Primary Cancer Sites and Clinical Features of Choroidal Metastasis in Mexican Patients

Purpose

To describe the primary cancer sites and clinical features of choroidal metastasis in Mexican patients.

Methods

This was a retrospective, observational, and multi-center study. Data were recollected from 6 ophthalmological hospitals in Mexico from patients with choroidal metastasis diagnosed from 2000 to 2018.

Results

Seventy-eight patients were studied: 43 were female and 35 were male. Mean age at presentation was 57.6 years. Overall, primary cancer sites were: 1) breast: 27 cases (34.6%); 2) lung: 19 cases (24.3%); 3) unknown: 8 cases (10.2%); 4) gastrointestinal: 7 cases (8.9%); 5) renal: 5 cases (6.4%); 6) testicular: 3 cases (3.8%); 7) ovary: 3 Cases (3.8%); 8) prostate: 2 cases (2.5%); 9) thyroid: 2 cases (2.5%); 10) carcinoid: 1 case (1.2%); and 11) multiple myeloma: 1 case (1.2%). Divided by gender, for women, the main three sites were: breast, unknown, and ovary. For men, the main three sites were: lung, gastrointestinal, and testicular. Oldest cases were breast cancer (87 and 85 years); youngest cases were testicular (23 and 25 years). Solitary lesions were observed in 56 cases (71.7%); multiple lesions were observed in 22 cases (28.2%). Forty-two cases had a white or yellowish color, while 6 cases presented an orange color.

Conclusion

Primary cancer sites and clinical features of choroidal metastasis in Mexican patients show important differences from other populations previously studied, mainly the presence of a higher proportion of gastrointestinal and renal cancer, as well as higher incidence of ovarian and testicular cancer. These types of cancer, although not as common as breast or lung, need to be taken into account when studying Mexican patients living abroad.

Oxymetazoline: reduction of subconjunctival hemorrhage incidence after intravitreal injections

OBJECTIVE

Subconjunctival hemorrhage (SCH) is an important minor side effect that might affect patient compliance to antivascular endothelial growth factor (anti-VEGF) intravitreal injection treatment (IVI). We sought to compare SCH incidence and pain score responses after topical oxymetazoline in naïve patients undergoing a single IVI of ranibizumab for diabetic macular edema.

METHODS

Prospective, randomized, double-blinded, single centre study. One hundred two patients naïve to anti-VEGF were assigned to receive either topical oxymetazoline or placebo 30 minutes before IVI. SCH incidence and area were measured by slit lamp 24 hours after, and pain was evaluated 5 minutes and 24 hours after.

RESULTS

SCH incidence was reported on 72% in control group versus 51% in oxymetazoline group (p = 0.037). Mean size of SCH was 16.82 mm² in control group versus 12.55 mm² in oxymetazoline group (p = 0.394). Prevalence of local pain in the overall study population was 60%. No significant statistical difference was achieved between groups 5 minutes or 24 hours after IVI in either pain scale evaluation.

CONCLUSION

Administration of topical oxymetazoline 30 minutes before IVI is a single, harmless, cost-effective intervention that decreases the incidence of subconjunctival hemorrhage. This may considerably improve patient treatment satisfaction and promote compliance to IVI therapy.

Widely power-tunable polarization-independent ultrafast mode-locked fiber laser using bulk InN as saturable absorber

The growing demand of ultrafast mode-locked fiber lasers in the near infrared has boosted the research activity in this area. One of the most convenient ways to achieve passive mode locking consists of inserting a semiconductor saturable absorber in the laser cavity to modulate the losses. However, in such a configuration, the limited power range of operation is still an unsolved issue. Here we report the fabrication of an ultrafast, high-power, widely power-tunable and non-polarization-dependent mode-locked fiber laser operating at 1.55 µm, using an InN layer as saturable absorber. With post-amplification, this laser delivers 55-fs pulses with a repetition rate of 4.84 MHz and peak power in the range of 1 MW in an all-fiber arrangement.