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Exo-resection of Iris-ciliary Body Melanoma After Failed Brachytherapy. Intra & Postoperative Complications. Five Year Follow-up

We present the case of a 37-year-old male with an iris-ciliary body melanoma. 2 years after brachytherapy, the tumor started to grow and we decided to perform a partial lamellar sclerouvectomy plus iridectomy, followed by phacoemulsification without intraocular lens and 23 g vitrectomy for the consequent retinal detachment, leaving 5000 cs silicone oil. 7 months later, because of extreme photophobia with intense anxiety and despite...

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Partial Lamellar Scleral Resection in a Choroidal Melanoma with Extraocular Extension

A 60-year-old male presenting with large sized melanoma with extraocualr extension. Management included partial lamellar resection, with full thickness eye wall resection around the extra ocular extension and scleral graft. Postoperative recovery was smooth and patient received adjuvant transpupillary thermotherapy. Five year follow up was uneventful. Contact Details: Email: ihabsaad@hotmail.com Cell Phone:...

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Wide Angle Fundus Imaging and Fluorescein Angiography in Evaluation and Management of Retinal Pathologies and Intraocular Tumors

Introduction: Wide angle fundus photography using Retcam II is the state of the art technique in evaluating pediatric retinal diseases and tumor conditions. The introduction of ultra wide field 200Ëš fundus imaging and fluorescein angiography for adult fundus imaging is opening the window for diagnosis and management of many peripheral retinal conditions in retinal disorders and tumor conditions. Materials & Methods: Prospective...

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Intraoperative Detection of a Vasoproliferative Tumor During Phacovitrectomy

Purpose: To illustrate a personal approach to the accidental intraoperative finding of a very large (8mm max. diameter) Vasoproliferative Retinal Tumor (VPRT) during Phacovitrectomy for long-standing Coat’s disease. Background: VPRTs are benign, vascular masses located in the peripheral retina. Shields and Coworkers have classified them as idiopathic or secondary to congenital, inflammatory, vascular, traumatic, dystrophic or...

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Long-term Evolution of Combined Hamartoma of the Retina and the Retinal Pigment Epithelium: A Report of Two Cases

Miriam Garcia Fernandez_SCIENTIFIC POSTER 2015_3 Advantages: To report the long-term evolution in two cases of combined hamartoma of the retina and retinal pigment epithelium. Methods: A 46-year-old male and a 35-year-old female, diagnosed as having a combined hamartoma of the retina and retinal pigment epithelium, were observed for eleven and four years, respectively. The first one was treated with pars plana vitrectomy due to large...

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Uveal Melanoma: Accuracy of Diagnosis and Efficiency of the Referral Pathway

Amun Sachdev_SCIENTIFIC POSTER 2015 Purpose: To investigate the accuracy of diagnosis in patients referred with suspected uveal melanoma from a multispecialty ophthalmology department to a specialist ocular oncology centre and the efficiency of the referral pathway for these patients according to national standards. Methods: A retrospective study was performed on 68 patients who were referred for suspected uveal melanoma from the University...

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25G Endoresection of Choroidal Melanoma

This is a video of 25G endoresection of choroidal melanoma done in our centre (Dr Rajendra Prasad Centre for Ophthalmic Sciences, New Delhi, India). Previously endoresection of choroidal melanoma was done using 20G pars plana ports. The first 25G endoresection in India was done by Prof Pradeep Venkatesh which is shown in this video. Contact Details: Email: nasiq.imtiaz@gmail.com Cell Phone:...

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Large Vasoproliferative Tumor Detected During Phacovitrectomy for Coat’s Disease

Enrico Bertelli_RETINA PHOTO 2015 Contact Details: Email: enrbertelli@gmail.com Cell Phone: +393409191017

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Retinal Capillary Hemangioma

Retinal Capillary Hemangioma Woohyok Chang_RETINA PHOTO 2015 Color photo of 14 year old boy with retinal capillary hemangioma. Contact Details: Email: changwh@ynu.ac.kr Cell Phone:...

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Buckle in RD Surgery: My Way

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   How to perform buckle surgery with a scrubbed nurse only ? As our policy is to perform retinal detachment surgery as soon as there is a capacity in the OR, I do not always have a hold on a resident or fellow, who could assist me. An experienced nurse can equally perform the instrumentation and assist me simultaneously. She already has...

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Vitrectomy Instruments for Buckling Surgery

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Scleral buckling surgery for retinal detachment is a skill mastered by performing many cases. It is becoming increasingly difficult for a new generation of “vitrectomy surgeons” to achieve sufficient experience to become comfortable with the techniques involved. This is firstly because of expanding vitrectomy indications and...

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Why I Still Perform Buckling in Selected Cases

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Principles of rhegmatogenous retinal detachment (RRD) surgical management remains the same than 40 years ago: finding all retinal breaks, sealing the retinal breaks by creating a chorioretinal scar around the breaks («retinopexy»), drainage of subretinal fluid in some cases, and relief of vitreoretinal traction. To achieve these...

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Scleral Buckling…Are you Crazy!!! Back to the Future!

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   We have developed a new scleral buckling exoplant that can be inserted in minutes with one anterior suture which provides 4 clock hours of circumferential buckling.It is removed in three weeks, usually in the office. It resolves most problems associated with scleral buckling including strabismus, induced refractive error, and buckle...

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Capillary Hemangioma of the Optic Disc

RETINA PHOTO_Miguel Lume To present a photo of a capillary hemangioma of the optic nerve. A 60 year old female patient with a history of reduced visual acuity of her left eye (Hand Movements) was referred to our department for treatment. The patient was previously asymptomatic and her medical records showed only arterial hypertension. She had no history of headaches. At fundus examination, a large orange prepapillary mass was identifiable...

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Long-term Evolution of Combined Hamartoma of the Retina and Retinal Pigment Epithelium

Poster 1 Miriam Garcia-Fernandez Advantages: To show the long-term evolution of two cases of Combined Hamartoma of Retina and Retinal Pigment Epithelium (CHR-RPE), one managed by vitrectomy, and other managed conservatively. Methods: A 46-year-old male and a 35-year-old female, diagnosed as having a CHR-RPE, were observed during four years. One of them underwent pars plana vitrectomy (PPV) due to an extensive associated epiretinal...

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A Case Report of Melanocytoma Monitoring and Diagnosis

Introduction: We report a case of a 73-year-old Caucasian woman, who comes in our department for floaters and phosphenes for 6 months. The visual acuity (VA) was 20/20 in the right eye (OD) and 20/25 in the left eye (OS), anterior segment examination was normal. On examination of the fundus posterior vitreous detachment is seen in both eyes, in the left eye we observed a hyperpigmented lesion, flat, irregular borders, juxtapapillary 1.5...

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Super-selective Intraophthlamic Artery Melfalan for Management of Advanced Intraocular Retinoblastoma: Two-year Results

Purpose: To evaluate the role of superselective ophthalmic artery melfalan (SSOAM) for management of advanced retinoblastoma whether as a primary or secondary treatment modality. Methods: Ten cases of advanced stage D disease were managed by SSOAM. Seven cases presented after failure of other therapeutic modalities to control the tumor and 3 cases presented with advanced uniocular disease. SSOAM was given as initial therapy for 1-3...

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Excision of Multiple Capillary Hemangiomas of Retina in a Patient with Rhegmatogenous Retinal Detachment and Proliferative Vitreoretinopathy

Introduction: Capillary hemangiomas of retina could be associated with rhegmatogenous retinal retachment (RRD) with proliferative vitreoretinopathy (PVR), situation that is difficult to manage. The surgical outcome is poor and recurrences are common. Vitrectomy along with excision and removal of capillary hemangiomas of the retina can be can be a viable treatment option for these cases. Methods: A 25-year-old male was diagnosed to have...

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Coats’ Disease: Intravitreal Triamcinolone with or Without Transscleral Drainage: The Way to Go!

Purpose: To evaluate the role of intravitreal Triamcinolone (TA) in the early management of Coats’ disease with or without trans-scleral drainage. Methods: Retrospective, interventional case series. Fifteen consecutive cases with Coats’ disease were managed with 4mg/0.1ml intravitreal Triamcinolone injection on presentation and were followed up for a minimum duration of one year. Additional management strategies included...

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Angiography and Swept Source OCT

Advantages:   Wide-angle fundus photography is the state of the art technique in evaluating pediatric retinal diseases and tumor conditions. The introduction of ultra wide field 200˚ fundus imaging and fluorescein angiography for adult fundus imaging is opening the window for diagnosis and management of many peripheral retinal conditions in retinal disorders and tumor conditions. Methods: Prospective evaluation of pediatric and...

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Serous Macular Detachment Secondary to Choroidal Osteoma: Inefficacy of Intravitreal Ranibizumab Therapy

Francisco J. Ascaso, Laura Villén, Valentín Huerva, Javier Mateo, María A. Del Buey (Zaragoza, Spain) Advantages: Choroidal osteoma (CO), typically found in healthy young women, is a rare benign intraocular tumor composed of mature cancellous bone replacing the full thickness of the choroid. Vision loss in CO depends on tumor location, serous retinal detachment (RD) associated or not, the presence of choroidal neovascularization (CNV),...

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Management of Unusual Choroidal Tumors Presenting with Exudative Retinal Detachment

Ihab Saad Othman (Giza, Egypt) Advantages: Partial lamellar resection is an advantageous method in diagnosis and management of unusual choroidal tumors. Methods: We present a series of 5 cases of unusual choroidal tumors including uveal hemangiopericytoma, schwannoma, leiomyoma ectopic lacrimal gland tumor, presenting with exudative retinal detachment. Cases were recognized and managed with partial lamellar resection resulting in...

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Management of Localized Choroidal Hemangioma by Brachytherapy

Ihab Saad Othman (Giza, Egypt) Advantages: Brachytherapy is a safe and an effective method in inducing vascular occlusion and flattening of the retina in localized choriodal hemangiomas. Methods: Prospective evaluation of 12 cases of localized choroidal hemangiomas associated with exudative retinal detachment managed by brachytherapy application in a dose of 20 Gys. Method follow up was 5 years. Effectiveness / Safety: Brachytherapy...

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Retinal Capillary Hemangioma and von Hippel-Lindau Disease: Diagnostic and Therapeutic Implications

C Gonzalez Castano, R Salazar Mendes, J Castro Navarro, M Fonolla Gil, A Garcia Alonso, P Rozas Reyes (Oviedo, Spain) Advantages: To confirm the efficacy of laser photocoagulation in retinal capillary hemangioma’s treatment, but also the retinal complications associated to this procedure and to reveal the implications of its diagnosis in patients with von Hippel-Lindau disease. Methods: A male carrier of VHL gene with large-evolution loss...

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Serous Macular Detachment Complicating Choroidal Tumors Successfully Treated with Transpupillary Thermotherapy

Rim Kahloun*, Riadh Messaoud, Anis Mahmoud, Salah Jenzeri, Salim Ben Yahia, Moncef Khairallah (Monastir, Tunisia Advantages: To manage serous retinal detachment (SRD) associated with choroidal osteoma and choroidal hemangioma with transpupillary thermotherapy (TTT). Methods: Two patients (choroidal ostema 1, choroidal hemangioma 1) presented with serous macular detachment. TTT was applied in one session using 810 nm diode lasers to the...

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A case of Nasal NK/T Cell Malignant Lymphoma Misdiagnosed as Conjunctivitis

Sun Mo Yang, Jaeryung Oh (Seoul, South Korea) Although there have been a few reported cases of nasal NK/T cell lymphoma, this is an unusual case of lymphoma presented with vague symptoms and misdiagnosed as conjunctivitis. A 58-year-old woman presented with no specific abnormality in left eye, except simple conjunctivitis. After 10 days she presented again with a complaint of decreased visual acuity, proptosis, and severe ocular pain in...

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Proliferative Retinopathy Secondary to Chronic Lymphocytic Leukemia. The Role of Intravitreal Ranibizumab Prior to Pars Plana Vitrectomy

Ester Nuñez, Francisco J. Ascaso, Beatriz Jimenez, José A. Cristóbal (Zaragoza, Spain) Advantages: Retinal neovascularization is rare in patients with leukemia. To our knowledge, no case of chronic lymphocytic leukemia (CLL) has been associated with bilateral proliferative retinopathy. Intravitreal Ranibizumab facilitated the surgery reducing active neovascularization and intraoperative bleeding. Methods: We present the case report of a...

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Radiotherapy Plus Endoresection to Treat Malignant Melanoma Associated with Exudative Retinal Detachment

http://www.evrs.eu/medias/2009/congress/Tumor.flv Authors: Facino Mario, Mochi Benedetto, Giacomelli Fabio, Mosci Carlo, Genoa, Italy Advantages: Exudative retinal detachment is the main cause of visual loss in choroidal malignant melanoma. If not treated, in addition to the loss of visual function of the eye, a high probability of neovascular glaucoma and a high risk of enucleation occur after radiotherapy. Combined radiotherapy and...

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Partial Lamellar Uvectomy for Choroidal Tumors: 9 Years Egyptian Experience

http://www.evrs.eu/medias/2009/congress/Tumor.flv Ihab Saad Mahmoud Othman, MD, FRCS (Glasg), Cairo, Egypt Advantages: Uveal melanoma resection offers a last resort in management of large and extra-large uveal tumors when enucleation remains the only option. Studies have shown no statistical difference in long-term survival between enucleation and surgical resection. Methods: Consecutive prospective case series presenting with iris,...

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Vitrectomy and Tumor Resection for Retinal Capillary Hemangioma with Retinal Detachment

Wu Liu, Bin Mo, Qian Li (Beijing Tongren Eye Center, Tongren Hospital, Capital Medical University, Beijing, China) Advantages: This allows removal of large peripheral retinal capillary hemangioma (RCH) and treatment of the detached retina. Methods: Large peripheral RCH with retinal detachment was treated with vitreoretinal surgery. The techniques included vitrectomy, perfluorocarbon liquid injection, diathermized angiotomy of the feed...

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Technique of Transscleral Fine Needle Aspiration Biopsy

http://www.evrs.eu/medias/2008/congress/Technique-of-Transscleral-Fine-Needle-Aspiration-Biopsy.flv Tara A. Young, Ben J. Glasgow Advantages: To demonstrate a technique of obtaining adequate sample material from choroidal lesions of unknown origin via a transscleral approach. Methods: After adequate scleral exposure is obtained and transillumination or indirect ophthalmoscopy is used to delineate the borders of the lesion, a 30-gauge...

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Biopsy Technique for Cytogenetic Phenotyping of Posterior Choroidal Melanoma

http://www.evrs.eu/medias/2008/congress/Biopsy-Technique-for-Cytogenetic-Phenotyping-of-Posterior-Choroidal-Melanoma.flv Javier Elizalde, Bárbara Delás Advantages: As an alternative to fine-needle aspiration biopsy (FNAB) monitored by indirect ophthalmoscopy, we present a new method for obtaining a cytologic tumor sample using a surgical microscope and a 25G system at the time of plaque radiotherapy. Methods: Through a three-port 25G...

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Miscellaneous Medical Session

http://www.evrs.eu/medias/2007/videos/miscellaneous.flv

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Acquired Retinal Astrocytoma Managed with Endoresection

http://www.evrs.eu/medias/2006/videos/Acquired-Retinal-Astrocytoma-Managed-with-Endoresection.flv Daniel Vilaplana, MD (Sabadell, Spain), Vladimir Poposki, MD (Barcelona, Spain), Miguel Castilla Cespedes, MD (Barcelona, Spain), Francesc Alameda, MD (Barcelona, Spain), Carol L. Shields, MD (Philadelphia, PA) SYNOPSIS A 49 year old male noted decreased visual acuity in the left eye for 5 months. The visual acuity was 20/200. Endoresection was...

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Mission Possible: Iridocyclectomy for Ciliary Body Leiomyoma

Michael A. Samuel, MD (Los Angeles, CA), Jennifer I. Lim, MD (Los Angeles, CA) SYNOPSIS 63-year old healthy man presents with a visual field defect and a ciliary body mass eroding through the iris. Ultrasonography showed a low reflective solid dome-shaped lesion suspicious for a melanoma. A diagnostic and therapeutic iridocyclectomy was performed. Histopathology revealed the lesion to be a leiomyoma. ...

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Functional and Anatomical Investigations in Racemose Hemangioma

Carsten H. Meyer, MD (Marburg, Germany), Jörg C. Schmidt, MD (Marburg, Germany), Stefan Mennel, MD (Marburg, Germany), Peter Kroll, MD (Marburg, Germany) PURPOSE: To determine the vascular morphology of racemose hemangioma and related functional alterations in arteriovenous (AV) malformation type 3. METHODS: A 17-year-old teenager with unilateral racemose hemangioma received a full ophthalmic examination including Snellen visual acuity...

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Acquired Retinal Astrocytoma Managed with Endoresection

Acquired Retinal Astrocytoma Managed with Endoresection

Daniel Vilaplana, MD (Sabadell, Spain), Vladimir Poposki, MD (Barcelona, Spain), Miguel Castilla Cespedes, MD (Barcelona, Spain), Francesc Alameda, MD (Barcelona, Spain), Carol L. Shields, MD (Philadelphia, PA) SYNOPSIS A 49 year old male noted decreased visual acuity in the left eye for 5 months. The visual acuity was 20/200. Endoresection was performed and a low grade astrocytoma was confirmed. Two years later the visual acuity is...

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Mission Possible: Iridocyclectomy for Ciliary Body Leiomyoma

http://www.evrs.eu/medias/2006/videos/Mission-Possible:-Iridocyclectomy-for-Ciliary-Body-Leiomyoma.flv Michael A. Samuel, MD (Los Angeles, CA), Jennifer I. Lim, MD (Los Angeles, CA) SYNOPSIS 63-year old healthy man presents with a visual field defect and a ciliary body mass eroding through the iris. Ultrasonography showed a low reflective solid dome-shaped lesion suspicious for a melanoma. A diagnostic and therapeutic iridocyclectomy was...

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Standard and High Resolution Echographic Features of Melanocytoma

Amy C. Schefler, MD (Miami, FL), Brandy Hayden (Miami, FL), David H. Abramson, MD (New York, NY), Timothy G. Murray, MD (Miami, FL) PURPOSE: This study characterizes the echographic features of optic nerve head melanocytoma as detected by standard 10mHz and high-resolution 20 mHz ophthalmic ultrasound. METHODS: A retrospective chart review of all patients diagnosed with melanocytoma of the optic nerve head was performed for all patients...

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Retinoblastoma Tumor Vascular Heterogeneity: A Model for Angiogenic Vacular Maturation and Implications for Vascular Targeting Therapy

Timothy G. Murray, MD (Miami, FL),* Maria Elena Jockovich, PhD (Miami, FL), Yoland Pina, PhD (Miami, FL), Fernando Suarez, (Miami, FL), Sander Dubovy, MD (Miami, FL), Amy Schefler, MD (Miami, FL) PURPOSE: The purpose of this study is to evaluate blood vessel maturation in the murine transgenic model of retinoblastoma and to correlate with pediatric enucleated retinoblastoma tumors specimens to determine if vessel heterogeneity can be...

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Pars Plana Vitrectomy for Epiretinal Membrane Associated with Combined Hamartoma of the Retina and Retinal Pigment Epithelium Extending to the Fovea

Edmund Y.M. Wong, MD (Singapore, Singapore), Boon Kwang Loh, MBBS, MRCS (Singapore, Singapore), Jocelyn Chua, MBBS, MRCS (Singapore, Singapore), Caroline K. Chee, MBBS, FRCSEd, FRCOphth (Singapore, Singapore) PURPOSE: To report the favorable surgical outcome in a rare case of combined hamatoma of the retina and retinal pigment epithelium (RPE) extending to the fovea despite reduced amplitudes of foveal and perifoveal preoperative...

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