RESUMO
Self-directed learning based on adult education theory and self-assessment are necessary for continuing medical education. Self-directed learning is the process whereby the individual takes the initiative in diagnosing his learning needs and setting his own individual learning goals, showing clearly the human and physical resources, putting an appropriate plan into practice, and evaluating the learning outcome. Because self-assessment is the evaluation of the process where the individual confirms his actual learning, portfolio assessment is utilized for this purpose. In the continuing medical education program of the Japanese Ophthalmological Society, it is vital that the appropriate credit and recognition program keep up with the changes in adult education theory. Therefore, portfolio assessment is introduced for self-assessment. The Ophthalmic Pathology Slide Seminar is a model of medical education based on self-directed learning.
Assuntos
Educação Médica Continuada/tendências , Oftalmologia/educação , Educação Médica Continuada/métodos , Humanos , Japão , Modelos Educacionais , Autoavaliação (Psicologia) , Sociedades MédicasRESUMO
PURPOSE: To analyze the effect of indocyanine green (ICG) dye on cultured Müller cells. METHODS: Cultured quail Müller cells were exposed to ICG dye at different temperatures and ICG concentrations for different exposure duration. Viability and death of the Müller cells were determined spectrophotometrically. RESULTS: The cells did not change in viability or morphology soon after the exposure to ICG at 20 degrees C. However, further cultivation of the ICG-exposed cells after washing out ICG caused cell death and morphological changes depending on dose and duration of the preceding ICG exposure at 20 degrees C. Although ICG exposure at a higher concentration and longer duration induced more cell death and reduced cell viability, ICG exposure at a lower concentration and shorter duration raised cell viability in spite of increased cell death. ICG exposure at 37 degrees C for 60 minutes induced morphological changes soon and the cells were stained more intensively with ICG than with exposure at 20 degrees C. Shortened exposure of three minutes at 37 degrees C showed less change of cell viability and cell death than exposure of 60 minutes. CONCLUSION: ICG exposure at 37 degrees C caused earlier and more cell death than exposure at 20 degrees C. The cytotoxicity of ICG on Müller cells was dose and exposure-time dependent.
Assuntos
Sobrevivência Celular/efeitos dos fármacos , Verde de Indocianina/toxicidade , Neuroglia/citologia , Neuroglia/efeitos dos fármacos , Retina/citologia , Retina/efeitos dos fármacos , Animais , Células Cultivadas , CodornizRESUMO
PURPOSE: Miosis and anterior chamber inflammation-like reactions were recognized after six instillations of 0.1% cyclosporin A eye drops every 30 minutes into rabbit conjunctival sacs. In order to consider species specificity, 0.1% cyclosporin A eye drops were applied by the same method in monkeys. METHODS: Eye drops were applied in five monkeys (monkey A, B, C, D, E); in one eye as control and in nine eyes with 0.1% cyclosporin A. We investigated the changes of pupil diameter, intraocular pressure, and anterior chamber flare before and after applying the eye drops. We also examined the effect on ocular tissue histopathologically. RESULTS: Miosis was recognized in six eyes, but no significant intraocular pressure change was observed in any eyes. In both eyes of monkey A anterior chamber flare increased significantly, and flare increased slightly in both eyes of monkeys B, C, and D. On the other hand, there was no change in either eye of monkey E, including the control eye. Localized necrosis of nonpigmented ciliary epithelium was recognized at the beginning of the ciliary process in both eyes of monkey A. Mild cystoid degeneration of nonpigmented ciliary epithelium was seen at the beginning of the ciliary process in the right eye of monkey C, and in the left eye of monkey D. CONCLUSION: No species specificity can be recognized in monkeys from the fact that there is the selective destruction of nonpigmented epithelium at the beginning of the ciliary process after repeated instillation of 0.1% cyclosporin A eye drops, although there was a difference in miosis and anterior chamber inflammation-like reaction in individual monkeys.
Assuntos
Câmara Anterior , Ciclosporina/efeitos adversos , Miose/induzido quimicamente , Animais , Ciclosporina/administração & dosagem , Haplorrinos , Inflamação/induzido quimicamente , Masculino , Soluções Oftálmicas/administração & dosagem , Soluções Oftálmicas/efeitos adversos , CoelhosRESUMO
PURPOSE: To report a macular hole secondary to an idiopathic epiretinal membrane in a 14-year-old girl. DESIGN: Interventional case report. METHODS: A 3-year-old girl who failed a public visual-screening test was examined. Since then, she had been followed-up for her epiretinal membrane, which began to peel spontaneously in the left eye for 11 years until a macular hole was observed. She was treated by vitrectomy and membranectomy, and the membrane was histologically examined. RESULT: The macular hole was successfully closed, and her visual acuity improved. The membrane appeared to have a homogenous structure and contained no cells. CONCLUSIONS: The juvenile idiopathic epiretinal membrane sometimes peels spontaneously. However, long-term follow-up is needed because vitreous traction of the membrane by intraocular aging change may result in a macular hole.
Assuntos
Membrana Epirretiniana/complicações , Perfurações Retinianas/etiologia , Pré-Escolar , Membrana Epirretiniana/patologia , Membrana Epirretiniana/cirurgia , Feminino , Humanos , Perfurações Retinianas/patologia , Perfurações Retinianas/cirurgia , Tomografia de Coerência Óptica , Acuidade Visual , VitrectomiaRESUMO
PURPOSE: To compare the reactive proliferation of non-pigmented ciliary epithelial cells in patients with cyclitis, or after cyclophotocoagulation and cyclocryocoagulation, and the cultured non-pigmented ciliary epithelial cells from adult pigs. METHODS: Porcine ciliary epithelial cells were cultured and non-pigmented ciliary epithelial cells were isolated. Detection of DNA synthesis, morphological observation by a phase contrast microscope and a transmission electron microscope, and staining of senescence-associated beta-galactosidase were carried out. RESULTS: The cells proliferated without showing contact inhibition of growth or reconstitution of epithelial morphology. With a decrease of proliferative activity, the cultured cells expressed senescence-associated beta-galactosidase. Although DNA synthesis persisted for a long time, some cells in later culture periods showed morphologically abnormal nuclei or plural nuclei indicating dysfunction of cell division, or apoptotic features. CONCLUSION: The uncontrolled growth and loss of the epithelial nature of non-pigmented ciliary epithelial cells in vitro resembles the process of formation of cyclitic membrane and proliferation of ciliary epithelium after cyclophotocoagulation and cyclocryocoagulation in patients. Observatin of the behavior of cultured non-pigment epithelial cells could aid in understanding the mechanism of cyclitic membrane formation.
Assuntos
Corpo Ciliar/citologia , Células Epiteliais/citologia , Animais , Apoptose , Divisão Celular , Núcleo Celular/patologia , Células Cultivadas , Senescência Celular/fisiologia , Corpo Ciliar/enzimologia , Corpo Ciliar/ultraestrutura , Criocirurgia , DNA/biossíntese , Células Epiteliais/enzimologia , Células Epiteliais/ultraestrutura , Humanos , Fotocoagulação a Laser , Fotocoagulação , Microscopia Eletrônica de Varredura , Suínos , Uveíte Intermediária/patologia , beta-Galactosidase/metabolismoRESUMO
BACKGROUND: Magnetic resonance imaging (MRI) is useful in pathogenesis, diagnosis, and treatment. CASE: A 70-year-old man. He noticed that the right side of his upper lid had swollen 3 weeks previously. No abnormal findings were recognized in visual acuity, intraocular pressure, anterior segment, lens, vitreous, or fundus. From MRI findings 10 days after his first visit, dermoid cyst, soft tissue tumor, and nodular fasciitis were suspected. Because MRI 2 months after the first visit showed a decrease in tumor size, soft tissue tumor was ruled out. Finally histopathological examination revealed nodular fasciitis, although the findings during the operation did not differentiate between dermoid cyst and nodular fasciitis. CONCLUSION: MRI at different intervals was useful for clinical diagnosis.
Assuntos
Pálpebras/patologia , Fasciite/diagnóstico , Fasciite/patologia , Imageamento por Ressonância Magnética , Idoso , Diagnóstico Diferencial , Pálpebras/cirurgia , Fasciite/cirurgia , Humanos , Masculino , Monitorização Fisiológica , Fatores de TempoRESUMO
PURPOSE: To report two new forceps for use during and after external dacryocystorhinostomy (E-DCR). Description of surgical instruments is provided. METHODS: Interventional case series. The E-DCR forceps were modified from the usual ophthalmic forceps, and they were designed for grasping the posterior flaps in the narrow and deep surgical region. The washout forceps under the transnasal endoscopic (TNE) examination consists of the usual otolaryngeal forceps with an injector tip at the apex to wash out discharge around the ostium in the nasal cavity. RESULTS: In consecutive 28 E-DCR procedures cases (25 patients), E-DCR was successfully performed using the E-DCR forceps. This forceps was useful to suture the posterior flaps in all cases. The washout forceps was available to remove the congealed discharge that could not be aspirated. CONCLUSION: These two forceps proved to be useful during and after the E-DCR procedure.
Assuntos
Dacriocistorinostomia/instrumentação , Desenho de Equipamento , Humanos , Instrumentos Cirúrgicos , Técnicas de Sutura/instrumentaçãoRESUMO
PURPOSE: Exposure of Y79 cells, a retinoblastoma cell line, to sodium butyrate, a histone deacetylase inhibitor, induces neuronlike morphological changes and apoptosis. To determine whether the effect of butyrate results from an inhibition of histone deacetylation, we examined the morphological changes, cell viability, and histone acetylation levels of Y79 cells induced by butyrate and trichostatin A (TSA), a specific inhibitor of histone deacetylases. METHODS: Y79 cells cultured in a synthetic medium were exposed to butyrate or TSA, and the morphological changes and cell viability were followed. Actinomycin D was used to determine whether the morphological changes were transcription-dependent. The level of acetylated histone was determined by Western blotting and immunocytochemistry. RESULTS: Butyrate and TSA induced morphological changes and apoptosis of Y79 retinoblastoma cells in a dose-dependent manner. The morphological changes were sustained and reversible with butyrate but were transient with TSA. Actinomycin D completely inhibited the morphological changes induced by butyrate and TSA. The elevation of histone H3 levels was sustained and reversible in butyrate but transient in TSA. The change in histone H3 acetylation levels preceded the morphological changes and apoptosis. CONCLUSION: The induction of morphological changes by butyrate results from an inhibition of histone deacetylation and transcription.
Assuntos
Apoptose , Butiratos/farmacologia , Inibidores de Histona Desacetilases , Histonas/metabolismo , Neoplasias da Retina/patologia , Retinoblastoma/patologia , Acetilação , Western Blotting , Diferenciação Celular/efeitos dos fármacos , Divisão Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Eletroforese em Gel de Ágar , Inibidores Enzimáticos/farmacologia , Humanos , Ácidos Hidroxâmicos/farmacologia , Imuno-Histoquímica , Técnicas In Vitro , Neoplasias da Retina/enzimologia , Retinoblastoma/enzimologiaRESUMO
PURPOSE: To determine the utility of multifocal electroretinograms (mfERGs) in patients with early primary open-angle glaucoma (POAG) with unilateral visual field abnormalities. METHODS: mfERGs were recorded from 24 eyes of 12 cases of early POAG (stage I for 1 eye and stage II for the other eye on the Kosaki scale). The implicit times and amplitudes of the second-order kernel summed for the whole visual field, for the superior and inferior hemi-fields, and for quadrantic fields of the stage I and stage II eyes were compared. RESULTS: Neither the first- nor the second-order kernels of the mfERGs showed any changes reflecting glaucomatous visual field abnormalities. The implicit times and amplitudes of the second-order kernel summed for the whole visual field, the superior and inferior hemi-visual fields, and quadrantic visual fields of the stage I and stage II eyes were also not significantly different. CONCLUSIONS: We conclude that because the second-order kernel of the mfERG does not correlate with the visual field abnormality in early POAG, the second-order kernel of the mfERG that can be recorded at present is highly unlikely to reflect the function of the ganglion cells in the inner retinal layers.
Assuntos
Eletrorretinografia/métodos , Glaucoma de Ângulo Aberto/diagnóstico , Transtornos da Visão/diagnóstico , Campos Visuais , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes de Campo VisualRESUMO
PURPOSE: To report the molecular genetic analysis of a Japanese pedigree with Meesmann's corneal dystrophy (MCD). METHODS: Sequencing of the keratin 3 and keratin 12 genes was performed in 2 patients who were siblings and in an unaffected individual in the same family. The patients had the typical corneal microcysts and recurrent erosions with mild photophobia. RESULTS: A novel mutation resulting in the substitution of alanine to proline in codon 137 of the keratin 12 gene (Ala137Pro) was found in the 2 patients, but not in the unaffected member of the family and the 50 controls. CONCLUSIONS: This novel mutation (Ala137Pro) of the keratin 12 gene found in a Japanese family had caused MCD.
Assuntos
Distrofias Hereditárias da Córnea/genética , Queratinas/genética , Mutação Puntual , Idoso , Substituição de Aminoácidos/genética , Distrofias Hereditárias da Córnea/etnologia , Distrofias Hereditárias da Córnea/patologia , Análise Mutacional de DNA , Feminino , Heterozigoto , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Linhagem , Reação em Cadeia da PolimeraseRESUMO
PURPOSE: To investigate whether the multifocal visual evoked potential (mVEP) is dependent on the electrode position, and to confirm the reproducibility of the mVEP. METHODS: The mVEPs were recorded using the Veris III system with two different bipolar electrode settings. In Position 1, electrodes were placed at equal distances in vertical alignment 2 cm above and below the inion. In Position 2, the electrodes were placed in horizontal alignment at equal distances 2 cm to the left and right of the inion. Dartboard pattern stimulation was conducted. The mVEPs were repeatedly recorded from 4 volunteers, and mainly the second-order kernel response components were analyzed. RESULTS: Although the reproducibility of mVEP was good in both Position 1 and Position 2, each waveform of the mVEP was drastically different between the two positions. This difference in the waveforms was clearly shown in the center and at the horizontal meridian. We also investigated the first-order kernel response components of the mVEPs. Several traces of the first-order kernel response components did not reveal flat traces. This point is also worthy of consideration. CONCLUSION: Responses from mVEPs are clearly dependent on the electrode position.
Assuntos
Eletrofisiologia/instrumentação , Eletrofisiologia/métodos , Potenciais Evocados Visuais , Adulto , Eletrodos , Humanos , Estimulação Luminosa , Reprodutibilidade dos TestesRESUMO
PURPOSE: In our recent paper, we have reported the presence of serum autoantibody against neuron-specific enolase (NSE) in patients with glaucoma. The purpose of the present study was to investigate further the pathological effects of anti-NSE antibody on retina by comparing them with the effects induced by N-methyl-D-aspartate (NMDA). METHODS: Either a glaucoma patient's serum or purified anti-NSE antibody, or 10-40 mM NMDA was intravitreously administered into Lewis rat eyes, and electrophysiological, histopathological, and biochemical evaluations were performed. In addition, the neuroprotective effects of anti-glaucoma drugs, such as timolol, betaxolol, nipradilol, and isopropyl unoprostone, and a calcium antagonist were also studied using these animal models. RESULTS: Electron microscopy revealed that intravitreal administration of a glaucoma patient's serum, which immunoreacted with retinal 50 kDa in Western blot analysis, and purified anti-NSE antibody induced retinal ganglion cell apoptosis in rat eyes. Functionally, these eyes showed a significant decrease in electroretinogram (ERG) responses and a remarkable decrease in rhodopsin phosphorylation reaction. These changes were comparable to the effects observed after the intravitreal administration of 20 mM NMDA. Co-administration of nipradilol, an alpha- and beta-blocker, with anti-NSE antibody or 20 mM NMDA caused marked recovery of the affected ERG responses within 2 weeks. In contrast, administration of timolol or betaxolol showed no recovery effect on the ERG responses. Among these drugs, only betaxolol showed a recovery effect on NMDA-induced decrease of rhodopsin phosphorylation. Nilvadipine functioned beneficially on both impaired ERG and rhodopsin phosphorylation reactions observed in rat eyes injected intravitreously with anti-NSE antibody or NMDA. These effects of nilvadipine were not changed by the addition of endothelin-1. In contrast, isopropyl unoprostone had no effect on these functions. CONCLUSION: These observations suggest that serum autoantibody against NSE found in some patients with glaucoma induces retinal dysfunction in vivo, similarly to NMDA.
Assuntos
Autoanticorpos/farmacologia , Autoantígenos/imunologia , Glaucoma de Ângulo Aberto/imunologia , Fosfopiruvato Hidratase/imunologia , Doenças Retinianas/induzido quimicamente , Células Ganglionares da Retina/efeitos dos fármacos , Antagonistas Adrenérgicos alfa , Antagonistas Adrenérgicos beta/farmacologia , Idoso , Animais , Reações Antígeno-Anticorpo/imunologia , Anti-Hipertensivos/farmacologia , Apoptose/efeitos dos fármacos , Western Blotting , Eletrorretinografia , Feminino , Humanos , N-Metilaspartato/farmacologia , Fosforilação , Ratos , Ratos Endogâmicos Lew , Doenças Retinianas/patologia , Doenças Retinianas/fisiopatologia , Células Ganglionares da Retina/patologia , Células Ganglionares da Retina/fisiologia , Rodopsina/metabolismoRESUMO
The visual outcome in 308 patients treated for retinal vessel obstruction was examined retrospectively and the effectiveness of each treatment was evaluated using stepwise multiple linear regression analysis and the chi-square test. Visual acuity was used as the parameter for assessing treatment effectiveness and the variables investigated included treatment factors [stellate ganglion block (SGB), urokinase administration, and prostaglandin administration] and patient factors (age, duration of visual impairment before treatment, hypertension, and diabetes mellitus). SGB treatment, the duration of visual impairment, and the presence of diabetes mellitus were significantly correlated with the visual prognosis following treatment. These results support the current hypothesis that SGB is a viable treatment for patients with obstructive disease of the retinal vessels.
RESUMO
Histopathological findings of ciliary epithelium and muscle were discussed in the inflammatory conditions that are induced in endophthalmitis, blood-aqueous barrier destruction, cyclocryotherapy and cyclophotocoagulation. The clinical results were also discussed regarding the reduction of aqueous production and uveoscleroplasty which are introduced by the experimental cyclophotocoagulation at the pars plicata/pars plana. Tissue destruction by inflammatory reaction occurred in not only the ciliary body but also in the retina if the endophthalmitis had progressed to the point of severity. The post-inflammatory reactive hypertrophy of nonpigmented and pigmented ciliary epithelium was mild at pars plicata and the anterior portion of the pars plana. On the other hand, it was severe at the posterior portion of the pars plana and the ora serrata, and it was clear that the cyclitic membrane developed into proliferative vitreoretinopathy. Adult pig cultured nonpigmented ciliary epithelium showed proliferated tissue resembling the cyclitic membrane. These results show that nonpigmented ciliary epithelium has a strong proliferative activity as much the same as fibroblasts. The destruction of the blood-aqueous barrier was produced by corneal perforation, paracentesis, prostaglandin E1 (PGE1) subconjunctival injection, and hyperosmotic agent intraophthalmic artery injection. The localization of the tissue destruction was made clear at the beginning portion of the ciliary process and the posterior part of the pars plana. The repetitive instillation of latanoprost and cyclosporin A eye drops showed the same localization of the tissue damage. These results suggest that the beginning portion of the ciliary process is vulnerable to inflammatory agents. Cyclosporin A might produce a toxic reaction on nonpigmented ciliary epithelium, and latanoprost destroys the blood-aqueous barrier. Cyclocryotherapy produces severe necrosis of the pigmented ciliary epithelium and melanocytes, and atrophy of pigmented ciliary epithelium and ciliary muscle, and the proliferation of nonpigmented ciliary epithelium follows. Because cyclocryotherapy is a blind therapy, hypotony and phthisis bulbi will occur if the pars plicata is damaged severely, and the intraocular pressure (IOP) decrease will not be achieved if pars plana is damaged locally. Finally, we demonstrated that it is difficult to predict the therapeutic outcome of cyclocryotherapy. Cyclophotocoagulation of the pars plicata and the pars plana produced severe necrosis of pigmented ciliary epithelium and melanocytes, and atrophy of pigmented ciliary epithelium and ciliary muscle, and the proliferation of nonpigmented ciliary epithelium followed. Cyclitic membrane was developed from the proliferation of nonpigmented ciliary epithelium depending on the severity of photocoagulation. From these experiments the complete destruction of the pars plicata might result in for hypotony and phthisis bulbi. The reduction of aqueous production for angle-closure glaucoma was achieved by moderate cyclophotocoagulation of the pars plicata. On the other hand, moderate cyclophotocoagulation of the pars plicata for open-angle glaucoma produced the obstruction of uveoscleral aqueous outflow which compensated for the reduction of aqueous production. From these results we suggested that moderate cyclophotocoagulation of the pars plana for open-angle glaucoma might be necessary to effect the increase of uveoscleral aqueous outflow. Moderate and severe cyclophotocoagulation of the transit area between the pars plicata and the pars plana might bring about reduction of aqueous production and the increase of uveoscleral aqueous outflow.
Assuntos
Corpo Ciliar/patologia , Oftalmopatias/patologia , Animais , Corpo Ciliar/cirurgia , Corpo Ciliar/ultraestrutura , Haplorrinos , Humanos , Inflamação/patologia , Procedimentos Cirúrgicos Oftalmológicos , SuínosRESUMO
BACKGROUND: Histopathological evaluation of primary congenital glaucoma with extensive corneal amyloidosis. CLINICAL FINDINGS: A three-month-old infant. At the first examination, corneal diameter was 12 mm in both eyes, intraocular pressure (IOP) 43 mmHg in the right eye and 47 mmHg in the left eye. A diagnosis was made of primary congenital glaucoma. At 4 months of age bilateral goniotomy, at 1 year and 2 months of age bilateral goniotomy, and at 2 years and 2 months of age bilateral trabeculectomy and the superficial keratectomy of the right eye were done. At 14 years and 11 months of age the enucleation of the right eye was done because of corneal opacity, visual loss, and figure. HISTOPATHOLOGICAL FINDINGS: In the cornea disappearance of Bowman's membrane, accumulation of amyloid in the rough endoplasmic reticulum of the basal cells and subepithelial fibroblasts, and thickeniny of Descemet's membrane could be seen. At the peripheral anterior synechia new Descemet's membrane was spread over the anterior surface of the peripheral iris. CONCLUSION: Unilateral corneal amyloidosis might have been present in infancy, amyloid produced in the rough endoplasmic reticulum of the basal epithelium and subepithelial fibroblasts and deposited in the subepithelial region. At puberty amyloid might have been produced in the subepithelial fibroblasts. The poor IOP control at puberty might have been due to the complication of neovascular glaucoma.
Assuntos
Amiloidose/complicações , Doenças da Córnea/complicações , Glaucoma/congênito , Glaucoma/patologia , Adolescente , Amiloidose/patologia , Doenças da Córnea/patologia , Glaucoma/complicações , Humanos , Lactente , MasculinoRESUMO
PURPOSE: We studied macroscopic pictures with polarizing filter and microscopic pictures of the corneas in keratoconus and bullous keratopathy. METHOD: Among penetrating keratoplasty specimens referred to the National Defense Medical College, we investigated 16 keratoconus and 189 bullous keratopathy specimens. Macrophotographs with polarizing filter and light microscopic photographs (hematoxylene-eosin staining) were investigated. The hyperbolic polarizing pattern, stromal thickness of corneal specimens and number of fibroblast-like cells in the stroma were analyzed. RESULT: Hyperbolic polarizing patterns depended on the number of fibroblast-like cells in the stroma and the thickness of the stroma, but hyperbolic polarizing patterns had no relation with the epithelium or endothelium of the cornea.
Assuntos
Córnea/patologia , Doenças da Córnea/patologia , Ceratocone/patologia , Birrefringência , Doenças da Córnea/cirurgia , Humanos , Ceratoplastia Penetrante , Microscopia de PolarizaçãoRESUMO
PURPOSE: To evaluate the lesion and repair process of the ciliary body and adjacent tissues in glaucomatous human eyes and normal monkey eyes with cyclocryotherapy. METHODS: We used light and electron microscopy to observe the ciliary body and adjacent tissues in five glaucomatous human eyes and five normal monkey eyes which were given cyclocryotherapy. RESULTS: Five absolute glaucomatous eyes were given cyclocryotherapy from one and a half to 3 years before the enucleation. One eye had no coagulated spots on the ciliary process, but five eyes had coagulated spots on the pars plana. The pigment epithelial cells were atrophic or had disappeared, but non-pigment epithelial cells had proliferated by one or two layers. At the lesion of monkey pars plicata cyclocryotherapy up to three months, melanophage phagocytosed pigment epithelium and melanocytes accumulated, although the proliferation of non-pigment epithelial cells was seen. At the lesion of monkey pars plana cyclocryotherapy melanophage accumulation was also marked, although non-pigment epithelial proliferation was greater than in pars plicata cyclocryotherapy. CONCLUSION: As cyclocryotherapy is a blind therapy, it is uncertain and difficult to destroy the ciliary process precisely. The repair process continued up to three months after monkey cyclocryotherapy, but it took up to one year and 6 months after human cyclocryotherapy.
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Corpo Ciliar/ultraestrutura , Criocirurgia/métodos , Glaucoma/cirurgia , Adulto , Idoso , Animais , Corpo Ciliar/patologia , Corpo Ciliar/fisiologia , Corpo Ciliar/cirurgia , Feminino , Humanos , Macaca fascicularis , Masculino , Microscopia Eletrônica , Pessoa de Meia-Idade , Regeneração , Fatores de TempoRESUMO
PURPOSE: To investigate the pathogenesis of suprachoroidal and supraciliary hemorrhage that might have been induced during enucleation. METHODS: A histopathological examination of 392 enucleated eyeballs was carried out and 8 eyeballs with suprachoroidal and supraciliary hemorrhage were selected for further clinicopathological examination. RESULTS: Among 14 eyeballs with severe acute intraocular inflammation, 7 eyeballs with suprachoroidal and supraciliary hemorrhage were found and one other such eyeball was seen among 53 with neovascular glaucoma. Among these 8, there was one case of prolapse of intraocular tissue with severe hemorrhage into the suprachoroidal and supraciliary spaces; 4 cases of severe hemorrhage into the suprachoroidal and supraciliary spaces without prolapse of intraocular tissue; and 3 cases of mild hemorrhage into the suprachoroidal or supraciliary spaces. CONCLUSIONS: In the eyeballs with severe acute intraocular inflammation, intraocular pressure was elevated and the blood vessels were weakened by inflammatory cell infiltration. During enucleation external forces affected the blood vessel wall of the ciliary arteries and vortex veins, and the breakdown of vessel walls might have been the cause of the suprachoroidal and supraciliary hemorrhage.
Assuntos
Hemorragia da Coroide/patologia , Corpo Ciliar/patologia , Enucleação Ocular/efeitos adversos , Hemorragia Ocular/patologia , Doença Aguda , Adulto , Idoso , Idoso de 80 Anos ou mais , Hemorragia da Coroide/etiologia , Hemorragia Ocular/etiologia , Feminino , Humanos , Pressão Intraocular , Masculino , Pessoa de Meia-Idade , Úvea/irrigação sanguínea , Uveíte/patologia , Uveíte/fisiopatologiaRESUMO
OBJECTIVE: To evaluate the effect of clioquinol on the optic nerve and retina of rhesus monkeys by ophthalmoscopy, electrophysiology and histopathology. METHODS: Clioquinol was given orally to 5 monkeys, gradually increasingly from 100 mg/kg/day up to 14 months(total dosage 227 g/kg). Ophthalmoscopy, erectroretinogram(ERG), visual evoked potential(VEP) and histopathological examination of enucleated eyeballs were done periodically up to 10 years. RESULTS: The margin of the optic disc was not clear at the early stage, but the colour became atrophic at the late stage. VEP maximum amplitude decreased quickly at the early stage and the amplitude of ERG a and b waves and oscillatory potential decreased gradually. 37 months after the discontinuation of administration of VEP, ERG amplitude increased gradually. Swelling of axons and disorganization of the myelin sheath were noticed 2.5 months after beginning treatment. Swelling of the peripapillary nerve fiber layer was seen 5.5 months after beginning treatment. Karyorrhexis was seen in the inner layer of the retina after 12.5 months. Axonal swelling disappeared and the myelin sheath became reorganized 9 months after the discontinuation of treatment. CONCLUSIONS: Clioquinol produced an early decrease of electrophysiological function, but recovery of function was seen after discontinuation of treatment. The degeneration of axons and myelin sheath continued during treatment, and interruption of the degeneration was seen after discontinuation of treatment.
Assuntos
Clioquinol/toxicidade , Nervo Óptico/efeitos dos fármacos , Retina/efeitos dos fármacos , Animais , Eletrorretinografia , Potenciais Evocados Visuais , Feminino , Macaca mulatta , Oftalmoscopia , Nervo Óptico/patologia , Retina/patologiaRESUMO
PURPOSE: To evaluate the surgical outcome of vitrectomy and foveal thickness before and after vitrectomy for idiopathic epiretinal membranes. SUBJECTS AND METHODS: Twenty-three eyes of 21 patients with idiopathic epiretinal membranes were analyzed. The mean follow-up period was 17.8 months. In 16 eyes of 14 patients, foveal thickness was measured by optical coherence tomography (OCT). RESULTS: Preoperative visual acuity ranged from 0.1 to 0.7. Postoperatively, 17 eyes achieved a final visual acuity of 1.0 or better, and 21 eyes achieved 0.5 or better. Preoperative foveal thickness ranged from 205 to 575 microns (mean +/- standard deviation, 409.9 +/- 103.3 microns). Postoperatively, mean foveal thickness was 347.7 +/- 106.0 microns (1 week follow up), 338.6 +/- 103.7 microns (2 months), 304.6 +/- 97.0 microns (6 months), and 274.3 +/- 78.7 microns (1 year). There was a weak negative correlation between visual acuity and foveal thickness. CONCLUSION: Visual acuity improves significantly after surgery. OCT is useful for idiopathic epiretinal membrane surgery.