Uveal tract melanoma is the most common primary intraocular malignancy in adults, accounting for about 5-10% of all the melanomas. Since there are no lymphatic vessels in the eye, uveal melanoma can only spread hematogenously leading to liver metastasis. A wide variety of treatment modalities are available for its management, leading to dilemma in selecting the appropriate therapy. This article reviews the diagnostic and therapeutic modalities available and thus, can help to individualize the treatment plan for each patient.
Metastatic lesions to the clivus have been reported in various cancers including lung cancer, prostate carcinoma, skin melanoma, and hepatocellular carcinoma. There have been only a few reports of breast cancer presenting with isolated clival metastasis. We report a case of 35-year-old lady, who was known case of breast carcinoma presented with diplopia as the only sign of clival metastasis. The etiology was established by magnetic resonance imaging which showed an enhancing lesion in the clivus. The diagnosis of clival metastasis from breast cancer was confirmed by transsphenoidal biopsy.
Background: Retinoblastoma is the most common primary intraocular malignancy of childhood. The present study was undertaken to overcome the scarcity of data regarding the epidemiology, demographic and clinical profile, and nature of the first health-care professional consulted. Materials and Methods: A retrospective analysis of medical records was performed for all cases of retinoblastoma who presented to the department of ophthalmology and oncology between 2010 and 2017. A total of 54 cases were reviewed. Results: Unilateral disease was seen in 85.2% while 14.8% presented with bilateral disease with a median age of 3 years and 2 years, respectively, at diagnosis. The male: female ratio was 2:1. The most common presenting symptom was leukocoria which was noticed in 42 patients (77.7%), followed by red eye (33.3%) and proptosis (20.3%). The most common stage of presentation was Stage I (44.4%), followed by Stage IV (20.4%), Stage III (9.3%), and Stage II (5.6%). The median time to diagnosis was 8.7 months (range, 0.5–98.7 months), and the median time to treatment was 37.4 days (range, 0–645 days). Majority of the patients were referred by local ophthalmologists (48%), followed by general practitioners (20%), nurses (19%), and quacks (13%). Enucleation was the most preferred treatment modality (48.1%), followed by chemotherapy (33.3%), radiotherapy (13%), photocoagulation (3.7%), and exenteration (1.9%). The overall remission rate was 79.6%, while 12.3% had relapse and 7.4% died. Conclusion: The study showed a dire need for timely detection and treatment of retinoblastoma which is possible with improved awareness and better accessibility to health-care facilities. It also revealed a decrease in histopathological risk factors with chemoreduction.
Congenital cataract has various modes of inheritance. In Nance Horan syndrome, X linked recessive pattern of inheritance of congenital cataract is seen. Protein truncation mutation in an NHS gene located on Xp21.2-p22.3. could be associated with this syndrome. We report a case of Nance Horan syndrome family with bilateral congenital cataract with microcornea, strabismus, nystagmus, mental retardation, dysmorphic facies and dental anomalies. Treatment consists of surgery for cataract extraction, although results are poor.
Background: Rhino-orbital-cerebral mucormycosis has reached epidemic proportion during second wave of COVID-19 pandemic in India. In this study we aimed to understand the demographics, presentation, temporal sequence, risk factors and outcomes to undertake measures for prevention and treatment and benefit of administering liposomal amphotericin via retrobulbar injection in addition to systemic antifungals in the setting of rhino-orbital-mucormycosis.Methods: Study of patients with COVID-19-associated mucormycosis managed or co-managed by ophthalmologists in our centre from April 2021 to June 2021.Results: Male predominance and more than 75% associated with COVID-19 infection. Common risk factors associated were DM and corticosteroids use. Unilateral involvement was common (82.4%). Most common primary symptom and sign of ROCM is orbital/facial pain (68.4%) and ptosis (84.2 %) respectively. retro bulbar amphotericin B injections had slight improvement in vision (25%), ptosis (37.5%) and extra ocular movement (25%) with few complications. Surgical management were PNS debridement (42.1%), exenteration added in 17.5 % and with above procedure additional maxillectomy needed in 14%. 22.8 % cases were succumbed by disease while 40.1 % of live patients needed orbital exenteration.Conclusions: ROCM has visible signs and symptoms, help us in early diagnosis as compared to mucormycosis at other anatomical sites and should be known to all ophthalmologists. Early diagnosis by involving root level health worker and creation of standard treatment guideline on emerging heath problem is an urgent need.
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