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Ildikó Süveges

Publications and source records attributed to Ildikó Süveges.

15 recordsLinked to original sources
PubMed2006

The role of lumican and keratocan genes in persistent subepithelial corneal haze following excimer laser photorefractive keratectomy.

PURPOSE: A retrospective clinical and a genetic study was carried out of severe subepithelial corneal haze occurring after photorefractive keratectomy (PRK). Since this clinical condition resembles the lumican-null mouse phenotype, mutation analysis of lumican and keratocan was carried out to investigate whether germline genetic alterations have an effect on development of severe corneal haze in humans. Corneal thickness, photoablation depth, and severity of persistent corneal haze were also analyzed. In vivo confocal microscopy examination was also performed to study corneal structure and endothelial cells. METHODS: Severity of corneal haze was evaluated by slit-lamp biomicroscopy according to Hanna's scale. Corneal structure and endothelial cell shapes and density were viewed with a scanning confocal microscope. PCR-based mutational analysis was performed using temperature gradient gel electrophoresis (TGGE) and direct sequencing. RESULTS: Preoperative corneal thickness was normal (539+/-23.13 microm, mean+/-SD), and the photoablation depth was 88.94+/-18.64 microm (mean+/-SD). The most severe corneal haze was grade 2.0 on Hanna's scale one year after PRK. In vivo confocal microscopy also showed normal endothelial cell density and morphology. Aside from an intronic polymorphism in a control, no genetic alterations were found in the lumican and keratocan genes. CONCLUSIONS: There was no evidence that endothelial dysfunction and germline mutation of lumican and keratocan genes participate in the etiology of subepithelial corneal haze. Our findings suggest that the mechanisms of the development of severe corneal opacity are different in humans after PRK compared to the lumican deficient knockout mouse model.

Adult↗
PubMed2005

[Photodynamic therapy in age-related macular degeneration].

INTRODUCTION: Exudative form of age-related macular degeneration is the leading cause of legal blindness in elderly. PURPOSE: The purpose of this study is to report 3.5 years experience with photodynamic therapy in this disorder. PATIENTS AND METHODS: Patient files of all patients underwent photodynamic therapy with verteporfin in Department of Ophthalmology, Semmelweis University, Budapest in a 3.5 years period were reviewed. Changes in visual acuity were considered as main outcome variable compared to natural history data. RESULTS: From April, 2000 to September 2003, 302 patients were treated using photodynamic therapy with verteporfin for exudative form of age-related macular degeneration. The mean change of visual acuity were 2.6 and 2,7 lines at 12 and 24 months, respectively, while according to the natural history data 4.2 and 4.5 could have been expected. After 2 years, 83% of the patients had visual acuity better than or equal to 20/200 (this is the level of legal blindness), while only 33% was expected according to natural history data. Visual acuity of 20/80 or better (practical ambulatory vision) was found in 39% of the treated eyes (12% in natural history data). There was no severe adverse event. CONCLUSIONS: Photodynamic therapy was found to reduce the risk of severe visual loss. The authors' results confirm the data from the international trials. To achieve good results, good patient compliance and continuous access to the treatment are indispensible.

Aged↗
PubMed2005

[Intraocular tumours].

Intraocular tumours may be benign or malignant. The latter are more numerous, and endanger not only vision but life as well. Two of them deserve special attention: melanoma malignum oculi in adults and retinoblastoma in children. Melanoma malignum may arise from all three areas of the uvea: the iris, the ciliary body and the choroid. The more malignant growths are those which are situated closer to the posterior pole. Histologically the epitheloid cell-type of melanoma is more malignant than those containing only spindle cells. Their treatment depends on the size: in the case of large tumours enucleation is required, while for the smaller ones, radiation therapy can be applied. Retinoblastoma is most common in children of 1-2 years of age. It has familial and sporadic forms. Sixty-seven percent of the inherited-type cases are bilateral. An early symptom in small children is strabismus. A white tissue mass growing into the vitreous is seen on the fundus. A diagnostic feature that can be detected by ultrasound examination is calcification. The tumour may also present intracranially, therefore CT of the skull should be performed in each case. Histologically the tumour contains malignant neuroepithelial cells, which may form a rosette. In the case of large tumours the treatment is enucleation; in bilateral processes the bulbus with the larger mass is removed and the other eye is treated with radiation therapy. In both cases chemotherapy is used according to a prescribed schedule. Metastases to the eye occur most frequently from carcinomas of the breast, lungs or gastrointestinal tract. These are treated with radiotherapy, chemotherapy and hormone therapy. Primary intraocular lymphoma often occurs bilaterally, and may be accompanied by primary lymphoma of the central nervous system (CNS). Some benign tumours are found by chance on routine eye examinations, others due to subjective and objective symptoms.

Eye Neoplasms↗
PubMed2005

[Results of photorefractive keratectomy in myopia with flying spot excimer laser with high speed and small beam diameter].

PURPOSE: To examine the result of photorefractive keratectomy (PRK) with the next generation of flying spot excimer laser for the treatment of myopic refractive errors. PATIENTS AND METHODS: During the study 164 eyes of 98 patients were assessed. The average age was 29.4 +/- 4.62 years. The myopic eyes were divided into 3 groups: in Group 1. (n = 115 eyes) the eyes between -1.0 D and -6.0 D were evaluated, in this group the preoperative average refraction was -3.43 +/- 1.2 D (SE = spherical equivalent); in Group 2. (n = 31 eyes) the eyes between -6.1 D and -9.0 D were evaluated; the preoperative average refraction was -7.26 +/- 2.4 D (SE). In Group 3. (n = 18 eyes) eyes above -9.0 D were examined; in Group 3. the average preoperative refraction was -10.22 +/- 3.4 D (SE) Follow-up is 6 months. PRK treatments were carried out with the Zeiss Meditec MEL 80 G-Scan flying spot excimer laser, which was operated with a 0.7 mm beam diameter and 250 Hz frequency. RESULTS: In Group 1. The preoperative correction decreased to -0.14 D (SE); in 71% of the treated eyes uncorrected visual acuity (UCVA) was 1.0; in 24% of the eyes UCVA improved to 1.2. Best corrected visual acuity (BCVA) was unchanged in 65% of the eyes; while in 34 improved (in 24% it improved by more than 2) Snellen lines. In Group 2. the preoperative correction decreased to -0.13 +/- 0.01 D (SE); 67% had 1.0 and 8% had a 1.2 UCVA. BCVA was unchanged in 92% in Group 2.; in 8% BCVA increased by 1 or 2 Snellen lines. In Group 3., the preoperative correction decreased to -0.44 +/- 0.2 D (SE); 96% of the eyes had a 0.8 UCVA; BCVA did not change in 75% of the eyes, 25% of the eyes gained 1 Snellen line. CONCLUSIONS: Myopic PRK treatments with the 3rd generation of excimer laser were effective and safe. Regarding BCVA, best results were obtained in the low and medium myopia groups.

Adult↗
PubMed2005

Proliferation and apoptosis in the corneal stroma in longterm follow-up after photorefractive keratectomy.

This study aimed at investigating the proliferation and apoptosis of corneal cells following photorefractive keratectomy (PRK) treatment. PRK (-6.0 D correction) was performed with the Asclepion-Meditec MEL70 G-scan excimer laser on the right eye of each of 33 rabbits under combined local and general anaesthesia. Animals were sacrificed at 4 h, 1, 4, 7, 14, 28, 56, and 112 days postoperatively, and corneal samples from these eight groups were examined histologically. Stromal cell proliferation was evaluated by immunocytochemical analysis of Ki67. Apoptosis was detected using the terminal deoxyribonucleotidyl transferase-mediated dUTP-digoxigenin nick-end labeling (TUNEL) assay method. The untreated left eyes served as controls. Ki67 positivity was detected in the upper stroma on day 1, 4, 7, and 14, and keratocyte apoptosis on day 1, 4, 7, and 14 after PRK, but not at an earlier or later time. Neither Ki67 positivity nor apoptotic activity was observed in the controls (untreated corneas). PRK was found to trigger proliferation and apoptosis of corneal keratocytes. The frequency and spatial distribution of keratocyte proliferation and apoptosis are likely to be important determinants of the corneal wound healing process, but the detailed regulatory mechanisms have not yet been characterized.

Animals↗
PubMed2004

Silicone oil in the subarachnoidal space--a possible route to the brain?

Using this case report, we sought evidence that silicone oil may infiltrate the subarachnoidal space. Vitrectomy combined with silicone oil implantation was performed on the right eye of a 72-year-old woman. The silicone oil was removed 2 months later, because the patient had developed elevated intraocular pressure. The blind and painful eye was subsequently enucleated. By light microscopy, presumed silicone oil bubbles were identified in the optic nerve and the subarachnoidal space of the enucleated eye. These vacuoles were examined by energy-dispersive X-ray analysis (EDAX). In addition, in the vacuoles, immunohistochemistry was used to test for the presence of CD 68-positive macrophages. Silicone oil infiltration sites in the optic nerve, in the central retinal artery, and in the subarachnoidal space were located by light microscopy and confirmed by EDAX. CD 68-positive macrophages were found in the silicone-filled vacuoles. Silicone oil used for endotamponade may infiltrate the optic nerve and even the subarachnoidal space. This supports the assumption that silicone oil, under special circumstances, may even migrate into the brain.

Aged↗
PubMed2004

Laser treatment of cultured retinal pigment epithelial cells-evaluation of the cellular damage in vitro.

PURPOSE: Evaluation of the effects of laser photocoagulation on cultured primary retinal pigment epithelial cells. METHODS: Cells were treated by a diode laser (678 nm) with 800 and 1600 mW for 0.186 second. Cell toxicity was tested by the WST-1 assay, and the uptakes of glutamate and gamma-aminobutyric acid (GABA) were measured. RESULTS: Laser photocoagulation (1600 mW) caused cell damage and the mitochondrial enzyme activity evaluated by a WST-1 test significantly decreased by 20%-30%. Laser treatment caused a dose-dependent decrease in glutamate uptake but increased GABA uptake. CONCLUSIONS: Laser treatment and the laser-induced increase in temperature influence transport processes in retinal pigment epithelial cells and may cause cell damage in the posterior part of the retina.

Animals↗
PubMed2003

Corneal topographic results after eccentric, biconvex penetrating keratoplasty.

PURPOSE: To study the surgical outcomes and postoperative corneal topographies in 5 patients who had eccentric, biconvex penetrating keratoplasty (PKP) for peripheral corneal disorders whose extent did not allow the use of round grafts without involving the center of the cornea. SETTING: 1st Department of Ophthalmology, Semmelweis University, Medical School, Budapest, Hungary. METHODS: Eccentric, biconvex PKP that spared the optical axis of the cornea was performed in 5 eyes. Indications for surgery were perforated peripheral ulcerative keratitis (n = 3), extensive infiltrated peripheral ulcerative keratitis with impending perforation (n = 1), and ulcerated corneal degeneration caused by an intracameral foreign body for 9 years (n = 1). Computer-assisted corneal topography was performed postoperatively. The follow-up ranged from 8 to 27 months. RESULTS: All grafts were tectonically effective. Postoperative corneal topography showed normal central corneal regularity in 4 cases (1 case, normal pattern with surface regularity index [SRI] and surface asymmetry index [SAI] within the normal range; 3 cases, normal surface regularity within the central area of the cornea but moderate or high central corneal asymmetry). One eye had irregular astigmatism with a high SRI and SAI. In the first 4 cases, the best spectacle-corrected visual acuity was 0.8 (20/25) or better. CONCLUSIONS: The results show that eccentric, biconvex PKP sparing the central cornea may be an option in some eyes with perforated peripheral corneal disorders. Postoperative visual acuity may be good as the procedure may result in a regular central anterior corneal surface.

Adult↗
PubMed2002

[Experience with laser in situ keratomileusis].

AIM OF THE STUDY: To evaluate the results of laser in situ keratomileusis (LASIK) in groups with different refractive errors. PATIENTS AND METHODS: 68 LASIK procedure have been performed in the following patient groups: Group 1 (-3.0 D to -6.0 D) n = 14; Group 2 (-6.25 D to -9.0 D) n = 29; Group 3 (-9.25 D to -14.0 D) n = 13; Group 4 (eyes with hyperopic refractive error between +1.75 D and +7.5 D) n = 12. A Moria CB manual mikrokeratom was used, flap thickness was 130 microns. Excimer laser treatment was carried out with Asclepion-Meditec MEL 70 G-Scan flying spot excimer laser. Follow-up time is 6 months. RESULTS: The preoperative correction decreased in Group 1. from -4.45 D +/- 0.93 D (SE = spherical equivalent) to -0.04 D +/- 0.13 D, in Group 2. from -7.81 D +/- 0.98 D (SE) to -0.56 D +/- 0.9 D, in Group 3. from -11.33 D +/- 1.97 D (SE) to -1.88 D +/- 1.64 D, and in Group 4. from +4.67 D +/- 1.67 D (SE) to +0.24 D +/- 0.50 D 6 months following LASIK. The best spectacle corrected visual acuity (BSCVA) decreased by 2 or more Snellen lines in 4 eyes in Group 2, in 2 eyes in Group 3, and there was no change in Group 1 and Group 4. BSCVA improved by 2 or more Snellen lines in one eye in Group 2, in 2 eyes in Group 3 and there was no change in Group 1 and in Group 4. CONCLUSIONS: The preoperative correction decreased significantly following LASIK procedure in each patient group. The method was found to be effective, safe and durable during the 6 months follow-up. Application is recommended especially in eyes with a refractive error higher than -6.0 D due to possible intra- and early postoperative complications.

Adult↗
PubMed2002

The role of ultraviolet-B in corneal healing following excimer laser in situ keratomileusis.

Corneal photoablation with the 193 nm argon fluoride excimer laser during photorefractive keratectomy (PRK) in high diopter range is frequently associated with subepithelial haze and consequent refractive regression due to avascular corneal wound healing. The wound healing response can be augmented by Ultraviolet-B (UV-B) exposure originating from sun or solarium. Clinically Laser in situ Keratomileusis (LASIK) even in high diopter range is associated with less subepithelial haze and regression than PRK. In an animal model, the morphologic changes of the rabbit cornea were evaluated following LASIK and secondary UV-B exposure. Light microscpic changes were found to be insignificant. Transmission electron microscopy (TEM) normal epithelium, epithelial adhesion structures and normal anterior stroma showed in the LASIK treated UV-B irradiated rabbit eyes. Around the peripheral LASIK cut, migrating keratocytes with pseudopodia were observed. Under the flap (160 microm depth) the overall stromal collagen structure was normal, some activated keratocytes and mild extracellular matrix formation within and around keratocytes were noted. Within activated keratocytes TEM showed prominent rough endoplasmic reticulum, Golgi apparatus, mitochondria and extracellular vacuoles, which showed resolution with time. These changes were much milder than in PRK treated-UV-B irradiated eyes. Secondary UV-B caused no long-term disturbance in corneal transparency in LASIK and UV-B treated rabbit eyes.

Animals↗
PubMed2002

C1r-C1s-C1inhibitor (C1rs-C1inh) complex measurements in tears of patients before and after penetrating keratoplasty.

PURPOSE: The aim of this pilot study was to determine the presence of complement activation products in tears from pre- and postkeratoplasty eyes and the fellow eyes in order to investigate the activation of the classical and alternative pathways of the complement system in the early postkeratoplasty period. METHODS: Tear samples from both eyes of 19 prekeratoplasty patients were tested. From 10 patients, samples were taken before operation, one week and 3 weeks after penetrating keratoplasty. Only baseline and 1 weak samples, and baseline and 3 week samples were available from 5 and 2 patients, respectively, while only baseline tear samples were collected from 2 patients. Tear concentration of two complement activation products, C1rs-C1inh and C3bBbP were determined by enzyme-linked immunosorbent assay. RESULTS: There was no difference (p = 0.339) between baseline samples of the eyes waiting for operation (0.93 +/- 0.51 AU/ml, mean +/- SEM) and the fellow eyes (0.33 +/- 0.33 AU/ml) in respect of mean C1rs-C1inh complex concentration. The one-week samples of the operated eyes revealed significantly (p = 0.006) elevated levels of C1rs-C1inh complexes (18.8. +/- 6.37 AU/ml), compared to their baseline samples (1.18 +/- 0.64 AU/ml), whereas the one-week values of the fellow eyes did not differ from the baseline values. Compared to the increased one-week values, the three-week values decreased to the baseline values in the operated eyes. C3bBbP could be detected in 3/68 tear samples. CONCLUSIONS: In our study we demonstrated the increased concentration of C1rs-C1inh complex in several tear samples taken early after human penetrating keratoplasty. These findings provide direct evidence that the classical pathway of complement may be activated in the early postoperative period after penetrating keratoplasty.

Adult↗
PubMed1996

Leiomyoma of The Ciliary Body and Hemangiopericytoma of the Choroid.

Two unusual uveal tumors occurring in eyes enucleated for presumed malignant melanoma are discussed. One was a leiomyoma of the ciliary body, affecting a 22-year-old female, the other a hemangiopericytoma of the choroid in an 84-year-old male patient. The latter case is the fourth intraocular hemangiopericytoma reported in the literature to date. The histopathologic diagnosis was confirmed by immunohistochemistry and electron microscopy.

Journal Article↗
PubMedDate not supplied

Ultrasound evaluation of flap thickness, ablation depth, and corneal edema after laser in situ keratomileusis.

PURPOSE: The aim of our study was to evaluate the predictability of flap thickness and changes in flap edema over time after laser in situ keratomileusis (LASIK). METHODS: LASIK was carried out in 30 eyes. The corneal flap was created with a Moria CB manual microkeratome with a flap thickness of 130 microm. Photoablation was performed with the Zeiss-Meditec MEL 70(G-Scan) flying spot excimer laser. Ultrasound pachymetric measurements were performed with the Humphrey Model 855 pachymeter. RESULTS: Preoperative mean corneal thickness was 568.43 +/- 34.6 microm. After LASIK, mean flap thickness was 133 +/- 26.4 microm. After excimer laser treatment, mean central corneal thickness decreased to a mean 392.4 +/- 37.4 microm. Five minutes after repositioning the flap, mean central corneal thickness was 572.1 +/- 43.4 microm. On the first postoperative day, it decreased to a mean 501.6 +/- 46.6 microm followed by additional decreases: mean 487.4 microm on day 5, 481.8 microm after 1 month, and 479.6 microm at 6 months. The actual photoablation depth was 10 microm less than the predicted depth (paired sample t-test, no statistically significant difference, P = .018). A significant linear correlation was found (Pearson, R =.725, P = .001) between predicted and measured photoablation depth. CONCLUSIONS: Corneal flap thickness had greater variability than expected. After flap creation, stromal and flap edema occurred, but decreased during the first five postoperative days and stabilized thereafter.

Astigmatism↗
PubMedDate not supplied

Spatial distribution of keratan sulfate in the rabbit cornea following photorefractive keratectomy.

PURPOSE: To examine the keratan sulfate content of the stroma and to assess its correlation with the healing process (epithelialization and keratocyte density) after photorefractive keratectomy (PRK). METHODS: Using an Aesculap Meditec MEL 70(G-scan) excimer laser, -6.0 diopters (6.0-mm diameter, 82 microm photoablation depth), PRK was carried out on the right eye of 32 New Zealand pigmented rabbits. After enucleation (at days 1, 4, 7, 14, and 28 and months 2, 3, and 7; sub-groups of 4 animals), fluorescent immunohistochemistry was performed on sections from the central comea using monoclonal mouse anti-keratan-sulfate antibody, immunohistochemistry with proliferative cell nuclear antigen antibody, and hematoxylin-eosin histology. The left, untreated eyes served as controls. Cellular morphology and spatial distribution of keratan sulfate were recorded, stromal thickness measured, and keratocyte density calculated. RESULTS: Keratan sulfate was found on the surface of migrating epithelial cells in the early stage (from days 1 to 7). In the stroma, three phases were noted. (Phase 1) Day 1 to 14, intense granular fluorescence appeared in the anterior stroma with hypocellularity. (Phase 2) Month 1 to 2, newly synthesized lamellar keratan sulfate restored the repopulating anterior stroma. Endothelial cells became keratan sulfate positive, while in the posterior stroma, lamellar-form keratan sulfate increased from week 1 and peaked at month 1 (100% increase). (Phase 3) Month 2 to 7, remodeling and deposition of keratan sulfate was noted, which was produced in phase 2. CONCLUSIONS: Keratan sulfate was found in the epithelium, stroma, and endothelium. By controlling the interlamellar spacing, keratan sulfate plays a role in postoperative edema, remodeling of the corneal stroma, and simultaneous regulation of inflammation after PRK.

Animals↗