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Grusha YO, Fedorov AA, Prause JU, Eksarenko OV, Sheptulin VA. [Experimental study of hyaluronic acid gel fillers biodegradation in orbit]. Vestn Oftalmol 2020; 136:13-19. [PMID: 32366064 DOI: 10.17116/oftalma202013602113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Recently, hyaluronic acid gel (HAG) fillers were proposed as an effective alternative treatment option for surgical orbital volume augmentation. Several authors reported about long-standing effect of the filler. PURPOSE To assess the features of HAG biodegradation after intraorbital injection in experimental environment. MATERIAL AND METHODS In the course of the experiment, 7 chinchilla rabbits (14 eyes) received a single 1ml intraorbital HAG injection (Restylane SubQ, Galderma, Sweden) using a cannula. The animals' orbits were examined by ultrasound scan after the injection and at 1, 3, 6, 9, 12 and 18 months. The animals were subsequently sacrificed for morphological study of orbital tissue containing the HAG filler. RESULTS The HAG filler persisted in the orbit of experimental animals during the whole follow-up period. The volume of HAG depot and its density diminished gradually till the 18th month, after which the particles of HAG could still be detected with the morphological study and ultrasound. CONCLUSION The HAG filler persisted in the orbit of experimental animals up to 18 months. Incomplete biodegradation explains the longstanding duration of the injection effect.
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Affiliation(s)
- Ya O Grusha
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Research Institute of Eye Diseases, Moscow, Russia
| | - A A Fedorov
- Research Institute of Eye Diseases, Moscow, Russia
| | - J U Prause
- Eye Pathology Institute, University of Copenhagen, Copenhagen, Denmark
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Grusha YO, Sheptulin VA, Prause JU, Danilov SS. [Hyaluronic acid gel implants for correction of pathological conditions of the orbit and eyelids]. Vestn Oftalmol 2018; 134:61-71. [PMID: 30499541 DOI: 10.17116/oftalma201813405161] [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] [Indexed: 11/18/2022]
Abstract
PURPOSE To evaluate the effectiveness of injectable implants made of hyaluronic acid gel (HAG) in ophthalmoplastics. MATERIAL AND METHODS The study included 57 patients (37 patients with lagophthalmos related to acute or chronic facial nerve palsy, endocrine ophthalmopathy; 20 patients with enophthalmos, anophthalmic syndrome). Depending on filler particle size, the patients received either intrapalpebral or intraorbital HAG injection. The biometric measures of palpebral fissure, the position of the eye/implant, and the condition of the cornea were evaluated during the follow-up period (12 months for eyelid and 18 for orbital injection). RESULTS In the course of the follow-up, all patients showed reliable reduction of lagophthalmos; additionally, improvement of the condition of the cornea was observed in patients after intrapalpebral injection; patients after intraorbital injection exhibited reduction in enophthalmos, upper orbital palpebral fold retraction and upper eyelid excursion. No serious complications have occurred after the injection. CONCLUSION As minimally invasive method of treating various pathologies of the orbit and eyelids, HAG fillers showed good clinical effectiveness and safety.
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Affiliation(s)
- Y O Grusha
- Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021; I.M. Sechenov First Moscow Medical University, 8-2 Trubetskaya St., Moscow, Russian Federation, 119991
| | - V A Sheptulin
- Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021
| | - J U Prause
- Eye Pathology Institute, University of Copenhagen, 10 Nørregade, Copenhagen, Denmark, 1165
| | - S S Danilov
- Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021
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Abstract
Purpose To present two cases of rapidly growing tumors in the ocular adnexa. Both tumors were Epstein-Barr virus (EBV) positive peripheral T-cell lymphoma. Methods Case 1 was a 60-year-old man with a non-tender ulcerating tumor involving the lateral third of both upper and lower right eyelid. Case 2 was a 55-year-old man with a swelling of the left eyelid expanding cranially and dislocating the left eye, resulting in proptosis and diplopia. Both patients underwent incisional biopsy that did not disclose the malignant nature of the tumors. Clinical evaluation resulted in suspicion of malignancy and surgical excision was performed. Results The tumors were found to be consistent with EBV-positive peripheral T-cell lymphoma. Conclusions Peripheral T-cell lymphoma is uncommon but a diagnosis to be considered in a patient with a tumorous lesion in the eye region. Furthermore, peripheral T-cell lymphoma may be EBV-positive.
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Affiliation(s)
- L D Sjö
- Eye Pathology Institute, University of Copenhagen, Copenhagen, Denmark
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Eisgart F, Gregersen E, Prause JU. Experiences with fresh refrigerated corneas versus corneas stored in McCarey-Kaufman medium. Dev Ophthalmol 2015; 11:32-6. [PMID: 3894090 DOI: 10.1159/000411084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Grusha YO, Fedorov AA, Ismailova DS, Prause JU. [Rare case of primary orbital osteoma]. Vestn Oftalmol 2015; 131:76-81. [PMID: 26977730 DOI: 10.17116/oftalma2015131676-81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We report a case of primary orbital osteoma originated from the sphenoid and notable for a mismatch between its giant size and mild clinical presentation. A lot of attention has been paid to the choice of surgical technique.
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Affiliation(s)
- Y O Grusha
- Research Institute of Eye Diseases, 11 A,B, Rossolimo St., Moscow, Russian Federation, 119021; I.M. Sechenov First Moscow State Medical University, 2-4 Bol'shaya Pirogovskaya St., Moscow, Russian Federation, 119991
| | - A A Fedorov
- Research Institute of Eye Diseases, 11 A,B, Rossolimo St., Moscow, Russian Federation, 119021
| | - D S Ismailova
- Research Institute of Eye Diseases, 11 A,B, Rossolimo St., Moscow, Russian Federation, 119021; I.M. Sechenov First Moscow State Medical University, 2-4 Bol'shaya Pirogovskaya St., Moscow, Russian Federation, 119991
| | - J U Prause
- Eye Pathology Institute, University of Copenhagen, INF - Frederik V's Vej 11, 2100, Copenhagen, Denmark
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Abstract
UNLABELLED Hyaluronic acid gel (HAG) fillers are successfully used in the treatment of many eyelid disorders. It is considered that the effect of HAG injection lasts for 6 months on average. However, in our experience volume augmentation persists longer, suggesting that the presence of the filler in the eyelid may be associated with certain tissue reactions. The objective of the study was to investigate morphological features of HAG biodegradation. MATERIAL AND METHODS Seven adult Chinchilla rabbits (14 eyes) received a single 0.1 ml HAG (Restylane, Q-Med AB, Sweden) subcutaneous upper eyelid injection followed by contouring of the skin for 1.5 mm on average. Tissue samples containing HAG were collected for histopathological examination with morphometric analysis on day 0, week 2, months 1, 2, 4, 6, and 9. RESULTS HAG persisted subcutaneously in the eyelid during the 9 months of the study in the form of a sponge-like structure with compartments of varying shape and size. Its total volume diminished gradually, nevertheless at the end of the study the filler could still be found in some compartments, mainly peripheral. In the central area of the depot residual HAG was surrounded by optically transparent spaces. CONCLUSION After being injected subcutaneously into the eyelids of experimental animals HAG formed a sponge-like structure causing a significant increase in eyelids volume. Gradual biodegradation of HAG was accompanied by neocollagenogenesis and 9 months later the process was still ongoing.
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Affiliation(s)
- Y O Grusha
- I.M. Sechenov First Moscow State Medical University, Ophthalmology Department, 8-2 Trubetskaya St., Moscow, Russian Federation, 119991; Research Institute of Eye Diseases, 11 A, B Rossolimo St., Moscow, Russian Federation, 119021
| | - A A Fedorov
- Research Institute of Eye Diseases, 11 A, B Rossolimo St., Moscow, Russian Federation, 119021
| | - J U Prause
- Eye Pathology Institute, Department of Neuroscience and Pharmacology, University of Copenhagen, Frederik V's Vej 11, 1., Copenhagen, Denmark, 2100
| | - V A Sheptulin
- Research Institute of Eye Diseases, 11 A, B Rossolimo St., Moscow, Russian Federation, 119021
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Abstract
PURPOSE Introducing a simple image grading system to support the interpretation of in vivo confocal microscopy (IVCM) images in filamentous fungal keratitis. SETTING Clinical and confocal studies took place at the Department of Ophthalmology, Aarhus University Hospital, Denmark. Histopathological analysis was performed at the Eye Pathology Institute, Department of Neuroscience and Pharmacology, University of Copenhagen, Denmark. METHODS A recent series of consecutive patients with filamentous fungal keratitis is presented to demonstrate the results from in-house IVCM. Based upon our experience with IVCM and previously published images, we composed a grading system for interpreting IVCM images of filamentous fungal keratitis. RESULTS A recent case series of filamentous fungal keratitis from 2011 to 2012 was examined. There were 3 male and 3 female patients. Mean age was 44.5 years (range 12-69), 6 out of 17 (35%) cultures were positive and a total of 6/7 (86%) IVCM scans were positive. Three different categories of IVCM results for the grading of diagnostic certainty were formed. CONCLUSION IVCM is a valuable tool for diagnosing filamentous fungal keratitis. In order to improve the reliability of IVCM, we suggest implementing a simple and clinically applicable grading system for aiding the interpretation of IVCM images of filamentous fungal keratitis.
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Affiliation(s)
- E Nielsen
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Skejby, Denmark
| | - S Heegaard
- Eye Pathology Institute, Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Skejby, Denmark ; Department of Ophthalmology, Glostrup Hospital, Glostrup, Aarhus University Hospital, Skejby, Denmark
| | - J U Prause
- Eye Pathology Institute, Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Skejby, Denmark
| | - A Ivarsen
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Skejby, Denmark
| | - K L Mortensen
- Department of Clinical Microbiology and Infectious Diseases, Aarhus University Hospital, Skejby, Denmark
| | - J Hjortdal
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Skejby, Denmark
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Lou AR, Madsen KH, Paulson OB, Julian HO, Prause JU, Siebner HR, Kjaer TW. Monocular Visual Deprivation Suppresses Excitability in Adult Human Visual Cortex. Cereb Cortex 2011; 21:2876-82. [DOI: 10.1093/cercor/bhr082] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Prause JU, Børgesen SE, Carstensen H, Fledelius HC, Jensen OA, Kirkegaard J, Lauersen H, Naeser P, Nehen JH. Cranio-orbital teratoma. Acta Ophthalmol Scand Suppl 2009:53-6. [PMID: 8741121 DOI: 10.1111/j.1600-0420.1996.tb00388.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
A new-born baby presented with a large, rapidly growing tumour. The tumour involved the right orbit, the anterior half of the right intracranial space and extended through the skull of the temporal region. The proptotic eye ruptured due to exposure. The tumour was extirpated when the patient was 12 days old. A large recurrence was extirpated two months later. The tumour was firmly bound to the medial aspect of the superior orbital fissure which probably was the location of origin of the tumour. Based on the size of the intracranial-and the orbital part of the tumour, it was classified as a secondary orbital teratoma. The tumour was macroscopically composed of cystic and solid areas. Microscopically it was seen to be a benign teratoma with tissue from all three germinal layers.
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Affiliation(s)
- J U Prause
- Eye Pathology Institute, University of Copenhagen, Denmark
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Prause JU. A semiquantitative enzyme assay for corneal collagenase [proceedings]. Acta Ophthalmol 2009:46-7. [PMID: 184672 DOI: 10.1111/j.1755-3768.1975.tb01234.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Jensen JE, Fledelius HC, Prause JU, Scherfig E. An unusual ophthalmic tumour in a 5-year-old boy. Acta Ophthalmol 2009:110-2. [PMID: 1332385 DOI: 10.1111/j.1755-3768.1992.tb04941.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
A rare tumour in a 5-year-old boy is presented and discussed. In time and location the story had two parts (Fig. 1): 1) a conjunctival granuloma at the nasal limbus of the right eye was surgically removed. 2) a few months later a huge lesion presented in the posterior segment of the same eye. Was it an ocular tumour with extension to the orbit or an orbital process with impression or invasion of the eye? Repeated surgical biopsies have indicated nodular scleritis of the posterior eye segment as the definitive diagnosis.
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Affiliation(s)
- J E Jensen
- Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Denmark
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Prause JU. Transactions of the Danish Ophthalmological Society 1979-1981. Acta Ophthalmol 2009. [DOI: 10.1111/j.1755-3768.1987.tb08521.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
Using reservoirs containing 50 microliters of antigen solution in combination with a micro-modification of the electroimmunoassay a detection limit of 0.05 ng applied in 400 microliters corresponding to 0.125 ng/ml has been achieved. Tear fluid eluate from Schirmer paper strips has been tested in the assay. The eluation procedure failed to extract all tear proteins as 32 ng were left in the paper. Despite the loss, experiments have shown the method to be suitable for immunological determination of tear proteins collected by the Shirmer I test.
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Abstract
AIMS To characterise clinicopathological features of mantle cell lymphoma (MCL) in the orbital and adnexal region. METHODS Data on lymphoid lesions were retrieved searching the Danish Ocular Lymphoma Database 1980-2005. Specimens were collected from Danish pathological departments and re-evaluated with a panel of monoclonal antibodies. For all patients with confirmed MCL the complete clinical files were collected and reviewed. RESULTS Twenty-one patients with MCL in the orbital and adnexal region were identified comprising 9% (21/230) of all lymphoma in the ocular region. There were 18 male patients and three female patients with an age range from 60 to 90 years (median 75 years). Orbital and adnexal region MCL as first presenting symptom comprised 67% of the patients. Of these, 71% had bilateral involvement. The orbit (71%) and eyelids (64%) were the most commonly affected sites. All but two presented in stage III/IV. Secondary MCL comprised 33% of the patients. Bilateral affection (29%) was less common in this patient group. The median survival was not different between the two presentation groups. Patients receiving anti-CD20 (rituximab)-containing chemotherapy had a significantly better 5-year overall survival (OS) rate (83%) than patients in treatment regimes without rituximab (5-year OS rate, 8%). CONCLUSIONS Orbital and adnexal region MCL presents in elderly males. The orbit and eyelid are frequently involved. There is a very high proportion of systemic involvement in general with MCL of the orbital and adnexal region. Most patients presented with stage IV disease and had multiple relapses and short survival time. Treatment with rituximab-containing chemotherapy improved survival significantly compared with combination chemotherapy without rituximab.
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Affiliation(s)
- P Rasmussen
- Department of Neuroscience and Pharmacology, Section of Eye Pathology, University of Copenhagen, Denmark
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Holfort SK, Lindegaard J, Isager P, Prause JU, Heegaard S. CNS metastasis from malignant uveal melanoma: a clinical and histopathological characterisation. Br J Ophthalmol 2008; 93:641-4. [PMID: 19091854 DOI: 10.1136/bjo.2008.145664] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To characterise uveal melanoma that has metastasised to the central nervous system (CNS). METHODS Review of 2365 patients constituting all patients diagnosed as having primary uveal melanoma in Denmark during the period 1943-1997. All patients with malignant uveal melanoma and metastasis to the CNS were identified. For each patient, clinical and histopathological data were gathered. RESULTS Sixteen patients with CNS metastasis were identified. The median age was 58 years. The majority of CNS metastases were located in the frontal and parietal lobes. Eleven patients had widespread metastases. Five patients had exclusively metastasis to the CNS. The average time from diagnosis of primary tumour to symptoms of CNS metastasis was 91 months. The average time from the initial CNS symptoms to death was 20 months. All tumours were composed of either mixed or spindle cells. The average largest basal diameter of the primary tumours was 12 mm. One tumour was a ring melanoma. The majority of tumours had a ruptured Bruch membrane. Retinal invasion was observed in 36% of tumours. No specimen had optic nerve invasion. Scleral invasion was pronounced in 36% of cases, and extrascleral extension was observed in two cases (14%). The amount of tumour infiltrating lymphocytes was pronounced in three cases (23%). CONCLUSION The proportion of uveal melanoma patients having CNS metastasis was 0.7%. Eleven patients had multiple organ metastases, and the average time from the initial CNS symptoms to death was 8 months. Five patients had metastasis to the CNS solely, and the average time from the initial CNS symptoms to death was 57 months.
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Affiliation(s)
- S K Holfort
- Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark
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Sjö LD, Ralfkiaer E, Juhl BR, Prause JU, Kivelä T, Auw-Haedrich C, Bacin F, Carrera M, Coupland SE, Delbosc B, Ducrey N, Kantelip B, Kemeny JL, Meyer P, Sjö NC, Heegaard S. Primary lymphoma of the lacrimal sac: an EORTC ophthalmic oncology task force study. Br J Ophthalmol 2006; 90:1004-9. [PMID: 16672329 PMCID: PMC1857190 DOI: 10.1136/bjo.2006.090589] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To define the clinical and histopathological characteristics of primary lacrimal sac lymphoma in a predominantly white population. METHODS Specimens of lacrimal sac lymphoma and follow up data were solicited from members of the Ophthalmic Oncology Task Force of the European Organization for Research and Treatment of Cancer (EORTC) and the European Ophthalmic Pathology Society (EOPS). Specimens were stained with haematoxylin and eosin and an immunohistochemical panel against leucocyte antigens was applied. Diagnosis was reached by consensus of five experienced pathologists according to the World Health Organization classification system. The histopathological findings were correlated with the clinical data. RESULTS Of 15 primary lacrimal sac lymphomas, five (33%) were diffuse large B cell lymphoma (DLBCL), five (33%) were extranodal marginal zone B cell lymphoma of mucosa associated lymphoid tissue (MALT lymphoma), three were classified as "transitional MALT lymphoma," being in transition from MALT lymphoma to DLBCL, and two were unclassified B cell lymphomas. Nine of the patients were female, and the median age at the time of diagnosis was 71 years (range 45-95 years). The most frequent presenting symptoms were epiphora (85%), swelling in the region of the lacrimal sac (79%), and dacryocystitis (21%). All but one patient presented in stage I. Systemic spread occurred in three of nine patients (33%). The 5 year overall survival was 65%. CONCLUSIONS DLBCL and MALT lymphoma are equally common in the lacrimal sac in contrast with the remaining periorbital and/or orbital region where MALT lymphoma predominates.
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MESH Headings
- Aged
- Aged, 80 and over
- Antigens, CD/metabolism
- Antigens, Neoplasm/metabolism
- Female
- Humans
- Lacrimal Apparatus Diseases/diagnosis
- Lacrimal Apparatus Diseases/pathology
- Lacrimal Apparatus Diseases/therapy
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/pathology
- Lymphoma, B-Cell/therapy
- Lymphoma, B-Cell, Marginal Zone/diagnosis
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, B-Cell, Marginal Zone/therapy
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/therapy
- Male
- Middle Aged
- Retrospective Studies
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Affiliation(s)
- L D Sjö
- Eye Pathology Institute, University of Copenhagen, Denmark
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Mey KH, Buchwald C, Daugaard S, Prause JU. Sinonasal schwannoma--a clinicopathological analysis of five rare cases. Rhinology 2006; 44:46-52. [PMID: 16550950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Schwannoma of the nasal cavity or the sinuses is a rare condition. We report a small series of five consecutive patients; three males and two females, age range 22-81 years, all Caucasian. Symptoms were typically non-specific, and the tumours were often quite large when diagnosed, being locally infiltrating and even destructive. Histologically, the tumours were remarkable by sparse occurrence of Antoni type B areas and lack of encapsulation. Four cases were benign; however, one case of melanotic schwannoma, exhibited malignant transformation. Two of the patients had intracranial involvement, but with an intact dura. All tumours were treated surgically; only the malignant case received adjuvant radiotherapy. Patients were followed from five months to 15 years, with a median of 57 months. The benign cases have so far shown good prognosis without recurrences; however, in the case of the melanotic schwannoma a fatal malignant transformation was seen 13 years after initial diagnosis. On the basis of our review early detection and complete surgical removal is recommended.
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Affiliation(s)
- K H Mey
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Rigshospitalet, Copenhagen, Denmark.
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Heegaard S, Rosenberg T, Preising M, Prause JU, Bek T. An unusual retinal vascular morphology in connection with a novel AIPL1 mutation in Leber's congenital amaurosis. Br J Ophthalmol 2003; 87:980-3. [PMID: 12881340 PMCID: PMC1771788 DOI: 10.1136/bjo.87.8.980] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [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] [Indexed: 11/03/2022]
Abstract
AIMS To report a case of an unusual retinal vascular morphology in connection with a novel AIPL1 mutation in a patient with Leber's congenital amaurosis (LCA). METHODS A patient with LCA and no light perception from birth had both eyes enucleated at the age of 22 years because of excruciating pain. Mutation analysis was performed on known LCA genes. The eyes were processed for casts of the vascular tree, routine histopathology, and electron microscopy. RESULTS A novel H82Y (244C-->T) mutation and a H90D (286G-->C) polymorphism were detected in exon 2 of the AIPL1 gene. Both the cast and the histopathological examination showed dilated retinal vessels, mainly venules, primarily localised in the posterior pole. In the mid-peripheral retina the density of capillaries on the arteriolar side of the microcirculatory units was significantly decreased. The vascular system was seen to gradually attenuate towards the retinal periphery, and to stop at a zone located approximately 4 mm from the ora serrata along the whole circumference. In this zone pigmented aggregates characteristic of retinitis pigmentosa were seen to ensheath the retinal vessels. The photoreceptors were almost totally absent and retinal gliosis was present. A decreased number of ganglion cells and an increased vacuolisation of the nerve fibre layer were observed. The retinal pigment cells and Bruch's membrane appeared normal in all regions. CONCLUSION An unusual retinal vascular morphology in an LCA patient is presented and possible pathogenic mechanisms of the findings are discussed.
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Affiliation(s)
- S Heegaard
- Eye Pathology Institute, University of Copenhagen, Denmark.
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Abstract
The purpose of this study was to develop a suitable animal model for the investigation of the pathogenesis and therapy of uveal malignant melanoma. Eight choroidal malignant melanomas from eight patients were transplanted into nude mice in an attempt to establish a serially transplantable tumour model. Tumour tissue blocks (2 x 2 x 2 mm) from enucleated eyes with choroidal malignant melanoma were transplanted subcutaneously into the flanks of nude mice. The growing tumours were measured and serially transplanted. The tumour samples were investigated by histology, immunohistochemistry and electron microscopy. Only one of the eight transplanted primary tumours (13%) was established as a xenograft in nude mice. Furthermore, the take rate of the transplantable tumour was low (13%). The growth of the tumour fitted a Gompertz function, and the calculated tumour volume doubling time was 54 days. The transplanted tumour cells were epithelioid and slightly larger than the primary tumour cells and had prominent nucleoli. However, the transplanted tumour retained a morphological appearance similar to that of the primary tumour. Immunohistochemical examinations demonstrated that the cells preserved the characteristic properties of malignant melanoma. However, the transplanted cells demonstrated vimentin reactivity, whereas the primary tumour cells were negative for vimentin. It can be concluded that a new experimental model of malignant uveal melanoma with tumours that were easy to observe and access was established in nude mice.
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Affiliation(s)
- S Heegaard
- Eye Pathology Institute, University of Copenhagen, Copenhagen, Denmark.
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Abstract
PURPOSE To describe a patient with liposarcoma metastatic to the left orbit. METHODS A 72-year-old man was admitted with diplopia and proptosis of the left eye. Previously, a retroperitoneal liposarcoma had been surgically removed followed by postoperative radiation. Visual acuity was normal. There was proptosis of the left eye, increased retrobulbar resistance and reduced mobility. Trans-septal orbital biopsies showed liposarcoma. The patient was initially treated with prednisolone and later received radio- and chemotherapy. Despite treatment he lost vision of the left eye and died a few months later. RESULTS Histological examination of the orbital tumor revealed a spindle-cell liposarcoma similar to the primary tumor of the retroperitoneum. CONCLUSIONS Liposarcoma metastatic to the orbit is rare, but should be suspected in a patient with proptosis caused by a space-occupying lesion and a history of liposarcoma.
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Affiliation(s)
- A H Y Tehrani
- Eye Pathology Institute, University of Copenhagen, Denmark
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Heegaard S, Larsen JN, Fledelius HC, Prause JU. Neoplasia versus hyperplasia of the retinal pigment epithelium. A comparison of two cases. Acta Ophthalmol Scand 2001; 79:626-33. [PMID: 11782230 DOI: 10.1034/j.1600-0420.2001.790614.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE To present the clinical and histopathological characteristics of two different tumor-like lesions of the retinal pigment epithelium (RPE). METHODS Two cases of tumor-like lesions of the RPE were identified in the files of the Eye Pathology Institute. The clinical characteristics and the light- and electron microscopical morphology of the lesions were compared and the diagnoses were re-evaluated applying modern immunostainings. RESULTS Clinically, both adenoma and tumor-like hyperplasia of the RPE may present with prominent retinal feeder arterioles. The lesions are hypofluorescent in the filling phases and have multiple hyperfluorescent zones in the late phase in fluorescein angiography. They show high internal reflectivity by A-scan and appear as solid tumors by B-scan ultrasonography. Histologically, the two presented lesions of the RPE are different. The first is an adenoma of the vacuolated subtype. The other lesion is a hyperplasia of the RPE disclosing a tubular morphology. The pathologically active cells in both cases were positive for the reaction with antibodies against: cytokeratin, NSE, vimentin, S-100, HMB-45, desmin and SMA. However, only the adenoma was sporadic melan-A positive. CONCLUSION Adenomas and tumor-like hyperplastic lesions of the RPE are very rare lesions. They share many morphological and immunohistological characteristics. Of the presented cases only the RPE adenoma is sporadic melan-A positive.
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Affiliation(s)
- S Heegaard
- Eye Pathology Institute, University of Copenhagen, Frederik V's Vej 11, DK-2100 Copenhagen Ø, Denmark.
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23
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Pe'er J, Stefani FH, Seregard S, Kivela T, Lommatzsch P, Prause JU, Sobottka B, Damato B, Chowers I. Cell proliferation activity in posterior uveal melanoma after Ru-106 brachytherapy: an EORTC ocular oncology group study. Br J Ophthalmol 2001; 85:1208-12. [PMID: 11567966 PMCID: PMC1723747 DOI: 10.1136/bjo.85.10.1208] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To evaluate the cell proliferation activity in posterior uveal melanomas after Ru-106 brachytherapy. METHODS Eyes containing choroidal or ciliary body melanoma from seven ocular oncology centres, which were enucleated after first being treated by Ru-106 brachytherapy and which had enough melanoma tissue to enable histological assessment, were included. The 57 eligible specimens were divided into a group of 44 eyes that were enucleated because of tumour regrowth, and a non-recurrent group of 13 eyes that were enucleated because of complications such as neovascular glaucoma. 46 non-irradiated eyes harbouring uveal melanoma served as a control group. All specimens underwent routine processing. They were cut into 5 microm sections, and were stained with two main cell proliferation markers: PC-10 for PCNA and MIB-1 for Ki-67. The stained sections were assessed, and the cells that were positive in the immunostaining were counted in each section. The results were evaluated by various statistical methods. RESULTS The PC-10 score showed a statistically significant difference across the three groups (p = 0.002). The control group showed the highest PC-10 score (median 31.0 PCC/HPF) followed by the tumour regrowth group (median 4.9 PCC/HPF). The lowest PC-10 scores were found in the non-recurrent tumours (median 0.05 PCC/HPF). The MIB-1 score in the control group (median 5.77 PCC/HPF) was similar to the regrowth group (median 5.4 PCC/HPF). In contrast, the MIB-1 score in the non-recurrent tumours was statistically significantly lower (median 0.42 PCC/HPF). The PC-10 and MIB-1 scores were similar in tumours composed of either spindle cells or epithelioid cells in all groups. CONCLUSIONS The non-recurrent melanomas demonstrate significantly lower cellular proliferation activity than melanomas that showed regrowth or that were not irradiated at all. In our hands, PCNA gave more meaningful information than Ki-67. Our findings strongly support the need for treating regrowing posterior uveal melanoma either by enucleation or re-treatment by brachytherapy. On the other hand, also in the non-recurrent uveal melanomas there are viable cells with potential for proliferation, although fewer in number, with unknown capacity for metastatic spread. Therefore, the irradiated tumours should be followed for many years, probably for life.
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Affiliation(s)
- J Pe'er
- Department of Ophthalmology, Hadassah University Hospital, Jerusalem, Israel.
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24
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Fledelius HC, Illum N, Jensen H, Prause JU. Interferon-alfa treatment of facial infantile haemangiomas: with emphasis on the sight-threatening varieties. A clinical series. Acta Ophthalmol Scand 2001; 79:370-3. [PMID: 11453856 DOI: 10.1034/j.1600-0420.2001.079004370.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE To report on the efficacy of systemic Interferon-alfa therapy in controlling the endothelial proliferation in expanding facial haemangiomas of infancy threatening the eye. METHODS The series comprised 9 subjects with facial haemangiomas of rapid growth within the first few months of life. All haemangiomas had relation to an eyelid and affected the visual access to the eye. At least three tumours were also intraorbital, and in one case the glottis was affected. Interferon-alfa was given subcutaneously in daily doses of 3 mio units/m2. Ophthalmic follow-up including ultrasound evaluation was done, initially with intervals of 4-8 weeks. RESULTS Interferon-alfa was given over 9-41 weeks (median duration 22 weeks) in cumulated doses of 63-287 million units. Progression was arrested in all and with a subsequent tumour regression considered accelerated as judged from earlier clinical giant haemangioma experience. A control series was not possible. One patient had systemic prednisone added over some weeks. Two infants reacted with a flu-like malaise. A premature infant developed a slight spastic diplegia. CONCLUSIONS In the 9 infants with growing ophthalmic haemangiomas we recorded a good response to systemic Interferon-alfa administered as daily doses by subcutaneous injection. In general the treatment appeared well tolerated. During clinical follow-up diagnostic ultrasound evaluation (the depth dimension) proved helpful; in particular there was a sparing effect on CT and MRI scans which require general anaesthesia.
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Affiliation(s)
- H C Fledelius
- The University Eye Clinics of Rigshospitalet and Glostrup County Hospital and the University Department of Paediatrics, Rigshospitalet, Copenhagen, Denmark
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25
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Abstract
AIM To examine conjunctival papillomas for the presence of human papillomavirus (HPV) and koilocytosis. METHODS Archival paraffin embedded tissue from 55 conjunctival papillomas was analysed for the presence of HPV by polymerase chain reaction and subsequent filter hybridisation. Histological sections of the 55 papillomas were evaluated for the presence of koilocytosis. RESULTS HPV was present in 48 of 52 (92%) beta globin positive papillomas. HPV type 6/11 were found in 40 of 47 investigated papillomas and a double infection with HPV 6/11 and 16 was identified in a single papilloma. In six papillomas the HPV type could not be identified. Koilocytosis was present in 22 of 55 papillomas (40%). CONCLUSION There is a strong association between HPV and conjunctival papillomas. HPV type 6/11 is the most common HPV type in conjunctival papilloma. The sensitivity of koilocytosis as an indicator of HPV in conjunctival papilloma is low.
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Affiliation(s)
- N C Sjö
- Eye Pathology Institute, University of Copenhagen, Denmark
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26
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Kaestel CG, Madsen HO, Prause JU, Jørgensen A, Liang Y, la Cour M, Lui GM, Odum N, Nissen MH, Röpke C. Lack of FasL expression in cultured human retinal pigment epithelial cells. Exp Clin Immunogenet 2001; 18:34-41. [PMID: 11150851 DOI: 10.1159/000049085] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Retinal pigment epithelial (RPE) cells have been proposed to play a part in maintaining the eye as an immune privileged organ. However, our knowledge of the implicated mechanism is still sparse. Fas ligand (FasL) expression of RPE cells is generally recognized to be essential for the immune privilege of the eye, but due to contradictory published results, it is unclear whether RPE cells express this molecule. The purpose of this study was to investigate the expression of FasL in RPE cells in vitro and in vivo. Cultured human fetal and adult RPE cells were examined by flow cytometry, Western blotting, RT-PCR and RNase Protection assay for FasL expression. Additionally, sections of ocular tissue were stained for FasL by immunohistochemistry. None of the used methods indicated FasL expression in cultured fetal or adult RPE cells of various passages. However, RPE cells in vivo, as judged from tissue sections, were positive for FasL, indicating a discrepancy between RPE cells in vitro and in vivo with regard to this molecule.
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Affiliation(s)
- C G Kaestel
- Institute of Medical Anatomy, Section A, The Panum Institute, University of Copenhagen, Copenhagen, Denmark
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27
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Abstract
PURPOSE To determine morphological and clinical characteristics of conjunctival papilloma. METHODS Specimens of conjunctival papilloma registered during the period 1983-1997 were collected. For each case the patient's sex and age, number of papillomas/patient, seasonal debut, duration, number of recurrences, localisation and presence of dysplasia andlor inflammation in the papilloma were registered. RESULTS A total of 245 papillomas in 219 patients were found. 132 (60.3%) of the patients were males. The age distribution showed skewness to the left with a peak in the age groups 20-29 years and 30-39 years. No variation of seasonal debut was found. 14 patients (6%) had more than one papilloma concurrently. 24 (11%) of the patients had recurrence. Most of the papillomas were located medially and inferiorly. 98 (40%) of the papillomas were inflamed. 14 (6%) of the papillomas were dysplastic. CONCLUSION The conjunctival papilloma is a common tumour. More males than females develop conjunctival papillomas and the incidence is highest among patients aged 20-39 years. The conjunctival papilloma is primarily located medially and inferiorly.
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Affiliation(s)
- N Sjö
- Eye Pathology Institute, University of Copenhagen, Denmark
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28
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Abstract
PURPOSE To re-evaluate a case of Kyrle's disease with conjunctival and corneal changes in a 52-year-old patient with onset at the age of 5 years. METHODS Repeated biopsies from the skin, conjunctiva and oral mucosa along with a corneal button obtained from a right eye keratoplasty were examined histopathologically. RESULTS The skin, oral, conjunctival and corneal histopathology showed parakeratosis, dyskeratotic cells and single cell keratinization. The clinical picture and the histopathological findings are consistent with the diagnosis of Kyrle's disease. CONCLUSIONS This is the first reported case of Kyrle's disease with conjunctival changes. We suggest that Kyrle's disease, although predominantly affecting young adults, may also be seen in childhood. The disease may be a genodermatosis. It is not confined only to the skin, but can be seen in mucous membranes like the conjunctiva and buccal mucosa, and in tissues having the same embryological origin as the skin, i.e. the cornea.
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Affiliation(s)
- G A Alyahya
- Eye Pathology Institute, University of Copenhagen, Denmark
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29
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Abstract
PURPOSE To determine the frequency, distribution according to diagnosis and the recurrence frequency of orbital space-occupying lesions in Denmark, to determine sex and age of the patients and to establish a national orbital data register. METHODS All biopsied/surgically removed orbital lesions collected by Danish pathological departments during the period 1974-1997 were identified by SNOMED codes. In addition, in each case gender and age of the patients and number of recurrences were registered. RESULTS 965 orbital lesions from 841 patients were identified during the 24-year period. The incidence of orbital lesions increased significantly over the study period and at present about 80 cases/year are registered. The ratio benign/malignant lesion per year remained constant during the observation period. Lesions in children constituted a total of 152 (16%), the percentage of lesions in children being constant during the period. Malignant tumors comprised a total of 364 (45%) in adults and 34 (22%) in children. Malignant tumors were in adults distributed with 43% primary, 48% secondary invading and 9% metastatic tumors, and in children with 65% primary, 29% secondary invading and 6% metastatic tumors. Normal tissue was only found in 6% of the cases recorded. CONCLUSION A registration of all histologically evaluated orbital space-occupying lesions in Denmark during a period of 24 years was performed and a national orbital database established. Orbital lesions are rare and primarily benign.
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Affiliation(s)
- S Johansen
- Eye Pathology Institute, University of Copenhagen, Denmark
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30
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Nicolini J, Kiilgaard JF, Wiencke AK, Heegaard S, Scherfig E, Prause JU, la Cour M. The anterior lens capsule used as support material in RPE cell-transplantation. Acta Ophthalmol Scand 2000; 78:527-31. [PMID: 11037908 DOI: 10.1034/j.1600-0420.2000.078005527.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE To investigate the use of an ocular basement membrane as support material for transplanted porcine RPE cells. METHODS Porcine RPE cells were grown on bovine corneal extracellular matrix (ECM), isolated bovine- and porcine lens capsules, and tissue culture plastic. Cell density, and cell morphology were studied by phase contrast microscopy and transmission electron microscopy. RESULTS RPE cells grown on porcine anterior lens capsule and on ECM obtained better morphology and higher final cell density than cells grown on plastic and on bovine anterior lens capsule. It was possible to transplant the porcine anterior lens capsule to the subretinal space in pigs. Within two weeks of observation, the lens capsule was well tolerated in the subretinal space. CONCLUSION The anterior lens capsule seems to be promising as support material for use in RPE cell-transplantation.
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Affiliation(s)
- J Nicolini
- Rigshospitalet, University of Copenhagen, Denmark
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31
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Alyahya GA, Heegaard S, Fledelius HC, Rechnitzer C, Prause JU. Primitive neuroectodermal tumor of the orbit in a 5-year-old girl with microphthalmia. Graefes Arch Clin Exp Ophthalmol 2000; 238:801-6. [PMID: 11045350 DOI: 10.1007/s004170000178] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To report an orbital, intraconal, primitive neuroectodermal tumor (PNET) in a 5-year-old child with microphthalmia since birth. METHODS Orbitotomy was performed and a large, polycystic, retroscleral, intraconal tumor was removed and subsequent histological, immunohistochemical and electron-microscopic analyses of the excised mass were performed. RESULTS The tumor showed characteristic features of peripheral primitive neuroectodermal tumor including pseudorosettes, positive immunohistochemical reactions for the MIC2 gene and synaptophysin and ultrastructural finding of neurosecretory granules. CONCLUSION This case is the first reported intraconal PNET of the orbit, and the first orbital case that expresses the MIC2 gene. In spite of the aggressive malignant features of peripheral PNET, the orbital variety seems to be the least aggressive since most of the reported patients are still alive.
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Affiliation(s)
- G A Alyahya
- Eye Pathology Institute, University of Copenhagen, Denmark
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32
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Heegaard S, Jensen OA, Prause JU. Immunohistochemical diagnosis of malignant melanoma of the conjunctiva and uvea: comparison of the novel antibody against melan-A with S100 protein and HMB-45. Melanoma Res 2000; 10:350-4. [PMID: 10985669 DOI: 10.1097/00008390-200008000-00006] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A novel antibody A103, which recognizes melan-A/MART-1, has been found to be more sensitive than the antibody HMB-45, which recognizes gp100, in melanocytic lesions of the skin and might therefore also be useful in the diagnosis of uveal and conjunctival melanocytic lesions. In this study we compared the staining characteristics of anti-melan-A, anti-S100 protein and HMB-45 in 13 conjunctival, 11 iris and 37 ciliary and choroidal malignant melanomas. The ciliary and choroidal melanomas comprised 13 spindle cell (10 spindle B and three spindle A), 14 mixed cell and 10 epithelioid cell tumours. In the conjunctival melanomas the diagnostic sensitivity was 100% for anti-S100 and anti-melan-A and 85% for HMB-45. In the iris melanomas the sensitivity was 100% for anti-S100 and anti-melan-A and 55% for HMB-45. A high staining intensity of anti-melan-A was particularly noticed in iris melanomas. In the choroidal malignant melanomas, the spindle cell and mixed cell types showed a sensitivity of only 69-79% with all three antibodies. In the epithelioid cell type the sensitivity was 80% for anti-S100 and 100% for HMB-45 and anti-melan-A. In conclusion, anti-melan-A was found to be a useful addition to antibody panels for ocular melanocytic lesions. Anti-melan-A has a higher sensitivity than HMB-45 in conjunctival and iris melanomas, but the sensitivity is similar to HMB-45 in choroidal melanomas. Anti-melan-A stains in a very similar pattern to anti-S100, but the staining intensity of anti-melan-A is higher than that of anti-S100 in iris melanoma.
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Affiliation(s)
- S Heegaard
- Eye Pathology Institute, University of Copenhagen, Denmark
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Abstract
PURPOSE To report a patient with a history over 25 years of a slowly growing, large, invasive crateriform tumour filling the anterior part of the orbit. METHODS A 61-year-old male presented with a large tumour of the left orbit. Exenteration was performed with subsequent histological analysis of the excised mass. RESULTS The main tumour showed the characteristic features of a keratoacanthoma. However, the posterior aspect of the tumour disclosed the morphology of a squamous cell carcinoma. Six months later, the patient presented with metastases to lymph nodes, lung and mediastinal tissue. A leukemoid reaction was diagnosed by fine needle biopsy. CONCLUSION The giant variety of keratoacanthoma may fail to regress and can transform into a squamous cell carcinoma. In our patient, the development of a chronic lymphoid leukemia raises the possibility that it may be the underlying cause for the transformation of the posterior part of the keratoacanthoma into a frank squamous cell carcinoma.
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Affiliation(s)
- G A Alyahya
- Eye Pathology Institute, University of Copenhagen, Denmark
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Thygesen J, Aaen K, Theodorsen F, Kessing SV, Prause JU. Short-term effect of latanoprost and timolol eye drops on tear fluid and the ocular surface in patients with primary open-angle glaucoma and ocular hypertension. Acta Ophthalmol Scand 2000; 78:37-44. [PMID: 10726786 DOI: 10.1034/j.1600-0420.2000.078001037.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE To investigate and compare the short term effects of topical latanoprost and timolol on the tear fluid and ocular surface condition in patients with bilateral primary open angle glaucoma or ocular hypertension. METHODS Thirty-seven patients were included in this randomized, double-masked, parallel group study. Patients received either latanoprost 0.005% (n= 18) or timolol 0.5% (n= 19) instilled once daily in the morning for a treatment period of 27 days. Routine ophthalmic examinations, including intraocular pressure measurement, as well as tests to evaluate tear fluid and the ocular surface were performed. RESULTS After one drop of medication, tear secretion was significantly reduced by timolol, but not by latanoprost. At the end of the study the break-up time (BUT) was significantly decreased in the timolol group but not in the latanoprost group. The BUT still remained in the normal range in both groups, although it is important to note that timolol was administered at half the clinical dose. Both latanoprost and timolol tended to increase Rose-Bengal staining of the cornea and conjunctiva after one month of treatment but no statistically significant difference was found between the groups. Corneal sensitivity was within the normal range for all patients during the study. CONCLUSION Regarding ocular surface effects, no clinically important differences between latanoprost and timolol were observed as all the effects remained in the normal range.
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Affiliation(s)
- J Thygesen
- Department of Ophthalmology, Vejle Sygehus, Denmark.
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Abstract
PURPOSE AND METHODS The files of the Eye Pathology Institute contain only two cases of leiomyoma of the ciliary body. The diagnoses were re-evaluated, applying modern immunostainings. RESULTS The tumors were composed of interlacing fascicles of spindle-shaped cells with bright eosinophilic cytoplasm and cigar-shaped nuclei. Both tumors were well-vascularized, mostly by thin, branching capillaries. Larger vessels were also seen. In one case the tumor perforated the sclera. The tumor cells reacted with the reticulum stain and the Masson trichrome and were positive for antibodies against: smooth muscle actin (SMA), muscle specific actin (MSA), laminin and vimentin (one case). CONCLUSION Leiomyoma of the ciliary body is a rare smooth muscle cell tumor that may arise from either pericytes, ciliary - or intrascleral heterotopic muscle.
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Affiliation(s)
- S Heegaard
- Eye Pathology Institute, University of Copenhagen, Denmark
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36
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Buch H, Nielsen NV, Prause JU. Pachometry before and after vitrectomy with silicone oil injection. Acta Ophthalmol Scand 1999; 77:410-3. [PMID: 10463411 DOI: 10.1034/j.1600-0420.1999.770410.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE To evaluate differences in central corneal thickness (CCT) before and after vitrectomy with injection of silicone oil as vitreous substitution material in order to determine whether silicone oil causes more frequent and/or pronounced corneal decompensation than other substitution materials. METHODS CCT was measured by ultrasonic pachometry in 42 eyes. 25 eyes received injection of silicone oil and 17 eyes C3F8, atmospheric air or saline. Measurements were performed 24 hours pre operatively, during anaesthesia pre operatively and 24 hours, 48 hours and five months post operatively. RESULTS A progressive central corneal thickening could be demonstrated in both groups. Eyes which received silicone oil showed maximum CCT increase of 0.083 mm (14.1%) 48 hours post operatively. At follow-up CCT had decreased to baseline value in both groups. Silicone oil did not induce CCT changes that were significantly different from those induced by other substitution materials. CONCLUSION Silicone oil injection in detachment surgery induces reversible corneal decompensation to the same degree as other substitution materials within the first five months post operatively.
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Affiliation(s)
- H Buch
- Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Denmark
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37
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Hansen AB, Petersen C, Heegaard S, Prause JU. Review of 1028 bulbar eviscerations and enucleations. Changes in aetiology and frequency over a 20-year period. Acta Ophthalmol Scand 1999; 77:331-5. [PMID: 10406156 DOI: 10.1034/j.1600-0420.1999.770317.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE To evaluate possible changes in aetiology and frequency of bulbar eviscerations and enucleations. METHODS A total of 1028 cases from three two-year periods: 1975-76, 1985-86 and 1995-96 collected by the Eye Pathology Institute were reviewed. RESULTS A significant decrease (p<0.001) in number of enucleations was observed from 358 in 1975-76 to 214 in 1995-96, corresponding to an almost equivalent increase in number of eviscerations from 5 in 1975-76 to 83 in 1995-96. The total number of eye removals decreased significantly (p<0.01) over the last two periods from 368 in 1985-86 to 296 in 1995-96. This was primarily caused by a decrease in the number of glaucoma-related enucleations from 32.7% in 1975-76 to 15.0% in 1995-96. The reduction in number was not fully balanced by the increase in glaucoma-related eviscerations. CONCLUSION Over the last 20 years there has been a change in choice of operation from enucleation to evisceration.
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Affiliation(s)
- A B Hansen
- Eye Pathology Institute, University of Copenhagen, Denmark
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38
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Ussing AP, Baelde HJ, Olesen Larsen S, Naeser P, Prause JU, Bruijn JA. Haematopathology of 'Sjögren-mice': histopathological changes in spleens after semiallogeneic cell transfer. Scand J Immunol 1999; 49:641-8. [PMID: 10354376 DOI: 10.1046/j.1365-3083.1999.00548.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Haematopoietic transplantation chimeras may be readily produced in adult mice, using F1-hybrids of selected inbred strains as recipients and mice from one of the parental strains as donors. We transplanted spleen cells from BALB/c donors into nonirradiateded F1-hybrids of BALB/c and CBA/H-T6. Both female and male recipients developed a primary Sjögren's syndrome-like exocrinopathy without signs of kidney disease. At long-term follow-up, 7(1/2) months after cell transfer, lymph nodes were enlarged, and spleens were diminished and irregular in shape. In general, changes in haematopoietic organs were more prominent in males. The results verify that although hybrid mice of either sex develop glandular manifestations comparable with primary Sjögren's syndrome, when the immune system is stimulated by semiallogeneic immunocytes, the evoked reactions in haematopoietic tissues show gender difference.
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Affiliation(s)
- A P Ussing
- The Danish National Library of Science and Medicine, Documentation Department, Copenhagen; August Krogh Institute, Zoophysiological Laboratory, University of Copenhagen, Denmark
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39
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Schurmans LR, Blom DJ, De Waard-Siebinga I, Keunen JE, Prause JU, Jager MJ. Effects of transpupillary thermotherapy on immunological parameters and apoptosis in a case of primary uveal melanoma. Melanoma Res 1999; 9:297-302. [PMID: 10465586 DOI: 10.1097/00008390-199906000-00012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Transpupillary thermotherapy (TTT) is a new treatment modality for uveal melanoma. We studied whether application of TTT influences the immunogenicity of the tumour cells in vivo or the expression of molecules related to apoptosis. Immunohistochemistry using monoclonal antibodies directed against HLA molecules, HMB45, P53, Fas ligand (FasL), Fas, Bcl-2 and tumour-infiltrating cells was applied to sections of an enucleated eye containing a uveal melanoma that received TTT 1 week before enucleation. The innermost part of the tumour which had been exposed directly to the laser treatment showed no staining for HLA antigens, nor for Fas or FasL epitopes. The intermediate part of the tumour showed a wet necrosis and HLA expression similar to the expression in the peripheral tumour. A large number of macrophages were observed in the necrotic as well as the intact tumour tissue, especially bordering the wet necrotic area. FasL and Bcl-2 were only expressed in the viable, outer part of the tumour. This immunological evaluation of one case of uveal melanoma treated with TTT revealed that TTT may not only have a direct destructive effect on the primary tumour, but may also influence the immunogenicity of uveal melanoma cells, induce infiltration of macrophages into the tumour, and induce apoptosis. The presence of many macrophages suggests that they play a role in the removal of the TTT-treated tumour tissue by phagocytosis.
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Affiliation(s)
- L R Schurmans
- The Department of Ophthalmology, Leiden University Medical Center, The Netherlands.
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40
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Eskelin S, Pyrhönen S, Summanen P, Prause JU, Kivelä T. Screening for metastatic malignant melanoma of the uvea revisited. Cancer 1999; 85:1151-9. [PMID: 10091801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
BACKGROUND The purpose of the current study was to assess the value of routine imaging and liver function tests in detecting metastases from malignant melanoma of the uvea. METHODS Forty-six consecutive patients diagnosed with metastatic uveal melanoma between 1985 and 1996 who had participated in a screening program that included annual liver function tests (LFT), chest X-ray, and abdominal ultrasonography (US) were eligible for this retrospective cohort study. Main outcome measures were the sensitivity of screening tests, presence of symptoms, recurrence free interval, and metastatic burden. RESULTS Metastases were diagnosed in 74% of patients (95% confidence interval [95% CI], 59-86) at screening and in 26% (95% CI, 14-41) when the patient consulted a physician because of symptoms that developed before the next scheduled visit. Of all the patients, 59% (95% CI, 43-73) were asymptomatic, and 80% (95% CI, 66-91) had only hepatic metastases. The median recurrence free interval, greatest dimension of the largest metastasis, and metastatic burden of the two groups did not differ. US was diagnostic in 78% (95% CI, 64-89), at least 1 LFT test was abnormal in 70% of patients (95% CI, 54-82), and a chest X-ray was abnormal in 2% of patients (95% CI, 0-12). LFTs and US did not reveal hepatic metastases in 33% and 4% of patients, respectively. The sensitivity of individual LFTs ranged from 0.27 to 0.67, and their specificity from 0.90 to 0.96, with lactate dehydrogenase being the most sensitive LFT used. CONCLUSIONS The authors believe that annual screening with LFTs and abdominal US will identify 59% of patients while they are still asymptomatic and that semiannual screening will detect >95% of such patients. Chest X-ray has a very low yield and is recommended only at baseline to exclude metastatic disease to the eye and if pulmonary symptoms develop.
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Affiliation(s)
- S Eskelin
- Department of Ophthalmology, Helsinki University Central Hospital, Finland
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Abstract
A 43-year-old Caucasian male, presented with a swelling of the left caruncle which had persisted for more than ten years. Clinical examination showed a small, smooth, not painful 2x2x2 mm tumor located at the caruncle. There were no signs of orbital involvement. Histologically, the tumor was composed of interlacing fascicles of spindle-shaped cells with bright eosinophilic cytoplasm and cigar-shaped nuclei. Mitotic activity was not observed and the tumor showed no atypia or pleomorphism. The tumor cells reacted with the reticulum stain and Masson trichrome. Immunohistochemically, the tumor cells were positive for vimentin, SMA, MSA, CD34, laminin and a scattered number for S-100. The tumor was classified as a leiomyoma of the caruncle and is the first described in this localisation. The origin of the tumor is discussed.
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Affiliation(s)
- S Heegaard
- Eye Pathology Institute, University of Copenhagen, Denmark
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Abstract
The aetiology of Sjögren's syndrome (SS) is unknown, and consequently curative treatments are not available. The immunopathogenesis of SS is partly clarified and immune-regulating drugs (IR) may therefore be of therapeutic value. However, the present understanding of SS is still too unclear to allow an exact and evidence-based algorithm for therapeutic decision making. Rational drug recommendations for the therapy of SS must, therefore, rely mostly on empirical data. Several IR drugs have been shown to be able to downregulate the immunopathological activity of primary SS, but it is not certain whether the diagnostic and cardinal manifestations from the eyes and mouth can be improved. In primary SS the disease-modifying qualities of IR and cytotoxic drugs, therefore, largely apply to the treatment of severe internal organ involvement, inflammatory vascular disease and malignant B lymphocyte disease. In secondary SS the IR therapy is directed against the basic immunoinflammatory connective tissue disease. Symptom-modifying therapies include drugs to stimulate and substitute for exocrine functions, and drugs to treat complications of the exocrine disease manifestations and to improve the various nonexocrine disease manifestations. The main drugs available for increasing lacrimal and salivary gland output are bromhexine and pilocarpine, respectively. However, exocrine substitutes, and in particular eye drops, are still the most important means of alleviating the sicca symptoms. They are also indispensable local treatment measures which may help to prevent mucosal complications.
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Affiliation(s)
- P Oxholm
- Department of Rheumatology, Copenhagen County Hospital in Gentofte, University of Copenhagen, Denmark.
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Jørgensen A, Wiencke AK, la Cour M, Kaestel CG, Madsen HO, Hamann S, Lui GM, Scherfig E, Prause JU, Svejgaard A, Odum N, Nissen MH, Röpke C. Human retinal pigment epithelial cell-induced apoptosis in activated T cells. Invest Ophthalmol Vis Sci 1998; 39:1590-9. [PMID: 9699548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
PURPOSE The immune privilege of the eye has been thought to be dependent on physical barriers and absence of lymphatic vessels. However, the immune privilege may also involve active immunologic processes, as recent studies have indicated. The purpose of the present study was to investigate whether human retinal pigment epithelial (RPE) cells can induce apoptosis in activated T cells. METHODS Fas ligand (FasL) expression was detected by flow cytometry and immunohistochemistry. Cultured RPE cells were cocultured with T-cell lines and peripheral blood lymphocytes for 6 hours to 2 days. Induction of apoptosis was detected by 7-amino-actinomycin D and annexin V staining. RESULTS Retinal pigment epithelial cells expressed FasL and induced apoptosis in activated Fas+ T cells. Blocking of Fas-FasL interaction with antibody strongly inhibited RPE-mediated T-cell apoptosis. Retinal pigment epithelial cells induced apoptosis in several activated T-cell populations and T-cell lines, including T-cell antigen receptor (TCR)-CD3-negative T-cell lines. In contrast, RPE cells induced little or no apoptosis in resting peripheral T cells. Major histocompatibility complex (MHC) class II monoclonal antibodies, which block alloactivation, had no inhibitory effect on RPE-mediated T-cell apoptotic responses in MHC class II-specific CD4+ T-cell lines. CONCLUSIONS Retinal pigment epithelial cells express FasL and induce TCR-independent apoptosis in activated human T cells through Fas-FasL interaction. Retinal pigment epithelial cells may constitute an immunologic functional barrier against potentially harmful T cells.
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Affiliation(s)
- A Jørgensen
- Institute of Medical Anatomy Section A, University of Copenhagen, Denmark
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Johansen S, Heegaard S, Prause JU, Rask-Pedersen E. The healing effect of all-trans retinoic acid on epithelial corneal abrasions in rabbits. Acta Ophthalmol Scand 1998; 76:401-4. [PMID: 9716324 DOI: 10.1034/j.1600-0420.1998.760403.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE The aim of the study was to investigate the possible healing effect of the vitamin A analogue all-trans retinoic acid 0.05% (RA) in vaseline on epithelial corneal abrasions in 13 ocularly healthy Copenhagen white rabbits. METHODS A corneal abrasion with a diameter of 6 mm was created centrally in both eyes with a trephine and subsequent rubbing off of the corneal epithelium with an n-heptanol soaked swab The corneal abrasions were treated twice daily with topical applications (50 microl); RA was placed in the right inferior fornix and its vaseline vehicle in the left inferior fornix. Photographic documentation of fluorescein stained, non-healed areas, was performed at time points 0, 12, 24, 36, 48 and 72 h. The rabbits were sacrificed by an overdose of pentobarbital and enucleated. Planimetry was performed from corneal photographs. RESULTS Healed epithelial mean area at time point 36 h was significantly higher after RA compared to vehicle (p=0.036, paired t-test). Median time to 75% and 85% healing was significantly shorter for RA compared to vehicle (p= 0.03 and 0.02, log rank-test). No morphological difference, evaluated by light microscopy (hematoxylin-eosin) or scanning electron microscopy, was noted between the two treatments. CONCLUSION It is concluded that RA 0.05% applied twice daily increases the healing rate compared to vaseline vehicle.
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Affiliation(s)
- S Johansen
- Eye Pathology Institute, University of Copenhagen, Denmark
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Johansen S, Heegaard S, Bjerrum K, Prause JU. Healing effect of sodium-sucrose-octasulfate and EGF on epithelial corneal abrasions in rabbits. Adv Exp Med Biol 1998; 438:683-6. [PMID: 9634955 DOI: 10.1007/978-1-4615-5359-5_97] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- S Johansen
- Eye Pathology Institute, University of Copenhagen, Denmark
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Gerner IL, Nørregaard JC, Jensen OA, Prause JU. [Conjunctival nevi in Denmark 1960-1980. A 21-year follow-up]. Ugeskr Laeger 1998; 160:3728-3731. [PMID: 9641059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The clinicopathological characteristics of 343 naevi of the conjunctiva were studied. A significant increase in the number of naevi excised per year was observed. This may have been caused by an increased exposure to actinic rays. An approximately even distribution was found between the three main locations: caruncle, limbal area and eye ball. Intrastromal naevi were excised at a higher median age than compound naevi, and the lowest median age at excision was for junction naevi, which is in accordance with the known histopathological nature of naevi. Recurrence occurred in nine patients (2.7%), and one had transformed into a malignant melanoma. Eight of the recurring naevi were located in the limbal area. Eight of the nine patients were women, suggesting hormonal factors as a possible cause. Recommendations for the handling of conjunctival naevi are given, based on the present findings and on previous reports.
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Affiliation(s)
- I L Gerner
- H:S Frederiksberg Hospital, øjenafdelingen
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47
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Abstract
We describe a patient with bilateral extreme microphthalmia with bilateral congenital glaucoma, bilateral medial oblique facial cleft ending in lid colobomas, bilateral stenosis of the choanae, bifid uvula, frontal encephalocele, and premature craniosynostosis. The cause is unknown, but the phenotype resembles the Fryns anophthalmia-plus syndrome, which may be a recessive trait, although intrauterine environmental factors cannot be excluded.
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Affiliation(s)
- M Warburg
- Department of Ophthalmology, Herlev Hospital, University of Copenhagen, Denmark
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48
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Ussing AP, Josefsen K, Larsen SO, Sørensen I, Prause JU. Sex-specific patterns of spleen recolonization in semiallogeneic "Sjögren-mice". In Vivo 1997; 11:387-92. [PMID: 9427040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
"Sjögren-mice" were produced by the transfer of two entire spleen equivalents of cells from parental strain mice to non-irradiated, adult F1 hybrids. The recipients developed an autoimmune exocrinopathy resembling primary Sjögren's syndrome. Since donor and host mice are haploidentical, no new antigens are introduced into the recipients. Donor cells may react against recipient antigens, eliciting a graft versus host (GVH) reaction. The origin of spleen cells was investigated by flow cytometry, using antibodies against murine MHC antigens. The results showed different colonization patterns: spleens of female recipients, grafted with cells from female donors, were almost completely colonized by donor type cells, whereas spleens of male recipients, grafted with either male or female cells, showed partial or complete colonization by donor type cells. The results suggest that the sex of both donor and host influences cellular reactions in lymphohaemopoietic chimeras.
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Affiliation(s)
- A P Ussing
- Documentation Department, Danish National Library of Science and Medicine, Copenhagen, Denmark.
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49
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Jensen OA, Prause JU, Scherfig E. Transvitreal retino-choroidal biopsy of suspected malignant lesions of the choroid. Follow-up of cases over 7 years. Acta Ophthalmol Scand 1997; 75:409-11. [PMID: 9374250 DOI: 10.1111/j.1600-0420.1997.tb00400.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The cases of transvitreal retino-choroidal (TVRC) biopsy from 1987 to 1994 were assembled in order to examine the efficiency, complications and risks to patients. Of 92 biopsies 91 had sufficient material for diagnosis. Eighty (87%) contained malignant tissue, whereas 10 cases were negative and two unsuccessful. Tumours of appropriate size were treated by brachytherapy. Twenty-three large tumours were enucleated primarily. Eight irradiated eyes had to be removed. In 31 cases, therefore, it was possible to examine the whole tumour for changes caused by the biopsy and to compare the typing of the biopsy with that of the whole tumour. In the irradiated eyes histologically viable tumour cells remained mostly in the inner part of the tumour. Scleral necrosis was not found. The technique used appears to be safe. Histological verification is highly recommended before any conservative therapy, inter alia to obtain true statistics of therapeutic results.
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Affiliation(s)
- O A Jensen
- Eye Pathology Institute, University of Copenhagen, Denmark
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50
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Asmussen K, Andersen V, Bendixen G, Bendtzen K, Prause JU, Thorn J, Wiik A, Oxholm P. Quantitative assessment of clinical disease status in primary Sjögren's syndrome. A cross-sectional study using a new classification model. Scand J Rheumatol 1997; 26:197-205. [PMID: 9225875 DOI: 10.3109/03009749709065681] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Quantitative and qualitative assessment of the clinical disease manifestations in 41 primary Sjögren's syndrome (pSS) patients was performed according to a new classification model. Frequencies of subgrouped disease manifestations were as follows: 1) surface exocrine disease: 100%, 2) internal organ exocrine disease: 63%, 3) monoclonal B lymphocyte disease: 5%, 4) inflammatory vascular disease: 71%, 5) non-inflammatory vascular disease: 59%, 6) mediator induced disease: 98%. Summary scores for severity of surface exocrine disease correlated to the summary scores of all other disease manifestations (p = 0.02), to the summary scores of internal organ exocrine disease (p = 0.003), and to the summary scores of mediator induced disease (p = 0.03). Blood leucocyte counts showed significant negative correlations to levels of plasma IgG, serum IgA-RF, IgM-RF, anti-SSA/SSB antibodies, IL-6, and IL-1Ra. We conclude that the model made detailed analysis of the clinical presentation of pSS possible, and thus may assist in elucidating important pathobiological aspect of the disease.
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Affiliation(s)
- K Asmussen
- Department of Medicine TA, Rigshospitalet, Copenhagen, Denmark
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