Axial length increases and related changes in highly myopic normal eyes with myopic complications in fellow eyes.

PURPOSE: To determine whether the axial length (AL) in highly myopic normal adult eyes with myopic complications in the fellow eyes increases significantly during a 1-year interval and to investigate the relationships between the changes in the AL and different ocular parameters. METHODS: The medical records of 20 highly myopic normal eyes whose fellow eyes had myopic complications were reviewed. The AL, subfoveal choroidal thickness, height of a posterior staphyloma, and length of the retinal pigment epithelium from the fovea to 3-mm superior, inferior, nasal, and temporal retina were measured twice at an interval of approximately 1 year. The changes in these ocular parameters and their correlations were investigated. RESULTS: The AL increased, the choroid became thinner (both P < 0.001), the superior (P < 0.05) and temporal (P < 0.01) staphyloma height increased, and the superior and temporal retinal pigment epithelial length increased (both P < 0.01). All the changes were significant. Stepwise analyses indicated that the factor most associated with the increase in the AL was the increase in the superior retinal pigment epithelial length (P < 0.001). CONCLUSION: Our results indicate that the AL can increase significantly in highly myopic normal adult eyes during a 1-year interval, and the increase in the posterior staphyloma height is the most likely cause for the increased AL.

Immunolocalization of vascular endothelial growth factor on intramuscular ectopic osteoinduction by bone morphogenetic protein-2.

When recombinant human bone morphogenetic protein-2 (rhBMP-2) is implanted in soft tissues, bony tissue is induced during the course of endochondral ossification. The relationship between endochondral ossification and vascularization is important in bone formation, and vascular endothelial growth factor (VEGF) is considered to play an important role in this process. In this study, the immunohistological localization of VEGF was investigated in rhBMP-2-induced ectopic endochondral ossification in the calf muscle of rats. In addition, the characteristics of anti-VEGF antibody-reactive cells were histologically investigated using electron microscopy to examine the cause of endochondral ossification induced by recombinant human bone morphogenetic protein-2. The role of VEGF in rhBMP-2-induced osteoinduction and vascular induction was studied by observing the relationship between the localizations of anti-VEGF antibody-reactive cells and vascularization. During the process of rhBMP-2-induced ectopic endochondral ossification, fibroblast-like cells, which were located at the margin of the implant and reactive to BMP-2 at 5 days, were positive for VEGF immunostaining. Hypertrophic chondrocytes appeared 9 days and osteoblasts appeared 14 to 21 days after implantation, and all these cells were reactive with anti-VEGF antibody. Bony trabeculae subsequently appeared in the muscle, and new blood vessels were formed alongside the trabeculae. When VEGF was added to rhBMP, more new blood vessels and bone were formed in the induced bone. These findings suggested that rhBMP-2 induced the differentiation of undifferentiated mesenchymal cells to chondrocytes and osteoblasts, and these differentiated cells expressed VEGF, creating an advantageous environment for vascularization in bony tissue.

Coccygeal Pad With an Anterior Flexed Coccyx: A Case Report.

Objective: A coccygeal pad is a nodular lesion in the sacrococcygeal area. It is a rare disease characterized by corneal thickening, the proliferation of collagen bundles, and an anterior flexed coccyx. In the English literature, 42 patients have been reported. Methods: We present a young male case of a typical coccygeal pad with an anterior flexed coccyx. Results: After resection of the nodule and coccygectomy, there has been no recurrence during the 6-month postoperative follow-up. Conclusions: Plastic surgeons should recognize this as a disease to be differentiated from gluteal skin tumors.

Changes in vitreous temperature during intravitreal surgery.

PURPOSE: To determine how different intraoperative surgical procedures affect the midvitreous temperature. METHODS: The vitreous temperatures were monitored continuously with an intravitreal thermocouple in 87 eyes of 81 cases undergoing vitrectomy. Thirty-three eyes had diabetic retinopathy (DR), 35 eyes had an epiretinal membrane, and 19 eyes had an idiopathic macular hole. In eyes with DR, the correlation between the number of photocoagulations (PCs) and the change in temperature was analyzed. The temperature was also recorded before and after combined phacoemulsification and aspiration (PEA) and vitrectomy in 10 eyes. RESULTS: The average midvitreal temperature before the vitrectomy was 33.0 ± 1.3°C, 30.7 ± 1.7°C after core vitrectomy, 32.9 ± 1.3°C after membrane peeling, and 29.2 ± 1.4°C after peripheral vitrectomy. The temperature before PC was 29.8 ± 1.3°C, and it increased to 31.5 ± 1.9°C post-PC. The differences in the temperatures between consecutive procedures were significant (P < 0.01, respectively, Wilcoxon signed-rank test). The difference in the temperatures of the same procedures among the different diseases was not significant except after membrane peeling. A significant correlation was detected between the number of PCs and the duration of the PCs, and between the duration of PCs and the change in vitreous temperature after PC (r = 0.719, P = 0.0010, and r = 0.800, P = 0.0002, respectively, Spearman's rank correlation coefficient test). The temperature after PEA decreased significantly by 2.3°C. CONCLUSIONS: Our results showed that vitreous temperatures vary during different vitrectomy procedures.

Correlation between cross-sectional shape of choroidal veins and choroidal thickness.

PURPOSE: To determine whether a significant correlation exists between the ratio of the vertical and horizontal diameters of the choroidal veins and the choroidal thickness in normal eyes. METHODS: Six clinic-based normal eyes were studied. The macula and retina around the optic disc were examined by spectral-domain optical coherence tomography (OCT) during indocyanine green angiography (IA), and choroidal thickness maps were constructed. The vertical and horizontal diameters of the choroidal veins in the OCT images and horizontal diameters in the IA images in the venous phase were measured at 12 locations of different choroidal thickness. The horizontal diameter of the choroidal veins measured in the OCT images and the corresponding IA images were compared, and the correlation between the ratio of the vertical and horizontal diameters of the choroidal veins and the corresponding choroidal thickness was determined. RESULTS: The horizontal diameters of the choroidal veins measured in IA and OCT images were not significantly different and were significantly correlated (r = 0.73; P < 0.01). The ratio of the vertical and horizontal diameters of the choroidal veins was significantly correlated with the choroidal thickness (r = 0.85; P < 0.001). CONCLUSION: The significant correlation between the ratio of the vertical and horizontal diameters of the veins to the choroidal thickness should be considered when the cross-sectional area of the choroidal veins is evaluated.