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At least 181 records · Page 10Linked to original sources
PubMed2006

25-gauge scleral tunnel transconjunctival vitrectomy.

PURPOSE: To compare the intraocular fluid leakage rate between 25-gauge (25G) transconjunctival vitrectomy with scleral tunnels and standard 25G transconjunctival vitrectomy. DESIGN: Single-center, retrospective, interventional case series. METHODS: Transconjunctival vitrectomies were conducted by the use of only 25G instruments with peripheral vitrectomy. Standard 25G vitrectomy was conducted in 542 eyes and 25G vitrectomy with scleral tunnels in 337 eyes. The scleral tunnel was created by inserting trocars at an oblique angle. RESULTS: The intraocular fluid leakage rate was significantly lower (Fisher exact probability test: P < .0001) when scleral tunnels were used in 25G vitrectomy (1%, five of 337 eyes) compared with standard 25G vitrectomy (9%, 50 of 542 eyes). The wound leakage rate was significantly lower when using (rather than not) scleral tunnels in 25G vitrectomy, both without air-gas (P = .0258) and with air exchange (P = .0007). CONCLUSION: The use of scleral tunnels in 25G transconjunctival vitrectomy reduces the frequency of wound leakage even when the peripheral vitreous is removed.

Adolescent↗
PubMed1996

Melanocyte lysis by cytotoxic T lymphocytes recognizing the MART-1 melanoma antigen in HLA-A2 patients with Vogt-Koyanagi-Harada disease.

The MART-1/Melan-A melanoma antigen recognized by the majority of HLA-A2-restricted tumor-infiltrating lymphocytes is a self antigen expressed on melanocytes and the retina. We have investigated whether Vogt-Koyanagi-Harada (VKH) disease and sympathetic ophthalmia (SO), systemic inflammatory disorders affecting various organs containing melanocytes, are autoimmune diseases directed toward the MART-1 antigen. In two of three patients with VKH disease and one patient with SO, CD8(+) T cell clones (TCC) form intraocular fluid of HLA-A2(+) patients lysed T2 cells when pulsed with a HLA-A2-binding MART-1 peptide, but not a HLA-A2-binding pMel-17 or tyrosinase peptide, in a HLA-A2-restricted manner. In addition, Th, TCC recognizing a HLA-A2-binding MART-1 peptide were also established from peripheral blood mononuclear cells of a patient with VKH disease. In contrast, either CD4(+) TCC from these patients or CD8(+) TCC from the intraocular fluid of HLA-A2(+) patients with uveitis associated with Behcet's disease or HTLV-1 uveitis did not show this cytotoxicity. The results demonstrate that the MART-1 peptide-specific cytotoxic T lymphocytes lyse melanocytes in the eye of patients with VKH disease or SO, suggesting that these diseases are autoimmune diseases directed toward the MART-1 antigen in HLA-A2(+) patients.

Antigens, Neoplasm↗
PubMedDate not supplied

[Methods of digital differential fluorescein study of the ocular drainage tract].

Intraocular fluid contrasting is achieved via subconjunctival injection of 0.1 ml of 1% sodium fluorescein solution then diffusing along the outflow tract through the anterior chamber. Then the area concerned of the drainage tracts is photographed by means of a slit lamp completed with a digital camera operating in the infrared photographing mode and with a system of special filters, which makes it possible to enhance the sensitivity of the system to the spectrum of fluorescein irradiation. A series of the images made before and at a certain temporal interval after administration of the contrast substance is analyzed by using the original computer program "Digital Differential Fluorescein Study of the Ocular Drainage Tract". The result of the analysis is the possibility of functional characterization of the intraocular fluid outflow tract in the area under study. The procedure yields a picture of the relative hydrodynamic activity of drainage collectors located in any perisuperficial structures of the eye.

Anterior Chamber↗
PubMed1977

The state of eye hydrocircular system in view of age pathology and open-angle glaucoma.

With age the eye drainage system undergoes a number of changes because less favorable conditions arise for intraocular fluid reflux. The manifestation and extent of these changes were closely connected with the manifestation of arteriosclerotic affection of the cardiovascular system. The changes in eye drainage passages in persons with pronounced complicated arteriosclerosis and advanced open-angle glaucoma were identical in character and comparable in the manifestation. The changes in eye drainage passages in persons with pronounced arteriosclerosis and open-angle glaucoma did not have the character of isolated trabecular lesion or lesions of Schlemm's canal or intrascleral tracts, but they were detected in all these sectors. The obtained data indicate that the changes in the eye drainage system connected with age pathology an open-angle glaucoma took place and were more pronounced in the superior sectors of the eye, gradually spreading downward. The conditions for intraocular fluid reflux along the primary tracts being deteriorated, its reflux appears to increase through the uveal tract.

Adult↗
PubMed2004

Diagnostic approaches to severe, atypical toxoplasmosis mimicking acute retinal necrosis.

PURPOSE: To describe the means of diagnosis and clinical features of atypical toxoplasmic chorioretinitis mimicking acute retinal necrosis. DESIGN: Observational case series. PARTICIPANTS: Twenty-two patients (25 eyes) with widespread chorioretinitis resulting from toxoplasmosis examined between 1990 and 2001. TESTING: Patients were diagnosed by various techniques, including polymerase chain reaction (PCR) of aqueous and vitreous, serum and intraocular antibody determination, culture of intraocular fluid, retinal biopsy, histopathologic examination, therapeutic trial of antibiotics active against toxoplasmosis, or a combination thereof. MAIN OUTCOME MEASURES: The primary outcome measure was diagnosis of disseminated toxoplasmic chorioretinitis by any combination of tests or by empiric use of specific antibiotics. The secondary outcome measure was visual and anatomic outcome of treatment. RESULTS: Mean age was 53.5 years (range, 19-77 years), with a median of 59.5 years. There were 9 women and 13 men. Six patients were infected with HIV, and 3 patients, 1 with HIV, had bilateral disease. Mean initial vision was 20/110 (median, 20/400; range, 20/20 to no light perception [NLP]). Sixteen patients (73%) had received oral or injectable corticosteroids and 11 (50%) had received antiviral therapy before the diagnosis of toxoplasmosis. Diagnosis was made solely by clinical response to antitoxoplasmosis medications in 4 patients. Sixteen patients were diagnosed based on evaluation of intraocular fluids and tissue by antibody determinations, culture, PCR, histopathologic examination, or a combination thereof. Visual acuity improved after treatment in 7 of 25 eyes (28%). Mean final visual acuity was 20/156 (median, 20/2500; range, 20/30 to NLP). Anatomically, 18 of 23 eyes with follow-up had healed or improved chorioretinitis. Retinitis was progressive in 1 eye, 2 eyes were enucleated, and 2 were phthisical. CONCLUSIONS: Diagnosis of atypical toxoplasmic chorioretinitis that mimics viral retinitis can be accomplished by several means. Prompt diagnosis may help avoid poor visual and anatomic outcomes after prolonged initial treatment with oral prednisone or antiviral medications.

Adult↗
PubMed1986

Factors influencing the cholesterol esterification rate in lecithin cholesterol acyltransferase radioassay.

Factors affecting the esterification rate of cholesterol by lecithin cholesterol acyltransferase (LCAT E.C. 2.3.1.43) in native cold labelled substrates (human, rabbit, rat serum, plasma, VLDL, LDL depleted serum, rabbit intraocular fluids) repaired by use of ready-made 14C-cholesterol discs (Cholesterol kinetics LCAT-test, UVVVR, Czechoslovakia) were investigated. EDTA added to the serum during the cold incubation (18 h, 0 degrees C-4 degrees C) increased the rate of esterification due to elimination of Ca2+ ions. The similar stimulating effect was found in the presence of mercaptoethanol (ME) in the serum, while in the plasma already stimulated by EDTA no additional effect by ME could be noticed. Freezing and thawing did not affect the fractional esterification rate (FER-per cent of total serum unesterified cholesterol esterified per hour) in normolipidaemic sera, whereas in hyperlipidaemic sera, particularly those with high levels of VLDL, FER was stimulated. Esterification partially proceeded during the cold incubation of serum or plasma with 14C-cholesterol ready-to-use discs, attaining the values of about 0.3%/h and 2-6%/h, respectively, in human sera and in rabbit and rat sera. The starting level of esterification did not affect the linearity of LCAT reaction during warm incubation (30 min at 37 degrees C), neither was the absolute value of FER changed as compared with cold labelled sera with those inhibited by DTNB and reactivated by ME. Substantial LCAT activity was also detected in extremely diluted substrates--such as intraocular fluid collected from rabbits with induced uveitis or after preceding paracentesis.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2001

[New trends in ocular toxoplasmosis--the review].

For past ten years some new trends can be observed in the field of ocular toxoplasmosis. In this article on the basis of reviewing scientific articles the author tried to point out important, or new information which may have an impact on clinical researches and clinical practice in the close future. 1. There is evidence that some tissue cysts can be present in untouched retinal tissue, and can produce an inflammatory reaction even many years after primary infection. This concerns both congenital and acquired toxoplasmosis. 2. The coexistence of intraocular inflammatory reaction without focal necrotizing retinochoroiditis in patients with acquired systemic toxoplasmosis was described--but there is no evidence that those inflammations were directly cause by T. gondii parasite themselves. It is too early to include this changes into the classical clinical picture of toxoplasmic retinochoroiditis. 3. For the past ten years there have been published articles showing higher prevalence of acquired ocular toxoplasmosis but this is well documented only in south America. In Europe and USA the frequency of ocular toxoplasmosis cases are low. Despite the different percentage of infected people in these populations, this controversial result can be caused by different distribution of pathogenic and non-pathogenic strains of the parasite as like by differences in human genotypes. 4. There is model of "dynamic equilibrium" existing between host defence and parasite cyst ruptures helpful for understanding reactivation. Level of tissue cyst-specific antigens does not rise in the population of HIV patients or during reactivation of ocular retinochoroiditis--this places the responsibility for reactivation on the side of host immunoresponse. 5. The most specific and reliable laboratory assessment for ocular toxoplasmosis, which is specifically helpful in clinically atypical cases, is combination of IgG, IgA and IgM serology tests made of serum and intraocular fluids. It can proof intraocular production of antibodies. PCR tests have got some value, but they are not as efficient as have been thought previously. 6. There is no efficient treatment diminishing recurrence rate and the time of singular inflammation yet. The combination of pyrimethamine, sulfadiazine and clindamycin, given for 3 to 4 weeks with supplementation of folinic acid for diminishing side effects, can diminish the measure of future scar. Long lasting treatment as it is used in children with congenital disease or in HIV patients can be probably more efficient. Atovaquone is as effective as traditional drugs and gives fewer side effects.

Animals↗
PubMed1997

Fine structure of the choroidal coat of the avian eye. Lymphatic vessels.

PURPOSE: To clarify the fine structure of the avian choroid and thus help explain the mechanisms for normal and abnormal eye function and growth. METHODS: Eyes from normal chickens and from experimental chickens subjected to unilateral paracentesis were fixed either by perfusion or in situ, with or without post-fixation by microwave irradiation, and then processed for light and electron microscopic analysis. RESULTS: The avian choroid contains thin-walled lacunae, whose fine structure is identical to that of lymphatic vessels. The lacunae are much smaller toward the anterior chamber and the Schlemm's canal than posteriorly in the eye bulb. Large lacunae are situated primarily in the suprachoroidea, and their blind-ended capillary branches enter the choriocapillaris and the walls of large veins. The walls of the large veins contain villous structures that protrude into their lumina and are penetrated by thin lacunar branches and by side lines of the venous lumen. In normal chickens, the lacunae usually are devoid of blood cells. After paracentesis of the anterior eye chamber, the lacunae become filled with erythrocytes on the side that was operated on, but not on the contralateral side. CONCLUSIONS: The authors propose that the lacunae of the avian choroid represent a system of posterior short lymphatic vessels, which drain intraocular fluids directly into the eye's venous system, and that the villous structures are sites of communication between lacunae and veins. The demonstration of a choroidal lymphatic system opens new insights into the processes of fluid removal, control of intraocular pressure, and regulation of choroidal thickness in the avian eye under normal and experimental conditions.

Animals↗
PubMedDate not supplied

Detection of HIV RNA levels in intraocular and cerebrospinal fluids in patients with AIDS-related cryptococcosis.

The objective of the present study was to evaluate human immunodeficiency virus (HIV) levels in the aqueous humor and vitreous fluid in patients with and those without ocular involvement due to AIDS-related cryptococcosis. We also assessed whether cryptococcosis infection in the central nervous system (CNS) was associated with elevated HIV levels in the cerebrospinal fluid (CSF). From 1993 to 2003, we obtained 16 CSF samples from 9 AIDS patients with cryptococcal meningitis and 7 AIDS patients without CNS opportunistic infection. Samples of intraocular fluids were obtained from all 9 patients with cryptococcal meningitis. Five cases presented with ocular involvement in patients with meningitis. By using the method of reverse transcriptase-polymerase chain reaction, we detected higher HIV loads in aqueous humor (27,244+/-4,123 copies/ml) and vitreous fluid (84,930+/-5,071 copies/ml) in patients with concomitant CNS and ocular involvement due to AIDS-related cryptococcosis (p<0.05). HIV levels in the vitreous fluid were correlated with levels in CSF (r=0.77). Mean HIV level in the CSF (209,761+/-18,787 copies/ml) was significantly elevated in AIDS patients with cryptococcoal meningitis (p<0.05). To our knowledge, this is the first report to study the level of HIV loads in the CSF and intraocular fluid simultaneously in AIDS patients with cryptococcosis. Our results revealed the intrathecal and intraocular HIV replication in patients with cryptococcosis.

AIDS-Related Opportunistic Infections↗
PubMed1993

Trabecular outflow facility and formation rate of aqueous humor during propofol, nitrous oxide, and halothane anesthesia in rabbits.

Propofol decreases intraocular pressure (IOP) and the IOP response to laryngoscopy and intubation, but the mechanisms responsible for this effect have not been reported. The present study examined the effect of propofol on IOP, intraocular fluid formation and outflow facility, and intraocular compliance. Twenty-two white New Zealand rabbits were anesthetized with halothane (0.8%-1.0% inspired concentration) in nitrous oxide (2 L/min) and oxygen (1 L/min). Muscle paralysis was established with pancuronium, and the lungs were mechanically ventilated through a tracheal tube. Twelve rabbits examined under these conditions served as controls. In the treatment group (n = 10), 6 mg/kg propofol followed by 18 mg.kg-1 x h-1 propofol intravenously was added to halothane/nitrous oxide/oxygen anesthesia. In both groups, a series of intraocular infusions was made via a 30-gauge needle in the anterior chamber, and IOP, the rate of aqueous humor formation (Fa), and trabecular outflow facility (Ctr) were determined using conventional analysis. These same measures, as well as intraocular compliance, were determined using a new method of analysis adapted from the manometric technique for determining cerebrospinal fluid dynamics. IOP was 11.3 +/- 1.8 mm Hg (mean +/- SD) in halothane-anesthetized controls and decreased to 9.4 +/- 2.2 mm Hg when propofol was added to halothane anesthesia (P < 0.05). By conventional analysis, Fa was 2.82 +/- 0.94 microL/min and Ctr was 0.121 +/- 0.044 microL.min-1 x mm Hg-1 in controls. After addition of propofol, Fa decreased by 24% to 2.15 +/- 0.62 microL/min (P < 0.05) and Ctr decreased by 18% to 0.099 +/- 0.034 microL.min-1 x mm Hg-1 (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, General↗
PubMed2002

Transscleral Coulomb-controlled iontophoresis of methylprednisolone into the rabbit eye: influence of duration of treatment, current intensity and drug concentration on ocular tissue and fluid levels.

The major problems associated with the use of corticosteroids for the treatment of ocular diseases are their poor intraocular penetration to the posterior segment when administered locally and their secondary side effects when given systemically. To circumvent these problems more efficient methods and techniques of local delivery are being developed. The purposes of this study were: (1) to investigate the pharmacokinetics of intraocular penetration of hemisuccinate methyl prednisolone (HMP) after its delivery using the transscleral Coulomb controlled iontophoresis (CCI) system applied to the eye or after intravenous (i.v.) injection in the rabbit, (2) to test the safety of the CCI system for the treated eyes and (3) to compare the pharmacokinetic profiles of HMP intraocular distribution after CCI delivery to i.v. injection. For each parameter evaluated, six rabbit eyes were used. For the CCI system, two concentrations of HMP (62.5 and 150mg ml(-1)), various intensities of current and duration of treatment were analyzed. In rabbits serving as controls the HMP was infused in the CCI device but without applied electric current. For the i.v. delivery, HMP at 10mg kg(-1)as a 62.5mg ml(-1)solution was used. The rabbits were observed clinically for evidence of ocular toxicity. At various time points after the administration of drug, rabbits were killed and intraocular fluids and tissues were sampled for methylprednisolone (MP) concentrations by high pressure liquid chromatography (HPLC). Histology examinations were performed on six eyes of each group. Among groups that received CCI, the concentrations of MP increased in all ocular tissues and fluids in relation to the intensities of current used (0.4, 1.0 and 2.0mA/0.5cm(2)) and its duration (4 and 10min). Sustained and highest levels of MP were achieved in the choroid and the retina of rabbit eyes treated with the highest current and 10min duration of CCI. No clinical toxicity or histological lesions were observed following CCI. Negligible amounts of MP were found in ocular tissues in the CCI control group without application of current. Compared to i.v. administration, CCI achieved higher and more sustained tissue concentrations with negligible systemic absorption. These data demonstrate that high levels of MP can be safely achieved in intraocular tissues and fluids of the rabbit eye, using CCI. With this system, intraocular tissues levels of MP are higher than those achieved after i.v. injection. Furthermore, if needed, the drug levels achieved with CCI can be modulated as a function of current intensity and duration of treatment. CCI could therefore be used as an alternative method for the delivery of high levels of MP to the intraocular tissues of both the anterior and posterior segments.

Animals↗
PubMed2002

Herpes simplex virus infection of the human eye induces a compartmentalized virus-specific B cell response.

Intraocular infection with herpes simplex virus (HSV) can cause uveitis, a potentially sight-threatening disease. The disease is characterized by an ocular infiltration of inflammatory cells such as macrophages and B and T cells. The characteristics of the local humoral and cellular immune responses elicited on intraocular HSV infection are poorly understood. The local HSV-specific antibody production, which are used routinely for confirmation of a clinical diagnosis of herpetic uveitis, has never been analyzed in detail. This study analyzed the humoral immune response against HSV type 1 (HSV-1) in paired samples of intraocular fluid and serum of patients with intraocular herpesvirus infection. In addition, the B cell epitope distribution on a single HSV-1 type-specific antigen, glycoprotein G, was compared for these paired samples. The results presented here indicate that the inflamed eyes of patients with HSV-induced uveitis display a compartmentalized B cell response directed toward the triggering virus.

Adolescent↗
PubMed2004

Silicone oil concentrates fibrogenic growth factors in the retro-oil fluid.

AIM: To determine whether silicone oil concentrates protein and growth factors in the retro-oil fluid. METHODS: A laboratory analysis of intraocular fluid and vitreous specimens obtained from patients undergoing removal of silicone oil, revision vitrectomy, or primary vitrectomy for macular hole, proliferative vitreoretinopathy (PVR), or retinal detachment. Patients were prospectively recruited from routine vitreoretinal operating lists. Vitreous cavity fluid and vitreous samples were analysed for the presence of transforming growth factor beta (TGF-beta2), basic fibroblast growth factor (bFGF), interleukin 6 (IL-6), and total protein using either commercially available enzyme linked immunosorbent assays (ELISA) or protein assay kits. RESULTS: The median levels of bFGF, IL-6, and protein in the retro-oil fluid were raised (p<0.05) compared to all the other vitreous and vitreous cavity fluid samples. bFGF, IL-6, and protein levels were raised in PVR vitreous compared to non-PVR vitreous. TGF-beta2 levels were not significantly raised in retro-oil fluid or in PVR vitreous. CONCLUSIONS: The concentration of fibrogenic (bFGF) and inflammatory (IL-6) growth factors and protein is raised in retro-silicone oil fluid. This may contribute to the process of retro-oil perisilicone proliferation and subsequent fibrocellular membrane formation.

Enzyme-Linked Immunosorbent Assay↗
PubMedDate not supplied

[Effectiveness of convex ophthalmocompression in the course of combined preoperative treatment aimed at decrease of intraocular pressure before extracapsular cataract extraction with intraocular lens implantation].

Two groups of patients with cataracts of different origin (a total of 110) are compared, in whom intraocular pressure was decreased by different methods before surgery: mechanical (convex compression) and combined (convex compression combined with hypotensive drugs). The decrease of intraocular pressure depended on the coefficient of intraocular fluid discharge easiness. Time course of intraocular pressure during and after convex compression is analyzed.

Acetazolamide↗
PubMed1980

Evidence that hypotony in retinal detachment is due to subretinal juxtapapillary fluid drainage.

One case of aphakic retinal detachment with increased intraocular pressure is described. Overnight the intraocular pressure fell abruptly to non-measurable values, and simultaneously the detachment had advanced to the optic disc border. The hypothesis is formulated that decreased intraocular pressure in eyes with retinal detachment is brought about because intraocular fluid is leaking out of the eye through a subretinal route to the perioptic connective tissue. Additional support for this posterior aqueous outflow is obtained from clinical studies showing that maximum hypotony is reached when the detachment has advanced to the optic disc border.

Aged↗
PubMed1998

Cytomegalovirus retinitis and low-grade non-Hodgkin's lymphoma: case report and review of the literature.

Patients with non-Hodgkin's lymphoma may develop retinal or choroidal lesions during the course of their disease. New immunosuppressive therapies currently used in reticuloendothelial malignancies have increased the incidence of opportunistic infections in this patient population. The differentiation of lymphomatous infiltration from opportunistic infection as a cause of chorioretinal infiltrates is critical, as the treatments are fundamentally different. We report a case of a patient with non-Hodgkin's lymphoma who developed a chorioretinal infiltrate that was initially thought to represent progressive disease. The patient received radiation treatment appropriate for intraocular lymphoma. The lesion progressed further and after reevaluation a diagnosis of cytomegalovirus retinitis was made and therapy initiated. Review of the literature for intraocular lymphoma and cytomegalovirus retinitis is provided and diagnostic strategies are described. We recommend analysis of intraocular fluid when there is difficulty in clinically differentiating intraocular lymphoma from opportunistic infection.

Antiviral Agents↗