Jessalinea nr 10

Page 37

NATIONAL GLOBAL RESOLUTE PROGRAM.

revascularisation (7.7% vs 6.5%, p=0.32), and

succumbed 4 years later to generalized meta-

Farooq V, Vranckx P, Mauri L, Cutlip DE, Belardi J,

definite/probable stent thrombosis (1.4% vs

static disease. No other primary paraganglio-

Silber S, Widimsky P, Leon M, Windecker S, Mere-

0.9%, p=0.28). 13-month adjusted angio-

ma was found; however, paraganglion cells in

dith I, Negoita M, van Leeuwen F, Neumann FJ,

graphic outcomes were comparable between

the eye have never been described.

Yeung AC, Garcia-Garcia HM, Serruys PW.

overlapping and non-overlapping DES.

Keywords: Choroidal tumor, Metastatic dis-

Abstract

Conclusions: Overlapping newer generation

ease, Paraganglioma.

Background: Overlapping first generation

DES are safe and effective, with comparable

sirolimus- and paclitaxel-eluting stents are as-

angiographic and clinical outcomes-including

sociated with persistent inflammation, fibrin

repeat revascularisation-to non-overlapping

Gepubliceerd in J Fr Ophtalmol. 2013 Jan 7.

deposition and delayed endothelialisation in

DES.

INTRAVITREAL INJECTION OF ANTI-VEGF AND

preclinical models, and adverse angiographic

DIAGNOSIS OF PRIMARY INTRAOCULAR CEN-

and clinical outcomes-including death and

TRAL NERVOUS SYSTEM LYMPHOMA.

myocardial infarction (MI)-in clinical studies.

Gepubliceerd in Case Rep Ophthalmol. 2013 Jan;4(1):17-22.

Gambrelle J, Missotten G, Delhoum S, Desjardins L.

Objectives: To establish as to whether there

CHOROIDAL PARAGANGLIOMA WITH METAS-

Abstract

are any safety concerns with newer genera-

TASES TO THE FELLOW EYE.

We report a case of primary intraocular central

tion drug-eluting stents (DES).

Ginderdeuren RV, Missotten GS, van den Oord J.

nervous system (CNS) lymphoma in a patient

Design: Propensity score adjustment of

Abstract

previously treated with intravitreal anti-vascu-

baseline anatomical and clinical characteris-

Purpose: To report a case of a paraganglioma

lar endothelial growth factor (VEGF) injections

tics were used to compare clinical outcomes

in the right eye with metastatic disease in the

for age-related macular degeneration (AMD).

(Kaplan-Meier estimates) between patients

fellow eye 3 years later.

An 88-year-old woman, with past medical his-

implanted with overlapping DES (Resolute

Methods: A 70-year-old man presented with

tory significant for bilateral age-related macu-

zotarolimus-eluting stent (R-ZES) or R-ZES/

a painful amblyopic right eye; rubeosis iridis

lar degeneration (AMD) treated with intra-

other DES) against no overlapping DES. Ad-

and a large choroidal tumor were found. The

vitreal ranibizumab injections for 1year, was

ditionally, angiographic outcomes for over-

tumor was treated by enucleation. Pathology

referred to our department for bilateral vitritis

lapping R-ZES and everolimus-eluting stents

diagnosed the tumor as a paraganglioma.

diagnosed 10days after the last anti-VEGF in-

were evaluated in the randomised RESOLUTE

Screening for other tumors or metastatic dis-

jection. A complete uveitis work-up including

All-Comers Trial.

ease was negative at that moment. After 3

aqueous humour analysis, brain MRI and vitre-

Setting: Patient level data from five con-

years, a paraganglioma skin metastasis was

ous biopsy enabled us to confirm the diagnosis

trolled studies of the RESOLUTE Global

detected, and screening revealed metastatic

of primary intraocular CNS lymphoma. To the

Clinical Program evaluating the R-ZES were

disease in the liver. Another 6 months later he

best of our knowledge, this is the first report

pooled. Enrolment criteria were generally un-

was referred for tumors in the left eye, which

of the diagnosis of primary intraocular CNS

restrictive.

were treated by radiotherapy. He succumbed

lymphoma in a patient treated with anti-VEGF

Patients: 5130 patients.

6 months later.

for AMD. The differential diagnosis of vitritis

Main Outcome Measures: 2-year clinical out-

Results: Histopathology of the right eye

in elderly patients is relatively broad. Endoph-

comes and 13-month angiographic outcomes.

revealed the typical image of a paragan-

thalmitis and uveitis have been described af-

Results: 644 of 5130 patients (12.6%) in the

glioma, with expression of synaptophysin,

ter anti-VEGF injections. In such a situation,

RESOLUTE Global Clinical Program underwent

neuron-specific enolase and chromogranin.

there is actually a risk of missing the diagnosis

overlapping DES implantation. Implantation of

S-100 staining was positive in the susten-

of intraocular lymphoma in the mistaken belief

overlapping DES was associated with an in-

tacular cells; staining for HMB-45, SME, EMA

that the observed vitritis may be a reaction

creased frequency of MI and more complex/

and pan-keratin was negative. Microscopy of

to administered anti-VEGFs. If no direct time-

calcified lesion types at baseline. Adjusted

the tumors in the skin and liver 3 years later

relationship with the anti-VEGF injections can

in-hospital, 30-day and 2-year clinical out-

showed a dedifferentiated tumor with the

be found, a classic vitritis work-up should be

comes indicated comparable cardiac death

same immunological characteristics, but with

performed. Our observation suggests that ra-

(2-year overlap vs non-overlap: 3.0% vs 2.1%,

higher Ki67 expression and more mitoses.

nibizumab, at the dosage used for AMD, does

p=0.36), major adverse cardiac events (13.3%

Conclusions: This report documents a very

not impede the spread of CNS lymphoma in the

vs 10.7%, p=0.19), target-vessel MI (3.9% vs

rare choroidal paraganglioma which pre-

eye nor interfere with cytological diagnosis.

3.4%, p=0.40), clinically driven target vessel

sented clinically as a melanoma. The patient

JESSALINEA 37


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