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At least 649 records · Page 36Linked to original sources
PubMed1996

Demonstration of renin mRNA, angiotensinogen mRNA, and angiotensin converting enzyme mRNA expression in the human eye: evidence for an intraocular renin-angiotensin system.

AIMS/BACKGROUND: All components necessary for the formation of angiotensin II, the biologically active product of the renin-angiotensin system (RAS), have been demonstrated in ocular tissue or vitreous and subretinal fluid. The tissue concentrations of renin were too high to be explained by admixture of blood. This raises the possibility of an intraocular RAS, independent of the RAS in the circulation. METHODS: In the present study, gene expression of RAS components in different parts of enucleated human eyes was investigated as evidence for tissue specific production. RESULTS: By using pooled tissue samples renin mRNA could be detected with the RNAse protection assay in retinal pigment epithelium (RPE) choroid, but not in neural retina or sclera. With reverse transcription polymerase chain reaction (RT-PCR), renin mRNA was detected in individual samples of RPE choroid and neural retina, and not anterior uveal tract or sclera. Angiotensinogen and angiotensin converting enzyme (ACE) gene expression could be demonstrated by RT-PCR in individual RPE choroid and neural retina samples and marginally in sclera samples. CONCLUSIONS: These results support the concept of intraocular synthesis of angiotensin II, independent of renin, angiotensin, and ACE in the circulation. Since gene expression was highest in ocular parts, which are highly vascularised, local angiotensin II may be involved in blood supply and/or pathological vascular processes such as neovascularisation in diabetic retinopathy.

Adult↗
PubMed2006

Inhibition of intraocular fibrin formation after infusion of low-molecular-weight heparin during combined phacoemulsification-trabeculectomy surgery.

PURPOSE: To evaluate the effect of intraocular infusion of dalteparin, a low-molecular-weight heparin (LMWH) administered in the infusion fluid to prevent early postoperative fibrin formation in combined phacoemulsification-trabeculectomy surgery (phacotrabeculectomy). SETTING: Farabi Eye Hospital, Tehran, Iran. METHODS: Standard combined phacotrabeculectomy was performed prospectively in a masked fashion in 60 eyes; 35 eyes received 5 IU/mL LMWH in the infusate and 25 eyes served as controls. Masked postoperative examinations assessed visual acuity, intraocular pressure (IOP), anterior chamber cell and flare, and fibrin formation with slitlamp examinations 1, 3, 7, 30, and 90 days after surgery. RESULTS: The rate of intraocular fibrin/membrane formation was significantly lower in the LMWH group than in the control group at each follow-up (P<.001, Student t test) . The amount of IOP was lower in LMWH group at each follow up (P<.01, Student t test). Final visual acuity was better in LMWH group (P = .03, Student t test). The frequency of synechia formation was lower in the LMWH group on day 90 (P = .002, chi-square test). CONCLUSIONS: Infusion of dalteparin, a LMWH, may be an effective inhibitor of postoperative fibrin formation in phacotrabeculectomy surgery. It may reduce the frequency of synechia formation and improve visual acuity. It may not be associated with increased risk for intraoperative or postoperative complications at the tested dose. This drug may be a useful adjunct in combined surgery.

Aged↗
PubMed1993

Intraoperative measurement of intraocular pressure in vitrectomized aphakic air-filled eyes using the Tono-Pen XL.

The Tono-Pen XL (Bio-Rad, Santa Ana, CA) was compared with manometer readings for intraoperative measurement of intraocular pressure (IOP) in 40 eyes of 40 consecutive patients after vitrectomy, lensectomy, and fluid-air exchange. Tono-Pen readings corresponding to manometer readings of 10, 20, 30, 40, and 50 mmHg were obtained in a masked fashion with a randomized sequence of manometer readings. A correlation was obtained between the manometer and Tono-Pen readings (r = 0.96 in emmetropic eyes and r = 0.93 in myopic eyes). The regression curve that represents the calibration curve of Tono-Pen in terms of the manometer readings for air-filled vitrectomized eyes was obtained. Any Tono-Pen reading can be easily translated into the corresponding manometer reading by referring to the curve. The Tono-Pen can therefore be effectively used to accurately determine intraoperative IOP in eyes undergoing vitrectomy, lensectomy, and fluid-air exchange.

Adolescent↗
PubMed1998

Differences between intraocular and serum antibody responses in patients with ocular toxoplasmosis.

PURPOSE: To investigate the antigen specificity of the intraocular anti-Toxoplasma gondii antibody response in patients with ocular toxoplasmosis. METHODS: Paired ocular fluid and serum samples were collected from 13 patients with active ocular toxoplasmosis. Serum IgM anti-T. gondii antibodies were tested to distinguish recently-acquired from chronic infection. Anti-T. gondii IgG specificity was analyzed by immunoblotting using a crude T. gondii extract. RESULTS: Two of the 13 patients tested were IgM positive and considered to have acquired ocular toxoplasmosis. The antibody specificity in ocular fluid and serum of these two patients was similar, whereas in the patients with presumed chronic disease, marked differences could be observed. Most ocular fluid samples contained antibodies that stained a 28-kD antigen more intensely than did antibodies from paired serum samples. Using absorption and elution experiments, we demonstrated that this 28-kD protein was identical to the GRA-2 antigen, which is expressed in both the tachyzoite and the bradyzoite stages of the parasite. CONCLUSIONS: Our results show that the intraocular T. gondii antibody response of patients with recurrent ocular toxoplasmosis differs from the systemic response. This finding may have implications for our understanding of the immunopathogenesis of ocular toxoplasmosis and could be employed to improve diagnosis of the disease.

Adult↗
PubMed1989

Pharmaceutical production and intraocular lens implantation: technology appropriate to the Third World.

Eritrea, in the Horn of Africa, suffers the serious health problems and obstacles to the provision of adequate health care that typify Third World countries. Yet, despite the compounding effect of war, the Eritreans' pharmaceutical facility meets 40% of their capsule and tablet requirements, and all their intravenous fluid demands. If intravenous fluid production is possible in this environment, as it is, then the authors contend that routine microscopic intraocular surgery (including intraocular lens implantation) should be as well. The establishment of an Eritrean facility capable of such surgery is recorded. The authors believe this type of surgery should be seriously considered in any attempt to deal with the problem of Third World cataract blindness.

Cataract Extraction↗
PubMed2004

Perfluorocarbon-perfused vitrectomy: a new method for vitrectomy--a safety and feasibility study.

PURPOSE: To evaluate the safety and feasibility of perfluorocarbon-perfused vitrectomy (PCPV) as a technique during vitrectomy for proliferative diabetic retinopathy (PDR) and rhegmatogenous retinal detachment (RRD). METHODS: In an experimental, prospective, noncomparative and interventional study, 28 eyes of 28 patients were submitted to vitrectomy with the PCPV technique, 18 eyes with PDR and 10 with RRD. In this technique we replaced the traditional balanced saline solution (BSS) in the infusion line (conventional vitrectomy) by perfluorocarbon liquids (PCL). Some patients with PDR were treated with oxygenated PCL. Clinical evaluation, electroretinography (ERG), and endothelial cell count (ECC) were used to assess the safety of this procedure. An arbitrary grading system (grades 0-5) was used to classify the surgery and maneuvers to assess feasibility. RESULTS: No eyes had a significant decrease in ECC, and the patients in whom we could obtain ERG postoperatively showed no significant differences from preoperative ERG. In the PDR group (using oxygenated and nonoxygenated PCL), 77.8% were graded 5/5; in the RRD group 90% were 5/5. PCPV allowed better visualization of vitreous and intraocular structures, rapid retinal reattachment, less blood in the vitreous cavity, subretinal fluid resolution, blood confinement, retinal stabilization, and easier dissection of epiretinal membranes. In all cases at least one surgical step was eliminated. CONCLUSIONS: PCPV in humans is a safe and feasible technique. Probably in selected cases the use of PCL offers several advantages over BSS, because of their properties (gravitational forces, immiscibility with bodily fluids, and ability to transport oxygen). Prospective and comparative studies are necessary to establish formal indications and possible contraindications.

Adult↗
PubMedDate not supplied

Considerations of glaucoma in patients undergoing corneal refractive surgery.

Glaucoma patients present a unique set of challenges to physicians performing corneal refractive surgery. Corneal thickness, which is modified during corneal refractive surgery, plays an important role in monitoring glaucoma patients because of its effect on the measured intraocular pressure. Patients undergo a transient but significant rise in intraocular pressure during the laser-assisted in situ keratomileusis (LASIK) procedure with risk of further optic nerve damage or retinal vein occlusion. Glaucoma patients with filtering blebs are also at risk of damage to the bleb by the suction ring. Steroids, typically used after refractive surgery, can increase intraocular pressure in steroid responders, which is more prevalent among glaucoma patients. Flap interface fluid after LASIK, causing an artificially low pressure reading and masking an elevated pressure has been reported. The refractive surgeon's awareness of these potential complications and challenges will better prepare them for proper management of glaucoma patients who request corneal refractive surgery.

Cornea↗
PubMed1990

Experimental endoretinal biopsy.

We performed transvitreal endoretinal biopsy in rabbit eyes to develop a reliable and safe technique to obtain retinal specimens from attached retina. Pars plana vitrectomy without lensectomy was followed by injection of Ringer's solution into the subretinal space to produce a focal retinal detachment. The apex of the focal detachment was excised by intraocular scissors and removed from the eye by pneumohydraulic expulsion. A fluid-air exchange reattached the retina. The biopsy sites were evaluated clinically and by light and electron microscopy at regular intervals up to 20 weeks postoperatively. The initial five procedures were performed without heparin in the infusion fluid, and they were complicated by severe fibrin reaction and early retinal detachment. Of the remaining 17 eyes, 15 were without intraoperative complication and maintained attached retinas. The biopsy site developed an early ring of hyperpigmentation along the border, and the biopsy bed became increasingly hyperpigmented because of cytoplasmic hyperplasia and hypertrophy of the pigment epithelium. Epiretinal membranes and subretinal neovascularization were observed histologically. Retinal biopsy specimens were reproducible and suitable for diagnostic studies.

Animals↗
PubMed1989

A new modified vitreoretinal surgical approach in the management of massive suprachoroidal hemorrhage.

The authors describe a new surgical approach used in six consecutive patients referred to us between August 1986 and August 1988 with massive suprachoroidal hemorrhage (MSCH) during or after cataract extraction (4 patients), glaucoma filtering surgery (1 patient), or scleral buckling (1 patient). All patients had large hemorrhagic choroidal detachments with five eyes showing "kissing" detachments. Secondary surgery was delayed 7 to 25 days (mean, 14 days) to allow liquefaction of the blood clot and reduce intraocular inflammation. All eyes underwent posterior drainage sclerotomies under constantly maintained limbal fluid infusion line pressure, followed by pars plana anterior and posterior vitrectomy in five of six eyes. Additionally, two eyes underwent secondary lens implantation during surgery and 6 months later, respectively. Mean follow-up was 10 months. Visual acuity improved in all eyes from a preoperative range of light perception-hand motions to hand motions-20/40. Advantages and disadvantages of this aggressive surgical approach in the management of MSCH are discussed.

Aged↗
PubMed1996

Optical coherence tomography of macular lesions associated with optic nerve head pits.

PURPOSE: Although optic pits were described more than a century ago, the pathogenesis and pathologic nature of the associated macular lesions remain controversial. The authors used the technique of optical coherence tomography (OCT) to further define the anatomic relation that exists between optic pits, macular schisis-like spaces, and macular detachments. METHODS: Four eyes of three consecutive patients with optic pit-related macular pathology were evaluated. Cross-sectional OCT images were correlated with findings from slit-lamp biomicroscopy and stereo fundus photography. All eyes previously had undergone unsuccessful photocoagulation to the temporal juxtapapillary retina. One eye had undergone vitrectomy and intraocular gas tamponade, resulting in partial resorption and displacement of the submacular fluid. RESULTS: Retinal edema and cystic degeneration were present, overlying macular neurosensory detachments in all four eyes. The most prominent edema was present in the outer retina at the level of the outer plexiform layer. This mimicked a true retinoschisis cavity, although bridging retinal elements were identifiable. A lesser degree of edema was present in the inner retina, predominantly located between the disc and fovea. In one eye, a lamellar hole was shown to be a defect in the outer neurosensory retina. In another eye, a macular detachment developed under a pre-existing schisis-like cavity. The schisis-like cavity or edematous retina communicated with the optic disc in all eyes, whereas none of the eyes demonstrated a direct connection between the macular detachment and optic pit. CONCLUSION: These findings support the concept of a bilaminar structure in which a macular detachment develops secondarily to a pre-existing schisis-like lesion consisting of severe outer retinal edema. Fluid may enter from the optic pit into the retinal stroma and not directly into the subretinal space, explaining the prolonged recovery and frequency of treatment failure after photocoagulation to the juxtapapillary retina.

Adult↗
PubMed2002

Nucleus cryoinversion for extraction of highly complicated cataracts.

We describe a technique for cataract extraction in vitrectomized eyes that uses secured removal of the nucleus with no manipulation of the capsular bag. After a large scleral tunnel is prepared and a capsulorhexis created, a 20-gauge retinal cryoprobe enveloped in a plastic or a silicone sleeve is introduced into the anterior chamber. The cryoprobe engages the nucleus by a "freeze-grip" and rotates it 180 degrees so that the nucleus is elevated into the anterior chamber with no force applied to the capsule and the cryoprobe supporting it from below. The cryoprobe is replaced by a vectis under the nucleus and with the help of another instrument from above, the nucleus is removed. Aspiration of cortical material under low-pressure fluid maintenance of the anterior chamber completes removal of the cataract. An intraocular lens is then implanted in the ciliary sulcus for maximum capsule support.

Capsulorhexis↗
PubMed1975

Retinal tumor induction by ocular inoculation of human adneovirus in 3-day-old rats.

A direct causal relationship between a human DNA virus, adeno serotype 12, and malignant transformation in target cells (sensory retinal neuronal precursors) was suggested by the development of a remarkably uniform retinoblastoma-like neoplasm in rats. In order to focus upon incipient photoreceptor differentiation, 27 3-day-old CD rats were selected for intraocular virus inoculation. A single injection of 0.03 ml of the virus fluid, 104.5 TCID50 HeLa cells/0.1 ml was given in the left eye. Within 73 to 167 days after the virus inoculation, 12 rats (44.4%) developed retinal tumors in the left eye. Although retinal tumors mimicking human retinoblastoma with true rosettes were anticipated, the highly uniform histopathologic appearance of all 12 eyes was virtually indistinguishable from that of 0-day-old rats. However, multiple foci of malignant cells fusing with the inner segment of relatively well-differentiated retinal layers were found haphazardly throughout the cases; such retinal remnants were not detectable in tumors of 0-day-old rats. Electron microscopy revealed poorly differentiated tumor cells that possessed a single cilium consisting of a typical ring of nine doublets with no axial pair (a 9 plus 0 pattern). Advenovirus-specific T-antigens detected in vivo by the immunofluorescein microscopic procedure in abortively infected or transformed cells clearly indicated that some neuronal precursors destined for part of the ganglioneuronic layer are selectively susceptible to viral oncogenesis. No preferential involvement of the photoreceptor cells was observed. No control animals developed retinal neoplasms.

Adenoviridae↗
PubMed1996

The pathogenesis of polychromatic cholesterol crystals in the anterior chamber.

PURPOSE: Polychromatic cholesterol crystal of the anterior chamber are an interesting and unusual finding. This paper examines the different pathogenetic mechanisms leading to the formation of these clinically detectable anterior chamber crystals. METHODS: Three aetiologically different cases which exhibited polychromatic crystals in the anterior chamber were reviewed. Aqueous samples were examined by wet field microscopy in all cases and additionally by electron microscopy in one of these. One enucleated globe was available for histopathology. RESULTS: Typical highly refringent cholesterol crystals were identified in the aqueous of all cases. In the first case, the cholesterol crystals developed following the breakdown of vitreous and anterior chamber haemorrhage. In the second case, the cholesterol appeared to derive from the subretinal fluid of a chronic total retinal detachment in the absence of any intraocular haemorrhage. The cholesterol crystals of the final case resulted from phacolysis and were associated with a marked neutrophil response and the presence of proteinaceous crystals consistent with the crystallins. CONCLUSIONS: Anterior chamber cholesterolosis is a secondary phenomenon that always occurs as a result of an ocular disease process. Although the prognosis is dismal for chronically diseased eyes displaying cholesterol crystals in the anterior chamber, the prognosis for eyes with phacolysis may be excellent.

Adult↗
PubMed1979

Irrigating instruments for intraocular lens implantation.

A series of small instruments to assist with insertion of intraocular lenses and placement of lens fixation sutures has been described. Added to the main function of each, is the capability for infusion of fluid or injection of air and medication.

Anterior Chamber↗
PubMed1996

[Vitreous surgery for subretinal neovascular membrane and hemorrhage].

OBJECTIVE: To study the indications, techniques and therapeutic effects of vitreous surgery for subretinal neovascular membranes. METHODS: 6 cases of subretinal neovascularization and subretinal hemorrhage were treated by vitreoretinal surgery. The surgical techniques consisted of three port pars plana vitrectomy, intraocular laser, retinotomy, subretinal neovascular membrane resection or hemorrhage removal, air-fluid exchange, etc. The pre and post-operative examinations included fundus fluorescein angiography (FFA), Humphry visual field to evaluate the therapeutic effects of the surgery. RESULTS: The postoperative follow-up ranged from 4 to 7 months. The visual acuities of 4 cases improved, 0.3 or over in 2 cases and unchanged in 2 cases. CONCLUSION: Subretinal operation may be a safe and effective method to treat subretinal neovascularization if the indication was well mastered.

Adult↗