Metabolic, pediatric, and systemic ophthalmology最新文献

The paper presents the results of the study on oxygen metabolism in glaucoma patients. In the study a combined method, including oxyhemography and polarography, was used: a) for the determination of the tissue oxygen absorbtion constant (TOAC); and b) for the determination of the blood oxygen discharge rate (BODR) performed by the method of polarographic coulonometry. In 93 glaucoma patients, various forms, stages, and intraocular pressure compensation degree were examined. The results of the oxyhemographic measurements showed oxygen deficiency in the majority of patients. In 41 patients, TOAC determination showed the increase of these values by 38%. The blood oxygen discharge rate (BODR) also exceeded the norm. The above-mentioned results indicate some significant errors of the oxygen metabolism at all stages of glaucoma.

There is considerable evidence which supports a link between abnormalities in copper metabolism and some pigmentary retinopathies. In a previous study, we found such abnormalities in high myopic Caucasian patients. Since the incidence of myopia, and the connection of the latter with retinal detachment, in the black are different from those found in the Caucasian, we modeled the present study on the black after the above-mentioned one carried out on the Caucasian. In the present study no abnormalities in copper metabolism were present, in the black high myopic patient.

We performed epikeratophakia for the correction of aphakia in 31 children, ages 2 months to 7 years, who had unilateral congenital or traumatic cataracts. In 27 patients with more than 4 months of follow-up, 23 of 30 (77%) grafts were successful. In the 15 patients with 6 months or more followup, the average increase in corneal curvature was 12.39 diopters. The average overrefraction needed to achieve emmetropia was + 2.14 diopters spherical equivalent. Two patients operated on within the first year of life have achieved 6/15 (20/50) visual acuities, as measured by visual evoked potentials. One patient operated on in the second year of life achieved 5/30 visual acuity, as measured by Allen cards. Two patients operated on for traumatic cataracts at ages 2 and 4 years achieved 6/9 (20/30) and 8/30 (Allen cards) visual acuities, respectively. Five older patients who had congenital cataracts or persistent hyperplastic vitreous showed some improvement in visual function. Advantages of epikeratophakia include the placement of most of the correction directly on the eye in a permanent attachment and the elimination of contact lens manipulation in uncooperative patients, so that more time and energy can be devoted to the occlusion therapy.

The level of non-protein sulphydryl compounds (NP-SH) and protein sulphydryls (P-SH) was investigated in lenses of rats with an acute and extended insulin induced hypoglycemia. No difference was found in the level of NP-SH between the controls and the rats with an acute hypoglycemia induced by cristalline insulin. After 10 hours of hypoglycemia induced by NPH insulin, the decrease of NP-SH was very significant (P less than 0.001). The level of P-SH in lenses of the animals treated with cristalline insulin was found to be lower than in the controls (P less than 0.01), the difference being more significant in the animals treated with NPH insulin (P less than 0.001). The possible reason for these findings is discussed.

The pupil cycle time (PCT) was prolonged in 11 subjects with familial dysautonomia. In the younger age group (10-19 years), mean PCT was 872 +/- 88 msec as compared to 15 normal age matched controls (728 +/- 88). In the 3 oldest patients (30-39 years) mean PCT was 980 +/- 133 msec as compared to 13 age matched normals (748 +/- 56). It is proposed that prolongation of PCT in familial dysautonomia may be due to functional denervation of the iris or that it is a result of a structural abnormality of its musculature and/or its neuromuscular junctions.

The clinical studies reviewed here indicated the usefulness of topical application of Human-fibroblast-derived (Beta) interferon (HulFN-B) in treatment of Adeno-8 Epidemic-keratoconjunctivitis. A week treatment with 2-5 X 10(5) reference units daily doses, starting early as possible, reduced the length of the disease from 22 day to a week, and almost totally prevented the appearance of subepithelial keratitis which occurred in 57% of the control group. Possibly interferon should be given also prophylactically to individuals exposed to contagion. Our results encourage further investigation on the Hul FN-B use as a drug for treatment and prevention of viral infection.

This paper presents an account of a series of parallel experiments aimed at determining the relationship of biochemical and biomechanical qualities of the scleral membrane of the human eye. In all, 59 scleras of humans were tested, including 47 normal scleras of people belonging to different age groups and 12 myopic scleras of mature eyes. It is demonstrated that eye formation in ontogenesis is accompanied by thickening of all scleral regions, especially the posterior region, accumulation of collagen and elastin in the posterior pole par excellence, a reduced share of soluble collagen fractions, a lower content of glycosaminoglycanes in the equatorial region and an increase of tensile strength and elasticity module. The authors distinguish a so-called group of risk marked by a reduced content of collagen in the posterior scleral region as well as a delayed decrease of its soluble fractions with age in the posterior and in the equatorial regions and a diminished tensile strength. For this group, the appearance and progress of myopia is rather probable.

A case of glaucomatocyclitis crisis with recurrent episodes of increased I0P, abnormal appearance of the angle structure and periphlebitis was presented. Some of these episodes involving first one eye and later occurring bilaterally were characterized by absence of flare in the anterior chamber. It is suggested that protein leakage following retinal periphlebitis or an inflammatory reaction involving the ciliary body might be the underlying mechanism for the elevated ocular pressure. The abnormal angle structure in our patient favored this protein glaucoma. A permanent increase in I0P observed at the latter stages of the disease indicate that the trabecular meshwork might be damaged irreversibly by protein glaucoma.

The clinical value of five synthetic antiherpetic nucleosides is discussed: iododeoxyuridine (IDU), adenine-arabinoside (Ara-A), trifluorothymidine (TFT), acyclovir (ACV), and bromovinyldeoxyuridine (BVDU). Depending on the type of herpes simplex virus eye disease, either TFT or ACV are currently the drugs of choice. For BVDU, further controlled studies have to be awaited. For the special situation of superficial herpetic keratitis (dendritic keratitis), a combination therapy with either TFT or ACV plus interferon has proven to be significantly better than a monotherapy with only nucleosides.

Steroids that inhibit glucose-6-phosphate dehydrogenase (G6PD) were used to examine the correlation between the loss of GSSG-reducing activity and G6PD deficiency in the lens. The correlation was found to be nonlinear. In senile cataracts, which had lost 36% of NADPH-generating activity as compared to clear lenses, the estimated loss of GSSG reduction was only 20%. On the other hand, lenses with severe G6PD deficiency (i.e. 93% loss) retained at least 28% GSSG-reducing activity. The declined reducing activity, however, suggested a possible role of G6PD deficiency in cataract formation in young patients.