bluuebunny/crossref_metadata_2025 huggingface dataset:
Orbital Tumor in Acute Myeloid Leukemia Associated with Karyotype 46,XX,t(8;21)(q22;q22): A Case Report
Authors: Tanigawa Maki , Tsuda Yasuo , Amemiya Tsugio , Yamada Kazuhiko , Nakayama Masahiko , Tsuji Yoshiro
Published: April 2003

Orbital tumor formation in acute myeloid leukemia (AML) is rare as an initial symptom. Furthermore, orbital granulocytic sarcoma (myeloid sarcoma) in pediatric patients is uncommon. We describe a 5-year-old Japanese girl with a left orbital mass as an initial symptom of AML, the mass revealed by computed tomography. Periperal blood and bone marrow pictures and a chromosomal analysis disclosing 46,XX,t(8;21)(q22;q22) showed AML (M2 according to the French-American-British classification). She was treated with antileukemic chemotherapy systemically. Three weeks after the initiation of chemotherapy, the orbital tumor regressed markedly. AML as an initial symptom of the orbital mass should be fully considered in a differential diagnosis, even in the absence of typical leukemic symptoms, and chromosomal analysis and immunophenotypical analysis may explain the pathogenesis of the extramedullary leukemic tumor.
Pattern ERG Changes in Suspected Glaucoma
Authors: Panagakis E. , Moschos M.
Published: April 2003

Pattern ERG (P-ERG) changes were studied in patients with suspected glaucoma. P-ERG was recorded in 48 eyes with good visual acuity, normal visual fields and elevated intraocular pressure ranging between 18 and 26 mm Hg. The amplitude of the P1 wave was within normal limits and ranged between 1.0 and 1.9 μV in 46 eyes (95.8%). In contrast, the amplitude of the N2 wave in 32 eyes (66.6%) was subnormal, ranging between 0.2 and 0.8 μV. The implicit time of the P1 and N2 waves was normal, ranging from 60.1 to 69.4 and from 95.1 to 103.8 ms, respectively. In conclusion, the N2 wave changes of the P-ERG may predict those hypertonic eyes which will eventually develop glaucoma and need early antiglaucoma therapy. On the contrary, in ocular hypertensives with normal N2 wave the development of glaucoma is less likely.
Bacterial Corneal Ulcer: A Multivariate Study
Authors: Wang An-Guor , Wu Chih-Chiau , Liu J.-H.Jorn-Hon
Published: April 2003

A retrospective clinicomicrobiological review of 314 patients with bacterial corneal ulcers from January 1982 to December 1992 was performed. Multivariate statistical analysis was done with multiple logistic regression using PROC LOGIST of SAS statistical software. Positive cultures were grown from 134 (42.7%) of the patients. Pseudomonas aeruginosa, staphylococci, and Acinetobacter spp. were the most frequent pathogens. Significant associations between contact lens use and P. aeruginosa (odds ratio, OR 8.16), between previous herpes simplex keratitis and Streptococcus spp. (OR 18.2) were found. Acinetobacter spp. occurred more frequently in eyes with burn and/or lagophthalmos (OR 13.1/26.2). Staphylococcus aureus was associated with trauma (OR 6.27) and age under 50 (OR 5.08–13.6). Nonpseudomonal gram-negative bacilli were associated with age over 50 (OR 3.24). Drug sensitivity tests for these isolated microorganisms showed that vancomycin and ceftazidime were the most effective agents.
Experimental Ocular Toxoplasmosis in Naive and Primed Rabbits
Authors: Garweg Justus G. , Kuenzli Hans , Boehnke Matthias
Published: April 2003

Purpose: Investigations of the course of ocular toxoplasmosis and the influence of a host’s immunological status in an animal model would contribute to our understanding of the pathophysiology underlying this condition. In the current study, these aspects are addressed using naive and primed rabbits infected transvitreally with the non-cyst-forming BK strain of Toxoplasma gondii. Materials and Methods: Of 45 latex agglutination test-negative rabbits, 27 were infected subcutaneously with 5,000 Toxoplasma tachyzoites, and the ensuing infection treated by systemic administration of clindamycin for 20 days. Four of these rabbits died from generalized infection. The remaining 23 primed rabbits were then inoculated periretinally with a further 5,000 Toxoplasma tachyzoites, administered via the transvitreal route; the 18 naive rabbits were treated likewise. Results: All 18 naive and 21 of the 23 primed rabbits developed toxoplasmic retinochoroiditis. As regarded progression of the disease, dissemination of the condition (p = 0.0001), degree of vitreal infiltration (p = 0.0001) and incidence of retinal detachment (p < 0.05) were all more pronounced in the naive group. Despite treatment, 4 of the 18 (22%) naive rabbits died from generalized infection, as did 4 of the 27 (15%) subcutaneously infected ones (prior to periretinal infection). In the primed (secondarily infected) animal group, only moderate signs of systemic infection were manifested, and there were no fatalities. Conclusion: The high incidence (> 90%) of retinochoroiditis achieved even in primed animals, by introducing Toxoplasma tachyzoites via the transvitreal route, may reflect the maintenance of an intact uveovascular barrier during the early stages of the disease. The pattern of infection, in being restricted primarily to the retina, mimics the situation evinced in humans. Regarding propagation of the disease, the condition manifested in naive rabbits resembles that occurring in immunodeficient patients, whereas that evoked in primed animals corresponds to recurrence of infection in immunocompetent patients.
Bull’s-Eye Macular Dystrophy Associated with Peripheral Involvement
Authors: Suzuki Ryo , Hirose Tatsuo
Published: April 2003

Although central vision in Stargardt’s disease is impaired relatively early, peripheral function is usually little affected and patients do not lose all vision. We report 4 patients with bull’s-eye macular dystrophy that is indistinguishable from Stargardt’s disease/fundus flavimaculatus, but with very depressed peripheral retinal function. One patient had bull’s-eye maculopathy with a dark choroid on the fluorescein angiogram with a normal peripheral fundus and good retinal function initially. Sixteen years later, however, peripheral bone corpuscle pigmentation and optic disc atrophy developed and the electroretinogram became nonrecordable. Three patients from another family also had peripheral pigment degeneration besides macular degeneration. These cases may represent a rare combination of Stargardt’s disease and retinitis pigmentosa. However, there was no clinical sign or even suggestion of retinitis pigmentosa at the initial examination in 1 patient. The mode of inheritance in 3 of our patients is probably autosomal recessive.
Diabetic Vitreopathy – Findings Using the Celloidin Embedding Technique
Authors: Faulborn Jürgen , Dunker Stephan , Bowald Sylvia
Published: April 2003

Background: To evaluate the role of the vitreous in diabetic eyes, autopsy eyes from diabetic patients have been examined by means of light and electron microscopy. Methods: Twenty-five eyes were obtained from 19 patients. The duration of diabetes was from 8 to 26 years (average 17 years). All patients had type II diabetes. The glycerol-dehydrated globes were embedded in celloidin and hardened with chloroform. For light microscopy, areas of interest were cut from 200-μm-thick celloidin sections and embedded in paraffin, and 10-μm sections were cut. Such 200-μm and 10-μm sections were also used for scanning electron microscopy. For transmission electron microscopy, areas of interest were cut from thick celloidin sections and embedded in Epon for thin sectioning. Results: The vitreous in diabetic eyes exhibits delayed senile degeneration in case of early onset of diabetes. It shows intensified staining of the vitreous cortex. Posterior detachment is often incomplete without collapse. The vitreous collagen fibers are coarse and aggregated in the centrally located cortical region of the vitreous. Hyalocytes in diabetic eyes have a different shape than normally, and their number seems to be increased. All these structural changes were not demonstrated in nondiabetic eyes. Conclusion: The vitreous in diabetic patients is morphologically different from normal vitreous. Features of the diabetic vitreous are aggregated collagen fibers, increased density of the vitreous cortex and morphological changes of hyalocytes. It is discussed whether these findings arise from nonenzymatic glycosylation of collagen molecules resulting in diabetic vitreopathy.
Fibrinolytic Therapy with Low-Dose Recombinant Tissue Plasminogen Activator in Retinal Vein Occlusion
Authors: Hattenbach Lars-Olof , Steinkamp Gerd , Scharrer Inge , Ohrloff Christian
Published: April 2003

Fibrinolytic therapy aimed at early restoration of blood flow appears to be a promising therapeutic approach in haemorrhagic retinopathy. The risk of bleeding complications, a major problem with fibrinolysis, can be reduced by the use of low-dose thrombolytic regimens. In our study, 14 patients with ischaemic central (CRVO) or branch (BRVO) retinal vein occlusion who presented with severe visual loss and recent onset of symptoms were treated with a low dose (50 mg) of recombinant tissue plasminogen activator (rt-PA) and intravenous heparin. In 10 of 14 patients (7 CRVO, 3 BRVO), an increase in visual acuity of one line or more on the logarithmic visual acuity chart was noted and in 8 patients (6 CRVO, 2 BRVO) a reduction of areas of capillary non-perfusion was observed, suggesting that a restoration of retinal capillary blood flow can be achieved if fibrinolysis is initiated in the early phase of haemorrhagic retinopathy. In view of the poor prognosis in the natural course of haemorrhagic retinopathy and the potential haemorrhagic risk in fibrinolysis, the use of low-dose rt-PA appears to constitute an encouraging approach in the management of this disease.
Congenital Malformation of the Iris’s Major Arterial Circle Simulating an Angioma
Authors: Isola V.M. , Pece A. , Menchini U. , Vergari M. , Fasolino G. , Brancato R.
Published: April 2003

A case of anatomical anomaly of the iris’s major arterial circle simulating an angioma was discovered in the right eye of a 64-year-old asymptomatic woman during routine ocular examination. We report its clinical and gonioangioiridographic findings.
Etude comparative de l’irradiation bêta (106Ru/106Rh) et de l’irradiation gamma (125I) sur l’œil du lapin
Authors: Bacin F. , Amara S. , Kemeny J.L. , Rozan R. , Bard J.J. , Donnarieix D.
Published: April 2003

Beta Irradiation (106Ru/106Rh) versus Gamma Irradiation (125I): A Comparative Study on the Normal Rabbit Eye. We compared beta irradiation (106Ru/106Rh) to gamma irradiation (125I) on the normal rabbit eye, using ophthalmic plaques to deliver doses similar to those recommended in man for choroidal melanoma treatment. A detailed dosimetry was performed and the animals were followed up by clinical and histological examinations during 1 year. The mean total doses were either comparable, or larger with iodine-125, but the globes treated with ruthenium-106 exhibited more damaging effects: total destruction of the chorioretina on the plaque site, abnormalities of the retinal vessels and of the close nerve fiber layers, cavernous atrophy of the optic nerve. In the eyes treated with iodine-125, only the external retinal layers were destroyed.
The Evaluation of Corneal Graft Tissue by the Use of Trypan Blue
Authors: Georgiadis N. , Kardasopoulos A. , Bufidis T.
Published: April 2003

Background: The quality of the donor cornea, which basically depends on the condition of the endothelial sheet, is an important factor for the successful outcome of penetrating keratoplasty. Patients and Methods: In this retrospective study, we present our experience in using trypan blue staining for the examination and evaluation of 498 consecutive corneal grafts from 251 donors, concerning their suitability for penetrating keratoplasty, during the decade 1986–1995. Results: Forty-two grafts out of 498 (8.5%) were considered not suitable for surgery because of the great number of destroyed cells (cell density less than 1,500 cells/mm2) and the abnormal cell size and cell shape. Nine out of the 456 (1.97%) operated eyes exhibited primary donor failure and needed re-operation, probably because of boundary cell density of the graft (ranged in those cases from 1,600 to 1,800 cells/mm2). No infections of grafts were observed. Conclusion: Tissue evaluation of corneal grafts by the use of trypan blue staining is a simple, cost-effective, safe and accurate method that does not influence the vitality of the endothelial layer of the grafts.
Expression and Distribution of Extracellular Matrices during Corneal Wound Healing after Keratomileusis in Rabbits
Authors: Kang Shin Jeong , Kim Eung Kweon , Kim Hong Bok
Published: April 2003

We compared the corneal wound healing responses of keratomileusis and keratectomy in rabbits. A single pass of thin lamellar keratectomy was performed with a microkeratome in rabbits. The lenticule was repositioned with a hinge in one group and discarded in the other. With immunofluorescence techniques, we studied the appearance and distribution of fibronectin, fibrinogen and type III collagen at follow-up intervals from 1 h to 3 months. Fibronectin and fibrinogen began to deposit on the periphery of the denuded stroma 3 h after induced injury and diminished once reepithelialization had completed in both groups. In the corneas with attached lenticules, type III collagen was detected 7 days after surgery and lasted for at least 3 months. Type III collagen was detected only in the periphery of the interface and not in its center. These findings suggest that fibronectin and fibrinogen may play roles in epithelial healing after in situ keratomileusis in rabbits. Stromal healing of colla- gen seems to take place 7 days after keratomileusis and to last for several months. No deposits of new collagens in the center of the interface between lenticule and stromal bed may explain the optical clarity in the keratomileusis.
Etiology and Pathogenetic Mechanisms of Optic Disc Swelling with Visual Loss
Authors: Stammen Johannes , Unsöld Renate , Arendt Gabriele , Vester Ernst G. , Heering Peter , Freund Hans-Joachim , Strauer Bodo-Eckehard , Grabensee Bernd
Published: April 2003

A nonrandomized, prospective, interdisciplinary pilot study of 102 patients with noncompressive optic disc swelling with visual loss (ODSWVL) was performed in order to investigate etiologic and pathogenetic mechanisms. Forty-six patients suffered from underlying inflammatory disease. Seventeen patients suffered from highly probable cardiogenic embolization, 16 patients from multiple vascular risk factors. The remaining patients of the noninflammatory disease group suffered from leukemia, previously unknown or severely decompensated diabetes mellitus, acute arterial hypertension, different kinds of coagulopathies and others. Ninety-six of the 102 patients required medical treatment according to general medical standards. Inhomogeneity of the underlying disease processes explains the ineffectiveness of different monotherapies in previous studies. Interdisciplinary search for the underlying causes allows causative treatment. ODSWVL and anterior ischemic optic neuropathy in particular seem to be a common final pathway of various pathogenetic mechanisms due to different etiologies rather than a disease entity by itself.
The Effect of Cyclosporin A on Cultured Rabbit Subconjunctival Fibroblast Proliferation
Authors: Bagci Gülseren , Yücel İclal , Duranoglu Yaşar
Published: April 2003

The aim of this study was to examine the possible effects of local application of a potent immunosuppressive drug, cyclosporin A (CsA), on fibroblast proliferation in vitro. Rabbit subconjunctival fibroblasts were cultured and incubated with varying doses of CsA (from 0.5 to 5%). Growth inhibition curves were obtained, and cell attachment and reversibility of drug-induced growth inhibition were studied. None of the doses stimulated fibroblast proliferation. CsA inhibited fibroblast proliferation depending on the dose and duration of application. Also, drug-induced growth inhibition decreased depending on dose and duration of application. While the dosage which led to 50% inhibition was found to be 7.2 mg/ml, 4% and higher doses had toxic effects.
Experimental Intravitreal Application of Ciprofloxacin in Rabbits
Authors: Wiechens Burkhard , Grammer Joachim B. , Johannsen Ute , Pleyer Uwe , Hedderich Jürgen , Duncker Gernot I.W.
Published: April 2003

Background: Ciprofloxacin (CFLX) is a fluoroquinolone antibiotic with a broad antimicrobial spectrum. This study was performed to examine the retinal toxicity of free and liposome-incorporated CFLX in rabbit eyes after intravitreal injection. Materials and Methods: Free CFLX in doses of 100, 250, 500, 1,000 and 2,000 µg was injected into the midvitreous of rabbit eyes (n = 28). To prolong the intravitreal antibacterial level, CFLX was incorporated into multilamellar liposomes: 0.1 ml of this suspension (≙ 273.6 µg CFLX) was injected into the midvitreous of a second group of rabbit eyes (n = 6). The other eye served as a control and received normal saline solution or empty liposomes, respectively. Before injection and at the end of follow-up an electroretinogram (ERG) was obtained. After a follow-up of 1, 14 and 28 days the animals were perfused with glutaraldehyde and the eyes were examined by light and transmission electron microscopy. Results: Significant reduction of the ERG was observed after 2,000 µg free CFLX in 4 out of 6 eyes after 14 days. Fourteen days after injection of 2,000 µg CFLX the central retina showed pigmentary changes in 4 out of 6 eyes. In the second group the ERG as well as the histologic studies did not reveal any pathologic changes after injection of liposome-incorporated CFLX compared to the control eyes. Conclusion: In therapeutic doses of 100–500 µg, free CFLX does not have retinal toxicity in rabbit eyes. No retinal toxicity was observed after intravitreal injection of liposome-incorporated CFLX.
Conjunctival Malignant Melanoma in Children
Authors: Strempel Ilse , Kroll Peter
Published: April 2003

The first case concerns a 14-year-old girl with a brown conjunctival mass temporally in her right eye which was excised and diagnosed as active conjunctival melanotic lesion. Five years later, a malignant melanoma of the right lacrimal sac and orbit led to general metastatic spread. The second case demonstrates a conjunctival brown mass temporally in the left eye of a 3-year-old boy which enlarged over 4 years. The excision revealed a melanotic lesion which was of uncertain histological dignity. The third case occurred in a 4-year-old boy with a conjunctival glassy tumor temporally in his right eye which after excision led to controversial discussions concerning benign nevus or malignant melanoma.
Three Types of Retinal Bleeding as a Complication of Hypotony afterTra beculectomy
Authors: Suzuki Ryo , Nakayama Masako , Satoh Noriaki
Published: April 2003

Although small retinal bleeding has been evaluated as a complication of filtering surgery, long-standing retinal bleeding is rare. We report 3 rare cases of young patients with massive retinal hemorrhages following trabeculectomy with 5-fluorouracil or mitomycin C. The bleeding in 1 case resolved spontaneously, whereas the bleeding in the other 2 cases did not resolve and the visual acuity remained poor. Every patient showed markedly delayed retinal circulation. Possible dysfunction of the retinal blood vessels may be responsible for the development of the other two types of massive bleeding, especially in advanced glaucoma with a total cup disk: one is decompression retinopathy and another central retinal vein occlusion or hemorrhagic retinopathy.
Primary Orbital Leiomyoma and Leiomyosarcoma
Authors: Wiechens Burkhard , Werner JochenA. , Lüttges Jutta , Rudert Heinrich , Rochels Rainer
Published: April 2003

A case of an extremely rare primary orbital leiomyoma in a 25-year-old male patient is presented who had a lifelong history of deviation of the left eye globe with slight enophthalmos and reduced motility. Because of pain and increasing deviation of the eye the tumor was totally resected. On histologic examination the tumor showed ossification which is extremely rare so that a calcifying fibroma had to be ruled out. In immunohistochemistry, however, this tumor stained with smooth muscle antigen. Less than 2% of cells stained positive for Ki-S1, a proliferation marker. The second case is a rare primary orbital leiomyosarcoma in an 84-year-old female patient that showed massive growth. After exenteration histologic examination showed a dedifferentiated highly malignant soft tissue tumor which expressed desmin and smooth muscle actin but was negative for myoglobin, S-100 and HMB-45.
Evaluation of the Peripherin/RDS Gene as a Candidate Gene in Families with Age-Related Macular Degeneration
Authors: Shastry BarkurS. , Trese MichaelT.
Published: April 2003

Age-related macular degeneration (AMD) is a heterogeneous group of disorders and is the leading cause of blindness in the elderly. While degeneration changes in the macula can occur at any time in life, it is the most common cause of severe visual impairment with advancing age. The disease affects approximately 11 million Americans and causes loss of central vision, impairing activities such as reading. The exact cause of the disorder is not known. In this report, we studied two unrelated families having familial-type AMD, with the assumption that mutations in the peripherin/retinal degeneration slow (RDS) gene could contribute to the disease phenotype. Our extensive analyses have identified two silent mutations (84D and 106V) in one family in the same allele of exon 1 which segregated in 3 patients with AMD. However, the fourth affected individual in the same family, as well as 40 normal controls, did not contain this mutation. Further analysis of exon 2 and exon 3 in both families did not show any other sequence alterations. Since one of these silent mutations (106V) has been reported to exist in certain general populations and the other mutation (84D) failed to segregate completely in the family, it is unlikely that these mutations are pathogenic. The results of the study suggest that the peripherin/RDS gene is not a major factor responsible for AMD in the families analyzed.
Unilateral Glaucomatous Damage in a Patient with Hemifacial Spasm
Authors: Killer H.E. , Rüst O. , Müller O. , Flammer J.
Published: April 2003

We report a patient with hemifacial spasm of the right hemiface and ipsilateral glaucomatous optic neuropathy. No risk factors were found to explain the unilateral glaucoma. Ocular pressure readings were always within normal range.
Das multifokale Elektroretinogramm in der Diagnostik und Verlaufskontrolle lokalisierter Netzhautfunktionsstörungen: Fallbericht eines Patienten mit Chorioretinopathia centralis serosa
Authors: Palmowski Anja M. , Sutter Erich E. , Bearse Jr. Marcus A. , Fung Wane
Published: April 2003

The role of multifocal electroretinography (MF-ERG) in the diagnosis and follow-up of localized areas of retinal dysfunction is discussed. A 42-year-old male with the preliminary diagnosis of optic neuritis in his left eye was referred for evaluation with the MF–ERG. Simultaneous cone ERGs were obtained from 103 locations within the central 50 degrees of the retina. During an 8-month follow-up four MF–ERGs were obtained. Bilaterally reduced paracentral response amplitudes contradicted the preliminary diagnosis. Subsequently central serous chorioretinopathy was diagnosed. Follow-up showed normalization of the MF-ERG responses in the left eye while retinal function in the right eye showed initial worsening. The noninvasive MF–ERG lends itself to follow-up in patients with central serous chorioretinopathy.
Hypofluorescent Spots on Indocyanine Green Angiography at the Recovery Stage in Multiple Evanescent White Dot Syndrome
Authors: Tsukamoto Eiki , Yamada Tetsuya , Kadoi Chiharu , Hayasaka Seiji , Nagaki Yasunori , Hayasaka Yoriko
Published: April 2003

Purpose: To evaluate the fundus lesions in a young woman. Methods: Visual function, ophthalmoscopy, electrophysiology, fluorescein angiography, and indocyanine green angiography were performed. Results: A 24-year-old woman had decreased visual acuity (0.2), granularity in the macula, and multiple yellow-white patches in the fundus, reduced a wave on electroretinography, hyperfluorescence on fluorescein angiography, and hypofluorescence on indocyanine green angiography in the left eye. When visual acuity improved to 1.0, the white dots disappeared ophthalmoscopically, and fluorescein angiography showed normal findings. Hypofluorescent spots were found, however, on indocyanine green angiography. Conclusion: It is possible that signs of multiple evanescent white dot syndrome may remain longer during examination by indocyanine green angiography than by visual function, ophthalmoscopy, or fluorescein angiography.
Evaluation of the Analgesic Effect of 0.1% Indomethacin Solution on Corneal Abrasions
Authors: Patrone G. , Sacca S.C. , Macri A. , Rolando M.
Published: April 2003

Purpose: The authors wished to verify the analgesic action of 0.1% indomethacin in a water-based solution on patients affected by traumatic corneal abrasions. Methods: 347 patients affected by traumatic corneal abrasions, having been randomly divided into 2 groups on the basis of the administration of indomethacin, were evaluated at 30 min, 12 h and 24 h after the initial treatment of the abrasion. The level of pain experienced was evaluated on a verbal pain scale and the healing time was evaluated relative to the dimension of the abrasion. Results: The pain level was initially overwhelming for both groups: p = 0.737; at successive check-ups it was possible to verify a reduction of the symptomatology, with a more pronounced decrease in pain in the group treated with indomethacin (p < 0.0001), which also demonstrated a lower sensitivity to pain in the case of larger lesions (p < 0.0001). There was no difference in the healing time between groups, and the reduction of pain is not correlated with corneal anesthesia and healing time. Conclusions: Our study highlighted the efficacy of indomethacin as a pain reducer for acute corneal pathology and suggested that the medication may act on the corneal nociceptors in a qualitative way.
Visual Outcome after Treatment with Low-Dose Recombinant Tissue Plasminogen Activator or Hemodilution in Ischemic Central Retinal Vein Occlusion
Authors: Hattenbach Lars-Olof , Wellermann Georg , Steinkamp Gerd Wilhelm Karl , Scharrer Inge , Koch Frank Heinz Johannes , Ohrloff Christian
Published: April 2003

The ischemic type of central retinal vein occlusion (CRVO) is associated with a poor visual and ocular prognosis. Although several reports have indicated that hemodilution or thrombolytic therapy may be of benefit, there is still no consensus among ophthalmologists about the management of this disorder. In our study, we retrospectively evaluated the visual outcome after medical treatment in 58 patients with ischemic CRVO and severe visual loss (≤20/50). We separately investigated three different groups, depending on the following criteria: onset of symptoms within 11 days prior to admission and thrombolytic treatment with 50 mg of recombinant tissue plasminogen activator (rtPA) and intravenous heparinization (n = 23) or hemodilution therapy (n = 22) or onset of symptoms >11 days before the initial visit and hemodilution (n = 13). An advancement of 2 or more lines on the logarithmic visual acuity chart was noted in 10 cases (44%) in the rtPA group and in 3 subjects (14%) in the early-phase hemodilution group, whereas only 1 patient in the late-phase hemodilution group showed a comparable improvement. Our findings suggest that treatment with low-dose rtPA or hemodilution aimed at early restoration of blood flow has the potential to improve the visual prognosis in ischemic CRVO. The finding that thrombolysis had a favorable outcome supports the hypothesis that specific subgroups of patients may benefit from this therapeutic approach. Further investigation will be required to definitively prove the effectiveness of fibrinolytic agents.
Full-Thickness Retinal Transplants: A Review
Authors: Ghosh Fredrik , Ehinger Berndt
Published: April 2003

Embryonic full-thickness rabbit neuroretinal sheets were transplanted to the subretinal space of adult hosts. This was accomplished by using a new transplantation technique involving vitrectomy and retinotomy. The grafts were followed from 10 to 306 days after surgery and were then examined by different histological techniques. In the light microscope, the transplants were seen to develop the normal retinal lamination and fusion with the host retina, especially after long survival times. Ultrastructurally, normal photoreceptor outer segments, well integrated with the host retinal pigment epithelium, were found. Growth cones were present in the zone of fusion between graft and host retina. Immunohistochemical labeling revealed many of the normal retinal components not previously found in retinal transplants, and graft-host connections between neurons in the rod pathway were seen. The morphology of vibratome-sectioned neuroretinal sheets as well as adult full-thickness grafts was also examined. These transplantation types showed less of the normal morphology compared with embryonic full-thickness grafts. The immunogenicity of embryonic full-thickness and fragmented grafts was compared using major histocompatibility complex immunolabeling. Fragmented grafts elicited a response from the host immune system similar to a chronic transplant rejection. This reaction was absent in the full-thickness grafts which is in accordance with their good long-term survival.
Primary Open-Angle Glaucoma Is Associated with Sleep Apnea Syndrome
Authors: Mojon Daniel S. , Hess Christian W. , Goldblum David , Böhnke Matthias , Körner Fritz , Mathis Johannes
Published: April 2003

Introduction: The etiology of primary open-angle glaucoma remains unclear. Various risk factors, including vascular abnormalities, have been associated with this disease. Sleep-associated diseases, like sleep apnea syndrome, might also represent a risk factor. Sleep apnea syndrome is characterized by repetitive upper airway obstructions during sleep, inducing hypoxia and sleep disruption with the risk of cardiovascular and neurological sequelae. In this study, we determined the prevalence of sleep apnea syndrome in primary open-angle glaucoma patients. Methods: Overnight transcutaneous finger oximetry was performed in 30 consecutive patients having primary open-angle glaucoma. We assessed the oximetry disturbance index during night sleep, a parameter used to diagnose sleep apnea syndrome and to grade its severity. Results: Sleep apnea syndrome was more prevalent among primary open-angle glaucoma patients compared to normal historic controls of the same age and sex distribution (χ2 = 9.35, d.f. = 3, p < 0.025). The oximetry disturbance index grade was significantly larger in the primary open-angle glaucoma group compared to normal controls (U = 3,352, p = 0.01). According to the oximetry disturbance index, 20% (6/30) of primary open-angle glaucoma patients had sleep apnea syndrome. Conclusion: Primary open-angle glaucoma is associated with sleep apnea syndrome. Early recognition and treatment of sleep apnea syndrome are important to avoid cardiovascular and neurological complications.
Visual Field Defects and Normal Nerve Fiber Layer: May They Coexist in Primary Open-Angle Glaucoma?
Authors: De Natale Renato , Marraffa Michele , Morbio Roberta , Tomazzoli Laura , Bonomi Luciano
Published: April 2003

The retinal nerve fiber layer (RNFL) is the anatomical structure most sensitive to glaucoma injury. Before a functional loss such as a visual field defect is displayed, a large number of nerve fibers can be damaged. However, there are glaucoma patients in which an apparently normal RNFL coexists with evident visual field defects. A total of 54 eyes affected with primary open-angle glaucoma were studied. Visual field was examined with the Humphrey Field Analyzer (Zeiss) using program 30-2. The Nerve Fiber Analyzer II (Laser Diagnostic Technologies) was used to study the RNFL of these patients. Mean deviation of the visual field ranged from 6 to 31 dB in all eyes that were examined. The average thickness of the RNFL ranged from 20 to 90 μm. According to our previous experience 75 μm was fixed as the cutoff between normal and pathological values of RNFL thickness. We identified 5 eyes with a RNFL thickness over 75 μm and a visual field with a mean deviation over 6 dB; 9% of the studied eyes were found to have a visual field defect with no changes in RNFL. We conclude that not all subjects have the same number of fibers at birth and that it is therefore possible to underestimate the RNFL changes. Our study illustrates that the concept of normal and altered has to be considered as a relative one for all the aspects characterizing the glaucomatous disease.
Development of Glycine-Accumulating Neurons in Retinal Transplants
Authors: Sharma Rajesh Kumar
Published: April 2003

Previous studies have shown that the fetal retina not only survives transplantation but also continues to develop and differentiate in the host eye. Several structural and functional proteins have been demonstrated in the transplanted retinas, and the presence of such proteins has been taken as evidence for the capability of retinal transplants to function. Glycine is an important inhibitory neurotransmitter and is found in a large number of the retinal neurons. Uptake of glycine rather than de novo synthesis is the main source of glycine in glycinergic neurons. The present study examined whether glycine-accumulating neurons develop normally in rabbit retina transplants. Embryonic day (E) 15 rabbit retinas were transplanted into the eyes of adult rabbits of the same strain. Transplants were allowed to survive for various times so that the grafts attained the equivalent ages of (donor age + survival time) E 19, 22 and 29 and postnatal days (PN) 2, 5, 9, 12, 19 and 58. On formaldehyde-fixed cryostat sections of these transplants, glycine-accumulating neurons were demonstrated by immunohistochemistry by using an antibody against one of the glycine transporters: GLYT1. Immunoreactivity was first detected 2 days before birth and increased with age until it reached its mature level at PN 19. The immunoreactivity was found in cells belonging to the inner retinal layers, and in plexiform layers of the transplant equivalent to the normal inner and the outer plexiform layers. In places these cells integrated well with similar cells in the host. In the host retina, the immunoreactivity was found in proximal cell layers of the inner nuclear layer, in certain bipolar cells, and in the inner and the outer plexiform layers. The immunoreactivity was preserved even in the degenerated retina overlying the retinal graft. In conclusion, the present study demonstrates that glycine-accumulating neurons develop, integrate and survive in retinal transplants.
Antiproliferative Wirkung von Genistein auf kultivierte retinale Pigmentepithelzellen vom Schwein
Authors: Krott Ralf , Lebek Julia , Grisanti Salvatore , Esser Peter , Heimann Klaus
Published: April 2003

The isoflavonoid genistein is known as a potent inhibitor of proliferation in endothelial cells and in some tumor cell lines in vitro and in vivo. Cell growth arrest is mediated by inhbitor of the tyrosine-kinase receptor, a target for many growth factors such as fibroblast growth factor, platelet-derived growth factor, epidermal growth-factor and vascular endothelial growth factor, which may play a role in the development of proliferative vitreoretinopathy (PVR). In this study we report on the antiproliferative effect of genistein on retinal pigment epithelial cells (RPE), which is the major cell type involved in PVR. Methods: Cell culture experiments using porcine RPE treated with different concentrations (5 up to 100 μg/ml) of genistein in minimum essential medium +10% fetal calf serum. Inhibition of proliferation was demonstrated by two different methods: (1) uptake of 5-bromo-2-deoxyuridin (BrdU) in S phase after different exposure times (2) expression of proliferating cell nuclear antigen 72 h after scratching confluent RPE. Results: Exposure of RPE to genistein resulted in a concentration-dependent inhibition of cell proliferation at concentrations over 25 μg/ml geinistein. BrdU incorporation was reduced to 65% after 24- and 48-hour treatment with 100 μg/ml genistein in comparison with the untreated cells. Proliferation of RPE growing into the artificial wound was inhibited when cells were exposed for 72 h to more than 25 μg/ml genistein. Conclusions: Genistein at concentrations over 25 μg/ml inhibits RPE proliferation. Further studies will be required to determine the applicability of genistein or other phytoestrogens in order to prevent uncontrolled wound healing processes such as PVR.
Changes in Deviation following Correction of Hyperopia in Children with Fully Refractive Accommodative Esotropia
Authors: Watanabe-Numata Konomi , Hayasaka Seiji , Watanabe Kazuhiko , Hayasaka Yoriko , Kadoi Chiharu
Published: April 2003

Changes in deviation may occur following the correction of hyperopia in children with accommodative esotropia. We analyzed possible factors involving the development of changes in deviation. We examined 49 children (23 boys and 26 girls) who had fully refractive accommodative esotropia at the age of 3 or 4 years. All children wore glasses to correct the fully cycloplegic refractive errors. At the age of 10 or 11 years, 28 (57.1%) of these children had good alignment, 12 (24.5%) developed partial accommodative esotropia and 9 (18.4%) developed consecutive exotropia. The age at onset of esotropia, age at initial visit, and refraction, deviation and presence of stereopsis, as determined by the Titmus test using a fly at the initial visit, were similar among the three groups. In the consecutive exotropia group, amblyopia at the initial visit was significantly higher (89%) than that of the good alignment group (50%). The age at the start of the correction, and the refraction, amblyopia and presence of fusion (10 or 11 years) were almost equal among the three groups. We conclude that some children with fully refractive accommodative esotropia associated with amblyopia at the age of 3 or 4 years may be predisposed to developing consecutive exotropia.
Effect of Melatonin on Lenticular Calcium and Magnesium in Rats Exposed to Ultraviolet Radiation
Authors: Bardak Yavuz
Published: April 2003

Six-week-old rats received 8 kJ/m2 ultraviolet B (UVB) for 15 min. For the intervention in cataract development, intraperitoneal injection of melatonin (4 mg/kg daily for 1 week) following UVB exposure was performed. Lenticular calcium and magnesium levels were determined in UVB + melatonin, UVB and control groups. One week after exposure, significantly more cataractous changes were observed in the UVB group than the UVB + melatonin group. The mean lens calcium and magnesium levels for the UVB group were significantly higher than those for the control and the UVB + melatonin groups. There were no significant differences between the control and the UVB + melatonin groups for the mean lens calcium and magnesium levels.
Idiopathic Juxtafoveolar Retinal Telangiectasis: Clinical Pattern in 19 Cases
Authors: Abujamra Suel , Bonanomi Maria Teresa B.C. , Cresta Fernando B. , Machado Cleide G. , Pimentel Sérgio L. , Caramelli Christiane B.
Published: April 2003

Background: Idiopathic juxtafoveolar telangiectasis (IJT) is a rare retinal vasculopathy of adulthood that may cause central loss of visual acuity. The purpose of this paper is to evaluate the type and distribution of fundus changes in patients with this disorder. Methods: Medical records of 19 patients with IJT using the Gass & Blodi classification were studied. Eight patients in group 1A (42%) and 11 in group 2A (58%) were analyzed. By projecting color photographs we divided the macula into four quadrants and studied the fundus changes in each one. Results: All patients in group 1A presented unilateral disease with easily seen telangiectasis, lipid deposits and cystic macular edema. The mean age of this group was 55.8 years. Five (63%) patients were male and 3 (37%) were female. All patients in group 2A, 2 males (18%) and 9 females (82%), had bilateral disease evidenced by fluorescein angiography. The mean age of this group was 54.5 years. Fundoscopic findings included: intraretinal pigment plaques, grayish coloring of the macular retina, superficial crystalline deposits, right-angle venules, subretinal and intraretinal neovascularization. Conclusions: All patients in this survey were adults. In group 1A, men were affected 2 times more often than women, and the main affected macular quadrant was the inferior temporal, followed by the inferior nasal. In group 2A, women were affected 4 times more often than men and all eyes had inferior and superior temporal macular quadrant involvement.
The Reykjavik Eye Study – Prevalence of Lens Opacification with Reference to Identical Japanese Studies
Authors: Sasaki Hiroshi , Jonasson Fridbert , Kojima Masami , Katoh Nobuyo , Ono Masaji , Takahashi Nobuo , Sasaki Kazuyuki
Published: April 2003

Purpose: A population-based cataract epidemiological study, the Reykjavik Eye Study, was conducted to determine the prevalence and characteristics of lens opacities in Iceland. The results were compared with those from previous surveys in Japan to determine the influence of race and environmental factors. Methods: 1,635 randomly selected residents of Reykjavik, Iceland, were enrolled, and among them, 1,045 responded and took part in the study. The subjects received ophthalmological examination of both the anterior and the posterior segments. Changes in the crystalline lens were examined and photographed under maximal pupillary dilation. Classification of the opacity types and grading of the extent of lens opacificiation were done using a standardized scheme, and the data were analyzed with Student’s test, the χ2 test and the Mantel-Haenszel test. Results: The prevalence of lens opacities in subjects in their 50s, 60s, 70s and in those 80 years and older was 42.7, 61.0, 85.3 and 100%, respectively. Grade II and III lens opacities were found in 2.2% of subjects in their 50s and in 10.5, 35.9 and 62.3% in their 60s, 70s, and over 80 years, respectively. Cortical opacities predominated in all age groups followed by nuclear opacities; subcapsular opacities, on the other hand, were quite rare. A unique type of opacity, i.e., granular opacity, seldom seen among the Japanese, was found in 6.6% of the Icelandic subjects. Conclusions: Our results show that cortical opacity is the major type of opacity in Icelandic subjects, although its prevalence was lower than that in the Japanese subjects. Interestingly, the first appearance of lens opacities of grades II and III in Icelanders was delayed by 10 years compared to the Japanese suggesting fewer or less severe risk factors for cataract formation in Iceland.
Bilateral Superior Cervical Ganglionectomy Increases Choroidal Blood Flow in the Rabbit
Authors: Chou Ping-I , Lu Da-Wen , Chen Jiann-Torng
Published: April 2003

In this study, we evaluate the effect of bilateral superior cervical ganglionectomy on albino rabbit choroidal blood flow (CBF) in changes of perfusion pressure (PP). Twenty albino rabbits of either sex weighing between 2.0 and 3.0 kg were randomly divided into two groups. The experimental group (group S) included 10 rabbits (20 eyes) that received bilateral superior cervical ganglionectomy one week prior to the study. The other 10 rabbits (20 eyes) served as a control (group N): each received the same procedure as group S except that the superior cervical ganglion was preserved. By means of a laser Doppler flowmeter (Perimed PF4001), blood cell flux (PF), velocity (V), and concentration of moving blood cells (CMBC) were recorded simultaneously while intraocular pressure was increased linearly by a syringe pump. Blood pressure and intraocular pressure were continuously monitored. The laser beam focused on the posterior pole away from major retinal vessels. When PP decreased from 75 to 0 mm Hg, in group N, PF, V and CMBC decreased from 100% to 6.94 ± 0.91%, 8.41 ± 0.87%, and 19.38 ± 1.11%; in group S, it was 17.75 ± 2.58%, 16.78 ± 1.48%, and 34.58 ± 4.42%, respectively. Group S poses higher PF, V, and CMBC than group N while PP decreased gradually. These results indicate that the superior cervical ganglion plays a role in CBF regulation. Bilateral sympathectomy led to a higher PF in the group S rabbits, indicating increased CBF. PF, V, and CMBC remained constant until PP <55 mm Hg demonstrated the existence of CBF autoregulation within a limited perfusion range in both groups. This autoregulation did not change after sympathectomy.
Juvenile Xanthogranuloma of the Orbit in an Adult
Authors: Mencía-Gutiérrez Enrique , Gutiérrez-Diaz Esperanza , Madero-García Santiago
Published: April 2003

We present a case of juvenile xanthogranuloma (JXG) with unilateral involvement of the orbit and eyelid and proptosis, histologically confirmed in a 32-year-old man with a 1-year history of a pansinusitis and dacryoadenitis with rhinitis. Nine months later an infiltration of the anterior upper part of the right orbit and right eyelid appeared. Computed tomography scan and magnetic resonance imaging studies confirmed the presence of pansinusitis and infiltration. The patient underwent a blepharoplasty and excision of the infiltrated tissues of the orbit, eyelid, and levator muscle. Hematoxylin-eosin and immunohistochemical studies revealed features consistent with a diagnosis of JXG (Touton giant cells). JXG, a non-Langerhans’-type benign proliferation, is a rare condition in adulthood.
A Method for the Induction of a Cochlea-Specific Auditory Deprivation in the Gerbil (Meriones unguiculatus)
Authors: Hessel Horst , Walger Martin , Ernst Sabine , Foerst Astrid , von Wedel Hasso , Klünter Heinz-Dieter , Walkowiak Wolfgang
Published: April 2003

The neurophysiological effects of early electrical stimulation on the development and neural plasticity of the central auditory system in prelingually deafened children with cochlear implants are still unknown. Many of these basic questions can be answered systematically only in animal experiments. Meriones unguiculatus is a well-established animal model in hearing research. Deafening is produced by a single intracochlear application of an ototoxic aminoglycoside antibiotic (neomycin sulfate) on the 14th day after birth (DAB), i.e. before the late natural onset of hearing on the 16th DAB. A single application of the antibiotic abolishes auditory brainstem responses (ABR) to clicks completely and reduces sensitivity to low frequency tonebursts by 50 dB SPL. Scanning electron microscopy results show a destruction of the stereocilia of the inner and outer hair cells of the basal and medial cochlear turn and a reduction of those in the apical turn. Our method avoids a systemic application of antibiotics and can be used in studies dealing with the consequences of different forms of auditory deprivation, neuronal compensation processes or with ontogenetic studies and chronic electrostimulation in an animal model.