Ultrastructure of leiomyoma of the ciliary body

Leiomyoma of the ciliary body of the eye was studied with the help of optical microscope at the ultrastructural level. The tumour was characterized by 4 types of cells: micro immature myoblasts, macro differentiated myoblasts, dystrophically changed muscle cells with lipofuscin inclusions, and fibroblasto-like cells. At the luminous level the differentiation of pigmental granules of melanin and lipifuscin was impeded. At the ultrastructural level they had different morphology, and therefore the differential diagnosis of a slightly pigmented melanoma and leiomyoma is possible.     

Sulfated glycolipids in ciliary body epithelium

The sulfated material which locates in the basal membrane of ciliary body epithelium when immature rat eyes are incubated with Na235SO4 was studied. On the basis of its chromatographic behavior compared with standard preparations, we conclude that the material consists of sulfatides.     

Evaluation of ciliary body detachment in hypotony

PURPOSE: This article describes an anatomic classification for the hypotonous eye and links this classification with approaches to the surgical treatment of this condition. The classification is based on very-high-resolution ultrasound scans and three-dimensional reconstruction of planar ultrasound scans. METHODS: Standard 10-MHz B-scans and very-high-resolution (40-60 MHz) scans were performed with a planar motor system using the immersion method. The anatomic changes in the hypotonous eye were classified and correlated with clinical and ultrasonographic findings at the time of therapeutic intervention and after resolution of the hypotonous condition. RESULTS: Hypotony is defined as low intraocular pressure most commonly due to ciliary body detachment or ciliary body dysfunction. With ciliary body detachment, three anatomically related causative types were identified: tractional hypotony, which has ultrasonographically demonstrable proliferative vitreociliopathy with membrane attachments between the ciliary body, iris, and formed vitreous; dehiscence hypotony, which has a modification in the scleral acoustic architecture consistent with a scleral break or wound dehiscence; and primary type hypotony, which has ciliary body detachment but no ultrasonographically demonstrable tractional component or scleral anatomic modification, but may have an iris scleral separation. CONCLUSIONS: Each type of ciliary body detachment hypotony may have a different management approach, so high-resolution ultrasound, particularly when shown with sequencing or three-dimensional displays to demonstrate the extent of detachment, can aid in the selection and implementation of appropriate therapy.     

Endoresection of the iris and ciliary body in epithelial downgrowth

We present a case of epithelial downgrowth with intractable glaucoma after multiple intraocular surgeries. The eye was successfully managed with a pars plana approach. The iris and epithelial tissue over the ciliary body were removed with intraocular scissors and a vitrector combined with unipolar diathermy and endophotocoagulation. The use of moderate hypotensive anesthesia may have helped prevent intraoperative hemorrhage. During more than 3 years of follow-up, intraocular pressure ranged from 13 to 19 mm Hg, visual acuity was 20/80 with aphakic correction with a rigid gas-permeable lens, and there was no recurrence of epithelial downgrowth.     

Orbital extension of Choroidal and ciliary body melanomas

In a review of 432 choroidal and ciliary body melanomas, histopathologic evidence of orbital extension was found in 45 cases (10.4 percent). The occurrence of orbital extension was influenced mainly by the cell type (P less than .05) and by the size of the choroidal mass (P less than .001). Local orbital recurrence occurred in 23 percent of cases with evidence of extrascleral extension. Survival rates were independent of cell type, pigmentation, and size and shape of the extension. Patients treated by exenteration had significantly better prognosis than nontreated patients or patients treated by chemotherapy, radiotherapy, or local excision (P equals .0002). Early exentration is the best treatment for choroidal melanomas with orbital extension.     

Effect of adrenaline on the secretory activity of the ocular ciliary body in rabbits

In intact rabbits and in rabbits with intracerebral unilateral section of the n. oculomotorius, instillation of 2 drops of 0.1% adrenaline into the conjunctival sack increased and then decreased the intraocular pressure (IOP); i.v. administration of adrenaline (50 mcg) or electrophoresis decreased IOP. In conditions of disturbed parasympathetic innervation of the eye its sensitivity to adrenaline increased as revealed by a sharper lowering of IOP.     

Ring recurrence of ciliary body melanoma after proton-beam therapy

A malignant ciliary body melanoma was treated by proton-beam irradiation. Ring-shaped recurrence with extraocular extension appeared thirty-six months later and required enucleation. Histologic study revealed a predominant epithelioid cell type tumor, flattened in previously treated area. Proton-beam irradiation efficiency depends on clinical evaluation, which remains questioned in ciliary body locations where circumferential extension could be misevaluated.     

Ultrastructural changes in rabbit ciliary body after extraocular mitomycin C

PURPOSE: To study the ultrastructural changes in ciliary body epithelium of the rabbit eye after subconjunctival injections of mitomycin C. METHODS: One eye of six New Zealand white rabbits was given a subconjunctival injection at the 12-o'clock position with 0.005, 0.02, 0.08, 0.1, 0.12, or 0.16 mg mitomycin C. The fellow eye was given a subconjunctival injection of balanced salt solution. Two weeks after treatment, the eyes were enucleated, and the ciliary body was exposed and submerged in fresh 4% paraformaldehyde/2% glutaraldehyde in 0.1 M phosphate buffer, pH 7.4, at 4 degrees C. Electron microscopy of the ciliary body was performed at two sites: the injection site (12-o'clock position) and 180 degrees away (6-o'clock position). RESULTS: At dosages of 0.1 mg and higher, ciliary body epithelial cells beneath the injection site were thinned. There were vacuoles and expansion of intracellular and intercellular spaces. Plasma membrane infoldings were disrupted, and the apical membrane was thinned. Mitochondria and nuclei were normal. Ciliary body epithelium at 6-o'clock position showed only mild architectural distortion of the plasma membrane infoldings. Eyes that received lower doses of mitomycin C (0.005 mg, 0.02 mg, and 0.08 mg) and balanced salt solution showed normal ciliary body epithelium at the injection site and 180 degrees away. CONCLUSIONS: Subconjunctival injection of mitomycin C in the rabbit produces dose-dependent localized ultrastructural changes of the ciliary body epithelium.     

The cytotoxic effect of topical mitomycin C on the ciliary body in rabbits]

In order to know the initial lens changes that accompany atopic dermatitis (AD), 99 patients diagnosed dermatologically to have AD without any or with slight external ocular inflammations and with no habit of rubbing the eyelid due to severe itching were examined opthalmologically. Clinically, none of them showed any cataractous changes in their eyes. For the sake of comparison with the above population, 4 AD patients with cataractous eyes, 49 renal transplantation patients who were administered steroids over a long period of time but clinically had no cataractous lenses, and 94 healthy individuals with transparent lenses were also selected as subjects. The crystalline lenses of the subjects were examined using an anterior eye segment analysis system and specular microscopy. From Scheimpflug slit images of the lens, light scattering intensity of different lens layers was measured as an indicator of lens transparency changes. The subcapsular basement membrane and changes in the lens epithelial layers were analyzed from specular images of these areas by image processing. Results and considerations from the investigations were: (1) Initial lens changes in cases with AD which may be occult cataractous findings were often detectable. (2) Cataract associated with AD can be accelerated by steroid administration or the habit of strongly rubbing the eyelid, but this may not be the original cause of cataract formation. (3) Two types of cataract are seen in patients with AD: (a) anterior subcapsular plaque formation and (b) anterior and posterior subcapsular opacity formation. The latter type, however, is also accompanied by epithelial damage from the early stage. (4) Significant numbers of patients with AD who have not yet shown manifest lens changes were found among the subjects.     

Malignant rhabdoid tumor of the small intestine in an adult: a case report with immunohistochemical and ultrastructural findings

The expression of platelet-derived endothelial cell growth factor (PD-ECGF) was determined immunohistochemically in 143 non-small cell lung carcinomas. Staining was observed in 48% of the cases. A relationship between histology, stage, erbB-1, erbB-2, ras and PD-ECGF expression was not found. A relationship of borderline significance was observed between PD-ECGF and p53 expression. There was also no relationship between PD-ECGF expression and proliferative activity (G1 phases, S phases, cyclin A). In contrast, a correlation between PD-ECGF- and VEGF-expression was detectable (p=0.009). Furthermore, PD-ECGF expression was related to the response of lung carcinomas to doxorubicin (p=0.0004). Of 35 sensitive tumors, 26 carcinomas were PD-ECGF-positive (74%) while of 108 resistant carcinomas only 43 tumors (40%) exhibited PD-ECGF expression.     

An experimental study of pathomorphology in the iris and ciliary body after intraocular lens implantation]

Recent studies have suggested that cytokines play a critical role in the pathophysiology of alopecia areata; however, no information is available regarding the difference in cytokine profiles in these patients. Serum levels of cytokines, including interferon gamma (IFN-gamma), tumor necrosis factor alpha, interleukin 1 alpha (IL-1 alpha), IL-2, IL-4, and IL-6, were measured using radioimmunoassay or enzyme-linked immunosorbent assay techniques in patients with the localized form and the extensive form (alopecia universalis). The serum levels of IL-1 alpha and IL-4 were significantly elevated in patients with the localized form. In contrast, the serum levels of IFN-gamma and IL-2 were significantly elevated in patients with the extensive form. These results indicate that immune responses in the localized form and the extensive form of alopecia areata are regulated by Th2 cytokines and Th1 cytokines, respectively.     

Systemic injections of ciliary neurotrophic factor induce sprouting by adult motor neurons

The ability of ciliary neurotrophic factor (CNTF) to induce sprouting by undamaged adult motor neurons was studied in gluteal muscles of adult ICR mice. Low doses of CNTF (0.02 mg kg-1 day-1) only induced sprouting in gluteus muscles that were beneath the site of injection, whereas high doses of CNTF (0.4-1.2 mg kg-1 day-1) acted systemically to induce motor neuron sprouting. We found little difference between the type or quality of sprouting induced by CNTF compared with muscle paralysis. Both stimuli induced sprouts of the same length, although muscle paralysis tended to induce more sprouts per end-plate. Paralysis also induced more nodal sprouting than did CNTF, but both were weaker stimuli for nodal sprouting than was partial denervation. In addition to its effects on motor neuron sprouting, high doses of CNTF induced loss of up to 36% of the body weight of treated mice. The substantial wasting caused by CNTF indicates that the factor has potent cachectic activity.     

Photodynamic therapy of the ciliary body with tin ethyl etiopurpurin and tin octaethyl benzochlorin in pigmented rabbits

BACKGROUND AND OBJECTIVES: The authors used a pigmented rabbit model to investigate two photosensitizers, tin ethyl etiopurpurin (SnET2) and tin octaethyl benzochlorin (BNZ 203), to determine their potential for creating ciliary body injuries during photodynamic therapy (PDT). MATERIALS AND METHODS: The biodistribution of SnET2 (n = 10) and BNZ 203 (n = 9) was studied by fluorescence microscopy using a low light detection system, based on charged-coupled device photography, with digital image processing at 1 and 24 hours after injection. PDT with SnET2 (n = 8; 664 +/- 7-nm light; 75 mW/cm2; 50 or 100 J/cm2; 1-mm spot size) and BNZ 203 (n = 6; 689 nm; 75 mW/cm2; 50 or 100 J/cm2; 1-mm spot size) was performed at 24 hours post-injection. The control subjects for SnET2 (n = 5) and BNZ 203 (n = 3) were given a maximal light dose (100 J/cm2). RESULTS: Both photosensitizers demonstrated an intravascular distribution at 1 hour that shifted to a ciliary body distribution at 24 hours (SnET2 much greater than BNZ 203). In addition, the SnET2 demonstrated suborgan localization to the nonpigmented ciliary body epithelium. Both photosensitizing agents were able to produce selective injury to the rabbit ciliary body (SnET2 much greater than BNZ 203), with evidence of a small component of thermal damage (SnET2 greater than BNZ 203). CONCLUSIONS: PDT with SnET2 or BNZ 203 can produce selective injury to the pigmented rabbit ciliary body. The nonpigmented ciliary body epithelium exhibits selective retention of SnET2. This finding warrants further investigation.     

Long-term survival in choroidal and ciliary body melanoma after enucleation versus plaque radiation therapy

OBJECTIVE: This study aimed to determine whether the long-term melanoma-specific mortality rate of patients with a primary choroidal or ciliary body melanoma treated by enucleation is appreciably lower than that of similar patients treated by plaque radiation therapy. DESIGN: Retrospective, nonrandomized, comparative clinical trial. PARTICIPANTS: A previously reported group of 237 patients, 140 treated by enucleation and 97 treated by cobalt-60 (Co-60) plaque between May 1976 and June 1980, and a residual group of 122 patients, 51 treated by enucleation and 71 treated by Co-60 plaque, were identified by variable-by-variable range matching. INTERVENTION: Primary treatment by enucleation or Co-60 plaque radiation therapy was performed. MAIN OUTCOME MEASURES: Melanoma-specific mortality and duration of post-treatment survival were measured. RESULTS: The melanoma-specific mortality rate was substantially worse in the original enucleation subgroup over the entire 15-year follow-up interval; however, differences in baseline prognostic factors between the subgroups are likely to explain the difference in survival curves. After elimination of patients with nonoverlapping values of individual clinical variables to adjust for recognized intergroup differences at baseline, there was no significant or clinically important difference in the 15-year mortality curves of the residual subgroups. The relative rate ratio for the treatment effect in the residual patients was 0.97 (95% confidence interval, 0.51-1.86). There was no late downturn in the survival curve of the plaque-treated patients or late crossing of the curves. CONCLUSION: A large difference in survival between equivalent groups of patients with primary choroidal or ciliary body melanoma treated by enucleation versus plaque radiation therapy appears to be unlikely.     

Scurvy in an adult

The case is reported of a 29-year-old previously healthy female patient who developed the typical clinical picture of scurvy eight months after changing to a diet exclusively containing cooked cereals. Serum levels of B12, folic acid, and calcium were lowered and the alkaline phosphatase was slightly raised due to the dietary lack of vitamins A, D, B12 and folic acid. No clinical signs of these deficiencies could be observed. Addition of vitamin C to this diet resulted in complete cure in a matter of days. Signs and symptoms of scurvy are discussed in the light of the recent literature. This rare disease is particularly worth considering if one of the following situations is encountered: hemorrhages in the skin, muscles, joints or mucous membranes without apparent cause; therapy-resistant ulcers of mucous membranes in elderly patients; Sicca syndrome and/or wounds exhibiting poor healing.     

Cheilo-candidosis in an adult

A rare case of candidal infection of the lips is presented. Predisposing factors appeared to be intra-oral candidal carriage, actinic lip damage and Sj?gren's syndrome. Systemic antifungal therapy with fluconazole resolved the initial infection and a subsequent recurrence.