Abbot G. Spaulding

Ophthalmia Nodosa Caused by Tarantula Hairs

A young woman presented with ocular discomfort after handling her pet tarantula. Multiple fine hairs were detected on the eyelids, in the palpebral and bulbar conjunctiva, and in the corneal epithelium and stroma. In addition, foreign body granulomas were found in the conjunctiva. Six months later, peripheral chorioretinal lesions were seen. The clinical and histologic findings in this case closely resemble the findings in ophthalmia nodosa caused by caterpillar hairs.

Case of Complex Craniofacial Anomalies, Bilateral Nasal Proboscides, Palatal Pituitary, Upper Limbs Reduction, and Amnion Rupture Sequence: Disorganization Phenotype?

We report a case of a dizygotic twin with complex abnormalities of head, body, and limbs. The anomalies include the following: lateral and midline cleft upper lip, ectopic palatal pituitary, natal teeth, bilateral nasal proboscides with an absent nose, left microphthalmia with conjunctival-lined cyst, right ocular dysgenesis, bilateral retinal dysplasia, platybasia with skull asymmetry, hydrocephalus secondary to aqueductal atresia, brain hemispheric asymmetry with a parietal–occipital cortical flap, agenesis of posterior corpus callosum, absence of the olfactory nerves and left anterior cerebral artery, leptomeningeal and intraventricular heterotopias, right radial longitudinal terminal meromelia with constriction rings of fingers, partial syndactyly of the third and fourth left fingers, dorsiflexed great toes and pes equinovarus bilaterally, and multiple skin tags with a sacral appendage. Additionally, this twins placental disc and extraplacental membranes were devoid of amnion. We regard these anomalies as a possible expression of the human homologue of the disorganization phenotype or another gene mutation. Nevertheless, an abnormality of blastogenesis with early damage to organizing tissues of the frontonasal region and limbs, or a vascular disruption, cannot be excluded. Early amnion rupture sequence (possible extraamniotic pregnancy with amniotic bands, limb reduction defects with Streeter bands, and multiple skin tags tapering into amniotic bands) was also present in this case, and may have acted as a contributing factor.

Medulloepithelioma of the optic disc

A 6-year-old boy with a history of an amblyopic, occasionally red left eye was found to have a solid white mass overlying the optic disc on dilated ocular fundus examination. Transvitreal endoincisional biopsy of the mass yielded neoplastic tissue consistent with intraocular medulloepithelioma. The eye was removed subsequently because of concern that the tumor may invade the retrobulbar optic nerve. Histopathologic and immunohistochemical analysis of the tumor confirmed nonteratoid medulloepithelioma of the optic disc. The child has been followed up for over 36 months without any signs of orbital tumor recurrence or metastasis.

Clinical and histopathological features and immunoreactivity of human choroidal and ciliary melanomas as prognostic factors for metastasis and death

PurposesTo determine the relationship between immunohistochemical reactivity to osteopontin, vimentin, keratin 8/18, LZTS1, and beta-catenin and clinical and histopathological prognostic factors for metastasis and death in archival specimens of primary uveal melanomas, and the prognostic value of the evaluated study variables for death from metastasis.MethodsRetrospective analysis of clinical records and formalin-fixed, paraffin-embedded slides of primary uveal melanomas treated by enucleation during May 1 1999, through June 30 2009. Immunofluorescent staining of each tumor was assessed on newly prepared histologic slides after the application of antibodies directed against five biomarkers associated with unfavorable prognosis in uveal melanoma.ResultsAfter exclusions, our study group consisted of 82 cases. Immunofluorescence was observed in 40.2% of specimens evaluated for keratin, 50.0% evaluated for osteopontin, 26.8% evaluated for β-catenin, 65.9% evaluated for vimentin, and 70.7% evaluated for LZTS1. Through available follow-up, 27 patients (32.9%) were dead of confirmed or suspected metastatic uveal melanoma. None of the patients whose tumor exhibited strong immunoreactivity to β-catenin died of metastasis. In contrast, patients whose tumor exhibited immunoreactivity of any intensity to LZTS1 were more likely to develop metastasis. In multivariate Cox proportional hazards modeling, a composite variable that took into account the immunostaining for both β-catenin and LZTS1 had a statistically significant relationship with patient’s survival time.ConclusionsOur study suggests that conventional clinical and histopathological prognostic factors, and immunoexpression of β-catenin and LZTS1 combined may allow better prognostication of metastasis than clinical and histomorphological factors alone.

Cell density dependency of vitreous fibrosis induced by monocytes and lymphocytes

The possible roles of monocytes and lymphocytes in vitreous fibrosis were examined by injecting various numbers of the peripheral cell types into the rabbit vitreous. Our results indicated that the degree of vitreous fibrosis and the presence of traction retinal detachment corresponded to the number of cells injected. It was suggested that these findings are probably similar to vitreous membrane formation and retinal detachment in various clinical ocular diseases or inflammations in humans.

Secondary intraocular uveal involvement by primary paranasal sinus lymphoma.

To report an unusual case of primary paranasal sinus lymphoma associated with intraocular secondary uveal involvement. Retrospective case report emphasizing the histopathologic diagnosis as well as imaging studies, and review of the pertinent literature. The diagnosis of ophthalmologic lymphoma can be difficult due to the infrequency of the disease, the diverse presentation, and the need for biopsy for definitive diagnosis. Prior clinical history and systemic testing may be important confirmations in diagnosing such cases.