Metabolic, pediatric, and systemic ophthalmology (New York, N.Y. : 1985)最新文献

With the use of automated vitrectomy instruments a new dimension has been added to the treatment of soft cataracts. Surgical approach through the limbus and pars plicata has been described previously. This work is to compare the results of both surgical techniques. Twenty eyes of soft cataract underwent lensectomy and vitrectomy using the vitrophage. Pars plana approach was applied to 10 eyes, while limbal approach was applied to the rest of the cases. No major preoperative or postoperative complication were encountered in both techniques in a follow up period up to 12 months. However, pars plana lensectomy and vitrectomy offers many advantages over the limbal one with minimal complications.

Altered platelet function has been reported in diabetic patients. This article reports plasma levels of beta-thromboglobulin and platelet factor 4 as measures of in vivo platelet activity in diabetic and control groups. Both beta-thromboglobulin and platelet factor 4 were significantly higher in diabetics than in controls (p < 0.01). The levels observed were not significantly affected by age, sex, diabetes type or whether the diabetic had nonproliferative or proliferative retinopathy, but beta-thromboglobulin levels were significantly higher in diabetics of less than 10 years standing than in those who had suffered diabetes for over 20 years (p < 0.05).

Posterior capsule opacification (PCO) is the most frequent complication following extracapsular cataract extraction (ECCE). To evaluate the rate of PCO we examined 939 eyes (786 patients) following ECCE after a period of 26.3 months on the average. In 202 eyes (21.5%) cataract was associated with a clinically manifest type I or type II diabetes mellitus. The overall incidence of PCO was 28.1% (264 eyes). In patients with no other diseases (371 eyes, 100%) it was 33.4% (124 eyes). Out of 202 eyes (100%) associated with diabetes PCO was seen in 21.8% (44 eyes). This difference was statistically significant (p = 0.05). Average age and sex did not differ significantly in both groups. In diabetic patients the lens epithelial cells show accumulation of sorbitol and fructose which is proposed to contribute to cataract formation by disturbing cellular metabolism. This mechanism may explain our findings of a lower incidence of PCO possibly caused by reduced proliferation of lens epithelial cells.

This study concerns the quantitative modifications of the prostaglandins, PGF alpha e PGE2, in the vitreous and in the lens following the application of Nd-Yag Laser. Five minutes after the Yag-laser treatment, an increase of PGF1 alpha concentration of PGE2 decreased in the lens and increased in the vitreous. These changes, similar to those occurring in the aqueous humor, may be related to the activation of specific enzymatic pathways of prostaglandin synthesis.

A case of rhegmatogenous retinal detachment with high myopia is presented in a 17 year old boy with the typical characteristics of the Rubinstein-Taybi syndrome. Although multiple eye anomalies are known to occur in this syndrome, the occurrence of retinal detachment has not been reported up to now. The importance of including a thorough fundus examination in the routine eye examination of these patients is emphasized.

Two cases of a brother and a sister with characteristic manifestations of Vogt-Koyanagi-Harada syndrome are presented. To the best of our knowledge, this is the first report of a typical appearance of Vogt-Koyanagi-Harada syndrome in two siblings.

Ocular posterior aging degeneration syndrome (OPADS) is related to age excepting inflammation, trauma, tumor, congenital abnormalities. Clinically, it can be divided into several types: degeneration, pre-retinal membrane, hole and mixed types. Changes can be seen in the choroidoretina with fluorescein angiography. In the degeneration type, there are changes of chroid-blood vessels, pigment epithelium and neovasculization. The manifestation in pre-retinal membrane type are small vascular tortuosity, expansion or fluorescein leadage, retinal pigment epithelium window defects. The hole type shows lack of retinal capillaries and retinal pigment epithelium window defects. Visual electrophysiological tests by various intensities and colors show the abnormal ERG. The bio-electricity active changes indicated the correlation among several ocular posterior aging degeneration types.

Inborn errors of metabolism are a substantial field of medicine. Although genetic syndromes associated with cataracts are rare, they are important since early detection and effective treatment of visual handicaps is one of the most urgent duties of any practitioner and pediatrician. Cooperation among pediatricians, ophthalmologists, orthoptists and geneticists, as well as the institution of a high-risk registry for visual handicaps appears to be of paramount importance.

Three middle-aged and elderly patients presenting with their first attack of acute anterior uveitis (AAU) were found to have previously undiagnosed diabetes mellitus. A first attack of AAU is unusual in this age group and may indicate underlying systemic disease. Diabetes is an infrequent cause of uveitis but should be considered in the differential diagnosis. It is important to be aware of this uncommon presentation of the disease, thereby stating the value of performing routine urinalysis in AAU.

Since many years experimental evidences have suggested an association between nutrition and lens opacities. A dietary deficiency of antioxidants and reactive oxygen scavengers may be involved in the pathogenesis of the "idiopathic" human senile cataract, as it has been demonstrated in some experimental cataracts. We tested the levels of ascorbic acid (vit. C), alpha-tocopherol (vit. E), reduced glutathione (GSH) and malondialdehyde (MDA) in the plasma or in the red blood cells (RBC) of 42 patients who were affected by surgically significant cataract and of 40 age-matched controls. Plasma vit. C mean level was 4.46 gamma/ml in cataracts and 4.62 gamma/ml in controls, while vit. E level was 7.70 and 7.09 gamma/ml respectively. RBC GSH was found to be 342 gamma/ml in cataracts and 346 in controls, while the MDA content was 4.06 picoMol/ml and 4.08 picoMol/ml respectively. The level of each tested nutrient or metabolite was not found to be statistically different between cataractous patients and controls, nor any significant trend was found to be present when the nutrients and metabolites were correlated to each other. Our results do not support the hypothesis of a nutritional deficiency in human senile cataracts. However, a defect in the antioxidative metabolism pathways could be present either systemically or at lens level.