1/36. indocyanine green angiography of optic nerve head melanocytoma.PURPOSE: To determine the features of fluorescein and indocyanine green angiography of melanocytoma. methods: Fluorescein and indocyanine green angiography is used to assess an optic nerve head melanocytoma in a 45-year-old female. RESULTS: fluorescein angiography revealed increased vascularity on the surface, with staining around the lesion in the late stages. The lesion was hypofluorescent in all stages of indocyanine green angiography. CONCLUSIONS: indocyanine green angiography is helpful in identifying the benign nature of the lesion by showing hypofluorescence, indicating lack of vascularity in the tumor.- - - - - - - - - - ranking = 1keywords = optic (Clic here for more details about this article) |
2/36. Clinical and histopathologic findings of iris nevus (Cogan-Reese) syndrome.PURPOSE: To report a case of Cogan-Reese syndrome. METHOD: Case report. A 37-year-old man presented with Cogan-Reese syndrome. RESULTS: visual acuity was 0.5 in the right eye and 1.0 in the left eye. There were corneal edema and pigmented nodules on the anterior surface of the iris, iris atrophy and ectropion uvea in the right eye. The intraocular pressure was 42 mmHg in the right eye and there was glaucomatous optic atrophy of the optic disk. trabeculectomy with mitomycin C has been performed as the intraocular pressure did not decrease with the maximum medical treatment. Electron microscopic examination of the trabeculum and the iris tissue revealed a lot of melanocytic cells in the stroma. CONCLUSION: trabeculectomy with mitomycin C might be effective in Cogan-Reese cases with glaucoma resistant to medical treatment.- - - - - - - - - - ranking = 1.8078828104695keywords = optic disk, optic, disk (Clic here for more details about this article) |
3/36. Malignant transformation of an optic disk melanocytoma.PURPOSE: To report a case of malignant transformation of an optic disk melanocytoma with a second melanocytoma in the ciliary body. methods: Clinical data including visual acuity, visual fields, color fundus photographs, fluorescein angiogram, and ultrasonogram and histopathologic studies of this case were reviewed. RESULTS: The right eye of a 65-year-old white woman was diagnosed with melanocytoma of the optic nerve. Four years later, the tumor became significantly larger. The best-corrected visual acuity declined from 20/40 to counting fingers and the size of the tumor increased fourfold in 2 years. The right globe was enucleated. Histopathologic studies demonstrated moderately pigmented spindle-B malignant melanoma cells adjacent to and within a population of large, polyhedral, heavily pigmented melanocytoma cells that extended to the lamina cribrosa and optic nerve. There was also a deeply pigmented melanocytoma in the ciliary body. CONCLUSION: This is a rare case of malignant melanoma transformed from an optic disk melanocytoma. Periodic follow-up of the patient with optic disk melanocytoma is necessary.- - - - - - - - - - ranking = 11.655179673287keywords = optic disk, optic, disk (Clic here for more details about this article) |
4/36. Q-switched ruby laser treatment of a congenital melanocytic nevus.BACKGROUND: The treatment of medium-sized (1.5-20 cm diameter) congenital melanocytic nevi (CMN) has been the concern of dermatologists for decades. Although many techniques have been described and utilized, no single treatment has emerged as applicable under all circumstances. methods: The Q-switched ruby laser (QSRL) at 694 nm, a wavelength well absorbed by melanin relative to other optically absorbing structures in skin, causes highly selective destruction of pigment-laden cells. In addition, the 20-nanosecond pulse duration produced by this laser approximates the thermal relaxation time for melanosomes, thereby confining the energy to the targeted cells. RESULTS: In the present report, treatment using the QSRL resulted in complete clinical removal of a biopsy-documented medium-sized compound CMN with no recurrence after 5 years. In contrast to other therapeutic modalities, complications such has hypertrophic scarring, dyspigmentation, or atrophy were not observed.- - - - - - - - - - ranking = 0.2keywords = optic (Clic here for more details about this article) |
5/36. Melanocytoma of the left optic nerve head and right retrobulbar optic neuropathy compressed by a tuberculum sellae meningioma.A 40-year-old woman had a highly pigmented, slightly elevated tumor on the left optic disc. She had no visual disturbance in the left eye. The tumor was stationary for 5 years. At age 45 years, she complained of decreased visual acuity in the right eye. magnetic resonance imaging showed a right-shifted homogeneous lesion at the tuberculum sellae. Histopathologic study of the excised lesion revealed interlacing bundles of spindle-shaped fibroblast-like cells with whorl formation. We believe that a relationship between melanocytoma of the optic nerve head and a tuberculum sellae meningioma may exist rather than a chance occurrence, as previously suggested by others.- - - - - - - - - - ranking = 2keywords = optic (Clic here for more details about this article) |
6/36. Optical coherence tomography of melanocytoma.PURPOSE: To evaluate the use of optical coherence tomography in differentiating between melanocytoma and choroidal melanoma. methods: case reports. Three consecutive patients with melanocytoma were scanned using optical coherence tomography. RESULTS: Optical coherence tomography showed lesions with a high reflectance signal anteriorly and optical shadowing behind, corresponding to the melanocytomas. The high signal was continuous with the retinal nerve fiber layer, consistent with known growth patterns of melanocytoma. CONCLUSION: Optical coherence tomography may be useful in differentiating melanocytoma from choroidal melanocytic lesions.- - - - - - - - - - ranking = 0.6keywords = optic (Clic here for more details about this article) |
7/36. Central retinal vascular obstruction secondary to melanocytoma of the optic disc.A 35-year-old black man developed abrupt visual loss in his left eye. Ophthalmic examination revealed a deeply pigmented mass obscuring the optic disc, hemorrhagic retinopathy, and signs of central retinal vascular obstruction. fluorescein angiography disclosed sluggish filling of the retinal blood vessels; ultrasonography disclosed an acoustically solid mass in the optic nerve head. Cytopathologic findings of a fine needle aspiration biopsy specimen demonstrated probable benign tumor cells, but melanoma could not be excluded. Histopathologic findings in the enucleated eye revealed a large, necrotic melanocytoma of the optic disc and hemorrhagic necrosis of the retina secondary to obstruction of the central retinal artery and vein. Melanocytoma of the optic nerve can undergo spontaneous necrosis and induce central retinal vascular obstruction. Abrupt visual loss in a patient with a melanocytoma does not necessarily imply malignant transformation.- - - - - - - - - - ranking = 1.6keywords = optic (Clic here for more details about this article) |
8/36. Late normalization of melanocytomalytic intraocular pressure elevation following excision of iris melanocytoma.BACKGROUND: Melanocytoma of the iris is a rare tumor which may sometimes undergo necrosis that could result in elevated intraocular pressure through pigment dispersion. Only nine similar patients have been previously reported. methods: A 27-year-old woman presented with a dark brown iris stromal mass located between the 4 and 8 o'clock positions in the inferior quadrant. Her left visual acuity was 20/60. The tumor encroached on the lens and caused focal cataract. There was massive pigmented debris over the iridocorneal angle and the intraocular pressure was 42 mmHg. RESULTS: Fine needle aspiration biopsy did not suggest malignancy. A wide sector iridectomy was performed and histopathological examination of the lesion revealed melanocytoma of the iris. There was no ciliary body involvement. In the postoperative period, intraocular pressure, which persisted in the mid-twenties, was successfully lowered with topical dorzolamide and betaxolol drops. These drugs were continued for 2 years while the angle pigmentation gradually disappeared. There has been no documented glaucomatous damage to the optic nerve and visual fields. A year after the cessation of the drops, the left intraocular pressure stabilized and did not rise above 15 mmHg. Her left visual acuity remained 20/25. CONCLUSION: In contrast to previously reported cases, the normalization of intraocular pressure in this patient took 26 months, a period that could be associated with the self-clearing process of pigment from the iridocorneal angle. Close follow-up with medical treatment averted a pressure lowering surgical procedure in this case.- - - - - - - - - - ranking = 0.2keywords = optic (Clic here for more details about this article) |
9/36. Optical coherence tomography in the diagnosis of subclinical serous detachment of the macula secondary to a choroidal nevus.We present a case in which optical coherence tomography (OCT) aided in the diagnosis of subretinal fluid (SRF) secondary to a choroidal nevus. A patient with a raised lesion above the left optic disc and distorted central vision was referred to our unit because of suspected choroidal melanoma. Fundus fluorescein angiography and slit-lamp investigation did not indicate any areas of SRF; however, OCT showed serous detachment in the macular area. The lesion was treated with laser photocoagulation and, when reviewed at four weeks post-treatment, repeat OCT scans showed that the area of SRF had cleared. In this case OCT was able to detect a subclinical serous detachment in the macula. This may have important implications in the monitoring of patients with small suspicious lesions.- - - - - - - - - - ranking = 0.4keywords = optic (Clic here for more details about this article) |
10/36. Melanocytoma of the choroid: angiographic and histopathologic findings.A juxtapapillary choroidal melanocytoma that was clinically confused with a choroidal melanoma is described. The clinical examination of a 40-year-old female patient included ultrasonography, fluorescein, and indocyanine green angiography. Histopathologic and immunohistochemical study of the enucleated eye resulted in the identification of a markedly pigmented, 3.8 mm elevated choroidal melanocytic tumor observed nasally to the disk. A-scan ultrasonography showed a high initial spike with a low to medium internal reflectivity with decreasing amplitude. On fluorescein angiography, the tumor was surrounded by a rim of retinal pigment epithelium depigmentation with a well-defined comet-tail. The lesion was hypofluorescent in the early phases of the indocyanine green angiogram, but from the late venous phase appeared ill-defined hyperfluorescence. Histopathologic study revealed a juxtapapillary choroidal melanocytoma The pigmented tumor cells stained positive for HMB45 and vimentin but negative for S100, GFAP, NSE, and MNF116. No tumor cells stained positive for the proliferation marker Ki67. These findings conclude that choroidal melanocytoma may mimick choroidal melanoma. Abnormalities on fluorescein angiography may be a clinical hint to suspect a pigmented tumor different from a choroidal melanoma.- - - - - - - - - - ranking = 0.084113692223051keywords = disk (Clic here for more details about this article) |
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