Conjunctival intraepithelial neoplasia in a patient treated with tacrolimus after liver transplantation.

Purpose: To report a case of conjunctival intraepithelial neoplasia in a patient treated with tacrolimus after liver transplantation for hepatic carcinoma.

Methods: Description of the initial clinical presentation of a patient, tumor management, and 15-month follow-up.

Results: A 70-year-old man presented with a conjunctival intraepithelial neoplasia that developed on the site of a preexisting pterygium.

Pars Plana vitrectomy and epiretinal membrane peeling for vitreoretinal traction associated with combined hamartoma of the retina and retinal pigment epithelium (CHRRPE).

Background: Combined hamartoma of the retina and retinal pigment epithelium (CHRRPE) are rare, benign tumours that typically appear slightly elevated and are characterised by varying amounts of pigmentation, vascular tortuosity, and epiretinal membrane formation that can be related to macular distortion. The importance of changes at the vitreoretinal interface in this condition as a risk for visual loss was early recognised but controversy exists concerning the benefits of surgical removal of the tractional component. We describe 2 cases of CHRRPE who demonstrated significant visual acuity improvement after pars plana vitrectomy and epiretinal membrane peeling.

Melanocytomas of the optic disk.

Purpose: To evaluate the various forms of clinical presentation, the potential of growth, the risk of functional loss and the possibility of malignant transformation of optic disk melanocytomas in European patients.

Design: Retrospective observational case control study.

Methods: Evaluation of 37 cases of optic disk melanocytomas identified in the computer files of the ocular oncology unit of Jules Gonin Hospital to determine the clinical presentation of these tumors and the risk of complications.

Systemic melanoma metastatic to the retina and vitreous.

Purpose: Report of a case of retinal and vitreous metastases of a systemic melanoma, possibly arising in the lung, that responded favourably to radiotherapy.

Case Report: Retinal and vitreous metastases were demonstrated in a 57-year-old woman during routine follow-up after surgical resection of a melanoma presumed to be a primary pulmonary melanoma. After a 7-week observation period, which confirmed the progressive nature of the intra-ocular lesions, the patient was treated by external beam radiotherapy at a dose of 35 Gy delivered in 14 fractions of 2.

Metastatic melanoma in the eye and orbit.

Objective: Presentation of a large series of patients with metastatic melanoma involving the eye and orbit.

Design: Retrospective clinical study.

Participants: Thirteen cases of metastatic melanoma involving intraocular tissues, 6 cases of metastatic melanoma in the orbit, and 1 case of metastatic melanoma involving both the eye and the orbit, treated in Lausanne between 1986 and 2002, were identified from the computer files of the ocular oncology and orbitopalpebral surgery units of Jules Gonin Hospital.

[Choroidal melanoma in neurofibromatosis type 2: description of a case].

To the best of our knowledge this is the first description of a choroidal melanoma with documented growth in neurofibromatosis type 2 (NF2). A 20-year-old patient with NF2 presenting deafness due to bilateral acoustic neurinomas and unilateral amaurosis due to a meningioma of the optic nerve developed a pigmented parapapillary choroidal tumor. Despite signs indicating the diagnosis of a melanoma, periodic observation was chosen in order to postpone functional amputation following optic nerve irradiation.

Chorioretinitis induced by intravesical Bacillus Calmette-Guérin (BCG) instillations for urinary bladder carcinoma.

Background: We report the rare case of a chorioretinitis occurring after intravesical BCG instillation to cure in situ carcinoma.

History And Signs: A 57-year-old man was treated for bladder carcinoma with BCG instillations. Visual acuity was 20/20 in the right eye and 20/40 in the left eye.

Eye retention after proton beam radiotherapy for uveal melanoma.

Purpose: To analyze the long-term results of eye retention after conservative treatment of uveal melanoma with proton beam radiotherapy, and to analyze the causes leading to enucleation after this conservative treatment approach.

Materials And Methods: This was a prospective, noncomparative, interventional, consecutive case series. A total of 2645 patients (2648 eyes) with uveal melanoma were treated between 1984 and 1999 with proton beam radiotherapy.

Maximizing local tumor control and survival after proton beam radiotherapy of uveal melanoma.

Purpose: This study reports local tumor control and survival after proton beam radiotherapy (PBRT) of uveal melanoma. It identifies the risk factors for local tumor-control failure and for ocular tumor-related death. It presents the improvements implemented to increase the rate of local tumor control, and compares the survival rate of patients with locally controlled tumors to those of patients who had to receive a second treatment.

Adenocarcinoma of the nonpigmented ciliary body epithelium: report of a rare case.

Acquired tumours of the nonpigmented ciliary body epithelium are rare. We present herein a case of low-grade adenocarcinoma in order to stress the problems related to the clinical diagnosis. The tumour in our case was circumscribed, localised on the ciliary body, and nonpigmented.

Proton beam irradiation of choroidal hemangiomas.

Purpose: To present a large series of choroidal hemangiomas treated with proton beam irradiation and to describe the treatment outcomes.

Methods: We treated 54 eyes of 53 patients with choroidal hemangioma. The lesions consisted of 48 circumscribed hemangiomas and six diffuse hemangiomas in patients with Sturge-Weber syndrome.

[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.

[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.

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.

[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.

[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).

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.

[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.

[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%.

[Ocular melanocytosis, oculodermal melanocytosis and choroid melanomas].

Among 837 cases of choroidal melanomas treated conservatively, 22 cases (2.69%) presented an ocular or oculodermal melanocytosis. This incidence is compared with the data of the literature.

[Report on the conservative treatment of melanoma of the uvea at the Lausanne University Ophthalmologic Clinic].

A great number of techniques are currently available for the conservative treatment of uveal melanomas: ocular applicators emitting gamma rays 60Co, 125I) or high-energy beta rays (106Ru/106Rh), light photocoagulation, surgical excision, and accelerated proton beam irradiation. Life expectancy following conservative treatment is equal to or better than that following enucleation. This is demonstrated by nonrandomized comparative studies, and by the authors' own long-term results following the conservative treatment of melanomas by 60Co applicators: mortality due to metastases of small melanomas was 3% (V = smaller than 10 x 10 x 3 mm), with medium-size melanomas it was 12% (V = 10 x 10 x 3-15 x 15 x 5 mm), and with large melanomas 21% (V = larger than 15 x 15 x 5 mm).

[Tumors and pseudotumors of the pigment epithelium].

Tumors and tumor-like lesions of the pigment epithelium of the iris, ciliary body, and retina are discussed with special emphasis on definitions and the various elements of help in the differential diagnosis. One of these lesions, hypertrophy of the retinal pigment epithelium, is classically described as non-progressive. However, we report here 4 cases with documented progression of various forms.