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1.
BMC Ophthalmol ; 24(1): 255, 2024 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-38872120

RESUMO

BACKGROUND: Vitreoretinal lymphoma (VRL) is a rare intraocular malignancy that poses a diagnostic challenge due to the non-specific clinical presentation that resembles uveitis. The use of spectral domain optical coherence tomography (SD-OCT) has emerged as a valuable imaging tool to characterize VRL. Therefore, we sought to determine the specific OCT features in VRL compared to the uveitides. METHODS: Retrospective chart review of patients who were seen at Mayo Clinic from January 1, 2010 through December 31, 2022. The medical records and SD-OCT images at time of initial presentation were reviewed in patients with biopsy-proven VRL, intermediate uveitis, or biopsy-confirmed sarcoid posterior uveitis. Patients with VRL or similar uveitides including intermediate uveitis or sarcoid posterior uveitis were included. RESULTS: There were 95 eyes of 56 patients in the VRL group and 86 eyes of 45 patients in the uveitis group, of whom 15 (33.3%) were diagnosed with intermediate uveitis and 30 (66.7%) with sarcoid chorioretinitis. The SD-OCT features more commonly seen at initial presentation in VRL patients (vs. uveitis) included preretinal deposits (31.6% vs. 9.3%, p = 0.002), intraretinal infiltrates (34% vs. 3.5%, p < 0.001), inner retinal hyperreflective spots (15.8% vs. 0%, p < 0.001), outer retinal atrophy (22.1% vs. 2.3%, p < 0.001), subretinal focal deposits (21.1% vs. 4.7%, p = 0.001), retinal pigmented epithelium (RPE) changes (49.5% vs. 3.5%, p < 0.001), and sub-RPE deposits (34.7% vs. 0%, p < 0.001). Features more frequently seen in uveitis included epiretinal membrane (ERM) (82.6% vs. 44.2%, p < 0.001), central macular thickening (95.3% vs. 51.6%, p < 0.001), cystoid macular edema (36% vs. 11.7%, p < 0.001), subretinal fluid (16.3% vs 6.4%, p = 0.04), and subfoveal fluid (16.3% vs. 3.2%, p = 0.003). Multivariate regression analysis controlling for age and sex showed absence of ERM (OR 0.14 [0.04,0.41], p < 0.001) and absence of central macular thickening (OR 0.03 [0,0.15], p = 0.02) were associated with VRL as opposed to uveitis. CONCLUSION: OCT features most predictive of VRL (vs. uveitis) included absence of ERM and central macular thickening.


Assuntos
Neoplasias da Retina , Tomografia de Coerência Óptica , Uveíte , Corpo Vítreo , Humanos , Tomografia de Coerência Óptica/métodos , Estudos Retrospectivos , Masculino , Feminino , Pessoa de Meia-Idade , Neoplasias da Retina/diagnóstico , Neoplasias da Retina/diagnóstico por imagem , Idoso , Corpo Vítreo/patologia , Corpo Vítreo/diagnóstico por imagem , Uveíte/diagnóstico , Adulto , Linfoma Intraocular/diagnóstico , Acuidade Visual , Diagnóstico Diferencial , Idoso de 80 Anos ou mais
2.
Med Oncol ; 41(7): 168, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38834895

RESUMO

Retinoblastoma (RB) is a pediatric cancer of the eye that occurs in 1/15000 live births worldwide. Albeit RB is initiated by the inactivation of RB1 gene, the disease progression relies largely on transcriptional alterations. Therefore, evaluating gene expression is vital to unveil the therapeutic targets in RB management. In this study, we employed an RT2 Profiler™ PCR array for a focused analysis of 84 cancer-specific genes in RB. An interaction network was built with gene expression data to identify the dysregulated pathways in RB. The key transcript alterations identified in 13 tumors by RT2 Profiler™ PCR array was further validated in 15 tumors by independent RT-qPCR. Out of 84 cancer-specific genes, 68 were dysregulated in RB tumors. Among the 68 genes, 23 were chosen for further analysis based on statistical significance and abundance across multiple tumors. Pathway analysis of altered genes showed the frequent perturbations of cell cycle, angiogenesis and apoptotic pathways in RB. Notably, upregulation of MCM2, MKI67, PGF, WEE1, CDC20 and downregulation of COX5A were found in all the tumors. Western blot confirmed the dysregulation of identified targets at protein levels as well. These alterations were more prominent in invasive RB, correlating with the disease pathogenesis. Our molecular analysis thus identified the potential therapeutic targets for improving retinoblastoma treatment. We also suggest that PCR array can be used as a tool for rapid and cost-effective gene expression analysis.


Assuntos
Neoplasias da Retina , Retinoblastoma , Retinoblastoma/genética , Retinoblastoma/patologia , Retinoblastoma/metabolismo , Humanos , Neoplasias da Retina/genética , Neoplasias da Retina/patologia , Neoplasias da Retina/metabolismo , Perfilação da Expressão Gênica/métodos , Regulação Neoplásica da Expressão Gênica
3.
Invest Ophthalmol Vis Sci ; 65(6): 18, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38861274

RESUMO

Purpose: Regression of retinoblastoma vitreous seeds (VS) during intravitreal chemotherapy can be delayed, resulting in supernumerary injections. Similarly, VS relapse may not be clinically evident at first. A predictive biomarker of tumor regression and relapse could help guide real-time clinical decision making. Retinoblastoma is an oxygen-sensitive tumor; paradoxically, VS survive in the hypoxic vitreous. We hypothesized that VS elaborate pro-angiogenic cytokines. The purpose was to determine if pro-angiogenic cytokine signatures from aqueous humor could serve as a biomarker of VS response to treatment. Methods: Multiplex ELISA was performed on aqueous from rabbit eyes with human retinoblastoma VS xenografts to identify expressed proangiogenic cytokines and changes in aqueous cytokine levels during intravitreal treatment were determined. Confirmatory RNAscope in situ hybridization for VEGF-A was performed on human retinoblastoma tumor sections and VS xenografts from rabbits. For human eyes undergoing intravitreal chemotherapy, serial aqueous VEGF-A levels measured via VEGF-A-specific ELISA were compared to clinical response. Results: VEGF-A was highly expressed in human retinoblastoma VS in the xenograft model, and was the only proangiogenic cytokine that correlated with VS disease burden. In rabbits, aqueous VEGF-A levels decreased in response to therapy, consistent with quantitative VS reduction. In patients, aqueous VEGF-A levels associated with clinical changes in disease burden (regression, stability, or relapse), with changes in VEGF-A levels correlating with clinical response. Conclusions: Aqueous VEGF-A levels correlate with extent of retinoblastoma VS, suggesting that aqueous VEGF-A may serve as a predictive molecular biomarker of treatment response.


Assuntos
Humor Aquoso , Biomarcadores Tumorais , Ensaio de Imunoadsorção Enzimática , Injeções Intravítreas , Neoplasias da Retina , Retinoblastoma , Fator A de Crescimento do Endotélio Vascular , Corpo Vítreo , Retinoblastoma/metabolismo , Retinoblastoma/tratamento farmacológico , Retinoblastoma/patologia , Animais , Neoplasias da Retina/metabolismo , Neoplasias da Retina/tratamento farmacológico , Neoplasias da Retina/patologia , Fator A de Crescimento do Endotélio Vascular/metabolismo , Humor Aquoso/metabolismo , Humanos , Corpo Vítreo/metabolismo , Corpo Vítreo/patologia , Coelhos , Biomarcadores Tumorais/metabolismo , Biópsia Líquida/métodos , Inoculação de Neoplasia , Feminino , Inibidores da Angiogênese/uso terapêutico , Citocinas/metabolismo
4.
Indian J Ophthalmol ; 72(6): 778-788, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38804799

RESUMO

Retinoblastoma is the most common pediatric ocular malignancy. It is triggered by a biallelic mutation in the RB1 gene or MYCN oncogene amplification. Retinoblastomas can be unilateral (60%-70%) or bilateral (30%-40%); bilateral tumors are always heritable and present at an earlier age as compared to unilateral ones (18-24 months vs. 36 months in India). High prevalence rates, delayed presentation, and inaccessibility to healthcare lead to worse outcomes in developing countries. The past few decades have seen a paradigm change in the treatment of retinoblastomas, shifting from enucleation and external beam radiotherapy to less aggressive modalities for eye salvage. Multimodality treatment is now the standard of care and includes intraarterial or intravenous chemotherapy along with focal consolidation therapies such as transpupillary thermotherapy, cryotherapy, and laser photocoagulation. Intravitreal and intracameral chemotherapy can help in controlling intraocular seeds. Advanced extraocular or metastatic tumors still have a poor prognosis. Genetic testing, counseling, and screening of at-risk family members must be incorporated as essential parts of management. A better understanding of the genetics and molecular basis of retinoblastoma has opened up the path for potential targeted therapy in the future. Novel recent advances such as liquid biopsy, prenatal diagnosis, prognostic biomarkers, tylectomy, and chemoplaque point to promising future directions.


Assuntos
Neoplasias da Retina , Retinoblastoma , Humanos , Retinoblastoma/terapia , Retinoblastoma/diagnóstico , Retinoblastoma/genética , Retinoblastoma/epidemiologia , Neoplasias da Retina/terapia , Neoplasias da Retina/diagnóstico , Neoplasias da Retina/genética , Saúde Global , Terapia Combinada
5.
BMJ Case Rep ; 17(5)2024 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-38729656

RESUMO

A late adolescent with tuberous sclerosis (TS) presented with reduced vision in one eye to our tertiary care university hospital 4 years ago. Fundus examination revealed multiple retinal astrocytic hamartomas (RAHs) in both eyes. His younger sibling, who also had TS, was found to have RAH on retinal screening. The swept-source optical coherence tomography (SS-OCT) findings were typical of RAH. We further noted that some of the RAH lesions showed segmental whitening of the outer walls of the arterioles, which traversed through them. The segmental whitening may suggest the enveloping of normal retinal vessels by the tumour. En-face and B-scan SS-OCT angiography of patients with TS showed vascularity within the tumour. The vessels within the tumour appeared to be in continuity with the retinal vasculature. Both siblings were reviewed annually. At the end of 4 years, there was no change in visual acuity, tumour size, number, vascularity and behaviour.


Assuntos
Astrocitoma , Fundo de Olho , Neoplasias da Retina , Irmãos , Tomografia de Coerência Óptica , Esclerose Tuberosa , Humanos , Esclerose Tuberosa/complicações , Esclerose Tuberosa/diagnóstico , Masculino , Astrocitoma/diagnóstico , Astrocitoma/complicações , Astrocitoma/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Neoplasias da Retina/diagnóstico , Neoplasias da Retina/diagnóstico por imagem , Adolescente , Seguimentos , Angiofluoresceinografia/métodos , Acuidade Visual
7.
Asia Pac J Ophthalmol (Phila) ; 13(3): 100072, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38789041

RESUMO

Retinoblastoma (RB), originating from the developing retina, is an aggressive intraocular malignant neoplasm in childhood. Biallelic loss of RB1 is conventionally considered a prerequisite for initiating RB development in most RB cases. Additional genetic mutations arising from genome instability following RB1 mutations are proposed to be required to promote RB development. Recent advancements in high throughput sequencing technologies allow a deeper and more comprehensive understanding of the etiology of RB that additional genetic alterations following RB1 biallelic loss are rare, yet epigenetic changes driven by RB1 loss emerge as a critical contributor promoting RB tumorigenesis. Multiple epigenetic regulators have been found to be dysregulated and to contribute to RB development, including noncoding RNAs, DNA methylations, RNA modifications, chromatin conformations, and histone modifications. A full understanding of the roles of genetic and epigenetic alterations in RB formation is crucial in facilitating the translation of these findings into effective treatment strategies for RB. In this review, we summarize current knowledge concerning genetic defects and epigenetic dysregulations in RB, aiming to help understand their links and roles in RB tumorigenesis.


Assuntos
Epigênese Genética , Neoplasias da Retina , Retinoblastoma , Retinoblastoma/genética , Humanos , Neoplasias da Retina/genética , Epigênese Genética/genética , Mutação , Metilação de DNA/genética , Proteínas de Ligação a Retinoblastoma/genética , Ubiquitina-Proteína Ligases
8.
Molecules ; 29(10)2024 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-38792122

RESUMO

The eye's complex anatomical structures present formidable barriers to effective drug delivery across a range of ocular diseases, from anterior to posterior segment pathologies. Emerging as a promising solution to these challenges, nanotechnology-based platforms-including but not limited to liposomes, dendrimers, and micelles-have shown the potential to revolutionize ophthalmic therapeutics. These nanocarriers enhance drug bioavailability, increase residence time in targeted ocular tissues, and offer precise, localized delivery, minimizing systemic side effects. Focusing on pediatric ophthalmology, particularly on retinoblastoma, this review delves into the recent advancements in functionalized nanosystems for drug delivery. Covering the literature from 2017 to 2023, it comprehensively examines these nanocarriers' potential impact on transforming the treatment landscape for retinoblastoma. The review highlights the critical role of these platforms in overcoming the unique pediatric eye barriers, thus enhancing treatment efficacy. It underscores the necessity for ongoing research to realize the full clinical potential of these innovative drug delivery systems in pediatric ophthalmology.


Assuntos
Sistemas de Liberação de Medicamentos , Retinoblastoma , Retinoblastoma/tratamento farmacológico , Humanos , Portadores de Fármacos/química , Criança , Nanopartículas/química , Micelas , Lipossomos/química , Dendrímeros/química , Neoplasias da Retina/tratamento farmacológico , Administração Oftálmica , Nanotecnologia/métodos
10.
Vestn Oftalmol ; 140(2. Vyp. 2): 94-101, 2024.
Artigo em Russo | MEDLINE | ID: mdl-38739137

RESUMO

This case report presents the diagnostic features of isolated primary intraocular lymphoma, which was initially misdiagnosed as neovascular age-related macular degeneration. A comprehensive examination using ultrasound, optical coherence tomography, and fundus autofluorescence revealed changes characteristic of vitreoretinal lymphoma. Molecular genetic analysis of the vitreous body showed the presence of a MYD88 gene mutation and B-cell clonality by immunoglobulin heavy chain (IGH) gene rearrangement tests, which confirmed the diagnosis.


Assuntos
Neoplasias da Retina , Tomografia de Coerência Óptica , Corpo Vítreo , Humanos , Corpo Vítreo/patologia , Corpo Vítreo/diagnóstico por imagem , Neoplasias da Retina/diagnóstico , Tomografia de Coerência Óptica/métodos , Diagnóstico Diferencial , Linfoma Intraocular/diagnóstico , Masculino , Fator 88 de Diferenciação Mieloide/genética , Angiofluoresceinografia/métodos , Idoso , Neoplasias Oculares/diagnóstico
11.
Int J Mol Sci ; 25(7)2024 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-38612869

RESUMO

Cyclin-dependent kinases (CDK2, CDK4, CDK6), cyclin D1, cyclin E1 and phosphorylated retinoblastoma (pRB1) are key regulators of the G1/S cell cycle checkpoint and may influence platinum response in ovarian cancers. CDK2/4/6 inhibitors are emerging targets in ovarian cancer therapeutics. In the current study, we evaluated the prognostic and predictive significance of the CDK2/4/6-cyclin D1/E1-pRB1 axis in clinical ovarian cancers (OC). The CDK2/4/6, cyclin D1/E1 and RB1/pRB1 protein expression were investigated in 300 ovarian cancers and correlated with clinicopathological parameters and patient outcomes. CDK2/4/6, cyclin D1/E1 and RB1 mRNA expression were evaluated in the publicly available ovarian TCGA dataset. We observed nuclear and cytoplasmic staining for CDK2/4/6, cyclins D1/E1 and RB1/pRB1 in OCs with varying percentages. Increased nuclear CDK2 and nuclear cyclin E1 expression was linked with poor progression-free survival (PFS) and a shorter overall survival (OS). Nuclear CDK6 was associated with poor OS. The cytoplasmic expression of CDK4, cyclin D1 and cyclin E1 also has predictive and/or prognostic significance in OCs. In the multivariate analysis, nuclear cyclin E1 was an independent predictor of poor PFS. Tumours with high nuclear cyclin E1/high nuclear CDK2 have a worse PFS and OS. Detailed bioinformatics in the TCGA cohort showed a positive correlation between cyclin E1 and CDK2. We also showed that cyclin-E1-overexpressing tumours are enriched for genes involved in insulin signalling and release. Our data not only identified the prognostic/predictive significance of these key cell cycle regulators but also demonstrate the importance of sub-cellular localisation. CDK2 targeting in cyclin-E1-amplified OCs could be a rational approach.


Assuntos
Neoplasias Ovarianas , Neoplasias da Retina , Retinoblastoma , Feminino , Humanos , Carcinoma Epitelial do Ovário , Ciclina D1/genética , Neoplasias Ovarianas/genética , Quinase 2 Dependente de Ciclina/genética , Ubiquitina-Proteína Ligases , Proteínas de Ligação a Retinoblastoma/genética
12.
Invest Ophthalmol Vis Sci ; 65(4): 39, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38662390

RESUMO

Purpose: Little is known regarding differences in childhood growth between somatic and heritable retinoblastoma (Rb) populations. We aimed to compare childhood growth parameters between somatic and heritable Rb cohorts at birth and at time of diagnosis with Rb. Methods: A multinational, longitudinal cohort study was conducted with patients from 11 centers in 10 countries who presented with treatment naïve Rb from January to December 2019. Variables of interest included age, sex, and size characteristics at birth and at time of presentation, as well as germline mutation status. After Bonferroni correction, results were statistically significant if the P value was less than 0.005. Results: We enrolled 696 patients, with 253 analyzed after exclusion criteria applied. Between somatic (n = 39) and heritable (n = 214) Rb cohorts, with males and females analyzed separately, there was no significant difference in birth weight percentile, weight percentile at time of diagnosis, length percentile at time of diagnosis, weight-for-length percentile at time of diagnosis, or change of weight percentile from birth to time of diagnosis. Patients with heritable Rb had a smaller mean weight percentile at birth and smaller mean weight and length percentiles at time of diagnosis with Rb, although this difference was not statistically significant. All cohorts experienced a slight negative change of weight percentile from birth to time of diagnosis. No cohort mean percentiles met criteria for failure to thrive, defined as less than the 5th percentile. Conclusions: Children with Rb seem to have normal birth and childhood growth patterns. There is no definitive evidence that somatic or heritable Rb has a biological or environmental impact on childhood growth parameters.


Assuntos
Peso ao Nascer , Neoplasias da Retina , Retinoblastoma , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estatura/genética , Peso Corporal , Desenvolvimento Infantil/fisiologia , Mutação em Linhagem Germinativa , Estudos Longitudinais , Neoplasias da Retina/genética , Retinoblastoma/genética , Estudos Retrospectivos
13.
BMJ Open ; 14(4): e082779, 2024 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-38688668

RESUMO

OBJECTIVE AND DESIGN: Retinoblastoma (Rb) is a rare childhood eye cancer, with 45% of individuals impacted by heritable disease and the remainder impacted non-heritably. The condition can leave survivors with life-long psychological and social challenges. This qualitative study examined the psychosocial needs of teenagers and young adults living beyond Rb. SETTING: A qualitative, exploratory study was conducted using focus groups with teenagers and interviews with young adults. Participants were recruited via the Childhood Eye Cancer Trust and the two national Rb treatment centres in the UK. Reflexive thematic analysis was used to analyse data using exploratory and inductive methods. PARTICIPANTS: 32 young survivors of Rb (10 heritable, 21 non-heritable, 1 unknown; 23 unilateral, 9 bilateral) aged between 13 and 29 years (12 male, 20 female). RESULTS: Data were rich and spanned the life course: three key themes were generated, containing eight subthemes. Theme 1 describes participants' experiences of childhood and trauma, including survivor guilt, memories from treatment and impact on personality. Theme 2 focuses on the challenges of adolescence, including the psychological impact of Rb, the impact on identity, and the sense of normality and adaptation to late effects. The third theme considered adulthood and the development of acceptance, a state of being widely considered unachievable during childhood, as well as the 'work' needed to feel supported, including seeking out information, peer support and therapeutic strategies. CONCLUSIONS: This study provides in-depth insight into the experiences of life beyond Rb. Findings highlight the need for specific psychosocial interventions informed by codesign.


Assuntos
Adaptação Psicológica , Sobreviventes de Câncer , Grupos Focais , Pesquisa Qualitativa , Retinoblastoma , Humanos , Retinoblastoma/psicologia , Retinoblastoma/terapia , Feminino , Masculino , Adolescente , Adulto Jovem , Adulto , Sobreviventes de Câncer/psicologia , Neoplasias da Retina/psicologia , Neoplasias da Retina/terapia , Reino Unido
15.
Int J Mol Sci ; 25(8)2024 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-38674157

RESUMO

Protein tyrosine phosphatase receptor type E (PTPRE) is a member of the "classical" protein tyrosine phosphatase subfamily and regulates a variety of cellular processes in a tissue-specific manner by antagonizing the function of protein tyrosine kinases. PTPRE plays a tumorigenic role in different human cancer cells, but its role in retinoblastoma (RB), the most common malignant eye cancer in children, remains to be elucidated. Etoposide-resistant RB cell lines and RB patients display significant higher PTPRE expression levels compared to chemosensitive counterparts and the healthy human retina, respectively. PTPRE promotor methylation analyses revealed that PTPRE expression in RB is not regulated via this mechanism. Lentiviral PTPRE knockdown (KD) induced a significant decrease in growth kinetics, cell viability, and anchorage-independent growth of etoposide-resistant Y79 and WERI RB cells. Caspase-dependent apoptosis rates were significantly increased and a re-sensitization for etoposide could be observed after PTPRE depletion. In vivo chicken chorioallantoic membrane (CAM) assays revealed decreased tumor formation capacity as well as reduced tumor size and weight following PTPRE KD. Expression levels of miR631 were significantly downregulated in etoposide-resistant RB cells and patients. Transient miR631 overexpression resulted in significantly decreased PTPRE levels and concomitantly decreased proliferation and increased apoptosis levels in etoposide-resistant RB cells. These impacts mirror PTPRE KD effects, indicating a regulation of PTPRE via this miR. Additionally, PTPRE KD led to altered phosphorylation of protein kinase SGK3 and-dependent on the cell line-AKT and ERK1/2, suggesting potential PTPRE downstream signaling pathways. In summary, these results indicate an oncogenic role of PTPRE in chemoresistant retinoblastoma.


Assuntos
Apoptose , Resistencia a Medicamentos Antineoplásicos , Etoposídeo , Neoplasias da Retina , Retinoblastoma , Humanos , Retinoblastoma/metabolismo , Retinoblastoma/genética , Retinoblastoma/patologia , Resistencia a Medicamentos Antineoplásicos/genética , Linhagem Celular Tumoral , Animais , Apoptose/efeitos dos fármacos , Etoposídeo/farmacologia , Etoposídeo/uso terapêutico , Neoplasias da Retina/metabolismo , Neoplasias da Retina/genética , Neoplasias da Retina/patologia , Neoplasias da Retina/tratamento farmacológico , Proliferação de Células/efeitos dos fármacos , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , MicroRNAs/genética , MicroRNAs/metabolismo , Transdução de Sinais/efeitos dos fármacos , Masculino
16.
Turk J Ophthalmol ; 54(2): 108-111, 2024 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-38645965

RESUMO

We report the visual and clinical outcomes of a middle-aged woman who presented with exudative retinal detachment (ERD) secondary to a vasoproliferative tumor (VPT) in an eye with sarcoidosis-associated intermediate uveitis. A 55-year-old woman previously diagnosed with sarcoidosis presented with decreased vision in the left eye (LE). Visual acuity in the LE was counting fingers. She had active vitritis, and a peripheral retinal vascular mass was noted in the superotemporal periphery. The mass was associated with ERD involving the posterior pole. The patient was managed with systemic and intravitreal steroids, and cyclosporine was subsequently added as a steroid-sparing agent. Because of recurrence of ERD, the patient underwent pars plana vitrectomy, and cryotherapy and laser photocoagulation were applied to the VPT. Two months postoperatively, visual acuity in the LE improved to 6/10. There was marked regression of the VPT and total resolution of the ERD. In conclusion, we report a favorable visual and clinical outcome in a patient with VPT-associated ERD who responded to a combination of medical therapy and surgical intervention. VPT may lead to different remote complications, so timely diagnosis of these tumors and proper management of their complications is warranted.


Assuntos
Angiofluoresceinografia , Neoplasias da Retina , Sarcoidose , Uveíte Intermediária , Acuidade Visual , Humanos , Feminino , Pessoa de Meia-Idade , Sarcoidose/complicações , Sarcoidose/diagnóstico , Angiofluoresceinografia/métodos , Neoplasias da Retina/diagnóstico , Neoplasias da Retina/complicações , Neoplasias da Retina/terapia , Uveíte Intermediária/diagnóstico , Uveíte Intermediária/complicações , Tomografia de Coerência Óptica/métodos , Fundo de Olho , Vitrectomia/métodos , Glucocorticoides/uso terapêutico , Descolamento Retiniano/etiologia , Descolamento Retiniano/diagnóstico
17.
BMC Ophthalmol ; 24(1): 194, 2024 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-38664667

RESUMO

BACKGROUND: Vitreoretinal lymphoma (VRL) still represents a diagnostic challenge for retinal specialists. Early diagnosis and treatment are critical for a better prognosis. Several diagnostic tools have proven helpful in the identification of VRL abnormalities. However, swept-source OCT angiography (SS-OCT-A) findings and their long-term follow-up are yet to be explored. CASE PRESENTATION: a 42-year-old man presented with blurred vision in his left eye for 2 weeks. He denied any systemic symptoms. A multimodal imaging examination was performed, raising the clinical suspicion of VRL and guiding the ensuing diagnostic procedures. The patient underwent treatment and at the last FU visit three years later, no disease signs were present on fundus examination, nor on oncologic evaluation. Some novel SS-OCT-A features were identified, and uncommonly reported findings were examined over a long-term follow-up. At baseline multiple hyperreflective alterations were detected on the enface outer retina slabs and choriocapillary analysis revealed low reflectance areas in the foveal and parafoveal areas. One month after the first presentation, multiple hyperreflective retinal lesions in a vertical shape were detected on OCT which appeared on midretinal slabs of enface SS-OCT-A as hyperreflective spots mainly located near second-order retinal vessels. These alterations remarkably reduced after treatment. CONCLUSION: SS-OCT-A may be a useful imaging technique in the detection of VRL, providing ophthalmologists additional findings that assist the diagnosis and follow-up of this disease. This may prove useful for a more timely and precise diagnosis, prompt therapy, and treatment response monitoring. The original aspects found in this case may provide grounds for future studies, ultimately fostering a better understanding of the disease.


Assuntos
Angiofluoresceinografia , Neoplasias da Retina , Tomografia de Coerência Óptica , Humanos , Masculino , Tomografia de Coerência Óptica/métodos , Adulto , Neoplasias da Retina/diagnóstico por imagem , Neoplasias da Retina/diagnóstico , Angiofluoresceinografia/métodos , Seguimentos , Corpo Vítreo/patologia , Corpo Vítreo/diagnóstico por imagem , Acuidade Visual , Fundo de Olho , Linfoma Intraocular/diagnóstico , Linfoma Intraocular/diagnóstico por imagem
20.
Asia Pac J Ophthalmol (Phila) ; 13(2): 100061, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38641204

RESUMO

Retinoblastoma stands as a paradigm of success in treating malignancies among pediatric patients. Over recent decades, the approach to managing retinoblastoma has evolved significantly, transitioning from the preservation of patients' lives to the preservation of eyes and vision while minimizing treatment-related complications. Chemotherapy, administered through diverse routes, has solidified its role as the cornerstone of retinoblastoma treatment. In addition to intravenous chemotherapy (IVC), alternative administration routes, including intraarterial (IAC), intravitreal, intracameral, and periocular delivery, have emerged as promising modalities for retinoblastoma management. Numerous studies have demonstrated outstanding outcomes, achieving nearly 100% salvage rates for eyes classified under groups A-C. However, for advanced intraocular retinoblastoma (groups D and E eyes), IAC appears to offer superior local control rates compared to IVC. Intravitreal injection of chemotherapeutic agents, when administered in a controlled and secure manner, holds promise in averting the need for enucleation and radiotherapy in advanced retinoblastoma cases presenting with vitreous seeds. The optimal chemotherapy strategy remains meticulously tailored based on numerous factors. This review provides a comprehensive update on chemotherapy across various routes, encompassing key considerations, dosages, administration methods, treatment outcomes, and potential complications. Furthermore, it explores emerging potential treatments and outlines future directions aimed at enhancing treatment outcomes.


Assuntos
Antineoplásicos , Neoplasias da Retina , Retinoblastoma , Retinoblastoma/tratamento farmacológico , Humanos , Neoplasias da Retina/tratamento farmacológico , Antineoplásicos/uso terapêutico , Antineoplásicos/administração & dosagem , Injeções Intravítreas
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