[Fundus fluorescein angiography in metastatic choroidal carcinomas and differentiating metastatic choroidal carcinomas from primary choroidal melanomas].

OBJECTIVE: To investigate the characteristics of fundus fluorescein angiography (FFA) in metastatic choroidal carcinomas and determine the value of FFA in differentiating metastatic choroidal carcinomas from primary choroidal melanomas. METHODS: It was a retrospective case series. The retrospective analysis of clinical data and FFA findings was performed in 23 eyes of 22 patients with metastatic choroidal carcinomas and 31 eyes of 31 patients with primary choroidal melanomas as the control. RESULTS: Ocular fundus findings of metastatic choroidal carcinomas were divided into three types: solitary flat (tumor thickness less than 3 mm), solitary elevated (tumor thickness more than 3 mm) or diffuse type. FFA of the three types showed hypofluorescence during the arterial phase and progressive hyperfluorescence during the subsequent phases. The border of the lesions revealed retinal capillary dilation during the arteriovenous phase and persistent pinpoint leakage throughout the angiogram. Retinal capillary dilation and pinpoint leakage were more frequently presented in the solitary flat type. Simultaneous visualization of retinal and tumor circulation (the so called double circulation) was more frequently presented in the solitary elevated type. Pinpoint leakage could be detected in 17 (73.91%) eyes of metastatic choroidal carcinomas and in 5 (16.13%) eyes of primary choroidal melanomas. The difference between the visibility of pinpoint leakage in metastatic choroidal carcinomas and primary choroidal melanomas was statistically significant (P = 0.0000). When pinpoint leakage of FFA was used to differentiate metastatic choroidal carcinomas from primary choroidal melanomas, the sensitivity, specificity, accuracy, positive and negative predictive values were 73.91%, 83.87%, 79.63%, 77.27%, 81.25% respectively. CONCLUSIONS: FFA is helpful for the diagnosis of metastatic choroidal carcinomas. Pinpoint leakage on the border of lesions has some value in differentiating metastatic choroidal carcinomas from primary choroidal melanomas.

[Clinical and pathological analysis of 2734 cases of eyelid neoplasms].

OBJECTIVE: To study the histopathological classification and changes of eyelid neoplasms. METHOD: In this retrospective case series, the pathological specimens of 2734 cases with eyelid neoplasms examined between 1993-2005 were claimed and analyzed. RESULTS: There were 1248 eyelid tumors (45.65%) in 2734 cases with eyelid neoplasms, including 875 benign neoplasms (71.11%) and 960 malignant cases (29.89%). The three leading malignant eyelid tumors were basal cell carcinoma, meibomian gland carcinoma and squamous cell carcinoma The mean ages of the occurrence of these three tumors were 64.16, 63.30 and 60.38 years old, respectively. CONCLUSION: Pathologic classification of eyelid neoplasms is helpful for the pathological diagnosis and provides information for the diagnosis and treatment of these diseases.

[Histopathological study of epiretinal membranes in retinopathy of prematurity].

OBJECTIVE: To study the pathological characteristics of epiretinal membranes (ERMs) in retinopathy of prematurity (ROP), and to discuss the pathogenesis of ROP. METHODS: It was a retrospective case series. Thirty-four ERMs obtained from twenty-four patients with stage 5 ROP during open-sky vitrectomy were examined by light microscopy (HE staining). Fifteen ERMs of them were examined by transmission electron microscopy. Glial fibrillary acidic protein staining (GFAP) of two ERMs were observed. Spearman rank correlation analysis of SPSS 11.0 software and random-effects model of STATA 7.0 software were used to make statistical analysis. RESULTS: Collagen was the main component of the ERMs. The amount of neovascularization was highly correlated with the age and postconceptual age (r = - 0.469, -0.482; P <0.05, respectively), but no statistically significant correlation with the gestational age and birth weight (r = - 0.179, - 0.272; P > 0.05). The amount of the fibroblasts varied in different specimens. It was related to the gestational age, age and postconceptual age (Z = -1.99, -3.45, -3.64; P <0.05). No obvious relationship was found between the amount of the fibroblasts and the birth weight (Z = 0.21, P > 0.05). Electron microscopy showed a wide variety of cell types, which scattered in the ERMs, including fibroblasts, myofibroblasts, vascular endothelial cells, macrophages and other inflammatory cells. GFAP staining of the ERMs was positive, and staining positive cells were mostly distributed on the retinal side of the ERMs. CONCLUSIONS: Fibroblasts and myofibroblasts were the main cells of the ERM of ROP. The regression of the ERM of ROP was correlated to the actual age and postconceptual age, and it had no relationship with the birth weight. The glial cells played an important role in the progression of ROP.

[Orbital solitary fibrous tumor: a clinicopathologic analysis].

OBJECTIVE: To study clinicopathologic features, histologic characteristics, differential diagnosis and the treatment of orbital solitary fibrous tumor (SFT). METHODS: Clinical, radiographic and pathologic findings of 6 cases of SFT were retrospectively analyzed. Immunohistochemistry were performed on selected samples. RESULTS: Four patients were males and 2 were females. Patients age ranged from 19- to 57-years-old. The location of the tumor was in the muscle cone (case 1 and case 5), medial (case 3), lateral (case 4), superior (case 2) and inferolateral (case 6) portion of the orbit, respectively. The presenting symptom was proptosis in 3 cases and was mass of subconjunctival or orbit margin in other 3 cases. Image examination: SFT appeared as a round (case 6 showed irregular) and well-circumscribed parenchymatous mass that could be homogenously enhanced by contrast. Histologically, SFT displayed as a mass of spindle cells in an irregular arrangement Sometime, tumor cells could be storiform or sarciniform. Mitotic figures were infrequent and usually there were 0 to 3 mitotic figures per 10 high-power fields. Hyalinization and staghornform blood vessels were frequently observed. SFT was immunoreactive for markers such as Vim, CD34 and CD99. Two cases were recurred. CONCLUSIONS: SFT is a rare orbital tumor and could be confused with other types of orbital tumors. This tumor can be diagnosed by pathological and immunocytochemical studies, these characteristics can be used to differentiate it from other types of orbital tumors.

[Clinical and pathological analysis of primary lacrimal sac tumors].

OBJECTIVE: To investigate the clinical features and pathological classification of primary lacrimal sac tumors. METHODS: A retrospective study of 96 cases of primary lacrimal sac tumors in past 50 years from EENT Hospital (Jan. 1956 to Dec. 2005) was performed to investigate the clinical features, radiological manifestation, histopathological classification and treatment. RESULTS: Primary lacrimal sac tumors were more common in men than in women (1.8:1.0) and the median age at presentation was 46 years (ranged 11 - 80 years). The most common sign and symptom were epiphora and lacrimal sac mass, respectively. Among these primary lacrimal sac tumors, 94.8% were malignant tumors (91/95). All epithelial lacrimal sac tumors (83 cases, 86.5%) were malignant and squamous cell carcinoma was the most common tumor (64 cases, 66.7%), followed by undifferentiated carcinoma (10 cases, 10.4%), mucoepidermoid carcinoma (4 cases, 4.2%), adenocarcinoma (4 cases, 4.2%) and transitional cell carcinoma (1 case, 1.0%). The nonepithelial tumors consisted of mucosa-associated lymphoid tissue (MALT) lymphoma (5 cases, 5.2%), melanoma (3 cases, 3.1%), neurilemoma (2 cases, 2.1%), hemangiopericytoma (2 cases, 2.1%) and cavernous hemangioma (1 case, 1.0%). CONCLUSIONS: Primary lacrimal sac tumors are extremely rare, but most of them are malignant tumors and are often misdiagnosed as dacryocystitis and lacrimal sac obstruction. Therefore, ophthalmologists should pay more attention to the diagnosis of lacrimal sac tumors.

[Analysis of the relationship between pathology and recurrence of primary lacrimal epithelial tumors].

OBJECTIVE: To analyze the relationship between pathology and recurrence of primary lacrimal epithelial tumors. METHODS: 128 cases of primary lacrimal epithelial tumors including benign mixed tumor (74 cases, 57.8%), adenoid cystic carcinoma (22 cases, 17.2%) and malignant mixed tumor (18 cases, 14.1%) were subjected in the study. Pathological features were analyzed and compared with their recurrence. RESULTS: The recurrent rate of benign mixed tumor, adenoid cystic carcinoma and malignant mixed tumor was 23.0%, 18.2% and 27.8%, respectively. The recurrence of benign mixed tumor was statistically related to pathological classification and encapsulates. CONCLUSIONS: Primary lacrimal epithelial tumors show variant types and high recurrent rate. The pathological features were decisive in diagnosis, selection of treatment and the time of follow-up.

[Histopathological study of corneal wound healing in guinea pigs after deep lamellar endothelial keratoplasty with small incision].

OBJECTIVE: To study the histopathological characteristics of corneal wound healing after deep lamellar endothelial keratoplasty (DLEK) with small incision. METHODS: Forty-five guinea pigs were divided into the donor and recipient groups, which consisted of 15 and 30 guinea pigs respectively. DLEK was performed in the right eye, and the left eye was used as histopathological control. Two guinea pigs with clear right corneas under biomicroscopy examination were killed at 1 week, 2 weeks, 1 month, 2 months, 3 months and 4 months postoperatively, separately. Bilateral corneal buttons were harvested for the evaluation of endothelial cells (alizarin red stain) and for the light microscopy study (HE or PAS staining). RESULTS: Clear cornea could be obtained in 22 recipient eyes postoperatively. In these corneas, the endothelial cells either in the donor disc or recipient's bed were normal in shape and size. However, there was a band area between the donor disc and recipient's bed, where the endothelial cells were abnormal. In the early postoperative period, histopathological study disclosed increase of number of cells in the corneal stroma along the pathway of lamellar separation. The tissue connecting the gap between the donor and recipient lacked lamellar structure. The new descemet's membrane appeared beneath the endothelium 1 month postoperatively. Three to four months after the operation, the continuity of the descemet's membrane and the posterior lamella was rehabilitated. CONCLUSIONS: The corneal wound healing process after the DLEK with small incision is related with the type of trauma. Collagen is arranged well at the surface of the lamellar. Fibrotic repair is seen in the marginal area connecting the donor disc and recipient's bed.

[Clinical and pathological analysis of 151 cases of tumors in lacrimal fossa].

OBJECTIVE: To investigate the clinical features and pathological classification of tumors in lacrimal fossa. METHODS: A retrospective study of 151 cases of tumors in lacrimal fossa in recent 8 years from EENT hospital was performed to investigated the clinical features, histopathological classification and prognoses. RESULTS: In 69 cases of benign lacrimal epithelial tumors, pleomorphic adenoma was the most common tumor (63 cases, 41.7%), followed by myoepithelioma (3 cases, 1.2%), lacrimal duct cyst (2 cases, 1.3%). In 34 cases of malignant lacrimal epithelial tumors, adenoid cystic carcinoma was the most common tumor (15 cases, 9.9%), followed by pleomorphic adenocarcinoma (14 cases, 9.3%), adenocarcinoma (4 cases, 2.6%). There were 48 cases of lacrimal non-epithelial lesions. Mucosa-associated lymphoid tissue (MALT) lymphoma was the most common tumor (17 cases, 11.3%), followed by pseudotumor (12 cases, 7.9%), benign lymphoepithelial lesion (7 cases, 4.0%). CONCLUSIONS: There are a variety of tumors in lacrimal fossa. The treatment of pleomorphic adenoma and the diagnosis of MALT lymphoma are the most difficult tasks in present clinical work.

[Neuroprotection of nerve growth factor in experiment retinal detachment].

OBJECTIVE: To study the neuroprotection by nerve growth factor (NGF) in retina in experimental retinal detachment (RD). METHODS: Thirty one Sprague-Dawley rats were used as RD animal model by injected 0.1% sodium hyaluronate into the sub-neuroretina space. Those rats were divided into NGF experimental group, placebo group, normal control groups and pathologic control group. NGF 1 g/L/eye was injected into vitreous every 4 days in NGF experimental group and 5 micro l of PBS intravitreal injection was used as control after RD. On postoperative time 1/2 d, 1 d, 2 d, 4 d, 8 d, 16 d, 32 d, rats were sacrificed and eyes were enucleated. The effect of NGF on retina was assessed by electron, light microscopy and cell counters. RESULTS: Histology studies showed markedly changes in photoreceptor cells, bipolar cells and ganglion cells after RD, included depletion and shorten of inner and outer segments, disturbance and thinness of inner and outer nuclear layer and swelling of ganglion cells in NGF treated group and control. Changes in the microscopic examination in NGF group showed significantly less than that in control groups, especially in inner and outer segments of photoreceptor cells. In reattached retina, the tissue structure and cell morphology showed more close to normal in NGF group than that in RD control groups. Cell counters showed the cell numbers decreased both in NGF groups and RD control groups. When retina reattached, the cell number in experimental groups showed significantly lower than that in normal control group (P < 0.05). Nuclear number of outernuclear layer and ganglion cell layer in NGF groups was greater than that in RD control groups (P < 0.05). CONCLUSION: Intravitreal injection exogenous NGF partly protects retinal cells from degeneration in experimental RD and help recovery of retinal cells after retina reattached.