Purpose: To evaluate the efficacy of macular grid photocoagulation in preserving or improving central visual acuity in eyes with macular edema due to central vein occlusion (CVO) and best-corrected ...visual acuity of 20/50 or poorer.
Methods: Patients with angiographically documented macular edema due to CVO were entered into a multicenter randomized controlled clinical trial supported by the National Eye Institute. Eligibility was determined based on both clinical examination findings and photographic documentation evaluated at a photograph reading center. Eyes were assigned randomly to macular grid photocoagulation (77 eyes) or no treatment (78 eyes). Patients were followed every 4 months for 3 years or until the end of the study. The outcome measure was visual acuity.
Results: The study population consisted of 155 eyes in 155 patients. There was no difference between treated and untreated eyes in visual acuity at any point during the follow-up period. Initial median visual acuity was 20/160 in treated eyes and 20/ 125 in control eyes. Final median visual acuity was 20/200 in treated eyes and 20/160 in control eyes. However, treatment clearly reduced angiographic evidence of macular edema.
Conclusion: The results of this study do not support a recommendation for macular grid photocoagulation for the population meeting the Central Vein Occlusion Study macular edema group eligibility criteria.
To study the ability of acute myelogenous leukaemia blasts to spontaneously differentiate in vitro, bone marrow and/or blood mononuclear cells from 63 patients with acute myelogenous leukaemia were ...incubated in liquid suspension cultures containing human serum, without addition of chemical inducers of differentiation. Cultures were examined weekly for disappearance or persistence of blasts, and for appearance of morphologically recognizable granulocytes and macrophages. Culture outcomes were extremely variable, ranging from lack of appearance of differentiated cells to complete disappearance of blasts with replacement by mature cells. In 50 cases an increase (25-185%) in the absolute number of differentiated cells in culture was noted during the culture period. Full differentiation was seen exclusively in cultures from 13/48 (27.1%) patients studied at diagnosis, as compared to 0/20 patients studied at relapse (P less than 0.01). The ability to fully or partially differentiate in culture was lost to a significant degree at relapse (13/20 patients) as compared to diagnosis (48/48 patients, P = 0.0001). At diagnosis full differentiation in culture was associated with a significantly higher remission rate than partial differentiation (89% versus 40%, P less than 0.02). Origination of mature cells from leukaemic rather than normal precursors was suggested by the appearance of Auer rods in mature cells in seven cases, by the correlation of types of differentiated cells seen in culture with the FAB class of leukaemia and by cytogenetic data in one case.
Two patients with indolent B‐cell lymphomas (small B‐cell and small cleaved cell) developed a coexistent malignant histiocytosis 3 and 6 years after diagnosis of their lymphomas. In both patients, ...malignant histiocytosis presented as new onset of fever, weight loss, and rapidly progressive bulky disease superimposed on a previously stable clinical course without constitutional symptoms. Both patients failed to respond to combination chemotherapy. The terminal aggressive phase of indolent B‐cell lymphomas usually represents transformation of the original neoplasm to a large non‐cleaved or immunoblastic B‐cell histology. Malignant histiocytosis has not previously been reported as a second neoplasm in patients with B‐cell lymphomas.
A congenital cystic neck mass causing respiratory distress and hypoplasia of the mandible was excised from a 3-month-old infant. The lesion was subsequently diagnosed as heterotopic brain, a rare, ...benign condition that should be considered in the differential diagnosis of the neonatal head and neck mass.
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