1. Surv Ophthalmol. 2015 Nov 3. pii: S0039-6257(15)30019-9. doi:
10.1016/j.survophthal.2015.10.007. [Epub ahead of print]

Primary Cutaneous Marginal Zone B Cell Lymphoma of the Eyelid Skin: Diagnostic
Clues and Distinction from Other Ocular Adnexal Disease.

Stagner AM(1), Jakobiec FA(2), Freitag SK(3).

Author information: 
(1)David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye & Ear
Infirmary, Boston, MA; Department of Ophthalmology, Harvard Medical School,
Boston, MA. (2)David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts
Eye & Ear Infirmary, Boston, MA; Department of Ophthalmology, Harvard Medical
School, Boston, MA. Electronic address: Fred_Jakobiec@meei.harvard.edu.
(3)Department of Ophthalmology, Harvard Medical School, Boston, MA; Ophthalmic
Plastic Surgery, Massachusetts Eye & Ear Infirmary, Boston, MA.

A 60-year-old man developed a rubbery thickening and erythema of his left lateral
upper and lower eyelids and lateral canthus over several months. He was treated
for an extended period of time for blepharitis and chalazia. Incisional biopsy
eventually disclosed microscopically a hypercellular lymphoid population sparing 
the epidermis that surrounded adnexal structures and infiltrated between
orbicularis muscle fibers. Immunohistochemically, the lesion was found to be
composed of neoplastic, kappa restricted B cells with an equal number of reactive
T cells and small reactive follicles. The diagnosis was a primary cutaneous
marginal zone B cell lymphoma of the eyelid skin (EMZL). We review the
distinguishing clinical, histopathologic and immunohistochemical features of
cutaneous EMZL and contrast those with EMZL of other ocular adnexal sites. We
offer differential diagnosis of cutaneous lymphomas of the eyelid skin, which are
predominately T cell lesions.

Copyright © 2015 Elsevier Inc. All rights reserved.

PMID: 26545575   [PubMed - as supplied by publisher]


2. Surv Ophthalmol. 2015 Oct 28. pii: S0039-6257(15)30028-X. doi:
10.1016/j.survophthal.2015.10.006. [Epub ahead of print]

Seeing through thick and through thin: Retinal manifestations of thrombophilic
and hyperviscosity syndromes.

Rajagopal R(1), Apte RS(2).

Author information: 
(1)Department of Ophthalmology and Visual Sciences, Washington University School 
of Medicine, Saint Louis, Missouri. Electronic address:
rajagopalr@vision.wustl.edu. (2)Department of Ophthalmology and Visual Sciences, 
Washington University School of Medicine, Saint Louis, Missouri. Electronic
address: apte@vision.wustl.edu.

The presence of retinal vasculopathy in the absence of typical predisposing
factors should suggest a possible underlying hematologic abnormality. In such
cases, a systemic investigation may reveal a potentially fatal hypercoagulability
or hyperviscosity syndrome. Retinal vein occlusion is the most
commonly-encountered ophthalmic finding in such syndromes; however, abnormalities
of the arterial system, the choroid, and the macula are also possible. Visual
symptoms may be the only manifestation of the underlying process, making timely
diagnosis by the ophthalmologist critical for both treatment and thrombotic
prophylaxis. Moreover, as newer ophthalmic diagnostic technologies arise, there
is an increasingly important role for eye physicians in the management of such
syndromes.

Copyright © 2015 Elsevier Inc. All rights reserved.

PMID: 26519860   [PubMed - as supplied by publisher]


3. Surv Ophthalmol. 2015 Oct 27. pii: S0039-6257(15)00181-2. doi:
10.1016/j.survophthal.2015.10.003. [Epub ahead of print]

Association of Age-Related Macular Degeneration and Reticular Macular Disease
with Cardiovascular Disease.

Rastogi N(1), Smith RT(2).

Author information: 
(1)Department of Ophthalmology, New York University School of Medicine.
(2)Department of Ophthalmology, New York University School of Medicine.
Electronic address: roland.smith@nyumc.org.

Age-related macular degeneration is the leading cause of adult blindness in the
developed world. Thus, major endeavors to understand the risk factors and
pathogenesis of this disease have been undertaken. Reticular macular disease is a
proposed subtype of age-related macular degeneration correlating histologically
with subretinal drusenoid deposits located between the retinal pigment epithelium
and the inner segment ellipsoid zone. Reticular lesions are more prevalent in
females and in older age groups and are associated with a higher mortality rate. 
Risk factors for developing age-related macular degeneration include
hypertension, smoking, and angina. Several genes related to increased risk for
age-related macular degeneration and reticular macular disease are also
associated with cardiovascular disease. Better understanding of the clinical and 
genetic risk factors for age-related macular degeneration and reticular macular
disease has led to the hypothesis that these eye diseases are systemic. A
systemic origin may help to explain why reticular disease is diagnosed more
frequently in females as males suffer cardiovascular mortality at an earlier age,
prior to the age of diagnosis of reticular macular disease and age-related
macular degeneration.

Copyright © 2015 Elsevier Inc. All rights reserved.

PMID: 26518628   [PubMed - as supplied by publisher]


4. Surv Ophthalmol. 2015 Oct 20. pii: S0039-6257(15)00182-4. doi:
10.1016/j.survophthal.2015.10.004. [Epub ahead of print]

Autoregulation and neurovascular coupling in the optic nerve head.

Prada D(1), Harris A(2), Guidoboni G(3), Siesky B(2), Huang AM(2), Arciero J(4).

Author information: 
(1)Department of Mathematical Sciences, Indiana University-Purdue University
Indianapolis (IUPUI), Indianapolis, Indiana. Electronic address:
dprada@iupui.edu. (2)Department of Ophthalmology, Indiana University School of
Medicine, Indianapolis, Indiana. (3)Department of Mathematical Sciences, Indiana 
University-Purdue University Indianapolis (IUPUI), Indianapolis, Indiana;
Department of Ophthalmology, Indiana University School of Medicine, Indianapolis,
Indiana; LabEx IRMIA, University of Strasbourg, France. (4)Department of
Mathematical Sciences, Indiana University-Purdue University Indianapolis (IUPUI),
Indianapolis, Indiana.

Impairments of autoregulation and neurovascular coupling in the optic nerve head 
play a critical role in ocular pathologies, especially glaucomatous optic
neuropathy. We critically review the literature in the field, integrating results
obtained in clinical, experimental, and theoretical studies. We address the
mechanisms of autoregulation and neurovascular coupling in the optic nerve head, 
the current methods used to assess autoregulation--including measurements of
optic nerve head blood flow (or volume and velocity)--blood flow data collected
in the optic nerve head as pressure or metabolic demand is varied in healthy and 
pathological conditions, and the current status and potential of mathematical
modeling work to further the understanding of the relationship between ocular
blood flow mechanisms and diseases such as glaucoma.

Copyright © 2015 Elsevier Inc. All rights reserved.

PMID: 26498862   [PubMed - as supplied by publisher]


5. Surv Ophthalmol. 2015 Oct 21. pii: S0039-6257(15)30013-8. doi:
10.1016/j.survophthal.2015.10.002. [Epub ahead of print]

Spitz Nevus Arising in the Eyelid of a Teenager.

Shields PW(1), Jakobiec FA(2), Stagner AM(3), Yoon MK(4).

Author information: 
(1)Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia,
PA. (2)David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye & Ear
Infirmary, Boston, MA; Department of Ophthalmology, Harvard Medical School,
Boston, MA. Electronic address: Fred_Jakobiec@meei.harvard.edu. (3)David G. Cogan
Laboratory of Ophthalmic Pathology, Massachusetts Eye & Ear Infirmary, Boston,
MA; Department of Ophthalmology, Harvard Medical School, Boston, MA.
(4)Department of Ophthalmology, Harvard Medical School, Boston, MA; Ophthalmic
Plastic Surgery, Massachusetts Eye & Ear Infirmary, Boston, MA.

A 16-year-old boy developed over a two month interval a lightly pigmented lesion 
measuring 1.5 mm in greatest diameter that, when excised, microscopically was
hypercellular and composed almost exclusively of non-pigmented epithelioid cells 
that created florid, large intraepidermal junctional nests and sheets and nests
of subepidermal cells. The diagnosis was a Spitz nevus. HMB-45, MART-1 and MiTF
were all positive and established the melanocytic nature of the benign tumor. The
Ki-67 proliferation index (5%) and 2 mitoses/mm(2) were both low; p16 protein was
immunohistochemically identified in the nevoid cells. We review the clinical,
histopathologic, and other immunohistochemical features of this entity and
provide a brief differential diagnosis (including separation from a Spitzoid
melanoma). This is only the third eyelid Spitz nevus reported in the literature
and is the most fully characterized. At their present stage of development,
contemporary immunohistochemical biomarkers, while providing supplemental
information, nonetheless remain less than definitive in terms of reliably
distinguishing benign from malignant Spitz lesions.

Copyright © 2015 Elsevier Inc. All rights reserved.

PMID: 26498574   [PubMed - as supplied by publisher]