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Biomedical subjects

W J Iliff

Publications and source records attributed to W J Iliff.

At least 19 recordsLinked to original sources
PubMed1996

Echographic evaluation and findings in metastatic melanoma to extraocular muscles.

PURPOSE: Metastatic melanoma to the extraocular muscles is an extremely rare condition characterized by marked enlargement of the involved muscles. The authors describe the echographic characteristics of metastatic melanoma to extraocular muscles. METHODS: The authors used standardized echography (standardized A-scan and contact B-scan) to examine two patients known to have malignant melanoma elsewhere with metastatic melanoma to the extraocular muscles. Both patients had orbital lesions with similar echographic characteristics. RESULTS: Echographically, metastatic melanoma to an extraocular muscle spares the tendon and produces marked thickening of the muscle belly fibers. Other echographic findings include low internal reflectivity, regular internal structure, and vascularity (similar to uveal melanoma). These previously unreported echographic features may be unique to metastatic melanoma to an extraocular muscle. CONCLUSION: Echography can be a useful adjunct in detecting and diagnosing suspected metastatic melanoma to the extraocular muscles in patients with clinical signs of an orbital mass and known melanoma elsewhere or in the absence of a known primary lesion.

Adult↗
PubMed1996

[Combined true exfoliation and pseudoexfoliation of the anterior lens capsule].

BACKGROUND: True exfoliation of the lens capsule is rare, and its occurrence with pseudoexfoliation in the same eye is very unusual. CASE REPORT: An 81-year-old female presented with bilateral cataracts and a history of working with ceramics in her home kiln. Slit-lamp examination revealed pseudoexfoliation. She underwent intracapsular cataract extraction and sector iridectomy in both eyes. Light and electron microscopy of the lenses revealed a central area of splitting of the anterior lens capsule into a thin anterior and a thicker posterior layer, and deposits pseudoexfoliation material on the anterior lens capsule, on the iris pigment epithelium, and in the iris stroma. CONCLUSIONS: We interpret our findings as representing a combination of true exfoliation and pseudoexfoliation, but we did not observe any signs that might indicate a correlation or a common pathogenesis of the two conditions. Although they may occur in one eye, true exfoliation of the lens capsule and pseudoexfoliation are two unrelated distinct entities.

Aged↗
PubMed1987

Squamous cell carcinoma of the eyelids.

A clinicopathologic study of 31 squamous cell carcinomas of the eyelid was conducted. The tumor was encountered less frequently than in previous reports, due largely to the refinement of the pathologic diagnosis. Eighteen cases originally diagnosed as squamous cell carcinoma were eliminated because the diagnoses were changed to sebaceous gland carcinoma (10), basal cell carcinoma (4), seborrheic keratosis (2), inverted follicular keratosis (1), and papilloma (1). One of our 31 patients experienced tumor metastasis and tumor-related mortality. Despite the low incidence of metastasis, management recommendations include complete surgical excision using intra-operative frozen-section monitoring of the surgical margins.

Adolescent↗
PubMed1985

Aphakic cystoid macular edema and the operating microscope: is there a connection?

The literature documenting the phototoxic effect of relatively low intensity light on the retina and the suggestions by several authors that this might influence the development of cystoid macular edema in the aphakic and pseudophakic patient is reviewed. In particular, the possibility that the operating microscope may be a factor has been emphasized. A study is presented, designed to investigate the possibility that the operating microscope is a factor important in the development of cystoid macular edema. No correlation was found. The need for further investigation into other phototoxic effects from the light of the operating microscope is stressed.

Aphakia, Postcataract↗
PubMed1983

Pathology of intraocular lenses in 33 eyes examined postmortem.

Thirty-three pseudophakic eyes from 29 patients were examined postmortem. Clinically, 25 of the eyes had had visual acuities of 20/50 or better. In general the intraocular lenses (IOLs) were quite well tolerated. Iris atrophy and erosion were prominent features of eyes containing an anterior chamber, iris fixation, or iridocapsular lens. Angle recession and ciliary-body erosion were found in some eyes with anterior chamber lenses. Ciliary-body erosion by haptics was seen with posterior chamber lenses. Pupillary membranes were present in eight eyes. Granulomatous reaction to IOL material was present in 13 eyes. Usually this was localized to the site of the lens haptic, and was consistent with good visual acuity. One eye with a posterior chamber lens had been successfully treated for Staphylococcus epidermidis endophthalmitis after capsulotomy, shortly before death. Central corneal endothelial cell loss seemed to be of similar amount for the anterior chamber, iris fixation, and iridocapsular lenses, but was less severe in eyes with posterior chamber lenses. Cystoid macular edema was present in five eyes, retinal phlebitis in two eyes, and retinal detachments in four eyes.

Aged↗
PubMed1982

Fibrous histiocytoma of the lacrimal sac.

Fibrous histiocytoma is a rare tumor whose ocular manifestations usually involve the orbit or, less commonly, the conjunctiva and ciliary body. We have treated two patients with fibrous histiocytoma of the lacrimal sac. One, a 62-year-old woman who had had hordeolum and trachoma, had a visual acuity of counting fingers at 1 m in the affected eye. The fellow eye had been enucleated ten years previously. The entire lacrimal sac was surgically removed and a brown cystic tumor measuring 28 x 12 x 10 mm was found. The second patient, a 32-year-old man, had undergone an unsuccessful dacryocystectomy for epiphora. When he underwent a dacryocystorhinostomy some months later, a mass measuring 20 x 15 x 12 mm was found in the wall of the lacrimal sac. Microscopic examination of the two excised lacrimal sacs showed that the walls were thickened by cells resembling fibroblasts and by cells resembling histiocytes. The fibroblasts were characterized by collagen production, were fusiform or oval in shape, and were arranged in bundles. The histiocytes were larger and had abundant (and sometimes vacuolated) cytoplasm. All the cells appeared to be mature.

Adult↗
PubMed1982

Morphea of the eyelids.

Morphea, or localized scleroderma, of the eyelids is an uncommon disease. Morphea usually involves the thorax, trunk, lower and upper extremities, face, and genitalia. In the present report a patient with a biopsy-proven morphea of both upper eyelids is described. The salient histopathologic features included thinning of the epidermis with thickening and sclerosis of the collagen fibers in both the papillary and reticular dermis. There was a marked decrease in the fibrocytes. The eccrine sweat glands were entrapped by sclerotic collagen fibers. The pilosebaceous units were markedly decreased in number. There was a moderate lymphocytic infiltration in the dermis and a prominent lymphocytic perivasculitis. The clinical and histopathologic features of morphea are compared with those of lichen sclerosus et atrophicus.

Adolescent↗
PubMed1982

Granulomatous reaction to Choyce style intraocular lens.

Despite the large number of intraocular lens implants performed since Ridley first devised the procedure, there have been few reports of postmortem examination in clinically successful cases. We report a patient who tolerated his Choyce Mark VIII style implant well, despite a three-month episode of mild nongranulomatous uveitis occurring two months postoperatively, until his death 17 months later. This is the sixth postmortem study of an anterior chamber IOL and the only one in which there was a conspicuous granulomatous reaction on the anterior iris surface, with large foreign body giant cells. Despite the presence of a foreign body, the previous eyes that have clinically tolerated implants well and have come to postmortem examination have shown remarkably little inflammation; none have shown this degree of granulomatous reaction previously.

Eye↗
PubMed1982

Carbon dioxide laser therapy of recurrent squamous papilloma of the conjunctiva.

Juvenile squamous papilloma of the conjunctiva may exhibit "malignant" behavior with multiple recurrences presenting difficulty in management. We have successfully treated a child with the carbon dioxide laser who had failed three previous surgical excisions, cryotherapy (twice), and chemotherapy. The carbon dioxide laser permits a precise form of tissue excision with minimal trauma, edema, and scarring, and offers a safe alternative approach to the management of these lesions.

Child, Preschool↗
PubMed1980

Brown tumor of the orbit associated with primary hyperparathyroidism.

A 70-year-old woman had swelling of her left superior orbital ridge. A tumor was surgically removed, and histologic examination disclosed a tumor containing giant cells. Subsequent tests showed primary hyperparathyroidism caused by a carcinoma of the parathyroid. This rare instance of brown tumor of the orbit led us to review the differential diagnoses of giant-cell lesions of the orbit and to examine published case reports. Laboratory determinations of serum calcium, phosphorus, and alkaline phosphatase levels for all patients with lytic orbital bone lesions can establish whether they have hyperparathyroidism, a diagnosis making orbital surgery unnecessary.

Aged↗
PubMed1979

Orbital lymphangiomas.

The exact nature of lymphangiomas of the orbit is controversial. Nineteen cases with typical clinical, surgical, and histopathologic findings are presented. These tumors are diffuse, slowly progressive, difficult to remove, and relatively insensitive to irradiation. They frequently hemorrhage, causing rapid increase in proptosis, which may require emergency surgery, and they fluctuate in size with upper respiratory tract infections. Optic disc edema and amblyopia secondary to astigmatism are occasionally noted.

Adolescent↗
PubMed1976

X-linked ocular albinism. An oculocutaneous macromelanosomal disorder.

Three unrelated kindreds with the Nettleship-Falls type of X-linked ocular albinism were studied. Postmortem examination of the eyes of an affected man revealed the presence of macromelanosomes in the pigment epithelia. Skin biopsy specimens of this patient, seven other affected male, and nine carrier female kindred members revealed the presence of Fontana-positive and dopa oxidase-positive macromelanosomes within the epidermis and dermis. Although clinically this disorder has been considered to be a form of albinism confined to the eyes, these findings indicate that an unusual disturbance in melanosome production characterized by macromelanosome formation affects the skin and the eyes. Histopathologic study of the skin is a useful adjunct in the diagnosis of X-linked ocular albinism, both in the affected and the carrier states. Linkage studies confirmed the close association of the Xg blood group with this disorder.

Adult↗
PubMed1975

Invasive squamous cell carcinoma of the conjunctiva.

In cases of invasive conjunctival squamous cell carcinoma, three cases of deep corneal invasion and two cases of intraocular extension were found. Four cases showed orbital invasion, and one patient died of generalized metastases 18 months after diagnosis. The relatively low-grade nature of these lesions and their potential for local treatment is noted, but it is emphasized that careful clinical examination and close cooperation with the pathologist to ensure adequate evaluation of excised tissue are essential.

Adolescent↗
PubMed1975

Visual loss as the initial symptom in Hodgkin disease.

Involvement of the visual system in Hodgkin Disease generally occurs late in the course of the illness. A 43-year-old man was seen at the Johns Hopkins Hospital complaining of monocular visual loss. Clinical observations and neuroradiologic examinations suggested a chiasmal mass lesion, and the patient underwent a frontal craniotomy with biopsy of the chiasm. The biopsy specimen was diagnosed as a spongioblastoma of the optic chiasm, and the patient underwent a course of radiotherapy. Shortly after craniotomy, the patient developed evidence of a systemic illness and died eight months after onset of visual symptoms. Autopsy revealed extensive systemic involvement by Hodgkin sarcoma. Microscopical examination of the optic chiasm revealed no evidence of optic glioma but revealed diffuse infiltration by Hodgkin sarcoma. Reexamination of the original biopsy specimen confirmed that initial visual symptomatologic findings were secondary to intracranial Hodgkin disease.

Adult↗