Pub Date : 2024-05-01DOI: 10.1016/j.apjo.2024.100068
Jun Yu , Marten E. Brelen , Carmen K.M. Chan , Zhen Ji Chen , Shaheeda Mohamed , Jason C. Yam , Dennis S.C. Lam , Chi Pui Pang , Clement C. Tham , Li Jia Chen
Purpose
To evaluate the associations of the TIE2 gene with diabetic retinopathy (DR) and diabetic macular edema (DME).
Methods
This study included a Chinese cohort of 285 non-proliferative DR patients and 433 healthy controls. The DR patients were classified further into those with or without DME. Thirty haplotype-tagging single-nucleotide polymorphisms (SNPs) in TIE2 were genotyped using TaqMan technology. Associations of DR and subtypes were analyzed by logistic regression adjusted for age and sex. Stratification association analysis by sex was performed.
Results
TIE2 rs625767 showed a nominal but consistent association with DR [odds ratio (OR) = 0.71, P = 0.005] and subtypes (DR without DME: OR = 0.69, P = 0.016; DME: OR = 0.73, P = 0.045). SNP rs652010 was consistently associated with overall DR (OR = 0.74, P = 0.011) and DR without DME (OR = 0.70, P = 0.016), but not with DME. Moreover, SNPs rs669441, rs10967760, rs549099 and rs639225 showed associations with overall DR, whilst rs17761403, rs664461 and rs1413825 with DR without DME. In stratification analysis, three SNPs, rs625767 (OR = 0.62, P = 0.005), rs669441 (OR = 0.63, P = 0.006) and rs652010 (OR = 0.64, P = 0.007), were associated with DR in females, but not in males. Moreover, one haplotype T-T defined by rs625767 and rs669441 was significantly associated with DR in females only.
Conclusions
This study revealed TIE2 as a susceptibility gene for DR and DME in Chinese, with a sex-specific association in females. Further validation should be warranted.
{"title":"Genetic association of TIE2 with diabetic retinopathy and diabetic macular edema","authors":"Jun Yu , Marten E. Brelen , Carmen K.M. Chan , Zhen Ji Chen , Shaheeda Mohamed , Jason C. Yam , Dennis S.C. Lam , Chi Pui Pang , Clement C. Tham , Li Jia Chen","doi":"10.1016/j.apjo.2024.100068","DOIUrl":"10.1016/j.apjo.2024.100068","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate the associations of the <em>TIE2</em> gene with diabetic retinopathy (DR) and diabetic macular edema (DME).</p></div><div><h3>Methods</h3><p>This study included a Chinese cohort of 285 non-proliferative DR patients and 433 healthy controls. The DR patients were classified further into those with or without DME. Thirty haplotype-tagging single-nucleotide polymorphisms (SNPs) in <em>TIE2</em> were genotyped using TaqMan technology. Associations of DR and subtypes were analyzed by logistic regression adjusted for age and sex. Stratification association analysis by sex was performed.</p></div><div><h3>Results</h3><p><em>TIE2</em> rs625767 showed a nominal but consistent association with DR [odds ratio (OR) = 0.71, <em>P</em> = 0.005] and subtypes (DR without DME: OR = 0.69, <em>P</em> = 0.016; DME: OR = 0.73, <em>P</em> = 0.045). SNP rs652010 was consistently associated with overall DR (OR = 0.74, <em>P</em> = 0.011) and DR without DME (OR = 0.70, <em>P</em> = 0.016), but not with DME. Moreover, SNPs rs669441, rs10967760, rs549099 and rs639225 showed associations with overall DR, whilst rs17761403, rs664461 and rs1413825 with DR without DME. In stratification analysis, three SNPs, rs625767 (OR = 0.62, <em>P</em> = 0.005), rs669441 (OR = 0.63, <em>P</em> = 0.006) and rs652010 (OR = 0.64, <em>P</em> = 0.007), were associated with DR in females, but not in males. Moreover, one haplotype T-T defined by rs625767 and rs669441 was significantly associated with DR in females only.</p></div><div><h3>Conclusions</h3><p>This study revealed <em>TIE2</em> as a susceptibility gene for DR and DME in Chinese, with a sex-specific association in females. Further validation should be warranted.</p></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000690/pdfft?md5=557de62f295c250b5dc64cbf64543286&pid=1-s2.0-S2162098924000690-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140943302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1016/j.apjo.2024.100070
Sudarshan Seshasai , Feng He , Betty Lam , Haslina Hamzah , Ching-Yu Cheng , Jialiang Li , Tien Yin Wong , Gavin Siew Wei Tan , Charumathi Sabanayagam
Purpose
To evaluate the dynamic transitions in diabetic retinopathy (DR) severity over time and associated risk factors in an Asian population with diabetes.
Design
Longitudinal cohort study
Methods
We analyzed data from 9481 adults in the Singapore Integrated Diabetic Retinopathy Screening Program (2010–2015) with linkage to death registry. A multistate Markov model adjusted for age, sex, systolic blood pressure (SBP), diabetes duration, HbA1c, and body mass index (BMI) was applied to estimate annual transition probabilities between four DR states (no, mild, moderate, and severe/proliferative) and death, and the mean sojourn time in each state.
Results
The median assessment interval was 12 months, with most patients having 3 assessments. Annual probabilities for DR progression (no-to-mild, mild-to-moderate and moderate-to-severe/proliferative) were 6.1 %, 7.0 % and 19.3 %, respectively; and for regression (mild-to-no, moderate-to-mild and severe-to-moderate) were 55.4 %, 17.3 % and 4.4 %, respectively. Annual mortality rates from each DR state were 1.2 %, 2.0 %, 18.7 %, and 30.0 %. The sojourn time in each state were 8.2, 0.8, 0.8 and 2.2 years. Higher HbA1c and SBP levels were associated with progression of no-mild and mild-moderate DR, and diabetes duration with no-to-mild and moderate-to-severe/proliferative DR. Lower HbA1c levels were associated with regression from mild-to-no and moderate-to-mild, and higher BMI with mild-to-no DR.
Conclusions
Our results suggest a prolonged duration (∼8 years) in developing mild DR, with faster transitions (within a year) from mild or moderate states. Moderate/above DR greatly increases the probability of progression and death as compared to mild DR/below. HbA1c was associated with both progression as well as regression.
目的:评估亚洲糖尿病患者糖尿病视网膜病变(DR)严重程度随时间的动态变化及相关风险因素:纵向队列研究 方法:我们分析了新加坡综合糖尿病视网膜病变筛查项目(2010-2015 年)中 9481 名成人的数据,并与死亡登记进行了链接。我们采用了一个多状态马尔可夫模型,并对年龄、性别、收缩压(SBP)、糖尿病病程、HbA1c 和体重指数(BMI)进行了调整,以估算四种 DR 状态(无、轻度、中度和重度/增殖性)与死亡之间的年度转换概率,以及在每种状态下的平均停留时间:评估间隔中位数为 12 个月,大多数患者接受过 3 次评估。DR进展(无至轻度、轻度至中度和中度至重度/增殖性)的年概率分别为6.1%、7.0%和19.3%;DR退化(轻度至无、中度至轻度和重度至中度)的年概率分别为55.4%、17.3%和4.4%。DR 各州的年死亡率分别为 1.2%、2.0%、18.7% 和 30.0%。在各州的停留时间分别为 8.2 年、0.8 年、0.8 年和 2.2 年。较高的 HbA1c 和 SBP 水平与非轻度和轻度-中度 DR 的进展有关,糖尿病持续时间与非轻度和中度-重度/增生性 DR 有关。较低的 HbA1c 水平与轻度至非轻度和中度至轻度 DR 的进展有关,较高的 BMI 与轻度至非轻度 DR 有关:我们的研究结果表明,轻度 DR 的发展持续时间较长(约 8 年),从轻度或中度状态过渡的速度较快(一年内)。与轻度 DR/轻度以下相比,中度 DR/中度以上大大增加了病情恶化和死亡的概率。HbA1c 既与病情进展有关,也与病情消退有关。
{"title":"Transition probabilities of diabetic retinopathy and death in an Asian population with diabetes","authors":"Sudarshan Seshasai , Feng He , Betty Lam , Haslina Hamzah , Ching-Yu Cheng , Jialiang Li , Tien Yin Wong , Gavin Siew Wei Tan , Charumathi Sabanayagam","doi":"10.1016/j.apjo.2024.100070","DOIUrl":"10.1016/j.apjo.2024.100070","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate the dynamic transitions in diabetic retinopathy (DR) severity over time and associated risk factors in an Asian population with diabetes.</p></div><div><h3>Design</h3><p>Longitudinal cohort study</p></div><div><h3>Methods</h3><p>We analyzed data from 9481 adults in the Singapore Integrated Diabetic Retinopathy Screening Program (2010–2015) with linkage to death registry. A multistate Markov model adjusted for age, sex, systolic blood pressure (SBP), diabetes duration, HbA1c, and body mass index (BMI) was applied to estimate annual transition probabilities between four DR states (no, mild, moderate, and severe/proliferative) and death, and the mean sojourn time in each state.</p></div><div><h3>Results</h3><p>The median assessment interval was 12 months, with most patients having 3 assessments. Annual probabilities for DR progression (no-to-mild, mild-to-moderate and moderate-to-severe/proliferative) were 6.1 %, 7.0 % and 19.3 %, respectively; and for regression (mild-to-no, moderate-to-mild and severe-to-moderate) were 55.4 %, 17.3 % and 4.4 %, respectively. Annual mortality rates from each DR state were 1.2 %, 2.0 %, 18.7 %, and 30.0 %. The sojourn time in each state were 8.2, 0.8, 0.8 and 2.2 years. Higher HbA1c and SBP levels were associated with progression of no-mild and mild-moderate DR, and diabetes duration with no-to-mild and moderate-to-severe/proliferative DR. Lower HbA1c levels were associated with regression from mild-to-no and moderate-to-mild, and higher BMI with mild-to-no DR.</p></div><div><h3>Conclusions</h3><p>Our results suggest a prolonged duration (∼8 years) in developing mild DR, with faster transitions (within a year) from mild or moderate states. Moderate/above DR greatly increases the probability of progression and death as compared to mild DR/below. HbA1c was associated with both progression as well as regression.</p></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000719/pdfft?md5=0263ffbc445267442e3c7663ae7a45f8&pid=1-s2.0-S2162098924000719-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1016/j.apjo.2024.100073
Melissa K. Shields , João M. Furtado , Stewart R. Lake , Justine R. Smith
Scleritis and episcleritis are rare, but potentially sight-threatening forms of syphilis. To provide a full description of this neglected subset of ocular syphilis, we evaluated the English literature for reports of syphilitic scleritis and episcleritis, recording the demographics, clinical characteristics, serological data, management practices, treatment responses, and visual outcomes. Previously published descriptions of 44 patients with syphilitic scleritis (50 eyes) and 9 patients with syphilitic episcleritis (14 eyes) were identified. The predominant type of scleritis was anterior scleritis, accounting for 92.9% of cases, with nodular anterior scleritis being the most frequent subtype at 58.1%. Almost one-quarter of patients were co-infected with human immunodeficiency virus (HIV). Initial misdiagnosis was common and led to delays in initiating treatment with appropriate antibiotics. Visual outcomes were often good in both scleritis and episcleritis, irrespective of HIV infection status, although complications including scleral thinning, keratitis, and uveitis, along with permanent visual loss and an association with neurosyphilis, were reported. Response to antibiotic treatment was typically rapid, often within 1 week. With the rising global incidence of syphilis, testing patients with scleritis or episcleritis for this infectious disease is important to ensure prompt diagnosis and treatment for best ocular and systemic outcomes.
{"title":"Syphilitic scleritis and episcleritis: A review","authors":"Melissa K. Shields , João M. Furtado , Stewart R. Lake , Justine R. Smith","doi":"10.1016/j.apjo.2024.100073","DOIUrl":"10.1016/j.apjo.2024.100073","url":null,"abstract":"<div><p>Scleritis and episcleritis are rare, but potentially sight-threatening forms of syphilis. To provide a full description of this neglected subset of ocular syphilis, we evaluated the English literature for reports of syphilitic scleritis and episcleritis, recording the demographics, clinical characteristics, serological data, management practices, treatment responses, and visual outcomes. Previously published descriptions of 44 patients with syphilitic scleritis (50 eyes) and 9 patients with syphilitic episcleritis (14 eyes) were identified. The predominant type of scleritis was anterior scleritis, accounting for 92.9% of cases, with nodular anterior scleritis being the most frequent subtype at 58.1%. Almost one-quarter of patients were co-infected with human immunodeficiency virus (HIV). Initial misdiagnosis was common and led to delays in initiating treatment with appropriate antibiotics. Visual outcomes were often good in both scleritis and episcleritis, irrespective of HIV infection status, although complications including scleral thinning, keratitis, and uveitis, along with permanent visual loss and an association with neurosyphilis, were reported. Response to antibiotic treatment was typically rapid, often within 1 week. With the rising global incidence of syphilis, testing patients with scleritis or episcleritis for this infectious disease is important to ensure prompt diagnosis and treatment for best ocular and systemic outcomes.</p></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000744/pdfft?md5=b14457d6b0f23204e914f3c8dbf37d08&pid=1-s2.0-S2162098924000744-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141141944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.apjo.2024.100057
Kristina Joana Schoelles, Claudia Auw-Haedrich
In this review, we aim to provide an overview of the five most common malignant eyelid tumors with current treatment recommendations based on international guidelines. Particular attention is paid to the clinicopathological correlation and the update with regard to adequate treatment. Newer systemic therapies enrich the existing treatment options, of which complete tumor excision remains the most important therapeutic measure.
{"title":"Updates on eyelid cancers","authors":"Kristina Joana Schoelles, Claudia Auw-Haedrich","doi":"10.1016/j.apjo.2024.100057","DOIUrl":"https://doi.org/10.1016/j.apjo.2024.100057","url":null,"abstract":"<div><p>In this review, we aim to provide an overview of the five most common malignant eyelid tumors with current treatment recommendations based on international guidelines. Particular attention is paid to the clinicopathological correlation and the update with regard to adequate treatment. Newer systemic therapies enrich the existing treatment options, of which complete tumor excision remains the most important therapeutic measure.</p></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000525/pdfft?md5=09cfa1bce3a657469c3251e5e0fe271d&pid=1-s2.0-S2162098924000525-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140650966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.apjo.2024.100050
Thomas M. Catapano, Rolika Bansal, Carol L. Shields
{"title":"Vitreous metastasis from cutaneous melanoma while on checkpoint inhibitors","authors":"Thomas M. Catapano, Rolika Bansal, Carol L. Shields","doi":"10.1016/j.apjo.2024.100050","DOIUrl":"10.1016/j.apjo.2024.100050","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000458/pdfft?md5=bd4583a6c643e85a3045bed008d6a50f&pid=1-s2.0-S2162098924000458-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140139841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.apjo.2024.100062
Mrittika Sen , Hakan Demirci , Santosh G. Honavar
There have been rapid advancements in the field of ocular oncology for the diagnosis and management of intraocular, adnexal, and orbital tumors. Targeted therapy is in the forefront of medical research in all fields including ocular oncology. Targeted therapy include drugs that target specific genetic mutations, pathways or proteins involved in the development of cancer. In contrast to traditionally used chemotherapy, drugs used in targeted therapy are highly specific for tumor cells and preserve the function of normal cells. This review aims to familiarize ophthalmologists with the drugs that are currently approved or undergoing clinical trials for use in ocular oncology. Targeted therapy is particularly useful for locally advanced or metastatic tumors, including but not limited to eyelid and periocular basal cell carcinoma, periocular cutaneous and conjunctival squamous cell carcinoma, ocular adnexal lymphoma, conjunctival melanoma, and uveal melanoma. The results are promising with improved survival outcomes and better tolerability than chemotherapeutic drugs.
{"title":"Targeted therapy in ophthalmic oncology: The current status","authors":"Mrittika Sen , Hakan Demirci , Santosh G. Honavar","doi":"10.1016/j.apjo.2024.100062","DOIUrl":"https://doi.org/10.1016/j.apjo.2024.100062","url":null,"abstract":"<div><p>There have been rapid advancements in the field of ocular oncology for the diagnosis and management of intraocular, adnexal, and orbital tumors. Targeted therapy is in the forefront of medical research in all fields including ocular oncology. Targeted therapy include drugs that target specific genetic mutations, pathways or proteins involved in the development of cancer. In contrast to traditionally used chemotherapy, drugs used in targeted therapy are highly specific for tumor cells and preserve the function of normal cells. This review aims to familiarize ophthalmologists with the drugs that are currently approved or undergoing clinical trials for use in ocular oncology. Targeted therapy is particularly useful for locally advanced or metastatic tumors, including but not limited to eyelid and periocular basal cell carcinoma, periocular cutaneous and conjunctival squamous cell carcinoma, ocular adnexal lymphoma, conjunctival melanoma, and uveal melanoma. The results are promising with improved survival outcomes and better tolerability than chemotherapeutic drugs.</p></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000574/pdfft?md5=85678c7a220df6a776bbd6d7db46735b&pid=1-s2.0-S2162098924000574-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140650981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.apjo.2024.100051
Xiaolu Yang , Ruonan Wang , Hao Zhou , Suqin Yu
{"title":"Bilateral diffuse uveal melanocytic proliferation secondary to combined hepatocellular-cholangiocarcinoma","authors":"Xiaolu Yang , Ruonan Wang , Hao Zhou , Suqin Yu","doi":"10.1016/j.apjo.2024.100051","DOIUrl":"10.1016/j.apjo.2024.100051","url":null,"abstract":"","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S216209892400046X/pdfft?md5=61680a9e0dd48211954fae0c94a3cfb6&pid=1-s2.0-S216209892400046X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140179282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.apjo.2024.100053
Eduardo Roditi , Shyam Panicker , Adrian T. Fung
Purpose
Intravascular large B-cell lymphoma (IVLBCL) is an extremely rare, aggressive, multi-system disease that can affect the eye. We describe the ophthalmic presentation, multimodal imaging and treatment response of uveal IVLBCL.
Methods
Review and case report.
Results
Twenty-five published cases of IVLBCL involving the eye including our own were identified. Of these, 15 patients (60%) had clinically-detectable intraocular involvement, 6 (24%) had extraocular ophthalmic involvement only and 4 (16%) had subclinical, undiagnosed intraocular involvement that was retrospectively detected on post-mortem ocular histopathology. The male to female ratio was 1.08:1 with a mean presenting age of 65.1 ± 11.7 years (range 38–82 years). The majority of cases had bilateral involvement (21/25 patients, 84%). Extraocular manifestations included diplopia, ptosis and ophthalmoplegia. Intraocular manifestations included serous retinal detachment (13/28, 46%), retinal hemorrhages (9/28, 32%), vascular changes (9/28, 32%), retinal pigment epithelial changes (7/28, 25%), thickened choroid (6/28, 21%), vitritis (5/28, 17%), cotton-wool spots (3/28, 10%), and a subretinal lesion (1/28, 3%). Histopathological diagnosis was most commonly confirmed on post-mortem enucleation (8/25 patients, 32%), skin (6/25 patients, 24%) or brain biopsy (6/25 patients, 24%).
Conclusion
The presence of intra-retinal hemorrhages, cotton wool spots and/or Roth spots help differentiate IVLBCL from other similarly presenting diseases such as central serous chorioretinopathy and Vogt-Koyanagi-Harada disease. New signs not previously described in IVLBCL include macular bacillary layer detachment and hypo-cyanescent spots on ultra-wide field indocyanine green angiography. The diagnosis is elusive and requires tissue biopsy, but systemic chemotherapy and rituximab can lead to rapid improvement of the eye.
{"title":"Intravascular large B-cell lymphoma of the eye: Literature review and new findings","authors":"Eduardo Roditi , Shyam Panicker , Adrian T. Fung","doi":"10.1016/j.apjo.2024.100053","DOIUrl":"10.1016/j.apjo.2024.100053","url":null,"abstract":"<div><h3>Purpose</h3><p>Intravascular large B-cell lymphoma (IVLBCL) is an extremely rare, aggressive, multi-system disease that can affect the eye. We describe the ophthalmic presentation, multimodal imaging and treatment response of uveal IVLBCL.</p></div><div><h3>Methods</h3><p>Review and case report.</p></div><div><h3>Results</h3><p>Twenty-five published cases of IVLBCL involving the eye including our own were identified. Of these, 15 patients (60%) had clinically-detectable intraocular involvement, 6 (24%) had extraocular ophthalmic involvement only and 4 (16%) had subclinical, undiagnosed intraocular involvement that was retrospectively detected on post-mortem ocular histopathology. The male to female ratio was 1.08:1 with a mean presenting age of 65.1 ± 11.7 years (range 38–82 years). The majority of cases had bilateral involvement (21/25 patients, 84%). Extraocular manifestations included diplopia, ptosis and ophthalmoplegia. Intraocular manifestations included serous retinal detachment (13/28, 46%), retinal hemorrhages (9/28, 32%), vascular changes (9/28, 32%), retinal pigment epithelial changes (7/28, 25%), thickened choroid (6/28, 21%), vitritis (5/28, 17%), cotton-wool spots (3/28, 10%), and a subretinal lesion (1/28, 3%). Histopathological diagnosis was most commonly confirmed on post-mortem enucleation (8/25 patients, 32%), skin (6/25 patients, 24%) or brain biopsy (6/25 patients, 24%).</p></div><div><h3>Conclusion</h3><p>The presence of intra-retinal hemorrhages, cotton wool spots and/or Roth spots help differentiate IVLBCL from other similarly presenting diseases such as central serous chorioretinopathy and Vogt-Koyanagi-Harada disease. New signs not previously described in IVLBCL include macular bacillary layer detachment and hypo-cyanescent spots on ultra-wide field indocyanine green angiography. The diagnosis is elusive and requires tissue biopsy, but systemic chemotherapy and rituximab can lead to rapid improvement of the eye.</p></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000483/pdfft?md5=83fb7b14d366b521f0b7f478f4278a02&pid=1-s2.0-S2162098924000483-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140331538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.apjo.2024.100047
Joevy Z. Lim , Akilesh Gokul , Stuti L. Misra , Xingzheng Pan , Amanda Charlton , Charles N.J. McGhee
Introduction
Magnetic resonance imaging (MRI) has demonstrated high levels of tissue contrast, accuracy and reproducibility in evaluating posterior uveal melanoma. Owing to smaller size, the role of MRI in detecting and characterising iris melanoma has not yet been explored. Aims: To develop a protocol to image iris melanoma and describe the MRI characteristics of histopathological-confirmed iris melanoma.
Materials and methods
An optimised MRI protocol, using a 3T MRI scanner and a 32-channel head coil, was developed to image iris tumours. A prospective, single-centre, 12-month study was conducted on all patients with lesions suspicious for iris melanoma. All patients were offered an MRI scan in addition to the standardised clinical procedures. Image quality comparison was made with existing clinical investigations. Iris melanoma characteristics on MRI are described.
Results
A successful optimised MRI scan protocol was developed that was able to detect and characterise iris melanoma. One normal participant and five patients with subsequent histopathological-confirmed iris melanoma (n = 6) were recruited. Four patients completed the full MRI sequence. All iris melanoma were detected on at least one T1- or T2-weighted images. When compared to the vitreous, all iris melanomas demonstrated hyper-intensity on T1-weighted images and hypo-intensity on T2-weighted images. On T1-mapping, T1-values of iris melanoma demonstrated an inverse relationship with the degree of tumour pigmentation.
Conclusions
This study highlights an optimised, easily reproducible MRI scan protocol to image iris melanoma. Numerous MR imaging characteristics of iris melanoma are reported for the first time and a potential non-invasive tumour biomarker is described.
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