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PubMed1977

Cultured epithelial cells of cornea, conjunctiva and skin: absence of marked intrinsic divergence of their differentiated states.

Keratinocytes of three different epithelia grown in cell culture express a large number of differentiation markers with either no differences or relatively small differences, depending on the species. Much of the distinctive phenotype of these epithelia in vivo must be due to external modulation and relatively little, at least in the case of the human, to permanent intrinsic divergence during development.

Animals↗
PubMed2003

Microvessels of bulbar conjunctiva in UPTAH goats.

Aiming to observe directly the microcirculation after total artificial heart (TAH) implantation, we performed a long-term follow-up in 2 goats using conjunctival angioscopy. A short segment of parallel arteriole and venule was photographed and analyzed on computer picture program (magnification 40x). Three main parameters were measured: arteriole diameter, venule diameter, and arteriovenous ratio (A/V ratio). The intrathoracically implanted TAH was the undulation pump total artificial heart (UPTAH) with cardiac output of 100 ml/kg/min. To stabilize the peripheral hemodynamics a 1/R biofeedback control system was used. Our results provided only elementary data about morphology of bulbar microvessels. The main finding was the tendency to general vasoconstriction, more intensive on the venous side (*P < 0.05 in one goat). We did not observe any pathological shapes (e.g., tortuosities, varicosities, or sludge); this result could be attributed to the high effectivity of 1/R control method. These preliminary results should be considered only as an attempt to apply the widely used clinical method of conjunctival angioscopy to the conditions of TAH.

Animals↗
PubMed2001

[Treatment of 9 squamous epithelial carcinoma in situ lesions of the conjunctiva (CIN) with mitomycin C eyedrops in cytological and DNA image cytometric control].

BACKGROUND: Conjunctival intraepithelial neoplasia (CIN) is a frequent conjunctival tumor. Following excision alone recurrences are frequent. An effective postsurgical recurrence prevention is therefore highly desirable. In this study we aimed to evaluate the effectivity of postsurgical chemotherapy of conjunctival squamous cell carcinoma in situ (CIN) with mitomycin C eyedrops. We introduced the otherwise established diagnostic tools of cytology and DNA-image-cytometry to the diagnosis and therapy-monitoring of CIN. PATIENTS AND METHODS: We treated 9 patients with CIN. For diagnosis the results of cytology and cytometry of presurgically obtained brush smears were compared with the histologic evaluation of the excised tissue. After surgery, we administered topical chemotherapy with mitomycin C eye drops 0.02% (MMC). Conjunctival brush smears were again evaluated by cytology and DNA-image-cytometry for postsurgical therapy monitoring. RESULTS: The clinical diagnosis of CIN was fully confirmed by cytology, DNA-image-cytometry and histology respectively in 7 patients. In one patient, the results of the applied diagnostic methods differed in results: Histologic evaluation indicated a moderate dysplasia but DNA-image-cytometry showed significant DNA-aneuploidy unequivocally indicating neoplasia like squamous cell carcinoma. In another patient the preoperatively obtained conjunctival brush smears could not properly analyzed by cytometry but clinical diagnosis was confirmed by histology. MMC-therapy was well tolerated except for a self-limited conjunctivitis. A complete remission of CIN was obtained in 8 of 9 patients (89%) who were free of CIN recurrences during a follow-up period of 27.2 months (11-48). Only one patient suffered from a recurrence 14 months after surgery and after 2 MMC-cycles. CONCLUSION: Adjuvant topical mitomycin C appears to be effective in the prevention of recurrences of conjunctival CIN after surgical removal. Our results indicate that at least 4 cycles of topical MMC are required to prevent local recurrences in the long term. Cytology and DNA-image cytometry are highly sensitive and specific methods for diagnosis and therapy monitoring of conjunctival squamous cell carcinoma in situ (CIN).

Adult↗
PubMed2005

Lethal Epstein-Barr virus associated NK/T-cell lymphoma with primary manifestation in the conjunctiva.

BACKGROUND: Lethal midline granulomas (LMG) are very rare angiocentric NK/T-cell lymphomas in association with Epstein-Barr virus. LMG are reported mainly in East Asia occurring in immune compromised patients. HISTORY AND SIGNS: A 41-year old male patient presented with a conjunctival swelling of his upper left eyelid. The lesion had increased over a period of 2 months despite topical corticosteroid treatment. Conjunctival biopsy revealed a highly malignant, CD3 + and BCL2 + extranodal T-cell lymphoma with features of an NK/T-cell origin (CD56 +, TIA + TCR-rearrangement: germline). All lymphoma cells were positive for Epstein-Barr virus RNA. The proliferation rate was highly elevated at 100 %. THERAPY AND OUTCOME: Systemic 1 (st) cycle chemotherapy with cyclophosphamide, doxorubicin, vincristin and prednisone resulted in a complete remission of the swelling within 4 days. However, one week later a massive conjunctival tumour reappeared with only partial regression after combined chemo- and radiotherapy. The patient died within a month because of untreatable pancytopenia due to malignant bone marrow infiltration. CONCLUSIONS: LMG is a rare but highly malignant Epstein-Barr virus associated NK/T-cell lymphoma that can occur in healthy, immune competent Caucasians. This is the first reported case of an LMG in an immune-competent Caucasian patient with primary ocular manifestation. The LMG has a high mortality rate despite systemic treatment and can be lethal within a few months or even weeks.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1999

[Intraocular invasion of melanoma of the conjunctiva].

BACKGROUND: The treatment of a localised conjunctival melanoma usually requires local excision combined with cryotherapy, brachytherapy and/or local chemotherapy. CASE REPORT: A 71 year old woman suffering from a conjunctival melanoma located at the limbus of her left eye was treated by local excision and cryotherapy. After this therapeutic procedure two recurrences occurred which had been again treated by excision and cryotherapy and finally brachytherapy. Nevertheless, a third recurrent tumor developed and was treated again with deep lamellar sclerectomy and keratectomy. During this procedure the anterior chamber was opened inadvertently in a tiny spot. Some months later an intraocular invasion of the melanoma was diagnosed clinically and the eye had to be enucleated 5 years after the first treatment. Histological examination revealed extended melanoma growth into iris, ciliary body, anterior choroid, and tumor cell seedings in the antertior chamber. CONCLUSIONS: Removing a conjunctival melanoma especially such a tumor growing at the limbus, the surgeon has to pay attention not to open the anterior chamber during sclerectomy and keratectomy. The possibility that prior local surgical excision aided the intraocular extension is discussed.

Aged↗
PubMed1998

[Atypical non-Hodgkin's lymphoma of the conjunctiva as an incidental finding in lower lid entropion].

PURPOSE: We want to demonstrate an unusual conjunctival Non-Hodgkin-Lymphoma with bleedings. PATIENT: A 77-year-old female patient presented with an entropion of the left lower eye-lid. Bilaterally reddish, soft tumors showed in the lower fornices with circumscript bleedings. On account of an absolute arrhythmia of the heart the patient has been on a medication of cumarine-derivates since 9 years. Histologically we found underneath the epithelium densely packed lymphocytic cells with small uniform nuclei intermingled with many erythrocytes. The immunohistological investigations revealed a Non-Hodgkin-Lymphoma of B-cell origin. CONCLUSIONS: Bleedings in a conjunctival Non-Hodgkin-Lymphoma can alter the clinical aspect of the tumor. It is necessary to inspect each entropion thoroughly in order to rule out any other pathological lesions.

Aged↗
PubMed1990

[Melanoma of the conjunctiva and its treatment].

37 cases of conjunctival melanomas treated in the University Eye Clinic of Lausanne are analysed. This total is made of 20 men and 17 women aged between 19 and 81 years with a mean age of 54.7 years. Tumors were localized in the bulbar conjunctival in 27 cases, in the palpebral conjunctival in 2 cases and were diffuse in 8 cases. Cornea was infiltrated in 19 cases. In 21 cases, the first treatment was made in our service and 16 cases were recurrences following a treatment made elsewhere. The mortality rate to 5 years was 20%. In a multivariant analysis using the COX Model, the height of the tumor was the only significant parameter (p = 0.035) for life expectancy. Recurrence of the tumor (p = 0.060) and presence of a PAM (p = 0.652) were not significant parameters. Benefits of cryocoagulation and indications for a proton beam irradiation are discussed.

Adult↗
PubMed1990

[Importance of diagnosis and preoperative care of the conjunctiva].

The conjunctival smear is an important part of preoperative diagnosis. Although the method is very easy there are many possible sources of error. The validity of smear results was studied; the sources of error are discussed in the present paper. The different bacterial flora of the conjunctival sac and the lid margin were investigated. It was shown that eye drop dispensers become contaminated during use. The use of single-dose Ophtiolen has the advantage--in addition to improved hygiene, that no stabilizing agents are used. Preoperative efforts to achieve asepsis have to be continued during the operation. A new adhesive tape specially developed for ophthalmic surgery has been found very effective. This new tape is described.

Anti-Bacterial Agents↗
PubMed1988

[Immune reactions of the conjunctiva and cornea following severe chemical burns of the outer eye].

Conjunctival and corneal tissue samples from nine patients with severe changes after acid and alkali burns were examined immunohistochemically. Epithelial HLA Class II antigen expression was present in three of five conjunctival samples, and all of the antigen markers examined in the conjunctival stroma could be stained. HLA Class II expression was demonstrated in four out of five corneal tissue samples. The results show that in Grade III or IV chemical burns, with the diverse changes of the external eye that they produce, immunological and possibly also autoimmune mechanisms can influence the clinical course.

Autoimmune Diseases↗
PubMed1985

[Eosinophilic, central necrotizing granuloma of the conjunctiva (Splendore-Hoeppli phenomenon). Clinical-histopathological study].

Six patients with the clinical and histological findings of a so-called Splendore-Hoeppli phenomenon are described. The clinical picture is one of yellow, painless episcleral nodules with associated vascular injection; they are unilateral or bilateral, and isolated or multiple. Histologically, the granulomas are composed of a central eosinophilic material surrounded by epitheloid cells, giant cells and numerous eosinophils. The phenomenon is interpreted as an antigen-antibody precipitation as originally described in relation to parasites and fungi. Blood eosinophilia was seen in two patients. No parasitic or fungal agents were found in serial sections in this series and would not be detected on general examination. The diagnosis is established by histological examination. Topical corticosteroid therapy was ineffective. Excisional biopsy of the granuloma is the therapy of choice.

Adolescent↗
PubMed2003

Suramin modulates wound healing of rabbit conjunctiva after trabeculectomy: comparison with mitomycin C.

PURPOSE: To investigate and compare the effects of suramin and mitomycin C on conjunctival wound healing after trabeculectomy in a rabbit model. MATERIALS AND METHODS: Thirty New Zealand White rabbits were divided into three groups, and trabeculectomy was performed on the left eyes under general anesthesia. During the surgery, suramin (250 mg/ml) and mitomycin C (0.4 mg/ml) were applied to the scleral flap site for 2 minutes in groups 1 and 2, respectively. The control animals (group 3) received no pharmacological treatment during trabeculectomy. Intraocular pressure (IOP) measurements were recorded before surgery and every 3 days after the operation, starting from postoperative day 1. Three animals from each group were sacrificed on days 15, 20, and 25, yielding a total of 27 eyes for histopathological study. Each specimen was histochemically and immunohistochemically (CD3, CD20, CD68, and collagen III) evaluated, and graded. RESULTS: Bleb failure time was significantly longer in both the suramin (15.0 +/- 4.7 days) and mitomycin C (16.7 +/- 5.1 days) groups than in the controls (10.3 +/- 4.2 days) (p < 0.05). Starting from postoperative day 9, the IOP in the suramin and mitomycin C groups was significantly lower than that in the control group (p < 0.05). This difference continued to be significant until day 18 for the suramin group, and until day 24 in the mitomycin C group. Histopathological evaluation showed lower degrees of cellularity, fibrosis, collagen III deposition, and CD3 density in the suramin- and mitomycin C-treated eyes compared to control eyes at all time points (p < 0.05). There was also no significant difference between the suramin and mitomycin C groups concerning these histopathological findings and CD3 density (p > 0.05). Although there were trends towards reduced mean elastic fiber deposition and lower CD20 and CD68 density in both groups of treated eyes, the differences between the treated and control groups were not significant (p > 0.05). CONCLUSIONS: The results of the current study suggest that suramin has beneficial effects on wound healing in glaucoma surgery, and effectively prolongs bleb survival in rabbits. Suramin may be a promising alternative to anti-metabolite therapy in glaucoma surgery.

Animals↗