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Query: UMLS:C0038379 (strabismus)
 9,317 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We studied by light and electron microscopy the diffuse iris nevus of an eye in a 16-year-old patient with oculodermal melanocytosis and choroidal malignant melanoma. The nevus cells in the anterior border layer of the iris appeared to be poorly differentiated, showing moderate infolding of the nuclear membrane with heterochromatin clumping, watery cytoplasm, abundant mitochondria, fine filaments, rough endoplasmic reticulum, and numerous pinocytotic vesicles. Small scattered immature melanosomes and occasional giant melanosomes were observed in these cells. Deep in the iris stroma, however, nevus cells were found singly or in small groups, and were associated with an increasing number of melanized melanosomes and cytoplasmic filaments and reduced numbers of other cytoplasmic organelles, such as mitochondria and free ribosomes. Differentiation of the iris nevus cells appeared to progress from the anterior border layer toward the iris stroma. This observation suggests that intrastromal nevi may be more benign than nevi with surface plaque. The ultrastructural characteristics of the diffuse nevi of oculodermal melanocytosis were compared with those of other iris nevi.
J Pediatr Ophthalmol Strabismus
PMID:Diffuse iris nevus in oculodermal melanocytosis: a light and electron microscopic study. 279 14

Sixty-six patients were treated "conservatively" for unilateral retinoblastoma. Forty-eight of 57 (84%) were treated primarily with unilateral radiation, one patient was treated with a cobalt plaque, and eight patients were treated with either cryopexy or xenon arc photocoagulation. With a median follow-up of 73 months, there have been no deaths. Five of 39 eyes that were in groups I to III have been salvaged. Virtually all eyes in groups IV and V (12 of 14) came to enucleation. The age at diagnosis for patients with a positive family history was early (2.5 months), and the patients had a greater number of individual tumors in one eye (2.4), compared with those without a positive family history (27 months, 1.2 tumors per eye). When unilateral retinoblastoma is detected at an early age, the most common sign is strabismus, not leukokoria.
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PMID:The management of unilateral retinoblastoma without primary enucleation. 710 8

Plaque radiotherapy has been used successfully as primary treatment for selected solitary retinoblastomas. However, there is relatively little information on its role as a secondary treatment after other methods have failed to control the tumor. We have used solitary plaque radiotherapy to treat 91 children with residual or recurrent retinoblastoma after failure of one or more treatment modalities, which included external beam radiotherapy in 63 children, plaque radiotherapy in 9, cryotherapy in 26, and photocoagulation in 18, for a total of 116 treatments in the 91 children. Despite the fact that enucleation was considered to be the only remaining option in many of these children, tumor regression was achieved in 81 cases (89%) and recurrence developed in only 10 cases (11%) during a mean follow up lf 52 months. Treatment of the recurrence following plaque radiotherapy in these 10 cases included repeat plaque radiotherapy in 6 cases, enucleation in 3 cases, and external beam radiotherapy in 1 case. In view of the fact that enucleation was being considered as the only remaining option in many of these children, control of the tumor with plaque radiotherapy in 89% of the cases is very encouraging. Plaque radiotherapy should be considered as an important option for recurrent retinoblastoma after failure of other methods to achieve tumor control.
J Pediatr Ophthalmol Strabismus
PMID:Plaque radiotherapy for residual or recurrent retinoblastoma in 91 cases. 780 1

A retrospective analysis of the records of 1253 retinoblastoma patients (567 females, 665 males, and sex of one unknown) seen in the years 1951-1965 (575 patients, Interval I) and 1966-1980 (678 patients, Interval II) was conducted to determine changes in the manner of presentation of the disease, the treatment modalities employed, and their subsequent outcomes following treatment. There was no significant difference between the two 15-year time intervals in the age at presentation (mean, range), laterality, gender, family history, laterality vs gender distribution, family history vs laterality, employment of chemotherapy in unilateral cases or the use of external beam radiation (EBR) in bilateral cases. Changing trends in the management of retinoblastoma were observed as a result of the introduction of new treatment modalities, such as cryotherapy, light coagulation, and radioactive plaque therapy. Bilateral patients have received chemotherapy less frequently in interval II. The use of photocoagulation, cryotherapy, and brachytherapy for bilaterals, and cryotherapy for unilaterals increased significantly during Interval II. During both time intervals, a significantly higher percentage of unilaterally affected eyes were enucleated compared with bilaterally affected eyes; in addition, there was a decrease in the percentage of enucleations performed on both unilaterally and bilaterally affected eyes. In Interval II, 87% of unilateral patients and 91% of the bilateral patients had an enucleation performed.
J Pediatr Ophthalmol Strabismus
PMID:Changing trends in the management of retinoblastoma: 1951-1965 vs 1966-1980. 819 60

The management of retinoblastoma has gradually changed over the past few decades. There is a trend away from enucleation and external beam radiotherapy toward focal conservative treatments. This is primarily because of earlier detection of the disease and more focused treatment modalities. Enucleation is still employed for retinoblastoma that fills most of the eye, especially when there is a concern for tumor invasion into the optic nerve or choroid. After enucleation, an integrated orbital implant, provides improved motility and appearance of the prosthesis. External beam radiotherapy continues to be an important method of treating less advanced retinoblastoma, especially when there is diffuse vitreous or subretinal seeding. Plaque radiotherapy is useful for controlling small- to medium-sized retinoblastomas, even those with focal vitreous seeds. Tumors that recur after failure of other methods are often suitable for plaque treatment. When plaque radiotherapy is employed in a child receiving chemotherapy, eventual radiation retinopathy can occur. Cryotherapy and photocoagulation provide excellent control of selected small tumors. Advanced laser delivery systems, particularly those that have been adapted to the indirect ophthalmoscope, have facilitated the visualization for treatment of tumors. Thermotherapy is the newest focal method for retinoblastoma. When combined with chemotherapy, thermotherapy provides satisfactory tumor control, leaving the child with a reasonably small scar, thus preserving more vision. Chemoreduction, using intravenous or subconjunctival routes, is often employed to reduce initial tumor volume and thus allow for focal treatment to eradicate the residual smaller tumor. Many children with advanced retinoblastoma can be spared external beam radiotherapy and enucleation mostly as a result of chemoreduction and focal methods. Chemoreduction combined with cryotherapy, thermotherapy, and plaque radiotherapy plays an important role in the current management of many children with retinoblastoma.
J Pediatr Ophthalmol Strabismus
PMID:Recent developments in the management of retinoblastoma. 997 9

The aim of this study was to look at the visual outcome and treatment complications of children diagnosed with Retinoblastoma during the years 1985-2003 inclusive. A retrospective review of all patients records was performed. Patient characteristics, treatment methods and complications were recorded. Twenty eight children presented to Temple street Hospital between 1985-2003. Six of these infants had bilateral tumours. The mean age at presentation was 23.7 months. Sixty-nine percent presented with Leucocoria, of these 33% also had a squint. The mean duration of symptoms was only known in 58% and this figure was approximately 19.8 months. Enucleation was performed in 24 eyes of 24 patients. Three patients required adjuvant chemotherapy post enucleation. Two eyes was treated with external beam radiation and one eye with plaque radiotherapy. One eye (second eye) was treated with systemic chemotherapy and radiation. Five eyes of three patients were treated with systemic chemotherapy followed by adjuvant Argon laser, cryotherapy and diode laser to each eye.The complications of each treatment group was recorded. The visual outcome in the salvaged eyes was favourable. There were no deaths recorded. Though chemotherapy with adjuvant local treatments provide adequate treatment for early tumours, enucleation still plays a major role in the treatment of Retinoblastoma. The total eye salvage rate in this study was 29% with an enucleation rate of 90% in unilateral cases and 33% in bilateral cases. Sixty-six percent of bilateral eyes affected were salvaged. Seventy-one percent of tumours were diagnosed after a parent noticed a gross abnormality of the eye. This highlights the possible need for screening for retinoblastoma in the infant population.
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PMID:A retrospective review of visual outcome and complications in the treatment of retinoblastoma. 1578 28

The authors report a secondary exudative vasoproliferative tumor of the retina associated with retinopathy of prematurity, managed by plaque radiotherapy. A 15-year-old girl with a history of mild, stable retinopathy of prematurity in both eyes noted progressively reduced visual acuity to hand motions in the left eye. Examination disclosed a vasoproliferative tumor of 10-mm base and 3.5-mm thickness with near total (macula-off) exudative retinal detachment. She was treated with iodine-125 plaque radiotherapy, giving apex dose of 40 Gy over 4 days. The tumor regressed to 1.9 mm and retinal detachment resolved 8 months following therapy. Epiretinal membrane with significant macular pucker and edema later developed and was managed with pars plana vitrectomy and membrane peeling. Visual acuity was counting fingers due to photoreceptor loss. Retinopathy of prematurity is a rare cause of vasoproliferative tumor. Iodine-125 plaque radiotherapy can lead to tumor regression and reattachment of the retina in such cases.
J Pediatr Ophthalmol Strabismus 2011 Feb 15
PMID:Management of retinal vasoproliferative tumor associated with ROP by plaque brachytherapy. 2132 3

The present paper describes an astrocytic thalamic hamartoma associated with tectal meningoangiomatosis in a 3-month-old female German shepherd dog showing strabismus, opistotonus, circling, and fore limb hypermetria. MR images of the brain showed a well-defined intra-axial mass in the tectal region. The mass was hypointense to gray matter on T2-weighted images and hyperintense to gray matter on precontrast T1-weighted images. Histologically, glial cells arranged in a multinodular pattern characterized the mass. More caudally the lesion merged with subpial abnormal newly formed plaque-like shaped tissue characterized by thick branching bundles of spindle-shaped cells surrounding a central vessel. In the nodules, GFAP and vimentin were diffusely expressed. In the vascular proliferation Factor VIII-positive reaction was limited to endothelial cells while the remaining spindle-shaped cells were diffusely SMA-positive. The glial nodules did not express lysozyme and MAC387, nor neurofilaments and nestin.
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PMID:Thalamic astrocytic hamartoma and associated meningoangiomatosis in a German shepherd dog. 2326 Nov 50

The authors describe a case of choroidal melanoma in a 13-year-old girl treated with plaque brachytherapy. Uveal melanoma is reported in all age groups but tends to manifest itself in adults more often than children. Childhood (< 20 years) uveal melanoma represents 1% of all cases. Clinical features and treatment options in childhood melanoma are discussed.
J Pediatr Ophthalmol Strabismus 2014 Dec 12
PMID:Choroidal melanoma in children: be aware of risks. 2549 Feb 40

A 32-year-old man with active unilateral group D retinoblastoma that was recurrent following external beam radiotherapy was treated with intra-arterial chemotherapy, leading to tumor regression. Additional plaque radiotherapy and intravitreal chemotherapy were required for complete control. Final visual acuity was 20/40. In selected cases, adult-onset retinoblastoma can be managed with intra-arterial chemotherapy. [J Pediatr Ophthalmol Strabismus. 2016;53:e43-e46.].
J Pediatr Ophthalmol Strabismus 2016 Jul 30
PMID:Intra-arterial Chemotherapy for Adult Onset Retinoblastoma in a 32-Year-Old Man. 2748 94


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