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Biomedical subjects

D M Albert

Publications and source records attributed to D M Albert.

At least 235 records · Page 13Linked to original sources

Histopathologic study of changes occurring in eyes with intraocular lens implantation: autopsy eyes, enucleated eyes and corneal buttons.

The clinicopathologic findings in 17 eyes which were surgically enucleated or removed at autopsy as well as the histopathology of 72 corneal buttons removed from eyes with intraocular lenses are described. In four of five autopsy eyes the intraocular lens was well tolerated; however, in all cases, changes related to the pseudophakos were found. In seven of 12 surgically enucleated eyes, postsurgical bacterial or fungal endophthalmitis had developed. On histopathological examination, one eye revealed clinically unsuspected endophthalmitis phacoanaphylactica after extracapsular cataract extraction and intraocular lens implantation. In two cases, choroidal melanoma became evident after cataract extraction and insertion of a pseudophakos. In both cases preoperative ultrasonography was limited to A-scan axial measurements. The 72 corneal buttons were removed from patients with pseudophakic bullous keratopathy; histologically the most striking findings were guttata-like changes in 50% of the specimens and retrocorneal membranes in 13.9% of the specimens.

Aged↗

Clinically unsuspected phacoanaphylaxis after extracapsular cataract extraction with intraocular lens implantation.

We describe the histopathological findings of an enucleation specimen from a clinically undiagnosed case of phacoanaphylaxis which occurred after extracapsular cataract extraction with intraocular lens implantation. Phacoanaphylaxis, a granulomatous inflammatory response to liberated lens protein, is potentially curable by prompt removal of residual lens material. This case emphasises that the diagnosis of phacoanaphylactic endophthalmitis should be considered in any case of extracapsular cataract extraction complicated by granulomatous intraocular inflammation.

Aged↗

Histopathological findings in necropsy eyes with intraocular lenses.

The histopathological findings in five post-mortem eyes with anterior chamber and iris fixation intraocular lenses (IOLS) are discussed. The interval between lens insertion and death ranged from 3 1/2 to 52 months. Clinically the lenses were well tolerated and the surgery was considered to be successful. In one case a vitrectomy was required. Prominent histopathological features included reduced corneal endothelium (five cases), central cornea guttata (one case), dislocation of an anterior chamber IOL (one case), abnormalities of the filtration angle (five cases), non-granulomatous iritis (two cases), and iris atrophy and erosion (five cases).

Aged↗

Demographic study of clinically atypical (dysplastic) nevi in patients with melanoma and comparison subjects.

We examined 296 patients with a history of melanoma and 145 controls for the presence of atypical (dysplastic) nevi. We found that 34% of patients with melanoma and 7% of controls had clinically atypical (dysplastic) nevi. Patients and controls with atypical (dysplastic) nevi had more nevi than the subjects without. The number of nevi varies negatively and significantly with age (r = 0.37, P less than 0.001). Ten % of patients and controls had hypopigmented halos around one or more nevi. Both patients and comparison subjects with atypical (dysplastic) nevi tended to have this subtle variant of halo nevi more often than those without (r = 0.17, P less than 0.01). The number of nevi on the irides of melanoma patients was greater than that in the comparison group. The results of this study suggest that patients with a melanoma exhibit more commonly cutaneous and ocular pigmentary lesions than comparison subjects without a melanoma.

Adolescent↗

Homozygosity of chromosome 13 in retinoblastoma.

We studied the frequency of chromosome 13 homozygosity in tumor tissue obtained directly from eyes harboring retinoblastomas. The data indicate that approximately half of all retinoblastomas are homozygous for large portions of 13q, that the homozygosity occurs in vivo and not as an event secondary to culture of the tumor cells, that chromosome 13 homozygosity is not correlated with the degree of histopathologic differentiation of the tumor, and that the homozygosity occurs in both sporadic and hereditary retinoblastomas. The development of chromosome 13 homozygosity may represent a fundamental event in the oncogenesis of a considerable number of retinoblastomas. This finding may have implications for the genetic counseling of patients with hereditary retinoblastoma. It may also be important in understanding the mechanism of oncogenesis of other tumors, especially hereditary tumors.

Alleles↗

Resection of solitary metastasis. Approach to palliative treatment of hepatic involvement with choroidal melanoma.

Local resection was performed as palliative treatment of solitary hepatic metastases from choroidal melanoma in two patients. One patient survived three years after partial hepatectomy, and the second patient was in excellent clinical condition one year after hepatic resection despite radiologic evidence of possible recurrent metastases elsewhere. Our review suggests that local resection of solitary hepatic metastases may constitute an effective approach to palliation of hepatic involvement with uveal melanoma and may possibly lead to longer survival.

Adult↗

Adenocarcinoma of the ciliary body pigment epithelium in a child.

Tumors arising from the pigment epithelium of the ciliary body are rare and most commonly occur in white adults. We describe a tumor that was clinically indistinguishable from a melanoma or medulloepithelioma occurring in a 7-year-old Japanese boy. Three months after initial evaluation, the eye was enucleated because of intractable intraocular pressure elevation and pain. On pathologic examination the tumor was found to fill approximately one third of the anterior chamber. Light microscopic and ultrastructural findings were consistent with an adenocarcinoma of the ciliary body pigment epithelium. To our knowledge, this is the youngest patient described with this tumor.

Adenocarcinoma↗

Sex-linked hereditary bilateral anophthalmos. Pathologic and radiologic correlation.

A 27-year-old man had X-linked true anophthalmos. No evidence of optic globe, nerves, or chiasm was found. Rudimentary structures suggesting optic tracts were present. Lateral geniculate nuclei were present but gliotic. Calcarine cortex was thinner but had usual lamination. The normal patches of cytochrome oxidase activity in layers II and III of visual cortex were absent.

Adult↗

Oxyphil cell adenomas. Three case reports.

The clinical and histopathologic features of three cases of oxyphil cell adenomas (oncocytomas) include two cases involving the lacrimal sac and one involving the caruncle. These lesions generally occur in the caruncle of elderly women, although they have been reported to involve the conjunctiva, lacrimal sac, and rarely the lacrimal gland. They are usually controlled by wide local excision.

Adenoma↗

Hyperthermic treatment of intraocular tumors.

A 5.8-gigahertz (GHz) ophthalmic microwave applicator was used to treat choroidal melanoma (Green strain) in rabbits. High-frequency electromagnetic radiation provides a favorable dose distribution to induce local hyperthermia in the treatment of intraocular tumors. Heating of the neoplasm, while sparing normal ocular structures, is best accomplished by a transscleral approach. A hyperthermia plaque is placed on the sclera at the base of the intraocular tumor. Contact (resistive) heating and electromagnetic radiation (radiofrequency and microwave) are best suited to a plaque technique. The advantages of electromagnetic heat induction, as compared with contact heating, are twofold: the depth of hyperthermic penetration can be modulated by frequency selection, and the tissues with low water content (sclera) remain relatively unaffected by microwaves. The 5.8-GHz ophthalmic microwave applicator satisfies the requirements for local hyperthermic treatment of intraocular tumors.

Animals↗

Corneal hematoma.

Two cases of corneal hematomas initially manifested as corneal blood staining, but were further complicated by the presence of persistent epithelial defects and stromal thinning. Both cases occurred following cataract surgery. Scanning electron and light microscopic examination in the second case demonstrated a loss of keratocytes, stromal collagen breakdown, and epithelial cell degeneration over the center of the hematoma. Large corneal hematomas may cause epithelial degeneration by functioning as barriers to nutrients and metabolic factors from the anterior chamber. Unlike corneal blood staining, conservative treatment is often insufficient therapy for corneal hematomas with associated persistent epithelial defects. Complications from epithelial defects, including corneal thinning, descemetocele, and perforation, may necessitate more aggressive treatment, even surgery. An epithelial defect overlying blood staining should suggest the presence of a corneal hematoma.

Aged↗

Development and aging of the eye in mice with inherited optic nerve aplasia: histopathological studies.

We have examined the morphological development of optic nerve aplasia in a subpopulation (10-20%) of anophthalmic mice (Strain ZRDCT -AN) that develop microphthalmia. During embryonic stages the optic fissure in microphthalmic mutants did not involute into the optic stalk. Even in the absence of a proper fissure, early differentiation of the various retinal elements was not disturbed. Subsequently, however, the optic nerve fibers failed to exit from the eye in their appropriate position. Secondary changes in the retina, probably resulting from a failure of optic axons to reach their central targets, were near total loss of ganglion cells and variable attenuation of the other nuclear and plexiform layers. Retinal rosettes were also commonly present.

Age Factors↗

A deficit survival analysis to assess the natural history of uveal melanoma.

A deficit survival analysis was conducted using a retrospective series of 230 patients with uveal melanoma. All underwent enucleation as primary treatment for their disease. Considering the three leading prognostic factors (epithelioid cells per high power field, tumor size, and tumor location), median age was plotted against median survival to determine pathways of disease spread, local and metastatic disease phases, consequences of delayed diagnosis, and the timing of enucleation. The subgroup with all three factors favorable could be subdivided into younger and older subsets on the basis of a bimodal age distribution. Only the older subset could be identified as a local disease state where survival following enucleation corresponded to normal population survival. All remaining subgroups were metastatic because of survival deficits compared to the normal population. Disease tended to progress according to three well defined pathways with 6-8 years required to progress from one subgroup to the next along these paths. These pathways were characterized by constant deficit survivals, suggesting that delays in diagnosis did not translate into loss in survival. Moreover, the value of enucleation as primary therapy can be questioned in the context that it does not appear to alter the natural history of the disease, except for tumors greater than 10 mm in largest dimension which are located anterior to the equator with fewer than 2 epithelioid cells per high power field. Findings suggest that uveal melanoma can be treated by means other than enucleation to allow a chance for prolonged survival with vision preservation.

Adult↗

Development of additional primary tumors after 62 years in the first patient with retinoblastoma cured by radiation therapy.

In the first well-documented case of bilateral retinoblastoma to be cured by X-irradiation of the nonenucleated eye, a basal cell carcinoma and then a squamous cell carcinoma of the eyelids developed 60 years after the original treatment. The patient, a 66-year-old man, had been treated by Verhoeff between 1917 and 1919. These new tumors may have been examples of second primary tumors, found in about 0.5% to 2.5% of patients with bilateral retinoblastoma, or they may have been coincidental. Because of the 60-year period between the patient's original treatment and the development of these tumors, it seems unlikely that they were the result of the irradiation.

Basal Cell Carcinoma↗

Iridocyclitis and an iris mass associated with secondary syphilis.

A 34-year-old white man developed iridocyclitis and an iris mass. The iridocyclitis was preceded by a nodular rash which spared the palms and soles. An anterior segment fluorescein angiogram was performed which showed numerous permeable vessels. An ultrasound examination of the mass showed that it extended to the ciliary body. He had both a positive RPRCT and FTA-Abs. A skin biopsy was done which disclosed the nodules to be a rare form of secondary syphilis. The patient was treated with topical steroids and a cycloplegic agent, and later prednisone and intravenous penicillin, with eventual resolution of iris mass, iridocyclitis and skin nodules.

Adult↗