Use of the computer in the study of retinal disease.
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Biomedical subjects
Publications and source records attributed to W H Jarrett.
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Subretinal neovascular membranes (SRNVM) in the pediatric population are rare. The clinical presentation, etiology, course, and management of SRNVM in 25 children (27 eyes) were studied retrospectively. Inflammatory or infectious conditions predominated (10 of 25). Eleven of 19 untreated SRNVM (58%) spontaneously involuted, with 9 of these 11 achieving a final visual acuity of 20/50 or better. A hyperpigmented ring on fluorescein angiography was associated with 9 of the 11 involuted SRNVM. The presence of this pigmented ring may help to identify those cases with a better visual prognosis.
A total of 27 cases of choroidal hemangioma was evaluated with radioactive phosphorus uptake studies. In each case the diagnosis of malignant melanoma was initially entertained, but the 32P test was unequivocally negative in every instance. Follow-up studies in every case have supported the clinical diagnosis. In 22 patients, the lesion was treated with photocoagulation, and in every treated case the serous macular detachment disappeared. The importance of early and correct clinical diagnosis is stressed, since these are salvageable and potentially useful seeing eyes.
One hundred consecutive histologically confirmed malignant melanomas of the posterior uvea; on which the 32-P test was performed prior to enucleation, were classified according to cell type. The 32-P uptake results of the pure spindle cell melanomas were compared with the results in the mixed and epithelioid cell tumors. There appears to be no relationship between 32-P uptake and cell type using the Callender classification. The 32-P uptake results in the 100 melanomas were then compared with the results in teh 30 benign lesions which are known to simulate melanoma occasionally. There was a significant difference in 32-P uptake between the benign and malignant lesions, and no false-positive results were encountered. The importance of the 32-P test as a diagnostic adjunct for malignant intraocular tumors is emphasized.
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We have presented mortality, clinical, and histopathologic data on a consecutive group of patients with malignant choroidal melanoma studied by a radioactive phosphorus uptake test. The mortality of 14% is the lowest reported in the literature (Table 11) and suggests that early diagnosis followed by prompt enucleation affords the patient a favorable prognosis. There is no evidence to suggest that the surgical manipulations involved expose the patient to added risks. Factors of importance regarding prognosis of malignant melanoma include tumor size, cell type, and presence or absence of extrascleral extension. Of these, we believe that cell type is the most important factor. Our data to date do not permit us to predict from the 32P tests the prognosis for patient survival.