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Biomedical subjects

L Zografos

Publications and source records attributed to L Zografos.

At least 55 records · Page 3Linked to original sources
PubMed1996

Cobalt-60 treatment of choroidal hemangiomas.

PURPOSE: We investigated the therapeutic possibilities of gamma brachytherapy to improve the final functional results of eyes with choroidal hemangiomas, which are benign vascular tumors that can induce progressive impairment of visual acuity. METHODS: We treated 41 patients with choroidal hemangioma with cobalt-60 applicators. The lesions consisted of 39 circumscribed hemangiomas and two diffuse hemangiomas in patients with Sturge-Weber syndrome. Before treatment, visual acuity in the affected eye was 20/200 in ten patients, 20/200 to 20/50 in 17 patients, 20/40 to 20/25 in 11 patients, and 20/20 in three patients. All patients were symptomatic. The macula was infiltrated by the tumor in 12 eyes (29.3%). There was retinal detachment in 40 eyes (97.6%), cystoid edema in ten eyes (24.4%), subretinal fibrosis in eight eyes (19.5%), and areolar atrophy in two eyes (4.9%). RESULTS: After treatment, the retina was reattached in all eyes, and the tumor progressively transformed into a flat scar. The postirradiation macular lesions that we identified were pigment migrations in the macular region, subretinal fibrosis, and an areolar atrophic scar. We correlated the functional results at two, five, and ten years after treatment with the initial visual acuity, and with pre-existing and posttreatment macular lesions. CONCLUSIONS: Our results suggest that radiotherapy is a valuable therapeutic modality for choroidal hemangiomas, particularly in hemangiomas that involve the macula, and for tumors associated with bullous retinal detachment.

Adolescent↗
PubMed1996

[Value of indocyanine green angiography in localization of occult choroid neovascularization].

PURPOSE: To determine the role of Indocyanin Green (ICG) angiography in localizing occult new vessels associated with age-related macular degeneration (ARMD) and assess the possibilities of ICG guided laser photocoagulations. PATIENTS AND METHODS: Fluorescein and ICG angiographies (IMAGEnet system) of 62 patients with occult new vessels (ONV), serous (SPED) or vascular (VPED) pigment epithelium detachment have been studied. RESULTS: Based on fondoscopic examination and fluorescein angiography, 43 eyes (69%) disclosed ONV, 8 (13%) SPED and 11 (18%) VPED. Choroidal neovascularisation was confirmed by ICG angiography in 37 ONV cases (86%), in 8 (72%) VPED cases, but in no SPED. Conversion of ONV in classical neovascular membranes was possible in 19 ONV cases (44%) and in 6 (54%) VPED cases, making a laser photocoagulation possible in 9 eyes (36%). CONCLUSION: ICG angiography plays an important role in the evaluation, classification and laser treatment of patients with ONV secondary to ARMD.

Aged↗
PubMed1996

[Value of indocyanine green videoangiography in differential diagnosis of nonpigmented tumors of the choroid].

BACKGROUND: Indocyanine green video-angiography (ICG) is a recent examination technique, its possibilities and limitations as far as intraocular tumours are concerned, haven't been fully explored yet. MATERIAL AND METHODS: We have studied 50 cases of non-pigmented choroidal tumours, including 14 cases of choroidal hemangioma's, 11 cases of posterior uveal metastases and 25 cases of non-pigmented melanoma's. RESULTS: Characteristic images were obtained when examining choroidal hemangioma's and, until a certain point, posterior choroidal metastases. Non pigmented melanoma's on the contrary, presented a great variety of different indocyanine green angiographic pictures. CONCLUSION: Indocyanine green video-angiography (ICG) has a definite value in the differential diagnosis of non-pigmented posterior choroidal tumours.

Angiography↗
PubMed1996

[Medullo-epithelioma: presentation of 3 cases].

Three cases of medullo-epithelioma are reported from a study of almost 350 cases of retinoblastomas or pseudo-retinoblastomas. The cases concern one female and two male children of 1,5, 2,5 and 6 years of age respectively at the time of diagnosis. Suspected of carrying retinoblastoma, two of the children were enucleated. Histological examination revealed the presence of a benign medullo-epithelioma in one case and a malignant condition in the other. The third case was treated by brachytherapy which led to total destruction of the tumor. A new iridian focus opposite the original tumor appeared one year later and was in turn destroyed by cobalt applicator.

Brachytherapy↗
PubMed1996

[Contribution of ultrasound biomicroscopy to conservative treatment of anterior uveal melanoma].

BACKGROUND: Ultrasound Biomicroscopy (UBM) is a new ophthalmological imaging technique essentially designed for the study of the anterior eye segment. Over the last 10 months, we've evaluated its contribution to the conservative treatment of anterior uveal melanoma's by means of accelerated proton beam irradiation. MATERIAL: Using UBM, we have examined 55 cases of uveal melanoma's, whose anterior border was situated at 6 mm or less from the limbus and that were consequently treated by proton beam irradiation. RESULTS: The presumed tumoral origin was the ciliary body's pars plicata in 13 cases and the pars plana or the choroid in 42 cases, 17 of which presented a tumoral invasion of the pars plicata. A pars plana detachment anterior to or surrounding the anterior tumoral border, was present in 22 cases. The height of the tumor could only be measured by UBM if it was less than 2.5 mm. Information gathered using UBM have contributed to an improvement of the therapy plan in 32 cases. CONCLUSION: Because of the strong attenuation of the high frequency ultrasound signal, UBM can only be used for the examination of intra-ocular structures situated in direct neighbourhood to the global wall. Despite this technical limitation, ist contribution to the planning of the conservative treatment of anterior uveal melanoma's by proton beam irradiation has appeared to be considerable.

Choroid Neoplasms↗
PubMed1996

Delineation of a 1-cM region on distal 5q containing the locus for corneal dystrophies Groenouw type I and lattice type I and exclusion of the candidate genes SPARC and LOX.

Granular Groenouw type I (CDGG1) and lattice type 1 (CDL1) corneal dystrophies are two distinct potentially blinding conditions. These two entities were recently mapped to a region on chromosome 5q. We have investigated 2 families of Swiss origin with CDGG1 and CDL1 by linkage analysis. Our data show a maximum lod score of 5.38 at theta = 0.00 for marker D5S393 in CDL1 and 4.17 at theta = 0.00 for D5S658 in CDGG1. When combined, these families show a maximum low score of 9.22 for D5S393 at theta = 0.00. This confirms previous reports. Furthermore, we describe a recombination centromeric to D5S399 in a member of the CDL1 family. Haplotype analysis in the 4 branches of the CDGG1 family demonstrated a common chromosomal region including D5S393 and D5S399 in all the affected members. By combining our data with previously reported mapping information and assuming that CDGG1 and CDL1 are allelic manifestations of the same gene, we can refine the location of the CDGG1/CDL1 gene to a 1-cM region on chromosome 5q. Using candidate genes in the 5q22-q32 interval, we investigated the possibility that mutations in the SPARC or LOX genes cause these corneal diseases. Several recombinations occurred between these two genes and CDGG1/CDL1 in our 2 families, thus excluding this hypothesis.

Alleles↗
PubMed1995

[Familial uveal melanoma].

BACKGROUND: Familial uveal melanoma are rare and a few number of cases has been described in literature until now. An autosomal dominant inheritance was proposed. MATERIAL AND METHOD: From the 2169 patients examined and/or treated in the Jules Gonin Hospital for an uveal melanoma from 1969, we identified 11 patients from 9 families in which at least two members were affected. We compared the clinical data of the familial melanoma with those of the sporadic cases of our collective with the Kruskal-Wallis Tests. The following parameters were studied: age and sex of patients, largest and smallest tumor diameter, height and volume of tumor, distance between tumor and optic nerve and macula, distance of tumor to the equator. Age and sex were also compared with literature. RESULTS: Among the 11 patients, nine were treated with an accelerated proton beam, one with Cobalt60 applicator and one has been enucleated. The median age was 58 years among the probands and 54.6 years among the sporadic cases of the collective. Sex ratio is superposable between both groups: male 45.5%, female 54.5% among the probands and male 48.6%, female 51.4% among the sporadic cases. The comparison between both groups with the Kruskal-Wallis Tests did not show any significant statistical difference. CONCLUSION: An uveal melanoma occurring at least in two members of the same family is not due to chance alone. Genetic factors associated to external factors are probably responsable.

Adolescent↗
PubMed1995

Study of the blood-aqueous barrier in choroidal melanoma.

AIMS: Aqueous flare was used to determine the frequency and amount of blood-aqueous barrier breakdown and correlate it with tumour variables. METHODS: Aqueous flare was analysed prospectively by laser flare photometry in 139 consecutive patients seen in the oncology unit for choroidal melanoma. Both eyes of patients were examined with a laser flare cell meter in a standard fashion. RESULTS: Mean flare difference between healthy and tumour eyes was 3.01 (SD 2.5) photons per millisecond (ph/ms) in 32 cases of small melanomas (p < 0.0001), 10.74 (13.9) ph/ms in 92 cases of medium and large melanomas (p < 0.0001), and 19.23 (11.8) ph/ms in 15 cases of very large melanomas (p < 0.0001). This mean differential flare was significantly higher in medium and large than in small melanomas (p < 0.002) and in very large melanomas than in medium and large melanomas (p < 0.028). A difference of > or = 7 ph/ms between affected and healthy eyes was noted in 70 of 139 melanomas (50.4%). It was found in 3/32 small melanomas (9.4%), in 53/92 medium and large melanomas (57.6%), and in 14/15 very large melanomas (93.3%). CONCLUSION: Multiple linear regression analysis showed that flare was most strongly correlated with tumour volume (r = 0.43; p < 0.0001) and tumour height (r = 0.41; p < 0.0008).

Aqueous Humor↗
PubMed1994

[Metastases to the uvea: statistical study of 133 cases].

133 cases of uveal metastasis were reviewed. The study included 97 women and 36 men, aged 10 to 80 (mean 53.1). Breast carcinoma in women and lung carcinoma in men were the primary malignancies, which most frequently led to uveal metastasis. Metastasis from lung carcinoma were often diagnosed before the primary tumor. Survival from ocular diagnosis to death depends on the histological type of the primary tumor.

Adolescent↗
PubMed1994

[Combined surgery, cryocoagulation and radiotherapy for treatment of melanoma of the conjunctiva].

BACKGROUND: Conjunctival melanomas are malignant tumors with a high local recurrence rate after simple surgical excision. The rate of recurrence is particularly high in cases of large size tumor, of widespread tumors and with PAM associated lesions. Tumor recurrences have a bad long-term prognostic significance and often necessitate exenteration. PATIENTS AND METHODS: A method of therapy combining total surgical excision with proton-beam irradiation, cobalt plaque irradiation and cryotherapy is described. This technique is used in particular unfavorable cases with the aim of lowering the rate of recurrences. It was practiced in 19 cases in Lausanne, 10 of which were recurrent tumors. The melanoma invaded 3 quadrants of the bulbar conjunctiva in 8 cases and 4 quadrants in 11 cases. At least one neighbouring tarsal conjunctiva was invaded in 11 cases and both in 7 cases. The skin of the eyelid was infiltrated in 6 cases and the caruncle in 9 cases. Tumor thickness was 1 to 2 mm in 8 cases, 3 to 4 mm in 4 cases and 5 to 10 mm in 7 cases. RESULTS: PAM was present in 16 cases. Follow-up period was less than 1 year in 2 cases, between 1 to 2 years in 5 cases, between 2 to 3 years in 5 cases and more than 3 years in 7 cases. 5 patients had lymph node metastases, 3 died of metastatic disease and 2 had a local recurrence. One of these recurrences was small-sized and was excised, the other was widespread and the patient died soon with metastatic disease. No exenteration was performed. CONCLUSION: The method of therapy that is here described appears to be a valuable alternative to exenteration of the orbit for the treatment of diffuse or large-size conjunctival melanomas which have a high risk of local recurrence.

Adult↗
PubMed1993

Fundus changes associated with congenital hypertrophy of the retinal pigment epithelium.

The clinical characteristics and follow-up changes of 64 patients with solitary congenital hypertrophy of the retinal pigment epithelium were studied. Thirty-five of the patients were followed up for one to 14 years with serial fundus photography. Progressive increase of the hypopigmented part of the lesion was observed in 29 of the 35 patients who were followed up (82.8%). An enlargement of the lesion was seen in 26 of the 35 patients (74.3%). Two additional changes, that is, pigmented areas adjacent to congenital hypertrophy of the retinal pigment epithelium and linear streaks of the pigment epithelium, were documented. Pathogenetic mechanisms for the development of these changes remain unknown.

Adult↗
PubMed1993

Survival prognosis of patients with retinal artery occlusion and associated carotid artery disease.

The records of 151 patients who developed retinal arterial obstruction were reviewed to evaluate the survival prognosis of these patients. Survival rates were calculated to expected rates of an age- and sex-matched control group of patients without retinal arterial obstruction. The presence of visible embolus and a branch retinal artery occlusion were found to be significant factors for worse survival prognosis (P = 0.0001 and P = 0.001, respectively). The survival rate of the entire group of 151 patients with retinal artery occlusion was not significantly different from that of the age- and sex-matched group (P = 0.29). Among the patients evaluated with continuous-wave Doppler sonography, the presence or the absence of the atheromatous carotid disease did not significantly affect the survival.

Adolescent↗
PubMed1993

Expression of CALLA/CD10 on human melanoma cells.

The reactivity spectrum of an anti-CALLA/CD10 monoclonal antibody for cutaneous melanoma was analysed by immunohistochemistry in a series of lesions of different Breslow thickness. Similar proportions of small primary tumours, advanced primary tumours and metastatic lesions were found to express CALLA/CD10 (31-47%). However the proportion of stained cells within a given lesion increased with tumour progression. Up to 23% of the advanced primary lesions (> 3.0 mm) showed 26-50% cells stained with the anti-CALLA/CD10 antibody and up to 14% of the metastatic lesions showed 76-100% stained cells. The expression of CALLA/CD10 was further analysed in 15 ocular melanoma lesions of different histiotype. All five spindle type lesions, three of six epitheloid and two of five mixed type lesions stained positively with the anti-CALLA/CD10 antibody. The percentage of stained cells within a given lesion varied from 30% to 100%. A total of 63% of the ocular melanomas and 38% of the cutaneous melanomas tested expressed CALLA/CD10. Experiments with cultured melanoma cell lines showed that the surface expression of CALLA/CD10 can be modulated in vitro by treatment with interleukin 2 (IL-2) and an adenosine 3',5'-cyclic monophosphate (analogue).

Antibodies, Monoclonal↗
PubMed1992

[Uveal melanomas in patients less than 20 years of age].

During the past 15 years we observed 21 uveal tumors in patients aged 20 years and younger. Four of them were younger than 10 years, 4 were 11 to 15 years' old, 4 ranged from 16-17 years and 9 from 18-20 years. An accelerated beam irradiation was applied in 11 cases, a surgical excision was carried out in 4 cases, and a 60 CO-applicator used for 3 patients. Three enucleations were carried out straight away. In this study we present the clinical characteristics of melanomas of young people, the therapy used, as well as the systematic analysis of the vital prognosis of the patients and of the functional prognosis of the eyes under treatment.

Adolescent↗
PubMed1992

[Treatment of eye tumors by accelerated proton beams. 7 years experience].

The therapeutic results of 1070 cases of intraocular tumors treated with an accelerated proton beam at the University Eye Clinic of Lausanne and at the Paul Scherrer Institute of Villigen are analysed. This total is composed of 981 cases of uveal melanomas treated by proton beam as first treatment modality, 42 cases of recurrent choroidal melanomas, 16 cases of conjunctival melanomas, 8 cases of choroidal hemangiomas, 18 cases of uveal metastases and of 5 other ocular tumors. The mortality rate at 5 years for tumors treated with an accelerated proton beam as first treatment modality was 13%, and the mortality rate of recurrent melanomas was 23%. The risk factor for life expectancy analysed with the Cox model pointed out that the largest tumor diameter, the width of the tumor, the presence of an extrocular extension and the age of the patient were the most significant parameters. The conclusions of this study are compared with those found in available literature.

Conjunctival Neoplasms↗
PubMed1992

[Treatment of exterior extension of choroid melanomas by accelerated proton beams].

Among the 934 patients with a choroidal melanoma treated in first intention with an accelerated proton beam since 1984, 41 (4.4%) presented an extrascleral extension, of which 11 were located anteriorly and 30 posteriorly. For these 30 cases, the diagnosis was made by B ultrasonography only when the volume of the extension was important, between 20 and 2280 mm3. The Cox model multi-variant analysis was used to study the statistically significant parameters in the development of an extrascleral extension. It appears that the maximal diameter of the intraocular tumor (p = 0.0012), the localisation of the anterior margin (p = 0.0304) and the age of the patients (p = 0.0097) are statistically meaningful. The 4 years' survival, studied with the Kaplan-Meier curves, is estimated at 60% for the patients with extrascleral extension and at 85% for the patients without. These results are similar to those of literature, whatever treatment is chosen (enucleation and radiotherapy, exenteration).

Adult↗
PubMed1992

[Anterior ischemia of the optic nerve and anemic retinopathy].

We report on the case of a 59-year-old man with the association of an anterior ischemic optic neuropathy on the left eye and a bilateral anemic retinopathy following an extreme and prolonged post-operative anemia, because the patient had refused blood-transfusion. After one year of follow-up, the visual acuity did improve on the left eye. This association is rare, and only few cases have been reported.

Anemia↗