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Objective: To determine if quality of life differs between patients with choroidal melanoma treated with enucleation and those treated with radiation therapy., Materials and Methods: Patients treated for choroidal melanoma at 5 Midwest centers were asked to participate. There were 65 participants treated with enucleation and 82 treated with radiation therapy. Quality of life was assessed using the Medical Outcome Study Short Form 36 and the National Eye Institute Visual Function Questionnaire and by the Time-Tradeoff interview method., Results: The average length of follow-up was 4.9 years for the group treated with radiation therapy and 6.3 years for the group treated with enucleation (P = .05). After adjusting for age, sex, years of follow-up, and the number of chronic conditions, there were few differences in any of the quality-of-life measures by treatment status. Participants in the group treated with radiation therapy were more likely to have higher (better) scores on the Vitality and Mental Component subscales of the Medical Outcome Study Short Form 36 than participants treated with enucleation. There were no differences on the National Eye Institute Visual Function Questionnaire or the Time-Tradeoff measures of quality of life., Conclusion: Choice of treatment for choroidal melanoma does not seem to be associated with large differences in quality of life in long-term follow-up.

Objectives: To describe the histopathologic findings attributable to irradiation in eyes with uveal malignant melanoma treated with iodine I 125 brachytherapy and to compare these findings with those reviewed in a previous study that compared histopathologic findings in eyes enucleated after proton beam teletherapy with those seen in eyes in a nonirradiated control group., Methods: The slides from 22 eyes with uveal melanoma that had undergone enucleation after the administration of 125I brachytherapy were studied. The histopathologic features of the tumor and the retina were graded. Results were compared with findings from a previously reported group of 47 proton beam-treated eyes and its control group., Results: Patient age, time between irradiation and enucleation, and ciliary body involvement were similar for the 125I brachytherapy-treated group and the proton beam-treated group and its control group. This allows comparison of the histopathologic findings. Comparing the 125I brachytherapy- and proton beam-treated groups, most histopathologic features were similar with nominally statistically significant differences only for cell type, number of mitotic figures, and fibrous metaplasia of the retinal pigment epithelium adjacent to the tumor., Conclusions: Irradiation of uveal melanoma induces changes in the tumor and in the surrounding retina. Brachytherapy and charged particle therapy are the 2 principal methods of irradiation. This study demonstrates that similar changes are produced by 125I plaque irradiation and proton beam irradiation.

In eight patients with proliferative diabetic retinopathy treated with focal photocoagulation for preretinal new vessels, recurrent preretinal new-vessel systems supplied from the choroid developed. Subsequent treatment in most cases failed to produce permanent obliteration of the new-vessels networks.

Ten cases of retinal pigment epithelial tears were observed in eight patients with serous pigment epithelial detachments associated with age-related macular degeneration. Eight of the ten tears were spontaneous and all occurred at the detachment margin. The resulting area of exposed choroid was sometimes initially mistaken for pigment epithelial atrophy. In two cases it was misdiagnosed as choroidal neovascularization and treated with laser photocoagulation. All but two patients suffered severe visual loss.

The effect of vasodilators on choroidal blood flow (CBF) was studied by the krypton clathrate Kr 85 desaturation technique in anesthetized cats. Niacin, papaverine hydrochloride, phentolamine mesylate, and tolazoline hydrochloride were injected via the lateral long posterior ciliary artery (LLPCA) and the femoral artery. The systemic administration of these drugs via the femoral artery, in the doses used, had no significant effect on mean arterial pressure, choroidal vascular resistance (CVR), or CBF. Local administration of the same agents via the LLPCA caused a decrease in CVR with a corresponding increase in CBF.

The evolution of lacquer cracks is documented by serial fundus photography and fluorescein angiography in a 27-year-old man with high myopia. The case report provides some insight into the possible pathogenic mechanism of lacquer crack formation.

A 13-year-old girl and a 20-year-old man with juvenile-onset diabetes mellitus developed transient bilateral optic disk edema with minimal impairment of optic nerve function and with minimal diabetic retinopathy. This conditions, termed diabetic papillopathy appears to be a local optic disk vasculopathy, and generally resolves without treatment. Diabetic papillopathy should not be mistaken for papilledema or for the optic disk neovascularization of diabetic retinopathy.

The effect of panretinal photocoagulation on ocular blood flow was studied in pigmented rabbits by means of labeled microsphere impaction and in monkeys by indocyanine-green-dye clearance. In the rabbits, one eye of each animal was photocoagulated and the follow eye of the same animal was used as the control. Twenty-six rabbits received full-scatter panretinal photocoagulation (300 +/- 20 burns, one half burn apart) and an additional 32 rabbits received partial-scatter panretinal photocoagulation (150 +/- 20 burns, one burn apart). After full-scatter photocoagulation there was a significant decrease in choroidal-retinal blood flow measured at 1 to 2 hr, 24 hr, 2 weeks, 4 weeks, and 3 months, but no change in iris-ciliary body blood flow. After partial scatter photocoagulation there was no consistent change. In one monkey, 100 burns were placed around the macular area and in a second monkey 100 burns were placed in the inferior half of the ocular fundus. Choroidal blood flow was significantly reduced in both monkeys for the initial hour during which is was continually measured.

Using the labeled microsphere impaction technique, we studied the effect of peripheral panretinal transscleral cryocoagulation in pigmented rabbits. One eye of each animal received peripheral cryocoagulation, and the fellow eye of the same animal was used as the control. Thirty-two animals received 40 exposures of peripheral cryocoagulation; twenty-six rabbits received 20 exposures. After 40 exposures of cryocoagulation, choroidal-retinal blood flow was significantly decreased when measured at one to two hours, 24 hours, and two weeks; normal flow recovered by four weeks. After 20 exposures of cryocoagulation, there was a significant reduction in choroidal-retinal blood flow at the earliest measurement time (one to two hours) only. The iris-ciliary body blood flow also was substantially decreased only at the earliest measurement time (one to two hours) and only after 40 exposures.

The right eye of a 9-year-old white boy with Best's vitelliform macular dystrophy had an intact egg-yolk lesion and a retinal pigment epithelial defect superiorly, suggesting an early pseudohypopyon stage. The disruptive phase of the left eye showed subretinal hemorrhages, a "signet ring," and a subretinal neovascular membrane.

Of 84 patients with unilateral disciform macular degeneration, 36 were followed up for one to four years (average, 22 months). The fellow eye in 13 cases developed disciform lesions during that follow-up period. A significantly greater number of drusen were found in the fellow eyes of patients with unilateral disciform macular degeneration than in the eyes of a comparable control group of patients (P less than .001). Furthermore, the eyes with unilateral disciform macular degeneration that developed disciform lesions in the other eye were characterized as a group by a significantly larger number of drusen than those that did not. We postulate that drusen are precursors of disciform macular degeneration in fellow eyes and are probably manifestations of the same exudative process.

Conjunctival capillary fragility (CCF) and skin capillary fragility (SCF) were studied by a negative-pressure suction cup method in 25 normal subjects and 38 diabetic patients with diabetic retinopathy. The CCF was significantly higher (P less than .001) in patients with diabetic retinopathy than in normal subjects; there was no significant difference in the SCF.