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[Hormonal homeostasis and intraocular pressure in chronic emotional stress caused by influences acting on the amygdala].

Changes in intraocular pressure, eye hydrodynamics and the amount of hypophyseal, thyroid, adrenal and pancreatic hormones were studied during continuous stimulation of amygdaloid complex or after administration of angiotensin II into the structure in rabbits. The effects involved changes in hormonal homeostasis and elevation of intraocular pressure due to a hypersecretion of intraocular fluid. The administration of angiotensin II during the amygdala stimulation enhanced the changes.

Amygdala↗

[The status of the iridocorneal angle after the implantation of anterior chamber intraocular lenses with flexible supporting elements].

The study was undertaken to examine the status of the iridocorneal angle (ICA) 1 to 4 years after implantation of anterior chamber intraocular lens with flexible supporting devices designed by M. L. Dvali. Correct implantation and gonioscopic monitoring wherein were found to provide reliable lens fixation, as a rule, in the area of the scleral spur and, occasionally, to the anterior part of the ciliary body, if the latter was broad. Additional fixation of the supporting devices was attained by delicate commissures at their small extent at the sites of iris contact, which were detected in the majority of cases. Strangulation of the iris or fixation in its periapical part occurred in small cases and were observed in the upper portion of ICA. Corneal epithelial contact with the supporting devices was revealed in 5.4% of cases, as well as in the upper part of ICA. Only in 1 out of 37 cases, the changes in the drainage area such as iris strangulation at a great extent were sufficient to impair its function and required additional surgical correction. The remaining eyes showed no abnormal intraocular fluid circulation. The visual acuity in 35 eyes was as great as 0.5 or more.

Cornea↗

Intraocular pressure (IOP) changes induced by regular dialysis treatment (RDT).

It has been long known that uremia and RDT could alter the optical fibers of the Central Nervous System: we also previously demonstrated the persistence of a delayed P100 wave evoked by Visual Potentials (VEPs) in RDT patients. Our present study evaluates changes in IOP during RDT and possible correlations between electrophysiological and tonometrical modifications. In twenty patients undergoing RDT (12 hrs/weekly, mean age 42.05 +/- 10.80 yrs) we performed, just before and immediately after the dialytic session the tonographic recordings and serum osmolality. The pre-dialysis IOP of all 20 patients ranged from 9.00 to 27.19 mmHg with a mean of 16.40 +/- 7.20. Serum osmolality predialysis was 326.10 +/- 5.72 mOsm/l and post-dialysis 290.33 +/- 2.95 mOsm/l. Our studies suggest a correlation between decrease in plasma osmolality and increase in IOP during dialysis. The effect of RDT on IOP depends on the balance between the rise in IOP with the reduction of the concentrations of "waste products" and the extracellular volume reduction associated with ultrafiltration. The elevation of IOP may be due to a decrease in post-dialysis outflow facility inducing an osmotic influx of water into the eye because of hyperosmolality of intraocular fluids. These continuous modifications may be partially responsible for the defective propagation and the delayed transmission documented by VEPs.

Adult↗

[Analysis of the protein pattern in physiologic and pathologic vitreous bodies by electrophoresis and immunologic identification].

The protein composition of normal and pathological human vitreous was analyzed using gradient SDS-PAGE and western blot. By electroblotting and immunodetection, the presence of ten proteins was proven in the normal vitreous. The major proteins included: albumin, transferrin, alpha-1-antitrypsin, and immunoglobulin G. For the detection of a distinct protein in the vitreous, western blot analysis seems to be an appropriate method. Using densitometric analysis of silver-stained gels, we compared the protein pattern of post-mortem vitreous, surgically obtained samples (from proliferative vitreous-retinopathy, proliferative diabetic retinopathy, and macular pucker patients), and serum. The protein composition of the pathological intraocular fluid was uniform, but different from that of normal vitreous and serum. These results suggest that a breakdown of the blood-retina barrier is the main reason for the increase of soluble proteins in the vitreous cavity under pathological conditions. The methods described allow detailed analysis of the vitreous protein pattern in intraocular proliferative disorders with a small sample volume (10 microliters).

Blood-Retinal Barrier↗

Extracapsular cataract extraction after vitrectomy.

OBJECTIVE: To ascertain the reliability, safety, and effectiveness of extracapsular cataract extraction (without the use of pars plana infusion) in eyes that have had vitrectomy. SETTING: The Manchester Royal Eye Hospital. METHODS: A retrospective analysis of surgical and postsurgical complications and visual acuity change in 41 patients who had one or more vitreoretinal procedures, followed by extracapsular cataract extraction and intraocular lens implantation at a subsequent date. RESULTS: No significant operative complications were encountered using an extracapsular technique without pars plana infusion. Thirty eyes (73.2%) had a significant increase in visual acuity, 10 (24.4%) did not change, and 1 worsened. CONCLUSIONS: A modified form of extracapsular extraction, with control of intraocular fluid flow but without the use of a pars plana infusion, is safe and effective in post-vitrectomy eyes.

Cataract↗

Vitreoretinal surgery using transconjunctival sutureless vitrectomy.

This report presents the effectiveness of 25-gauge Transconjunctival Sutureless Vitrectomy (TSV) for various vitreoretinal disorders. We performed vitreoretinal surgery on 6 patients using 25-gauge TSV. Minimal or no leakage of intraocular fluid or gas was observed at the entry site. No case required a suture to close the conjunctival or scleral opening site, and no complications resulted from the opening site. Median preoperative visual acuity was 0.04 and median postoperative best corrected visual acuity (BCVA) with a mean follow-up of 12 weeks, was 0.45. Median preoperative intraocular pressure was 12.67 mmHg, and median intraocular pressure on the first postoperative day was 15.67 mmHg. Because transconjunctival sutureless surgery is minimally invasive, it increases the efficiency of vitrectomy, hastens postoperative recovery, and improves outcomes due to the simplified surgical procedure. We feel that the adoption of the 25-gauge TSV would lead to improved patient comfort, care, and management.

Adult↗

[The effect of local corticosteroid therapy on ophthalmic tonus and ocular hydro- and hemodynamics in experimental inflammatory pathology].

The laboratory samples of 0.1% dexamethasone and 1% hydrocortisone eye drops which had been designed at the State Research Center of Drugs were investigated for their effects on intraocular pressure in the presence of photokeratitis caused by UV irradiation. Producing pronounced antiinflammatory effects, the daily triple instillations of corticosteroids for 9 days tended to gradually increase the ophthalmotone induced both by the imbalance of production and outflow of intraocular fluid and by ocular hemodynamic disorders associated with the enhanced blood filling of the choroidal vessels and with the higher intensity of pulse oscillations.

Animals↗

[Effects of monochromatic light on ocular hydrodynamics].

Effects of green and red optic filters on ocular hydrodynamics was studied. The results indicate that monochromatic green light causes a decrease of the true intraocular pressure, improves intraocular fluid discharge, and decreases Becker's coefficient. Green filters (ZSP) can be used as an additional method for conservative treatment of glaucoma patients.

Adult↗

[The clinical picture and pathogenetic problems in low-pressure glaucoma].

Dynamic examinations of 78 patients with a primary diagnosis of glaucoma with low intraocular pressure and 25 persons without disturbances in intraocular pressure regulation, using up-to-date adequate methods--ultrasound dopplerography, rheography, fluorescence angiography, electron tonography, as well as other traditional methods, allow to make a conclusion that glaucoma with low intraocular pressure is a variant of the development of a typical open-angle glaucoma complicated by involutional changes in the body in a form of chronic vascular deficiency (chronic ischemic neuropathy of the eye). Glaucoma with low pressure should be differentiated from ischemic neuropathy or its outcome. The criterium for a diagnosis of low pressure glaucoma is the presence of changes in hydrodynamic and their progression (intensification of retention in reduced level of intraocular fluid outflow), positive results of unloading tests. A term "primary open-angle glaucoma, chronic vascular deficiency" is proposed.

Aged↗

Rate of anterior chamber aqueous formation, trabecular outflow facility, and intraocular compliance during desflurane or halothane anesthesia in dogs.

The present study examined the effects of desflurane on intraocular pressure (IOP), the rate of anterior chamber aqueous formation, trabecular outflow facility, and intraocular compliance. The effects of desflurane were compared to those of halothane because the effects of halothane on intraocular fluid dynamics are well known. Twenty-two dogs were anesthetized for surgical preparation. Pancuronium was given intravenously to produce neuromuscular blockade, and the lungs were mechanically ventilated through a tracheal tube. After surgical preparation, anesthesia was maintained in Group 1 (n = 12) with halothane (0.8% expired) and in Group 2 (n = 10) with desflurane (7.0% expired). In both groups a series of intraocular infusions was made via a 30-gauge needle in the anterior chamber and IOP, aqueous formation, outflow facility, and intraocular compliance were determined. In Group 1 (halothane) IOP was 9.4 +/- 2.8 mm Hg (mean +/- SD), aqueous formation was 1.45 +/- 0.45 microL/min, outflow facility was 0.091 +/- 0.054 microL.min-1.mm Hg-1, and compliance was 377 +/- 282 nL/mm Hg. In Group 2 (desflurane) IOP was 11.3 +/- 3.8 mm Hg, aqueous formation was 1.61 +/- 0.56 microL/min, outflow facility was 0.097 +/- 0.062 microL.min-1.mm Hg-1, and compliance was 432 +/- 238 nL/mm Hg. These values did not differ between groups. It is concluded that in dogs aqueous humor dynamics during desflurane anesthesia are similar to those during halothane anesthesia.

Anesthesia↗

A test for crystalline lens biocompatibility.

The current use of monkeys for testing intraocular fluids and viscoelastic materials is being questioned because of the decreasing availability and increasing cost of these scarce animals. The rabbit is an inexpensive, readily available, and convenient animal which might provide an alternative model for this purpose. In this study we have outlined the lens changes (clefts or vacuoles) that are observed in the New Zealand white rabbit as a result of toxicity to intraocular test materials. We used two viscoelastic agents, 1% sodium hyaluronate-Healon and 2% carboxymethylcellulose, and balanced salt solution to evaluate the efficacy and reproducibility of lens changes in this test study. The lens changes in each case were reproducible and could easily be graded. When used in concert with other tests, this new test can help in the preliminary evaluation of an ophthalmic material before its final clinical use in humans.

Animals↗

Endophthalmitis.

Endophthalmitis is an inflammatory reaction of intraocular fluids or tissues. Infectious endophthalmitis is one of the most serious complications of ophthalmic surgery. Occasionally, infectious endophthalmitis is the presenting feature of an underlying systemic infection. Successful management of infectious endophthalmitis depends on timely diagnosis and institution of appropriate therapy. Recognition of the different clinical settings in which endophthalmitis occurs and awareness of the highly variable presentation it may have facilitate timely diagnosis. Biopsy of intraocular fluid/tissue is the only method that permits reliable diagnosis and treatment. The different presenting clinical settings, a rational approach to diagnosis (i.e., when, what, and how to biopsy), and the treatment of infectious endophthalmitis are reviewed.

Diagnostic Techniques, Ophthalmological↗

[Cerebrospinal fluid analysis in Kirisawa-Urayama type uveitis].

PURPOSE: We investigated whether viral encephalitis could occur in patients with Kirisawa-Urayama type uveitis by analysing the cerebrospinal fluid (CSF). METHODS: CSF samples were aspirated from nine patients with Kirisawa-Urayama type uveitis and assayed for local antibody production and the presence of herpesvirus DNA. RESULTS: Seven cases had mild CSF pleocytosis. In six of seven cases who underwent CSF antibody analysis, we found intrathecal antibody production against herpes simplex virus or varicella-zoster virus which were the causative viruses diagnosed from intraocular fluid in each patients. Polymerase chain reaction (PCR) assay was used to search for virus DNA in the CSF of six patients, but all were negative. CONCLUSIONS: The results of this study suggest that Kirisawa-Urayama type uveitis is often accompanied with optic nerve involvement and intrathecal antibody production against causative viruses, but we could not find any viral encephalitis.

Adult↗

Pathological findings in lens capsule and silicone intraocular lens extracted from eye with chronic infectious endophthalmitis.

The lens capsule and silicone intraocular lens (IOL) extracted from the eye of a patient with chronic infectious endophthalmitis was examined histopathologically to evaluate the pathology of a capsule and IOL surfaces in the presence of bacterial infection. A 69-year-old man developed an infection in his right eye 4 months after phacoemulsification and aspiration of a cataract and implantation of a silicone IOL. During vitrectomy, the capsule and IOL were extracted and processed for light or scanning electron microscopy. Cryosections of the capsule were subjected to Gram staining and immunohistochemical tests for extracellular matrix components. The lens capsule contained an accumulation of extracellular matrix, including collagen types and fibronectin. A colony of Gram-positive rod bacteria was detected inside the capsular bag. Scanning electron microscopy failed to detect any microorganisms on the IOL surface. Histological examination of cryosections of the extracted capsule confirmed the presence of infection during surgery even though preoperative cultures of intraocular fluid were negative. Immediate antibacterial treatment could be initiated.

Aged↗

Activated T lymphocytes in uveitis.

Two colour flow cytometry techniques were used to assess the activation stages of peripheral and intraocular T lymphocytes in uveitis. Increased numbers of T lymphocytes bearing the interleukin-2 (IL-2) receptors were found in intraocular fluids or peripheral blood or both of 35/51 patients with uveitis. This increased expression of IL-2 receptors on lymphocytes correlated with increased expression of other early T lymphocyte activation markers, HLA-DR and L-35. Both T helper cells (Leu-3A+) and suppressor cells (Leu 2A+) were activated in vivo. A positive correlation was seen between lymphocyte activation and clinical uveitis activity. In idiopathic uveitis activation of Leu-3A lymphocytes (helper/inducer) was significantly increased, and intraocular activation of the Leu-2A lymphocytes (cytotoxic/suppressor) was significantly decreased. These data show that some patients with idiopathic uveitis have a perturbation of T helper cells. Twenty-two of 31 patients with idiopathic uveitis, not associated with systemic disease, had increased peripheral T lymphocyte activation. This finding indicates that in some inflammations believed to be restricted to the eye an abnormal systemic immune activation exists.

Antigens, Differentiation, T-Lymphocyte↗

Distribution of morphine in the eye tissues and fluids of rabbits after systemic administration and after transfer via corneal grafting.

To determine whether corneas from animals receiving morphine could be used for grafting, rabbits were given a single intravenous injection of tritium-labelled morphine and killed 10 minutes later. Of the drug entering the eye, 12% was found in the cornea, 36% in the retina and optic nerve, 29% in the uveal tissues, 8% in the aqueous humour, 8% in the choroid, 4% in the vitreous humour and 2% in the lens. Another group of rabbits then received full-thickness corneal grafts from rabbits treated with morphine. The grafts contained the drug for up to 21 days after transplantation. From the graft bed the agent dispersed into the different solid ocular tissues and intraocular fluids. None of the grafts failed, and none of the recipients' eyes showed any adverse reaction. In-vitro tests showed that the amount of morphine found in the cornea and the aqueous humour of the donor did not have any significant effect on cell division or protein synthesis of the corneal cells. Higher concentrations of the drug, however, decreased both cell division and protein synthesis.

Animals↗

Biphasic model of the trabecular meshwork in the eye.

A biphasic continuum model for the flow of intraocular fluid, the aqueous humour, in the trabecular meshwork is proposed in the paper. The model considers the meshwork as a circular ring with uniform thickness of homogeneous, isotropic, viscoelastic material swollen with continuously percolating aqueous humour. The model further assumes the permeability of the meshwork as a function of dilation in its solid phase. The study considers steady and quasisteady states. Approximate solutions to the problem are obtained by Picard's type iterative procedure and computational results for the dimensionless solid displacement, permeability and pressure profiles are presented. It is concluded that intraocular pressure has a permeability-decreasing effect, whereas the elasticity of the meshwork shows a permeability-increasing effect. Thus, rising intraocular pressure develops a further rise in itself, whereas the elasticity tends to diminish the intraocular pressure through facilitating aqueous outflow.

Aqueous Humor↗

[Antiglaucoma drainage operations in the reconstruction of the anterior eye segment].

Two new methods for antiglaucoma draining surgery are suggested, consisting in perforating keratoplasty with elements of partial or complete reconstruction of the anterior segment of the eye in cases with combined injuries to the cornea and other structures, associated with secondary glaucoma. The first of these methods consists in conducting an 'active' draining tube, made of silicone, via the trabeculectomy site into the anterior chamber, the draining tube then being fixed to the iris in the ciliary zone; the drainage tube has an extra opening on its proximal end. The other method implies the creation of two new special routes for intraocular fluid discharge; a cyclodialysis opening is formed, through which a capillary drainage is introduced into the anterior chamber, that is fixed to the iris. To prevent over growing of the distal end of the drainage tube with tissues of the operated on eye it was placed in some patients under a silicone explant (sponge). Forty-five patients (45 eyes) were operated on making use of the former method and 23 patients (23 eyes) were operated on with the use of the latter method. The results were followed up for up to 3 years; intraocular pressure compensation was attained in 91.1% of cases, transparent and semitransparent taking in of perforated keratotransplants in 75.6%, vision acuity improvement from the right light projection up to 0.3 diopters and higher was observed in 62.2% of patients.

Adolescent↗