Objective To observe the clinical manifestation and ophthalmoscopic image characteristics of uveal metastatic carcinoma. Methods Thirty-six uveal metastatic carcinoma patients (43 eyes) were enrolled in this study. The patients included 21 males and 15 females. The patientsprime; ages ranged from 28 to 71 years, with a mean age of (47.3plusmn;10.2) years. Seven patients had bilateral carcinoma and 29 patients had unilateral carcinoma. There were 30 patients with lung cancer, three patients with breast cancer, one patient with gastric cancer and two patients without primary tumors. There were 20 patients with known primary cancer, 16 patients visited the Department of Ophthalmology first. All the patients were examined documenting visual acuity, intraocular pressure, slit-lamp microscopy and mydriatic fundus examination. Meanwhile, 22 patients (26 eyes) were examined using B-type ultrasound and/or color Doppler flow imaging (CDFI). Twelve patients (12 eyes) were examined using fundus fluorescein angiography (FFA) and/or indocyanine green angiography (ICGA). Seventeen patients (22 eyes) were examined using MRI and/or CT. The clinical manifestation and ophthalmoscopic image characteristics of uveal metastatic carcinoma patients were observed. Results Among 43 eyes, four lesions were in the iris, three lesions in the ciliary body and 32 lesions were in the choroid. Fundus examination showed an isolated mass in 26 eyes and more than two masses in nine eyes. Metastatic tumors of the iris and ciliary body often showed irregular cauliflower-like mass with gray-white or meat-red color and abundant vessels. The choroidal metastasis usually demonstrated flat rounded or irregular intraocular masses with gray-yellow or gray-white color in the posterior pole. B-type ultrasound showed ill-defined, flat, and irregular-shaped masses with uneven internal reflectivity. CDFI showed rich blood flow within the tumor. FFA and (or) ICGA showed pinpoint and mottled leaks against hyperfluorescence background. MRI revealed low or middle signal using T1WI and low signal intensity using T2WI. Conclusions The uveal metastatic carcinoma usually occurs in one eye with an isolated mass. Most of them show a flat gray-yellow mass in posterior choroids and have the primary cancer sites of the lung. FFA and/or ICGA show pinpoint and mottled leaks against hyperfluorescence background. B-type ultrasound and (or) CDFI show ill-defined, flat, and irregular-shaped mass with rich blood flow within the tumor. MRI reveals low signal intensity on T2WI.
Objective To investigate the expression of T cell receptor (TCR) Vβ8.3 gene on CD4+ T lymphocytes in the rats with experimental autoimmune uveoretinitis (EAU). Methods Eighteen Lewis rats were divided into EAU, complete Freund′s adjuvant, and the control group. Inter photoreceptor retinoid-binding protein (IRBP) R16 peptide was synthesized using Fmoc procedure for induction of EAU. Magnetic absorption cell sorting (MACS) me thod was used to isolate the CD4+T lymphocytes from the spleen of the rats. Flow cytometry was used to monitor the efficiency of isolation. The expression of TCR Vβ8.3 gene segment on CD4+T lymphocytes was determined by fluorescent quantitative polymerase chain reaction. Results EAU was successfully induced in the Lewis rats immunized with IRBP R16 peptide. The proportion of CD4+T lymphocytes isolated by means of MACS was statistically higher than that before isolation (P＜0.001). The expression of TCR Vβ8.3 gene segment on CD4+ T lymphocytes in EAU rats was significantly higher than that in the control (P＜0.05). Conclusions There is a predominant usage of antigen-specific TCR Vβ 8.3 gene in EAU rats induced by IR BP R16 peptide, which may serve as a target for immunotherapy of EAU. (Chin J Ocul Fundus Dis，2004，20：165-167)
PURPOSE:To evaluate the value of the apoptosis-suppressing oncogene bcl-2 protein expression in the development and progression of uveal and conjunctival melanomas. METHODS:Using flow cytometry and immunofluorescence methods to detect the bcl-2 protein expression in 40 cases of uveal malignant melanomas (UMM), 5 cases of conjunctival nevi (CN) and 7 cases of conjunctival malignant melanomas (CMM). RESULTS :The expression content of bcl-2 protein in CMM was significantly higher than that in CN (P＜0.05);the bcl-2 protein positive expression percentages in CMM and UMM were 85.71% and 72.50% respectively. The expression content of bcl-2 protein in UMM was not related to pathological classfication, scleral invasion,ciliary body involvement,and tumor dimensions (P＞0.05). CONCLUSIONS: The over-expression of bcl-2 protein and apoptosis suppressing might be related to the pathogenesis of CMM and UMM;bcl-2 protein expression might be helpful in discriminating CN from CMM, but unavailable in evaluating the patholgical malignancy of UMM. （Chin J Ocul Fundus Dis,1997,13: 73-74 ）
Objective To probe the relationship between the patients′prognosis and the gene of multidrugs and drug resistance in uveal melanoma.Methods The gene expression of cyclin D1, epithelial growth factor receptor (EGFR), non-metastasis gene 23 (nm 23), P glucose protein (P-gp ) , multidrug resistance relation protein (MRP) and lung resistance protein (LRP) expression in 96 cases of uveal melanoma were detected by depigment immunohistochemistry. The patients with complete anamnesis data were observed continuously, and the follow-up results were classified. Results Among the 96 cases of uveal melanoma, the epithelioid cell type was in 21, the mixed cell type in 56, and the spindle cell type in 19 ; including 76 at intraocular stage and 20 at extraocular stage. As the level of metastasis suppress gene nm 23 expression decreased and the level of cyclin D1 and EGFR expression increased, the expression level of drug resistance genes increased. The levels of LRP and MRP had negative correlation to the expressions of nm 23 and postive correlation to the expressions of nm 23, Cyclin D1 and EGFR. In 58 patients′who were observed continuously, 19 died in 5 years and 26 survived over 5 years.Conclusion There are significant as sociation between patients′prognosis and multidrug and drug resistance gene in uveal melanoma.(Chin J Ocul Fundus Dis，2003，19：1-4)
Objetive To observe the incidence of extraocular extension of malignant uveal melanoma, the relationship between the incidence and histopathologic type, the characters of clinical manifestation and iconography, and the factors influencing prognosis. Methods Nine cases of extraocular extension of malignant uveal melanoma within last 20 years were analyzed retrospectively. All cases were diagnosed by histopathological examination and most of them had undergone ultrasound and CT examinations. Results The incidence of extraocular extension of malignant uveal melanoma was 15%. Tumors of 6 patients were flat and 2 nodular in shape, 4 epithelial cell and 1 spindle cell in type. The follow-up results of 5 patients in this series indicated that the prognosis was related to the size of the tumor, the degree of extraocular extension, and histopathologic type. Conclusion Extraocular extension of malignant uveal melanoma might happen in early case and the occurrence is usually related to the histopathologic type of the tumor. Iconographic examination is very helpful for diagnosis in extraocular extension of this tfumor. (Chin J Ocul Fundus Dis,1999,15:30-32)
Objective To observe the therapeutic effects and security of the local resection for uveal melanoma, and to detect the factors which affect the prognosis. Methods The clinical data of 45 patients with uveal melanoma who had undergone local resection after examined by histopathology were retrospectively analyzed, including the age，sex，the longest diameter, the location of the tumor，with or without retinal detachment, intraocular pressure (IOP) and visual acuities before and after the operation, and the visual acuity. The relationship between the therapeutic method and the survival prognosis was analyzed. COX regression model was set up with knubbly metastasis relapse prognosis and the multiple factors which was the assistive variables. Results Among these factors, the metastasis and relapse had obvious relation to the longest diameter and height of the tumor(P=0.04), the IOP after operation(P=0.03), pathologic classification (P=0.04)、with or without scleral infiltration (P=0.03)、the location of the tumor (P=0.01) and complete or incomplete resection (P=0.00). The period when the metastasis and relapse of tumor were most likely to happen was 20 to 40 months. Conclusion Local resection is one of the effective methods for uveal melanoma. These patients should be followed up closely from 20 to 40 months after operation, and if necessary, should be treated combined with other treatments. (Chin J Ocul Fundus Dis, 2006, 22: 154-156)
Mucosa-associated lymphoid tissue (MALT) lymphoma is an indolent B cell derived non-Hodgkin's lymphoma. It is the main type of uveal lymphoma and is extremely rare. The pathogenesis of ocular MALT lymphoma remains unclear. It is now considered to be associated with many causes. The manifestations of primary uveal MALT lymphoma differ. So sometimes it is necessary to diagnose depending on diversity of auxiliary tests. Ultrasound examination shows typical low and homogeneous internal reflectivity, with blood flow signal. Optical coherence tomography, fundus imaging, fundus angiography, magnetic resonance imaging and positron emission tomography computerized tomography can assist diagnosing. Primary uveal MALT lymphoma is sensitive to radiation therapy, chemotherapy and biotherapy have positive influence too. The prognosis of uveal MALT lymphoma is good, but its early diagnosis is rather challenging. The nonspecific clinical manifestations and the rarity of the disease can confound the initial diagnosis, resulting in delayed treatments which may cause irreversible vision loss.
Objective To evaluate the role of the cell cycle related genes cyclinD1 and Bcl-2 protein expression in the pathogenesis and infilt ration of the uveal melanoma． Methods Using immunohis tochemistry to detect the cyclinD1 and bcl-2 protein expression in 96 cases of uveal melanoma． Results The expression content of bcl-2 was high in uveal melanoma, and there wasn't any relationship between bcl-2 cell positivity and tumor cell type and extrascleral extension． In contrast, cyclinD1 expression was higher in epithelial cell uveal melanoma than mix cell and spindle cell varieties． There was a positive correlation between cyclinD1 cell positivity and extrascleral extension． Conclusion The expression of bcl-2 protein is important for the survival of the uveal melanoma． CyclinD1 may serve as a sensitive index of its malignancy． (Chin J Ocul Fundus Dis, 2001,17:44-46)
Radiotherapy is the prior treatment for uveal melanoma, but a major problem confronted most of the patients is radiation retinopathy, which accompanied with severe visual loss and secondary enucleation potential. There is no optium choice and normative strategy so far, the intraocular melanoma society has focused on application of anti-vascular endothelial growth factor drugs injection and glucocorticoids. This article reviews a series of potential managements for radiation retinopathy and its further stage .
In the research process of uveal melanoma (UM), the Collaborative Ocular Melanoma Study (COMS) is a landmark and outstanding clinical study. Its research conclusions are the foundation for today's UM clinical work and guidelines. COMS is the first and largest randomized clinical trials conducted to date, comparing the survival outcomes of two or more treatment regimens for primary malignant intraocular tumors with high reliability. Its research design, methods, and conclusions are still widely cited in this day. Learning from the research experience of COMS, summarizing research data based on Asian populations, and studying treatment methods suitable for Asian UM patients is a powerful supplement to COMS data, but also an expansion of this global research, further improving the level of UM diagnosis and treatment in China.