PURPOSE: We investigated the clinical outcome of bone marrow (BM) involvement in patients with diffuse large B-cell lymphoma (DLBCL) who received rituximab-based therapy. MATERIALS AND METHODS: A total of 567 consecutive patients with newly diagnosed DLBCL treated with rituximab-CHOP (RCHOP) between November 2001 and March 2010 were included in the current study. All of the patients underwent a BM study at the initial staging and the clinical characteristics and prognosis of these patients with or without BM involvement were analyzed retrospectively. RESULTS: The total cohort included 567 patients. The overall incidence of BM involvement was 8.5%. With a median follow-up duration of 33.2 months (range, 0.1 to 80.7 months) for patients who were alive at the last follow-up, the five-year overall survival (OS) and event-free survival (EFS) rate in patients without BM involvement (76.3% and 67.5%, p<0.001) was statistically higher than that in patients with BM involvement (44.3% and 40.1%, p<0.001). In multivariate analysis, among total patients, BM involvement showed a significant association with OS and EFS. In univariate and multivariate analyses, even among stage IV patients, a significant association with worse EFS was observed in the BM involvement group. CONCLUSION: BM involvement at diagnosis affected the survival of patients with DLBCL who received RCHOP. Although use of RCHOP can result in significant improvement of the therapeutic effect of DLBCL, BM involvement is still a negative prognostic factor of DLBCL patients in the era of rituximab.
Antibodies, Monoclonal, Murine-Derived ; B-Lymphocytes ; Bone Marrow ; Cohort Studies ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Lymphoma, B-Cell ; Multivariate Analysis ; Prognosis ; Rituximab

So far most screening protocols for retinopathy of prematurity (ROP)have used a single parameter such as chronological age or postconceptional age. We attempted to test a screening protocol for ROP using dual parameter, chronological age and postconceptional age, to determine whether it could reduce the number of screening examinations safely.We retrospectively reviewed medical records of 23 infants (43 eyes)who had undergone laser treatment for threshold ROP.Mean gestational age at birth was 28 weeks and mean birth weight was 1055 gms.The mean age at which the study infants reached threshold ROP was 10 weeks in chronological age and 38 weeks in postconceptional age.Screening examinations as early as chronological age of 7 weeks or postconceptional age of 35 weeks could detect all threshold ROP while reducing the number of unnecessary early examinations.
Birth Weight ; Gestational Age ; Humans ; Infant ; Mass Screening* ; Medical Records ; Parturition ; Retinopathy of Prematurity* ; Retrospective Studies

In aphakic/pseudophakic retinal detachments, difficulty in visualizing the peripheral retina and perhaps higher incidence of proliferative vitreoretinopathy result in lower success rate than phakic retinal detachment. We performed pars plana vitrectomy on 20 eyes with aphakic/pseudophakic retinal detachment. In most cases, we combined scleral bucking or encircling procedure. Using scleral depression technique, we found retinal breaks, dissected the vitreous base meticulously, and removed the vitreoretinal tractions. Intraoperatively, we were able to find retinal breaks in 12 eyes in which retinal breaks were not identified preoperatively, and identify additional retinal breaks in 3 of the remaining 8 eyes. We obtained anatomical success in all eyes and favorable visual acuity of better than 0.025 in 16 eyes (80%). These results suggest that finding all retinal breaks and removing vitreoretinal tractions are directly related to the improvernent of the surgical results.
Depression* ; Incidence ; Retina ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Traction ; Visual Acuity ; Vitrectomy ; Vitreoretinopathy, Proliferative

The surgical success rate for retinal detachment caused by giant retinal breaks was very low in the past because of its frequent association with proliferative vitreoretinopathy and inverted retina I flap. Recently advances in vitreoretinal surgical techniques as well as introduction of perfluorocarbon liquid result in good surgical results. Eleven eyes with uncomplicated retinal detachment from giant retinal breaks underwent vitrectorny. A special effort was made to remove as much vitreous gel of the vitreous base as possible. Lensectomy or encircling was performed, when needed. Inverted retinal flap was unfolded using perfluorocarbon liquid. After laser ph/otocoagulation, internal tamponade was performed with C3 F8 gas or silicone oil. Postoperatively, we achieved anatomical success in all eleven eyes and favorable visual acuity of better than 0.4 in nine eyes(81.8%). We obtained good surgical results for uncomplicated giant retinal breaks using meticulous vitreous base dissection and perfluorocarbon liquid. Removal of crystalline lens or scleral buckling is not always needed in this complex retinal detachment surgery.
Lens, Crystalline ; Retina ; Retinal Detachment ; Retinal Perforations* ; Retinaldehyde* ; Scleral Buckling ; Silicone Oils ; Visual Acuity ; Vitreoretinopathy, Proliferative

To evaulate the closure and recurrence rate of laser treatment for juxtafoveal and extrafoveal CNV with well-defined boundary, we studied 15 eyes of 15 patients that could be followed up for at least 1 year. The follow-up ranged form 12 to 31 months(mean, 17.1 months). Three and six weeks after laser treatment, all neovascularization was obliterated. Eight months, after laserphotocoagulation was obliterated. Eight months, after laser photocoagulation there was one recurrence in juxtafoveal CNV. In7 of 10 laser-treated eyes in classic, extrafoveal CNV, visual or more in three eyes. Of 5 laser-treated eyes in classic, juxtafoveal CNV, visual acuity had changed by no more than 2 lines in 3 eyes and decreased by 2 or more lines in 2 eyes. The short-term results of laser treatment for classic CNV were good, but long-term evaluation is required.
Choroid* ; Choroidal Neovascularization* ; Follow-Up Studies ; Humans ; Light Coagulation* ; Recurrence ; Visual Acuity

More intraoperative and postoperative complications of diabetic vitrectomy may result in poor visual prognosis. Sixty eye (49 patients) underwent vitrectomy for complications of proliferative diabetic retinopathy. Iatrogenic retinal breaks occurred in 6 (10%) of 60 eyes. Postoperative vitreous emorrhage was complicated in 13 (21%) of 60 eyes. Postoperative vitreous hemorrhage cleared spontaneously in one eye. Fluid-air exchange alone was successful in clearing the vitreous cavity in 4 eyes. Two eyes in which clearing does not occur in the postexchange period underwent repeated vitrectomy. Remaining 6 eyes required repeated vitrectomy. Choroidal effusion occurred in 4 eyes (7%) and resolved spontaneously within one week. Neovascular glaucoma occurred in 4 eyes (7%) and was treated with glaucoma implant surgery in 2 eyes, trabeculectomy with Mitomycin C in 1 ye, and cyclophotocoagulation in 1 eye. Retinal detachment developed postoperatively in 3 eyes (5%) and was treated successfully. Corneal epithelial defect persisting more than one week was present in 2 eyes (3%). Accidental mechanical lens damage occurred in one eye. The anatomical success rate was 98% (59 eyes). Visual acuity of 0.025 or better was obtained in 49 eyes (82%). Minimizing intraoperative complications as well as properly managing postoperative complications produced better surgical results.
Choroid ; Diabetic Retinopathy* ; Glaucoma ; Glaucoma, Neovascular ; Incidence* ; Intraoperative Complications ; Mitomycin ; Postoperative Complications ; Prognosis ; Retinal Detachment ; Retinal Perforations ; Trabeculectomy ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage

Proliferative vitreoretinopathy is the principal cause of failure in rhegmatogenous retinal detachment surgery. The final cause of anatomic failure is anterior proliferative vitreoretinopathy. Surgical outcome of anterior proliferative vitreoretinopathy is poorer than that of posterior proliferative vitreoretinopathy. Of 147 cases which underwent vitreoretinal surgery from January through December 1993, 16 eyes(l6 patients) had anterior proliferative vitreoretinopathy. Seven eyes had anterior proliferative vitreoretinopathy at initial surgery(group 1). Remaining 9 eyes developed anterior proliferative vitreoretinopathy after primary vitrectomy(group 2). Of 16 eyes, 3 were aphakic, 2 were pseudophakic, and remaining 11 were phakic. Lens was removed in 11 phakic eyes. Meticulous vitreous base dissection and removal of anterior epiretinal membrane were performed. After minimal follow-up of 6 months, retina reattached in 11 eyes(69%) including all nine eyes of group 2. Nine eyes(56%) had postoperative visual acuity of 0.025 or better. These results suggest that both vitreous base dissection and meticulous removal of anterior and posterior epiretinal membrane should be crucial in improving surgical success rate of anterior proliferative vitreoretinopathy.
Epiretinal Membrane ; Follow-Up Studies ; Retina ; Retinal Detachment ; Visual Acuity ; Vitreoretinal Surgery ; Vitreoretinopathy, Proliferative*

Ophthalmic artery occlusion results in a circulatory disturbance of both central retinal artery and posterior ciliary arteries, causing an ischemia of retina and choroid. On fundus examination, white retinal opacification and cherry-red spot can be noted if central retinal artery occlusion is not associated with lateral posterior ciliary artery obstruction. If, however, central retinal artery occlusion is asssociated with lateral posterior ciliary artery obstruction, the cherry-red spot is no longer visible. The author experienced five patients with a mottled loss of retinal transparency in the macular region. Combined central retinal artery occlusion with obstruction of both medial posterior ciliary artery and lateral posterior ciliary artery were observed in two patients, both central retinal artery occlusion and medial posterior ciliary obstruction in two patients, and central retinal artery occlusion alone in one patient. The fundus findings in all five cases are compatible with an incomplete central retinal artery occlusion which in at least four cases was associated with evidence of choroidal vascular obstruction.
Choroid ; Ciliary Arteries ; Humans ; Ischemia ; Ophthalmic Artery ; Retina ; Retinal Artery Occlusion* ; Retinal Artery* ; Retinaldehyde

The acute retinal necrosis syndrome(ARN) is characterized by acute peripheral necrotizing retinitis, occlusive arteritis, and panuveitis. ARN is often complicated by late retinal detachment and a poor visual outcome. We describe herein a series of 4 consecutive patients(5 eyes) with ARN, complicated by retinal detachment. A patient with bilateral ARN(case 1) underwent prophylactic vitrectomy, 360 degrees scleral buckling, and intravitreal injection of acyclovir on the right eye while the retina was attached. Subsequently, the retina became detached. The retina was successfully reattached by performing fluid-gas exchange and laser photocoagulation. Argon laser photocoagulation was performed as a prophylaxis to prevent retinal detachment in two eyes. However, the two retinas subsequently detached. The two eyes were treated with vitrectomy, 360 degrees scleral buckling, fluid-gas exchange, and endolaser photocoagulation. Remaining two eyes required vitrectomy, silicone oil injection, and endolaser photocoagulation with(case 3) or without(case 4) 360 degrees scleral buckling. The retinas remined attached in all five eyes with no additional treatment. Four eyes achieved a visual acutiy of 0.1 or better. One had a final visual acuity of FC/40cm because of macular pucker and optic nerve atrophy.
Acyclovir ; Argon ; Arteritis ; Atrophy ; Humans ; Intravitreal Injections ; Light Coagulation ; Optic Nerve ; Panuveitis ; Retina ; Retinal Detachment* ; Retinal Necrosis Syndrome, Acute* ; Retinaldehyde* ; Retinitis ; Scleral Buckling ; Silicone Oils ; Visual Acuity ; Vitrectomy

A cilioretinal artery occlusion associated with a central retinal vein occlusion is a rare condition and has been reported to have a good visual prognosis. We report a young patient with this condition who also demonstrated prolonged filling of the branch retinal arteries with fluorescein angiography. Her initial visual acuity was 0.03 in the affected eye. Two months later, normal central retinal artery inflow resumed. Her visual acuity has improved to 0.5 over the three years' follow-up.
Arteries* ; Fluorescein Angiography ; Follow-Up Studies ; Humans ; Prognosis ; Retinal Artery ; Retinal Vein* ; Visual Acuity