The improved dual-immunoenrichment assay enabled the detection of intact and viable CMC in the majority of UM patients. We also were able to identify CMC after short-term culturing. Molecular characterization of the CMC rather than the prevalence of these cells is expected to provide relevant information on the individual risk of metastasis.

Monosomy-3 in primary uveal melanoma (UM) is associated with a high risk of metastasis and mortality. Although circulating melanoma cells (CMC) can be found in most UM patients, only approximately 50% of the patients develop metastases. We utilized a novel immuno-FISH assay to detect chromosome-3 in intact CMC isolated by dual immunomagnetic enrichment. Circulating melanoma cells were detected in 91% of the patients (n = 44) with primary non-metastatic UM, of which 58% were positive for monosomy-3. The monosomy-3 status of CMC corresponded to the monosomy-3 status of the primary tumor in 10 of the 11 patients where this could be tested. Monosomy-3 in the CMC was associated with an advanced tumor stage (P = 0.046) and was detected in all four patients who developed metastasis within the follow-up period of 4 yr. This non-invasive technique may enable the identification of UM patients at risk for metastasis particularly when a primary tumor specimen is unavailable.

Uveal melanomas are the most common malignant tumors of the eye. With modern molecular biological diagnostic methods, such as chromosome 3 typing and gene expression analysis, these tumors can be categorized into highly aggressive (monosomy 3, class II) and less aggressive forms. This molecular biological stratification is primarily important for determining the risk of these tumors as no therapy is currently available that is able to prevent or delay metastases. A randomized study of patients with a poor prognosis (monosomy 3) is currently being carried out in order to determine whether a cancer vaccine prepared from autologous (patient's own) dendritic cells and uveal melanoma RNA can prevent or delay progression and further metastases of this extremely aggressive form of cancer. Inclusion in the uveal melanoma study, which hopes to provide a potential therapeutic option for patients, is only possible if patients are referred to an institution that is able to manufacture and provide this vaccination before the patient is operated on or treated with radiation. Untreated tumor material is necessary for producing the vaccine on an individualized patient basis.

PurposeTo investigate the clinical value of multifocal electroretinography (mfERG) and microperimetry and the effects of intravitreal therapy with ranibizumab (Lucentis®) on macular function in the course of neovascular age-related macular degeneration (nAMD).Materials and methodsWe conducted a prospective single-arm interventional cohort study with 20 nAMD patients older than 50 years. Examinations were scheduled monthly for 1 year during intravitreal therapy with ranibizumab. The examinations included mfERG, microperimetry, spectral domain optical coherence tomography, and best-corrected visual acuity using ETDRS score.ResultsDuring the 12-month observation period, a significant positive linear correlation between the logarithm of minimum angle of resolution (logMAR) and scotoma area (r=0.28, 95% confidence interval [CI] 0.21–0.35), between logMAR and fovea thickness in optical coherence tomography (r=0.11, 95% CI 0.04–0.2), and a significant negative correlation between logMAR and mfERG (−0.37, 95% CI −0.43 to −0.31) were observed. A significant ranibizumab effect on logMAR was found (P=0.0065). From a total of 25 relapses, 14 were able to be predicted correctly by mfERG P1 decrease in the preceding month. However, there was no statistically significant relation between prediction and observed relapses (Fisher’s exact test, P=0.6726).ConclusionOur results indicate a possible role of mfERG and microperimetry in the monitoring of macular function and prediction of recurrence during intravitreal pharmacotherapy in wet AMD.

Background: Dye solutions such as indocyanine green (ICG) are used for the staining of intraocular structures. The aim of the presented study was to investigate the effects of ICG on bovine retinal function using different concentrations of ICG. Methods: Bovine retina preparations were perfused with a standard solution and the electroretinogram was recorded. The nutrient solution was substituted by an ICG solution at varying concentrations for 45 min. Afterwards the preparations were reperfused with standard solution for at least 85 min. Results: Significant reductions in b-wave amplitude were found for concentrations of 0.0025% (p = 0.0099) and 0.025% (p = 0.0378). For the concentration of 0.025%, the b-wave amplitude remained significantly decreased (p = 0.0082) after the observation period, but a full recovery of the b-wave was observed for the concentration of 0.0025% (p = 0.1917). Conclusion: Intraocular application of sufficient ICG concentrations for internal limiting membrane staining seems not possible without interfering with retinal function.