[Use of an operating microscope for the removal of foreign bodies from the anterior chamber and ciliary body].
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Anterior Chamber↗
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Effects of 0.005% latanoprost on ocular anterior structures and ciliary body thickness.
PURPOSE: To assess the effects of 0.005% latanoprost on the anterior segment geometry and ciliary body thickness using ultrasound biomicroscopy. Intraocular pressure, refraction, visual acuity, and pupil size were also evaluated. PATIENTS AND METHODS: Thirty patients with untreated ocular hypertension or primary open-angle glaucoma (mean age: 59.3 +/- 9.9 years) were recruited into this prospective, controlled, open trial. Before and after 1 week of 0.005% latanoprost administration, the following parameters were tested: refraction, visual acuity, pupil diameter, intraocular pressure, 5 conventional ultrasonographic A-scan variables, 16 ultrasound biomicroscopy parameters, and the ultrasound biomicroscopy ciliary body thicknesses at a distance of 1500 microns (CBT1), 2000 microns (CBT2), and 2500 microns (CBT3) from the scleral spur. RESULTS: Latanoprost 0.005% caused a marked intraocular pressure-lowering effect in all patients (from 22.8 +/- 3.1 mm Hg to 14.1 +/- 2.9 mmHg; -38%, P < 0.0001), without any refractive, visual acuity, or pupillary alterations. The A-scan echobiometry variables were unchanged, while ultrasound biomicroscopy confirmed a significant posttreatment increase of CBT2 (from 434 +/- 140 microns to 536 +/- 127 microns; +102 microns, P = 0.01) and CBT3 (from 319 +/- 103 microns to 412 +/- 100 microns; +93 microns, P = 0.003) compared with controls (CBT2: from 493 +/- 165 microns to 473 +/- 135 microns, -20 microns, P = NS; CBT3: from 388 +/- 130 microns to 365 +/- 87 microns, -23 microns, P = NS). None of the changes observed in the other UBM parameters was statistically significant. No significant correlation was detected between ciliary body thickness increase and intraocular pressure-lowering effect. CONCLUSION: The increase of ciliary body thickness, which was measured in vivo by ultrasound biomicroscopy and associated with the intraocular pressure-lowering effect, indirectly supports the mechanism of uveoscleral outflow enhancement induced by latanoprost. These data are in agreement with the biochemical hypothesis of the passage of the aqueous flow through the extracellular spaces of the ciliary muscle.
Adult↗
Photodynamic therapy of the ciliary body with tin ethyl etiopurpurin and tin octaethyl benzochlorin in pigmented rabbits.
BACKGROUND AND OBJECTIVES: The authors used a pigmented rabbit model to investigate two photosensitizers, tin ethyl etiopurpurin (SnET2) and tin octaethyl benzochlorin (BNZ 203), to determine their potential for creating ciliary body injuries during photodynamic therapy (PDT). MATERIALS AND METHODS: The biodistribution of SnET2 (n = 10) and BNZ 203 (n = 9) was studied by fluorescence microscopy using a low light detection system, based on charged-coupled device photography, with digital image processing at 1 and 24 hours after injection. PDT with SnET2 (n = 8; 664 +/- 7-nm light; 75 mW/cm2; 50 or 100 J/cm2; 1-mm spot size) and BNZ 203 (n = 6; 689 nm; 75 mW/cm2; 50 or 100 J/cm2; 1-mm spot size) was performed at 24 hours post-injection. The control subjects for SnET2 (n = 5) and BNZ 203 (n = 3) were given a maximal light dose (100 J/cm2). RESULTS: Both photosensitizers demonstrated an intravascular distribution at 1 hour that shifted to a ciliary body distribution at 24 hours (SnET2 much greater than BNZ 203). In addition, the SnET2 demonstrated suborgan localization to the nonpigmented ciliary body epithelium. Both photosensitizing agents were able to produce selective injury to the rabbit ciliary body (SnET2 much greater than BNZ 203), with evidence of a small component of thermal damage (SnET2 greater than BNZ 203). CONCLUSIONS: PDT with SnET2 or BNZ 203 can produce selective injury to the pigmented rabbit ciliary body. The nonpigmented ciliary body epithelium exhibits selective retention of SnET2. This finding warrants further investigation.
Animals↗
Prostaglandin E2 binding site distribution and subtype classification in the rabbit iris-ciliary body.
The distribution and characteristics of specific binding sites for tritium labeled prostaglandin E2 (3H-PGE2) were examined in membrane preparations from rabbit iris-sphincter, iris and ciliary body. The majority of 3H-PGE2 specific binding sites were found in the ciliary body (46%) followed by the iris (37%) and the iris-sphincter muscle (5%). Scatchard analysis of saturable 3H-PGE2 binding sites in the ciliary body indicated a single binding site with a Kd of 2.81 nM and Bmax value of 84 fmoles bound/mg protein. Competition by agonists selective for the EP1, EP2 and EP3 receptor subtypes of the EP (PGE2) prostanoid receptor indicated that the majority of rabbit ciliary body 3H-PGE2 binding sites are of the EP2 subtype. Incomplete displacement of labeled 3H-PGE2 from its binding sites by the EP2 selective agonist 11-deoxy PGE1 suggests the presence of additional EP or non-EP binding sites. There was essentially no binding to EP1 receptor sites as defined by the displacement of 3H-PGE2 by 17-phenyl-trinor PGE2. A weak displacement of 3H-PGE2 by the EP3/EP1 specific agonist, sulprostone, may account for the presence of a small number of EP3 specific binding sites in this tissue. The predominant distribution of PGE2 binding sites in the ciliary body and their identification as EP2 selective, supports recent functional studies where topical application of prostanoids with EP2 but not EP1 or EP3 agonist activity resulted in breakdown of the blood-aqueous barrier.
Animals↗
Ciliary body melanoma masquerading as chronic uveitis.
PURPOSE: To report a case of ciliary body melanoma that masqueraded as chronic uveitis. METHODS: A patient experienced persistent unilateral panuveitis and elevated intraocular pressure. Inflammation and pressure worsened after cataract extraction and lens implantation. Diagnostic vitrectomy was non-revealing. RESULTS: Repeat vitrectomy and lens implant removal revealed a ciliary body mass, suggestive of melanoma. Ultrasonography and clinical evaluation by the retinal oncologists supported this diagnosis. The uveitis persisted despite aggressive medical treatments, including methotrexate. Proton beam irradiation of the melanoma led to resolution of uveitis and restoration of normal intraocular pressure. CONCLUSION: Ciliary body melanoma can present as chronic uveitis and refractory glaucoma.
Cataract Extraction↗
Prostaglandin E2 and F2 alpha binding sites in the bovine iris ciliary body.
PURPOSE: To determine the regional distribution and selectivity of prostaglandin E2 (PGE2) and prostaglandin F2 alpha (PGF2 alpha) specific binding sites in membrane preparations from bovine iris ciliary body. METHODS: Bovine eyes were obtained fresh from a local abattoir. Whole irides were separated into sphincter muscle, ciliary body, and remaining iris tissue then homogenized in 50 mM tris buffer, pH 7.5, containing cyclooxygenase, protease, and soybean trypsin inhibitors. Membranes were obtained after three-stage high-speed centrifugation then reconstituted in buffer. Aliquot portions were incubated with 3H-PGE2 or 3H-PGF2 alpha at 37 degrees C for 30 min in a final volume of 500 microliters. Competition studies were performed in the presence of up to 1000-fold excess unlabeled ligand. At the end of a 30-min incubation period, free and membrane bound ligand were separated by rapid filtration through a type HA millipore filter preequilibrated with buffer. The radioactivity bound to the membranes retained on the filter was quantitated in a scintillation counter. RESULTS: The equilibrium dissociation constant and maximum number 3H-PGE2 saturable binding sites were determined by Scatchard analysis. The data best fit to a single binding site model for all three membrane preparations. The majority of the 3H-PGE2 specific binding sites were in sphincter muscle (65%), followed by iris (17%), and ciliary body (18%). 3H-PGE2 alpha binding sites were not measurable in either iris or ciliary body and PGF2 alpha was less competitive than PGE2 in all tissues. The rank order of potency for agonist displacement by both 3H-PGE2 and 3H-PGF2 in sphincter muscle membrane was PGE2 > PGF2 alpha > PGD2 > Iloprost. It was determined that 3H-PGE2 and 3H-PGF2 alpha binding in the bovine sphincter was primarily to EP not FP, DP, or IP prostaglandin receptor types. CONCLUSIONS: The characteristics of PGE2 and PGF2 alpha specific binding sites in the bovine sphincter correlate with its in vitro contractile response to these prostanoids. The inability of PGF2 alpha to effectively compete with PGE2 for specific binding sites in the sphincter and lack of high affinity PGF2 alpha specific binding sites in the iris and ciliary body suggests that this prostaglandin may exert its in vivo effects through PGE2 specific binding sites.
Animals↗
Detection of EP1 and FP receptor mRNAs in the iris-ciliary body using in situ hybridization.
OBJECTIVE: To determine the expression of E-prostanoid1 (EP(1)) and F-prostanoid (FP) receptor mRNAs in iris-ciliary bodies of the human eye using in situ hybridization. METHODS: EP(1) and FP receptor mRNAs were detected by riboprobes labeled with digoxigenin on paraffin sections of the iris-ciliary body tissue of the human eye using in situ hybridization. RESULTS: EP(1) and FP receptor mRNAs were highly expressed in blood vessels, muscles and the endothelia of the iris. EP(1) receptor hybridization signals were present in all muscle fibers of the ciliary body. Hybridization signal corresponding to FP receptor mRNA transcript was predominantly expressed in the circular muscle and in the collagenous connective tissues of the ciliary body. FP receptor mRNA was not detected in radial and longitudinal muscles. CONCLUSIONS: EP(1) and FP receptor mRNAs in human ocular tissues appear to be widely localized in the functional sites of the respective receptor agonists. Selective localization of EP(1) and FP receptor mRNAs in the circular muscles and collagenous connective tissues of the ciliary body suggests that EP(1) and FP receptors play an important role in enhancing uveoscleral outflow of aqueous humor.
Ciliary Body↗
PMN accumulation in aqueous humor and iris-ciliary body during intraocular inflammation.
The accumulation of polymorphonuclear leukocytes (PMNs) was determined in the aqueous humor and iris-ciliary body following an intravitreal injection of endotoxin in the albino rabbit. PMN accumulation in the iris-ciliary body was quantified by measuring myeloperoxidase (MPO) activity in homogenates of this tissue. Leukocyte appearance in the aqueous humor was determined by counting the number of PMNs in diluted aspirates of aqueous humor and also by measuring MPO activity in the same aspirates. Twenty-four hours following an intravitreal injection of endotoxin, there was marked vasodilatation in the iris, breakdown of the blood-aqueous barrier, and infiltration of PMNs into the aqueous humor. There was, however, no correlation between MPO activity in the iris-ciliary body and the number of PMNs or the MPO activity in the aqueous humor. Furthermore, the number of PMNs in the aqueous humor did not increase with increasing amounts of intravitreally injected endotoxin, whereas MPO activity in the iris-ciliary body increased in a dose-dependent manner. The results of this study suggest that quantification of leukocytes in the aqueous humor does not represent a meaningful index of intraocular inflammation.
Animals↗
[The histogenesis, clinical features and histopathological analysis on 52 cases of ciliary body neoplasms].
OBJECTIVE: To analyze the histogenesis, classification, incidence, clinical feature, the key point of differential diagnosis and histopathologic characteristics of ciliary body neoplasms to provide the basis for clinical diagnosis and treatment. METHOD: 52 specimens of ciliary body neoplasms on file were analyzed and studied for the characteristics of clinical presentation and histopathology. RESULTS: Of the 52 specimens, 38 were located in the ciliary body (73.1%), and 14 lesions involved the iris (26.9%). According to the results of histogenetic classification, the tumors of ciliary sensory epithelium were ranked the first place (20 cases, 38.5%) while malignant melanoma, the second one (14 cases, 26.9%) followed by melanocytoma (9 cases, 17.3%) and granulomatous lesions (5 cases, 9.6%). CONCLUSION: The clinical features and histopathologic characteristics of ciliary body neoplasms are systemically and deeply recognized, that may help clinical ophthalmologists to make correct diagnosis and proper treatment.
Adolescent↗
[New reconstructive surgery in traumatic detachment of the ciliary body with recession of the angle of the anterior chamber].
Penetrating wounds of the corneoscleral area are remarkable for particularly severe course of posttraumatic period, this being explained by direct injury to the ciliary body, impaired anatomic relationships in the anterior chamber corner, formation of this corner recession, this resulting in detachment of the ciliary body and development of the hypotonic syndrome. The authors suggest a new surgical technique of reconstructing the anterior chamber corner in its recession and detachment of the ciliary body with the aim of correcting the hypotension and fortifying the ciliary body at the site of its anatomic localization. This method was used in the treatment of 32 patients with subatrophy, detachment of the ciliary body, and hypotension; positive effect was achieved in 28.
Anterior Chamber↗
Constitutive expression and localization of COX-1 and COX-2 in rabbit iris and ciliary body.
Prostaglandins are involved in the regulation of intraocular pressure and the blood-aqueous barrier of the eye, and are used for the treatment of glaucoma. The decrease of the constitutively expressed PG-synthesizing enzyme cyclooxygenase-2 (COX-2) has been demonstrated in the ciliary non-pigmented epithelial layer of patients with primary open angle glaucoma. Little is known about the distribution of COX-1 and COX-2 in animals. We investigated this in the iris and ciliary body of the normal rabbit eye. The presence of COX-1 and COX-2 in freshly excised iris and ciliary body tissue from adult New Zealand White albino rabbits was demonstrated by real-time RT-PCR, and Western blot analysis. The localization of both isoforms and of the neuron-specific protein gene product 9.5 was determined by indirect immunofluorescence. Both enzymes are expressed in the iris and the ciliary body. Immunofluorescence studies including double staining techniques localized COX-1 and COX-2 to about 50% of cells in the stromal tissue of iris and ciliary body, mainly on the corneal side. They were co-localized in about 75% of these cells. Whereas all stained cells were positive for COX-1, COX-2 showed a gradient-like distribution in the stroma, with some restriction of expression near the epithelial layers, which we clearly showed to be completely negative for both COX-1 and COX-2. Also, neuronal elements did not show COX-1 or COX-2 immunoreactivity. These results establish the presence of COX-1 and COX-2 on the RNA and protein levels in normal, unstimulated rabbit iris and ciliary body. The pattern of distribution suggests a role for both enzymes in maintaining the physiology of the eye. In contrast to our results in man, non-pigmented epithelial cells of the ciliary body did not express immunoreactivity. This could account for differences in the regulation of intraocular pressure and/or blood-aqueous barrier between human and rabbit eyes.
Animals↗
Recurrent mesectodermal leiomyoma of the ciliary body: a case report.
A 19-yr-old woman with a previous history of a mass of the right ciliary body presented with a decreased visual acuity of right eye. Clinicoradiologic examinations suggested a recurrent mass of the ciliary body. Enucleation of the right eye was performed under the impression of malignant tumor. On microscopic examination, the tumor was a mesectodermal leiomyoma of the ciliary body. On immunohistochemistry, the tumor cells were reactive to smooth muscle actin and vimentin, but not reactive to cytokeratin, S-100 protein, neurofilament, desmin, epithelial membrane antigen, HMB-45, glial fibrillary acidic protein, and synaptophysin. Electron microscopy revealed numerous thin longitudinally placed myofilaments and focal densities in the cytoplasms. In the review of the literature, only 27 cases of mesectodermal leiomyoma of the ciliary body were reported, however, there was no report of recurrent cases. Mesectodermal leiomyoma should be differentiated from other orbital spindle-cell tumors such as amelanotic melanomas and glial tumors. Immunohistochemical and electron microscopic studies may be useful for the correct diagnosis by showing smooth muscle differentiation in the tumor cells.
Actins↗
Leiomyoma of the ciliary body extending to the anterior chamber: clinicopathologic and ultrasound biomicroscopic correlation.
Leiomyoma of the ciliary body is a rare tumor that often causes a diagnostic dilemma. Sclerouvectomy has been found to be beneficial in the management of iris and ciliary body leiomyoma. We treated a case of leiomyoma of the ciliary body presenting as a fleshy mass in the anterior chamber, removed by partial lamellar sclerouvectomy. Ultrasound biomicroscopic and histopathologic features, including light microscopic, immunohistochemistry, and transmission electron microscopic features, were studied and the literature was reviewed.
Actins↗
Molecular and biochemical analysis of ceruloplasmin expression in rabbit and rat ciliary body.
PURPOSE: To verify the capability of rabbit and rat ciliary body to synthesize and secrete ceruloplasmin. METHODS: Isolated ciliary body (CB) was cultured in the presence of [35S]-methionine, and the incubation medium was processed for immunoprecipitation. Total RNA from CB was processed for RT-PCR, and the amplification products were sequenced. Also, sections of CB were immunostained for the localization of ceruloplasmin. RESULTS: A labeled peptide, having a molecular weight of about 135 kDa, the expected size of ceruloplasmin, was immunopurified in the incubation media from both animal species. The RT-PCR and sequencing experiments detected the presence of ceruloplasmin mRNA in rat samples. Both layers of rabbit and rat ciliary epithelium (CE) exhibited ceruloplasmin reactivity after immunohistochemical processing. CONCLUSIONS: Taken altogether, these results indicate the CB, particularly its epithelium, as one of the possible sources of the ocular intrinsic ceruloplasmin.
Animals↗
Adenoma of the nonpigmented epithelium of the ciliary body.
A 42-year-old woman developed a ciliary body mass which indented the lens equator and produced a dense focal cataract in the right eye. The clinical diagnosis was malignant melanoma of the ciliary body, and the lesion was removed by a large iridocyclectomy. Histopathologic examination revealed an acquired adenoma of the non-pigmented ciliary epithelium. The clinical and histopathologic features of this rare intraocular tumor are discussed with emphasis upon its differentiation from malignant melanoma.
Adult↗
[An experimental study of pathomorphology in the iris and ciliary body after intraocular lens implantation].
OBJECTIVE: To study the pathological changes and morphological features in the iris and ciliary body after lens extraction and intraocular lens (IOL) implantation in rabbits and discuss the mechanism of postoperative intraocular inflammatory response. METHODS: 27 adult pigmented rabbits were divided into three groups, (1) extracapsular lens extraction and IOL implantation. (2) simple extracapsular lens extraction, and (3) the control group without surgical intervention. The iris and ciliary body in every eye were taken on the 1st, 7th and 14th days after surgery, their pathological changes were observed with light microscopy, and the number of inflammatory cells were counted. The data were analyzed by using analysis of variance of SAS software. RESULTS: The pathological changes might be divided into three stages: (1) acute inflammation and exudative changes in the early stage (on the 1st day postoperatively), (2) subacute inflammation and granuloma formation in the middle stage (on the 7th day postoperatively, and (3) chronic inflammation and fibrosis in the late stage (on the 14th day postoperatively). CONCLUSION: The inflammatory cells in the iris and ciliary body are significantly higher in eyes with IOL implantation than that in eyes with simple extracapsular lens extraction (P < 0.01). Besides macrophages, there are many lymphocytes, eosinophils and plasma cells in the iris and ciliary body, suggesting that an active immune response exist in the inflammation.
Animals↗
Ciliary body is not hyperplastic in Weill-Marchesani syndrome.
PURPOSE: To demonstrate the in-vivo morphology of the ciliary body in Weill-Marchesani syndrome which might be of pathophysiological importance for the spherical shape of the crystalline lens. METHODS: Three juvenile patients with Marchesani syndrome were examined by ultrasound biomicroscopy of the anterior segment. RESULTS: The in-vivo configuration of the ciliary body in these Weill-Marchesani patients with normal axial length of the eye showed no signs of hyperplasia, and was even relatively small. CONCLUSION: Spherophakia and hyperplasia of the ciliary body are not necessarily associated with the syndrome, as supposed by Marchesani and other investigators. Instead, spherophakia might be regularly accompanied by a small ciliary body in Weill-Marchesani syndrome.
Abnormalities, Multiple↗
An epithelioma of the ciliary body.
A 57-year-old woman developed a ciliary body mass which compressed the anterior side of the lens with focal cataract causing the iris to protrude into the anterior chamber. The lesion was removed by a large iridocyclectomy. The mass was classified as an epithelioma of the ciliary body, which was consistent with a benign epithelioma, i.e. an adenoma of the nonpigmented ciliary epithelium. Light and electron microscopic examinations revealed that the tumor cells had characteristics of both the ciliary and iris epithelium, which originated from the neuroectoderm, including abundant cytoplasmic filaments, and pheomelanosomes, and that the gland-like lumen was the pseudoacinous lumen, i.e. invaginated stroma containing the vitreous.
Adenoma↗