493 research outputs found
Osteopontin and `Melanoma Inhibitory Activity': Comparison of Two Serological Tumor Markers in Metastatic Uveal Melanoma Patients
Background: Evaluation of the protein osteopontin (OPN) as a potential new marker in comparison to melanoma inhibitory activity (MIA) for screening and detection of metastatic uveal melanoma. Methods: Plasma levels of 32 patients with uveal melanoma were analyzed for OPN and MIA by enzyme-linked immunosorbent assay (ELISA). Fourteen of these patients had clinically detectable liver metastases. Results: Median plasma concentration of OPN in patients with metastatic disease was 152.01 ng/ml compared to 47.39 ng/ml in patients without clinically detectable metastases (p < 0.001). The difference between the median MIA plasma levels in patients with (13.11 ng/ml) and patients without (5.64 ng/ml) metastatic disease was also statistically significant (p < 0.001). No correlation could be found between MIA or OPN levels and tumor height in patients without clinically detectable metastases. Conclusion: The proteins MIA and OPN seem to be promising tumor markers for the metastasis screening in patients with uveal melanoma. Copyright (C) 2009 S. Karger AG, Base
Intracameral Injection of Bevacizumab for the Treatment of Neovascular Glaucoma
Purpose: To assess the duration of the effect of intracameral bevacizumab in patients presenting with rubeosis iridis and neovascular glaucoma (NVG). Methods: Retrospective analysis of 24 consecutive eyes of 24 patients with decompensated NVG (> 21 mm Hg) treated with a single intracameral injection of bevacizumab over a minimum follow-up of 6 months. The endpoint of the study was the need for retreatment due to recurrence of raised intraocular pressure (IOP). Secondary outcome was the course of visual acuity (VA) and IOP over 6 months. Results: A Kaplan-Meier calculation revealed a mean duration of the treatment effect of 23 +/- 4.4 days. Compared to mean IOP before treatment (26.3 mm Hg), decreases to 17.5 mm Hg at 1 week after treatment (p < 0.002) and to 17.1 mm Hg (p < 0.005) at 6 months following a single injection were seen. At 6 months, additional treatment was performed in 87.5% (n = 21) of eyes. VA remained stable or improved in 75% (n = 18) of all cases. Conclusion: The IOP-lowering effect of intracameral bevacizumab can be seen 1 week after the injection, but is limited to a period of approximately 3 weeks. However, the fast and effective response to intracameral bevacizumab injection opens a time window for additional treatments, which are often necessary. Copyright (C) 2011 S. Karger AG, Base
Anatomic Success of Scleral Buckling for Rhegmatogenous Retinal Detachment - A Retrospective Study of 524 Cases
Background/Aim: Our purpose was to investigate the anatomic success of scleral buckling surgery for rhegmatogenous retinal detachment. Material and Methods: A total of 524 consecutive patients were retrospectively analysed. Several parameters including the lens status, number of breaks and extent of retinal detachment, preoperative proliferative vitreoretinopathy and refractive errors were examined. The minimum follow-up was 6 months. The primary success rate was defined as anatomic success being stable over a period of at least 6 months after surgery. The secondary success rate was defined as anatomic success after the second intervention if necessary. Besides an analysis over all patients, the patients were grouped according to the severity of the preoperative situation in simple, medium and severe cases. Results: The overall primary anatomic success rate was 84.7% and the secondary success rate 96.4% after 1 initial scleral buckling surgery and 1 additional surgery in case of persisting retinal detachment, and 19.1% of the patients with an initially attached retina after 1 scleral buckling surgery experienced a redetachment in the postoperative course and were successfully treated in 60/85 cases. In phakic patients (n = 359) the primary success rate was 89.7%, whereas in pseudophakic patients (n = 165) a primary success rate of 73.9% was obtained. The primary success was additionally influenced by the extent of the retinal detachment measured in clock hours (p <0.001), undetected holes (p = 0.004), small (p = 0.037) and no gas tamponade (p = 0.021). In simple, medium and severe cases, phakic patients always achieved better anatomic results (89.9, 89.1 and 90.2%) compared to pseudophakic ones (82.5, 70.3 and 36.4%). Conclusion: Scleral buckling is a very good surgical option in phakic patients irrespective of the preoperative severity and simple cases in pseudophakic patients. Scleral buckling represents a surgical technique worth being trained and performed in the light of favourable results especially in phakic eyes. Copyright (C) 2010 S. Karger AG, Base
Interference microscopy delineates cellular proliferations on flat mounted internal limiting membrane specimens.
Aim: To demonstrate that interference microscopy of flat
mounted internal limiting membrane specimens clearly
delineates cellular proliferations at the vitreomacular
interface.
Methods: ILM specimens harvested during vitrectomy
were fixed in glutaraldehyde 0.05% and paraformaldehyde
2% for 24 h (pH 7.4). In addition to interference
microscopy, immunocytochemistry using antibodies
against glial fibrillar acidic protein (GFAP) and neurofilament
(NF) was performed. After washing in phosphatebuffered
saline 0.1 M, the specimens were flat-mounted
on glass slides without sectioning, embedding or any
other technique of conventional light microscopy. A cover
slide and 49,6-diamidino-2-phenylindole (DAPI) medium
were added to stain the cell nuclei.
Results: Interference microscopy clearly delineates
cellular proliferations at the ILM. DAPI stained the cell
nuclei. Areas of cellular proliferation can be easily
distinguished from ILM areas without cells.
Immunocytochemistry can be performed without changing
the protocols used in conventional microscopy.
Conclusion: Interference microscopy of flat mounted ILM
specimens gives new insights into the distribution of
cellular proliferations at the vitreomacular interface and
allows for determination of the cell density at the ILM.
Given that the entire ILM peeled is seen en face, the
techniques described offer a more reliable method to
investigate the vitreoretinal interface in terms of cellular
distribution compared with conventional microscopy
How it appears: electron microscopic evaluation of internal limiting membrane specimens obtained during brilliant blue G assisted macular hole surgery
How to treat recurrences after Avastin treatment for neovascular AMD: stick to Avastin or switch to Lucentis?
Retinal Hemorrhages in 4 Patients with Dengue Fever
We report 4 patients with retinal hemorrhages that developed during hospitalization for dengue fever. Onset of symptoms coincided with resolution of fever and the nadir of thrombocytopenia. Retinal hemorrhages may reflect the rising incidence of dengue in Singapore or may be caused by changes in the predominant serotype of the dengue virus
Chromovitrectomy and the Vitreoretinal Interface
It still remains unclear to which extent the presence and the amount ofretinal debris seen in internal limiting membrane (ILM) specimensharvested during macular surgery for macular holes or epiretinalmembranes are related to the procedure of ILM peeling itself or tomodifications of the surgical technique, such as application of vitaldyes for visualization of the ILM, or to pathological conditions withepiretinal membrane formation at the vitreoretinal interface. Thepresence of cellular fragments on the retinal side of the removed ILMappears to be of multifactorial origin, and additional causes besidesdye application need to be considered. However, morphological studieswith evaluation of vital dyes are still of relevance and provideadditional insights into the ultrastructure of the vitreoretinalinterface and its interaction with adjuvants used during macularsurgery. Chromovitrectomy is an emerging field in vitreoretinal surgery.It is of importance to better understand the tissue-dye interactions,which not only alter the mechanical properties of the tissue beingstained, but may also have an impact on the functional resultpostoperatively
Alpha-Lipoic Acid for the Prevention of Diabetic Macular Edema
Introduction: To evaluate the effect of alpha-lipoic acid (ALA) on the occurrence of diabetic macular edema. Methods: Randomized, double-blind, placebo-controlled, multicenter, multinational study. Patients were randomized to the treatment group with 600 mg ALA per day or the placebo group. Every 6 months stereo fundus photographs, HbA1c levels, and an ophthalmological examination were documented. The primary endpoint was the occurrence of clinically significant macular edema (CSME) within a follow-up period of 2 years. Results: We randomized 235 patients with type II diabetes mellitus into the treatment group (mean age 58.0 years) and 232 into the placebo group (mean age 57.9 years). Mean HbA1c level was 8.1, with no significant differences between the treatment (mean 8.2, SD +/- 1.35) and placebo groups (mean 8.1, SD +/- 1.29). HbA1c values remained constant over time. In the treatment and placebo groups, 84 and 86 patients (35.7 and 37.1%) had insulin-dependent diabetes mellitus (IDDM) with a median duration of diabetes of 9.3 versus 9.0 years in the placebo group. Visual acuity remained unchanged during the entire trial. Concerning the primary endpoint, the study provided a negative result, i.e. 26/235 patients in the treatment group and 30/232 patients in the placebo group developed CSME. Confirmatory intention-to-treat analysis of the primary endpoint revealed no statistically significant difference between groups (log-rank test, p = 0.7108, HR = 0.9057 with CI = 0.5355-1.5317). Median follow-up was identical (2.00 years). Conclusions: A daily dosage of 600 mg ALA does not prevent the occurrence of CSME in IDDM patients. Copyright (C) 2011 S. Karger AG, Base
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