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Corzo-Camberos F, Alvarez-Ascencio D, Martinez-Trujillo D, Becerra-Revollo C. Importance of multimodal imaging diagnostics in acute angle closure glaucoma: Case report. Arch Soc Esp Oftalmol (Engl Ed) 2024; 99:38-42. [PMID: 38042479 DOI: 10.1016/j.oftale.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/05/2023] [Indexed: 12/04/2023]
Abstract
To describe the natural history and management of an acute angle closure secondary to choroidal melanoma. A 70-year-old female presented with pain, elevated intraocular pressure, mature cataract, and angle closure in right eye. With further studies she was found to have a choroidal melanoma causing the acute angle closure. Enucleation was performed and the patient is currently in close postoperative surveillance by ophthalmology and oncology. The importance of early identification and treatment of intraocular tumors to decrease incidence of metastasis. In secondary acute angle-closure glaucoma treatment should be targeted towards resolving the triggering factor of glaucoma.
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Affiliation(s)
| | | | | | - C Becerra-Revollo
- Ocular Ultrasound Department APEC, Hospital de la Ceguera, Mexico City, Mexico
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Bermúdez Castellanos I, Saornil Álvarez MA, Almaraz Gómez A, Villoría Díaz S, García Álvarez C. Impact of COVID-19 on a rare disease (uveal melanoma) in a national reference unit of intraocular tumors in Spain. Arch Soc Esp Oftalmol (Engl Ed) 2023; 98:254-258. [PMID: 37075839 PMCID: PMC10110274 DOI: 10.1016/j.oftale.2023.04.007] [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] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 01/31/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVE To analyze the impact of the COVID-19 pandemic on the diagnosis and management of uveal melanoma (a tumor included in the Orphanet catalog of rare diseases) in a Spanish national reference unit for intraocular tumors during the first year of the pandemic. METHOD An observational retrospective study of patients with uveal melanoma in the National Reference Unit for Adult Intraocular Tumors of the Hospital Clínico Universitario de Valladolid (Spain) was performed, analyzing the pre- and post-COVID-19 periods: from March 15, 2019 to March 15, 2020 and from March 16, 2020 to March 16, 2021. Demographic data, diagnostic delay, tumor size, extraocular extension, treatment and evolution were collected. A multivariable logistic regression model was used to identify factors that were associated with the variable: enucleation. RESULTS Eighty-two patients with uveal melanoma were included, of which 42(51.21%) belonged to the pre-COVID-19 period and 40(40.78%) to the post-COVID-19 period. An increase in tumor size at diagnosis and in the number of enucleations was observed during the post-COVID-19 period (p < 0.05). Multivariable logistic regression demonstrated that both medium-large tumor size and patients diagnosed in the post-COVID-19 period were independently related to an increased risk of enucleation (OR 250, 95%CI, 27.69-2256.37; p < 0.01 and OR 10; 95%CI, 1.10-90.25; p = 0.04, respectively). CONCLUSIONS The increase in tumor size observed in uveal melanomas diagnosed during the first year of the COVID-19 pandemic may have favored the increase in the number of enucleations performed during that period.
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Affiliation(s)
| | - M A Saornil Álvarez
- Servicio de Oftalmología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - A Almaraz Gómez
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
| | - S Villoría Díaz
- Servicio de oftalmología, Complejo Asistencial Universitario de Palencia, Palencia, Spain
| | - C García Álvarez
- Servicio de Oftalmología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
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Stael Apolo JA, Conde I, Fernández D, Fernández S, Bande M, Pardo M, Ruiz-Oliva F, Blanco MJ, Piñeiro A. Identification of extraocular extension in uveal melanoma by ophthalmological ultrasound. Arch Soc Esp Oftalmol (Engl Ed) 2022; 97:70-76. [PMID: 35152951 DOI: 10.1016/j.oftale.2021.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 02/03/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND PURPOSE Uveal melanoma is the most common primary malignant intraocular tumour in the adult population, with a survival rate of 50% despite advances in treatment and knowledge of this disease. The presence of extraocular extension (EE) worsens the prognosis of these patients, so its proper identification can ensure its management and early intervention. Ophthalmological ultrasound is the technique of choice for the diagnosis and follow-up of these patients, both of the anterior EE using ultrasonic biomicroscopy (UBM), and the posterior EE using A and B ultrasound. The aim of this study is to describe the ultrasound characteristics of the BMU and the A and B ultrasound. MATERIAL AND METHODS A descriptive and retrospective study is carried out on patients diagnosed with uveal melanoma (UM) and EE from 2003 to 2019. The ultrasound characteristics of the local disease and the follow-up after treatment were recorded completely and at each visit. In the case of anterior EE, photographs of the anterior segment and UBM were taken, while those involving the posterior segment were explored under A and B mode ultrasound. All enucleated eyes were sent for anatomopathological study. RESULTS Ten patients with an average age of 72.3 years were included. The largest proportion of them were medium-sized tumours, followed by large and small ones. The most frequent morphology of the primary tumour was cupuliform. All the EE presented lower internal reflectivity compared to the primary tumour. No trans-scleral connection bridges were found between the primary tumour and the EE in the ultrasound studies. 50% of patients underwent primary enucleation at the time of diagnosis of intraocular MU due to the presence of the EE, and the remaining 50% presented the EE after initial treatment of the primary tumour with I125 brachytherapy. Sixty percent of the patients presented with posterior EE, and were therefore diagnosed with ultrasound A and B. The most frequent histopathological pattern with 87.5% of patients was the epithelioid pattern. DISCUSSION Ultrasound scanning in patients with MU is mandatory for diagnosis and follow-up of EE. BMU and A and B ultrasound are the test of choice for anterior and posterior EE, respectively. EE have particular ultrasound characteristics such as low internal reflectivity, regularity of their contour and their location usually adjacent to the base of the primary intraocular tumor.
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Affiliation(s)
- J A Stael Apolo
- Unidad de Retina Quirúrgica y Tumores Intraoculares del Adulto (URQTIA), Área Sanitaria de Santiago de Compostela y Barbanza, Complejo Hospitalario Universitario de Santiago de Compostela. Servicio Gallego de Salud (SERGAS), Santigo de Compostela, Spain; Servicio de oftalmología, Hospital de Palamós, Servicio de Salud Integral del Bajo Empordá, Palamós, Spain.
| | - I Conde
- Unidad de Retina Quirúrgica y Tumores Intraoculares del Adulto (URQTIA), Área Sanitaria de Santiago de Compostela y Barbanza, Complejo Hospitalario Universitario de Santiago de Compostela. Servicio Gallego de Salud (SERGAS), Santigo de Compostela, Spain
| | - D Fernández
- Unidad de Retina Quirúrgica y Tumores Intraoculares del Adulto (URQTIA), Área Sanitaria de Santiago de Compostela y Barbanza, Complejo Hospitalario Universitario de Santiago de Compostela. Servicio Gallego de Salud (SERGAS), Santigo de Compostela, Spain
| | - S Fernández
- Unidad de Retina Quirúrgica y Tumores Intraoculares del Adulto (URQTIA), Área Sanitaria de Santiago de Compostela y Barbanza, Complejo Hospitalario Universitario de Santiago de Compostela. Servicio Gallego de Salud (SERGAS), Santigo de Compostela, Spain
| | - M Bande
- Unidad de Retina Quirúrgica y Tumores Intraoculares del Adulto (URQTIA), Área Sanitaria de Santiago de Compostela y Barbanza, Complejo Hospitalario Universitario de Santiago de Compostela. Servicio Gallego de Salud (SERGAS), Santigo de Compostela, Spain; Departamento de Cirugía y Especialidades Médico Quirúrgicas, Área de Oftalmología, Universidad de Santiago de Compostela, Santigo de Compostela, Spain; Laboratorio de Tumores Intraoculares del Adulto, IDIS, Santiago de Compostela, Spain
| | - M Pardo
- Laboratorio de Tumores Intraoculares del Adulto, IDIS, Santiago de Compostela, Spain
| | - F Ruiz-Oliva
- Unidad de Retina Quirúrgica y Tumores Intraoculares del Adulto (URQTIA), Área Sanitaria de Santiago de Compostela y Barbanza, Complejo Hospitalario Universitario de Santiago de Compostela. Servicio Gallego de Salud (SERGAS), Santigo de Compostela, Spain
| | - M J Blanco
- Unidad de Retina Quirúrgica y Tumores Intraoculares del Adulto (URQTIA), Área Sanitaria de Santiago de Compostela y Barbanza, Complejo Hospitalario Universitario de Santiago de Compostela. Servicio Gallego de Salud (SERGAS), Santigo de Compostela, Spain; Departamento de Cirugía y Especialidades Médico Quirúrgicas, Área de Oftalmología, Universidad de Santiago de Compostela, Santigo de Compostela, Spain; Laboratorio de Tumores Intraoculares del Adulto, IDIS, Santiago de Compostela, Spain
| | - A Piñeiro
- Unidad de Retina Quirúrgica y Tumores Intraoculares del Adulto (URQTIA), Área Sanitaria de Santiago de Compostela y Barbanza, Complejo Hospitalario Universitario de Santiago de Compostela. Servicio Gallego de Salud (SERGAS), Santigo de Compostela, Spain; Departamento de Cirugía y Especialidades Médico Quirúrgicas, Área de Oftalmología, Universidad de Santiago de Compostela, Santigo de Compostela, Spain; Laboratorio de Tumores Intraoculares del Adulto, IDIS, Santiago de Compostela, Spain
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Zimmermann-Paiz MA, Quezada-Del Cid NC, García-de la Riva JC, Ordóñez-Rivas AM. Amelanotic iris melanoma in a 7 year-old hispanic boy with subclinical globe perforation. ACTA ACUST UNITED AC 2018; 94:81-84. [PMID: 30342820 DOI: 10.1016/j.oftal.2018.09.007] [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] [Received: 05/10/2018] [Revised: 08/03/2018] [Accepted: 09/04/2018] [Indexed: 10/28/2022]
Abstract
We report an unusual case of an amelanotic melanoma in a 7 year old hispanic child with subclinical globe perforation. Uveal melanoma rarely occurs in children. Young affected patients are mostly light-colored eye Caucasian adolescents. Since they are not common, these tumors are usually not recognized and misdiagnosed. Differential diagnoses and therapeutic options are outlined.
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Affiliation(s)
- M A Zimmermann-Paiz
- Unidad de Oftalmología Pediátrica, Estrabismo y Neuro-Oftalmología «Dra. Ana María Illescas Putzeys», Benemérito Comité Pro Ciegos y Sordos de Guatemala, Hospital de Ojos y Oídos «Dr. Rodolfo Robles Valverde», Instituto de Ciencias de la Visión, Ciudad Guatemala, Guatemala
| | - N C Quezada-Del Cid
- Unidad de Oftalmología Pediátrica, Estrabismo y Neuro-Oftalmología «Dra. Ana María Illescas Putzeys», Benemérito Comité Pro Ciegos y Sordos de Guatemala, Hospital de Ojos y Oídos «Dr. Rodolfo Robles Valverde», Instituto de Ciencias de la Visión, Ciudad Guatemala, Guatemala.
| | - J C García-de la Riva
- Unidad de Patología Ocular, Benemérito Comité Pro Ciegos y Sordos de Guatemala, Hospital de Ojos y Oídos «Dr. Rodolfo Robles Valverde», Instituto de Ciencias de la Visión, Ciudad Guatemala, Guatemala
| | - A M Ordóñez-Rivas
- Unidad de Oftalmología Pediátrica, Estrabismo y Neuro-Oftalmología «Dra. Ana María Illescas Putzeys», Benemérito Comité Pro Ciegos y Sordos de Guatemala, Hospital de Ojos y Oídos «Dr. Rodolfo Robles Valverde», Instituto de Ciencias de la Visión, Ciudad Guatemala, Guatemala
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Delgado S, Rodriguez Reyes A, Mora Rios L, Dueñas-González A, Taja-Chayeb L, Moragrega Adame E. Ultrasound, histopathological, and genetic features of uveal melanoma in a Mexican-Mestizo population. Arch Soc Esp Oftalmol (Engl Ed) 2018; 93:15-21. [PMID: 28728954 DOI: 10.1016/j.oftal.2017.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 04/29/2017] [Accepted: 05/15/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To describe the ultrasound, histopathological and genetic characteristics of uveal melanoma in a Mexican-Mestizo population. MATERIAL AND METHODS A total of 39 enucleated eyes with a histopathological diagnosis of uveal melanoma were assessed by describing the clinical findings, and ultrasound, histopathological and genetic features. RESULTS A high correlation was observed between tumour height measurement using ultrasound and histopathology. In our cases, tumour size and reflectivity were higher compared with those reported in the literature. The preliminary data on the molecular assessment of the tumours show the presence of an unreported polymorphism (T>C IVS5+34) and one sample with GNAQ mutation (A>C CAA>CCA Gln 209 Pro). CONCLUSION Ultrasound is a reliable method to identify the size of the tumour. Furthermore, knowledge of the molecular mechanisms promises new perspectives for the development of new targeted therapeutics. Fortunately this leads to progress in the treatment of patients with metastatic disease or prevents it in those at high risk.
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Affiliation(s)
- S Delgado
- Departamento de Córnea, Asociación para Evitar la Ceguera en México, Coyoacán, México.
| | - A Rodriguez Reyes
- Departamento de Patología, Asociación para Evitar la Ceguera en México, Coyoacán, México
| | - L Mora Rios
- Departamento de Patología, Asociación para Evitar la Ceguera en México, Coyoacán, México
| | - A Dueñas-González
- Instituto de Investigaciones Biomédicas UNAM/Instituto Nacional de Cancerología, Coyoacán, México
| | - L Taja-Chayeb
- Instituto de Investigaciones Biomédicas UNAM/Instituto Nacional de Cancerología, Coyoacán, México
| | - E Moragrega Adame
- Departamento de Ultrasonido, Asociación para Evitar la Ceguera en México, Coyoacán, México
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Sánchez Marugán B, Acebes García M, García Hinojosa J, León Cabello MJ, Casal Valiño M. [Iris mammillations. Three case reports]. ACTA ACUST UNITED AC 2013; 89:279-81. [PMID: 24269445 DOI: 10.1016/j.oftal.2013.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 02/24/2013] [Accepted: 04/12/2013] [Indexed: 11/17/2022]
Abstract
CLINICAL CASES We report the cases of 3 young patients who were seen in our hospital with the diagnosis of iris mammillations. Two of them were bilateral without familial association. The third child had iris mammillations as part of an ocular melanocytosis. None of them had abnormalities in the posterior segment or the pachymetry. DISCUSSION The discovery of iris mammillations during an examination requires a long term follow up of these patients due to its association with uveal melanoma. This is required whether it is a casual discovery or in the presence of ocular melanocytosis.
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Affiliation(s)
- B Sánchez Marugán
- Servicio de Oftalmología, Hospital Universitario Infanta Leonor, Madrid, España.
| | - M Acebes García
- Servicio de Oftalmología, Hospital Universitario Infanta Leonor, Madrid, España
| | - J García Hinojosa
- Servicio de Oftalmología, Hospital Universitario Infanta Leonor, Madrid, España
| | - M J León Cabello
- Servicio de Oftalmología, Hospital Universitario Infanta Leonor, Madrid, España
| | - M Casal Valiño
- Servicio de Oftalmología, Hospital Universitario Infanta Leonor, Madrid, España
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Vicente N, Saornil MA, García-Álvarez C, Almaraz A, Alonso Martínez P, Frutos-Baraja JM, López-Lara F. [Uveal melanoma: clinical characteristics, treatment and survival in a series of 500 patients]. ACTA ACUST UNITED AC 2013; 88:433-8. [PMID: 24157321 DOI: 10.1016/j.oftal.2013.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 06/09/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To analyse the clinical features, treatment and survival of uveal melanoma patients diagnosed in a referral Intraocular Tumours Unit over a twenty-year period. METHODOLOGY A prospective study was performed including five hundred patients, diagnosed between January 1992 and December 2011. Clinical tumour characteristics and treatment were collected in a database in Microsoft@ Access@. The numeric variables were expressed as means of frequency and standard deviation, and the quantitative variables using frequency tables. RESULTS The mean age of the sample was 62.19 years, with 51.2% females, and 64.2% presented with symptoms. The tumours were small in 31.12% of cases, and large in 23.09%, according to COMS criteria. Hazel green was the iris colour in 42.2% of the cases. The initial treatment was episcleral brachytherapy in 42.4% of the total. The overall mortality rate was 17% and 31.3%, and melanoma-related mortality rate was 11.6% and 14.8%, at 5 and 10 years, respectively. CONCLUSIONS In the serie studied melanomas were more frequent in women, and a higher proportion of darker irides were observed than in other previous studies. Most of the tumours were diagnosed when they became symptomatic and in the early or medium stages, allowing conservative therapies to be used, with brachytherapy being the predominant treatment. The melanoma-related mortality appeared to be lower than previously data published. However, further studies are required on the factors influencing survival.
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Affiliation(s)
- N Vicente
- Servicio de Oftalmología, Hospital Clínico Universitario de Valladolid, Valladolid, España.
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