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ABSTRACT: Purpose: To describe a case of sclerochoroidal calcification in a patient with hypercalcemia from undiagnosed parathyroid adenoma.
Methods: A 66-year-old white woman was found to have asymptomatic bilateral yellow choroidal tumors characteristic of sclerochoroidal calcification. The calcified tumors were echogenic on ultrasonography.
Results: Systemic evaluation disclosed hypercalcemia, and there was no abnormality of the parathyroid glands with hormone levels or nuclear medicine scans. After 4 years, the hypercalcemia persisted, prompting surgical exploration of the parathyroid glands that revealed an adenoma. After resection of the glands, the serum calcium reverted to normal.
Discussion: Sclerochoroidal calcification can be associated with systemic hypercalcemia. A search for the cause is warranted, and in this case, a subclinical adenoma was the source of the hypercalcemia.
Retinal Cases & Brief Reports 12/2008; 3(4):431-433.
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ABSTRACT: To describe the autofluorescence features of choroidal nevi.
Noncomparative case series.
Sixty-four consecutive patients.
Correlation of fundus photography with autofluorescence photography.
Autofluorescence features of choroidal nevus and overlying retinal pigment epithelium (RPE).
The mean patient age was 62 years. The choroidal nevus was a mean of 5 mm from the optic disk and foveola. The mean tumor basal dimension was 5.0 mm and mean tumor thickness was 1.0 mm. The choroidal nevus showed hypoautofluorescence in 56%, isoautofluorescence in 19%, and hyperautofluorescence in 25%. The autofluorescence features appeared unaffected by tumor thickness, but increasing tumor base and disrupted overlying RPE appeared to produce slightly brighter autofluorescence. Nevi located in the macular region showed darker hypoautofluorescence than those outside the macular region. Overlying RPE hyperplasia, atrophy, and fibrous metaplasia were generally hypoautofluorescent. Drusen, subretinal fluid, and orange pigment were generally hyperautofluorescent. The brightest hyperautofluorescence was found with orange pigment.
Choroidal nevus shows little intrinsic autofluorescence. Overlying RPE alterations show dramatic autofluorescence ranging from dark hypoautofluorescence of RPE atrophy to bright hyperautofluorescence of orange pigment.
Retina (Philadelphia, Pa.) 11/2008; 28(8):1035-43. · 2.93 Impact Factor
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ABSTRACT: To evaluate regression rates after plaque radiotherapy and thermotherapy of uveal melanoma with chromosome 3 monosomy versus disomy.
Noncomparative case series.
Two hundred and seventy patients with uveal melanoma.
Fine needle aspiration biopsy was used at the time of plaque radiotherapy to sample tumor cells for genetic testing.
Tumor thickness regression based on chromosome 3 status.
At the time of plaque radiotherapy, the median tumor thickness was 4.0 mm for melanomas with chromosome 3 monosomy and 3.5 mm for those with disomy 3. The median tumor thickness (% original thickness) at 4, 8, 12, 15, and 18 months after radiotherapy for melanoma with monosomy 3 was 77%, 67%, 58%, 55%, and 50% and for those with disomy 3 was 82%, 70%, 69%, 67%, and 61%. The median monthly regression rate was 3.1% for tumors with monosomy 3 and 2.7% for those with disomy 3. The overall regression and monthly rate of regression was statistically greater at 12 months (P < 0.001) and 15 months (P = 0.003) for melanomas with monosomy 3 compared with disomy 3.
Uveal melanomas with chromosome 3 monosomy showed faster and greater tumor thickness regression at 12 and 15 months after plaque radiotherapy and thermotherapy than melanomas with disomy 3.
Retina (Philadelphia, Pa.) 10/2008; 28(9):1289-95. · 2.93 Impact Factor
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Archives of ophthalmology 05/2008; 126(4):578-9. · 3.86 Impact Factor
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ABSTRACT: To describe the autofluorescence features of CHRPE.
Noncomparative case series.
Thirteen consecutive eyes with CHRPE.
: CHRPE was studied with fundus photography and autofluorescence. Autofluorescence was judged relative to the surrounding retinal pigment epithelium.
Autofluorescence features of CHRPE.
The mean CHRPE basal dimension was 4.75 mm and the tumor location was between the macular and equator (n = 10) or equator and ora serrata (n = 3). Overall, CHRPE show hypoautofluorescence in every case and was classified as trace (n = 1), moderate (n = 6), or marked (n = 6) hypoautofluorescence. Compared to the central portion of CHRPE, the margin showed isoautofluorescence (n = 8) or trace hyperautofluorescence (n = 5). There were eight lesions with lacunae and this feature generally showed trace to moderate hyperautofluorescence (n = 6). A nonpigmented halo was present surrounding six lesions, generally showing trace hyperautofluorescence (n = 3). A pigmented halo was present surrounding eight lesions, usually showing isoautofluorescence (n = 6).
CHRPE shows striking hypoautofluorescence and this correlates with known histopathologic evidence of lack of lipofuscin in the retinal pigment epithelium of CHRPE. The lacunae showed general mild hyperautofluorescence that might correlate with scleral autofluorescence.
Retina 11/2007; 27(8):1097-100. · 2.81 Impact Factor
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ABSTRACT: To describe the autofluorescence features of orange pigment (intracellular lipofuscin) overlying small presumed choroidal melanomas.
The diagnostic testing results (fluorescein angiography, optical coherence tomography, and fundus autofluorescence imaging) for two patients with pigmented choroidal melanoma and two patients with nonpigmented choroidal melanoma were reviewed.
Clinically, the intracellular lipofuscin pigment appeared brown overlying the nonpigmented melanoma (two cases) and orange overlying the pigmented melanoma (two cases). Fluorescein angiography demonstrated that the lipofuscin pigment displayed fluorescein blockage in all four cases. Optical coherence tomography revealed serous retinal detachment in all four cases. Fundus autofluorescence imaging showed discrete, bright hyperautofluorescence of the orange pigment separated by hypoautofluorescent voids. The melanoma was isoautofluorescent.
Intracellular lipofuscin overlying small choroidal melanomas shows discrete and bright hyperautofluorescence. The brightness correlates directly with the clinically visible orange pigment.
Retina 11/2007; 27(8):1107-11. · 2.81 Impact Factor
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Ophthalmic plastic and reconstructive surgery 24(5):430-431. · 0.69 Impact Factor
