PURPOSE: To report a case of iridocorneal endothelial syndrome with pigmentary glaucoma. METHODS: We encountered a 44-year-old unilateral glaucoma patient who complained of intermittently decreased visual acuity in the right eye. For differential diagnosis, we carried out ophthalmic and systemic examination. RESULTS: Binocular corrected visual acuity was 1.0. His intraocular pressure, measured using a Goldmann applanation tonometer, was 50 mm Hg in the right eye and 18mm Hg in the left. Upon examination of the right eye, we found pigments with a Krukenberg's spindle appearance on the corneal endothelium, peripheral anterior synechia extending beyond Schwalbe's line, trabecular hyperpigmentation, endothelial pleomorphism, polymegathism, cell loss, dark area within the cells, a light central spot and light peripheral zone, retinal nerve fiber layer defects, and visual field defects, which together led to the diagnosis of iridocorneal endothelial syndrome with pigmentary glaucoma. We observed progressed glaucomatous injury upon examination of the disc stereo photograph, retinal nerve fiber layer photograph, and visual field test, even though we used topical IOP reducers. Eventually, we performed a trabeculectomy in the right eye. CONCLUSIONS: We experienced a case of iridocorneal endothelial syndrome with unilateral pigmentary glaucoma. The glaucoma was not well-controlled with topical IOP reducers. The glaucoma was then treated by a trabeculectomy. We report this case with a review of the literature.
Adult ; Diagnosis ; Diagnosis, Differential ; Endothelium, Corneal ; Glaucoma ; Glaucoma, Open-Angle* ; Humans ; Hyperpigmentation ; Intraocular Pressure ; Iridocorneal Endothelial Syndrome* ; Nerve Fibers ; Retinaldehyde ; Telescopes ; Trabeculectomy ; Visual Acuity ; Visual Field Tests ; Visual Fields

We report a case of soft fibroma occured in a 27-year-old female. The lesion was multiple, pea-to walnut-sized, baglike, pedunculated growth on the vulva. The histopathologic findings of excisional biopsy specimen evaled a slightly t.hinned epidermis and loosely arranged collagen fibers in the dermis.
Adult ; Biopsy ; Collagen ; Dermis ; Epidermis ; Female ; Fibroma* ; Humans ; Vulva*

We report two cases of hyalinizing trabecular carcinoma (HTC) of the thyroid gland. These two patients were euthyroid women aged 36 and 65 years of age. The tumors were encapsulated and measured 0.8 and 4.0 cm in diameter, respectively. Histologically, the tumors were composed of a compact proliferation of cells in a lobular and trabecular pattern with an intervening hyalinized, fibrotic vascular stroma. Occasionally the cells were arrayed in microfollicles. Multiple and serial sections showed cords of tumor cells invading into the capsule in both cases and vascular invasion in one case. These findings suggested that HTCs are a malignant counterpart of hyalinizing trabecular adenoma, similar to conventional follicular tumor. Positive immunostaining of tumor cells for thyroglobulin and negative staining for high molecular weight cytokeratin, cytokeratin 19, neuron specific enolase, chromogranin, and synaptophysin allowed distinction from medullary carcinoma. Even though HTCs are an heterogeneous group of tumors, the present two cases are probably variants of follicular carcinoma rather than papillary carcinoma.
Adenoma ; Carcinoma, Medullary ; Carcinoma, Papillary ; Female ; Humans ; Hyalin* ; Keratin-19 ; Keratins ; Molecular Weight ; Negative Staining ; Phosphopyruvate Hydratase ; Synaptophysin ; Thyroglobulin ; Thyroid Gland*

PURPOSE: To investigate the clinical features of 7 cases (8 eyes) of normal-tension glaucoma with the temporal visual defect only. METHODS: Patient's age, gender, systemic disease, refractive error, intraocular pressure, stereo disc photograph, nerve fiber layer photograph and visual field were analyzed. RESULTS: Age was 32+/-5 years, male:female ratio was 2:5 and 6 eyes were unilateral. Refractive error was -8.80+/-3.80 D, intraocular pressure was 16.0+/-1.90 mmHg and cup:disc ratio was 0.66+/-0.09 (horizontal) X 0.58+/-0.10 (vertical). There was disc hemorrhage in 1 eye, nasal cup in 1 eye, beta-type peripapillary atrophy in 2 eyes and undermining of nasal cup edge in 5 eyes. Pattern of temporal visual field defect, corresponding to the retinal nerve fiber layer defect were horizontal in 1 eye, cecopetal in one eye and cecofugal in 6 eyes. CONCLUSIONS: It is recommend to carefully evaluate nerve fiber layer in the young, high myopic patients showing undermining of nasal cup edge.
Atrophy ; Glaucoma* ; Hemorrhage ; Humans ; Intraocular Pressure ; Nerve Fibers ; Refractive Errors ; Retinaldehyde ; Visual Fields*

Tego (dodecylic aminoethyl glycine HCl) is an antiseptic detergent used abroad in hospitals, food industries, public baths, and for cleaning machinery. Allergic contact dermatitis may occur in hospital operating-room personnel, swimming instructors, and deep-sea divers. We present two cases of allergic contact dermatitis to Tego in two siblings after dressing the accidental abrasion with Tego . The patch test results showed a strong positive reaction to 0.1% Tego.
Bandages ; Baths ; Dermatitis, Allergic Contact* ; Detergents ; Food Industry ; Glycine ; Humans ; Patch Tests ; Siblings* ; Swimming

PURPOSE: To investigate the frequency and characteristics of artifacts which can cause errors in retinal nerve fiber layer nalysis using optical coherence tomography (OCT). METHODS: The frequency, characteristics and retinal lesions responsible for the artifact were analyzed for 179 patients (338 eyes) by OCT. All images were categorized into two groups according to the presence of artifacts and then, the differences between the two groups were analyzed by t-test and cross-tabulation analysis in terms of age, refractive error, peripapillary atrophic areas, and type of glaucoma. RESULTS: The male to female ratio was 1.37:1, average age was 47.6+/-15.7 years and average degree of refraction was -1.78+/-0.23 diopter. Artifacts were noted in 64 eyes (18.9%), and were present in the temporal quadrant in 12 eyes (18.8%), superior quadrant in 51 eyes (79.7%), nasal quadrant in 19 eyes (87.5%), and inferior quadrant in 8 eyes (48.4%). The average angle of the artifact was 138 degrees. Although retinal lesion, age, and glaucoma type were not significantly different between the two groups, peripapillary atrophy and myopia were significantly more common in the group with the artifact. CONCLUSIONS: When analyzing retinal nerve fiber layer by OCT, artifacts should be considered, especially in cases of peripapillary atrophy and myopia.
Artifacts ; Atrophy ; Eye ; Female ; Glaucoma ; Humans ; Male ; Myopia ; Nerve Fibers ; Refractive Errors ; Retinaldehyde ; Tomography, Optical Coherence

Primary nodal marginal zone B-cell lymphoma (MZBCL) is recognized as a rare and distinct entity. The rate of histologic transformation into diffuse large B-cell lymphoma (DLBCL) seems lower than the rate of transformation in follicular lymphoma. We herein report a rare case ofnodal MZBCL showing transformation into DLBCL. The patient was a 73-year-old female withcervical lymphadenopathy. On the initial biopsy, the lymph node architecture was diffuselyeffaced with an extensive interfollicular and parafollicular infiltrate of monocytoid B-cells. Therewere scattered large blastic B-cells without formations of compact sheets. The diagnosis ofnodal MZBCL was made. The patient did not receive chemotherapy and was treated with aconservatively supportive regimen. Forty two months later, the patient developed a new cervicallymphadenopathy and a biopsy was performed. Histologically, the lymph node revealeddiffuse sheets of transformed large B-cells showing prominent nucleoli. The diagnosis ofDLBCL transformed from nodal MZBCL was made. The patient was treated with 3 cycles ofcombined CHOP chemotherapy and she showed clinical improvement. These observationssuggest that an untreated primary nodal MZBCL may undergo high-grade transformation.
Aged ; B-Lymphocytes ; Biopsy ; Diagnosis ; Drug Therapy ; Female ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, B-Cell, Marginal Zone* ; Lymphoma, Follicular

PURPOSE: To investigate the correlation of peripapillary atrophy with disc hemorrhage in glaucoma patients with a unilateral disc hemorrhage METHODS: A retrospective review was performed on the medical records of 36 glaucoma patients (7 with primary open-angle glaucoma and 29 with normal-tension glaucoma) with a unilateral disc hemorrhage during a mean follow-up period of 25 months. Topographic measurements were performed with Heidelberg Retina Tomograph (HRT) within three months of detection of a disc hemorrhage. The parameters of zone beta of peripapillary atrophy were analyzed by the atrophy zone analysis program and compared with the fellow eyes. RESULTS: The area, angular and radial extent of zone beta, and ratio of zone beta area to disc area were significantly greater in the hemorrhagic eyes than in the contralateral eyes. The difference of refractive error, intraocular pressure, MD and CPSD of visual fields was not found to be significant between both eyes. CONCLUSIONS: The area and extent of peripapillary atrophy was significantly greater in the eyes with disc hemorrhage compared to the contralateral control eyes. This study suggested quantitatively that the peripapillary atrophy is associated closely with disc hemorrhage in glaucoma patients.
Atrophy* ; Follow-Up Studies ; Glaucoma* ; Glaucoma, Open-Angle ; Hemorrhage* ; Humans ; Intraocular Pressure ; Medical Records ; Refractive Errors ; Retina ; Retrospective Studies ; Visual Fields

Orbital lymphangiomas are benign vascular hamartomas that may be found in the conjunctiva, the eyelids, the orbit, or elsewhere in the head and neck region. Deep lymphangiomatous lesions are classically characterized by acute onset of a fulminant proptosis resulting from spontaneous hemorrhage within the orbit. Complete surgical excision is often difficult because of the infiltrative nature of the tumor.We report one case of lymphangiomas considered to be associated with cavernous hemangioma which could not be removed completely by several surgical excisions and was exenterated because of orbital abscess of unknown origin and septic condition.
Abscess* ; Conjunctiva ; Exophthalmos ; Eyelids ; Hamartoma ; Head ; Hemangioma, Cavernous ; Hemorrhage ; Lymphangioma ; Neck ; Orbit*

PURPOSE: To make an optic nerve crush injury model and to investigate the neuroprotective effect of intravitreally injected ciliary neurotrophic factor (CNTF) on rat retinal ganglion cells (RGCs) in the model. METHODS: The optic nerves of 12 Sprague-Dawley rats were crushed at 3 mm posterior to the eyeball for 1 minute using aneurysm clip (110 g). Two micrograms of CNTF in 2 micro liter of vehicle was injected intravitreally in one group (n=6) and 2 micro liter of PBS was injected in the control group (n=6) at 4, 7, and 10 days after the optic nerve injury. After 2 weeks, the retrograde labeling of the RGCs was done by the dextran tetramethylrhodamine. Twenty-four hours after the labeling, the retina was wholly mounted and the labeled RGCs were counted under the fluorescence microscope. RESULTS: The death of RGCs in this model began at 1 week and continued for 3 weeks. The number of labeled RGCs in CNTF-injected group (510+/-139/mm2) were significantly higher than that in control group (345+/-87/mm2)(p<0.05). CONCLUSIONS: The optic nerve crush injury model was established by use of aneurysm clip. In this model, the intravitreally injected CNTF had a neuroprotective effect on the rat RGCs.
Aneurysm ; Animals ; Ciliary Neurotrophic Factor* ; Dextrans ; Fluorescence ; Neuroprotective Agents* ; Optic Nerve Injuries ; Optic Nerve* ; Rats* ; Rats, Sprague-Dawley ; Retina ; Retinal Ganglion Cells* ; Retinaldehyde*