Activity of crizotinib over choroidal metastases in non-small-cell lung cancer (NSCLC)-ALK rearranged: a case report.

BACKGROUND: Adenocarcinoma of the lung with EML4-ALK translocation is a rare subtype of Non Small-Cell Lung Cancer (NSCLC) that has recently shown to benefit from treatment with crizotinib. Despite the concerns about the efficacy of crizotinib over cerebral metastases, some reports have described its activity, although always after local treatment with radiotherapy. Recently it has been reported activity of crizotinib over choroidal metastases, again after radiotherapy. CASE PRESENTATION: Herein we report a case of activity of crizotinib over choroidal metastases not previously treated with radiotherapy. CONCLUSION: We suggest crizotinib may be active over choroidal metastases in a patient harboring ALK translocation with no need of radiotherapy.

Microperimetry and fundus autofluorescence in patients with early age-related macular degeneration.

BACKGROUND: Early age-related macular degeneration (AMD) has been correlated with different functional alterations, but the exact relationship between fundus lesions and overlying sensitivity is not well known. The aim of this study was to compare fundus-related sensitivity (microperimetry) and fundus autofluorescence (FAF) of the macular area with drusen and pigment abnormalities in early AMD. METHODS: 13 consecutive patients with early AMD and visual acuity of 20/20 were studied by means of microperimetry, which automatically analyses macular light differential threshold and fixation patterns. Fundus colour photo and FAF of the macular area were recorded on the same day. Microperimetry was exactly (topographically) superimposed over FAF images. RESULTS: Macular sensitivity significantly decreased over large drusen (11.2 +/- 5.6 dB, p<0.0001) and over pigment abnormalities (13.1 +/- 3.6 dB, p<0.0001). When both characteristics were present the reduction was greater if compared with its absence (9.6 +/- 4.3 versus 15.0 +/- 4.5 dB, p<0.0001). Sensitivitity reduction was significant in areas with altered FAF when compared with areas with normal FAF (p<0.0001). CONCLUSIONS: Increased FAF in early AMD has a functional correlate exactly quantified by microperimetry. In retinal areas affected by early AMD retinal sensitivity deteriorates, despite good visual acuity. Microperimetry may allow the early detection of functional impairment caused by these lesions. Both microperimetry and FAF may be useful to monitor AMD progression.

Combined 50- and 20-MHz frequency ultrasound imaging in intermediate uveitis.

PURPOSE: To evaluate the information provided by multifrequency ultrasound examination in patients with intermediate uveitis. DESIGN: Prospective observational case series. METHOD: High-resolution ultrasonography with 50- and 20-MHz frequency immersion probes was performed in seven eyes of five young patients with clinical diagnosis of intermediate uveitis. RESULTS: Exudative material over the inferior pars plana and peripheral retina (snowbank) was found in all eyes with 50- and 20-MHz probe, although resolution of the latter was poorer. The 50-MHz imaging was superior for visualization of angle structures and details of pars planitis; the anterior vitreous involvement and cyclitic bands were better shown with the 20-MHz probe, which could also evidence cystoid macular edema. CONCLUSIONS: Ultrasound examination with both 50- and 20-MHz frequency probes can detect the typical snowbank in intermediate uveitis and be useful in eyes with small pupil, dense vitreitis, or both, especially before pars plana vitrectomy or cataract surgery.