To determine the presence of vascular endothelial growth factor A (VEGF-A) in the aqueous humor of eyes with uveal melanoma and to identify its source. Methods: The VEGF-A concentrations were determined in aqueous humor samples obtained after enucleation from 74 eyes with untreated uveal melanoma and from 8 eyes with treated uveal melanoma. Patient survival and clinical and histopathological tumor variables were compared. In situ hybridization, Western blot analysis, and enzyme-linked immunosorbent assay were used to determine expression of VEGF-A in tumor tissue and in overlying retina. Results: Aqueous VEGF-A concentrations ranged from 18 to 826 pg/mL in 74 untreated eyes, while concentrations in 30 control eyes were significantly lower (median, 50.1 pg/mL) (PϽ.001). Concentrations in 8 treated eyes were much higher (median, 364 pg/mL). In situ hybridization on tissue sections and Western blot analysis and enzyme-linked immunosorbent assay on tissue extracts revealed VEGF-A in uveal melanoma tissue and in retinal tissue. Conclusions: Uveal melanoma is associated with increased concentrations of VEGF-A in aqueous humor. Aqueous VEGF-A concentration correlates with largest basal tumor diameter and with the tumor height. In eyes with uveal melanoma, tumor and retinal tissues are sources of VEGF-A.
The present series demonstrates that even limited, low-irradiance, single-spot photodynamic therapy with verteporfin is an effective first-line treatment for choroidal hemangiomas.
We prospectively studied the results of carotid angiography in 45 patients with transient or nondisabling neurologic deficits caused by lacunar infarction in the internal capsule or corona radiata and demonstrated by computed tomography. An ipsilateral stenosis at the bifurcation of the internal carotid artery was found in 14 patients (31%, 95% confidence limits 18-47%), seven of whom also had stenosis of the contralateral internal carotid artery. In previous studies an average of 65% of patients with transient hemispheric deficit had internal carotid artery stenosis or occlusion. Hypertension and hypertensive retinal vasculopathy assessed by fundus photographs were found in most patients, but not significantly more often in the patients without internal carotid artery stenosis. Our findings support the notion that small vessel disease rather than emboli from the carotid bifurcation is the most common cause of lacunar infarction. {Stroke 1988; 19:1093-1096)
Dendritic cell vaccination is feasible and safe in metastatic uveal melanoma. Dendritic cell-based immunotherapy is potent to enhance the host's antitumor immunity against uveal melanoma in approximately one third of patients. Compared with other prospective studies with similar inclusion criteria, dendritic cell vaccination may be associated with longer than average overall survival in patients with metastatic uveal melanoma.
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