Localized, central optic snowflake degeneration of a polymethyl methacrylate intraocular lens: clinical report with pathological correlation.

نویسندگان

  • Nathan Dahle
  • Liliana Werner
  • Luther Fry
  • Nick Mamalis
چکیده

tral retinal vein occlusion, and retinal detachment. Although data in the literature regarding the presence of VEGF in uveal melanoma are conflicting, our report shows the presence of VEGF in an iris melanoma. Kvanta and colleagues demonstrated the presence of VEGF protein in retinoblastoma but not in posterior uveal melanomas. Similarly, in a study of VEGF expression in central retinal vein occlusion, Pe’er and coworkers used eyes with uveal melanoma as control specimens after finding that VEGF messenger RNA was undetectable or barely detectable in all 5 cases. In contrast, Ijland and colleagues showed that human uveal melanoma cell lines expressed both VEGF and angiopoietin-2, a factor that appears to inhibit early maturation of newly formed vessels, suggesting that these tumors undergo a high degree of vascular remodeling. Two additional studies found 27% (10 of 37 eyes) and 22% (11 of 49 eyes) of ocular melanomas to be positive for VEGF protein on immunohistochemical staining. In a study by Sheidow and coworkers, 94% of 47 choroidal melanomas had VEGFprotein immunoreactivity. In a number of eyes with choroidal melanoma, evidence of breakdown of the blood-ocular barrier, including sites remote from the tumor such as the iris or ciliary body, suggests the presence of a soluble mediator of vascular permeability. In the studies described earlier, investigators found high levels of VEGF protein centrally within the uveal melanoma and in the immediate perivascular distribution as well as in the adjacent retina and choroid. Likewise, VEGF receptor levels are elevated in the endothelial cells of the tumor vasculature and in uninvolved retina, choroid, and iris vasculature. The combination of up-regulation of VEGF receptors and elevated VEGF levels locally could explain the neovascularization responses seen in some eyes with intraocular melanomas. Our patient had a vascularized iris mass with an associated hyphema. Histopathologic examination confirmed the diagnosis of iris melanoma and demonstrated that VEGF was indeed present. These findings are consistent with some recent studies that have found an association between uveal melanomas and VEGF expression. Future intraocular tumor therapy research targeting VEGF and its activity might also warrant an investigation of the applicability of this approach in the treatment of iris melanomas. Correspondence: Dr Pulido, Mayo Clinic, Department of Ophthalmology, 200 First St SW, Rochester, MN 55905-0001 (pulido.jose@mayo .edu). Financial Disclosure: None reported.

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عنوان ژورنال:
  • Archives of ophthalmology

دوره 124 9  شماره 

صفحات  -

تاریخ انتشار 2006