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ABSTRACT: We report a case of extensive paranasal sinus and orbit rhabdomyosarcoma (RMS) with intra-cranial invasion treated successfully with chemotherapy and radiotherapy. A 13-years-old male patient complained of painless and progressive proptosis of his left eye for two weeks. Ocular examination showed elevated intraocular pressure, limited extraocular movement, proptosis, and conjunctival ciliary injection in the left eye. Brain CT and MRI demonstrated a large enhancing soft tissue mass lesion with bone destruction involving left ethmoid sinus, nasal cavity, maxillary sinus, and orbital cavity with crossing of the midline to the right ethmoid sinus, nasal cavity, and intra-cranial invasion across the frontal base. The pathology of tumor biopsy revealed rhabdomyosarcoma, alveolar type. Systemic survey showed no evidence of distant metastasis. Then, the patient received combined radiochemotherapy with Taiwan Pediatric Oncology Group Rhabdomyosarcoma 2007 High-risk Treatment Protocol. No light perception in his left eye with optic disc atrophy was noted at the beginning of radiotherapy. After 44 weeks of combined radiochemotherapy, the tumor regressed, and no recurrence has been noted until now. In young patients with sudden-onset proptosis, RMS should be considered, and early diagnosis is crucial due to more effective prognosis with current radiochemotherapy protocol.
Journal of the Chinese Medical Association 03/2011; 74(3):140-3. · 0.79 Impact Factor
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ABSTRACT: Vasostatin 48 (VS48) is a peptide of 48 amino acids derived from calreticulin. This study aimed to investigate the effects of topical application of VS48 eyedrops on experimental choroidal neovascularization (CNV).
Recombinant VS48 was expressed and purified as a thioredoxin (TRX)-fused protein, TRX-VS48. The anti-angiogenic effects of TRX-VS48 were validated by migration and tube formation assays performed on cultured endothelial cells, and by rat aorta ring assays. CNV lesions were created in Brown Norway rats by laser-induced photocoagulation at day 1. After topical TRX-VS48 application for 21 days, the CNV lesions were monitored via either choroidal flat mounts on day 21 or by fluorescent angiography on days 21, 28, 35, and 42. CNV lesions were evaluated by histological analysis. The retinal function of animals was examined by electroretinogram (ERG) to evaluate the safety and therapeutic efficacy of TRX-VS48.
Application of TRX-VS48 inhibited the migration and tube formation of endothelial cells. TRX-VS48 inhibited the growth of sprouting vessels in aorta rings. ERG analysis revealed that topical TRX-VS48 application for 21 days had no effect on rat retinal functions. After CNV induction, topical TRX-VS48 application for 21 days significantly reduced the size of CNV, as assayed by flat mounts. Fluorescent angiography revealed that the CNV areas in TRX-VS48-treated eyes were significantly reduced compared with TRX-treated eyes on days 21, 28, 35, and 42. Histological analysis also revealed attenuated CNV lesions in TRX-VS48-treated eyes. Topical TRX-VS48 treatment significantly reversed the CNV-induced alterations in ERG parameters on day 35.
Topical TRX-VS48 application suppressed laser-induced CNV in rats, thereby constituting a possible modality for ocular diseases due to excessive angiogenesis.
Molecular vision 01/2010; 16:756-67. · 2.20 Impact Factor
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ABSTRACT: Choroidal neovascularization (CNV) is the leading cause of blindness in patients with age-related macular degeneration (AMD). This study evaluated the inhibitory effect of vasostatin (VS), an endogenous angiogenesis inhibitor, on CNV.
Anti-angiogenic activity of VS was evaluated in vitro by migration and tube formation assays in human umbilical vein endothelial cells (HUVECs). CNV lesions were induced in Brown Norway rats by fundus argon laser photocoagulation. Beginning one day after CNV induction, rats were treated with eye drops containing 1 microg/ml VS in PBS buffer for three times daily for 20 days. The extent of CNV was examined by flat mount analysis on day 24 or by fundus fluorescein angiography (FAG) on days 21, 28, 35, and 42, respectively. CNV lesions and choroidal vascularity were evaluated by histological analysis. The spatial distribution of topically applied VS in rat eyes was evaluated by immunoblot analysis.
VS inhibited migration and tube formation in HUVECs. Flat mount analysis revealed that, after laser-induced photocoagulation, topical VS application for 20 days significantly reduced CNV lesions. Moreover, serial FAG analysis indicated that a 20 day VS treatment significantly reduced CNV lesions on all subsequent days. Histological analysis revealed attenuated lesions, intact Bruch's membrane, and reduced choroidal vascularity in VS-treated eyes. Finally immunoblot analysis reveled VS expression in choroids.
Topical VS application suppresses the progression of laser-induced CNV via angiogenesis inhibition and may constitute a therapeutic alternative for excessive neovascularization occurring with ocular diseases.
Molecular vision 01/2009; 15:1897-905. · 2.20 Impact Factor
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ABSTRACT: This study was undertaken to examine the possible association of large-conductance calcium-activated potassium channels (BK(Ca) channels) and human retinal pigment epithelial (RPE) R-50 cell phagocytosis. The potential antioxidative effect of resveratrol in human RPE cells also was investigated. Cultured human RPE R-50cells were treated with hydrogen peroxide ( H(2)O(2), 10 microM, 20 min), meclofenamic acid (30 microM, 20 min), paxilline (100 nM, 20 min), or resveratrol (10 microM, 20 min), respectively. Meclofenamic acid (30 microM, 20 min) or resveratrol (10 microM, 20 min) was given after exposure to H(2)O(2) . Pretreatment with meclofenamic acid, resveratrol, or paxilline before H(2)O(2) exposure also was performed. Fluorescent latex beads then were fed for 4 h, and phagocytic function was assessed by flow cytometry. H(2)O(2) inhibited the phagocytic function of human RPE R-50 cells. The BK(Ca) channel inhibitor, paxilline, inhibited RPE phagocytosis, as did hyperoxide stress. The BK(Ca) channel opener, meclofenamic acid, prevented the damage caused by H(2)O(2) . Pretreatment with resveratrol also provided protection against damage caused by H(2)O(2) . However, further treatment with resveratrol or meclofenamic acid was not found to offer protection from H(2)O(2) exposure. In conclusion, the dietary antioxidant, resveratrol, significantly reduced oxidative damage on phagocytic function in human RPE R-50 cells. One of the underlying mechanisms might be linked to the activity of BK(Ca) channels in RPE cells.
Journal of ocular pharmacology and therapeutics: the official journal of the Association for Ocular Pharmacology and Therapeutics 01/2009; 24(6):551-5. · 1.46 Impact Factor
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ABSTRACT: This study compared the ocular manifestations of Graves' disease in different age groups and between genders. This was a retrospective study with a chart review of 210 patients seen in the Kaohsiung Veterans General Hospital Ophthalmology Department from 1990 to 2006. Clinical manifestations were recorded, scored, and compared between different age groups and between genders. A total of 77 male and 133 female patients were included. The mean age of the patients was 48.71 years (53.80 for male and 45.77 for female patients). The average ophthalmopathy score was 3.72 (4.51 for male and 3.26 for female patients). Age was positively correlated with ophthalmopathy score (p < 0.01). The male patients scored higher than the female patients, generally and in different age groups, but the difference did not reach a statistically significant level. One hundred and six patients underwent tests for thyroid-stimulating hormone receptor antibody (TRAb); 92 (86.80%) were positive, but the titers did not correlate with the severity of ophthalmopathy. In conclusion, the severity of Graves' ophthalmopathy is correlated with age (r = 0.286). Thus, older patients should be more closely followed up and more aggressively treated.
The Kaohsiung journal of medical sciences 06/2008; 24(6):283-8. · 0.61 Impact Factor
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ABSTRACT: Current photodynamic therapy (PDT) for choroidal neovascularization (CNV) uses a standard radiant exposure of 50 J/cm2 at an irradiance of 600 mW/cm2. However, low-intensity PDT with verteporfin for neovascular tissue has been shown to be more effective than regular high-intensity PDT in an animal model of healthy choroids and corneal neovascularization. Low-intensity PDT also supposedly induces less retinal damage. In this study, we compared the effect of reduced-dose and standard light application PDT in an animal model of CNV.
A laser injury model was used to induce CNV 3 weeks prior to PDT in brown Norway rats. The CNV lesions were then treated with verteporfin PDT with a dose of verteporfin 6.0 mg/m2 and 5 activating doses of light energy (43, 53, 63, 73 and 83 seconds). Closure of CNV was assessed by fundus fluorescein angiography (FAG). Histopathologic study was done after the last FAG.
PDT with verteporfin significantly reduced the CNV area compared with control non-treated groups 1 week after PDT (p < 0.05). Only those lesions treated for 63 seconds or longer retained their significantly attenuating effect on CNV up to 3 weeks after PDT. There was no significant difference between the inhibition effects induced by reduced-intensity light application for 63 or 73 seconds compared to the standard radiant exposure (83 seconds). Histopathologic study showed that eyes treated with PDT showed significantly less extent and vascularity of CNV lesion than control lesions.
Reduced-intensity PDT with 63-second duration seemed to be as effective as standard dose for CNV suppression. Considering the possible retinal damage following standard PDT, the PDT dose might be adjusted to reduce side effects. Further preclinical study will provide more data on what constitutes appropriate dosimetry for effective and safe PDT in CNV.
Journal of the Chinese Medical Association 03/2008; 71(3):135-42. · 0.79 Impact Factor
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ABSTRACT: The purpose of this study was to evaluate the efficacy of gene delivery of angiogenesis inhibitor, vasostatin (VS), in suppressing experimental model of choroidal neovascularization (CNV). A mammalian expression vector carrying VS, pCMV3-VS, was constructed and evaluated for its ability to produce VS in transfected cells using western blot analysis and a cell viability assay. CNV was induced in Brown Norway rats by fundus argon laser photocoagulation and evaluated by fundus fluorescein angiography (FAG). Ten days post-laser treatment, gene delivery was achieved by intramuscular (IM) injection of poly-(N-vinyl pyrrolidone) (PVP) polymer conjugated with pCMV3-VS (PVP-VS) or a control vector (PVP-vector). Systemic VS expression was analysed by western blot analysis and enzyme linked immunosorbent assay (ELISA), and the extent of CNV was monitored by FAG analysis at different time intervals post-PVP treatment. Transfection of pCMV3-VS into muscle cells resulted in increased production and release of exogenous VS, which specifically inhibited the proliferation of endothelial cells. Besides, IM injection of PVP-VS, but not PVP-vector, led to elevated VS level in plasma for 30 days. After laser photocoagulation, rats injected with PVP-VS exhibited significantly lower incidence of CNV comparing with animals of control groups (P < 0.01) for at least 42 days. Moreover, rats treated with PVP-VS also showed a significant reduction in the CNV lesions compared with control groups (P < 0.001) for at least 42 days. Above all, no overt adverse effects were observed in rats received PVP-VS. These results demonstrate the potential of IM VS gene delivery for CNV treatment.
Experimental Eye Research 01/2006; 81(6):673-9. · 3.26 Impact Factor
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ABSTRACT: A 39-year-old female came with the chief complaint of acute decrease of left eye vision for the past 2 weeks. No history of systemic diseases or headache was complained. The visual acuity of the left eye was "hand motion", and rapidly responded to methylprednisolone therapy in 3 days. On tapering oral prednisolone, the visual acuity decreased again from 20/20 to light perception in the left eye. The magnetic resonance image (MRI) study showed a large suprasellar mass. The patient underwent craniotomy and removal of the tumor successfully, and the pathological report turned out to be a meningioma. The visual acuity of the left eye remained poor after the surgery. In conclusion, neuroimaging study is necessary in every case of presumed retrobulbar optic neuritis which shows atypical course. Early detection of a brain tumor may save the vision of the patient.
Journal of the Chinese Medical Association 12/2003; 66(11):689-92. · 0.79 Impact Factor
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ABSTRACT: We retrospectively reviewed 27 cases diagnosed as idiopathic optic neuritis between 1992 and 2001 at Kaohsiung Veterans General Hospital to assess the clinical features, visual prognosis, neuroimaging, laboratory studies, and development of multiple sclerosis in Chinese patients with optic neuritis. Patient age ranged from 13 to 54 years (mean, 35.8 +/- 11.3 years). Five cases presented as bilateral optic neuritis and 22 as unilateral. Visual function improved gradually from 2 weeks after treatment. Twelve (44.4%) cases showed disc swelling and ocular pain was also noted in 44.4% of patients. All cases that underwent visual field and visual evoked potential tests showed abnormality in lesion eyes. Of the 23 cases that underwent neuroimaging studies, including computerized tomography (17 patients) and magnetic resonance imaging (6 patients), 10 revealed optic nerve thickening. Four cases (14.8%) developed multiple sclerosis during follow-up (mean, 4.3 years). The incidence of disc swelling was higher than that reported by the Optic Neuritis Treatment Trial, but the incidence of initial ocular pain, the presence of periventricular plaques, and the development of multiple sclerosis were lower in our study. The unilateral group had significantly better visual outcome than the bilateral group.
The Kaohsiung journal of medical sciences 04/2003; 19(3):105-12. · 0.61 Impact Factor
