Ocular Oncology and Pathology最新文献

{"title":"Dramatic Inflammatory Regression of Choroidal Metastases from Renal Cell Carcinoma following Ipilimumab and Nivolumab Immunotherapy: A Case Series.","authors":"Carter W Lim, Kirk A J Stephenson, Katherine E Paton","doi":"10.1159/000548216","DOIUrl":"10.1159/000548216","url":null,"abstract":"<p><strong>Introduction: </strong>Renal cell carcinoma (RCC) is a rare cause of ophthalmic metastasis. Immune checkpoint blockers (ICBs) such as ipilimumab and nivolumab (ipi/nivo) are first-line therapies for advanced RCC. There are limited efficacy reports of ICBs for RCC choroidal metastases (CMs).</p><p><strong>Case one: </strong>A 43-year-old male with metastatic (lung) clear cell RCC presented with left eye scleritis and a 3.4 mm choroidal mass. One week after starting ipi/nivo, the lesion rapidly expanded to 11.9 mm with vitritis, subtotal exudative retinal detachment (ERD), and features of necrosis (heterogenous echogenicity). The lesion regressed over 10 months to 1.29 mm with resolution of ERD and improved visual acuity from counting fingers to 20/50.</p><p><strong>Case two: </strong>A 63-year-old male with clear cell RCC presented with a right eye 7.2 mm choroidal mass and subretinal haemorrhage. The lesion enlarged to 10.9 mm with ERD and heterogenous echogenicity after starting ipi/nivo, which then regressed to 2.4 mm by 7 months, leaving retinal folds. Vision declined to hand motions and remained stable.</p><p><strong>Conclusion: </strong>Ipi/nivo can induce rapid and sustained regression of RCC CM but may cause profound intraocular inflammation, collateral damage to surrounding structures, and subsequent vision loss. This response may be enhanced in the presence of pre-existing scleritis.</p>","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":"11 4","pages":"252-259"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12705098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse Event Following Change in Brachytherapy Plaque-Cleaning Chemicals: A Case Series.","authors":"Jesintha Navaratnam, Thomas Bærland, Ola Nilsen, Bernt Rekstad, Rowan Faber, Nils Eide","doi":"10.1159/000548234","DOIUrl":"10.1159/000548234","url":null,"abstract":"<p><strong>Introduction: </strong>The brachytherapy plaques used for uveal melanoma treatment are reused following sterilization processes. Here, we report patients with adverse reaction following a new cleaning procedure for brachytherapy plaques.</p><p><strong>Case presentations: </strong>The brachytherapy plaque sewn on the outer eyewall would be removed following the delivery of calculated radiation dose. They are reused following standard calibration testing and sterilization processes. From September 2021 to January 2022, 6 patients treated with ruthenium-106 plaque brachytherapy presented with severe unilateral pain, eyelid swelling, and conjunctival injection with hemorrhage 1-2 days following plaque insertion. The surgeons observed a frosted appearance of the plaques in contrast to the normal shiny look during removal. The unusual severe postoperative reactions and the frosted appearance of plaques led to further investigations. A change in sterilization procedures with the use of LifeClean™ instead of PeraSafe™ was noticed. Ruthenium-106 brachytherapy plaques contain a uniformly distributed radioactive source covered by a thin silver shield. A test was performed by using two plates of pure silver that underwent its respective cleaning procedure using either PeraSafe™ or LifeClean™.</p><p><strong>Conclusion: </strong>The test results demonstrated formation of silver chloride with LifeClean™, while no such formation was demonstrated with PeraSafe™. We did not observe any new cases of severe postoperative reaction or frosting of plaques after changing back to PeraSafe™. Chlorine salt deposits probably contributed to severe inflammatory reaction of ocular surface.</p>","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":" ","pages":"210-215"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Potential Role of Hyperspectral Retinal Imaging of Choroidal Tumors.","authors":"Darvy Dang, Xavier Hadoux, Rod O'Day","doi":"10.1159/000548219","DOIUrl":"10.1159/000548219","url":null,"abstract":"<p><strong>Background: </strong>Early and accurate diagnosis of choroidal tumors including benign nevi, melanomas, and vascular lesions is essential for effective clinical management. Conventional imaging techniques such as fundus photography, optical coherence tomography, fundus autofluorescence, and ultrasonography have greatly advanced the accuracy of choroidal tumor assessment but do have limitations. Hyperspectral imaging (HSI) is a noninvasive modality capturing high-resolution spectral data across multiple wavelengths and has shown promise in various medical fields. Its emerging use in ophthalmology may offer novel insights, although clinical evidence remains preliminary.</p><p><strong>Summary: </strong>This review explores the principles of HSI and its early investigational role in ocular oncology. Although clinical evidence remains limited, HSI may help improve lesion differentiation, tumor margin delineation and potentially provide indirect biochemical insights. When combined with existing imaging techniques, HSI could support a more comprehensive and individualized diagnostic approach. Key challenges and future directions are discussed.</p><p><strong>Key messages: </strong>HSI is a promising, noninvasive imaging innovation with potential to enhance choroidal tumor characterization. While still primarily investigational, further clinical validation is essential to determine its role in ophthalmic practice.</p>","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":" ","pages":"194-203"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Need of Structured Recovery, Ocular Oncology Needs Enhanced Recovery after Surgery.","authors":"Paige Campbell, Ezekiel Weis, Adam Michael Wandzura, Michelle Pham, Trafford Crump","doi":"10.1159/000548157","DOIUrl":"10.1159/000548157","url":null,"abstract":"","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":" ","pages":"216-218"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraocular Pressure Changes following Intravitreal Topotecan 90 μg/0.18 cc for the Treatment of Retinoblastoma.","authors":"Crystal W Law, Jasmine H Francis, David H Abramson","doi":"10.1159/000546729","DOIUrl":"10.1159/000546729","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to investigate the impact of injecting Topotecan 90 μg/0.18 cc on intraocular pressure (IOP) in children with retinoblastoma.</p><p><strong>Methods: </strong>This was a retrospective study of 78 eye encounters of 37 patients with retinoblastoma (22 males, 15 females, mean age: 3.5 ± 2.2 years, range 0.50-7.96 years) injected with intravitreal 90 μg topotecan with 0.18 mL volume. IOP was measured with a Schiotz tonometer at baseline prior to injecting, after digital massage, and then at specified time intervals following intravitreal injection of topotecan 90 μg in 0.18 mL volume. Mean arterial pressure (MAP) was either calculated from anesthesia records or recorded during anesthesia.</p><p><strong>Results: </strong>Mean preinjection IOP was 7.6 ± 2.5 mm Hg (range: 2-20 mm Hg). Mean IOP 60 s after intravitreal topotecan was 37.3 ± 17.4 mm Hg (range: 20-82 mm Hg). The IOP of 93.6% of patients was less than the MAP at all observed time points after injection. In patient eye encounters where IOP exceeded MAP, IOP resolved to below MAP in 4 min in all encounters. Additionally, in 4 min, 91% of patient eye encounters had IOP of below 29 mm Hg.</p><p><strong>Conclusion: </strong>Topotecan 90 μg/0.18 cc dose is increasingly important for retinoblastoma treatment. Injection of intravitreal topotecan 90 μg/0.18 cc chemotherapy caused a transient rise in IOP with spontaneous resolution below MAP for all patients after 4 min without further intervention. This is the first study of intravitreal topotecan 90 μg/0.18 cc on IOP and provides reassurance for the safe use of higher dose and volume of topotecan 90 μg/0.18 cc.</p>","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":" ","pages":"164-169"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subconjunctival Steroids for Conjunctival Benign Reactive Lymphoid Hyperplasia.","authors":"Jai W Thompson, Joseph Whitfield, Lindsay A McGrath","doi":"10.1159/000546824","DOIUrl":"10.1159/000546824","url":null,"abstract":"<p><strong>Introduction: </strong>Conjunctival benign reactive lymphoid hyperplasia (CBRLH) is a rare, polyclonal lymphoproliferative disorder on the benign end of the spectrum of lymphocytic infiltrative disorders. There is currently no established standard of care, and various treatment options have been explored. This 2-patient case series highlights the successful use of subconjunctival triamcinolone acetate as an effective therapeutic approach, contributing to the growing body of literature on CBRLH management.</p><p><strong>Case presentations: </strong>This case series presents 2 patients presenting with erythematous conjunctival thickening and histological examination suggestive of CBRLH. Treatment involved subconjunctival injection of triamcinolone acetate. Within 3 weeks, the patients demonstrated complete clinical resolution of the CBRLH lesions, with no observed recurrence at 12-month follow-up.</p><p><strong>Conclusion: </strong>This case series underscores the effectiveness of intralesional subconjunctival triamcinolone acetate as an effective treatment option for CBRLH. The rapid and sustained resolution of lesions highlights the potential role of subconjunctival steroid therapy in the management of this condition. Further research may help establish standardised guidelines for optimal treatment strategies.</p>","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":" ","pages":"204-209"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinal Capillary Haemangioblastoma: Clinical Spectrum, Imaging Insights, and Treatment Strategies.","authors":"Ramesh Venkatesh, Chaitra Jayadev, Vishma Prabhu, Pratibha Hande, Karishma Tendulkar, Nagesha Krishnappa Chokkahalli, Vedant Gambhir, Naresh Kumar Yadav, Snehal Hemkant Bavaskar","doi":"10.1159/000548217","DOIUrl":"10.1159/000548217","url":null,"abstract":"<p><strong>Background: </strong>Retinal capillary haemangioblastoma (RCH) is a benign but potentially vision-threatening vascular tumour of the retina. It may occur sporadically or as multifocal, bilateral lesions in association with von Hippel-Lindau (VHL) disease, often serving as the first manifestation of this multisystem disorder. The pathogenesis involves dysregulated angiogenesis through hypoxia-inducible factor (HIF) pathways, resulting in capillary proliferation and stromal recruitment.</p><p><strong>Summary: </strong>RCHs may present as asymptomatic peripheral lesions or as juxtapapillary tumours, leading to exudation, retinal detachment, and vision loss. Classification based on anatomical location and growth pattern (endophytic, exophytic, sessile) aids prognostication and treatment planning. Diagnosis relies on multimodal imaging, including fluorescein angiography, optical coherence tomography (OCT), OCT angiography, and occasionally indocyanine green angiography. Treatment is individualized according to tumour size, location, and complications, ranging from laser photocoagulation, cryotherapy, photodynamic therapy, and intravitreal anti-vascular endothelial growth factor (VEGF) injections to vitrectomy for tractional complications. Recently, systemic HIF-2α inhibitors such as belzutifan have shown promise in stabilizing retinal lesions in VHL patients. Accurate differentiation from mimickers such as vasoproliferative tumours, Coats disease, and cavernous haemangiomas remains essential.</p><p><strong>Key messages: </strong>RCH is often the first sign of VHL disease, highlighting the need for systemic evaluation. Its pathogenesis stems from HIF pathway dysregulation, with tumour size and location - especially juxtapapillary lesions - determining visual risk. Multimodal imaging is vital for diagnosis, differentiation, and monitoring. Management is individualized, using focal therapies, anti-VEGF injections, or surgery for complications, while systemic HIF-2α inhibitors like belzutifan show promise in VHL-associated cases. Early detection and a multidisciplinary approach are essential for preserving vision and managing systemic disease.</p>","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":" ","pages":"183-193"},"PeriodicalIF":1.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Refractive Parameters of Treated Retinoblastoma Eyes.","authors":"Hany Anwar Abdallah, Momen Mahmoud Hamdi, Sameh Hany Abdel Rahman, Noha Salah Mohamed, Nada Abdel Salam Abdel Aziz","doi":"10.1159/000546959","DOIUrl":"10.1159/000546959","url":null,"abstract":"<p><strong>Introduction: </strong>The study aimed to investigate the effect of treated retinoblastoma on refractive parameters.</p><p><strong>Methods: </strong>A case-control study was conducted in the ophthalmology department at Ain Shams University from September 2023 to April 2024. Refractive parameters of treated retinoblastoma eyes were compared to those of age matched: (a) fellow eyes of unilateral retinoblastoma children, (b) normal eyes of healthy controls. Cycloplegic refraction, ocular biometry, and anterior segment optical coherence tomography were performed. Image J software was used to calibrate the radii of curvature of lens surfaces.</p><p><strong>Results: </strong>The study included 35 diseased eyes and 25 fellow eyes of 49 retinoblastoma subjects as well as 26 normal eyes of 26 healthy controls. A statistically significant difference existed between retinoblastoma eyes and eyes of healthy controls regarding refractive astigmatism (<i>p</i> = 0.02), corneal astigmatism (<i>p</i> = 0.047), anterior chamber depth (<i>p</i> < 0.001), and posterior lens curvature (<i>p</i> = 0.041). A statistically significant difference existed between RB eyes and fellow eyes regarding refractive astigmatism (<i>p</i> < 0.001) and corneal astigmatism (<i>p</i> = 0.001). There was no statistically significant difference between fellow eyes and eyes of healthy controls regarding any of refractive parameters.</p><p><strong>Conclusion: </strong>Treated retinoblastoma eyes had shallower anterior chamber, more rounded lens, more astigmatic corneas, and more refractive astigmatism than healthy eyes.</p>","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":" ","pages":"155-163"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Series: Retinal Pigment Epithelial Detachments Over Choroidal Nevi - What Is the Clinical Significance?","authors":"Julie M Shabto, Jill R Wells, Hans E Grossniklaus, Corrina P Azarcon","doi":"10.1159/000542860","DOIUrl":"10.1159/000542860","url":null,"abstract":"<p><strong>Introduction: </strong>Retinal pigment epithelial detachment (PED) is an uncommon finding associated with choroidal nevi. In this case series, we describe PED overlying a choroidal nevus in 4 patients and discuss the clinical significance of this diagnosis.</p><p><strong>Case presentations: </strong>Four adult patients diagnosed with unilateral choroidal nevi with associated overlying PEDs were followed over time. Two patients were referred for evaluation due to concerns about potential growth. Fundus photography, B-scan ultrasonography, and optical coherence tomography were performed in all cases. None of the patients developed visual symptoms attributable to the choroidal nevus or PED. No progression or malignant transformation was observed during follow-up.</p><p><strong>Conclusion: </strong>While PED does not appear to increase the risk of progression to melanoma, it may complicate the evaluation of the underlying choroidal nevus and could lead to decreased visual acuity. Therefore, choroidal nevi with overlying PED should be monitored over time, with particular attention to the potential development of secondary choroidal neovascularization.</p>","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":"11 2","pages":"125-131"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low Occurrence of Ocular Adverse Events after CAR-T Cell Therapy.","authors":"Tara Murty, Karen M Wai, Ehsan Rahimy, Prithvi Mruthyunjaya","doi":"10.1159/000543055","DOIUrl":"10.1159/000543055","url":null,"abstract":"<p><strong>Introduction: </strong>Chimeric antigen receptor (CAR)-T cell therapies have demonstrated remarkable therapeutic efficacy in leukemias and lymphomas that were previously considered incurable. However, concerns persist over potential risks related to toxicities, including those secondary to activation of the patient's immune system.</p><p><strong>Methods: </strong>To investigate ocular adverse effects (o-AEs) associated with CAR-T cell therapy, a retrospective cohort study was designed in which data were obtained from the TriNetX aggregated electronic health records database through August 2024, with data analysis performed in August 2024. Billing codes were used to identify patients receiving autologous CAR-T therapy approved by the US Food and Drug Administration (FDA) for the treatment of a hematological malignancy: tisagenlecleucel, brexucabtagene autoleucel, lisocabtagene maraleucel, ciltacabtagene autoleucel, idecabtagene vicleucel, or axicabtagene ciloleucel.</p><p><strong>Results: </strong>In a cohort of 684 patients on CAR-T therapy with at least 6 months of follow-up, the most prevalent o-AEs were related to vision changes (1.9%), which included vitreous opacities, visual disturbances, diplopia, and visual discomfort; inflammation (1.8%), which included optic neuritis, conjunctivitis, optic papillitis, chorioretinal inflammation, iridocyclitis, zoster ocular disease; and dry eyes (1.6%), which included dry eye syndrome, keratitis, and ocular manifestations of Vitamin A deficiency.</p><p><strong>Conclusion: </strong>In the period of 6 months following CAR-T therapy infusion, o-AEs were rare in patients receiving CAR-T cell therapy, indicating that patients without existing eye conditions do not need routine prescreening or directed follow-up after treatment, unless symptomatic. Ongoing monitoring and reporting of ocular adverse events will be important given the durable effects of CAR-T therapy in the treatment of hematologic cancers as well as increasing indications for CAR-T therapy in malignant and nonmalignant disease.</p>","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":"11 2","pages":"104-108"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}