Adenoma ; diagnosis ; pathology ; Female ; Humans ; Middle Aged ; Pigment Epithelium of Eye ; pathology ; Uveal Neoplasms ; diagnosis ; pathology

Adenomas of the nonpigmented ciliary epithelium (NPCE) are often clinically indistinguishable from amelanotic malignant melanomas of the ciliary body or metastatic carcinomas. This paper reports a case study of a distinctive variant of adenoma of the NPCE, which clinically appears as epiretinal membrane in the macular region. Histopathologic studies have revealed this is an adenoma of the NPCE. Identification of this clinic feature is important because it will miss the diagnosis of the adenoma of the NPCE. In this case study, B-scan ultrasonography as well as computerized tomography (CT) has been used to provide help in diagnosing the ciliary body tumor. Because of their anterior location in the ciliary body, partial lamellar sclerouvectomy is an effective method of treatment.
Adenoma ; pathology ; Adult ; Ciliary Body ; pathology ; Epithelium, Corneal ; pathology ; Humans ; Male ; Pigment Epithelium of Eye ; pathology ; Uveal Neoplasms ; pathology

proliferative vitreoretinopathy (PVR) is the most common cause of failure in retinal reattachment surgery. Three different procedures were performed in 20 pigmented rabbits to devise a simple model to induce experimental PVR. Rabbits were assigned randomly to three groups (I, II, and III). Group I rabbits (5 rabbits, 10 eyes) rereived normal saline into the vitreous cavity, after an iatrogenic retinal tear was made. In group II rabits (8 rabbits, 8 eyes), a suspension of retinal pigment epithelium (RPE) and choroid from the left eye was transferred into the vitreous cavity of the right eye. In group III rabbits (7 rabbits, 7 eyes), a suspension of RPE and choroid from the left eye was transferred into the vitreous cavity of the right eye after an iatrogenic retinal tear was made. The fundus was observed for 2 months with an indirect ophthalmoscope. The incidence of retinal detachment in group I was zero (O/IO), that of group II was 37.5% (3/8), and that of group III was 85.7% (6/7). Electron microscopic findings of the vitreous strand of one eye of group II showed a central melanocytic core, peripheral fibroblasts, and intercellular collasen fibril. Electron microscopic findings in one eye of group III revealed a subretinal membrane composed of suspected RPE and glial cells.
Animals ; *Disease Models, Animal ; Pigment Epithelium of Eye/pathology ; Rabbits ; Retinal Diseases/*etiology ; Vitreous Body/pathology

A 46-year-old man presented with visual disturbances in both eyes. His best corrected visual acuity was 0.7 (both eyes). Ptosis and limitation of ocular movement in every direction were observed. Slit lamp examination showed a bilateral iridescent cataract. Fundus examination showed peripheral depigmentation of the retinal pigment epithelium and pigmentary clumping in both eyes that agreed with blocked fluorescence and widow defects on fluorescein angiography. The amplitude of b-wave was decreased on electroretinography. Fourteen months later, the patient's best corrected visual acuity decreased to 0.3 due to increased lens opacity. Phacoemulsification and intraocular lens implantation were performed on both eyes. At the patient's final visit, retinal findings were stable with a best corrected visual acuity of 0.7 in both eyes. In conclusion, the visual disturbance could have been caused by both cataracts and retinal degeneration, meaning the fundus should be examined carefully in patients with myotonic dystrophy.
Diagnosis, Differential ; Fluorescein Angiography ; Fundus Oculi ; Humans ; Male ; Middle Aged ; Myotonic Dystrophy/*complications/diagnosis ; Pigment Epithelium of Eye/*pathology ; Retinal Degeneration/diagnosis/*etiology

The loss of retinal pigment epithelium (RPE) with aging is related to age-related macular degeneration (AMD). This study was conducted to investigate the mechanism of hydrogen peroxide (H2O2) induced cell death in a human retinal pigment epithelial cell line, ARPE-19. Hydrogen peroxide was added at different concentrations to ARPE-19 cells and cultured. The cytotoxicity was assayed by mitochondrial function using 3- (4, 5-dimethylthiazol-2-yl) -2, 5-diphenyl tetrazolium bromide (MTT) testing. The patterns of cell damage were assessed using an acridine orange-ethidium bromide differential staining method, in situ end labeling (ISEL) assay and transmission electron microscopy (TEM). Catalase, a major antioxidant, was used to prevent cell death. The cleavage of procaspase 3 and poly (ADP-ribose) polymerase (PARP) was determined by western blot analysis. Hydrogen peroxide significantly induced cell death in ARPE-19 cells, whereas pretreatment of the cells with catalase prevented cell death. Application of the ISEL assay and acridine orange/ethidium bromide staining demonstrated that the H2O2-induced cell death occurred by an apoptotic mechanism at lower concentrations of H2O2 (400, 500, 600 microM), whereas higher concentrations of H2O2 induced necrosis rather than apoptosis. Caspase 3 was associated with the apoptotic pathway in human RPE cell death. Western blot analysis confirmed caspase 3 activation and cleavage of substrate proteins in ARPE-19 cells treated with an H2O2 concentration of 600 microM. These results indicate that treatment with H2O2 induces apoptotic and necrotic cell death in ARPE-19, and that caspase 3 is associated with apoptotic cell death. Therefore, H2O2 may induce the destruction of RPE cells in AMD by the combined effects of apoptosis and necrosis.
Apoptosis ; Caspases/metabolism ; Catalase/pharmacology ; Cell Line ; Cell Survival/drug effects ; Enzyme Activation ; Human ; Hydrogen Peroxide/*pharmacology ; Necrosis ; Pigment Epithelium of Eye/*drug effects/enzymology/pathology/*physiology

PURPOSE: To report a case of cancer-associated nummular loss of the retinal pigment epithelium. METHODS: A 47-year-old man with a history of hepatocellular carcinoma presented with three weeks of bilateral visual loss. His best-corrected visual acuity was 20/40 in each eye. He had multiple round confluent grayish-brown patches at the level of retinal pigment epithelium, and no pigmented choroidal lesions. Fluorescein angiography showed circular areas of transmission defect and indocyanine green angiography showed early hyperfluorescence, corresponding with the multiple round confluent patches. CONCLUSIONS: We report a case of visual paraneoplastic syndrome which showed nummular loss of the pigment epithelial cells which distinguishes the clinical component of BDUMP syndrome.
Carcinoma, Hepatocellular/*pathology ; Diagnosis, Differential ; Fatal Outcome ; Fluorescein Angiography ; Fundus Oculi ; Humans ; Liver Neoplasms/*pathology ; Male ; Middle Aged ; Paraneoplastic Syndromes/*diagnosis ; Pigment Epithelium of Eye/*pathology ; Retinal Diseases/*diagnosis ; Tomography, Optical Coherence

We report a case of recurrent occlusion of laser iridotomy (LI) sites after a Visian ICL (Implantable contact lens version 4, Staar Surgical AG, Nidau, Switzerland) implantation. A 45-year-old woman had bilateral ICL implantation after placement of two peripheral LI sites in each eye to prevent pupillary block. At one month after the operation, severe narrowing or occlusion of four LI sites occurred. After this, although she received four additional LIs at postoperative months 1, 6, 9 and 10 in both eyes, the narrowing or occlusion recurred. Mild chronic anterior chamber inflammation was observed intermittently throughout the follow-up period. We performed clear lens extraction in both eyes (at postoperative month 11 in the left eye and month 26 in the right eye) due to recurrent occlusion of the LI sites and excess trabecular meshwork pigment deposition presumably caused by the four repeated LIs. Recurrent obstruction of LI sites can occur after ICL implantation. These problems were unresolvable despite four repeated laser iridotomies. The risks associated with anterior uveitis must be considered when planning an ICL implantation.
Female ; Humans ; Iridectomy/*methods ; Iris/*surgery ; *Laser Therapy ; Lasers, Solid-State ; Lens Implantation, Intraocular/*adverse effects ; Middle Aged ; *Phakic Intraocular Lenses ; Pigment Epithelium of Eye/pathology ; *Postoperative Complications ; Recurrence ; Reoperation ; Trabecular Meshwork/pathology ; Uveitis, Anterior/etiology

We report the clinical course of photodynamic therapy (PDT) in a patient with drusenoid pigment epithelium detachment (PED). A patient with drusenoid PED underwent PDT follow-up was carried out at one week, one month, three months, six months and one year after treatment. Fundus exam, optical coherence tomography (OCT) and fluorescein angiography were performed. After the PDT, drusen and PED were gradually diminished over one year. However, pure serous PED eventually developed at the same location of the drusenoid PED. The results of the PDT, on drusenoid PED, were initially effective, but not completely successful. Therefore, PDT may be considered as an alternative treatment option for drusenoid PED.
Aged ; Fluorescein Angiography ; Humans ; Male ; *Photochemotherapy ; Photosensitizing Agents/*therapeutic use ; Pigment Epithelium of Eye/*drug effects/pathology ; Porphyrins/*therapeutic use ; Retinal Detachment/diagnosis/*drug therapy ; Retinal Drusen/diagnosis/*drug therapy ; Tomography, Optical Coherence

A 52-yr-old male was referred for progressive visual loss in the left eye. The decimal best-corrected visual acuity (BCVA) was 0.01. Fundus examination revealed diffuse retinal pigment epithelial degeneration, focal yellow-white, infiltrative subretinal lesion with fuzzy border and a live nematode within the retina. Diffuse unilateral subacute neuroretinitis (DUSN) was diagnosed and the direct laser photocoagulation was performed to destroy the live nematode. During eight months after treatment, BCVA gradually improved to 0.2 along with the gradual restoration of outer retinal layers on SD-OCT. We report on the first case of DUSN in Korea. DUSN should be included in the differential diagnosis of unexplained unilateral visual loss in otherwise healthy subjects.
Animals ; Blindness/diagnosis/parasitology ; Eye Infections, Parasitic/diagnosis/parasitology/*therapy ; Fundus Oculi ; Humans ; Laser Therapy/methods ; Light Coagulation/methods ; Male ; Middle Aged ; Nematoda/*pathogenicity ; Republic of Korea ; Retinal Pigment Epithelium/*parasitology/pathology ; Retinitis/diagnosis/*parasitology/*therapy ; Visual Acuity

A 52-yr-old male was referred for progressive visual loss in the left eye. The decimal best-corrected visual acuity (BCVA) was 0.01. Fundus examination revealed diffuse retinal pigment epithelial degeneration, focal yellow-white, infiltrative subretinal lesion with fuzzy border and a live nematode within the retina. Diffuse unilateral subacute neuroretinitis (DUSN) was diagnosed and the direct laser photocoagulation was performed to destroy the live nematode. During eight months after treatment, BCVA gradually improved to 0.2 along with the gradual restoration of outer retinal layers on SD-OCT. We report on the first case of DUSN in Korea. DUSN should be included in the differential diagnosis of unexplained unilateral visual loss in otherwise healthy subjects.
Animals ; Blindness/diagnosis/parasitology ; Eye Infections, Parasitic/diagnosis/parasitology/*therapy ; Fundus Oculi ; Humans ; Laser Therapy/methods ; Light Coagulation/methods ; Male ; Middle Aged ; Nematoda/*pathogenicity ; Republic of Korea ; Retinal Pigment Epithelium/*parasitology/pathology ; Retinitis/diagnosis/*parasitology/*therapy ; Visual Acuity