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Abstract: The diagnosis of idiopathic intracranial hypertension (IIH) relies heavily on the appearance of the optic disc. We report eighteen children referred to us over a 3 year period with disc swelling and suspected IIH. Following a tertiary ophthalmological review, papilloedema was excluded in ten with buried drusen, disc crowding, pseudopapilloedema, or misinterpretation of normal appearances. In these ten children, five had a mean opening pressure on lumbar puncture of 27.2cm H2O, range19–32, which was significantly lower than those with IIH (37.5cm H2O, range 29–47; p<0.01). We conclude that diagnosis of IIH is difficult, and that more precisely defined criteria for assessment and diagnosis are needed. [Copyright &y& Elsevier]

Mudhar H S, Parsons M A, Sisley K, Rundle P, Singh A & Rennie I G (2004) Histopathology 45, 1–12 A critical appraisal of the prognostic and predictive factors for uveal malignant melanoma [ABSTRACT FROM AUTHOR]

Discusses the differential diagnosis of posterior uveal melanomas. Tumors and related lesions of the retinal pigment epithelium; Combined hamartoma of the retina and retinal pigment epithelium; Primary choroidal tumors; Vasoproliferative tumors of the retina; Age-related choroidal neovascularization; Posterior scleritis; Factors behind the improvement in the accuracy of diagnosis.

Tamoxifen plays a major role in the management of breast cancer in women and is currently used to a lesser extent in other neoplasias. Many of the pharmacological properties of tamoxifen are consistent with anti-estrogen activity, but it also has significant, although lesser, benefit in patients whose tumours are estrogen-receptor negative. We recently reported that murine B16 melanoma cell attachment to extracellular matrix proteins can be inhibited by calmodulin antagonists. In seeking a calmodulin antagonist that could be used clinically, we investigated tamoxifen, which is known to have calmodulin antagonist activity in vitro, and confirmed that it will inhibit murine melanoma cell attachment in vitro. In the current study, we examined the effect of tamoxifen on the attachment of human ocular melanoma cell lines to a range of extracellular matrix substrates to evaluate the potential relevance of calmodulin antagonists, including tamoxifen, to reducing metastatic spread of these tumours. We report that six ocular melanoma cell lines established from choroidal melanoma tumours showed rapid attachment to a range of substrates and that this attachment can be significantly reduced by an experimental calmodulin antagonist (J8) and by tamoxifen. In summary, we conclude that the ability of calmodulin antagonists, including tamoxifen, to inhibit ocular melanoma cell attachment to matrix proteins in vitro merits further investigation as it may offer another approach to reducing metastatic spread of these tumours. [ABSTRACT FROM AUTHOR]

Presents case reports of patients with adenoma of ciliary pigment epithelium. Paradoxical behavior of the condition; Extensive pigment dispersion caused by larger lesions with smaller lesions invading the angle; Consideration of fine needle aspiration biopsy for aiding diagnosis of malignancy.

PURPOSE. The aim of the study was to determineto what extent collagen gel contraction could be reduced by calcium and calmodulinantagonists and agents that elevate cyclic AMP in order to develop a pharmacologicalapproach to prevent/arrest RPE contraction of epiretinal membranes in proliferativevitreoretinopathy. We also explored a possible role of pigment in collagengel contraction. METHOD. We measured RPE mediated contraction of 3D collagen gels in thepresence and absence of the calcium and calmodulin antagonists TMB8, Verapamiland Tamoxifen and the cAMP elevating agents IBMX and Forskolin. The effectof pigment on collagen gel contraction was assessed by comparing gel contractionmediated by RPE cells re-pigmented with melanin with that mediated by unpigmentedRPE. The effect of IBMX on RPE proliferation was assessed using a BrdU ELISAand the effects of IBMX on RPE cytoskeleton and cell shape were assessed usingActin and Cytokeratin immunocytochemistry. RESULTS. We report that both cAMP elevating agents and calcium and calmodulinantagonists reduce RPE mediated collagen gel contraction. Cyclic AMP elevationwas more effective than a reduction in calcium in reducing contraction. Therewere no significant advantages in combining both approaches. The presenceof melanin had no effect on gel contraction. Calcium antagonists and particularlyagents which elevate cAMP caused RPE cells in collagen gels to extend fewerand shorter processes. cAMP elevation in particular caused RPE cells to becomemore rounded and develop arborised cell processes. Immunostaining for actinand cytokeratin revealed changes in cytoskeletal organisation in responseto IBMX in that cells contained less actin than untreated cells and concentratedcytokeratins more centrally. CONCLUSION. We have identified two possible pharmacological approacheswhich may provide a new direction for preventing or slowing down the developmentof PVR. [ABSTRACT FROM AUTHOR]

Analyzes the occurrence of occult chlamydial ophthalmia in men with non-gonococcal urethritis. Cause of chlamydial ophthalmia; Relationship between occult chlamydial ophthalmia and overt genitourinary infections; Evaluation of the prevalence of chlamydia in the eye of men.

PURPOSE. The aim of this study is to explore therole of intra-cellular calcium in the mechanism of co-regulation of retinalpigment epithelial cells (RPE) by vitreous fluid and platelet mitogens, inorder to evaluate the use of calcium modulating drugs in preventing RPE cellproliferation and contraction of fibrocellular membranes. METHODS. Monolayers of human RPE cells were loaded with Fura-2-AM and examinedin a fluorimeter for changes in intra-cellular free calcium in response toplatelet mitogens (PDG-FAB or TGFβ1) and vitreous fluid (containing vitreoussubstrate proteins), both alone or in combination. The effect of the calciumantagonists TMB8 and verapamil and the calmodulin antagonists J8 and tamoxifenwere then examined on RPE cell proliferation and pigmentation, both in thepresence and absence of vitreous substrate and platelet mitogens. RESULTS. We report that co-exposure of RPE cells to platelet mitogens andvitreous fluid produces an increase in intracellular free calcium of greaterduration than that with either PDG-FAB, TGFβ1 or vitreous fluid alone.Calcium and calmodulin antagonists significantly reduce RPE cell proliferationin both the presence and absence of vitreous substrate and platelet mitogens.Calcium antagonists also stimulate the accumulation of autofluorescent granuleswithin RPE cells. CONCLUSIONS. Calcium signalling plays a role in the co-regulation of RPEcells by vitreous substrate and platelet mitogens. Drugs that lower intracellularcalcium or inhibit calmodulin may offer an additional approach to preventingthe hyperproliferation of RPE cells in PVR. [ABSTRACT FROM AUTHOR]