Optic nerve invasion of non-juxtapapillary uveal melanoma: a rare occurrence

2020 ◽  
Vol 13 (6) ◽  
pp. e234610
Author(s):  
Abhimanyu Sharma ◽  
Dilip K Mishra ◽  
Swathi Kaliki
Keyword(s):  
Intraocular Pressure ◽  
Optic Nerve ◽  
Uveal Melanoma ◽  
Histopathological Examination ◽  
Bulbar Conjunctiva ◽  
Clinical Indicators ◽  
Poor Vision ◽  
Tumour Extension ◽  
Systemic Metastasis ◽  
Nerve Tumour

A 44-year-old man presented with complaints of pain and discomfort in his left eye (OS). On examination, he had bare perception of light in OS and had a diffuse pigmented mass lesion in the nasal quadrant of the bulbar conjunctiva, associated with neovascularisation of the iris and iridocyclitis, with no fundus view. Intraocular pressure OS was 40 mm Hg. B-scan ultrasonography OS revealed an intraocular mass with thickened sclerochoroidal complex. A clinical diagnosis of OS ciliochoroidal melanoma with extraocular extension was made. He underwent OS extended enucleation with implant. Histopathological examination confirmed the diagnosis of ciliochoroidal melanoma with tumour extension into the optic nerve posteriorly and the extrascleral tissues anteriorly. There was no evidence of systemic metastasis. Even in a case of non-juxtapapillary uveal melanoma, poor vision and high intraocular pressure are clinical indicators of optic nerve tumour invasion.

scholarly journals Importance of the length of excised optic nerve in enucleations for uveal melanoma

2006 ◽  
Vol 53 (3) ◽  
pp. 49-52
Author(s):  
A. Bobic-Radovanovic ◽  
Z. Vlatkovic
Keyword(s):  
Intraocular Pressure ◽  
Optic Nerve ◽  
Uveal Melanoma ◽  
Poor Vision ◽  
Nerve Invasion ◽  
Uveal Melanomas

The importance of a length of excised optic nerve in eyes enucleated for uveal melanoma isn't finally discussed. We analyzed 473 eyes enucleated for uveal melanoma between 1995. and 2004. at Institute of ophthalmology in Belgrade, 16 (3,7%) of which extended into the optic nerve or its meningeal sheaths. Peripapillary melanomas and large melanomas in eyes with increased intraocular pressure and poor vision were associated with optic nerve invasion. This tumors, as a rule, require an enucleation as a treatment of choice. Authors suggest that a long piece of optic nerve should be excised when eyes with uveal melanomas are enucleated. .

scholarly journals The Impact of Intraocular Pressure Elevation on Optic Nerve Head and Choroidal Blood Flow

2018 ◽  
Vol 59 (8) ◽  
pp. 3488 ◽  
Author(s):  
Naoki Kiyota ◽  
Yukihiro Shiga ◽  
Kohei Ichinohasama ◽  
Masayuki Yasuda ◽  
Naoko Aizawa ◽  
...  
Keyword(s):  
Blood Flow ◽  
Intraocular Pressure ◽  
Optic Nerve ◽  
Optic Nerve Head ◽  
Choroidal Blood Flow ◽  
Pressure Elevation ◽  
Intraocular Pressure Elevation ◽  
The Impact

scholarly journals Profile of Secondary Glaucoma at a Tertiary Hospital in East Java

2021 ◽  
Vol 56 (1) ◽  
pp. 56
Author(s):  
Evelyn Komaratih ◽  
Yuyun Rindiastuti ◽  
Yulia Primitasari
Keyword(s):  
Intraocular Pressure ◽  
Observational Study ◽  
Surgical Complication ◽  
Anterior Segment ◽  
Tertiary Hospital ◽  
Secondary Glaucoma ◽  
Female Ratio ◽  
Poor Vision ◽  
Detailed History ◽  
Male Female Ratio

Glaucoma is the leading cause of irreversible blindness. The aim of this study was to review the profile of secondary glaucoma cases visiting a tertiary hospital in East Java. This is retrospective observational study, completed case records of new patients with secondary glaucoma who presented to glaucoma clinic from January 2014 to April 2016 were included. Out of the 363 case records screened, 66 cases were found to eligible for inclusion. The evaluation included a detailed history and examination performed including vision, anterior segment examination, intraocular pressure (IOP), gonioscopy, and fundus evaluation. Diagnosis of secondary glaucoma was made on the basis of presence of a secondary cause for presence of raised IOP. 66 cases were eligible for inclusion in the study, most of the cases was occurred in the range age 21-50 years. The male female ratio was 1.3:1. Frequent causes of secondary glaucoma were lens factor 30.8%, steroid induced 29.5%, uveitic 20.5%, neovascular15.4%, and surgical complication 3.8%. Most patients with secondary glaucoma have poor vision < 0.1 with high IOP at presentation. Assessment and early detection of underlying cause is the key guide to treatment strategy.

scholarly journals Retrobulbar diameter of optic nerve in glaucoma

2009 ◽  
Vol 137 (3-4) ◽  
pp. 130-133
Author(s):  
Ivan Stefanovic ◽  
Ivan Marjanovic ◽  
Gordana Vlajkovic
Keyword(s):  
Intraocular Pressure ◽  
Optic Nerve ◽  
Optic Disc ◽  
Complex Disease ◽  
Normal Values ◽  
Nerve Fibres ◽  
Ultrasound Diagnostics ◽  
Pearson Test ◽  
Two Parameters

Introduction. The ultrasound diagnostics of the optic nerve includes the analysis of the optic nerve disc (PNO) and measuring of its retrobulbar diameter. With B-scan, by Schraeder's method, it is possible to measure very precisely the optic nerve, the pial diameter, the normal values for the pial diameter being 2.8-4.1 mm. In glaucoma, the disease that is most frequently associated with higher intraocular pressure, there comes the destruction of nerve fibres, which can be visualized as the excavation of the optic nerve disc. Objective. In this paper, we were interested in finding whether in glaucoma, and in what phase of the disease, the optic nerve starts growing thinner. Aware of many forms of this very complex disease, we were interested in knowing if the visualization of excavation on the optic nerve disc is related to diminishing of the pial diameter of the retrobulbar nerve part. Methods. There were treated the patients who had already had the diagnosis of glaucoma and the visualized excavation of the optic disc of various dimensions. Echographically, there was measured the thickness of the retrobulbar part of the optic nerve and the finding compared in relation to the excavation of the optic disc. Results. In all eyes with glaucoma, a normal size of the retrobulbar part of the optic nerve was measured, ranging from 3.01 to 3.91 mm with the median of 3.36 mm. Also, by testing the correlation between the thickness of the optic nerve and the excavation of the PNO, by Pearson test, we found that there was no correlation between these two parameters (r=0.109; p>0.05). Conclusion. In the patients with glaucoma, the retrobulbar part of the optic nerve is not thinner (it has normal values), even not in the cases with a totally excavated optic disc. There is no connection between the size of the PNO excavation and the thickness of the retrobulbar part of the optic nerve.

scholarly journals Evidence of Post Trabeculectomy Optic Nerve Reperfusion by OCT Angiography

2020 ◽  
pp. 35-39
Author(s):  
Jigyasa Sahu
Keyword(s):  
Intraocular Pressure ◽  
Optic Nerve ◽  
Nerve Fiber ◽  
Structural Parameters ◽  
Visual Fields ◽  
Vessel Density ◽  
Oct Angiography ◽  
Prognostic Indicators ◽  
Fiber Layer ◽  
Nerve Fiber Layer

Aim: To describe a case of glaucoma which showed increase in optical coherence tomography (OCT) angiographic vessel densities after intraocular pressure reduction suggesting reperfusion of optic nerve. Presentation of Case: A 55 year old female with primary open angle glaucoma was taken up for trabeculectomy in view of inadequate control of intraocular pressure (IOP) despite maximal medical therapy. In addition to routine glaucoma assessment by visual fields and nerve fiber layer assessment by OCT, OCT angiographic evaluation of peripapillary vessel density was done preoperatively. Three months after trabeculectomy, her intraocular pressure decreased from 35mmHg to 14mmHg. Compared with the preoperative baseline value, the vessel density increased significantly in all quadrants after three months from surgery as demonstrated by OCT angiography. Discussion: This case report suggests that decreased optic nerve head perfusion due to high IOP can be reversed by reduction of IOP. Conclusion: Vascular parameters like angiographic vessel density can show reversible changes as decreased blood flow reinstates and thus can be better prognostic indicators than structural parameters like OCT retinal nerve fiber layer (RNFL) in glaucoma patients.

scholarly journals Again about carbonic anhydrase inhibitors: modern aspects of the use of ICA in ophthalmology

2021 ◽  
Vol 9 (2) ◽  
pp. 64-71
Author(s):  
P.A. Bezdetko
Keyword(s):  
Antioxidant Activity ◽  
Intraocular Pressure ◽  
Optic Nerve ◽  
Carbonic Anhydrase ◽  
Macular Edema ◽  
Mechanism Of Action ◽  
Corneal Endothelium ◽  
Complex Treatment ◽  
Efficacy And Safety ◽  
Carbonic Anhydrase Inhibitors

For more than 70 years, the inhibitors of carbonic anhydrase (ICA) have been used in the treatment of glaucoma. Since 1995, topical forms of ICA have appeared among antiglaucoma drugs — dorzolamide, and since 1999 — brinzolamide. The hypotensive efficacy and safety of topical ICA gave rise to the widespread use of these drugs in the treatment of various forms of glaucoma. The peculiarities of the mechanism of action made it possible to create on their basis effective fixed combinations, which allow reducing the intraocular pressure by up to 40 % in patients with glaucoma. The attractiveness of the drug has expanded due to the effect of ICA on various tissues of the organ of vision. Thus, ICAs effectively improve the hemodynamics of the eye and optic nerve. The antioxidant activity of the drug makes it possible to expand the indications for its use in patients with vascular patho-logy of the retina and optic nerve. The biomechanical characte-ristics of the drug allowed its effective and safe use in the complex treatment of macular edema of various etiologies. The adjuvant use of topical ICAs expands the possibilities of anti-VEGF therapy in the treatment of macular edema of various etiologies. Features of the action of ICA on the endothelial pump function of the cornea made it possible to formulate the rules for the use of topical ICA in patients with an insufficient function of the corneal endothelium.

scholarly journals Unusual Tumours Hidden in Blind Eyes

2021 ◽  
Vol 13 (2) ◽  
pp. 225-229
Author(s):  
Smriti Nagpal Gupta ◽  
Ruchi Goel ◽  
Ravindra Kumar Saran ◽  
Neha Rathie
Keyword(s):  
Intraocular Pressure ◽  
Case Report ◽  
Histopathological Examination ◽  
Low Vision ◽  
Choroidal Melanoma ◽  
Posterior Pole ◽  
Recent Onset ◽  
Choroidal Osteoma ◽  
Melanoma Case ◽  
Rule Out

Introduction: This case report describes 3 cases of unsuspected neoplasms in previously blind eyes, with recent onset pain.  Cases and observations: Case 1: Female with pain, redness in the non-seeing right eye (R/E) for  two months. R/E had total cataract, low intraocular pressure and a well-defined globular mass lesion at the posterior pole, seen on ultrasound. Enucleation with an implant was done. Histopathology clinched the diagnosis of choroidal melanoma. Case 2: A 20-year male, developed pain, redness in left eye (L/E) for  two months. L/E was blind since childhood, secondary to trauma. The patient underwent enucleation and detailed histopathological examination and immunohistochemistry supported a diagnosis of ependymoma with vascular malformation. Case 3: A 24-year male with pain, redness in L/E for six months, with decrease in size of eyeball. L/E had low vision since childhood. On examination, L/E was phthisical with diffuse conjunctival congestion, band-shaped keratopathy, cataract, and neovascularization of iris. Imaging revealed a small distorted globe with highly reflective mass along the posterior pole. Histopathology of the enucleated specimen confirmed the diagnosis of choroidal osteoma, with gliosis of the adjacent RPE.  Conclusion: In the management of a painful blind eye, it is extremely important to rule out an intraocular malignancy, particularly in patients with recent onset of pain.

scholarly journals Ocular, Neurologic and Systemic Findings of the Cases with Optic Nerve Hypoplasia

2016 ◽  
Vol 10 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Eyyup Karahan ◽  
Ayse Tulin Berk
Keyword(s):  
Optic Nerve ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Optic Nerve Hypoplasia ◽  
Refractive Errors ◽  
Poor Vision ◽  
The Relationship ◽  
The Brain ◽  
Ocular Signs ◽  
Neurologic Findings

Aim: To describe the associated ocular, neurologic, and systemic findings in a population of children with optic nerve hypoplasia (ONH) and to evaluate the relationship between ocular signs and neurologic findings. Method: A retrospective chart review of 53 patients with the diagnosis of ONH seen between December 1998 and September 2012 was performed. All neurodevelopmental anomalies, neuroradiologic findings, endocrinologic and systemic findings were recorded. Poor vision was defined as the visual acuity poorer than logMAR 1.0 or inadequate central steady maintained fixation. Results: Thirty (56.6%) of the 53 children with ONH were boys. Mean age at presentation was 56.2±46.8 months (range; 3 months to 18 years). Poor vision defined for the purpose of this study was found in 47.2% of 53 patients. Thirty-three (62.3%) children had nystagmus. Thirty-four (64.2%) children had strabismus. Thirteen (38.2%) of those with strabismus had esotropia, 20 (58.8%) had exotropia. The total number of the children with neurodevelopmental deficit was 22 (41.5%) in our study. Conclusion: The vision of young children with ONH should be monitored at least annually, and any refractive errors should be treated. Neuroimaging of the brain and endocrinologic evaluation is necessary in all cases with ONH.

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