Homocysteine, vitamin B12, and folic acid in age-related macular degeneration.

PURPOSE: Hyperhomocysteinemia is considered an independent risk factor for atherosclerosis and thrombosis. The purpose of this study was to evaluate plasma homocysteine, red blood cell folate, plasma folate, and plasma vitamin B12 concentration in patients with exudative age-related macular degeneration (ARMD). METHODS: The participants of this study included 30 patients aged 60 to 71 years (mean age 66.2+/-3.6) with exudative ARMD. Plasma homocysteine levels were determined by high performance liquid chromatography (HPLC). Red blood cell folate, plasma folate, and plasma vitamin B12 concentration were determined using a standard kit (Dualcount Solid Phase No Boill radioassay kit for B12/folic acid, DPC Diagnostic, USA) by radioassay method. RESULTS: The plasma concentration of Hcy (14.88+/-6.23 micromol/L) in ARMD patients was significantly increased (p<0.0001) compared with the control group (8.72+/-3.34 micromol/L). We found not a significant decrease of the plasma vitamin B12 concentration in the ARMD group (476.88+/-220.91 pg/mL) compared with the control group (527.08+/-208.97 pg/mL). Red blood cell folate (158.44+/-56.30 ng/mL) and plasma folate (6.5+/-3.4 ng/mL) in ARMD patients were also not significantly decreased when compared with the control group (183.86+/-59.33 ng/mL and 7.93+/-5.05 ng/mL). CONCLUSIONS: Hyperhomocysteinemia might be one of the risk factors for the exudative form of ARMD.

[Hemodilution in the treatment of central retinal vein thrombosis]. / Hemodylucja w leczeniu zakrzepów zyly srodkowej siatkówki.

The authors present contemporary opinions on the aetiology, forms and prognosis in central retinal vein occlusion. Methods of treatment by haemodilution, indications and contraindications are discussed.

[Activity of selected enzymes of the anti-oxidase system in the vitreous body, aqueous humor and lens after subconjunctival ozone in experiments]. / Aktywnosc wybranych enzymów ukladu antyoksydacyjnego w ciele szklistym, cieczy wodnistej i soczewce po podspojówkowym podaniu ozonu w eksperymencie.

The influence of ozone on the activity of enzymes of the antioxydation system in selected structures of the eye were checked. Ozone given topically in weak concentrations acts stimulating, increasing the activity of the enzymes of the antioxydation system, instead in high concentrations causes a significant reduction of activity of the enzymes of the mentioned system.

[Valve implants of glaucoma pressure regulator for refractory glaucoma: own experience]. / Wszczepy zastawkowe Glaucoma Pressure Regulator w jaskrze opornej na leczenie--doswiadczenia wlasne.

PURPOSE: To present our experiences in valve implantation for refractory glaucoma. MATERIAL AND METHODS: From October 1993 to December 1996 implantations of Glaucoma Pressure Regulator Optimed were performed in 7 eyes of 7 patients. There were 4 men and 3 women aged from 32 to 65 years. There were 3 eyes with neovascular glaucoma due to diabetes mellitus, 2 eyes with posttraumatic glaucoma, including 1 case after keratoplasty, 1 eye with postkeratoplasty glaucoma and 1 eye with aphakic glaucoma. Preoperative IOPs ranged from 33 to 61 mm Hg (mean 37.6 +/- 7.2 mm Hg). RESULTS: Success was considered an IOP of less than 22 mm Hg without medication (complete success) or with medication (qualified success) without additional filtering surgery. Postoperative success was obtained in 4 out of 7 eyes after follow-up period of 37.4 +/- 17.08 months (range 16-39 months). Early complications were hyphema (1 patient, 14.3%), blockage of intracameral portion of the tube (1 patient, 14.3%), hypertony (1 patient, 14.3%). Late complications were: external conjunctival bleb failure (2 patients, 28.6%), blockage of intracameral portion of tube by fibrovascular tissue (1 patient, 14.3%). CONCLUSION: Our experiences confirm that the valve implant is still today an alternative surgical procedure for controlling IOP in eyes with refractory glaucoma that have visual potential.

[A grid pattern type of photocoagulation in treatment of diabetic maculopathy--personal experience]. / Fotokoagulacja typu grid pattern w leczeniu makulopatii cukrzycowej--doswiadczenia wlasne.

PURPOSE: The aim of the present study was the evaluation of visual outcome of 425 eyes in 283 patients treated by focal and grid pattern photocoagulation for clinically significant macular edema according to the recommendations of the Early Treatment Diabetic Retinopathy Study (ETDRS). MATERIAL AND METHODS: On the basis of baseline status of macula, eyes were classified into three groups: group I--eyes treated by focal photocoagulation (39 eyes), group II--eyes treated by focal photocoagulation and/or modified grid (84 eyes), group III--eyes treated by focal photocoagulation and/or grid pattern (302 eyes). Eligibility criteria for this retrospective study included a diagnosis of clinically significant macular edema according to the ETDRS scale. The baseline examination for all patients presented in this review included: the best corrected visual acuity (VA), slit lamp with contact lens indirect ophthalmoscopy, fundus color photography and fluorescein angiography. All patients were treated with argon green by grid with Nidek 2300 laser. Modified grid or focal photocoagulation according to the ETDRS recommendations were performed. Patients with proliferative diabetic retinopathy (PDR) were transferred to panretinal photocoagulation (PRP) after treatment of maculopathy. Development of VA from the baseline to last checkup in treated eyes was reported and compared. Follow-up ranged widely from 6 to 45 months. RESULTS: General stabilization was achieved in 51.3%, improvement in 10.1% and deterioration in 38.6% of eyes. The best results were achieved after selective and focal and/or modified grid treatment: in the Ist group stabilization of VA was achieved in 43.6% and improvement in 41% of eyes; in the IInd group: stabilization in 60.7% and improvement in 21.4% were stated; in the IIIrd group: stabilization in 49.7% and improvement only in 3.0%. In 164 (38.6%) cases supplemental treatment was administered. CONCLUSION: Photocoagulation has proved effective in the treatment of diabetic clinically significant macular edema.

[The evaluation of the usefulness of phacotrabeculectomy as the only surgery for glaucoma and cataract patients]. / Ocena skutecznosci fakotrabekulektomii jako jednoczesnej operacji jaskry i zacmy.

PURPOSE: To evaluate IOP changes after phacotrabeculectomy. MATERIAL AND METHODS: 24 glaucoma patients (27 eyes) with coexistence of cataract. Age: 56-79 years. Mean IOP level before surgery: 23.2 +/- 2.4 mm Hg. In all cases phacotrabeculectomy was performed. Follow-up ranged from 3 to 12 months. RESULTS: IOP decrease after surgery was achieved: mean decrease 7.1 +/- 2.3 mm Hg after 3 months and 5.5 +/- 2.4 mm Hg, and 4.1 +/- 2.1 mm Hg after 6 and 12 months, respectively. CONCLUSION: Phacotrabeculectomy combines all advantages of phacoemulsification and creates perspective for IOP normalization.

[Keratectomy for a malignant melanoma of the cornea]. / Keratektomia jako metoda leczenia czerniaka zlosliwego rogówki.

PURPOSE: To present the possibility of malignant melanoma treatment of the cornea using keratectomy. MATERIAL AND METHODS: A 59-year old woman with a primary malignant melanoma of the cornea. Visual acuity before surgery 0.2. Malignant melanoma was removed using keratectomy. Follow-up 18 months. RESULTS: Satisfactory cosmetic result and visual acuity 1.0 was obtained. In 18 months follow-up no local or general symptoms of tumor recurrence are observed. CONCLUSION: Keratectomy should be considered as an alternative treatment for primary malignant melanoma of the cornea.

Homocysteine, vitamin B12, and folic acid in age-related macular degeneration.

PURPOSE: Hyperhomocysteinemia is considered an independent risk factor for atherosclerosis and thrombosis. The purpose of this study was to evaluate plasma homocysteine, red blood cell folate, plasma folate, and plasma vitamin B12 concentration in patients with exudative age-related macular degeneration (ARMD). METHODS: The participants of this study included 30 patients aged 60 to 71years (mean age 66.23.6) with exudative ARMD. Plasma homocysteine levels were determined by high performance liquid chromatography (HPLC). Red blood cell folate, plasma folate, and plasma vitamin B12 concentration were determined using a standard kit (Dualcount Solid Phase No Boill radioassay kit for B12/folic acid, DPC Diagnostic, USA) by radioassay method. RESULTS: The plasma concentration of Hcy (14.886.23 micronmol/L) in ARMD patients was significantly increased (p<0.0001) compared with the control group (8,.723,.34 micronmol/L). We found not a significant decrease of the plasma vitamin B12 concentration in the ARMD group (476.88220.91 pg/mL) compared with the control group (527.08208.97 pg/mL). Red blood cell folate (158.4456.30 ng/mL) and plasma folate (6.53.4 ng/mL) in ARMD patients were also not significantly decreased when compared with the control group (183.8659.33 ng/mL and 7.935.05 ng/mL). CONCLUSIONS: Hyperhomocysteinemia might be one of the risk factors for the exudative form of ARMD.