CHARGE association, hyper-immunoglobulin M syndrome, and conjunctival MALT lymphoma.

PURPOSE: To report a case of a 5-year-old child with CHARGE association and bilateral conjunctival mucosa-associated lymphoid tissue (MALT) lymphoma treated with topical interferon-alpha. METHODS: Case report. RESULTS: A 5-year-old girl, diagnosed with nonclassical CHARGE association and hyper-immunoglobulin M (IgM) syndrome, was referred with a 2-month history of suspected purulent bilateral streptococcal conjunctivitis. Clinical symptoms did not resolve despite multiple antibiotic treatments, and her clinical course was attributed to underlying immunodeficiency. Biomicroscopy showed salmon-colored, nodular lesions occupying both fornices and caruncles. Inferior conjunctival biopsy was performed, and MALT lymphoma was diagnosed. Bilateral treatment was initiated with topical interferon-alpha, applied 3 times a day at a concentration of 5 x 10 U/m/d, for 4 months. Complete regression of symptoms and conjunctival lesions was achieved. No recurrences have been observed after 1-year follow-up. CONCLUSIONS: We report the use of topical interferon-alpha as treatment for bilateral conjunctival MALT lymphoma in a young child with CHARGE association and hyper-IgM syndrome.

Intraretinal immunohistochemistry findings in proliferative vitreoretinopathy with retinal shortening.

UNLABELLED: To report the major intraretinal pathological changes in retinas with proliferative vitreoretinopathy (PVR) and retinal shortening, 13 human retinal samples from postoperative PVR after primary surgery for retinal detachment were immunostained for vimentin, glial fibrillary acidic protein (GFAP), cytokeratins, and CD68. One more sample was studied with electron microscopy. Retinal disorganization, neuronal loss, and gliosis were observed in 12 out of 13 samples, but all 13 were positive for GFAP. Muller cell processes showed different degrees of intermediate filament hyperplasia. CD68-positive cells were present in 11 of 13 retinal samples. CONCLUSION: A gliotic response plays a major role in retinal shortening in PVR. In addition, the presence of macrophage-like cells in retinal tissues suggests a possible role of these cells in the pathogenesis of this variety of PVR.

Analysis of irises with a latanoprost-induced change in iris color.

PURPOSE: To study the histologic aspects of irises subjected to extended latanoprost treatment. DESIGN: Prospective, observer-masked study. METHODS: Iris biopsies of eyes treated with latanoprost were analyzed (all had a photographically documented increase in iris pigmentation) plus control eyes (untreated with prostanoids) using optical microscopy. PATIENT OR STUDY POPULATION: There were 14 study eyes treated with latanoprost and 8 untreated control eyes. MAIN OUTCOME MEASURE: The morphologic characteristics of the irises. RESULTS: The irises treated with latanoprost had an increased number of melanocytes with nuclear inclusions, granules of melanin in the vascular walls and the melanocytes and free granules in the stroma compared with control eyes (P = .001, P = .01, P = .004, P = .01, respectively, by the chi(2) test). CONCLUSIONS: Chronic therapy with latanoprost appears to induce more changes in the iris than a simple increase in the melanin content of the melanocytes.