Morgagnian cataract simulating iris neoplasia : case report

Purpose: to describe a case in which the diagnosis of Morganian cataract required clinical and instrumental differentiation from iris pathologies, including iris melanoma. Methods: a 60-years-old Caucasian man referred to our institute for worsening of vision in last few months. Clinical evaluation consisted in complete ophthalmological assessment, ultrasound examination (biomicroscopy and 20MHz), and Magnetic Resonance Imaging (MRI) completed with Susceptibility Weighted Imaging (SWI). Results: traumatic corneal wound of the left eye (LE) had occurred 5 years before, and was treated with medical therapy alone. Best-corrected visual acuity (BCVA) was 3/10 in the right eye (RE) and finger count in the LE, with intraocular pressure at 13 and 20mmHg, respectively. Chronic central serous chorioretinopathy, accounted for the low visual acuity of the RE. Slit-lamp biomicroscopy of the LE was as in Figure 1; LE fundus was not clinically observable. Despite MRI was compatible with an iris solid formation, characterized by contrast enhancement and hyperintense signal in SWI, ultrasound indicated rather a mixed solid and liquid content (moderately echogenic external layer, hyporeflective internal content). Iris root and ciliary body were not significantly altered; the lens showed inhomogeneous content. We considered Morgagnian cataract the most probable diagnosis. Surgery confirmed the presence of a hypermature cataract with prior anterior capsule fissuring; the liquefied cortex infiltrated the iris without anterior chamber seeping. Post-operative BCVA was 3/10 and fundus examination disclosed an advanced macular chronic central serous chorioretinopathy. Conclusions: In the reported case a previous perforating trauma have probably damaged the lens capsule and started cataract progression. Curiously cataract developed percolating into the iris stroma, thus simulating an iris mass. At our knowledge, Morgagnian cataract has never been included in the differential diagnosis of iris mass.

Guía para la incubación y alevinaje de trucha arco iris Oncorhynchus mykiss

Considerando este potencial y asociándolo con el uso exitoso de la trucha arco iris (Oncorhynchus mykiss) en actividades acuícolas en las zonas altoandinas del Perú, el Imarpe, dentro del Presupuesto por Resultados 2013 y 2014, a través de la meta Asistencia Técnica en Zonas Altoandinas y Amazónicas - Región Ayacucho, ha ejecutado el proyecto “Implementación de módulos prefabricados para la incubación de ovas importadas y obtención de alevinos de trucha arco iris”. Se inició las actividades con una evaluación e identificación de las zonas, cuyas características topográficas y de abastecimiento de agua fueron ideales para la incubación de ovas embrionadas de trucha arco iris. En tal sentido, las zonas identificadas fueron los Distrito de Socos, Chungui y Huanta.

Iris varix as a cause of late-onset inflammation after implantation of a phakic iris claw lens [Irisvarize als Ursache einer verzögerten Entzündung nach Implantation einer Iris-Clip-Linse ins phake Auge]

Implantation of a phakic iris claw intraocular lens is a common, effective and safe procedure to correct high myopia, hyperopia and astigmatism [2]. Due to the nature of its fixation on the iris using claws, chronic irritation and inflammation have remained a major concern with the Artisan® lens since its market introduction in 1998. Following iris claw implantation, monitoring of postoperative inflammation is mandatory [4][7]. Usually, signs of inflammation can be detected in the anterior chamber during the early postoperative period. We present here the first case of late-onset inflammation after implantation of an iris claw lens triggered by an iris varix. The iris varix is a rare benign iris vascular abnormality, with a low prevalence as a solitary primary lesion in the general population and little is known about its clinical characteristics [1][5][6]. This report shows that an iris varix could be a cause of a late onset and chronic inflammation after phakic Artisan® lens implantation.

Trascendiendo al yo ensimismado. La ética de la atención de Iris Murdoch

Muchos de los dilemas morales perderían su intensidad, piensa Iris Murdoch, si abandonáramos la idea de una voluntad soberana que elige autónomamente sus cursos de acción. Prestar atención a la constitución de la realidad posibilita una suerte de ascesis experiencial que conduce más allá del los devaneos de un yo ensimismado. El ejercicio de apreciación de los detalles, de las conexiones, de la complejidad, modifica la decisión misma: no se trata de elegir, sino de "ver" lo moral -la exigencia de la cosa-, igual que un artista cabal no pinta lo que "le gusta" sino "lo que está ahí".

Utility of a biopsy in suspicious pigmented iris tumors.

BACKGROUND: In the presence of pigmented iris lesions evocative of malignant melanoma and implying oncological treatment, a foregoing biopsy to exclude a benign lesion may seem a reasonable approach. After examining patient files, the utility of such a diagnostic approach was explored. MATERIAL AND METHODS: Retrospective, consecutive histopathologic case series of 10 pigmented iris tumor specimens excised since 1993. Histopathologic diagnosis was compared with final diagnosis and outcome in the patient's medical chart. RESULTS: Five biopsies had only nevus cells, whereas ulterior clinical data or histopathologic examinations were compatible with the diagnosis of malignant melanoma. One biopsy contained insufficient sample tissue. Four biopsies confirmed clinical suspicion of iris melanoma. CONCLUSION: In the current case series, 6 out of 10 biopsies provided a falsely reassuring negative or an inconclusive result. Modern management techniques such as ultrasound biomicroscopy and proton therapy of the whole anterior segment have equally diminished indications for a biopsy. In cases clinically evocative of iris melanoma, a biopsy has only a relative value.

Whole anterior segment proton beam radiotherapy for diffuse iris melanoma.

AIM: To report the results of whole anterior segment proton beam radiotherapy (PBR) for diffuse iris melanoma. METHODS: Between 2000 and 2011, 12 patients with iris melanoma received PBR to the entire iris and ciliary body. RESULTS: Patients had a mean age of 57 years and a median follow-up of 3.5 years (range 1-11.6 years). Tumour iris involvement was 1-4 h in five patients, 5-8 h in four and 9-12 h in three. Angle involvement was 6-8 h in five patients and 9-12 h in seven. The visual acuity (VA) before treatment was 6/5-6/6 in six patients, 6/8-6/9 in three and 6/18-6/38 in three. No tumour recurrence occurred during the follow-up period. Glaucoma treatment was required in 11 of 12 patients. The visual acuity at the last follow-up was 6/5-6/9 in five patients, 6/18-6/24 in three, 6/60-1/60 in two and no light perception in two. Four patients developed varying non-severe degrees of limbal stem cell deficiency, which was treatable with conservative measures. CONCLUSIONS: Whole anterior segment PBR is a useful alternative to enucleation for diffuse iris melanoma. Most patients will need treatment for glaucoma and some may require treatment for tear-film instability and/or stem cell failure.

Iris Murdoch on virtue

Murdoch trata del concepto de virtud en diversos textos en los que aparece estrechamente relacionado con otros conceptos que son esenciales para entender su explicación de la teoría ética. Definida como ¿atención desinteresada a la naturaleza¿, la virtud establece la conexión entre los seres humanos y la realidad y puede entenderse en términos de conocimientoy de imaginación; en consecuencia, Murdoch afirma que la virtud mantiene una clara relación con las novelas. La finalidad de este artículo es analizar los textos de IrisMurdoch sobre la virtud para explicar sistemáticamente las características de la virtud, su conexión con otros conceptos y su importancia en el mundo del arte.

A new locus for congenital cataract, microcornea, microphthalmia, and atypical iris coloboma maps to chromosome 2.

OBJECTIVE: To report a novel phenotype of autosomal dominant atypical congenital cataract associated with variable expression of microcornea, microphthalmia, and iris coloboma linked to chromosome 2. Molecular analysis of this phenotype may improve our understanding of anterior segment development. DESIGN: Observational case study, genome linkage analysis, and gene mutation screening. PARTICIPANTS: Three families, 1 Egyptian and 2 Belgians, with a total of 31 affected were studied. METHODS: Twenty-one affected subjects and 9 first-degree relatives underwent complete ophthalmic examination. In the Egyptian family, exclusion of PAX6, CRYAA, and MAF genes was demonstrated by haplotype analysis using microsatellite markers on chromosomes 11, 16, and 21. Genome-wide linkage analysis was then performed using 385 microsatellite markers on this family. In the 2 Belgian families, the PAX6 gene was screened for mutations by direct sequencing of all exons. MAIN OUTCOME MEASURES: Phenotype description, genome-wide linkage of the phenotype, linkage to the PAX6, CRYAA, and MAF genes, and mutation detection in the PAX6 gene. RESULTS: Affected members of the 3 families had bilateral congenital cataracts inherited in an autosomal dominant pattern. A novel form of hexagonal nuclear cataract with cortical riders was expressed. Among affected subjects with available data, 95% had microcornea, 39% had microphthalmia, and 38% had iris coloboma. Seventy-five percent of the colobomata were atypical, showing a nasal superior location in 56%. A positive lod score of 4.86 was obtained at theta = 0 for D2S2309 on chromosome 2, a 4.9-Mb common haplotype flanked by D2S2309 and D2S2358 was obtained in the Egyptian family, and linkage to the PAX6, CRYAA, or MAF gene was excluded. In the 2 Belgian families, sequencing of the junctions and all coding exons of PAX6 did not reveal any molecular change. CONCLUSIONS: We describe a novel phenotype that includes the combination of a novel form of congenital hexagonal cataract, with variably expressed microcornea, microphthalmia, and atypical iris coloboma, not caused by PAX6 and mapping to chromosome 2. FINANCIAL DISCLOSURE(S): The authors have no proprietary or commercial interest in any materials discussed in this article.

Efeito de deficiência de micronutrientes no estado nutricional da mamoneira cultivar Iris

Os objetivos deste trabalho foram caracterizar os sintomas visuais de deficiência de micronutrientes e avaliar efeitos desses micronutrientes no estado nutricional da mamoeira. O experimento foi realizado em casa de vegetação utilizando-se solução nutritiva, de fevereiro a junho de 2003. Foram utilizadas plantas de mamoneira (Ricinus communis L.) do híbrido comercial Íris. Os tratamentos foram: completo, omissão de B, omissão de Cu, omissão de Fe, omissão de Mn, omissão de Mo e omissão de Zn. A omissão de B, Fe e Mn resultou em sintomas característicos de deficiência. Os sintomas se desenvolveram primeiramente em plantas deficientes em Fe ou Mn, seguidas das deficientes em boro. A produção de matéria seca foi afetada na seguinte ordem: Fe>Mn>B. Tanto as folhas superiores como as inferiores refletem o estado nutricional da mamoneira em relação a B, Cu, Fe, Mn, Mo e Zn. O teor de clorofila nas folhas, medido em unidades SPAD, foi influenciado pela omissão dos micronutrientes.

Deficiências de macronutrientes no estado nutricional da mamoneira cultivar Iris

Os objetivos deste trabalho foram avaliar o efeito da deficiência dos macronutrientes no crescimento e estado nutricional da mamoneira (Ricinus communis L.) e a obtenção do quadro sintomatológico das deficiências de N, P, K, Ca, Mg e S. Cultivou-se Ricinus communis L. cultivar Iris em solução nutritiva, tendo como tratamentos soluções completa e deficientes em N, P, K, Ca, Mg e S. Foram determinadas a concentração indireta de clorofila, a atividade da redutase do nitrato, os teores solúveis de N (NO3-), P (H2PO4-) e K+ e realizados testes rápidos para N, P e K. As deficiências de N, Ca, S e Mg foram as que mais restringiram a produção de massa de matéria seca, na ordem decrescente: N>Ca>S>Mg>K>P. Os maiores acúmulos de macronutrientes, no tratamento completo, foram observados nas raízes e no limbo das folhas inferiores. As concentrações críticas para N e Ca, ambas no limbo das folhas superiores e, Mg, no pecíolo das inferiores foram, respectivamente, 46,7, 13,8 e 6,5 g kg-1. As deficiências influenciaram as leituras do clorofilômetro. A atividade da redutase do nitrato guardou relação direta com a determinação da clorofila. Os teores de N (NO3-), P (H2PO4-) e K+ foram menores nas folhas deficientes em N, P e K, respectivamente, o mesmo acontecendo quando avaliadas pela análise de toque.

Pekka Raittila lestadiolaisuutta koskevan lähdeaineiston kerräjänä ja järjestäjänä

Zusammenfassung: Pekka Raittila als Sammler und Ordner von Quellen über das Laestadianertum

Metadifferentiation of iris nevi after iridectomy: a clinicopathological small case series

Abstract Purpose Iridectomy of suspicious pigmented tumors provides the presumed advantage of both a histopathological diagnosis and treatment of the lesion. We present 2 patients that developed an iris melanoma with extrascleral extension at the site of their iridectomy of a histopathologically proven nevus, 46 and 2.5 years later. Methods Retrospective, clinicopathological small case series of 2 patients. Results Two patients underwent iridectomy for a suspicious tumor, the first in 1963 and the second in 2006. Pathological diagnosis was a benign and a borderline nevus respectively. In 2009, both patients presented with a recurrent melanocytic iridociliary tumor with an extrascleral extension adjacent to the surgical scar. Pathological examination confirmed melanoma. Consequently, the two patients underwent proton beam therapy of the whole anterior segment, with limbus deposition and reposition. Conclusion Iridectomy of a histopathologically proven nevus doesn't exclude the possibility of a metadifferentiation of remaining nevus cells into melanoma, even after 46 years. Additionally, treatment in case of a recurrence is more complicated than a primary radiotherapy of the unbiopsied iris tumor, with clinical proof of growth, would have been.