poland
| | - Adam Chicheł
- Department of Brachytherapy, Greater Poland Cancer Center, Poznan´, Poland
| | - Iwona Rospond-Kubiak
- Department of Ophthalmology, Poznan´ University of Medical Sciences, Poznan´, Poland
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Mularska W, Chicheł A, Rospond-Kubiak I. Radiation retinopathy following episcleral brachytherapy for intraocular tumors: Current treatment options. J Contemp Brachytherapy 2023; 15:372-382. [PMID: 38026080 PMCID: PMC10669920 DOI: 10.5114/jcb.2023.132398] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/04/2023] [Indexed: 12/01/2023] Open
Abstract
Radiation retinopathy (RR) and radiation maculopathy (RM) can occur as a result of uveal melanoma radiation treatment and after irradiation of other head and neck extraocular tumors, even with precise targeting techniques, such as stereotactic or proton beam radiotherapy. This review provides an overview of the current understanding of potential radiation damage to ocular tissues, and how recent developments in ophthalmic multimodal imaging techniques and treatment modalities have improved managing options. Several treatment strategies have been employed so far for the management of RR, including laser photocoagulation, intravitreal injections of anti-vascular endothelial growth factor (VEGF) agents or glucocorticosteroids and surgery. The use of intravitreal anti-VEGFs or dexamethasone implants have significantly altered the final visual outcome for uveal melanoma patients. As a prophylaxis, a few different strategies were proposed, but still there is a lack of large randomized clinical trials supporting these approaches and clear clinical guidelines for daily practice. Early detection and proper treatment are crucial in preventing or reducing vision loss, and improving patients' quality of life. Close monitoring and timely intervention are essential for successful management.
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Affiliation(s)
- Weronika Mularska
- Department of Ophthalmology, Poznan´ University of Medical Sciences, Poznan´, Poland
| | - Adam Chicheł
- Brachytherapy Department, Greater Poland Cancer Center, Poznan´, Poland
| | - Iwona Rospond-Kubiak
- Department of Ophthalmology, Poznan´ University of Medical Sciences, Poznan´, Poland
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Jouhi S, Jager MJ, de Geus SJ, Desjardins L, Eide NA, Grange JD, Kiilgaard JF, Seregard S, Midena E, Parrozzani R, Caujolle JP, Rospond-Kubiak I, Kivelä TT. The Small Fatal Choroidal Melanoma Study. A Survey by the European Ophthalmic Oncology Group. Am J Ophthalmol 2019; 202:100-108. [PMID: 30772347 DOI: 10.1016/j.ajo.2019.01.031] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 01/07/2019] [Accepted: 01/30/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine the size at which choroidal melanomas can metastasize and to report the characteristics of small fatal choroidal melanomas (SFCM). DESIGN Retrospective case series. METHODS Ten ocular oncology services submitted 45 patients with a choroidal melanoma 3 mm or less in thickness and 9 mm or less in largest basal diameter (LBD), when treated, who developed metastases. RESULTS Median tumor thickness was 2.4 mm (range, 1.0-3.0 mm) and LBD 7.3 mm (range, 3.0-9.0 mm). Of 14 (31%) tumors that were first observed, 12 grew a median of 0.5 mm (range, 0.1-1.2 mm) in thickness and 1.0 mm (range, 0-3.0 mm) in LBD within a median of 7 months; 3 were initially smaller than 3 mm in LBD. Number of risk factors for growth and metastasis was 0 for 4% of the tumors; 60% were over 2 mm in thickness, 63% had subretinal fluid, 84% caused symptoms, 57% had orange pigment, and 92% were within 3 mm of the disc. Local recurrence occurred in 8 of 31 eyes (26%) treated conservatively. Median metastasis-free survival was 4.5 years (range, 0.8-15.7 years). Kaplan-Meier estimate of metastasis developing was 15% (95% confidence interval [CI], 7-26), 51% (95% CI, 36-64) and 85% (95% CI, 71-92) by 2, 5, and 10 years, respectively. By the time of analysis, 37 patients had died of metastasis after a median of 7 months. CONCLUSIONS Choroidal melanomas less than 3.0 mm in LBD are highly unlikely to metastasize. Risk factors of an SFCM are similar to those for all choroidal melanomas of similar size.
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Jouhi S, Jager M, Desjardins L, Eide N, Rospond-Kubiak I, Caujolle J, Grange J, Kiilgaard J, Scheen L, Midena E, Raffaele P, Kivelä T. Small fatal choroidal melanomas: A survey by the European Ophthalmic Oncology Group. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.03641] [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] [Indexed: 11/30/2022]
Affiliation(s)
- S. Jouhi
- Ocular Oncology Service; Department of Ophthalmology; University of Helsinki and Helsinki University Hospital, Ophthalmology; Helsinki Finland
| | - M. Jager
- Leiden University Medical Center, Ophthalmology; Leiden The Netherlands
| | | | - N. Eide
- Oslo University Hospital-HF and University of Oslo, Ophthalmology; Oslo Norway
| | | | - J.P. Caujolle
- Saint-Roch University Hospital, Ophthalmology; Nice France
| | - J.D. Grange
- Croix-Rousse Hospital, Ophthalmology; Lyon France
| | - J.F. Kiilgaard
- Copenhagen University Hospital Glostrup, Ophthalmology; Copenhagen Denmark
| | - L. Scheen
- St. Erik′s Eye Hospital, Ophthalmology; Stockholm Sweden
| | - E. Midena
- University of Padova, Ophthalmology; Padova Italy
| | - P. Raffaele
- Ocular Oncology and Toxicology Research Unit, Ophthalmology; Rome Italy
| | - T. Kivelä
- Helsinki University Hospital, Ophthalmology; Helsinki Finland
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8
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Affiliation(s)
- Iwona Rospond-Kubiak
- Department of Ophthalmology, Poznan University of Medical Sciences, Poznan, Poland
| | - Grzegorz Oszkinis
- Department of Vascular Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Jaroslaw Kociecki
- Department of Ophthalmology, Poznan University of Medical Sciences, Poznan, Poland
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9
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Rospond-Kubiak I, Groenewald C, Coupland SE, Damato B. Core Endoresection as Neoadjuvant Treatment of Uveal Melanoma. Ocul Oncol Pathol 2016; 2:91-3. [PMID: 27171344 DOI: 10.1159/000439134] [Citation(s) in RCA: 2] [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: 09/18/2014] [Accepted: 07/29/2015] [Indexed: 11/19/2022] Open
Abstract
AIM To present a case of neoadjuvant treatment of uveal melanoma with a limited core endoresection, which enabled ruthenium plaque radiotherapy to be administered. MATERIAL AND METHODS A 77-year-old woman presented in 2005 with a ciliochoroidal uveal melanoma measuring 7.2 by 6.5 mm basally with a thickness of 6.2 mm. The vision in the affected eye was 6/9. Because of diagnostic uncertainty, we performed a biopsy, which produced a copious sample. The biopsy serendipitously reduced the tumour thickness to 4.4 mm, making ruthenium plaque brachytherapy possible. RESULTS Histopathological examination showed the tumour to be a melanoma predominantly of spindle cell type. Postoperative complications included a dense vitreous haemorrhage, which cleared spontaneously, and raised intraocular pressure, controlled with latanoprost. Seven years after brachytherapy, the vision was 6/5 and the thickness of the residual tumour was 2.5 mm. Nine years after treatment, there was no evidence of any intra- or extraocular seeding or distant metastases. CONCLUSIONS Core endoresection of a ciliochoroidal melanoma may reduce tumour thickness enough to allow subsequent ruthenium plaque radiotherapy.
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Affiliation(s)
- Iwona Rospond-Kubiak
- Liverpool Ocular Oncology Centre, Royal Liverpool University Hospital, Liverpool, UK; Department of Ophthalmology, Poznań University of Medical Sciences, Poznań, Poland
| | - Carl Groenewald
- Liverpool Ocular Oncology Centre, Royal Liverpool University Hospital, Liverpool, UK
| | - Sarah E Coupland
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | - Bertil Damato
- Ocular Oncology Service, Department of Ophthalmology, San Francisco, Calif., USA; Department of Radiation Oncology, University of California, San Francisco, San Francisco, Calif., USA
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10
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Al-Jamal RT, Cassoux N, Desjardins L, Damato B, Konstantinidis L, Coupland SE, Heimann H, Petrovic A, Zografos L, Schalenbourg A, Velazquez-Martin JP, Krema H, Bogdali A, Markiewicz A, Romanowska-Dixon B, Metz CHD, Biewald E, Bornfeld N, Kiratli H, Bronkhorst IHG, Jager MJ, Marinkovic M, Fili M, Seregard S, Frenkel S, Pe'er J, Salvi SM, Rennie IG, Rospond-Kubiak I, Kociecki J, Kiilgaard JF, Heegaard S, Cohen VML, Sagoo MS, Amiryan A, Saakyan S, Eide N, Krohn J, Midena E, Parrozzani R, Grange JD, Kilic E, Blasi MA, Saornil MA, Kivelä TT. The Pediatric Choroidal and Ciliary Body Melanoma Study: A Survey by the European Ophthalmic Oncology Group. Ophthalmology 2016; 123:898-907. [PMID: 26854035 DOI: 10.1016/j.ophtha.2015.12.024] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 12/13/2015] [Accepted: 12/14/2015] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To collect comprehensive data on choroidal and ciliary body melanoma (CCBM) in children and to validate hypotheses regarding pediatric CCBM: children younger than 18 years, males, and those without ciliary body involvement (CBI) have more favorable survival prognosis than young adults 18 to 24 years of age, females, and those with CBI. DESIGN Retrospective, multicenter observational study. PARTICIPANTS Two hundred ninety-nine patients from 24 ocular oncology centers, of whom 114 were children (median age, 15.1 years; range, 2.7-17.9 years) and 185 were young adults. METHODS Data were entered through a secure website and were reviewed centrally. Survival was analyzed using Kaplan-Meier analysis and Cox proportional hazards regression. MAIN OUTCOME MEASURES Proportion of females, tumor-node-metastasis (TNM) stage, cell type, and melanoma-related mortality. RESULTS Cumulative frequency of having CCBM diagnosed increased steadily by 0.8% per year of age between 5 and 10 years of age and, after a 6-year transition period, by 8.8% per year from age 17 years onward. Of children and young adults, 57% and 63% were female, respectively, which exceeded the expected 51% among young adults. Cell type, known for 35% of tumors, and TNM stage (I in 22% and 21%, II in 49% and 52%, III in 30% and 28%, respectively) were comparable for children and young adults. Melanoma-related survival was 97% and 90% at 5 years and 92% and 80% at 10 years for children compared with young adults, respectively (P = 0.013). Males tended to have a more favorable survival than females among children (100% vs. 85% at 10 years; P = 0.058). Increasing TNM stage was associated with poorer survival (stages I, II, and III: 100% vs. 86% vs. 76%, respectively; P = 0.0011). By multivariate analysis, being a young adult (adjusted hazard rate [HR], 2.57), a higher TNM stage (HR, 2.88 and 8.38 for stages II and III, respectively), and female gender (HR, 2.38) independently predicted less favorable survival. Ciliary body involvement and cell type were not associated with survival. CONCLUSIONS This study confirms that children with CCBM have a more favorable survival than young adults 18 to 25 years of age, adjusting for TNM stage and gender. The association between gender and survival varies between age groups.
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Affiliation(s)
- Rana'a T Al-Jamal
- Ocular Oncology Service, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | | | | | - Bertil Damato
- Ocular Oncology Service, Royal Liverpool University Hospital, Liverpool, United Kingdom
| | | | - Sarah E Coupland
- Ocular Oncology Service, Royal Liverpool University Hospital, Liverpool, United Kingdom; Department of Cellular Pathology, Royal Liverpool University Hospital, Liverpool, United Kingdom
| | - Heinrich Heimann
- Ocular Oncology Service, Royal Liverpool University Hospital, Liverpool, United Kingdom
| | - Aleksandra Petrovic
- Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles (FAA), Lausanne, Switzerland
| | - Leonidas Zografos
- Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles (FAA), Lausanne, Switzerland
| | - Ann Schalenbourg
- Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles (FAA), Lausanne, Switzerland
| | - Juan P Velazquez-Martin
- Department of Ocular Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Canada
| | - Hatem Krema
- Department of Ocular Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Canada
| | - Anna Bogdali
- Department of Ophthalmology and Ocular Oncology, Jagiellonian University, Collegium Medicum, Krakow, Poland
| | - Anna Markiewicz
- Department of Ophthalmology and Ocular Oncology, Jagiellonian University, Collegium Medicum, Krakow, Poland
| | - Bozena Romanowska-Dixon
- Department of Ophthalmology and Ocular Oncology, Jagiellonian University, Collegium Medicum, Krakow, Poland
| | - Claudia H D Metz
- Department of Ophthalmology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
| | - Eva Biewald
- Department of Ophthalmology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
| | - Norbert Bornfeld
- Department of Ophthalmology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
| | - Hayyam Kiratli
- Ocular Oncology Service, Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Inge H G Bronkhorst
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Martine J Jager
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Marina Marinkovic
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Maria Fili
- Department of Ophthalmic Oncology, St. Erik's Eye Hospital, Stockholm, Sweden
| | - Stefan Seregard
- Department of Ophthalmic Oncology, St. Erik's Eye Hospital, Stockholm, Sweden
| | - Shahar Frenkel
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Jacob Pe'er
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Sachin M Salvi
- Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield, United Kingdom
| | - Ian G Rennie
- Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield, United Kingdom
| | - Iwona Rospond-Kubiak
- Department of Ophthalmology, Poznán University of Medical Sciences, Poznán, Poland
| | - Jaroslaw Kociecki
- Department of Ophthalmology, Poznán University of Medical Sciences, Poznán, Poland
| | - Jens Folke Kiilgaard
- Department of Ophthalmology, Copenhagen University Hospital Glostrup, Copenhagen, Denmark
| | - Steffen Heegaard
- Department of Ophthalmology, Copenhagen University Hospital Glostrup, Copenhagen, Denmark
| | - Victoria M L Cohen
- Ocular Oncology Service, St Bartholomew's and Moorfields Eye Hospital, London, United Kingdom
| | - Mandeep S Sagoo
- Ocular Oncology Service, St Bartholomew's and Moorfields Eye Hospital, London, United Kingdom
| | - Anush Amiryan
- Department of Ophthalmic Oncology and Radiology, Helmholtz Institute, Moscow, Russia
| | - Svetlana Saakyan
- Department of Ophthalmic Oncology and Radiology, Helmholtz Institute, Moscow, Russia
| | - Nils Eide
- Department of Ophthalmology, Oslo University Hospital-HF and University of Oslo, Oslo, Norway
| | - Jørgen Krohn
- Department of Clinical Medicine, Section of Ophthalmology, University of Bergen, Bergen, Norway
| | - Edoardo Midena
- Department of Ophthalmology, University of Padova, Padova, Italy
| | - Raffaele Parrozzani
- G. B. Bietti Foundation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Ocular Oncology and Toxicology Research Unit, Rome, Italy
| | | | - Emine Kilic
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Maria Antonia Saornil
- Department of Ophthalmology, Ocular Oncology Unit, Valladolid University Hospital, Valladolid, Spain
| | - Tero T Kivelä
- Ocular Oncology Service, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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11
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Szpura E, Rospond-Kubiak I, Marszałek A, Kocięcki J. [Demodex spp. within the limbal dermoid – causal pathogen or an irrelevant finding? Case report]. Klin Oczna 2016; 118:136-138. [PMID: 29912500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The aim of the study is to report a case of limbal dermoid associated with infestation of Demodex species (Demodex spp.). A 27-year-old man presented with ocular discomfort and a pink conjunctival lesion in his left eye. The lesion had been present since birth and it occassionally grew eyelashes. The tumour was located in an inferior temporal quadrant, involving approximately 1/6 of the limbal surface area. High frequency ultrasound revealed deep corneoscleral inifiltration, so a subtotal resection was performed. Histological evaluation revealed the presence of Demodex spp. in an abnormal sebaceous gland located within the tumour. Limbal dermoid might be associated with Demodex spp. infestation, if abnormal sebaceous glands are formed inside the lesion.
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12
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Rospond-Kubiak I, Wroblewska-Zierhoffer M, Twardosz-Pawlik H, Kociecki J. The Liverpool Uveal Melanoma Prognosticator Online (LUMPO) for prognosing metastasis free survival in the absence of cytogenetic data after ruthenium brachytherapy for uveal melanoma. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0680] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- I. Rospond-Kubiak
- Department of Ophthalmology; Poznan University of Medical Sciences; Poznan Poland
| | | | - H. Twardosz-Pawlik
- Department of Ophthalmology; Poznan University of Medical Sciences; Poznan Poland
| | - J. Kociecki
- Department of Ophthalmology; Poznan University of Medical Sciences; Poznan Poland
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13
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Rospond-Kubiak I, Oszkinis G, Kociecki J. Intraarterial thrombocytic material revelative of essential thrombocytaemia in a 59-year-old woman. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0631] [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] [Indexed: 11/29/2022]
Affiliation(s)
- I. Rospond-Kubiak
- Department of Ophthalmology; Poznan University of Medical Sciences; Poznan Poland
| | - G. Oszkinis
- Department of Vascular Surgery; Poznan University of Medical Sciences; Poznan Poland
| | - J. Kociecki
- Department of Ophthalmology; Poznan University of Medical Sciences; Poznan Poland
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14
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Rospond-Kubiak I, Wroblewska-Zierhoffer M, Twardosz-Pawlik H, Kociecki J. The Liverpool Uveal Melanoma Prognosticator Online (LUMPO) for prognosing metastasis free survival in the absence of cytogenetic data after ruthenium brachytherapy for uveal melanoma. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.1680] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- I. Rospond-Kubiak
- Department of Ophthalmology; Poznan University of Medical Sciences; Poznan Poland
| | | | - H. Twardosz-Pawlik
- Department of Ophthalmology; Poznan University of Medical Sciences; Poznan Poland
| | - J. Kociecki
- Department of Ophthalmology; Poznan University of Medical Sciences; Poznan Poland
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15
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Rospond-Kubiak I, Coupland SE, Heimann H, Damato BE. Suprachoroidal adenoma in a 10-year-old girl. Clin Exp Ophthalmol 2014; 43:79-82. [PMID: 24995622 DOI: 10.1111/ceo.12381] [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] [Received: 02/26/2014] [Accepted: 06/10/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Iwona Rospond-Kubiak
- Liverpool Ocular Oncology Centre, Royal Liverpool University Hospital, Liverpool, England; Ocular Oncology Service, Department of Ophthalmology, Poznań University of Medical Sciences, Poznań, Poland
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16
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Rospond-Kubiak I, Damato B. The surgical approach to the management of anterior uveal melanomas. Eye (Lond) 2014; 28:741-7. [PMID: 24722505 DOI: 10.1038/eye.2014.74] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 12/04/2013] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Surgical excision of peripheral iris or ciliary body melanomas can be performed antero-posteriorly (irido-cyclectomy) with mydriasis or postero-anteriorly (cyclo-iridectomy) with miosis. The aim of this study was to evaluate the results of both surgical techniques. METHODS Patients were enrolled in the study if they underwent irido-cyclectomy or cyclo-iridectomy for iris and/or ciliary body melanoma at the Liverpool Ocular Oncology Centre between 1993 and 2012. RESULTS The 24 patients (8 male, 16 female) had a median age of 57 years. The largest median basal tumour diameter and the median tumour thickness were 4.8 and 2.2 mm, respectively. The resection was performed antero-posteriorly in 9 (37%) patients and postero-anteriorly or circumferentially in 15 (63%). Nine tumours contained epithelioid cells. Genetic studies were performed in 10 patients, showing chromosome 3 loss in two. Postoperative complications included hypotony in 9 (37%) patients, cataract in 8 (33%), hyphaema in 8 (33%), cyclodialysis in 1 (4%), wound dehiscence in 1 (4%) and bullous keratopathy in 1 patient (4%). The median follow-up time was 2.4 years. The last known visual acuity was 6/6-6/12 in 20 (91%) patients and 6/18-6/60 in 2 (9%), with 2 (8%) requiring secondary enucleation. Local tumour recurrence developed in 1 patient (4%). Two (8%) patients died of metastatic disease. CONCLUSIONS Surgical resection of peripheral iris melanomas achieves high rates of visual conservation and local tumour control and may be the preferred option when tissue is required for laboratory studies.
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Affiliation(s)
- I Rospond-Kubiak
- Department of Ophthalmology, Poznan University of Medical Sciences, Poznan, Poland
| | - B Damato
- 1] Liverpool Ocular Oncology Centre, Royal Liverpool University Hospital, Liverpool, UK [2] Ocular Oncology Service, Departments of Ophthalmology and Radiation Oncology, University of California San Francisco, San Francisco, CA, USA
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Konstantinidis L, Rospond-Kubiak I, Zeolite I, Heimann H, Groenewald C, Coupland SE, Damato B. Management of patients with uveal metastases at the Liverpool Ocular Oncology Centre. Br J Ophthalmol 2013; 98:92-8. [PMID: 24169654 DOI: 10.1136/bjophthalmol-2013-303519] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Uveal metastasis is the most common intraocular malignancy. METHODS This was a retrospective study of all patients with uveal metastases referred to the Liverpool Ocular Oncology Centre between January 2007 and December 2012. Biopsy was performed as a primary investigation if the clinical examination suggested metastasis with no evidence of any extraocular metastases. RESULTS Ninety-six patients (109 eyes) were included. Breast and lung carcinomas were the most common primary malignancies, affecting 41 and 27 patients, respectively. The median time interval between detection of primary cancer and uveal metastasis was 24 months (range 1-288 months). Thirty-nine patients underwent ocular biopsy, confirming the diagnosis in all patients. The biopsy indicated the site of origin in 24 out of the 27 without a known primary tumour. In 7 of these 27 cases, previous systemic investigations had failed to identify the primary tumour. Seventy-three patients received external beam irradiation; two patients received photodynamic therapy; and two patients had Ru-106 plaque radiotherapy. The visual acuity was stable or improved in 75.5% of the cases. CONCLUSIONS Immediate biopsy provides a quick diagnosis that may expedite treatment and improve any opportunities for conserving vision while facilitating the general oncologic management on these patients.
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Rospond-Kubiak I, Kocięcki J, Stopa M. Primary uveal lymphoma effectively managed with oral chlorambucil: a case report. J Med Case Rep 2013; 7:173. [PMID: 23822827 PMCID: PMC3704902 DOI: 10.1186/1752-1947-7-173] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 10/21/2012] [Accepted: 04/03/2013] [Indexed: 12/01/2022] Open
Abstract
Introduction Ocular lymphomas account for five to 10 percent of all extra-nodal lymphomas. Primary uveal lymphoma is quite a rare entity and usually unilateral. We present a case of a primary uveal lymphoma with conjunctival and orbital extension, successfully managed with oral chlorambucil. Case presentation A 71-year-old Caucasian man presented to our facility with visual loss in his only functioning eye (left). On clinical examination, we found a conjunctival lesion with a choroidal infiltration and a secondary retinal detachment. Ultrasound and magnetic resonance imaging studies revealed a choroidal tumour mass and two other lesions around the optic nerve. Results from an incisional biopsy revealed a low-grade B-cell lymphoma (CD20+, CD43+, bcl2+, CD3-). A diagnosis of primary uveal lymphoma was made. Our patient was started on a chemotherapy regime with no effect, and then oral chlorambucil was administered, with a relatively good result. At 10 months after the start of chlorambucil treatment, a best-corrected visual acuity of 0.4 was recorded, the choroidal mass had practically disappeared and the extra-ocular lesions had shrunk. Conclusions In all, 61 to 80 cases of primary uveal lymphoma have already been described in the literature. Generally, it is an indolent tumor with a good prognosis. However, there are some reports of aggressive tumor behavior a few years after initial diagnosis (about eight percent of cases). Other treatment options are orbital irradiation at low doses (20 to 40 Gy) or steroid administration. This is the first documented report of the efficacy of oral chlorambucil in the treatment of primary uveal lymphoma.
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Affiliation(s)
- Iwona Rospond-Kubiak
- Department of Ophthalmology, Poznań University of Medical Sciences, 1/2, Długa Street, Poznań, 61-848, Poland.
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Rospond-Kubiak I, Brązert A, Kocięcki J, Bręborowicz J. Poststreptococcal syndrome mimicking conjunctival lymphoma. BMC Infect Dis 2013; 13:149. [PMID: 23530852 PMCID: PMC3620925 DOI: 10.1186/1471-2334-13-149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 05/27/2012] [Accepted: 03/15/2013] [Indexed: 11/10/2022] Open
Abstract
Background Poststreptococcal syndrome (PSS) can be a consequence of nonpurulent primary infection with group A streptococci (GAS). Postreptococcal uveitis is a well recognized entity with quite a few descriptions in the literature, but so far no conjunctival involvement has been reported. The aim of the study is to present a rare case of postreptococcal conjunctival lesions mimicking a lymphoma. Case presentation 19-years-old Caucasian female presented with pink, nodular infiltrates in the right conjunctiva that occurred a few months after upper respiratory tract infection and tonsillectomy. Histopathological examination of collected lesion samples revealed inflammatory reaction with lymphocytes proliferation and failed to rule out a myeloma. Complementary flow-cytometry did not show monoclonal proliferation of lymphocytes B. During follow-up we observed the complete regression of conjunctival lesions after the benzyl penicillin treatment prescribed by ENT specialist due to elevated plasma ASO levels. Therefore, we suppose that those lesions must have represented a part of poststreptococcal syndrome. Conclusions To conclude, this is, to the best of our knowledge, the first report of conjunctival involvement in the course of PSS related to group A streptococci.
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Affiliation(s)
- Iwona Rospond-Kubiak
- Department of Ophthalmology, Poznań University of Medical Sciences, 1/2 Długa St., Poznań 61-848, Poland.
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Helak-Łapaj C, Rospond-Kubiak I, Czaplicka EL, Kociecki JA. [Isolated congenital hamartoma of retinal pigment epithelium in a long term follow-up--case report]. Klin Oczna 2013; 115:304-306. [PMID: 24908922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Retinal pigment epithelium hamartomas are rare, benign tumors, usually with no growth potential. The case of hamartoma observed at the Ocular Oncology Service, Department of Ophthalmology, University of Medical Sciences in Poznań is presented. In 2008 a 30-year-old woman presented with an asymptomatic choroidal pigmented lesion. Fundus evaluation revealed a lesion typical of retinal pigment epithelium hamartoma. The optical coherence tomography, fluorescein angiography and indocyanine green angiography results confirmed the diagnosis of retinal pigment epithelium hamartoma. No lesion growth was documented throughout the follow-up period of 4 years. Differential diagnosis between congenital retinal pigment epithelium hypertrophy (congenital hypertrophy of the retinal pigment epithelium) or uveal melanoma was included in the report. retinal pigment epithelium hamartoma, fluorescein angiography, optical coherence tomography.
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Stopa M, Kociecki J, Rospond-Kubiak I, Rakowicz P. [Choroidal melanoma treatment by endoresection]. Klin Oczna 2011; 113:367-372. [PMID: 22384657] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE To report choroidal melanoma treatment by endoresection. MATERIAL AND METHODS A retrospective review of a series of 2 patients with choroidal melanoma that did not meet the criteria for brachytherapy. Both patients were treated by tumor endoresection supported by brachytherapy. Outcome measures included preoperative and postoperative visual acuity at 1, 3, 6 months. Preoperative evaluation included tumor measurements in ultrasound. Systemic evaluation (liver function test, chest x ray, abdominal ultrasound), was carried out to monitor possible metastases in the observation period. RESULTS The two operated patients were followed-up for 6 months. Visual acuity deteriorated from 5/16 (0.51 logMAR) preoperatively to 5/25 (0.7 logMAR) postoperatively in patient 1, and improved from 3/50 (1.22 logMAR) do 5/25 (0.7 logMAR) in patient 2. This corresponded to deterioration by 0.19 logMAR and improvement by 0.52 logMAR respectively. Neither tumor recurrence nor metastases were detected in the follow-up period. CONCLUSIONS Endoresection is a treatment option, alternative to enucleation, that can conserve the eye It sometimes can be performed in eyes that are not eligible for trans-scleral resection. Further larger studies are needed to establish the efficacy of this still controversial surgery.
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Affiliation(s)
- Marcin Stopa
- Z Katedry i Kliniki Okulistyki Uniwersytetu Medycznego w Poznaniu.
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Stopa M, Rospond-Kubiak I, Rakowicz P, Kociecki J. [Autologous choroidal RPE patch transplantation for submacular hemorrhage in age-related macular degeneration]. Klin Oczna 2010; 112:230-235. [PMID: 21121126] [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] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
PURPOSE To report autologous choroidal RPE patch transplantation for treatment of submacular hemorrhage in a patients with age related macular degeneration. MATERIAL AND METHODS A case report of a patient with sudden vision deterioration due to submacular hemorrhage in AMD. The visual acuity was 5/5 in the right eye and 0.5/50 in the left eye. He was treated with autologous choroidal RPE patch transplantation. Outcome measures included preoperative and postoperative visual acuity at 1, 3, 6 months, duration of hemorrhage, hemorrhage size on preoperative fluorescein angiography and thickness of the subretinal hemorrhagic complex on preoperative and postoperative OCT scans. RESULTS Visual acuity improved from 0.5/50 to 5/50 in 6 months follow-up. No major intraoperative and postoperative complications were observed. The perfusion of the graft was confirmed in ICG angiography. CONCLUSIONS Autologous choroidal RPE patch transplantation is an effective option for submacular hemorrhage treatment in AMD. Unlike macular translocation, the surgery can be performed even in patients with excellent visual acuity in the fellow eye.
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Affiliation(s)
- Marcin Stopa
- Z Katedry i Kliniki Okulistyki Uniwersytetu Medycznego w Poznaniu.
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