PubMed · 46659
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N Sağiroğlu, T Ozgönül, S Müderris. Diagnostic intraocular cytology.. https://pubmed.ncbi.nlm.nih.gov/46659/
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Lactate dehydrogenase (LDH) activity was determined in 24 cases of histologically proved retinoblastoma. The mean level was 1,825 IU/L, with a range of 10 to 15,920 IU/L. Twenty-two patients had elevated aqueous humor LDH levels. In two, the aqueous humor level was within the normal range. Student's t testing showed a highly significant difference between cataract and retinoblastoma aqueous humor. The retinoblastoma aqueous humor to blood ratio ranged from 0.045 to 58,529--not a good index of retinoblastoma. Isozyme patterns of retinoblastoma aqueous humor were statistically similar to those of normal cataract aqueous humor. The serum LDH level of cataract patients was not statistically different from that of retinoblastoma patients. The LDH 5/LDH 1 ratio of retinoblastoma aqueous humor ranged from 0.042 to 27.05--not a good index of retinoblastoma, as 28 of 34 aqueous samples of cataract patients had LDH 5 greater than LDH 1. Ten of 13 retinoblastoma patients had aqueous humor LDH 5 greater than LDH 1. The best index of the presence or absence of retinoblastoma is the total aqueous humor LDH level.
Three variations of ghost cell glaucoma that occur following cataract extraction are presented. The most common variant occurred when a large, anterior chamber and vitreous hemorrhage complicated the immediate postoperative course. Weeks later, as the anterior chamber hemorrhage cleared, ghost cells that had formed within the vitreous cavity passed forward into the anterior chamber and obstructed the aqueous outflow channels. Ultramicroscopy of aqueous specimens confirmed that RBC ghost were the major aqueous component and were therefore the cause of the glaucoma, distinguishing this glaucoma from glaucoma due to macrophages and RBC debris. Scanning and transmission electron microscopy of hemorrhagic vitreous showed that RBCs disintegrated into ghosts and denatured extracellular hemoglobin aggregates. The latter, common in the vitreous, were bound within vitreous strands, accounting for their absence in the anterior chambers of patients with ghost cell glaucoma. In correlation with clinical findings, perfusion studies showed that neither fresh RBCs nor ghosts could pass through an intact anterior hyaloid face.