[Sensitivity of immunoscintigraphy in malignant melanoma of the choroid]. / Sensitivität der Immunszintigraphie beim malignen Melanom der Aderhaut.

Between June, 1988 and May, 1991 30 patients with clinically suspected malignant melanoma were examined in succession by means of immunoscintigraphy and the 225.28 S antibody (tagged with Tc-99m). Retrospectively, the results showed a sensitivity of over 70% by SPECT examination. Positive accumulation of the antibody within the suspected melanoma gives reason to believe that this degree of accuracy can be improved by comparative application of unspecific, radioactively tagged proteins. In the absence of accumulation within clinically, and in particular echographically, confirmed malignant melanoma treatment should be performed.

[Carcinoid tumor of the lung. An unusual form of ocular metastasis]. / Karzinoidtumor der Lunge. Eine ungewöhnliche Form der okulären Metastasierung.

Carcinoid tumors are slowly and locally invasive growing neoplasms. Their main localization is in the ileum or in organs derived from the embryonic foregut, i.e. bronchus, stomach, pancreas and thyroid. The low rate of metastatic manifestation of about 10% indicates their potential malignancy. The endocrine effects vary. We describe the case of a 30-year-old female patient, who had had a carcinoid tumor of the bronchus with infiltration of a hilar lymph node, which had been resected two years previously. The postoperative course was marked by an increased level of urine 5-hydroxyindolacetic acid (5-HIAA). Finally, the patient complained a 4-month history of recurrent episodes of refractory conjunctival hyperemia, visual loss and visual field defects in both eyes. Examination revealed bilateral multiple choroidal masses associated with retinal detachment. As various authors have reported, carcinoid tumor metastases to the eye are extremely rare. Diagnostic approaches and therapeutic considerations are described. Ultrasonic examination of the choroidal lesion, applying standardized A-scan echography at tissue sensitivity, showed solid tissue masses and bilateral circumscribed exudative retinal detachment. The tumor was characterized by medium to high reflectivity and slight sound attenuation. The internal structure showed less irregularity than is usually seen in metastases.

[Histiocytosis X (eosinophilic granuloma) of the caruncle]. / Histiocytosis X (eosinophiles Granulom) der Karunkel.

The lacrimal caruncle of an 11-year-old female patient developed a 2 mm x 3 mm-sized growth with the primary appearance of an abscess. The process did not regress under local antibiotic therapy and was excised. Histological examination revealed histiocytosis X (eosinophilic granuloma).

Irradiation of malignant eyelid melanoma with iodine 125 plaque.

We used contact irradiation with iodine 125 seeds to treat a large, exulcerative, nodular, amelanotic malignant eyelid melanoma with metastasis to the regional lymph nodes in an 80-year-old man. The procedure was similar to iodine 125 plaque irradiation of malignant choroidal melanoma; special equipment, however, was needed to protect the eye from radiation exposure. The response of the malignant eyelid melanoma to iodine 125 plaque irradiation was similar to that of malignant melanomas of the choroid. No complications were observed in a follow-up period of 15 months.

[Treatment of choroid melanoma with a radioactive iodine 125 plaque: initial results of a pilot study]. / Die Behandlung des Aderhaut-Melanoms mit radioaktiver Jod-125-Plaque: Erste Ergebnisse einer Pilotstudie.

UNLABELLED: The present paper reports on the treatment of 9 choroidal melanomas with a prominence of 5 to 8.7 mm, using iodine-125 plaque. FOLLOW-UP: 1-1 3/4 years. Radiation dose per hour: 0.3-0.6 Gy, tumor apex 70 Gy, tumor basis 370 Gy; plaque in situ 1 to 2 weeks. Localization of tumor: 2 X close to macula, 2 X extending into macula, 1 X 1 mm from disc. Postoperative regression of all 9 melanomas, by 51% after 1 year. Postoperatively no reduction in bulbus size, rubeosis iridis, cataract, or optic atrophy; however, 2 X reduced visual acuity: 1 X temporary (increase after laser coagulation of neovascularization), 1 X permanent (discrete subretinal gliosis in residual macular half not extending into radiation scar). Visual acuity 6 months postoperatively equal to that after 1-1 3/4 years and in 5 out of the 9 patients 20/100 to 20/30. An attempt is made to correlate the anatomical and functional results with the "tumor surgery in small steps" achieved with iodine-125 plaquing.

The treatment of giant tear detachments using retrohyaloidal perfluorocarbon gases without drainage or vitrectomy.

In a pilot study, an expanding perflurocarbon gas was injected into the retrohyaloidal space for treating giant tear detachments. Using the balloon-gas procedure with a single gas injection, a bubble was obtained that was large enough to tamponade a giant tear without prior drainage of subretinal fluid or vitrectomy. The procedure was performed under subconjunctival anesthesia in order to preserve the patient's light perception, the fading of which served as a safeguard against excessive gas injection. The posterior hyaloidal membrane was only attached to the anterior flap of the tear and to the circumference of the retina anterior to the equator. The retrohyaloidal gas injection was not followed by star-fold formation or other evidence of preretinal proliferation. During the follow-up, the detached posterior hyaloidal membrane appeared to have collapsed on the anterior retina in concertina-like folds. Reattachment occurred in four of the five cases; no retina redetached during an average follow-up of 2 years.

The treatment of difficult retinal detachments with an expanding gas bubble without vitrectomy.

In a prospective study on the use of perfluorocarbon gases (CF4, C2F6, C3F8) without prior mechanical vitrectomy, 51 retinal detachments that were not suitable for scleral buckling were treated by injection of a small bubble of gas into the vitreous to form a tamponade. There were 23 patients with giant tears, 16 with posterior holes, 9 with breaks at different latitudes, and 3 in whom the gas was used for diagnostic purposes. The gases were sustained at therapeutic volumes for 10-70 days. The tears were sealed with argon or krypton laser. The overall reattachment rate was 71%. Postoperative visual acuity improved or remained the same in all patients with reattached retina. In a follow-up of 1 year-38 months there were no late complications, such as cataract, glaucoma, keratopathy, or subsequent visual deterioration.