OBJECTIVE: To report two cases of malignant melanoma in the eye, one in the conjunctiva and the other in the choroid.
CASES: The first case was in a 49-year-old lady who presented with a swelling on the inner side of left upper eyelid. The vision was 6/6. On everting the eyelid, multiple, pigmented, nodular swellings were noted on the tarsal conjunctiva. Excision biopsy confirmed the diagnosis of malignant melanoma of the conjunctiva. A pigmented nodular swelling occurred on the lower bulbar conjunctiva in the same eye one-and-a-half years after the first presentation. There were no secondary nodules in the body. Excision biopsy confirmed malignant melanoma of the conjunctiva. The second case was in a 72-year-old lady who presented with pain and bleeding in the right eye. There was no perception of light. The cornea was hazy and the details behind it could not be seen. There was micro perforation of the cornea with oozing of blood and secondary glaucoma. B-scan ultrasonography of the right eye revealed an intraocular tumour. The histopathology of the enucleated eyeball confirmed the diagnosis of malignant melanoma of the choroid.
CONCLUSION: In the case of conjunctival melanoma, the occurrence of tumour at multiple sites and absence of recurrence at the original site suggests the possibility of de novo origin of the tumour. Secondary glaucoma and bleeding may be the presenting features of melanoma in the choroid.
METHODS: In this cross-sectional study, 30 severe glaucoma patients, 30 mild glaucoma patients and 30 age-matched controls were recruited. All subjects underwent standard automated perimetry, RNFL analysis and 3 T MRI examinations. Glaucoma patients were classified according to the Hodapp-Anderson-Parish classification. Pearson's correlation coefficient was used to correlate ON volume with RNFL, and receiver operating curve (ROC) analysis was performed to determine the sensitivity and specificity of ON volume in detecting glaucoma severity.
RESULTS: Optic nerve volume was significantly lower in both the left and right eyes of the severe glaucoma group (168.70 ± 46.28 mm(3); 167.40 ± 45.36 mm(3)) than in the mild glaucoma group (264.03 ± 78.53 mm(3); 264.76 ± 78.88 mm(3)) and the control group (297.80 ± 71.45 mm(3); 296.56 ± 71.02 mm(3)). Moderate correlation was observed between: RNFL thickness and ON volume (r = 0.51, p <0.001), and in mean deviation of visual field and optic nerve volume (r = 0.60, p glaucoma.
CONCLUSIONS: MRI measured optic nerve volume is a reliable method of assessing glaucomatous damage beyond the optic nerve head. A value of 236 mm(3) and below can be used to define severe glaucoma.
Methods: A cross-sectional study was conducted involving 114 Malay patients with POAG seen at the eye clinic of Hospital Universiti Sains Malaysia. Patients aged between 40 and 80 years who were diagnosed with other types of glaucoma, previous glaucoma filtering surgery or other surgeries except uncomplicated cataract surgery and pterygium surgery were excluded. A total of 101 patients who were followed up for dry eyes, age-related cataracts or post cataracts extraction surgery were recruited as control subjects. Those with family history of glaucoma or glaucoma suspect were excluded. Microvascular endothelial function was assessed using laser Doppler fluximetry and the process of iontophoresis. Iontophoresis with acetylcholine (ACh) and sodium nitroprusside (SNP) was used to measure microvascular endothelium-dependent and endothelium-independent vasodilatations, respectively.
Results: In general, POAG patients demonstrated lower ACh% and AChmax values compared with controls. There was significant difference in microvascular endothelial function [ACh%: mean, 95% confidence interval = 503.1 (378.0, 628.3), and AChmax: mean, 95% confidence interval = 36.8 (30.2, 43.5)] between primary open angle glaucoma cases (p
DESIGN: Prospective, longitudinal study.
METHODS: Sixty-five NTG patients who were followed up for 5 years are included in this study. All the enrolled patients underwent baseline 24-h IOP and BP monitoring via 2-hourly measurements in their habitual position and were followed up for over 5 years with reliable VF tests. Modified Anderson criteria were used to assess VF progression. Univariable and multivariable analyses using Cox's proportional hazards model were used to identify the systemic and clinical risk factors that predict progression. Kaplan-Meier survival analyses were used to compare the time elapsed to confirmed VF progression in the presence or absence of each potential risk factor.
RESULTS: At 5-year follow-up, 35.4% of the enrolled patients demonstrated visual field progression. There were statistically significant differences in the mean diastolic blood pressure (p 43.7 mmHg (log rank = 0.018).
CONCLUSION: Diastolic parameters of BP and OPP were significantly lower in the NTG patients who progressed after 5 years. Low nocturnal DOPP is an independent predictor of glaucomatous visual field progression in NTG patients.