Christopher K.H. Burris

Pilot Study of a “Large-Eye,” Surgically Induced Dry Eye Rabbit Model by Selective Removal of the Harderian, Lacrimal, and Meibomian Glands

Background/Aims: Establish a reliable rabbit dry eye (DE) model. Methods: An interventional cohort study surgically removing glands contributing to the tear film. Eight rabbits were studied after removal of left lacrimal, Harderian, or both glands. Additional rabbits had Meibomian glands in the left eye thermally obstructed. All were followed for 10 weeks with phenol red thread (PRT) and slit-lamp examination with 2% fluorescein. We assessed corneal sensitivity using a Cochet-Bonnet esthesiometer. Outcome measures were severity/duration of reduced PRT, punctate epithelial erosions (PEE), and histologic evidence of corneal pannus. Results: Fluorescein staining demonstrated signs of dryness including PEE in all of the interventional eyes. The subjective measurement of epithelial erosions correlated with decreased tear production. PRT measurements in the control eyes averaged 31.54 mm (±1.83) and 22.71 mm (±1.60) in the eight left eyes, without loss of corneal sensitivity. Conclusions: Surgical removal of either the Harderian or lacrimal gland results in statistically significant decreases in tear volume and the development of severe DE. Removal of both glands results in the occurrence of a DE of comparable severity/duration to removal of either the lacrimal or Harderian gland alone. Meibomian gland obstruction contributes less to the DE model.

Angiolymphoid Hyperplasia with Eosinophilia Accompanying Vernal Conjunctivitis

Financial Disclosure(s): The author(s) have made the following disclosure(s): R.E.H.: Grants e Novartis. I.S.Y.: Grant e European Union. P.T.dJ.: Travel support e European Commission. A.E.F.: Grant and travel support e European Commission. European Commission Vth Framework, Brussels, Belgium (Contract No. QLK6-CT-1999-02094). Additional funding for cameras was provided by the Macular Disease Society (Andover, UK). M.R.: Financed by the Ministry of Education and Science, Tallinn, Estonia (Target funding no. 01921112s02). Additional funding in Alicante was received from the Fondo de Investigacion Sanitaria (Madrid, Spain) (grant nos. FIS 01/1692E, RCESP C 03/09) and Oficina de Ciencia y Tecnologia Generalitat Valenciana (Valencia, Spain) (grant no. CTGCA/2002/06). The Thomas Pocklington Trust funded conversion of dietary data to nutrients. Author Contributions: Conception and design: Hogg, Woodside, Fletcher Data collection: Hogg, Woodside, McGrath, Young, Vioque, Chakravarthy, de Jong, Rahu, Seland, Soubrane, Tomazzoli, Topouzis, Fletcher Analysis and interpretation: Hogg, Woodside, McGrath, Fletcher Obtained funding: Not applicable Overall responsibility: Hogg, Woodside, McGrath, Young, Vioque, Chakravarthy, de Jong, Rahu, Seland, Soubrane, Tomazzoli, Topouzis, Fletcher Abbreviations and Acronyms: AMD 1⁄4 age-related macular degeneration; AREDS 1⁄4 Age-Related Eye Disease Study; CAREDS 1⁄4 Carotenoids in Age-Related Eye Disease Study; EPIC 1⁄4 European Prospective Investigation into Cancer and Nutrition; EUREYE 1⁄4 European Eye; FFQ 1⁄4 food-frequency questionnaire; GA 1⁄4 geographic atrophy; MDS 1⁄4 Mediterranean Diet Score; nvAMD 1⁄4 neovascular age-related macular degeneration. Correspondence: Jayne V. Woodside, PhD, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Grosvenor Road, Belfast, County Antrim, Northern Ireland BT12 6BA, UK. E-mail: j.woodside@qub.ac.uk.

Bilateral Primary Mucinous Carcinoma of the Eyelid.

The aim of this study is to report a case of bilateral primary mucinous carcinoma of the eyelids. This is a case report and literature review. A 71-year-old female presented with primary mucinous carcinoma of the left upper eyelid, which was excised with Mohs surgery. One year later, she developed primary mucinous carcinoma of the right upper eyelid, which was also treated Mohs surgery. Extensive workup was negative for evidence of an unknown primary carcinoma or metastasis. Primary mucinous carcinoma of the eyelids may occur as multifocal tumors, and bilateral disease is not necessarily indicative of metastatic disease.

Is There an Increased Prevalence of Asteroid Hyalosis in Eyes with Uveal Melanoma A Histopathologic Study

During the planning meeting for the Collaborative Ocular Melanoma Study (COMS) prior to the start of patient recruitment in 1986, there was an interest expressed in determining whether a relationship existed between the presence of uveal melanoma (UM) and asteroid hyalosis (AH). To answer this question, the ophthalmic examination form (unlike the pathology form for enucleated eyes) for each COMS patient asked whether AH was present or not. Though an increased prevalence was not found, this result was never published. A recent unpublished study at the University of Wisconsin School of Veterinary Medicine indicated a higher prevalence of AH in canine eyes with UM when compared to control eyes (without tumor) enucleated for goniodysgenesis. This further increased our interest in revisiting the published literature, clinical records, and histopathology slides of the enucleated eyes from the COMS study, as well as the histopathology slides on file in the University of Wisconsin Eye Pathology Laboratory. While cases with both AH and UM were occasionally encountered in the literature, clinically, we could not find a previous study focusing on these two processes. This study was conducted to explore whether such an association exists.

Scleral Necrosis Simulating Recurrent Uveal Melanoma after Plaque Brachytherapy

Supported by the National Eye Institute, National Institutes of Health, Bethesda, Maryland (cooperative agreement nos.: U10 EY017823, U10 EY017825, U10 EY017826, and U10 EY017828). The funding organization participated in the design and conduct of the study, data analysis and interpretation, and review of the manuscript. Author Contributions: Conception and design: Maguire, Martin, Ying, Jaffe, Daniel, Toth, Grunwald, Fine Analysis and interpretation: Maguire, Martin, Ying, Jaffe, Daniel, Toth, Grunwald, Ferris, Fine Data collection: Maguire, Martin, Ying, Jaffe, Daniel, Toth, Grunwald, Ferris, Fine

Scleritis with Devastating Consequences

Originally received: April 24, 2016. Final revision: July 18, 2016. Accepted: July 20, 2016. Available online: September 2, 2016. Manuscript no. 2016-858. 1 Department of Ophthalmology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. 2 Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. 3 Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, New York. Financial Disclosure(s): The author(s) have made the following disclosure(s): R.R.: Consultant e GLIA, LLC; Guardion Health Sciences; Mobius Therapeutics; Intelon Optics, Inc., Diopsys, Inc.; Gerson Lehrman Group; Sensimed, AG; Aeon Astron Europe, B.V.; Board membership e iSonic Medical; Xoma (U.S.) LLC; Expert testimony e Donahey, Defossez & Beausay; Tanoury, Nauts, McKinney & Barbarino, PLLC; Blume Forte Fried Zerres & Molinari; Lecturer e Santen Pharmaceutical Co., Ltd.; Royalties e Ocular Instruments, Inc.; Equity owner e The International Eye Wellness Institute, Inc. Author Contributions: Conception and design: Teekhasaenee, Suwan, Supakontanasan, Tulvatana, Ritch Analysis and interpretation: Teekhasaenee, Suwan, Supakontanasan, Tulvatana, Ritch Data collection: Teekhasaenee, Suwan, Supakontanasan, Tulvatana Obtained funding: none Overall responsibility: Teekhasaenee Abbreviations and Acronyms: DRS 1⁄4 double-ring sign; LI 1⁄4 laser iridotomy; PEX 1⁄4 pseudoexfoliation; POAG 1⁄4 primary open-angle glaucoma; TEX 1⁄4 true exfoliation syndrome; UBM 1⁄4 ultrasound biomicroscopy. Correspondence: Chaiwat Teekhasaenee, MD, Department of Ophthalmology, Ramathibodi Hospital, Rama 6, Bangkok 10400, Thailand. E-mail: chai1391@ gmail.com.

Histologic Changes in a Squamous Cell Carcinoma of Conjunctiva Refractive to Interferon-α2b

MD). Bausch & Lomb (Rochester, NY) provided support to the study in the form of donation of fluocinolone implants for patients randomized to implant therapy who were uninsured or otherwise unable to pay for implants, or who were located at a site where implants could not be purchased (e.g., the United Kingdom). Additional support was provided by Research to Prevent Blindness, Inc., New York, NY; the Paul and Evanina Mackall Foundation (Chicago, IL); and the Lois Pope Life Foundation (Delray Beach, FL). A representative of the National Eye Institute participated in the conduct of the study, including the study design; collection, management, analysis, and interpretation of the data; and review and approval of this manuscript. The sponsor or funding organization had no role in the design or conduct of this research.

Axenfeld Loop vs Extrasclerally Extending Ciliary Body Tumor

Axenfeld Loop vs Extrasclerally Extending Ciliary Body Tumor To the Editor In response to the article by Koch et al titled “Extraocular Extension of a Benign Ciliary Body Nevus,”1 I would like to note that the slitlamp photograph as well as the ultrasound biomicroscopic image appear identical to the pigmented elevation often seen in Axenfeld nerve loops.2 The location overlying the ciliary body (approximately 3 mm posterior to the limbus), where a long posterior ciliary artery is seen to traverse the sclera in an emissary channel, is classic for this. These nerve loops often incorporate uveal pigment and normal uveal melanocytes. I would like to caution clinicians from the routine biopsy of pigmented lesions in this location unless the clinical history and/or imaging warrant it.

Adult-onset asthma and periocular xanthogranulomas associated with systemic IgG4-related disease

Purpose The aim of this study was to report a case of Adult-Onset Asthma with Periocular Xanthogranulomas (AAPOX) associated with systemic IgG4-related disease (IgG4-RD). Observations A 57-year-old man presented with bilateral periorbital swelling for 1 year. Histopathology of a left orbital biopsy showed fibro vascular connective tissue inundated with foamy, lipid-laden histiocytes and touton giant cells with lymphocytic inflammation. Additional stains revealed CD68 positivity, and S100 negativity. The IgG and IgG4 stained slides showed increased IgG4 positive plasma cells but did not meet the criteria for IgG4-related orbital disease. His IgG4 serology was elevated, and IgG4 staining of his tissue previously diagnosed as autoimmune sclerosing pancreatitis was found to meet the criteria for IgG4-RD. Conclusion and importance AAPOX can be associated with systemic IgG4-RD.

Follicular Hybrid Cyst of the Eyelid

Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland (J.E.T.); the Skirball Foundation, New York, New York (G.N.H.); and the Stein Eye Institute Herb Ritts, Jr., Memorial Vision Fund, New York, New York (G.N.H.). The funding organizations had no role in the design or conduct of this research. Author Contributions: Conception and design: Ashraf, Holland, Van Natta, Wu, Thorne, Jabs Analysis and interpretation: Ashraf, May, Holland, Van Natta, Wu, Thorne, Jabs Data collection: Holland, Van Natta, Thorne, Jabs Obtained funding: none Overall responsibility: Ashraf, May, Holland, Van Natta, Wu, Thorne, Jabs