bromochloroacetic-acid and Blindness

Diffuse and cystic epithelial downgrowth occur rarely, but they represent a mostly preventable potential cause of blindness as sequels to trauma and surgery. The aim of this study is to report on the etiology and course of disease in patients with histologically verified epithelial downgrowth.. From 1986 until 2000 the ophthalmopathological laboratory of the University Eye Hospital Hamburg-Eppendorf received 13 (4 external) referrals. Ten patients with cystic of diffuse intraocular epithelial downgrowth were treated and 9 eyes were operated on in the Hospital.. At presentation 4/10 patients had a visual acuity of < or = 0.1, and 2/10 had no light perception. A cystic epithelial downgrowth was verified histologically in 9/13, and a diffuse form in 4/13 patients. Mucin production was proven histochemically in 1/9 intraocular epithelial downgrowth sections. In one case a spontaneous iris cyst was detected by the immunohistological examinations. Trauma (10/14) and surgery (3/14) were the most frequent causes and were symptomatic on average 17 years after the primary event. A curative surgery was done in 13/14 patients (5 x en bloc excision, 2 x penetrating keratoplasty, 1 x iridectomy, 2 x enucleations, 3 x external) resulting in no recurrences during the follow-up of 4(1/2) years (1 - 12 years). The postoperative visual acuity was ameliorated in 5/9, worsened in 2 patients, and 2 were enucleated.. Epithelial downgrowth is a rare but preventable cause of blindness. The most important prophylaxis is meticulous primary surgery including a sufficient wound closure. The visual outcome depends on the preoperative conditions.

Topics: Adolescent; Adult; Aged; Blindness; Cell Division; Child; Choristoma; Ciliary Body; Conjunctiva; Cysts; Epithelium; Epithelium, Corneal; Eye; Eye Diseases; Eye Enucleation; Eye Injuries; Female; Humans; Keratins; Male; Middle Aged; Postoperative Complications; Reoperation; Visual Acuity

The retinal pigment epithelium (RPE) can undergo reactive hyperplasia and metaplasia following a variety of ocular insults. However, true neoplasms of the RPE are rare. We report a case of a papillary adenocarcinoma of the RPE arising in the blind staphylomatous right eye of a 79-year-old woman with a long history of bilateral posterior staphylomas who was seen with increasing pain and exophthalmos of the right eye. Findings from ultrasonography and computed tomography demonstrated linear calcification consistent with osseous metaplasia of the RPE. Progression of the exophthalmos and worsening exposure keratitis led to enucleation of the eye. Gross pathology showed a 79-mm-long globe. Histopathologic findings revealed a largely amelanotic papillary adenocarcinoma arising from the RPE. Positive immunoreactivity for cytokeratin supported the epithelial origin of the tumor. Adenocarcinoma of the RPE is rare but may develop in a blind eye.

Topics: Adenocarcinoma, Papillary; Aged; Biomarkers, Tumor; Blindness; Calcinosis; Exophthalmos; Eye Enucleation; Female; Humans; Keratins; Magnetic Resonance Imaging; Metaplasia; Pain; Pigment Epithelium of Eye; Retinal Neoplasms; Scleral Diseases; Tomography, X-Ray Computed

Topics: Animals; Astrocytoma; Blindness; Brain; Brain Neoplasms; Glial Fibrillary Acidic Protein; Goat Diseases; Goats; Immunohistochemistry; Keratins; Motor Activity; Nerve Tissue Proteins; Neurofilament Proteins; Vimentin