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The contrast sensitivity of 21 patients was measured using TV equipment (Wavetek 143 function generator and Sony PVM-90CE video monitor) and the Vistech test 6-15 years after the acute stage of central serous retinopathy. In the majority of cases contrast sensitivity was lower in the affected eye. The difference between the affected and the fellow eye was statistically significant at 1 and 6 cycles/degree (c/d) but not at 19 c/d. In 13/21 cases (62%) the results of the Vistech test were consistent with those of the TV test. Contrast sensitivity did not correlate with the duration of the disease or with the ultimate clinical picture of the macula. At 6 c/d there was a statistically significant correlation between visual acuity and contrast sensitivity. If the visual acuity was less than 1.0, contrast sensitivity was decreased, but decreased contrast sensitivity was also observed in four eyes with normal visual acuity, indicating that the level of visual deficit may not be established by measurement of visual acuity alone.

Uveal melanoma is the most common primary intraocular tumour. Once haematogenous metastasis has occurred, there is no cure for the disease and there is an obvious need for new biological prognostic markers to estimate the risk of metastasis. In this study, the expression of matrix metalloproteinase‐2 (MMP‐2) was characterized immunohistochemically in 29 human uveal melanomas. Enzyme‐linked immunoassays and gelatin zymographies were assessed in order to quantify the expression of gelatinases A and B, as well as the tissue inhibitor of metalloproteinases (TIMPs), in the vitreous body. A total of 49 per cent of the uveal melanomas displayed a positive immunoreaction for MMP‐2 in melanoma cells, the epithelioid cells showing the most frequent staining. There was no correlation between the positivity of MMP‐2 staining and the size of the primary tumour, gender or age. The expression of MMP‐2 was associated with a dismal prognosis: the 5‐year overall survival rate for MMP‐2‐positive cases was significantly inferior to that of the MMP‐2 negative cases, 49 per cent vs. 86 per cent, respectively (p=0·02). A patient group at high risk of metastatic disease was identified; only 38 per cent of patients with a MMP‐2‐positive non‐spindle cell uveal melanoma survived for 5 years. The analyses of MMPs or TIMPs in the vitreous body had no prognostic value. Positive immunostaining for MMP‐2 was observed in the retinal pigment epithelium, corneal epithelium, and fibroblasts in the ciliary body and choroid. It is concluded that immunohistochemical analysis of MMP‐2 may help to predict a risk of metastasis in uveal melanoma. Copyright © 1999 John Wiley & Sons, Ltd.

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