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)
Uveal melanoma is the most common primary intraocular malignancy in adults. Although it is relatively rare, it is extremely malignant, with poor treatment effect. The current treatment for primary lesions can achieve ideal local control, but there are still nearly half of the patients with distant metastasis. This article reviews the epidemiology, genetic status, diagnosis, treatment and prognosis of uveal melanoma in combination with recent advances in diagnostic and therapeutic techniques.
ObjectiveTo analyze the clinical pathological features of mushroom shaped uveal melanoma.MethodsRetrospective clinical study. From June 2001 to Aprilh 2013, pathological sections from 102 eyes of 102 patients with uveal melanoma diagnosed in Beijing Tongren Eye Center were included in the study. The sections were divided into group A (mushroom shaped uveal melanoma, 30 eyes) and group B (flat, hemisperical and spherical uveal melanoma, 72 eyes). The height-to-base ratio was calculated. The tumors size was divided into small, medium and large according to the standards of American Multicentre Study of Ocular Melanoma. The tumor cell type was divided into spindle, epithelioid, mixed and others by Improved Callender taxonomy. Motic Med 6.0 software was used to collect and measure the images. The retinal thinning rate of group A and B was compared by χ2 test.ResultsIn group A, large size in 19 eyes (63.3%), medium size in 11 eyes (36.7%). In group B, large size in 49 eyes (68.1%), medium size in 16 eyes (22.%), small size in 7 eyes (9.7%). In group A and B, the average tumor base diameter were 14.2±5.1 mm and 18.7±6.4 mm, respectively; the average tumor height were 10.0±2.1 mm and 7.6±3.9, respectively; the height-to-base ratio were 0.77±0.29 and 0.44±0.28, respectively. In group A, spindle type in 24 eyes (80.0%), epithelioid type in 1 eye (3.3%), mixed type in 5 eyes (16.7%). In group B, spindle type in 52 eyes (72.2%), epithelioid type in 5 eyes (6.9%), mixed type in 11 eyes (15.3%), and others in 4 eyes (5.6%). The proportion of retinal thinning were 73.3% (22 eyes) and 29.2% (21 eyes) in group A and B, respectively. The difference in the proportion of retinal thinning between group A and B was significant (χ2=16.94, P=0.000).ConclusionThe height of the tumor increased rapidly and the retinal thinning rate is high in mushroom shaped uveal melanoma.
ObjectiveTo detect the level of serum melanoma-inbibiting activity (MIA) in patients with uveal melanomas, and investigate the value of MIA in diagnosing and inspecting uveal melanomas.MethodsEnzyme-linked immunosorbent assay (ELISA) was used to detect the concentrations of MIA in peripheral serum of 27 patients with uveal melanoma, 6 with melanocyte tumor, 7 with other ocular tumors and 16 healthy individuals, respectively.ResultsThe concentration of MIA in patients with uveal melanoma was significantly higher than that in the healthy ones (16 individuals) and the patients with adenoma of non pigmented ciliary epithelium (4 patients), retinoblastoma (2 patients), and retinal angioma 91 patient). The concnetration of MIA in patients with uveal melanoma without scleral infiltration or remote metastasis was obviously lower than that in the patients with scleral infiltration or remote metastasis, but didn′t differ much from which in the patients with melanocyte tumor. In the patients with uveal melanoma without infiltration or remote metastasis, there was no significant difference of MIA level between patients with spindle cell and mixed and epithelioid cell.ConclusionThe level of serum MIA may be an effective index in diagnosing uveal melanoma, which can monitor the metastasis of uveal melanoma.(Chin J Ocul Fundus Dis, 2005,21:153-155)
Objectivｅ To investigate the histopathologic charact eristic of the vitreous herniation out of sclerotomy site during vitrectomy. Methods Twenty specimens of tissues herniated at vitrectomy site were collected. The paraffin sections or fresh smears were stained with hematoxylineosin and examined under light microscope. The specimens were collected from the affected eyes with rhegmatogenous retinal detachment (9 cases), traumatic retinal detachment (1 case), miscellaneous vitreous hemorrhage (6 cases) and intraocular foreign body (4 cases). Results The herniated tissues were found to be retina in 4 cases, ciliary tissue in 1 case, retina and ciliary tissue in 1 case, uvea in 1 case, and hyaloid tissue in 13 cases. Conclusion There were not only vitreous, ciliary epithelial cells and pigment containe depithelia, but also ciliary body, retina and uvea in the prolapsed tissues of sclerotomy site, which might be related to the occurence of some clinical complications. (Chin J Ocul Fundus Dis,2001,17:99-101)
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)
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 role of anti apoptosis gene bcl-2 in the survival of cultured uveal melanoma UM cells. Methods Antisense oligodeoxynucleotides (AS-ODN) bcl-2 were delivered with cationic lipid to primary cultured UM cells. The inhibitory effect of AS-ODN bcl-2 on proliferation of UM cells was examined by 3,-4,5 Dimethyliazol-2,5 diphenyl tetrazolium bromide (MTT) method. Using DNA ladder to determine if the UM cells had been apoptotic. Bcl-2 expression was detected by RT-PCR and Westernblot technics. Results The effect of AS-ODN bcl-2 in inhibiting the proliferation of cultured UM cells had opposite relation to dosage. It down regulated the mRNA and protein level of bcl-2 gene, and the sense ODN didn′t have this effect. Conclusion AS-ODN bcl-2 can down regulate bcl-2 expression, inhibits UM cells proliferation and induces apoptosis. (Chin J Ocul Fundus Dis, 2002, 18: 38-41)
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.
ObjectiveTo observe the clinical features of uveal effusion syndrome (UES) and the efficacy of sclerectomy in the treatment of UES.MethodsA retrospective case series. Twenty patients (36 eyes) of UES with sclerectomy were enrolled in this study from June 2012 to December 2016 in Beijing Tongren Hospital. Among them, there were 12 males (22 eyes) and 8 females (14 eyes), with an average age of 37.8 years. All patients suffered from bilateral diseases, including 4 patients in single eye group and 16 patients in double eye group. Visual acuity, intraocular pressure, indirect ophthalmoscope, UBM, FFA combined with ICGA, A/B ultrasonography, axial length (AL) and scleral thickness were measured. All patients underwent lamellar sclerectomy, and those with exudative retinal detachment underwent four quadrant lamellar sclerectomy, followed by four quadrant full-thickness sclerectomy with the size of 1 mm × 2 mm in the center of the scleral bed. The follow-up time after operation was more than 6 months.Visual acuity, intraocular pressure and fundus examination were performed 1, 3 and 6 months after operation with the same equipment and methods before operation.ResultsThere was no obvious inflammation in the anterior chamber of all eyes, and intraocular pressure was 24-28 mmHg (1 mmHg = 0.133 kPa) in 4 eyes (11.1%). Axial length of 8 eyes (22.2%) were 16-18 mm (true microphthalmia). 12 eyes (33.3%) had scleral thickness＞1.0-1.8 mm. Visual acuity ranged from hand movement to 0.05 in 20 eyes, 0.1 to 0.3 in 10 eyes and＞0.3 in 6 eyes. Fundus examination showed peripheral choroidal and ciliary detachment; UBM examination showed annular peripheral ciliary and choroidal detachment. 32 eyes (88.9%) were complicated with exudative retinal detachment. FFA examination showed that 14 eyes (38.9%) had leopard spot changes. Compared with preoperative vision, the visual acuity improved in 28 eyes (77.8%) and remained unchanged in 8 eyes (22.2%) after surgery. Thirty-two eyes with different degrees of retinal detachment were found before surgery. After surgery, ciliary body detachment, choroidal detachment and retinal detachment were restored. Six eyes (16.7%) recurred and underwent sclerectomy again.ConclusionsThe mild symptoms and recurrent attack are the characteristics of UES. Sclerectomy is an effective method to treat UES.