* BACKGROUND AND OBJECTIVE: To compare the use of cyclocryotherapy and diode laser cyclophotocoagulation for the treatment of uncontrolled intraocular pressure. * PATIENTS AND METHODS: Seventy consecutive patients (70 eyes) treated for high, unresponsive intraocular pressure during a 4-year period with cyclocryotherapy (n = 38) or diode laser cyclophotocoagulation (n = 32) with a follow-up period of at least 3 months (mean follow-up = 15.7 months) were compared for intraocular pressure, visual acuity, and complication rate. * RESULTS: Mean intraocular pressure was reduced from 40.9 ± 11.9 to 20.5 ± 10.3 mm Hg in the cyclocryotherapy group, and from 35.9 ± 9.3 to 21.3 ± 10.7 mm Hg in the cyclophotocoagulation group. Intraocular pressure was controlled in 60.5% and 62.5% of eyes, respectively. Deterioration in visual acuity occurred in 31.5% of the cyclocryotherapy group and 37.5% of the cyclophotocoagulation group. Severe visual loss to no light perception was noted in 6 eyes and 2 eyes, respectively, and phthisis bulbi in 2 eyes in the cyclocryotherapy group (5.2%) and 1 eye in the cyclophotocoagulation group (3.1%). * CONCLUSIONS: Cyclocryotherapy and diode laser cyclophotocoagulation are equally effective in decreasing intraocular pressure in patients with persistent uncontrolled glaucoma, with a lower rate of complications associated with diode laser cyclophotocoagulation. [Ophthalmic Surg Lasers Imaging 2005,36:272279.]

The FD-FLIM system can provide a high throughput diagnostic technique that does not require a physician.

We aimed to characterise the response of locally advanced basal cell carcinoma (BCC) to systemic treatment with Vismodegib, a Hedgehog pathway inhibitor, by changes in the expression levels of Hedgehog pathway genes. Data were collected prospectively on 12 patients treated systemically for locally advanced BCC. Biopsy samples taken on admission and after treatment cessation were analysed pathologically and with the NanoString nCounter system to quantify the expression of 40 Hedgehog signaling pathway genes. Findings were compared before and after treatment, between complete and partial responders, and with localised BCC samples from 22 patients. Sixteen Hedgehog pathway genes changed significantly from before to after treatment. GAS1 was the only gene with a significantly different expression at baseline between complete responders (6 patients) and partial responders (4 patients) to Vismodegib (P = 0.014). GAS, GLIS2 and PRKACG1 showed different expression before treatment between the locally advanced and localised BCCs. The baseline expression level of GAS1 appears to be predictive of the response of locally advanced BCC to systemic Vismodegib treatment. A change in expression of many Hedgehog pathway genes, albeit expected by the known activity of Vismodegib, may nevertheless serve as an indicator of the response potential of the tumour.Basal cell carcinoma (BCC) is the most common cancer in the world, with a lifetime risk of 20% and an incidence that has grown continuously over recent decades 1,2 . BCC accounts for 80% of all nonmelanoma skin cancers. It occurs with greatest frequency in Caucasian and elderly populations 1,2 . The tumours are generally slow-growing, rarely fatal (mortality rate, less than 0.1%), and seldom metastasise (up to 0.5% of all cases) 1,2 . For localised BCCs, surgical treatment has a 5-year cure rate of more than 95% 3,4 . However, for the minority of BCCs that are locally advanced (laBCC) or metastatic (metBCC), conventional treatment methods are inadequate, and systemic therapies are considered the appropriate approach 2 .The Hedgehog (Hh) signal transduction pathway is one of the key regulators of cell proliferation and differentiation during embryogenesis and plays a major role in ensuring proper embryonic development 5,6 . In adults, the Hh pathway is normally inactive except in stem and skin cells and hair follicles. However, studies have shown that aberrant uncontrolled activation of the Hh pathway is maintained in 95% of sporadic BCCs in addition to several other malignancies 7 .The Hh pathway is activated when the Hh ligand binds to and inhibits the Patched 1 (PTCH1) receptor, an inhibitor of the G-protein-coupled smoothed (SMO) transmembrane receptor. As a result, the activated SMO then inhibits the negative regulator Suppressor of Fused protein which binds glioma associated (GLI) transcription factors in the cytoplasm. The GLI transcription factors are then left free to enter the cell nucleus and promote cell division and tumourigenesis (Fig. 1A) 5,6,8 . Approximately 90% ...

Optic pathway glioma (OPG) presents in childhood and can cause significant morbidity and visual loss. Magnetic resonance imaging (MRI) is the current imaging modality of choice for evaluation of OPG progression, but it is a relatively limited resource often requiring sedation in the pediatric age group. Additionally, OPG progression on MRI does not always correlate with clinical progression. As a result, several other modalities for evaluating OPG are being investigated, including optical coherence tomography (OCT), a readily available imaging technique in ophthalmic practice. The purpose of the present study was to examine the association between retinal nerve fiber layer (RNFL) thickness measured using OCT and optic nerve function in children with OPG with and without neurofibromatosis-1 (NF-1). A retrospective chart review was conducted to identify children diagnosed with OPG from 2001 to 2015 at a tertiary pediatric medical center. The correlation between OCT measurements and clinical visual parameters was statistically analyzed. Included were 23 children with imaging-confirmed OPG and spectral domain OCT: 10 with NF-1 (mean age at diagnosis 5.8 years) and 13 without (mean age at diagnosis 5.9 years). The glioma involved the chiasma-hypothalamus in 19 patients, optic nerve in 11, and optic tract in 7; more than one anatomic site was affected in 15. Symptoms were reported in 2 patients with NF-1 and most patients without NF-1. Visual field defects included monocular, bitemporal, nasal, and homonymous hemianopia. Initial mean RNFL was 85.4 μm in the NF-1 group and 65 μm in the non-NF-1 group. Visual acuity deteriorated in 1/10 patients and 5/13 patients, respectively. Repeated OCT showed continued RNFL thinning in 3 patients (5 eyes) in the NF-1 group and in 8 patients (11 eyes) in the non-NF-1 group, often associated with a decrease in optic nerve function. In conclusion, visual function in children with OPG is correlated with repeated OCT measurements and weakly with neuroimaging. Children without NF-1 are usually symptomatic and have a worse clinical outcome. These findings may have important implications when considering initiating, continuing or stopping chemotherapy for OPG. The application of OCT in the assessment of OPG and the correlation of the findings to clinical progression can have a significant impact on OPG patient management.