Dr. Albert is a founder, former managing member, and currently provides consulting on ocular pathology.
Dr. Albert is the RRF Emmett A. Humble Distinguished Director of the UW Eye Research Institute, Frederick A. Davis Professor of Ophthalmology and Former Chair of the Department of Ophthalmology and Vision Science, University of Wisconsin School of Medicine and Public Health. He is widely recognized as an expert in ocular pathology and is Director of the Ocular Pathology Laboratory at the University of Wisconsin-Madison.
His primary research concerns ocular neoplasia, but he has conducted clinical and laboratory research on the full spectrum of ocular disorders. He has over 500 publications in diverse areas of ophthalmic clinical and basic research and is an editor for a major authoritative multi-volume work on the practice of ophthalmology.
An Update on Endocrine Mucin-producing Sweat Gland Carcinoma: Clinicopathologic Study of 63 Cases and Comparative Analysis.
Am J Surg Pathol. 2020 May 22;:
Authors: Agni M, Raven ML, Bowen RC, Laver NV, Chevez-Barrios P, Milman T, Eberhart CG, Couch S, Bennett DD, Albert DM, Hogan RN, Phelps PO, Stiefel H, Mancera N, Hyrcza M, Wang A, Steele EA, Campbell AA, Potter HD, Lucarelli MJ
Endocrine mucin-producing sweat gland carcinoma (EMPSGC) is a rare, low-grade adnexal neoplasm with predilection for the periorbital skin of older women. Histologically and immunophenotypically, EMPSGC is analogous to another neoplasm with neuroendocrine differentiation, solid papillary carcinoma of the breast. Both lesions are spatially associated with neuroendocrine mucinous adenocarcinomas of the skin and breast, respectively. EMPSGC is ostensibly a precursor of neuroendocrine-type mucinous sweat gland adenocarcinoma (MSC), a lesion of uncertain prognosis. Non-neuroendocrine MSC has been deemed locally aggressive with metastatic potential, and previous works speculated that EMPSGC-associated (neuroendocrine-type) MSC had similar recurrence and metastatic potential with implications for patient follow-up. Only 96 cases of EMPSGC have been reported (12 cases in the largest case series). Herein, we present 63 cases diagnosed as "EMPSGC" in comparison with aggregated results from known published EMPSGC cases. We aim to clarify the clinicopathologic features and prognostic significance of the neuroendocrine differentiation of EMPSGC and its associated adenocarcinoma and to determine the nosological relevance of EMPSGC association in the spectrum of MSC histopathogenesis. Results established an overall female predominance (66.7%) and average presenting age of 64 years. EMPSGC lesions were associated with adjacent MSC in 33.3% of cases. The recurrence rate for neuroendocrine-type MSC was ~21%, less than the reported 30% for non-neuroendocrine MSC. There were no cases of metastasis. EMPSGC and neuroendocrine-type MSC are distinct entities with more indolent behavior than previously reported, supporting a favorable prognosis for patients.
PMID: 32452870 [PubMed - as supplied by publisher]
The COMS Randomized Trial of Iodine 125 Brachytherapy for Choroidal Melanoma: IV. Local Treatment Failure and Enucleation in the First 5 Years after Brachytherapy. COMS Report No. 19.
Ophthalmology. 2020 Apr;127(4S):S148-S157
Authors: Jampol LM, Moy CS, Murray TG, Reynolds SM, Albert DM, Schachat AP, Diddie KR, Engstrom RE, Finger PT, Hovland KR, Joffe L, Olsen KR, Wells CG, COMS Follow-up of Plaqued Eyes Working Group
OBJECTIVE: To describe the frequency and predictors of local treatment failure and enucleation after iodine 125 (I125) brachytherapy in patients with choroidal melanoma treated and followed up in a large randomized clinical trial.
DESIGN: Prospective, noncomparative, interventional case series within a randomized, multicenter clinical trial.
PARTICIPANTS: Patients enrolled in the Collaborative Ocular Melanoma Study (COMS) trial of enucleation versus brachytherapy between February 1987 and July 1998; tumors measured 2.5 to 10.0 mm in apical height and no more than 16.0 mm in longest basal dimension.
METHODS: I125 brachytherapy was administered via episcleral plaque according to a standard protocol. Follow-up ophthalmic evaluations, including ophthalmic ultrasound and fundus photography, were performed according to a standard protocol at baseline, every 6 months thereafter for 5 years, and subsequently at annual intervals. Survival analysis methods were used to estimate the cumulative risk of postirradiation treatment failure and enucleation. Factors associated with treatment failure and enucleation of plaqued eyes were evaluated using Cox proportional hazards analysis.
MAIN OUTCOME MEASURES: Reports of enucleation and of local treatment failure, defined as tumor growth, recurrence, or extrascleral extension, derived from clinical reports based on echographic and photographic documentation.
RESULTS: As of September 30, 2000, 638 of the 650 patients randomized to brachytherapy and so treated had been followed up for 1 year or longer, and 411 had been followed up for at least 5 years. Sixty-nine eyes were enucleated during the first 5 years after brachytherapy, and treatment failure was reported for 57 eyes. The Kaplan-Meier estimate of proportion of patients undergoing enucleation by 5 years was 12.5% (95% confidence interval [CI], 10.0%-15.6%); the risk of treatment failure was 10.3% (95% CI, 8.0%-13.2%). Treatment failure was the most common reason for enucleation within 3 years of treatment; beyond 3 years, ocular pain was most common. Risk factors for enucleation were greater tumor thickness, closer proximity of the posterior tumor border to the foveal avascular zone, and poorer baseline visual acuity in the affected eye. Risk factors for treatment failure were older age, greater tumor thickness, and proximity of the tumor to the foveal avascular zone. Local treatment failure was associated weakly with reduced survival after controlling for baseline tumor and personal characteristics (adjusted risk ratio, 1.5; P = 0.08).
CONCLUSIONS: Local treatment failure and enucleation were relatively infrequent events after I125 brachytherapy within the COMS. Treatment failure typically occurred early and was associated weakly with poorer survival. The COMS randomized trial documented the absence of a clinically or statistically significant difference in survival for patients randomly assigned to enucleation versus brachytherapy. This analysis documents the efficacy of brachytherapy to achieve sustained local tumor control and to conserve the globe.
PMID: 32200815 [PubMed - in process]
Capillary Hemangioma Presenting as a Scleral Vascular Lesion in a Child.
Ophthalmic Plast Reconstr Surg. 2019 Sep/Oct;35(5):e115-e116
Authors: Bradfield Y, Burkat CN, Albert DM, Potter HAD
A 7-year-old healthy girl presented for an evaluation of a left vascular scleral mass. The lesion appeared spontaneously with no history of trauma, coagulopathy, or topical medication use. It was nontender, enlarging, and did not extend intraocularly. Her OS vision was 20/20, and the remainder of her eye examination was normal. Evaluation of the ocular mass included B-scan ultrasound, ultrasound biomicroscopy, anterior segment optical coherence tomography (OCT), and orbital MRI. The anterior segment OCT demonstrated vessels within the mass with no defined capsule. The orbital MRI confirmed a lesion isolated to the scleral layers of the globe, with low blood flow. The patient had a partial response to oral propranolol. Because the lesion vessels began to extend into her corneal endothelium, there was a concern for malignancy. A biopsy confirmed a benign intrascleral capillary hemangioma. Discontinuation of the propranolol demonstrated stability of the lesion 6 months later.
PMID: 31503170 [PubMed - in process]
Investigation of Somatic GNAQ, GNA11, BAP1 and SF3B1 Mutations in Ophthalmic Melanocytomas.
Ocul Oncol Pathol. 2016 Apr;2(3):171-7
Authors: Francis JH, Wiesner T, Milman T, Won HH, Lin A, Lee V, Albert DM, Folberg R, Berger MF, Char DH, Marr B, Abramson DH
PURPOSE: The aim of this study was to use massively parallel DNA sequencing to identify GNAQ/11, BAP1 and SF3B1 mutations in ophthalmic melanocytoma.
PROCEDURES: Six ophthalmic melanocytoma specimens (1 iridociliary and 5 optic nerve) were profiled for genomic alterations in GNAQ/11, BAP1 and SF3B1 using a custom deep sequencing assay. This assay uses solution phase hybridization-based exon capture and deep-coverage massively parallel DNA sequencing to interrogate all protein-coding exons and select introns.
RESULTS: The only iridociliary melanocytoma showed a mutation in GNAQ but not in BAP1. Of the 2 optic-nerve melanocytomas that developed into melanoma, one had a GNAQ mutation and both a BAP1 mutation and monosomy 3. The remaining 3 optic-nerve melanocytomas did not reveal mutations in GNAQ/11 or BAP1. SF3B1 mutations were not detected in any specimen.
CONCLUSIONS: The presence of GNAQ mutation in some iridociliary and optic-nerve melanocytomas suggests a possible relationship between ophthalmic melanocytoma and other ophthalmic melanocytic neoplasms. BAP1 mutation may accompany the transformation of ophthalmic melanocytoma to melanoma.
PMID: 27239460 [PubMed]
Adult-Onset Asthma and Periocular Xanthogranulomas Associated with Systemic IgG4-Related Disease.
Am J Ophthalmol Case Rep. 2016 Apr;1:34-37
Authors: Burris CK, Rodriguez ME, Raven ML, Burkat CN, Albert DM
PURPOSE: The aim of this study was to report a case of Adult-Onset Asthma with Periocular Xanthogranulomas (AAPOX) associated with systemic IgG4-related disease (IgG4-RD).
OBSERVATIONS: A 57-year-old man presented with bilateral periorbital swelling for 1 year. Histopathology of a left orbital biopsy showed fibro vascular connective tissue inundated with foamy, lipid-laden histiocytes and touton giant cells with lymphocytic inflammation. Additional stains revealed CD68 positivity, and S100 negativity. The IgG and IgG4 stained slides showed increased IgG4 positive plasma cells but did not meet the criteria for IgG4-related orbital disease. His IgG4 serology was elevated, and IgG4 staining of his tissue previously diagnosed as autoimmune sclerosing pancreatitis was found to meet the criteria for IgG4-RD.
CONCLUSIONS AND IMPORTANCE: AAPOX can be associated with systemic IgG4-RD.
PMID: 27152364 [PubMed - as supplied by publisher]
Angiolymphoid hyperplasia with eosinophilia of the orbit and ocular adnexa: report of 5 cases.
JAMA Ophthalmol. 2014 May;132(5):633-6
Authors: Azari AA, Kanavi MR, Lucarelli M, Lee V, Lundin AM, Potter HD, Albert DM
IMPORTANCE: To report the clinical and histopathologic findings of ocular adnexal angiolymphoid hyperplasia with eosinophilia, an unusual but often misdiagnosed benign disorder.
OBSERVATIONS: The ophthalmologic findings of angiolymphoid hyperplasia with eosinophilia with ocular adnexal involvement are variable and include eyelid swelling, ptosis, proptosis, and loss of vision. Imaging studies typically reveal a well-circumscribed mass in the orbit. The condition may resemble other diseases that involve the orbit and ocular adnexal tissue, such as lymphoma, hemangioma, sarcoidosis, and dermoid cyst. Histopathologic analysis reveals marked vascular proliferation with an accompanying inflammation composed of numerous eosinophils, lymphocytes, and plasma cells.
CONCLUSIONS AND RELEVANCE: Angiolymphoid hyperplasia with eosinophilia is a rare disease that can affect the ocular adnexal tissue. The clinical presentation is often nonspecific; therefore, histopathologic studies are essential for diagnosis and subsequent management of this benign condition.
PMID: 24676051 [PubMed - indexed for MEDLINE]
A clinicopathologic case study of two patients with pediatric orbital IgG4-related disease.
Orbit. 2013 Dec;32(6):389-91
Authors: Griepentrog GJ, Vickers RW, Karesh JW, Azari AA, Albert DM, Bukat CN
The purpose of this report is to describe the clinical, radiographica, and histopathologic findings in two pediatric patients with orbital IgG4-related disease.
PMID: 23957841 [PubMed - indexed for MEDLINE]
Shaken adult syndrome: report of 2 cases.
JAMA Ophthalmol. 2013 Nov;131(11):1468-70
Authors: Azari AA, Kanavi MR, Saipe NB, Potter HD, Albert DM, Stier MA
IMPORTANCE: To establish that the intracranial and ophthalmologic findings present in victims of abusive head trauma can also be seen in shaken adults.
OBSERVATIONS: We report 2 cases of shaken adults with intracranial and ophthalmologic findings that resulted from repetitive acceleration-deceleration injury. These findings included intracranial hemorrhages, hemorrhages involving the optic nerve sheath, intraretinal and subretinal hemorrhages, and macular folds.
CONCLUSIONS AND RELEVANCE: The intracranial and ophthalmologic findings that are characteristic of abusive head trauma--subdural hemorrhages, optic nerve sheath hemorrhages, and retinal hemorrhages--are generally thought to be limited to young children and infants. Adults may also be victims of shaking abuse, and an ophthalmic examination may be beneficial when shaking is suspected.
PMID: 24077385 [PubMed - indexed for MEDLINE]
Hydration with saline decreases toxicity of mice injected with calcitriol in preclinical studies.
J Environ Pathol Toxicol Oncol. 2013;32(3):241-4
Authors: Azari AA, Kanavi MR, Darjatmoko SR, Lee V, Kim K, Potter HD, Albert DM
The effectiveness of saline injection in reducing the toxicity profile of calcitriol when coadministered in mice was evaluated. Mortality was used as an end point to study the toxic effects of calcitriol; the relative risk of mortality in mice injected with saline was evaluated from our previously published animal experiments. We discovered that coadministration with 0.25 mL normal saline solution injected intraperitoneally is associated with a lower mortality rate than calcitriol given alone. The estimated relative risk of mortality was 0.0789 (95% confidence interval, 0.0051-1.22; z = 1.82; P = 0.070) when saline is administered with calcitriol compared to calcitriol alone. There was a reduction in serum calcium levels in mice that received saline (11.4 ± 0.15 mg/dL) compared to mice that did not receive saline (12.42 ± 1.61 mg/dL). Hydration with saline seems to reduce mortality and toxicity in mice receiving calcitriol. Given the decrease in mortality rates, intraperitoneal injections of saline should be considered in studies involving mice receiving injections of calcitriol.
PMID: 24266410 [PubMed - indexed for MEDLINE]
Surgical removal of an atypical macular epiretinal membrane in neurofibromatosis type 2: clinicopathologic correlation and visual outcome.
Arch Ophthalmol. 2012 Oct;130(10):1337-9
Authors: Han DP, Chin M, Simons KB, Albert DM
PMID: 23044955 [PubMed - indexed for MEDLINE]
Resveratrol metabolites do not elicit early pro-apoptotic mechanisms in neuroblastoma cells.
J Agric Food Chem. 2011 May 11;59(9):4979-86
Authors: Kenealey JD, Subramanian L, Van Ginkel PR, Darjatmoko S, Lindstrom MJ, Somoza V, Ghosh SK, Song Z, Hsung RP, Kwon GS, Eliceiri KW, Albert DM, Polans AS
Resveratrol, a nontoxic polyphenol, has been shown to inhibit tumor growth in a xenograft mouse model of neuroblasoma. However, resveratrol is rapidly metabolized, mainly to its glucuronidated and sulfated derivatives. This study demonstrates that resveratrol alone, and not the glucuronidated or sulfated metabolites, is taken up into tumor cells, induces a rise in [Ca(2+)](i), and ultimately leads to a decrease in tumor cell viability. A new water-soluble resveratrol formulation was delivered directly at the site of the tumor in a neuroblastoma mouse model. The amount of unmodified resveratrol associated with the tumor increased more than 1000-fold. The increase of unmodified resveratrol associated with the tumor resulted in tumor regression. The number of residual tumor cells that remained viable also decreased as the ratio of the metabolites relative to unmodified resveratrol declined.
PMID: 21401048 [PubMed - indexed for MEDLINE]
Retinal light toxicity.
Eye (Lond). 2011 Jan;25(1):1-14
Authors: Youssef PN, Sheibani N, Albert DM
The ability of light to enact damage on the neurosensory retina and underlying structures has been well understood for hundreds of years. While the eye has adapted several mechanisms to protect itself from such damage, certain exposures to light can still result in temporal or permanent damage. Both clinical observations and laboratory studies have enabled us to understand the various ways by which the eye can protect itself from such damage. Light or electromagnetic radiation can result in damage through photothermal, photomechanical, and photochemical mechanisms. The following review seeks to describe these various processes of injury and many of the variables, which can mitigate these modes of injury.
PMID: 21178995 [PubMed - indexed for MEDLINE]
The practice of ophthalmology in rural Wisconsin in the mid-19th century: from the casebooks of Francis Paddock, MD.
Arch Ophthalmol. 2010 Jun;128(6):783-8
Authors: Albert DM, Atzen SL, Morgan P
Francis Paddock (1814-1889), a graduate of Fairfield Medical College in western New York State, opened a general medicinal and surgical practice in the small town of Salem in Kenosha County, Wisconsin, between 1838 and 1839, where he lived and worked until his death a half century later. Two early volumes of his casebooks, spanning the years 1841 to 1852, came to light and are now analyzed from the standpoint of ophthalmic-related problems and their treatment. His life as a frontier physician and leading citizen of his community are documented in the context of 19th-century medicine in America and Wisconsin.
PMID: 20547958 [PubMed - indexed for MEDLINE]
Sebaceous cell carcinoma of the eyelid: a rapidly enlarging lesion with massive xanthogranulomatous inflammation.
Ophthal Plast Reconstr Surg. 2010 May-Jun;26(3):208-10
Authors: Hwang FS, Neekhra A, Lucarelli MJ, Warner TF, Snow SN, Albert DM
A 76-year-old man presented atypically with a 4-week history of a rapidly enlarging ulcerated nodular lesion of the left upper eyelid that was found to be sebaceous cell carcinoma. Further investigation showed no metastatic disease, and Mohs surgery was performed to resect the tumor. Histopathologic analysis showed features diagnostic of sebaceous cell carcinoma. However, most of the mass consisted of xanthomatous granulomatous inflammatory reaction vastly out of proportion with the tumor burden. The patient was spared from orbital exenteration, and no evidence of recurrence was present 6 months after resection.
PMID: 20489549 [PubMed - indexed for MEDLINE]