[Characteristics of Fifty Cases of Pituitary Tumors in Eyes Diagnosed with Glaucoma].

PURPOSE: To determine the characteristics of 50 cases of pituitary tumor. METHODS: The medical records of 50 cases of pituitary tumor found in glaucoma patients treated between June 2013 and June 2014 were reviewed. RESULTS: There were 37 women and 13 men whose average age was 55.7 years with a range of 24 to 79 years. The glaucoma was unilateral in 19 and bilateral in 31. The pituitary tumors were classified as Rathke's Cleft Cyst (RCC) in 38 cases (76%), RCC with Cushing disease in 5 (10%), adenoma in 4 (8%), adenoma + growth hormone (GH) producing tumors in 2 (4%), and RCC with adenoma in 1 (2%). Of the 50 patients, 23 were treated by surgery (46%), 2 (4%) by hormone supplement therapy, 2 (4%) rejected therapy, and 23 (46%) were followed without treatment. The visual field defects corresponded with typical pituitary visual field defects in 26 (52%) cases, with that typical of unilateral glaucoma in 6 (23%), and with that typical of bilateral glaucoma in 20 (77%) cases. The major symptom was headaches in 24 (48%), headache with dizziness in 10 (20%), dizziness in only 8 (16%), and no complaints in 8 (16%). CONCLUSIONS: Fifty patients diagnosed with glaucoma had concurrent pituitary tumors. Special attention must be paid to glaucoma patients who complain of headaches with and without dizziness.

Optic Neuritis Caused by Rathke's Cleft Cyst in Young Adult.

We report a case of right optic neuritis caused by Rathke's cleft cyst (RCC) in a young adult. A 15-year-old boy presented with reduced visual acuity in the right eye. He was diagnosed with optic neuritis in the right eye 4 years earlier at other clinics before he was referred to our department. During our one-year examinations, the cause of the reduced vision in his right eye could not be determined conclusively. At the age of 17 years, a RCC was detected by a neurosurgeon who specialized in hypophyseal diseases. He underwent microscopic transsphenoidal resection of the cyst, and his vision recovered to 1.2 and he has had no recurrence for at least 9 months. We suggest that repeated rupturing of the RCC was the cause of the optic neuritis, and a RCC can be successfully treated by surgery even after 3 years of optic neuritis.

A case of choroidal metastasis of lung cancer successfully treated with erlotinib.

We present a case of choroidal metastasis of lung cancer in which choroidal metastasis, the first manifestation of recurrence, was successfully treated with erlotinib. A 49-year-old woman with a 2. 0 cm nodule in the right lung was diagnosed with adenocarcinoma, and a right upper lobectomy was performed. After 2 months, she presented with blurred vision of the right eye. Her right visual acuity had decreased to 0. 1, and there was a visual field defect temporal to the macula. Fundus examination of the right eye revealed an elevated mass with exudative retinal detachment temporal to the disc. Fluorescein angiography revealed hypofluorescence during the prearterial and arteriovenous phases, and fluorescein leakage surrounded by a circular hypofluorescence area during the venous phase. Spectral-domain optical coherence tomography showed exudative retinal detachment. The cancer cells had a mutation of the epidermal growth factor receptor gene in exon 19. She was treated with erlotinib at 100 mg per day, and after 4 days, her right visual acuity had improved to 1. 2.

Suppression of corneal neovascularization by culture supernatant of human amniotic cells.

PURPOSE: To examine the applicability of culture supernatant of human amniotic cells on basic fibroblast growth factor (bFGF)-induced corneal neovascularization. METHODS: Human amniotic epithelial and mesenchymal cells (AC) were obtained from human amniotic membranes by digesting with collagenase and maintained in serum-containing medium. The AC preparations predominantly contained cytokeratin-positive cells (91.2 +/- 3.1%, n = 4). The culture supernatant was prepared by cultivating AC in serum-free medium for 24 hours. Neovascularization was obtained by a micropocket assay with Hydron pellets containing bFGF. Migration assay was carried out by a double-chamber method using human umbilical vein endothelial cells (HUVEC). Cell growth assay was done by MTT assay using HUVEC. RESULTS: Basic fibroblast growth factor-induced corneal neovascularization was significantly reduced by administration of AC culture supernatant. When either control or AC culture supernatant was administered three times per day for 10 days, the area with neovascularization was 13.2 +/- 3.2 mm2 and 4.0 +/- 1.4 mm2 for the control and AC culture supernatant-treated eyes, respectively (n = 7, p = 0.021). AC culture supernatant strongly inhibited bFGF-induced migration and cell growth of HUVEC. CONCLUSIONS: Amniotic cell culture supernatant contains potent inhibitors of neovascularization. This effect is explained in part by inhibition of migration and cell growth of vascular endothelial cells. AC culture supernatant may be applicable for treatment of corneal diseases with neovascularization.