Objective To observe the time-intensity curve characteristics of contrast agents in intraocular tumor. Methods A total of 236 patients (238 eyes) with intraocular tumor were enrolled in this study. All the patients received regular ophthalmologic examination, two dimensional ultrasound, color doppler ultrasonography and contrast-enhanced ultrasonography. There were 166 patients (166 eyes) with choroidal melanoma, 16 patients (18 eyes) with choroidal metastatic carcinoma, 52 patients (52 eyes) with choroidal hemangioma, two patients (two eyes) with retinal hemangioma. The whole process of contrast-enhanced ultrasound were recorded, and exported as t images of Dicom format. These images were processed by Sonoliver software (Tomteck Company, Germany) to drawn the time-intensity curve of contrast agents in the intraocular tumors. Results All intraocular lesions were completely filled with contrast agent, concentric filling from the periphery to the center can be documented in some cases. The time-intensity curve of choroidal hemangioma and retinal hemangioma were basically the same. The time-intensity curve of choroidal melanoma and choroidal metastatic carcinoma were also basically the same. In the filling phase, all tumors were rapid filling type. In the regression phase, contrast agent subsided earlier than in control tissue within the melanoma or metastatic carcinoma lesions, but subsided synchronous or slightly faster than in control tissue within the choroidal hemangioma and retinal hemangioma lesions. Among 166 eyes with choroidal melanoma, 138 eyes (83.1%) were in full compliance with the above changes, 28 eyes (16.9%) were largely in line with these changes. All the eyes (100.0%) with choroidal metastatic carcinoma, choroidal hemangioma and retinal hemangioma were in full compliance with the above changes. Conclusion Time-intensity curve is quickly filling and fast regression for malignant intraocular tumors, but is quickly filling and slow regression for benign intraocular tumors.
Objective To evaluate the efficacy of transpupillary thermotherapy（TTT）on three kinds of intraocular benign tumors. Methods Seventeen patients with 3 kinds of intraocular tumors，3 eyes of 3 patients with papillary hemangioma，9 eyes of 9 patients with choroidal hemangioma and 8 eyes of 5 patients with choroidal osteoma were treated with transpupillary thermotherapy.All patients underwent pretreatment ocular examination，including visual acuity，biomicroscopy for anterior segment and fundus examination，fundus fluorescein and indocyanine green angiography，optic coherence tomography，perimetry test，ultrasonography，and CT.TTT was conducted with infrared diode laser at810nm.with power of 360-1200 mW;beam diameter of 3 mm or combined 2-5 spots according to the tumor size;the exposure time was 60-80 seconds.The treatment was completed in one session，and another treatment was given 1-3 month later if active leakage demonstrated.The follow-up period was 6-36 months（mean 14.5 month）. Results The best corrected visual acuity with Snellen chart on average for papillary hemangioma was 0.17 before TTT and 0.27 after;for choroidal hemangioma was 0.39 before TTT and 0.46 after;for choroidal osteoma was 0.20 before TTT and 0.31 after.Three eyes with papillary hemangioma had operation to release subretinal fluid and intraocular laser coagulation;the tumor remained reddish color with dilated vessels and patches of hemorrhages on the surface.After TTT the color appeared pale yellowish，hemorrhages absorbed，subretinal fluid subsided，and choroidal retinal atrophy disclosed along the lower border of the tumor.In 9 eyes with choroidal hemangioma, the red-light area disappeared, subretinal fluid subsided, and the pigment proliferation in the treatment area was found.Eight eyes with choroidal osteoma had choroidal neovessels and macular hemorrhages;after TTT blood disappeared，subretinal fluid absorbed，and the color of tumor showed pale yellow with dark pigment and thin scar tissue.There was no significant complication associated with TTT. Conclusions Transpupillary thermotherapy is effective on papillary hemangioma，circumscribed choroidal hemangioma and choroidal osteoma either as preliminary or supplementary treatment. (Chin J Ocul Fundus Dis, 2006, 22:181-184)
Objective To establish a new model of orthotopic-transplatation tumor of human malignant choroidal melanoma. Methods pEGFP-N1, the eukaryotic expressive plasmid of green fluorescent protein (GFP), was transfered into human malignant choroidal melanoma cell line (OCM-1) by liposome lipofectanine, then the cell clones with stable GFP expression were screened out by means of neomycin, fluorescence microscope, and flow cytometer. Two μl cell suspension of OCM-1 cells with GFP expression with the density of 4.5×107-5.5×107 cells/ml was injected into the subretinal space of right eyes of 40 nude mice (40 eyes) under binocular operating microscope with left eyes as the control ones. The growth of the transplanted malignant choroidal melanoma was observed in vivo using the fluorescence stereomicroscope. The mice were killed at different time after the operation to observe the metastasis of the tumor to optic nerve, brain and other organs including lung, liver, kidney and spleen. Moreover, pathological detection and immunohistochemical staining of GFP was carried out. Results At the postoperative 10th-12th days, the growths of the transplanted malignant choroidal melanoma with dilated and distorted blood vessels and neovascularization were observed; at the postope rative 20th-22nd days, the melanoma occupied the whole cavity of vitreous body; and at the postoperative 24th-26th days, the transplanted tumor grew out of the eye. Metastases of the carcinoma to olfactory bulb, kidney, lung and liver were seen at the failure phase soon after the extra-ocular phase. The histopathological characteristics of the transplanted tumor were similar to those of human, and the results of immunohistochemical staining showed positive expression of GFP in the tumor cells. Conclusion The orthotopic model of malignant choroidal melanoma set up via injection of human malignant choroidal melanoma cells labeled by GFP into the subretinal space of nude mice may provide a new approach to investigate the natural courses of growth and metastasis of malignant choroidal melanoma. (Chin J Ocul Fundus Dis，2004，20：245-248)