RESUMO
The investigations of tear fluid of eye after contusion injury revealed on increase of trypsin-like activity in 1-3 day and 10-19 day after trauma, the progressively elevation of elastase-like activity and lowering of inhibitory potential along 2-3 week. It was detected indirect correlation between the elastase-like activity and severity of the contusion injury of the eye, the grade of corneal edema, corneal erosion and conjunctival wound, hyphema. This results was shown the participation and the role of proteolytic and inflammatory processes in pathogenesis of eye blunt trauma. It was establish that the during of local inflammation is 2 week end more and is necessary antiinflammatory therapy with use the proteases inhibitors.
Assuntos
Contusões/enzimologia , Traumatismos Oculares/enzimologia , Elastase Pancreática/metabolismo , Inibidores da Tripsina/metabolismo , Tripsina/metabolismo , HumanosRESUMO
Angiotensin converting enzyme (ACE) activity was studied in tear fluid of the contusion injured eye. We found substantial decrease of ACE activity during 1 month after trauma. Reduced ACE activity can potentiate kinin action and may contribute to the maintenance of reduced vascular tone, high capillary permeability inducing ciliochoroidal effusion which leads to ocular hypotony. We have found decrease of ACE activity in another healthy eye.
Assuntos
Traumatismos Oculares/enzimologia , Peptidil Dipeptidase A/metabolismo , Ferimentos não Penetrantes/enzimologia , Traumatismos Oculares/fisiopatologia , Hemodinâmica , Humanos , Lágrimas/enzimologia , Ferimentos não Penetrantes/fisiopatologiaRESUMO
Clinical observations of 426 patients with blunt injuries to the eye (records of Moscow Ophthalmological Clinical Hospital) showed that eyeball contusions were responsible for 40.57% of hospital injuries, 364 cases (85.54%) were communal traumas and 22.77% criminal. The most frequent complication of blunt injury to the eye was hemorrhage to the anterior chamber (57.57%). Total or almost total hyphemas were observed in 5.83% cases, in 0.7% with repeated hemorrhages. Hemorrhages into the vitreous body were observed in 36.6% patients. Postcontusion opacities and retinal edemas were diagnosed in 25.87% cases. The most severe contusions of the eyeball with ruptures of fibrous membrane were observed in 19.11% cases, 6.29% of these along the postoperative cicatrix. Subdislocation or dislocation of the lens took place in 13.75% cases. Blunt injury to the eye resulted in alteration of ophthalmic tone presenting as reactive hypertension (22.33%), reactive hypotone (11.19%), secondary hypertension (17.01%), and stable hypotone (5.59%). By discharge from hospital visual functions improved in 72.73%, visual acuity of 0-0.03 diopters was observed in 14.92% and 0.4-1.0 in 63.87% cases. Secondary hypertension persisted in 1.86% and stable hypotone of the injured eye in 5.13% cases.
Assuntos
Contusões/diagnóstico , Traumatismos Oculares/diagnóstico , Adolescente , Adulto , Idoso , Contusões/complicações , Contusões/fisiopatologia , Olho/fisiopatologia , Traumatismos Oculares/complicações , Traumatismos Oculares/fisiopatologia , Feminino , Humanos , Hifema/complicações , Hifema/diagnóstico , Hifema/fisiopatologia , Masculino , Pessoa de Meia-Idade , Ruptura , Acuidade VisualRESUMO
Contusions of the eyeball involve reactive or secondary changes in intraocular pressure. Clinical examinations of 151 patients with contusion disorders in ophthalmic tone revealed reactive hypertension in 6.62%, reactive hypotone in 31.79%, secondary hypertension in 48.34%, and stable hypotone of the injured eye in 15.89% cases. Secondary changes in intraocular pressure were caused by massive intraocular hemorrhages and structural injuries to the eyeball. The main cause of reactive hypotone resulting from blunt injury to the eye was exfusion, detachment of the vascular membrane diagnosed at that period by ultrasonic examination in 76.92% cases. The main factors responsible for the postcontusion reactive syndrome are changes occurring within a very short period of time, intraocular pressure differences, and "loss" of the threshold volume of the anterior chamber humor because of its discharge during the shock, and activation of the kallikrein-kinin system with release of kinins causing capillary dilatation and increasing capillary wall permeability in the presence of low activity of angiotensin-converting enzyme which destroys bradykinin.
Assuntos
Contusões/fisiopatologia , Traumatismos Oculares/fisiopatologia , Pressão Intraocular/fisiologia , Humor Aquoso/fisiologia , Bradicinina/metabolismo , Permeabilidade Capilar , Contusões/complicações , Contusões/metabolismo , Traumatismos Oculares/complicações , Traumatismos Oculares/metabolismo , Humanos , Sistema Calicreína-Cinina/fisiologia , Hipertensão Ocular/etiologia , Hipertensão Ocular/metabolismo , Hipertensão Ocular/fisiopatologia , Hipotensão Ocular/etiologia , Hipotensão Ocular/metabolismo , Hipotensão Ocular/fisiopatologia , Peptidil Dipeptidase A/metabolismo , VasodilataçãoRESUMO
Studies of the plasma components of the kallikrein-kinin system (KKS) in the lacrimal fluid (LF) of damaged eyeball of 32 patients hospitalized for contusion for the eyeball showed an appreciable increase of KKS activity during the first three days and its less expressed increase on days 10-19 after the injury. The content of prekallikrein in the damaged eye LF depends on the severity of eye contusion and plasma KKS status, and the levels of LF prekallikrein in the damaged and intact eye correlate. Serum kallikrein activity depends on the severity of injury.
Assuntos
Contusões/metabolismo , Traumatismos Oculares/metabolismo , Sistema Calicreína-Cinina/fisiologia , Ferimentos não Penetrantes/metabolismo , Biomarcadores , Contusões/diagnóstico , Olho/metabolismo , Traumatismos Oculares/diagnóstico , Seguimentos , Humanos , Calicreínas/metabolismo , Pré-Calicreína/metabolismo , Lágrimas/metabolismo , Índices de Gravidade do Trauma , Ferimentos não Penetrantes/diagnósticoRESUMO
The authors analyze the records of the traumatic center in Moldavia. 104 patients with ocular wounds were treated there over the period starting in August 1987 through January 1988. The authors analyze the volume of surgical interventions and their functional outcomes. Stages of treatment of perforating wounds of the eyes are discussed as is the postoperative treatment of such patients.