bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrastructural Study of Extraocular Muscle in Congenital Nystagmus
Authors: Peng Guang-hua , Zhang Cheng , Yang Jing-cun
Published: April 2003

To determine the mechanism of congenital nystagmus (CN), the ultrastructure of the extraocular muscle in CN patients was examined with the transmission electron microscope. The specimen of muscle tissue was taken during surgery from horizontal recti in the slow and quick phase sides separately in the jerky type, and medial and lateral recti in the pendular type. The extraocular muscle was immediately fixed in 2.5% glutaraldehyde solution. (1) In the jerky type, the myocytes in the quick phase side showed myofibrillae that were perpendicular to axes of myocytes and had the structure of sarcomeres. In the slow phase side there were perpendicular myofibrillae in the periphery of myocytes. (2) In the pendular type, there were no perpendicular myofibrillae within myocytes. The myofibrillae that were parallel to the axes of myocytes were arranged disorderly. The length of the H and I bands in different myofibrillae was not identical. These results demonstrated, for the first time, the ultrastructural changes in the extraocular muscle of CN patients, which might provide the pathological basis for this disease.
Iridopathy in Eyes with Proliferative Diabetic Retinopathy: Detection of Early Stage of Rubeosis Iridis
Authors: Ino-ue Masanori , Azumi Atsushi , Shirabe Hisamitsu , Yamamoto Misao
Published: April 2003

Forty-two eyes of 31 proliferative diabetic retinopathy patients with laser flare intensity ≥ 20 photon counts/ms underwent fluorescein iris angiography to evaluate any changes in the blood-iris barrier and iris biomicroscopy to detect rubeosis iridis. Fluorescein iris angiography revealed abnormal dye leakage in all eyes. Laser flare intensity significantly correlated with the degree of dye leakage. Eyes with dye leakage from only the pupillary border had no rubeosis. In 11 out of 18 (61%) eyes with moderate dye leakage, proliferative diabetic iridopathy with early rubeosis was present in 8 and advanced iridopathy in 3 eyes. In all eyes with excessive leakage, rubeosis iridis was detected under slitlamp examination. High laser flare intensity has a close relationship with advanced blood-ocular barrier disruption. High flare intensity may be a helpful indicator in detecting incipient rubeosis or advanced diabetic iridopathy.
Cystatins in Tears of Patients with Different Corneal Conditions
Authors: ter Rahe Birgitta  S.  M. , van Haeringen Nicolaas  J.
Published: April 2003

A presence of cystatins, inhibitors of cysteine protease, was investigated in tears of patients with different corneal pathologies. Tear fluid samples were collected with glass capillaries in 28 patients (28 eyes) and 15 healthy controls (15 eyes). Only after corneal transplantation (8) or in corneal dystrophy (6) but not after cataract extraction (5) or other traumatic conditions of the cornea (9) was a significant difference in inhibitory activity of cystatins measured in comparison with the 15 controls. In this study it could not be decided whether the lower level of cystatins was related to the cause or the effect of the condition of the eye.
Morphological Changes in the Orbital Surface Layer Muscle of the Rabbit Eye Produced by Botulinum Toxin
Authors: Ohtsuki Hiroshi , Hasebe Satoshi , Okano Masaki , Furuse Takashi
Published: April 2003

We quantitated the morphological changes in the orbital surface layer muscles in the rabbit following the single injection of botulinum A toxin. Experiments were performed in 9 white rabbits (1.6–3.0 kg). They were administered 5 units (5 rabbits) or 10 units (4 rabbits) of botulinum toxin injected into the superior rectus muscle of one eye. The diameter of myofibers of the orbital and intermediate layer zones was measured with an ocular micrometer on histological sections 3 days and 1, 3 and 5 weeks after injection. Quantitative changes were noted in the muscle fibers of the orbital surface layer zone following the injection of 10 units of botulinum toxin. At 1 week, the diameter of myofibers in the orbital layer was reduced, but it was increased at 5 weeks compared to that in the control eyes; in contrast, no change in the diameter of muscle fibers was found in the intermediate layer zone.
Primary Congenital Ectropion uveae Associated with Vitreoretinal Degeneration
Authors: Dietlein Thomas S. , Jacobi Philipp C. , Krieglstein Günter K.
Published: April 2003

Primary congenital ectropion uveae is an extremely rare ocular malformation frequently associated with unilateral glaucoma. We report on a 15-year-old boy with unilateral congenital ectropion uveae, glaucoma and transvitreal strands in an optically empty vitreous. Dark adaptation was normal, but scotopic ERG showed subnormal b-wave amplitudes in the affected eye, which is a typical finding in hereditary vitreoretinal degenerations. The coincidence of primary congenital ectropion uveae and unilateral vitreoretinal degeneration without a family history seems to be sporadic and very extraordinary but could be due to a common defect of maturation.
In vitro Staphylococcus epidermidis Growth in Some Viscoelastic Substances Containing Sodium Hyaluronate
Authors: Gallenga Pier Enrico , Mastropasqua Leonardo , Carpineto Paolo , Ciancaglini Marco , Falconio Gennaro , Catamo Giovanni , Costagliola Ciro , Piccolomini Raffaele
Published: April 2003

The aim of our study was to verify the in vitro growth of Staphylococcus epidermidis in various dilutions of some viscoelastic substances containing hyaluronic acid (Healon® and Healon GV, IAL®, BiolonTM). Serial twofold dilutions of each sterile viscoelastic substance, prepared so as to obtain a final concentration ranging from 50 to 0.78% of the product in sterile saline solution (0.85% NaCl), were taken out with a pipette that delivered 1.0 ml/tube. One hundred microliters of the S. epidermidis inocula, used for the evaluation of the positive control of the test organism, was dispensed into each tube. After 24 h of aerobic incubation at 37 °C, 100 μl of sample was taken out from each tube and plated into the specific medium for the growth of the test organism. After 24 h of incubation at 37 °C, these agar plates were examined and the colony-forming unit count of the test organism was compared to the corresponding total colony count, acting as a positive control, in order to determine the quantitative variation of the test organism grown in the presence of the viscoelastic compounds. For the lowest dilutions (from 1: 2 to 1: 8) statistically significant bacterial growth was detected in all tested viscoelastic substances. For the highest dilutions (1: 64 and 1: 128) Biolon and Healon GV showed a significant inhibition of S. epidermidis growth. A significant inhibition was also observed in the highest dilution (1: 128) of Healon. In every dilution of IAL a statistically significant increase in bacterial growth was observed. It remains to be carefully considered whether S. epidermidis, accidentally penetrating the eye via the intraocular lens, could find a culture medium in a small amount of sodium hyaluronate left in the capsular bag behind the optic.
Ultrasound Biomicroscopic Findings in a Case of Cyclodialysis
Authors: Park Masami , Kondo Takehisa
Published: April 2003

Ultrasound biomicroscopy (UBM) with a high frequency can be used to evaluate the structure of the anterior eye segment in vivo. A 24-year-old male was referred to us after 1 month of follow-up by a local ophthalmologist, because of decreased visual acuity and hypotony after a blunt eye injury. A cyclodialysis cleft in the 2- to 4-o’clock position and a cavernous pattern all over the choroid were found using UBM. The patient underwent surgical treatment to close the cleft. Even after the recovery of intraocular pressure (IOP), the peripheral ciliary body around 360 ° was still separated from the sclera when examined by UBM. Despite the detached ciliary body, keeping IOP within normal levels is an interesting finding. UBM is helpful in the diagnosis and treatment of traumatic cyclodialysis.
Reproducibility of Optic Disk Topographic Measurements with the Topcon ImageNet and the Heidelberg Retina Tomograph
Authors: Azuara-Blanco Augusto , Harris Alon , Cantor L.  B.
Published: April 2003

Objective: To compare the reproducibility of optic disk measurements provided by an image analyzer and a scanning laser tomograph. Methods: Ten images of the same eye of 10 normal volunteers were taken with the Heidelberg Retina Tomograph and with the Topcon ImageNet. Intraclass correlation coefficient (ICC) and coefficient of variation (CV) were used to evaluate the reproducibility of the measurements. Results: Eleven parameters were analyzed with the Topcon ImageNet. Six parameters (55%) had ICC greater than 90%. Four parameters (36%) had CV less than 10%. Twelve parameters were evaluated with the Heidelberg Retina Tomograph. Nine parameters (75%) had ICC over 90%. Nine parameters (75%) had CV less than 10%. Conclusion: Both systems provided reproducible data. The optic disk parameters provided by the Heidelberg Retina Tomograph had a better reproducibility than those obtained from the Topcon ImageNet.
Evaluation of Cytomegalovirus Retinitis Management
Authors: Ries E. , Mühlbauer B. , Ruhswurm I. , Krepler K. , Derbolav A. , Svolba G. , Rieger A. , Wedrich A.
Published: April 2003

Cytomegalovirus (CMV) is the most common pathogen of opportunistic viral infections in patients with the acquired immunodeficiency syndrome. In this study, we assessed the therapeutic outcome of our treatment regimen of CMV retinitis by analysing retrospectively 33 consecutive patients. The clinical utility of CMV cultures from blood, urine and throat specimens obtained at the time of diagnosis was additionally evaluated. Treatment started with ganciclovir (GCV) therapy. In case of relapsing retinitis, re-induction therapy was initiated, and if unsuccessful, the patient was switched to foscarnet. Patients developing resistant retinitis despite foscarnet therapy were offered a GCV-foscarnet combination therapy. Under primary GCV therapy, the median first stable interval of the whole group was 202 days (mean 238 days). Twenty-five out of 33 CMV retinitis patients (76%) responded to initial GCV therapy. Eleven of these patients showed relapsing retinitis that could be stabilised in 3 patients solely with combination therapy. Eight patients did not respond to primary GCV therapy. Three of them improved with foscarnet, but 3 patients did not respond to either treatment. In 18 (56%) out of 32 patients, CMV cultures yielded positive results. Considering our series, we may conclude that in the majority of patients primary or secondary viral resistance can be overcome by dose increase, switching to the alternative drug or a combination therapy.
Effect of Epidermal Growth Factor upon Morphological Changes of Human Lens Epithelial Cells
Authors: Majima Kiyoyuki
Published: April 2003

Phase-contrast and transmission electron microscopic studies were performed to evaluate the effect of epidermal growth factor (EGF) upon the morphology of lens epithelial cells (LECs) obtained from human cataractous lenses, cultured on human anterior lens capsules, and divided into the following three groups: group 1 receiving no EGF supplement, group 2 supplemented with 1 ng/ml EGF, and group 3 supplemented with 10 ng/ml EGF. Phase-contrast microscopy revealed that the cells in the group supplemented with 1 ng/ml EGF concentration had elogated, and those supplemented with 10 ng/ml EGF disclosed changes indicating fibroblast-like cells. Under transmission electron microscopy, the cells in the group supplemented with 1 ng/ml EGF concentration had become multilayered and a few cells had a ball-and-socket junction structure and nucleolar chromatin condensation, while those supplemented with 10 ng/ml EGF showed changes not only in the cells but also in the anterior lens capsules to present numerous microfibers. This is the first study to confirm the effect of EGF upon LECs cultured on anterior lens capsules, a condition closely resembling the intraocular environment, and these findings are significant.
Recurrent RPE Microrips in a Case of Vascularised Pigment Epithelial Detachment
Authors: Virgili Gianni , Salati Carlo , Lanzetta Paolo , Basile Renato , Menchini Ugo
Published: April 2003

Microrips of the RPE are an infrequent finding in vascularised pigment epithelial detachments (PEDs). Fluorescein angiography revealed that they are identical to the leaks seen in central serous chorioretinopathy (CSC); it has been hypothesised that both may be caused by hydrostatic forces generating a mechanical disruption of the RPE. We report a case of vascularised PED that was complicated by repeated subretinal haemorrhages and presented recurrent microrips of the RPE, which is a finding never described before according to our knowledge. In this case, a very high protein concentration in the subretinal space, due to prolonged bleeding from the neovascular membrane, might have damaged the RPE and reduced the choroidal suction, as believed for CSC. It might also have increased the intraluminal pressure in the PED, finally determining the passage of fluid through the microrips, which have been hypothesised to be RPE defects. These observations represent further speculation about the pathogenesis and the unique angiographic pattern of the leaks in CSC and of RPE microrips.
Progressive Subretinal Fibrosis in Patients with Rheumatoid Arthritis and Renal Dysfunction
Authors: Matsuo Toshihiko , Matsuo Nobuhiko
Published: April 2003

We present two patients (56-year-old and 71-year-old women) who developed subretinal fibrosis in parallel with exacerbation of rheumatoid arthritis and deteriorated renal function. The first patient developed subretinal fibrosis in the right eye, coupled with multifocal choroiditis and serous retinal detachment in both eyes, in the course of rapidly progressive glomerulonephritis complicated with rheumatoid arthritis. Antineutrophil cytoplasmic antibody was positive in a perinuclear pattern (pANCA) and the increased dose of prednisolone to 40 mg/day resulted in subsidence of the subretinal inflammation. The second patient developed subretinal fibrosis in the left eye with mottled retinal pigment epithelium of both eyes, in the course of rheumatoid arthritis and stable chronic renal failure. Although the manifestations of subretinal fibrosis and concurrent renal dysfunction were different between these two patients, subretinal fibrosis might be noted as a complication of rheumatoid arthritis and renal dysfunction.
Expression and Distribution of Kallikrein-Binding Protein mRNA in Rat Ocular Tissues
Authors: Murata Masatoshi , Nakagawa Michihiro , Takahashi Shigeki
Published: April 2003

Kallikrein-binding protein (KBP) has recently been characterized as an endogenous inhibitor of kallikrein, and it is considered to be involved in several pathophysiological processes, such as hypertension. In the eye, its source has not been determined. We have investigated KBP mRNA expression in the ocular tissues of 5 Wistar-Kyoto rats using the technique of reverse transcription with polymerase chain reaction. Five cornea, sclera, iris, ciliary body and choroid samples were negative for KBP. Four retina samples were positive. KBP mRNA was more significantly expressed in the retina than in the other ocular tissues (p = 0.0238<0.05). Our present study demonstrates that KBP is synthesized in the rat retina, suggesting that KBP alteration may be involved in the retinal circulation.
The Role of Capsulotomy and Intraocular Lens Type on Tilt and Decentration of Polymethylmethacrylate and Foldable Acrylic Lenses
Authors: Mutlu F. Mehmet , Bilge A. Hamdi , Altinsoy H. Ibrahim , Yumusak Erhan
Published: April 2003

The purpose of this study is to determine the effects of different anterior capsulotomy techniques and intraocular lens (IOL) types on IOL tilt and decentration. For this purpose the device using Purkinje reflections and photographic documentation were evaluated. A total of 107 cataractous eyes undergoing IOL implant surgery were divided into four groups based on the type of IOL and capsulotomy: group 1, single-piece polymethylmethacrylate (PMMA) IOL with a haptic distance of 13.50 mm; group 2, single-piece PMMA IOL with 12.0 mm overall lenght; group 3, three-piece foldable acrylic IOL with 13.00 mm PMMA haptic distance; group 4, the same IOL as group 1. While continuous circular capsulorhexis was the type of capsulotomy in the first three groups, envelope capsulotomy was used in group 4. Mean tilt and decentration were significantly less when capsulorhexis technique was used in comparison with envelope capsulotomy. Mean tilt of group 1 (2.83±0.89 degrees) and mean decentration of group 2 (0.28±0.14 mm) were higher within the first three groups. The differences regarding both the IOL decentration and tilt between the first three groups were statistically significant. This study shows that if the IOLs were placed properly in the capsular bag after continuous circular capsulorhexis, foldable acrylic IOLs with PMMA haptics are superior in terms of tilt and decentration.
Cell Biological Analysis with Respect to Cause of Fibrous Opacification of the Anterior Capsule after Cataract Extraction
Authors: Majima Kiyoyuki , Kojima Yoshihisa , Ouhashi Fumitaka
Published: April 2003

It has been assumed that lens epithelial cells (LECs) existing at the capsulotomy edge have been traumatized through anterior capsulotomy in cataract extraction. In this study, the correlation between traumatized LECs remaining at the anterior capsulotomy edge and epidermal growth factor (EGF) found in the aqueous humor, a cell growth factor though to affect cell morphology, was determined. Anterior lens capsules with adhering LECs were obtained following anterior capsulotomy performed during cataract surgery to first confirm the presence of EGF receptors on LECs, which are needed for EGF to be biologically active. Besides, to identify any EGF receptors on traumatized LECs, I next intentionally traumatized the cells by pressing them with a forceps from the anterior capsular side. It has been found that the LECs containing EGF receptors were always those existing at the edge of the anterior capsular opening and LECs containing EGF receptors existed along the pressed region too. The present results indicate that traumatized LECs along the capsulotomy edge have undergone changes to manifest EGF receptors, thus allowing EGF from the aqueous humor to become more active. The physiological effect of EGF upon these LECs may therefore be one of the causative factors of fibrous opacification of the anterior capsulotomy edge after cataract extraction.
Detection of Vascular Endothelial Growth Factor and Tumor Necrosis Factor Alpha in Epiretinal Membranes of Proliferative Diabetic Retinopathy, Proliferative Vitreoretinopathy and Macular Pucker
Authors: Armstrong Donald , Augustin Albert J. , Spengler Robert , Al-Jada Ahmad , Nickola Tracy , Grus Franz , Koch Frank
Published: April 2003

Purpose: To evaluate epiretinal membranes in proliferative eye disease for the presence of vascular endothelial growth factor (VEGF) and tumor necrosis factor α (TNF-α). Methods: Membranes were surgically removed from 66 patients with proliferative diabetic retinopathy (PDR), proliferative vitreoretinopathy (PVR) and macular pucker (MP). Cytokine concentrations were determined by ELISA (VEGF) and bioassay (TNF-α). Results: VEGF was detected in all 66 membranes investigated. The highest VEGF values were found in patients with type I diabetes (mean = 5,994 pg/mg protein). In patients with type II diabetes, the values were at a mean of 1,242 pg/mg protein. When coagulation therapy was performed for longer than 3 months prior to surgery, VEGF was significantly (p < 0.05) reduced. Intermediate levels of VEGF were found in PVR membranes (mean = 1,417 pg/mg protein). The lowest activity was found in MP (mean = 216 pg/mg protein). In contrast, TNF-α was present in 16 PDR membranes, 9 PVR membranes and 8 MP membranes. Conclusion: The presence of VEGF in all membranes investigated indicates that this cytokine plays an important role in angiogenesis in ischemic retinal disease and in membrane growth in proliferative disorders.
Transient Acute Myopia Induced by Antilymphocyte Globulins
Authors: Milea Dan , Zech Christophe , Dumontet Charles , Coiffier Bertrand , Trepsat Christiane
Published: April 2003

Acute onset of transient myopia may be induced by several drugs, different mechanisms having been described. We report the occurrence of such an event after intravenous administration of equine antilymphocyte globulins in a patient treated for aplastic anemia. Clinical ocular examination revealed no other abnormality, and ultrasonography disclosed no swelling of the ciliary body. The drug-induced myopia resolved completely after instillation of topical cyclopentolate, suggesting that its mechanism was the occurrence of a ciliary spasm. Acute myopia is a rare event and, to the authors’ knowledge, this represents the first case described as being induced by antilymphocyte globulins.
Blood Flow Velocity in the Peripheral Circulation of Glaucoma Patients
Authors: O’Brien Colm , Butt Zahida
Published: April 2003

Using the laser Doppler technique we measured finger blood flow velocity in 25 untreated primary open-angle glaucoma (POAG), 22 untreated low-tension glaucoma (LTG) and 19 age-matched normal subjects. Four blood flow measurements were recorded: baseline flow, after immersion in warm water for 2 min (40°C maximum flow), after 10 s exposure to cold water (4°C minimum flow) and time to recover to baseline flow after cold immersion. Significant differences between the LTG group and both the normal and POAG groups were found in a greater maximum flow (p = 0.03 and p = 0.01, respectively), a lower minimum flow (p = 0.04 and p = 0.03, respectively) and a longer recovery time to baseline flow (p = 0.0001 for both the normal and POAG groups). A longer recovery time to baseline flow (p = 0.008) in POAG was the only difference between the normal and POAG groups. Both glaucoma groups had more systemic vascular disease than normal, and there were more smokers in the POAG group than normals. Subgroup assessment performed with migraine, vascular disease and smoking subjects excluded from the analysis did not alter the overall results. We conclude that systemic vasospasm is a strong feature of low-tension glaucoma.
Chondroplast®: A New Material for Eyelid Reconstruction
Authors: Müllner K. , Langmann G.
Published: April 2003

After tumor excision both lamellae of the eyelid require reconstruction in order to achieve good functional and cosmetic results. The tarsus is replaced either by autologous or heterologous material. We used Chondroplast® as a tarsal replacement in 25 patients who had undergone extensive tumor excision. Chondroplast is a β-irradiated bovine cartilage. A 1-mm-thick lamella is fixed to the rest of the tarsal plate or the canthal tendon and positioned in a preformed pocket or the conjunctiva and a thin layer of orbicularis muscle and skin. All implants took well. Postoperative results, lid closure and cosmetic appearance were excellent. No complications such as infection or loss of the implant occurred. The advantages of Chondroplast are: its availability in large pieces, no need for harvesting procedures and good biocompatibility.
Significant Immediate and Long-Term Reduction of Astigmatism after Lateral Rectus Recession in Divergent Duane’s Syndrome
Authors: Killer H.E. , Bähler A.
Published: April 2003

Duane’s syndrome is associated with anisometropia and amblyopia. We encountered 1 patient with right divergent Duane’s syndrome (type 2 according to Huber’s classification) with high astigmatism of the right eye and a head turn. In order to improve the head turn and thereby avoid eccentric gaze through the glasses, the right lateral rectus muscle was recessed by 7.75 mm. Postoperatively, the amount of astigmatism was reduced by 1.5 dpt with no change of the axis. This change of refraction remained stable over a follow-up time of 18 months.
Asymmetry in Intraocular Pressure and Retinal Nerve Fiber Layer Thickness in Normal-Tension Glaucoma
Authors: Gugleta Konstantin , Orgül Selim , Flammer Josef
Published: April 2003

The etiology of glaucoma is most probably multifactorial. This study intended to investigate the asymmetry in intraocular pressure (IOP) and that in retinal nerve fiber layer (RNFL) thickness in normal-tension glaucoma patients. Two diurnal tension curves, obtained within 3 months and counting at least five IOP readings each, including an early morning IOP measurement upon awaking, were obtained in 15 normal-tension glaucoma patients. None of the patients received IOP-lowering therapy. IOP asymmetry was present in at least three readings and was always in the same direction. The optic nerve was imaged in both eyes in each patient by means of confocal scanning laser ophthalmoscopy (Heidelberg Retina Tomograph). The interocular difference in RNFL thickness and the RNFL cross-sectional area were correlated with the interocular difference in IOP by means of Spearman’s rank correlation factor. Nine female and 6 male normal-tension glaucoma patients (mean ± SD age was 62.4 ± 16.9 years) were included in this study. Interocular IOP asymmetry varied between 0.30 and 4 mm Hg. Strong negative correlations were found between interocular asymmetry in IOP and interocular asymmetry in RNFL thickness asymmetry (R = –0.652, p = 0.0083) and interocular asymmetry in RNFL cross-sectional area (R = –0.702, p = 0.0034). The present results demonstrate for the first time a more marked thinning of the neuroretinal nerve fiber layer in the eye with the higher IOP in normal-tension glaucoma patients.
The Short-Term Effect of Adding Brimonidine 0.2% to Timolol Treatment in Patients with Open-Angle Glaucoma
Authors: Yüksel Nurşen , Altıntaş Özgül , Karabaş Levent , Alp Banu , Çağlar Yusuf
Published: April 2003

Brimonidine, a highly selective α2-adrenoceptor agonist, was studied to determine its ocular hypotensive effect and side effects in patients with elevated intraocular pressure (IOP) while on continuing therapy with timolol. This was a prospective, randomized, placebo-controlled study in 15 patients with primary open-angle or pseudoexfoliation glaucoma on therapy receiving timolol 0.5% twice daily, with IOP greater than or equal to 22 mm Hg in one eye. IOP measurements, blood pressure and pulse rate were assessed on 2 days at a baseline and 1, 2, 4, 6 and 8 h later. A single drop of brimonidine 0.2% or placebo was added to treatment with timolol. The reductions in IOP at all time intervals observed with brimonidine + timolol were significantly greater than those with timolol + placebo. The maximum mean net decrease in IOP was 19.23 ± 10.60% at 4 h. Statistically significant decreases in systemic blood pressure and pulse rate without clinical symptoms were observed in the group receiving brimonidine + timolol. This study suggests that a combination of brimonidine and timolol may have potential in the treatment of glaucoma. Further clinical trials with brimonidine are indicated to assess its further role as adjunctive agent.
Corneal Wound Healing after Superficial Foreign Body Injury: Vitamin A and Dexpanthenol versus a Calf Blood Extract
Authors: Egger S.F. , Huber-Spitzy V. , Alzner E. , Scholda C. , Vecsei V.P.
Published: April 2003

A prospective randomized double-blind clinical study was performed to investigate corneal wound healing after treatment either with an eye gel containing calf blood extract or an eye ointment containing vitamin A and dexpanthenol. A total of 54 outpatients were included in this study, all treated for corneal foreign body injury. The size of the corneal lesions was measured by planimetry on days 0, 1, and on the following days until complete epithelial healing occurred. Results showed the calf blood extract eye gel to be statistically more effective in promoting corneal wound healing, especially in patients with wound areas larger than 6 mm2.
Ultrasound Biomicroscopic Evaluation of Ciliochoroidal Effusion after Laser Treatment
Authors: Pierro Luisa , Azzolini Claudio , Brancato Rosario , Trabucchi Giuseppe , Calori Giliola
Published: April 2003

We evaluated ciliochoroidal effusion (CE) by ultrasound biomicroscopy (UBM) following diode endophotocoagulation at the end of the vitreoretinal surgery. The aim of our study was to assess any differences in the CE morphology following diode endophotocoagulation or transpupillary krypton photocoagulation, and to demonstrate the influence of diabetes and intravitreal surgery on CE formation. Sixty-six consecutive patients were divided in to four groups. Twenty-nine patients with proliferative retinopathy underwent transpupillary krypton photocoagulation; 11 diabetic patients underwent vitreoretinal surgery and diode endophotocoagulation; 18 nondiabetics underwent vitreoretinal surgery and diode endophotocoagulation; 8 consecutive nondiabetic patients were the control group and underwent vitreoretinal surgery, without laser treatment. UBM was performed in the four groups before and after laser treatment, if performed. We determined, by UBM, not only the presence, but also the thickness of CE. CE was present in all the patients treated by laser, diabetics and nondiabetics, and its thickness was not correlated with the number of laser spots (p = 0.28). CE was seen ultrasonically in all the patients undergoing transpupillary photocoagulation or endophotocoagulation, regardless of diabetes and surgical trauma.
The Comparison of Intraocular Pressure Reductions after Isometric and Isokinetic Exercises in Normal Individuals
Authors: Avunduk Avni Murat , Yilmaz Berna , Şahin Nermin , Kapicioglu Zerrin , Dayanır Volkan
Published: April 2003

The lowering effect of physical exercise on intraocular pressure (IOP) has been reported both in healthy people and those with glaucoma, but a comparison of the lowering effect of isometric and isokinetic exercises on IOP has not been conducted in any study. Our aims were to investigate the relationship between intensity of exercise and IOP, and whether a significant difference in IOP lowering effect existed between isometric and isokinetic exercises. Sixty-seven patients with an age range of 23–40 who had no ocular disease were randomly divided into two groups. While 31 patients in the first group, group A, performed isokinetic exercise with the Cybex 6000 dynamometer, 32 patients in the second group, group B, had isometric exercises with the same machine. IOP was measured in the right eye of patients with Shiøtz tonometer just before and 10 min following exercise. Exercise intensity and total energy consumption were determined by the machine for each patient. While IOP values measured before exercise, the degree of exercise applied, and total energy consumption did not differ significantly between groups, both isometric and isotonic exercises lowered IOP significantly. As a result, isometric and isokinetic exercises lowered IOP in ophthalmologically normal subjects with direct relationship to exercise intensity and total energy consumption. Since the pressure lowering effect of isokinetic exercise was more significant, it might prove useful to glaucomatous patients.
Natural Interferon Therapy: Optic Nerve Ischemic Damage?
Authors: Norcia Felicita , Di Maria Alessandra , Prandini Fausto , Redaelli Carla
Published: April 2003

The purpose of this study was the evaluation of retinal abnormalities during a treatment with natural interferon (IFN-α for chronic hepatitis C. Retinal hemorrhages and optic disk edema were found in a 40-year-old woman during IFN-α therapy. The disk edema and retinopathy resolved after the INF was discontinued. Although retinal abnormalities correlated with IFN therapy have been described recently by some authors, the pathogenesis is still unclear. Anterior ischemic optic neuropathy occurring in a patient treated with IFN is a probable complication of the therapy.
Postmortem Findings Two Weeks after Oral Treatment for Metastatic Candida Endophthalmitis with Fluconazole
Authors: Ohnishi Yoshitaka , Tawara Akihiko , Murata Toshinori , Sakamoto Taiji , Arakawa Tetsuo , Ishibashi Tatsuro
Published: April 2003

The purpose of this histological study was to present postmortem findings in both eyes of a 53-year-old male with liver dysfunction 2 weeks after short-time oral treatment with 200 mg/day fluconazole for metastatic Candida endophthalmitis due to intravenous hyperalimentation for 18 days. Candida had been demonstrated in the venous blood and on the tip of the intravenous catheter. The bilateral fungal endophthalmitis with hypopyon responded well to fungistatic therapy, but the patient suddenly died from heart failure. Both eyes were obtained at autopsy. Candida was demonstrated only in vitreous puff balls but not in the retina or uvea. Fluconazole administered for a short period had little effect in eliminating fungus from vitreous puff balls, which have no blood supply. Prolonged administration of the antifungal drug or vitrectomy should be considered when treating an eye with vitreous puff balls in the presence of fungal endophthalmitis.
Retinal Thickness Analysis in Subjects with Different Refractive Conditions
Authors: Kremser Bernhard , Troger Josef , Baltaci Mehmet , Kralinger Martina , Kieselbach Gerhard F.
Published: April 2003

Purpose: The aim of the present study is to evaluate a measure of retinal thinning at the posterior pole in eyes with increasing axial myopia. Methods: 129 eyes of 79 healthy persons with different refractive conditions were examined using a commercially available prototype of retinal thickness analyzer. Results: Increasing myopia has been found to be accompanied by bulbus elongation, and calculation of the values obtained with the instrument revealed a significant decrease in retinal thickness at the posterior pole in eyes with increasing axial myopia, i.e. 4.8 μm/spherical equivalent in the foveolar region and 6.6 μm/spherical equivalent in the other areas of the posterior pole. Conclusion: Our data show retinal thinning at the posterior pole in myopic eyes based for the very first time on in vivo measurements. Furthermore, our findings might influence measurement data for other purposes, if the degree of myopia is not taken into account.
Vascular and Glial Changes in the Retrolaminar Optic Nerve in Glaucomatous Monkey Eyes
Authors: Furuyoshi N. , Furuyoshi M. , May Ch.A. , Hayreh S.S. , Alm A. , Lütjen-Drecoll E.
Published: April 2003

Vascular and glial changes of the retrolaminar optic nerve were studied in monkey eyes with increased intraocular pressure (IOP) from 1 to 4 years and with different stages of optic nerve atrophy. In histological cross-sections of retrolaminar optic nerves of 11 rhesus and 6 cynomolgus monkeys the entire area, number of axons and vessels and area of pial septa were quantitated and three different kinds of nerve degeneration classified. Ultrathin sections of these different stages were performed and the number of open and occluded vessels was determined. In addition, in cynomolgus monkey optic nerves immunohistochemical staining for αB-crystallin, glial fibrillary acidic protein (GFAP) and vimentin was performed. Even in animals with the same duration of glaucoma and comparable mean IOP values the axon degeneration varied considerably. Independently of axon loss the number of capillaries in the rhesus monkeys remained constant, whereas there was a slight decrease in the cynomolgus monkeys. Some of the vessels, especially in the most severely damaged regions, were occluded. The density of glial cells increased whereas the total number remained nearly constant. In control sections all astrocytes stained for GFAP and αB-crystallin. In the glaucomatous optic nerves the density of αB-crystallin- and GFAP-positive cells was significantly increased. The vascular reaction in the retrolaminar glaucomatous optic nerves differs from that described in the prelaminar region. We assume that in the postlaminar region in areas with diminished nutritional needs vessels occlude and finally degenerate.
Comparative Study of Brain Lesions Detected by Magnetic Resonance Imaging between Strabismus and Nonstrabismus in Infancy
Authors: Ohtsuki Hiroshi , Yoshifumi Kori , Hasebe Satoshi , Kono Reika , Harada Yoshihiro
Published: April 2003

Purpose: To elucidate the causative factors in infantile esotropia, we evaluated morphological abnormalities in brain structures of esotropia patients showing any abnormal neurological signs in comparison to those of normal controls. Methods: Sixty-five developmentally normal children participated in this study. Of these 65, 38 demonstrated infantile esotropia and 27 were normal controls. All underwent magnetic resonance imaging (MRI) of the brain between 2 and 30 months. Results: Abnormal brain findings were noted in 3 (7.9%) children in the strabismus group, whereas none of the children in the normal control group showed brain lesions. In these 3 cases, brain lesions involved periventricular leukomalacia, enlargement of the lateral ventricles with hypoplasia of the corpus callosum and myelination delay at the anterior horn adjacent to the lateral ventricles. Conclusions: Brain lesions that may disturb normal maturation of the visuomotor system and eventually lead to strabismus could be found in some patients without any episode that would cause birth injury.
Cytomegalovirus Retinitis in a Patient with Wegener’s Granulomatosis
Authors: Tugal-Tutkun Ilknur , Kır Nur , Gül Ahmet , Koniçe Meral , Urgancioglu Meri
Published: April 2003

Cytomegalovirus retinitis (CMVR) is a rare complication of systemic immunosuppressive therapy in patients with rheumatic disorders. We describe a 44-year-old man with Wegener’s granulomatosis who was treated with cyclophosphamide and methylprednisolone and who subsequently developed bilateral CMVR. In spite of discontinuation of immunosuppressive therapy and administration of systemic ganciclovir, retinitis recurred and maintenance therapy was needed. In conclusion, increased awareness of this potentially serious complication of immunosuppressive therapy is critical. If immune recovery is slow after discontinuation of immunosuppressive agents, prolonged antiviral therapy is required in order to prevent recurrences of CMVR.
A Survey of Trachoma: The Histopathology and the Mechanism of Progressive Cicatrization of Eyelid Tissues
Authors: Guzey Mustafa , Ozardali Ilyas , Basar Emel , Aslan Gonul , Satici Ahmet , Karadede Sezin
Published: April 2003

The aim of this study is to demonstrate the spectrum of conditions encompassed by the term ‘trachomatous cicatrization of eyelid tissue’, to discuss the mechanisms of scar tissue formation and to describe sequelae in this potentially blinding condition. Specimens of eyelid tissues were taken from 27 upper eyelids of 21 patients with entropion who underwent surgical procedures and 2 post-mortem upper eyelids with severe trachomatous entropion. Upper palpebral conjunctival swabs and biopsy specimens were taken from 5 patients with active trachoma and they were examined by fluorescence microscopy and routine histopathological methods. Conjunctival impression cytology samples were collected in all patients. In specimens taken from patients with active trachoma the inflammatory infiltrate was organized as lymphoid follicles in the underlying stroma and impression cytology showed cytoplasmic elementary bodies. In specimens taken from patients with scarring trachoma light microscopy studies showed subepithelial fibrous membrane formation, squamous metaplasia and loss of goblet cells, pseudogland formation in conjunctiva, degeneration of orbicularis oculi muscle fibres, subepithelial vascular dilatation, localized perivascular amyloidosis and subepithelial lymphocytic infiltration. Accessory lachrymal glands and the ducts of glands were compromised by subepithelial infiltration and scarring. The contraction of the subepithelial fibrous tissue formed by collagen fibres and anterior surface drying are the main factors contributing to the chronic cicatrization and entropion formation.
Stevens-Johnson Syndrome in India – Risk Factors, Ocular Manifestations and Management
Authors: Pushker Neelam , Tandon Radhika , Vajpayee Rasik B.
Published: April 2003

We conducted a study to analyse the presentation, risk factors, ocular manifestations and ophthalmic management results of Stevens-Johnson syndrome (SJS) in Indian patients. A total of 20 patients with SJS with ocular involvement were studied. Female predominance (70%) was observed. The age ranged from 10 to 30 years (mean ± SD: 16.85 ± 5.96). The commonest precipitating risk factor was oral drug intake (80%), sulphonamide (30%; sulphamethoxazole-trimethoprim) being the commonest. One patient had reaction to ciprofloxacin which has not been reported previously. Four patients (20%) had spontaneous onset with no identifiable risk factor. None of the patients had specific infection per se as a risk factor. Conjunctival involvement and its sequelae were the major ocular manifestations. At presentation, the majority of the eyes (68%) had visual acuity less than 3/60. Despite appropriate medical treatment and surgical interventions (11 eyes; 28%) vision continued to deteriorate. In 1 eye, the vision improved after stem cell transplantation. Therapeutic penetrating keratoplasty could preserve ocular integrity in 1 patient.
Bilateral Serous Retinal Detachment Associated with Alport’s Syndrome
Authors: Yasuzumi Kenjiro , Futagami Soh , Kiyosawa Motohiro , Mochizuki Manabu
Published: April 2003

We report a 14-year-old girl with Alport’s syndrome who developed bilateral exudative retinal detachment in the macula. With the development of chronic renal failure, bilateral serous retinal detachment appeared which had the retinal flecks characteristic of Alport’s syndrome. The serous detachment was resolved and vision recovered following intensive hemodialysis. As far as we know this is the first case with documentation of the onset and resolution of serous retinal detachment in Alport’s syndrome.
Contamination of Contact-Lens-Related Sources with Pseudomonas aeruginosa
Authors: Micallef C. , Cuschieri P. , Bonnici M.R.
Published: April 2003

The studies conducted sought to estimate contamination of contact lens (CL) storage cases and commercial solutions with Pseudomonas aeruginosa as well as to investigate everyday sources, which the CL wearer uses or comes into contact with. The studies revealed that 13.1% of storage lens cases and 5.1% of commercial solutions in use were positive for the bacterium. Ten hermetically sealed CL solutions were tested for possible contamination, but these all proved to be sterile. In addition, environmental samples, of both a solid and liquid nature, yielded relatively high contamination rates with this opportunistic bacterium. Results showed that common sources, which the CL wearer is in contact with, possess P. aeruginosa and this may indeed predispose to corneal infections.
Electroretinographic Assessment of Early Changes in Ocular Siderosis
Authors: Imaizumi Masamoto , Matsumoto Celso S. , Yamada Kisaburou , Nanba Yoshie , Takaki Yasuhiro , Nakatsuka Kazuo
Published: April 2003

We examined a patient with an iron intraocular foreign body and recorded electroretinograms (ERGs) before and after the removal of the foreign body by vitrectomy. The amplitudes of the rod and cone ERGs and the oscillatory potentials (OPs) in the injured eye were reduced before the operation. In addition, the photopic on-responses (b wave) were more reduced than off-responses (d wave). One year after surgery, the amplitudes of the rod, cone and photopic on- and off-responses were markedly improved to within the low normal limit. However, the OP amplitudes remained unchanged with lower values. These findings suggest that iron retinotoxicity leads to a dysfunction of all layers but the changes may be reversible in the early period of the disease. The late period iron toxicity produces more severe damage to the inner retina than the outer retina.
Diabetic Retinopathy: Surrogate Outcomes for Drug Development for Diabetic Retinopathy
Authors: Cunha-Vaz J.G.
Published: April 2003

Diabetic retinopathy remains the most frequent cause of new cases of blindness among adults aged 20–74 years. A number of large clinical trials have validated treatment methods now considered standard. However, the disease continues to progress in approximately 50% of the eyes treated by photocoagulation. Other forms of therapy targeted at the earliest stages of retinal disease are needed. The difficulties in defining and accepting surrogate outcomes appropriate to evaluate the earlier stages of retinopathy are discussed. Special attention is given to trial design and the most likely possibilities for surrogate outcomes: mean difference on the Early Treatment Diabetic Retinopathy Study retinopathy scale of at least 2 steps per eye, reduction in macular thickening and reduction in fluorescein leakage.
Arcuate Relaxing Incisions with a 5.00-mm Optical Zone for the Correction of High Postcataract Astigmatism
Authors: Tsioulias George , Droutsas Dimitrios , Moschos Michael , David George , Theodossiadis George
Published: April 2003

The purpose of this study was to investigate the efficacy and safety of arcuate cuts with a 5-mm optical zone to correct high postoperative astigmatism after extracapsular cataract extraction. We performed 5-mm optical zone arcuate cuts on 23 eyes of 23 patients with high postoperative astigmatism. Ophthalmic examination included uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA) and the amount of the refractive and keratometric cylinder before and 9 months after operation. Surgically induced refractive change was calculated in all cases. A significant reduction in astigmatism was achieved in all cases with minimal axis deviation. No case developed clinically significant irregular astigmatism. The mean magnitude of astigmatism of the surgically induced refractive change calculated from standard keratometry and refractive data was 3.73 ± 0.72 and 3.70 ± 0.77 dptr, respectively. The mean axis deviation calculated from the keratometric and refractive data was 1.18 ± 2.33 and 1.32 ± 3.62°, respectively. At the last examination, 78.2% of the eyes had UCVA of 20/40 or better. No eye lost more than two lines of vision, 6 eyes lost one line, 2 eyes gained one and 1 eye gained two lines of BSCVA. The above data show that the 5-mm optical zone arcuate astigmatic keratotomy is an effective and safe method of correcting high postoperative astigmatism.
High Hurdle of Clinical Trials to Demonstrate Efficacy of Anticataractogenic Drugs
Authors: Sasaki K. , Hockwin O. , Sakamoto Y. , Sasaki H. , Kojima M.
Published: April 2003

Recently, the rapid progression of cataract surgical technique has led cataract patients in industrialized countries to ignore the possibilities of drug therapy. Globally, however, it will be impossible in the near future to treat cataract by surgery alone, mainly due to medicoeconomic reasons. Preventative measures must be sought. As one of the these measures, the development of anticataractogenic drugs has reemerged as a focus in the lens research field. Although clinical trials of newly developed drugs are absolutely necessary before they enter the market, they have been considered to be a rather easy task. However, in order to gain accurate and reproducible data from trials, the trial program must be carefully prepared. The numbers of participants to the trial, the selection criteria of the subjects, the objective judgment of cataractous changes, follow-up period, a high technical level for cataract documentation and image analysis are proposed. Although there still remain some difficulties concerning the methods for objective judgment, a scientifically acceptable examination must be conducted.