BACKGROUND Anaplastic lymphoma kinase(ALK)-positive large B-cell lymphoma(LBCL)is an aggressive and rare variant of diffuse LBCL.Herein,we report an uncommon case of stage IE extranodal ALK-positive LBCL initially ori...BACKGROUND Anaplastic lymphoma kinase(ALK)-positive large B-cell lymphoma(LBCL)is an aggressive and rare variant of diffuse LBCL.Herein,we report an uncommon case of stage IE extranodal ALK-positive LBCL initially originating in the bulbar con-junctiva.CASE SUMMARY A 63-year-old woman presented with a mass in the left bulbar conjunctiva that had persisted for six months,accompanied by swelling and pain that had per-sisted for 3 d.Eye examination revealed an 8 mm slightly elevated pink mass in the lower conjunctival sac of the left eye.Microscopically,the tumor was com-posed of large immunoblastic and plasmablastic large lymphoid cells with scattered anaplastic or multinucleated large cells.Immunophenotypically,the neoplastic cells were positive for ALK,CD10,CD138,Kappa,MUM1,BOB.1,OCT-2,CD4,CD45,EMA,CD79a,CD38,and AE1/AE3,and negative for CD20,PAX5,Lambda,BCL6,CD30 and all other T-cell antigens.The results of gene rearrangement tests showed monoclonal IGH/IGK/IGL and TCRD rearran-gements.Fluorescence in situ hybridization studies did not reveal any BCL2,BCL6 or MYC rearrangements.Furthermore,Epstein-Barr virus was not detected by in situ hybridization in the lesions.Based on the histopathological and imaging examinations,the neoplasm was classified as stage IE ALK-positive LBCL.No further treatments were administered.At the 6,15,and 21 mo postoperative follow-up visits,the patient was in good condition,without obvious discomfort.This case represents the first example of primary extranodal ALK-positive LBCL presenting as a bulbar conjunctival mass,which is extremely rare and shares morphological and immunohistochemical features with a variety of other neo-plasms that can result in misdiagnosis.CONCLUSION Awareness of the condition presented in this case report is necessary for early and accurate diagnosis and appropriate treatment.展开更多
Background:To evaluate the conjunctival flap cover surgery for the treatment of ocular surface disorders.Methods:Retrospective uncontrolled study was performed.A total of 253 eyes of 253 patients who had received conj...Background:To evaluate the conjunctival flap cover surgery for the treatment of ocular surface disorders.Methods:Retrospective uncontrolled study was performed.A total of 253 eyes of 253 patients who had received conjunctival flap cover surgery during a 10-year period were included.The indications,symptoms and complications experienced by patients undergoing partial or total conjunctival flap cover surgery were reviewed.Results:In all of these cases,satisfactory anatomic and functional outcomes were achieved.The BCVA of 224 eyes out of 253 patients(88.5%)were no worse than that of preoperative and the BCVA of 29 eyes out of 253 patients(11.5%)decreased postoperatively.No eye pain,foreign body sensation and other discomforts presented in the last visit.The surgical indications was therapeutic for 138 out of 253 patients(54.5%),aesthetic for 63 eyes out of 253 patients(24.9%),tectonic for 45 eyes out of 253 patients(17.8%),and analgesic for 7 eyes out of 253 patients(2.8%).The primary diagnose of therapeutic indications is refractory corneal ulcer for 135 eyes out of 253 patients(53.4%).The main diagnose of aesthetic indications is atrophy of eyeball for 45 eyes out of 253 patients(17.8%)and corneal leukoma for 18 eyes out of 253 patients(7.1%).The principal diagnose of tectonic indications is corneal perforation for 43 eyes out of 253 patients(17%).The main intraoperative complications is buttonhole formation for 8 eyes out of 253 patients(3.2%),which can be handled by simple suture.The most severe complications postoperatively was conjunctival flaps dissolving and corneal perforation for 3 eyes out of 253 patients(1.2%),and corneal transplantation had to be performed to avoid enucleation.In addition,4 eyes out of 253 patients(1.6%)presented cystic flap and two of them received surgical excision.Conclusions:Conjunctival flap cover surgery is an underused technique.Its primary indication is refractory corneal ulcer and corneal perforation,and its second indication is aesthetic with poor visual potential coexisting ocular surface diseases.It represents an interesting alternative to more mutilating surgeries.展开更多
Objective:To determine the prevalence of HIV seropositivity among patients with squamous cell carcinoma of the conjunctiva.Methods:All patients with clinical and histopathological confirmation of squamous cell carcino...Objective:To determine the prevalence of HIV seropositivity among patients with squamous cell carcinoma of the conjunctiva.Methods:All patients with clinical and histopathological confirmation of squamous cell carcinoma seen during a ten year period(July 1999 to June 2009) were tested for HIV(Human Immunodeficiency Virus).The number of patients with squamous cell carcinoma of the conjunctiva who are HIV positive were counted.Results:A total of thirty-three(33) eyes in thirtytwo(32) patients were confirmed histopathologically to have conjunctival squamous cell carcinoma. Their ages ranged from 22 years to 66 yean with a mean age of(38.6± 11.8) years(SD).The male to female ratio was 1:1.5.Twenty four(75%) of these patients were HIV positive.Conclusions: Squamous cell carcinoma is associated with the human immunodeficiency virus and is thus a marker for the disease in Benin City,Nigeria.展开更多
AIM: To investigate the ocular surface microbiome profile of patients with fungal keratitis(FK) through bacterial 16 S r DNA sequencing. METHODS: The swab samples were collected from 8 patients with FK(Group 1 from th...AIM: To investigate the ocular surface microbiome profile of patients with fungal keratitis(FK) through bacterial 16 S r DNA sequencing. METHODS: The swab samples were collected from 8 patients with FK(Group 1 from the corneal ulcer, Group 2 from the conjunctival sac of the infected eyes, and Group 3 from the conjunctival sac of the fellow eyes) and 10 healthy eyes(Group 4 from the conjunctival sac). Bacterial 16 S rDNA V4-V5 region sequencing was performed to characterize the bacterial communities on the ocular surfaces of the patients with FK. RESULTS: Our metagenomic data showed that 97% of the sequence reads were categorized into 245 distinct bacterial genera, with 67.75±7.79 genera detected in Group 1, 73.80±13.44 in Group 2, 74.57±14.14 in Group 3, and 89.60±27.49 in Group 4. Compared with the healthy eyes(Group 4), both infected(Groups 1 and 2) and fellow eyes(Group 3) of the patients with FK showed reduced bacterial diversity and altered ocular surface microbiota compositions, with lower abundance of Corynebacterium and Staphylo coccus and higher abundances of Pseudomonas, Achromobacter, Caulobacter and Psychrobacter. CONCLUSION: Our report depicts the altered ocular surface bacterial community structures both in the affected and fellow eyes of patients with FK. These changes may contribute to the pathogenesis of FK or the increased risk for FK.展开更多
AIM:To determine the possibility of the development of dry eye disease(DED) as a result of persistent infection with Chlamydia trachomatis and Ureaplasma urealyticum in the conjunctiva of patients.METHODS: This study ...AIM:To determine the possibility of the development of dry eye disease(DED) as a result of persistent infection with Chlamydia trachomatis and Ureaplasma urealyticum in the conjunctiva of patients.METHODS: This study was conducted on 58 patients of age range 20-50 y,diagnosed with DED confirmed by Schirmer I test and tear breakup time.The non-dry eye control group included 27 subjects of the same age.Ocular specimens were collected as conjunctival scrapings and swabs divided into three groups: the first used for bacterial culture,the second and third taken to detect Chlamydia trachomatis and Ureaplasma urealyticum by direct fluorescent antibody(DFA) assay and polymerase chain reaction(PCR) method. RESULTS: Chlamydia trachomatis was detected in 65.5% and 76% of DED patients by DFA and PCR methods respectively.Ureaplasma urealyticum was found in 44.8% of DED infected patients using the PCR method.Both organisms were identified in only 37.9% of DED patients found to be infected.Control subjects had a 22%detection rate of Chlamydia trachomatis by DFA assay versus a 7% detection rate by PCR; while Ureaplasma urealyticum was detected in 3.7% of the controls by PCR method.The conjunctival culture revealed that gram positive microorganisms represented 75% of isolates with coagulase negative Staphylococci the most common(50%) followed by Staphylococcus aureus(20%),whereas gram negative microorganisms occurred in 25% of cases,isolating Moraxella spp.as the most frequent organism. CONCLUSION: Our results tend to point out that Chlamydia trachomatis and Ureaplasma urealyticum were detected in a moderate percentage of patients with DED,and could be a fair possibility for its development.PCR is more reliable in detecting Chlamydia trachomatis than DFA technique.The presence of isolated conjunctival bacterial microflora can be of some potential value.展开更多
AIM:To compare the bacterial flora in palpebral conjunctiva of xerophthalmia seniors of Tibetan,Yi and Han,and analyze the differences and similarities of the bacteria.·METHODS:The test subjects were selected fro...AIM:To compare the bacterial flora in palpebral conjunctiva of xerophthalmia seniors of Tibetan,Yi and Han,and analyze the differences and similarities of the bacteria.·METHODS:The test subjects were selected from 2Tibetan,2 Yi and 3 Han populated places,respectively.Total 222 seniors(444 eyes) with dry eye were examined.Secretion was collected from the palpebral conjunctiva of the subjects and then inoculated onto a blood agar plate.After 48h of incubation,the bacteria were examined for the differences and similarities between different ethnics.·RESULTS:There was no significant difference(P >0.05)of Gram stain characterization,dominant bacteria and number of the bacterial species present in oxrophthalmia patients among Tibetan,Yi and Han nationalities.The bacteria presented in all groups include staphylococcus epidermidis,corynebacterium,micrococcus luteu,int-racellular bacteria sphingomonas,pseudomonas aerug-inosa.The bacteria detected from the two of three ethnic groups were staphylococcus aureus,staphylococcus haemolyticus,escherichia coli,kytococcus sedentarius,streptococcus angina,micrococcus lylae,and staphy-lococcus heads.The incidence rate of bacteria-associated dry eye in Tibetan population was significantly lower than that of Han and Yi population.·CONCLUSION:There is no significant difference in the bacteria flora of palpebral conjunctiva observed among dry eye elder populations of Tibetan,Yi and Han people.All of staphylococcus epidermidis,corynebacterium,micrococcus luteu,intracellular bacteria sphingomonas,pseudomonas aeruginosa,staphylococcus aureus,staphylococcus haemolyticus,escherichia coli,kytococcus sedentarius,streptococcus angina,micrococcus lylae and staphylococcus heads are common bacteria flora of the three nationalities inhibiting in this area.展开更多
AIM:To examine the integrity of the ocular surfaces of subjects with and without diabetes with no conjunctival and dry eye signs and symptoms and compare conjunctival impression cytology findings in diabetics with non...AIM:To examine the integrity of the ocular surfaces of subjects with and without diabetes with no conjunctival and dry eye signs and symptoms and compare conjunctival impression cytology findings in diabetics with non-proliferative and proliferative diabetic retinopathy.METHODS:Conjunctival impression cytology was performed on 43 eyes of 43 subjects with nonproliferative diabetic retinopathy(NPDR),42 eyes of 42subjects with proliferative diabetic retinopathy(PDR),and30 eyes of 30 control subjects.Impression cytology specimens of each group were graded and scored in the range 0-3 according to Nelson's method.RESULTS:There were 45(52.9%)women and 40(47.1%)men.The mean age of the patients was 59.6±9.3y(range,43-76y)in NPDR group and 58.0±8.8y(range,41-85y)in PDR group.Cases with NPDR and PDR showed statistically significant higher impression cytology scores than control group(P<0.05).There was no difference between the NPDR and PDR patients for impression cytology grading scores.CONCLUSION:It is determined that impression cytology grades are altered in patients with NPDR and PDR.Consequently,we suggest that there might be an association between the impression cytology grading scores and the severity of diabetic展开更多
● AIM: To evaluate the features and outcome of management of malignant conjunctival squamous tumors in King Hussein Cancer Center(a referral tertiary cancer center in the Middle East).● METHODS: Retrospective case s...● AIM: To evaluate the features and outcome of management of malignant conjunctival squamous tumors in King Hussein Cancer Center(a referral tertiary cancer center in the Middle East).● METHODS: Retrospective case series of 31 eyes for 31 patients with conjunctival squamous neoplasia. Main outcome measures included: age, gender, laterality, tumor location, pathological features, tumor stage, treatment modality, and outcome.● RESULTS: Twenty(65%) patients were males and median age was 58 y. Twenty-two(71%) eyes had the tumor in the nasal quadrant. Tumor invasion to nearby structures was seen in 19(61%) eyes, including the cornea, fornix, eyelid, and orbit in 17(55%), 1(3%), 2(6%), and 3(10%) eyes, respectively. Eye salvage was achieved by surgical excision with cryotherapy followed by topical chemotherapy in 28(90%) eyes, and orbital exenteration was necessary in 3(10%) eyes due to orbital tumor invasion. Tumor recurrence was seen in 7(23%) eyes, and the significant predictive factors for recurrence were tumor extension onto the nearby structures(P=0.04), tumor invasiveness(P=0.038), and tumor TNM stage(P=0.031). No significant change in visual acuity was seen, and disease related mortality was 6%(2 patients, both had orbital invasion by invasive squamous carcinoma).● CONCLUSION: Conjunctival squamous carcinoma is more common in males. Advanced American Joint Committee on Cancer(AJCC) T-stage, tumor local invasion, more pathologically aggressive tumors, and surgical treatment alone(without adjuvant therapy) are associated with higher risk for recurrence, and orbital invasion is the most important poor prognostic factor for metastasis and death. Treatment strategies should be affected by tumor characteristics at presentation.展开更多
AIM:To evaluate the frequency of bacterial flora of conjunctiva after death(cadaver eyes) which will give information about the bacterial contamination of donor eyes,and the in-vitro sensitivity of isolated bacteria t...AIM:To evaluate the frequency of bacterial flora of conjunctiva after death(cadaver eyes) which will give information about the bacterial contamination of donor eyes,and the in-vitro sensitivity of isolated bacteria to the commonly used antibiotics in ophthalmic practice.METHODS:Conjunctival swabs were taken from the cadavers(motor vehicle accident deaths and patients who died in the hospital),within 6h after death,and sent for culture and sensitivity test.Conjunctival swabs,taken from the healthy conjunctiva of patients admitted for cataract surgery,were sent for culture and sensitivity as controls(eyes in those of living status).The bacterial isolates were tested against the commonly used antibiotics(chloramphenicol,gentamicin,ciprofloxacin) in ophthalmology practice.RESULTS:Bacteria were isolated in 41 out of 100 conjunctival swabs(41%),taken from 50 cadavers(study group).Coagulase negative staphylococcus was the most common bacteria isolated(15%),followed by pseudomonas aeruginosa(5%).Gentamicin was effective against majority of the bacterial isolates(82%).Bacteria were isolated from 7 out of 100 conjunctival swabs taken as control group(eyes in living state).Coagulase negative staphylococcus was the most common organism(5%) isolated in control group;the others were staphylococcus aureus(1%) and beta hemolyticus streptococci(1%).CONCLUSION:Bacteria were isolated from 41% of the cadaver eyes.High percentage sensitivity of the bacterial isolates to gentamicin(82%) supports the practice of thorough irrigation of the eyes with gentamicin solution before starting the procedure of enucleation followed by immersion of the enucleated eyeballs in gentamycin solution,to prevent the bacterial contamination.展开更多
To revise the peer-reviewed literature on geometric properties of the scleral-conjunctival structure in order to define their clinical relevance and the potential relationship between their changes and myopia developm...To revise the peer-reviewed literature on geometric properties of the scleral-conjunctival structure in order to define their clinical relevance and the potential relationship between their changes and myopia development or progression.A bibliographic search focused on the study of the geometry of conjunctiva and/or sclera as well as those studies evaluating the relationship between geometric changes in the scleral-conjunctival structure and myopia was carried out.Several studies have been performed with different diagnostic technologies,including optical coherence tomography,profilometry and Scheimpflug imaging,to detect geometric changes of the scleralconjunctival tissue in different physiological conditions of the eye,after use of contact lenses and in different ocular pathologies.Likewise,these technologies have been shown to be a valuable clinical tool to optimize scleral contact lens fitting.Future studies should investigate new potential clinical applications of such technologies,including the evaluation of anterior scleral changes related to myopia,as well as to define standardized clinical standard operating procedures for obtaining accurate and reproducible clinical measurement of the scleral-conjunctival morphology.展开更多
Purpose: To assess prevalence of and risk factors for conjunctival colonization and types of organisms among adults undergoing elective intraocular surgery. Setting: Ha’Emek Medical Center, Afula, Israel. Methods: A ...Purpose: To assess prevalence of and risk factors for conjunctival colonization and types of organisms among adults undergoing elective intraocular surgery. Setting: Ha’Emek Medical Center, Afula, Israel. Methods: A prospective study conducted in the Ophthalmology Department at Ha’Emek Medical Center, Afula, Israel between May 1, 2006 and August 31, 2007. Included were adults undergoing elective intraocular surgeries. Conjunctival cultures were obtained from the lower fornix, prior to application of prophylactic decolonization treatment and were processed using routine microbiological techniques. Demographic, socioeconomic and medical data of our patient cohort were obtained from all participants. Results: Cultures were obtained from 501 patients. (Mean age 69.7 ± 12.0 years) of whom 52.1% were females. In 208 patients (40.5%) bacteria grew in conjunctival cultures, one type in 175 (34.9%) one, and two types in 28 (5.6%). In none fungi were isolated. Coagulase negative Staphylococcus was the most frequent bacteria isolated. By multivariate analysis, significant risk factors for conjunctival bacterial colonization were spring/summer seasons (OR 1.64, CI 1.15 - 2.36, P < 0.007), and showering on the day of the operation (OR 1.73, CI 1.11 - 2.69, P < 0.01). Conclusions: In addition to previously known risk factors for conjunctival microorganism colonization, the present study found showering on the morning of the operation, possibly related to bacteria on towels or in the eyelids and lashes, and time of year (spring/summer) perhaps resulting from higher temperature and humidity related to the presence of conjunctival bacteria to be significant in adults undergoing intraocular surgery.展开更多
Introduction: The conjunctiva is a thin, superficial mucosa that covers the anterior part of the eye lids and the anterior part of the sclera. The semi-lunar fold is located in the interior angle of the eye, and repre...Introduction: The conjunctiva is a thin, superficial mucosa that covers the anterior part of the eye lids and the anterior part of the sclera. The semi-lunar fold is located in the interior angle of the eye, and represents the third rudimentary eyelid. In the histological aspect, conjunctiva is composed of the epithelium and stroma. Thestroma is divided into two parts: the superficial adenoid part and the inner fibrotic part. The accessory lacrimal glands are found in the stroma. Materials and methods: A case study of a 14 year-old male patient, who came at our clinic as a result of a 5 - 6 mm tumefaction on the bulbar conjunctiva, on the nasal part of the bulbar conjunctiva, attached to the semi-lunar fold. The patient referred that the cyst appeared 6 - 7 months ago and was constantly growing. In the beginning the patient has been treated with antibiotic and corticosteroid eye drops. However, the cyst grew constantly therefore the best solution was the surgical treatment. The surgery was performed under local anesthesia. The total excision of the cyst was performed. The removed tumefaction was then diagnosed as a cyst of the conjunctival stroma. Purpose: The purpose of this study is to show that the best treatment of the conjunctival epithelium tumefaction, which is not reduced in size by the local treatment with antibiotics and corticosteroids, is the surgical treatment. Conclusion: Every change in the conjunctiva, causing functional and aesthetic problems, is an issue that should be directed to the ophthalmologist. Such changes should be treated with medications or surgically, the patient should be followed up, to see whether or not such changes will reappear.展开更多
Conjunctival squamous cell carcinoma is a common malignant tumor in adults. It affects the peri-limbic conjunctiva. This is a neoplasia that is increasing in tropical Africa because it occurs in subjects with prolonge...Conjunctival squamous cell carcinoma is a common malignant tumor in adults. It affects the peri-limbic conjunctiva. This is a neoplasia that is increasing in tropical Africa because it occurs in subjects with prolonged exposure to ultraviolet rays, in patients immunocompromised to the human immunodeficiency virus and HPV infection. Computed tomography allows one to make a diagnosis. We report the case of 57 patients in whom the diagnosis was made radiologically and confirmed by histology.展开更多
Dear Sir, I am Dr. Boyun Kim, form the Department of Ophthalmology, Bucheon St. Mary’s Hospital, Bucheon, Korea. I write to present a case report of apocrine hidrocystoma on temporal bulbar conjunctiva. Apocrine hidr...Dear Sir, I am Dr. Boyun Kim, form the Department of Ophthalmology, Bucheon St. Mary’s Hospital, Bucheon, Korea. I write to present a case report of apocrine hidrocystoma on temporal bulbar conjunctiva. Apocrine hidrocystoma (AH) is a benign cutaneous cystic nodule arising from apocrine glands of Moll [1]. This lesion usually occurs on eyelids and canthus [1,2], ears, chest, shoulders in adults but its occurrence in conjunctiva [3]展开更多
<span style="font-family:Verdana;">We report a case of a unilateral conjunctival neoformation in a 44-year-old female melanoderma subject. It was a conjunctival squamous cell carcinoma (CSC). The risk ...<span style="font-family:Verdana;">We report a case of a unilateral conjunctival neoformation in a 44-year-old female melanoderma subject. It was a conjunctival squamous cell carcinoma (CSC). The risk factor was exposure to sunlight and dust. No HIV or HPV infection was found. The treatment consisted of</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">simple removal of the tumour with a healthy margin of 3 to 4 mm. After a postoperative follow-up of 18 months, there was no recurrence. As CSC is the most common conjunctival malignancy and given the rate of recurrence with the possibility of associated local invasion, early diagnosis with long-term follow-up is necessary.</span>展开更多
Objective:To investigate the effect of vault on conjunctiva combined with fascia sheath suspension on the mobility and aesthetics of eyelid in patients with ptosis.Methods:A total of 80 patients with ptosis who were a...Objective:To investigate the effect of vault on conjunctiva combined with fascia sheath suspension on the mobility and aesthetics of eyelid in patients with ptosis.Methods:A total of 80 patients with ptosis who were admitted to our hospital from January 2017 to January 2019 were selected as the subjects.They were divided into 2 groups with random number table method,40 cases each.The control group was treated with modified single-incision frontalis fascia flap suspension,and the observation group was treated with vault on conjunctiva combined with fascia sheath suspension.The eyelid margin activity,aesthetics and complications were compared between the two groups.Results:The eyelid margin activity of the observation group after treatment was higher than that of the control group,the difference was statistically significant(P<0.05);the aesthetic satisfaction of the observation group after treatment was 95.00%(38/40)higher than that of the control group 70.00%(28/40)The difference was statistically significant(P<0.05);the incidence of complications in the observation group was 2.50%(1/40)lower than that in the control group 20.00%(8/40),and the difference was statistically significant(P<0.05).Conclusion:Patients with ptosis are treated with superior conjunctival fornix combined with fascia sheath suspension,which can improve the mobility of eyelid margin,and it is more beautiful and has less complications.展开更多
Background:Invasive squamous carcinoma(SCC)is the most frequent malignant neoplasia of the conjunctiva,33%of which will metastasize.C-erbB-2/neu(HER2)is an oncogene associated with poor prognosis,metastatic potential ...Background:Invasive squamous carcinoma(SCC)is the most frequent malignant neoplasia of the conjunctiva,33%of which will metastasize.C-erbB-2/neu(HER2)is an oncogene associated with poor prognosis,metastatic potential and aggressive behavior in several tumors,including breast,stomach,among others.HER2 amplification is also associated with the response to anti-HER2 treatment.The aim of this study is to evaluate HER2 expression in the progression of ocular surface squamous neoplasia(OSSN)and as a potential therapeutical target.Methods:Ninety-eight OSSN lesions including 17 papillomas(P),27 conjunctival intraepithelial neoplasia(CIN)I,19 CIN II,13 CIN III,and 11 SCC were evaluated.Eleven conjunctivas from normal human eyes(NHE)were also included in the analysis.Immunohistochemistry was performed to analyze HER2(clone 29D8)expression,which was graded as follows:complete membrane staining in more than 10%of malignant cells(3+);week to moderate complete staining in more than 10%of malignant cells(2+);none or fewer than 10%cells staining(0 to 1+,respectively).Positive HER2 was considered when a score 2+or 3+was determined.Breast carcinoma with HER2 amplification was used as a positive control.FISH technique was performed in the positive cases to confirm results.Statistical analysis was performed using Fisher’s exact test.Results:HER2 positive expression was detected in 6%of P(100%score 2+),11%of CIN I(100%score 2+),32%of CIN II(100%score 2+),30%of CIN III(100%score 2+),29%of SCC(50%score 2+and 50%score 3+).Benign lesions showed lower HER2 expression than in situ(P=0.03)and invasive tumors(P=0.02).No correlation between HER2 and age or tumor thickness in SCC was found(P>0.05).Conclusions:HER2 is expressed in conjunctival SCC.Moreover,one third of SCC were graded as 2+or 3+.These results support the evaluation of anti-HER2 therapy in conjunctival SCC.Pre-clinical trials should be performed to determine the importance of this marker in conjunctival SCC for predicting response to treatments targeting this pathway.展开更多
AIM: To evaluate the recurrence and complications after bare sclera resection(BSR) combined with mitomycin C(MMC) treatment and/or autograft limbus conjunctiva(ALC) in the surgery for pterygium.·METHODS: Meta-ana...AIM: To evaluate the recurrence and complications after bare sclera resection(BSR) combined with mitomycin C(MMC) treatment and/or autograft limbus conjunctiva(ALC) in the surgery for pterygium.·METHODS: Meta-analysis was used to evaluate the differences in patient outcomes between BSR of pterygium with or without MMC and/or ALC. All included studies were randomized trials of patients with pterygium who received BSR followed by MMC and/or ALC in the surgery. The recurrence of pterygium and other complications resulting from different treatments were extracted for analysis.·RESULTS: Thirteen studies met the inclusion criteria.The recurrence of pterygium with intraoperative(IO) MMC was higher than that with ALC(OR=2.38,95% confidence interval 1.45-3.91, I2=29%). Postoperative MMC resulted in an incidence of recurrence similar to that of ALC(OR=0.66, 95% confidence interval 0.30-1.42, I2=0%), and IO MMC treatment in combination with ALC produced similar patient outcomes to ALC alone(OR =0.41, 95%confidence interval 0.16-1.01, I2=16%). Other complications such as punctate epitheliopathy, scleral thinning and ischemia, irritation and persistent epithelium defect, were more common in patients in the MMC group as compared to those treated with ALC.·CONCLUSION: The recurrence of pterygium with BSR followed by ALC is lower than that of BSR followed by MMC, and the incidence of other complications is lower.While ALC is a more effective strategy for treating pterygium, the quality of the ALC transplant should be considered when the patient has a history of glaucoma.展开更多
AIM:To investigate the expression of matrix metalloproteinases 1 and 3(MMP-1 and MMP-3) and their tissue inhibitors of metalloproteinases 1 and 3( TIMP-1 and TIMP-3) in the conjunctiva of eyes with conjunctivochalasis...AIM:To investigate the expression of matrix metalloproteinases 1 and 3(MMP-1 and MMP-3) and their tissue inhibitors of metalloproteinases 1 and 3( TIMP-1 and TIMP-3) in the conjunctiva of eyes with conjunctivochalasis(CCh).METHODS:The conjunctival tissue was obtained from the CCh patients and controls,the MMPs/TIMPs expression concentration was determined by enzyme-linked immunosorbent assay(ELISA) and immunofluorescence staining.The expression levels of MMPs/TIMPs in the CCh fibroblasts were determined by analyzing its concentration in the cellular supernatant that was abstracted from the in vitro cultured CCh fibroblasts.RESULTS:MMP-1 and MMP-3 levels determined by ELISA were both significantly higher in the CCh group than that in the control group(P= 0.042,0.022,respectively),so was the levels of TIMP-1(P= 0.010).No significant difference in the expression of TIMP-3 in conjunctiva was found between the two groups(P= 0.298).The expression of MMP-1 and MMP-3 were both up-regulated significantly in the CCh group(P= 0.040,0.001,respectively) on immunofluorescence staining.MMP-1 and MMP-3 expression in the fibroblasts were both significantly higher in the CCh group than that in the control group(P= 0.027,0.001,respectively),while neither the TIMP-1 nor TIMP-3 expression was significantly different between the two groups(P= 0.421,0.237,respectively).CONCLUSION:The overexpression of MMP-1 and MMP-3 in conjunctival tissue and fibroblasts may play an important role in the pathogenesis and development of CCh.展开更多
AIM: To determine the types and incidence of tumors affecting the orbit, conjunctiva and lacrimal glands and to study the trend line of these tumors in the United States from 1973 to 2009.·METHODS: We used the pu...AIM: To determine the types and incidence of tumors affecting the orbit, conjunctiva and lacrimal glands and to study the trend line of these tumors in the United States from 1973 to 2009.·METHODS: We used the publicly available Surveillance,Epidemiology and End Results(SEER) database registries to determine the incidence rates. Age was adjusted to the 2000 US Standard Population. Patients were stratified according to age group, gender, race and histological grouping of tumor lesions. Three age groups were defined: 0-19, 20-49 and ≥50y. Annual percentage changes were calculated to examine trends.·RESULTS: The overall age adjusted incidence rate was3.39(95% CI: 3.27-3.52) per million person-years. The tumors were more prevalent in age group ≥50 counting9.51(95%CI: 9.11-9.92) per million person-years. Most of the soft tissue sarcomas occurred in the young age with incidence rate of 0.35(95% CI: 0.28-0.42) per million person-years. Lymphomas were the dominant subtype in the adult population with incidence rate of 5.74(95% CI:5.43-6.06) per million person-years. Incidence rates were higher in males than females with an overall rate ratio of1.31(95%CI: 1.21-1.41) mainly caused by the increase in carcinoma subtypes. White race had a higher tumor incidence with a rate ratio of 1.47(95% CI: 1.25-1.73)driven by the higher incidence of most histological subtypes. Orbital tumors showed a higher incidence rate followed by conjunctival and lacrimal gland tumors with incidence rates of 1.59, 1.37 and 0.43 per million personyears respectively. The trend line of overall incidence of tumors showed a significant increase(APC=3.11, 95%CI:2.61-3.61) mainly due to increase of lymphomas. This increase was higher than the increase of lymphomas at other sites.·CONCLUSION: Orbital, conjunctival and lacrimal gland malignant tumors differ among children and adults. Over the years there has been a noticeable increase in incidence rates of orbital and lacrimal gland tumors mainly caused by an increase in lymphomas and an apparent increase due to advances in diagnostic techniques. ICD-O-3 topographical coding should be improved to consider the different orbital bones and ocular structures.展开更多
文摘BACKGROUND Anaplastic lymphoma kinase(ALK)-positive large B-cell lymphoma(LBCL)is an aggressive and rare variant of diffuse LBCL.Herein,we report an uncommon case of stage IE extranodal ALK-positive LBCL initially originating in the bulbar con-junctiva.CASE SUMMARY A 63-year-old woman presented with a mass in the left bulbar conjunctiva that had persisted for six months,accompanied by swelling and pain that had per-sisted for 3 d.Eye examination revealed an 8 mm slightly elevated pink mass in the lower conjunctival sac of the left eye.Microscopically,the tumor was com-posed of large immunoblastic and plasmablastic large lymphoid cells with scattered anaplastic or multinucleated large cells.Immunophenotypically,the neoplastic cells were positive for ALK,CD10,CD138,Kappa,MUM1,BOB.1,OCT-2,CD4,CD45,EMA,CD79a,CD38,and AE1/AE3,and negative for CD20,PAX5,Lambda,BCL6,CD30 and all other T-cell antigens.The results of gene rearrangement tests showed monoclonal IGH/IGK/IGL and TCRD rearran-gements.Fluorescence in situ hybridization studies did not reveal any BCL2,BCL6 or MYC rearrangements.Furthermore,Epstein-Barr virus was not detected by in situ hybridization in the lesions.Based on the histopathological and imaging examinations,the neoplasm was classified as stage IE ALK-positive LBCL.No further treatments were administered.At the 6,15,and 21 mo postoperative follow-up visits,the patient was in good condition,without obvious discomfort.This case represents the first example of primary extranodal ALK-positive LBCL presenting as a bulbar conjunctival mass,which is extremely rare and shares morphological and immunohistochemical features with a variety of other neo-plasms that can result in misdiagnosis.CONCLUSION Awareness of the condition presented in this case report is necessary for early and accurate diagnosis and appropriate treatment.
文摘Background:To evaluate the conjunctival flap cover surgery for the treatment of ocular surface disorders.Methods:Retrospective uncontrolled study was performed.A total of 253 eyes of 253 patients who had received conjunctival flap cover surgery during a 10-year period were included.The indications,symptoms and complications experienced by patients undergoing partial or total conjunctival flap cover surgery were reviewed.Results:In all of these cases,satisfactory anatomic and functional outcomes were achieved.The BCVA of 224 eyes out of 253 patients(88.5%)were no worse than that of preoperative and the BCVA of 29 eyes out of 253 patients(11.5%)decreased postoperatively.No eye pain,foreign body sensation and other discomforts presented in the last visit.The surgical indications was therapeutic for 138 out of 253 patients(54.5%),aesthetic for 63 eyes out of 253 patients(24.9%),tectonic for 45 eyes out of 253 patients(17.8%),and analgesic for 7 eyes out of 253 patients(2.8%).The primary diagnose of therapeutic indications is refractory corneal ulcer for 135 eyes out of 253 patients(53.4%).The main diagnose of aesthetic indications is atrophy of eyeball for 45 eyes out of 253 patients(17.8%)and corneal leukoma for 18 eyes out of 253 patients(7.1%).The principal diagnose of tectonic indications is corneal perforation for 43 eyes out of 253 patients(17%).The main intraoperative complications is buttonhole formation for 8 eyes out of 253 patients(3.2%),which can be handled by simple suture.The most severe complications postoperatively was conjunctival flaps dissolving and corneal perforation for 3 eyes out of 253 patients(1.2%),and corneal transplantation had to be performed to avoid enucleation.In addition,4 eyes out of 253 patients(1.6%)presented cystic flap and two of them received surgical excision.Conclusions:Conjunctival flap cover surgery is an underused technique.Its primary indication is refractory corneal ulcer and corneal perforation,and its second indication is aesthetic with poor visual potential coexisting ocular surface diseases.It represents an interesting alternative to more mutilating surgeries.
文摘Objective:To determine the prevalence of HIV seropositivity among patients with squamous cell carcinoma of the conjunctiva.Methods:All patients with clinical and histopathological confirmation of squamous cell carcinoma seen during a ten year period(July 1999 to June 2009) were tested for HIV(Human Immunodeficiency Virus).The number of patients with squamous cell carcinoma of the conjunctiva who are HIV positive were counted.Results:A total of thirty-three(33) eyes in thirtytwo(32) patients were confirmed histopathologically to have conjunctival squamous cell carcinoma. Their ages ranged from 22 years to 66 yean with a mean age of(38.6± 11.8) years(SD).The male to female ratio was 1:1.5.Twenty four(75%) of these patients were HIV positive.Conclusions: Squamous cell carcinoma is associated with the human immunodeficiency virus and is thus a marker for the disease in Benin City,Nigeria.
基金Supported by the National Natural Science Foundation of China(No.81670839)the Key Research and Development Plan of Shandong Province(No.2018CXGC1205)
文摘AIM: To investigate the ocular surface microbiome profile of patients with fungal keratitis(FK) through bacterial 16 S r DNA sequencing. METHODS: The swab samples were collected from 8 patients with FK(Group 1 from the corneal ulcer, Group 2 from the conjunctival sac of the infected eyes, and Group 3 from the conjunctival sac of the fellow eyes) and 10 healthy eyes(Group 4 from the conjunctival sac). Bacterial 16 S rDNA V4-V5 region sequencing was performed to characterize the bacterial communities on the ocular surfaces of the patients with FK. RESULTS: Our metagenomic data showed that 97% of the sequence reads were categorized into 245 distinct bacterial genera, with 67.75±7.79 genera detected in Group 1, 73.80±13.44 in Group 2, 74.57±14.14 in Group 3, and 89.60±27.49 in Group 4. Compared with the healthy eyes(Group 4), both infected(Groups 1 and 2) and fellow eyes(Group 3) of the patients with FK showed reduced bacterial diversity and altered ocular surface microbiota compositions, with lower abundance of Corynebacterium and Staphylo coccus and higher abundances of Pseudomonas, Achromobacter, Caulobacter and Psychrobacter. CONCLUSION: Our report depicts the altered ocular surface bacterial community structures both in the affected and fellow eyes of patients with FK. These changes may contribute to the pathogenesis of FK or the increased risk for FK.
文摘AIM:To determine the possibility of the development of dry eye disease(DED) as a result of persistent infection with Chlamydia trachomatis and Ureaplasma urealyticum in the conjunctiva of patients.METHODS: This study was conducted on 58 patients of age range 20-50 y,diagnosed with DED confirmed by Schirmer I test and tear breakup time.The non-dry eye control group included 27 subjects of the same age.Ocular specimens were collected as conjunctival scrapings and swabs divided into three groups: the first used for bacterial culture,the second and third taken to detect Chlamydia trachomatis and Ureaplasma urealyticum by direct fluorescent antibody(DFA) assay and polymerase chain reaction(PCR) method. RESULTS: Chlamydia trachomatis was detected in 65.5% and 76% of DED patients by DFA and PCR methods respectively.Ureaplasma urealyticum was found in 44.8% of DED infected patients using the PCR method.Both organisms were identified in only 37.9% of DED patients found to be infected.Control subjects had a 22%detection rate of Chlamydia trachomatis by DFA assay versus a 7% detection rate by PCR; while Ureaplasma urealyticum was detected in 3.7% of the controls by PCR method.The conjunctival culture revealed that gram positive microorganisms represented 75% of isolates with coagulase negative Staphylococci the most common(50%) followed by Staphylococcus aureus(20%),whereas gram negative microorganisms occurred in 25% of cases,isolating Moraxella spp.as the most frequent organism. CONCLUSION: Our results tend to point out that Chlamydia trachomatis and Ureaplasma urealyticum were detected in a moderate percentage of patients with DED,and could be a fair possibility for its development.PCR is more reliable in detecting Chlamydia trachomatis than DFA technique.The presence of isolated conjunctival bacterial microflora can be of some potential value.
基金National Natural Science Foundation of China (No.81271035/H1205)Sichuan Provincial Health Ministry Research Fund,China (No.080302)
文摘AIM:To compare the bacterial flora in palpebral conjunctiva of xerophthalmia seniors of Tibetan,Yi and Han,and analyze the differences and similarities of the bacteria.·METHODS:The test subjects were selected from 2Tibetan,2 Yi and 3 Han populated places,respectively.Total 222 seniors(444 eyes) with dry eye were examined.Secretion was collected from the palpebral conjunctiva of the subjects and then inoculated onto a blood agar plate.After 48h of incubation,the bacteria were examined for the differences and similarities between different ethnics.·RESULTS:There was no significant difference(P >0.05)of Gram stain characterization,dominant bacteria and number of the bacterial species present in oxrophthalmia patients among Tibetan,Yi and Han nationalities.The bacteria presented in all groups include staphylococcus epidermidis,corynebacterium,micrococcus luteu,int-racellular bacteria sphingomonas,pseudomonas aerug-inosa.The bacteria detected from the two of three ethnic groups were staphylococcus aureus,staphylococcus haemolyticus,escherichia coli,kytococcus sedentarius,streptococcus angina,micrococcus lylae,and staphy-lococcus heads.The incidence rate of bacteria-associated dry eye in Tibetan population was significantly lower than that of Han and Yi population.·CONCLUSION:There is no significant difference in the bacteria flora of palpebral conjunctiva observed among dry eye elder populations of Tibetan,Yi and Han people.All of staphylococcus epidermidis,corynebacterium,micrococcus luteu,intracellular bacteria sphingomonas,pseudomonas aeruginosa,staphylococcus aureus,staphylococcus haemolyticus,escherichia coli,kytococcus sedentarius,streptococcus angina,micrococcus lylae and staphylococcus heads are common bacteria flora of the three nationalities inhibiting in this area.
文摘AIM:To examine the integrity of the ocular surfaces of subjects with and without diabetes with no conjunctival and dry eye signs and symptoms and compare conjunctival impression cytology findings in diabetics with non-proliferative and proliferative diabetic retinopathy.METHODS:Conjunctival impression cytology was performed on 43 eyes of 43 subjects with nonproliferative diabetic retinopathy(NPDR),42 eyes of 42subjects with proliferative diabetic retinopathy(PDR),and30 eyes of 30 control subjects.Impression cytology specimens of each group were graded and scored in the range 0-3 according to Nelson's method.RESULTS:There were 45(52.9%)women and 40(47.1%)men.The mean age of the patients was 59.6±9.3y(range,43-76y)in NPDR group and 58.0±8.8y(range,41-85y)in PDR group.Cases with NPDR and PDR showed statistically significant higher impression cytology scores than control group(P<0.05).There was no difference between the NPDR and PDR patients for impression cytology grading scores.CONCLUSION:It is determined that impression cytology grades are altered in patients with NPDR and PDR.Consequently,we suggest that there might be an association between the impression cytology grading scores and the severity of diabetic
文摘● AIM: To evaluate the features and outcome of management of malignant conjunctival squamous tumors in King Hussein Cancer Center(a referral tertiary cancer center in the Middle East).● METHODS: Retrospective case series of 31 eyes for 31 patients with conjunctival squamous neoplasia. Main outcome measures included: age, gender, laterality, tumor location, pathological features, tumor stage, treatment modality, and outcome.● RESULTS: Twenty(65%) patients were males and median age was 58 y. Twenty-two(71%) eyes had the tumor in the nasal quadrant. Tumor invasion to nearby structures was seen in 19(61%) eyes, including the cornea, fornix, eyelid, and orbit in 17(55%), 1(3%), 2(6%), and 3(10%) eyes, respectively. Eye salvage was achieved by surgical excision with cryotherapy followed by topical chemotherapy in 28(90%) eyes, and orbital exenteration was necessary in 3(10%) eyes due to orbital tumor invasion. Tumor recurrence was seen in 7(23%) eyes, and the significant predictive factors for recurrence were tumor extension onto the nearby structures(P=0.04), tumor invasiveness(P=0.038), and tumor TNM stage(P=0.031). No significant change in visual acuity was seen, and disease related mortality was 6%(2 patients, both had orbital invasion by invasive squamous carcinoma).● CONCLUSION: Conjunctival squamous carcinoma is more common in males. Advanced American Joint Committee on Cancer(AJCC) T-stage, tumor local invasion, more pathologically aggressive tumors, and surgical treatment alone(without adjuvant therapy) are associated with higher risk for recurrence, and orbital invasion is the most important poor prognostic factor for metastasis and death. Treatment strategies should be affected by tumor characteristics at presentation.
基金University of Malaya,Kuala Lumpur,short term research grant(No.F0704/2002D)
文摘AIM:To evaluate the frequency of bacterial flora of conjunctiva after death(cadaver eyes) which will give information about the bacterial contamination of donor eyes,and the in-vitro sensitivity of isolated bacteria to the commonly used antibiotics in ophthalmic practice.METHODS:Conjunctival swabs were taken from the cadavers(motor vehicle accident deaths and patients who died in the hospital),within 6h after death,and sent for culture and sensitivity test.Conjunctival swabs,taken from the healthy conjunctiva of patients admitted for cataract surgery,were sent for culture and sensitivity as controls(eyes in those of living status).The bacterial isolates were tested against the commonly used antibiotics(chloramphenicol,gentamicin,ciprofloxacin) in ophthalmology practice.RESULTS:Bacteria were isolated in 41 out of 100 conjunctival swabs(41%),taken from 50 cadavers(study group).Coagulase negative staphylococcus was the most common bacteria isolated(15%),followed by pseudomonas aeruginosa(5%).Gentamicin was effective against majority of the bacterial isolates(82%).Bacteria were isolated from 7 out of 100 conjunctival swabs taken as control group(eyes in living state).Coagulase negative staphylococcus was the most common organism(5%) isolated in control group;the others were staphylococcus aureus(1%) and beta hemolyticus streptococci(1%).CONCLUSION:Bacteria were isolated from 41% of the cadaver eyes.High percentage sensitivity of the bacterial isolates to gentamicin(82%) supports the practice of thorough irrigation of the eyes with gentamicin solution before starting the procedure of enucleation followed by immersion of the enucleated eyeballs in gentamycin solution,to prevent the bacterial contamination.
基金Supported by the Project UAIND18-06B of the University of Alicante within the program“Ayudas destinadas a la formación predoctoral en colaboración con empresas 2018”supported by the Vicerrectorado de Investigación y Transferencia de Conocimientosupported by the Ministry of Economy,Industry and Competitiveness of Spain within the program Ramón y Cajal,RYC-2016-20471。
文摘To revise the peer-reviewed literature on geometric properties of the scleral-conjunctival structure in order to define their clinical relevance and the potential relationship between their changes and myopia development or progression.A bibliographic search focused on the study of the geometry of conjunctiva and/or sclera as well as those studies evaluating the relationship between geometric changes in the scleral-conjunctival structure and myopia was carried out.Several studies have been performed with different diagnostic technologies,including optical coherence tomography,profilometry and Scheimpflug imaging,to detect geometric changes of the scleralconjunctival tissue in different physiological conditions of the eye,after use of contact lenses and in different ocular pathologies.Likewise,these technologies have been shown to be a valuable clinical tool to optimize scleral contact lens fitting.Future studies should investigate new potential clinical applications of such technologies,including the evaluation of anterior scleral changes related to myopia,as well as to define standardized clinical standard operating procedures for obtaining accurate and reproducible clinical measurement of the scleral-conjunctival morphology.
文摘Purpose: To assess prevalence of and risk factors for conjunctival colonization and types of organisms among adults undergoing elective intraocular surgery. Setting: Ha’Emek Medical Center, Afula, Israel. Methods: A prospective study conducted in the Ophthalmology Department at Ha’Emek Medical Center, Afula, Israel between May 1, 2006 and August 31, 2007. Included were adults undergoing elective intraocular surgeries. Conjunctival cultures were obtained from the lower fornix, prior to application of prophylactic decolonization treatment and were processed using routine microbiological techniques. Demographic, socioeconomic and medical data of our patient cohort were obtained from all participants. Results: Cultures were obtained from 501 patients. (Mean age 69.7 ± 12.0 years) of whom 52.1% were females. In 208 patients (40.5%) bacteria grew in conjunctival cultures, one type in 175 (34.9%) one, and two types in 28 (5.6%). In none fungi were isolated. Coagulase negative Staphylococcus was the most frequent bacteria isolated. By multivariate analysis, significant risk factors for conjunctival bacterial colonization were spring/summer seasons (OR 1.64, CI 1.15 - 2.36, P < 0.007), and showering on the day of the operation (OR 1.73, CI 1.11 - 2.69, P < 0.01). Conclusions: In addition to previously known risk factors for conjunctival microorganism colonization, the present study found showering on the morning of the operation, possibly related to bacteria on towels or in the eyelids and lashes, and time of year (spring/summer) perhaps resulting from higher temperature and humidity related to the presence of conjunctival bacteria to be significant in adults undergoing intraocular surgery.
文摘Introduction: The conjunctiva is a thin, superficial mucosa that covers the anterior part of the eye lids and the anterior part of the sclera. The semi-lunar fold is located in the interior angle of the eye, and represents the third rudimentary eyelid. In the histological aspect, conjunctiva is composed of the epithelium and stroma. Thestroma is divided into two parts: the superficial adenoid part and the inner fibrotic part. The accessory lacrimal glands are found in the stroma. Materials and methods: A case study of a 14 year-old male patient, who came at our clinic as a result of a 5 - 6 mm tumefaction on the bulbar conjunctiva, on the nasal part of the bulbar conjunctiva, attached to the semi-lunar fold. The patient referred that the cyst appeared 6 - 7 months ago and was constantly growing. In the beginning the patient has been treated with antibiotic and corticosteroid eye drops. However, the cyst grew constantly therefore the best solution was the surgical treatment. The surgery was performed under local anesthesia. The total excision of the cyst was performed. The removed tumefaction was then diagnosed as a cyst of the conjunctival stroma. Purpose: The purpose of this study is to show that the best treatment of the conjunctival epithelium tumefaction, which is not reduced in size by the local treatment with antibiotics and corticosteroids, is the surgical treatment. Conclusion: Every change in the conjunctiva, causing functional and aesthetic problems, is an issue that should be directed to the ophthalmologist. Such changes should be treated with medications or surgically, the patient should be followed up, to see whether or not such changes will reappear.
文摘Conjunctival squamous cell carcinoma is a common malignant tumor in adults. It affects the peri-limbic conjunctiva. This is a neoplasia that is increasing in tropical Africa because it occurs in subjects with prolonged exposure to ultraviolet rays, in patients immunocompromised to the human immunodeficiency virus and HPV infection. Computed tomography allows one to make a diagnosis. We report the case of 57 patients in whom the diagnosis was made radiologically and confirmed by histology.
文摘Dear Sir, I am Dr. Boyun Kim, form the Department of Ophthalmology, Bucheon St. Mary’s Hospital, Bucheon, Korea. I write to present a case report of apocrine hidrocystoma on temporal bulbar conjunctiva. Apocrine hidrocystoma (AH) is a benign cutaneous cystic nodule arising from apocrine glands of Moll [1]. This lesion usually occurs on eyelids and canthus [1,2], ears, chest, shoulders in adults but its occurrence in conjunctiva [3]
文摘<span style="font-family:Verdana;">We report a case of a unilateral conjunctival neoformation in a 44-year-old female melanoderma subject. It was a conjunctival squamous cell carcinoma (CSC). The risk factor was exposure to sunlight and dust. No HIV or HPV infection was found. The treatment consisted of</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">simple removal of the tumour with a healthy margin of 3 to 4 mm. After a postoperative follow-up of 18 months, there was no recurrence. As CSC is the most common conjunctival malignancy and given the rate of recurrence with the possibility of associated local invasion, early diagnosis with long-term follow-up is necessary.</span>
文摘Objective:To investigate the effect of vault on conjunctiva combined with fascia sheath suspension on the mobility and aesthetics of eyelid in patients with ptosis.Methods:A total of 80 patients with ptosis who were admitted to our hospital from January 2017 to January 2019 were selected as the subjects.They were divided into 2 groups with random number table method,40 cases each.The control group was treated with modified single-incision frontalis fascia flap suspension,and the observation group was treated with vault on conjunctiva combined with fascia sheath suspension.The eyelid margin activity,aesthetics and complications were compared between the two groups.Results:The eyelid margin activity of the observation group after treatment was higher than that of the control group,the difference was statistically significant(P<0.05);the aesthetic satisfaction of the observation group after treatment was 95.00%(38/40)higher than that of the control group 70.00%(28/40)The difference was statistically significant(P<0.05);the incidence of complications in the observation group was 2.50%(1/40)lower than that in the control group 20.00%(8/40),and the difference was statistically significant(P<0.05).Conclusion:Patients with ptosis are treated with superior conjunctival fornix combined with fascia sheath suspension,which can improve the mobility of eyelid margin,and it is more beautiful and has less complications.
文摘Background:Invasive squamous carcinoma(SCC)is the most frequent malignant neoplasia of the conjunctiva,33%of which will metastasize.C-erbB-2/neu(HER2)is an oncogene associated with poor prognosis,metastatic potential and aggressive behavior in several tumors,including breast,stomach,among others.HER2 amplification is also associated with the response to anti-HER2 treatment.The aim of this study is to evaluate HER2 expression in the progression of ocular surface squamous neoplasia(OSSN)and as a potential therapeutical target.Methods:Ninety-eight OSSN lesions including 17 papillomas(P),27 conjunctival intraepithelial neoplasia(CIN)I,19 CIN II,13 CIN III,and 11 SCC were evaluated.Eleven conjunctivas from normal human eyes(NHE)were also included in the analysis.Immunohistochemistry was performed to analyze HER2(clone 29D8)expression,which was graded as follows:complete membrane staining in more than 10%of malignant cells(3+);week to moderate complete staining in more than 10%of malignant cells(2+);none or fewer than 10%cells staining(0 to 1+,respectively).Positive HER2 was considered when a score 2+or 3+was determined.Breast carcinoma with HER2 amplification was used as a positive control.FISH technique was performed in the positive cases to confirm results.Statistical analysis was performed using Fisher’s exact test.Results:HER2 positive expression was detected in 6%of P(100%score 2+),11%of CIN I(100%score 2+),32%of CIN II(100%score 2+),30%of CIN III(100%score 2+),29%of SCC(50%score 2+and 50%score 3+).Benign lesions showed lower HER2 expression than in situ(P=0.03)and invasive tumors(P=0.02).No correlation between HER2 and age or tumor thickness in SCC was found(P>0.05).Conclusions:HER2 is expressed in conjunctival SCC.Moreover,one third of SCC were graded as 2+or 3+.These results support the evaluation of anti-HER2 therapy in conjunctival SCC.Pre-clinical trials should be performed to determine the importance of this marker in conjunctival SCC for predicting response to treatments targeting this pathway.
文摘AIM: To evaluate the recurrence and complications after bare sclera resection(BSR) combined with mitomycin C(MMC) treatment and/or autograft limbus conjunctiva(ALC) in the surgery for pterygium.·METHODS: Meta-analysis was used to evaluate the differences in patient outcomes between BSR of pterygium with or without MMC and/or ALC. All included studies were randomized trials of patients with pterygium who received BSR followed by MMC and/or ALC in the surgery. The recurrence of pterygium and other complications resulting from different treatments were extracted for analysis.·RESULTS: Thirteen studies met the inclusion criteria.The recurrence of pterygium with intraoperative(IO) MMC was higher than that with ALC(OR=2.38,95% confidence interval 1.45-3.91, I2=29%). Postoperative MMC resulted in an incidence of recurrence similar to that of ALC(OR=0.66, 95% confidence interval 0.30-1.42, I2=0%), and IO MMC treatment in combination with ALC produced similar patient outcomes to ALC alone(OR =0.41, 95%confidence interval 0.16-1.01, I2=16%). Other complications such as punctate epitheliopathy, scleral thinning and ischemia, irritation and persistent epithelium defect, were more common in patients in the MMC group as compared to those treated with ALC.·CONCLUSION: The recurrence of pterygium with BSR followed by ALC is lower than that of BSR followed by MMC, and the incidence of other complications is lower.While ALC is a more effective strategy for treating pterygium, the quality of the ALC transplant should be considered when the patient has a history of glaucoma.
基金Supported by Shanghai Municipal Health and Family Planning Commission Project(No.20124108)Putuo District of Shanghai Independent Innovation Research Foundation(No.2013PTKW009)
文摘AIM:To investigate the expression of matrix metalloproteinases 1 and 3(MMP-1 and MMP-3) and their tissue inhibitors of metalloproteinases 1 and 3( TIMP-1 and TIMP-3) in the conjunctiva of eyes with conjunctivochalasis(CCh).METHODS:The conjunctival tissue was obtained from the CCh patients and controls,the MMPs/TIMPs expression concentration was determined by enzyme-linked immunosorbent assay(ELISA) and immunofluorescence staining.The expression levels of MMPs/TIMPs in the CCh fibroblasts were determined by analyzing its concentration in the cellular supernatant that was abstracted from the in vitro cultured CCh fibroblasts.RESULTS:MMP-1 and MMP-3 levels determined by ELISA were both significantly higher in the CCh group than that in the control group(P= 0.042,0.022,respectively),so was the levels of TIMP-1(P= 0.010).No significant difference in the expression of TIMP-3 in conjunctiva was found between the two groups(P= 0.298).The expression of MMP-1 and MMP-3 were both up-regulated significantly in the CCh group(P= 0.040,0.001,respectively) on immunofluorescence staining.MMP-1 and MMP-3 expression in the fibroblasts were both significantly higher in the CCh group than that in the control group(P= 0.027,0.001,respectively),while neither the TIMP-1 nor TIMP-3 expression was significantly different between the two groups(P= 0.421,0.237,respectively).CONCLUSION:The overexpression of MMP-1 and MMP-3 in conjunctival tissue and fibroblasts may play an important role in the pathogenesis and development of CCh.
基金Supported by Grants 50015318 and 57147166 from The German Academic Exchange Service(DAAD)
文摘AIM: To determine the types and incidence of tumors affecting the orbit, conjunctiva and lacrimal glands and to study the trend line of these tumors in the United States from 1973 to 2009.·METHODS: We used the publicly available Surveillance,Epidemiology and End Results(SEER) database registries to determine the incidence rates. Age was adjusted to the 2000 US Standard Population. Patients were stratified according to age group, gender, race and histological grouping of tumor lesions. Three age groups were defined: 0-19, 20-49 and ≥50y. Annual percentage changes were calculated to examine trends.·RESULTS: The overall age adjusted incidence rate was3.39(95% CI: 3.27-3.52) per million person-years. The tumors were more prevalent in age group ≥50 counting9.51(95%CI: 9.11-9.92) per million person-years. Most of the soft tissue sarcomas occurred in the young age with incidence rate of 0.35(95% CI: 0.28-0.42) per million person-years. Lymphomas were the dominant subtype in the adult population with incidence rate of 5.74(95% CI:5.43-6.06) per million person-years. Incidence rates were higher in males than females with an overall rate ratio of1.31(95%CI: 1.21-1.41) mainly caused by the increase in carcinoma subtypes. White race had a higher tumor incidence with a rate ratio of 1.47(95% CI: 1.25-1.73)driven by the higher incidence of most histological subtypes. Orbital tumors showed a higher incidence rate followed by conjunctival and lacrimal gland tumors with incidence rates of 1.59, 1.37 and 0.43 per million personyears respectively. The trend line of overall incidence of tumors showed a significant increase(APC=3.11, 95%CI:2.61-3.61) mainly due to increase of lymphomas. This increase was higher than the increase of lymphomas at other sites.·CONCLUSION: Orbital, conjunctival and lacrimal gland malignant tumors differ among children and adults. Over the years there has been a noticeable increase in incidence rates of orbital and lacrimal gland tumors mainly caused by an increase in lymphomas and an apparent increase due to advances in diagnostic techniques. ICD-O-3 topographical coding should be improved to consider the different orbital bones and ocular structures.
