Conjunctival rhinosporidiosis: a case report from a Congolese patient.

PURPOSE: This report describes a case of conjunctival rhinosporidiosis. CASE PRESENTATION: A 10-year old Congolese boy (from DR Congo), presented in May 2003 with a history of a growing mass of the conjunctiva protruding through the palpebral aperture. Examination showed conjunctival polypoid mass with muco-purulent discharge from the affected eye. After surgical excision of the lesion, the microscopic diagnosis was rhinosporidiosis. CONCLUSION: Rhinosporidiosis is a condition which both clinicians and pathologists should keep in mind when managing patients living in or coming from endemic countries with conjunctival masses.

Upper eyelid localisation of Tunga penetrans.

PURPOSE: This report describes two cases of palpebral localisation of Tunga penetrans. METHODS: Two Congolese patients (a 17-year-old black man and a 12-year-old black girl) presented with a history of itching and oedema of the left upper eyelid. RESULTS: On inspection and slit lamp examination, the patients manifested the characteristic lesion of a white translucent papule with a central black pit. Scraping of the lesion revealed a gravid adult female flea, allowing the diagnosis of infection with the flea T. penetrans. After removal of the parasite, a complete local recovery occurred over a 1-week period with local application of tetracycline. CONCLUSION: With the increase in international travelling, it is useful to know that eyelid localisation of T. penetrans is possible.

Dissociation between prostaglandin levels and blood flow to the retina and choroid in the newborn pig after nonsteroidal antiinflammatory drugs.

To assess whether prostaglandins contribute to the control of basal retinal and choroidal hemodynamics, retinal (RBF) and choroidal blood flow (ChBF) were measured by a microsphere technique in 1- to 4-day-old pigs before and after (at 20 and 60 min) administration of indomethacin (0.3 mg/kg, n = 6 or 10 mg/kg, n = 5), ibuprofen (40 mg/kg, n = 7), naproxen (20 mg/kg, n = 5) or vehicle (n = 8). In 40 other animals, PGF2 alpha, PGE2, and 6-keto-PGF1 alpha were measured in the retina and choroid at times corresponding to blood flow measurements. Mean arterial blood pressure and blood gases and pH were not altered by any of the agents. Except for the lower dose of indomethacin (0.3 mg/kg), which did not change retinal and choroidal prostaglandin concentrations, the prostaglandin levels were decreased similarly (P < 0.01) by the three drugs. However, RBF and ChBF were not changed by ibuprofen and naproxen, but decreased to the same extent after low and high doses of indomethacin. The data suggest that the effects of indomethacin on RBF and ChBF cannot be simply attributed to prostaglandin synthesis inhibition, and that prostaglandins may not play a significant role in controlling basal blood flow to the retina and choroid.

Double vital staining using trypan blue and infracyanine green in macular pucker surgery.

AIMS: To study the clinical properties of double vital staining in premacular fibrosis, facilitating complete removal of all epiretinal tissue. METHODS: In a two step surgery, the epiretinal pucker was removed after staining with trypan blue, whereafter the inner limiting membrane was peeled after staining with infracyanine green. RESULTS: In all 30 patients, a separate epiretinal layer and inner limiting membrane were removed from the macular area. Pathological examination showed different histological properties of the removed layers. An increased visual acuity was measured in 26 patients, and a slightly decreased visual acuity in one patient. CONCLUSION: The described double staining technique could be a novel valuable tool that may help to achieve optimal anatomical and functional recovery after surgery for premacular fibrosis

Invasive squamous cell carcinoma of the conjunctiva.

A 75-year-old man, known with Morbus Kahler, was referred with a history of uveitis and hypopyon at the left eye. The uveitis did not respond to any steroid treatment. It was complicated with high intraocular pressure. Anterior chamber punction showed atypical cells of epithelial origin. Several weeks prior to this presentation an atypical pterygium of the same eye was biopsied. Histopathologic examination at that time showed mild atypical actinic changes. The biopsy specimen was reviewed in our laboratory and revealed an invasive squamous cell carcinoma originating from the bulbar conjunctiva. The eye was eventually enucleated. Histologic examination of the enucleated eye showed invasion of the cornea, sclera, trabeculum, anterior chamber angle and choroid by a muco-epidermoid squamous cell carcinoma.

Fungal keratitis caused by Pseudallescheria boydii (Scedosporium apiospermum).

Keratitis is rarely caused by fungi. Filamentous fungal keratitis is often preceded by corneal trauma and occurs mostly in previously healthy individuals. We studied a case of posttraumatic keratitis caused by Pseudallescheria Boydii, which belongs to the group of filamentous fungi.

Results of histo-pathologic examination of three enucleated eyes with a choroidal melanoma after strontium-90 irradiation.

Three patients with a choroidal melanoma, treated with HDR (High Dose Rate) Strontium-90 brachytherapy, underwent an enucleation. Radiation effect was only visible at the irradiation zone with a brisk transition to normal tissue. Tumour was replaced by necrotic and scar tissue. The underlying sclera had a markedly reduced number of fibrocytes, but no structural alteration of the collagen stroma.

Conjunctival squamous cell carcinoma and intraepithelial neoplasia in AIDS patients in Congo Kinshasa.

PURPOSE: To determine the clinical characteristics of conjunctival squamous cell carcinoma and conjunctival intraepithelial neoplasia in AIDS patients. METHODS: A review of AIDS patients with biopsy-confirmed conjunctival squamous cell carcinoma and conjunctival intraepithelial neoplasia seen between 1994 and 1997. RESULTS: Ten patients, aged from 25 to 46 years (average, 37.3 years) were seen. There were three men and seven women. The mean delay of diagnosis was 7 months. Of the 10 patients, three had squamous cell carcinoma of the conjunctiva and seven had conjunctival intraepithelial neoplasia. Both eyes were involved with equal frequency. Lesions involved the corneoscleral limbus and the conjunctiva in eight patients and the conjunctiva in two patients. Localization of lesions was temporal in six patients, nasal in three patients and inferior in one patient. All patients were treated by excision of the lesions. A recurrence was seen in two patients (during the follow-up of 6 months). CONCLUSION: The conjunctival squamous cell carcinoma and intraepithelial neoplasia in AIDS patients in this study showed similar clinical characteristics as those reported in immunocompetent persons, but occurred in a younger age group and were more aggressive.

A retinoblastoma with an unusual aspect in a 5-year-old girl.

A five-year-old girl presented with a white, semitransparent, slightly elevated retinal lesion in the left eye, with as most probable diagnosis retinoblastoma. Fluorescein angiography showed intraretinal vascular abnormalities and leakage. On computed tomography and ultrasound no calcifications were identified. As the tumor had grown, enucleation was performed and the diagnosis of retinoblastoma was confirmed by routine histology and by immunohistochemistry.

Preliminary results of the FRO project: chromosomal abnormalities in primary uveal melanoma.

Uveal melanoma is the most common primary intraocular tumor in adults in the western world. Recent studies indicate that the presence of cytogenetic abnormalities in tumor cells is strongly linked with prognosis. The purpose of this project is the detection of chromosomal abnormalities in a series of frozen tumors (retrospective study) and of fresh tumor tissues (prospective study) and to correlate these results with other prognostic factors and survival.