[Macular thickness measured by optical coherence tomography in pseudoaphakic eyes with clear vs yellow implant]. / Espesor macular medido con tomografía de coherencia óptica en ojos pseudoafáquicos con implante amarillo vs. transparente.

OBJECTIVE: To study the use of optical coherence tomography (OCT), for measuring the macular thickness variations produced over time in elderly pseudophakic subjects implanted with a clear intraocular lens (IOL) in one eye, and a yellow IOL in the other eye. METHODS: Macular thickness measurements were obtained in the 36 eyes of 18 subjects over 65 years, with cataracts surgically removed from both eyes and implanted with different absorbance (clear and yellow) IOLs in 2 separate surgeries. Stratus-OCT was used to determine the macular thickness in 2 sessions with 5 years of difference. RESULTS: After 5 years of follow-up, the eyes implanted with clear IOLs revealed a significant decrease in macular thickness. However, in eyes implanted with yellow IOLs the macular thickness remained stable. The mean overall decrease in macular thickness in eyes implanted with clear IOLs was 5 ± 8 µm (P=.02), and foveal thickness reduction was 10 ± 17 µm (P=.02). CONCLUSIONS: The macular thickness changes produced in eyes implanted with a yellow IOL differ from those with a clear IOL. These observation point to a possible protective effect of yellow IOL against the harmful effects of light in elderly pseudophakic subjects. However, studies with a longer follow-up are still needed to confirm that the protection provided by this IOL model is clinically significant.

Primary renal lymphoma: long-term results of two patients treated with a chemotherapy + rituximab protocol.

Primary renal lymphoma (PRL) is a rare disease of which the etiology and pathogenesis remain controversial, and there is currently no standard treatment for it. We present the results of a long-term followup of two patients who were diagnosed with PRL and treated with cyclophosphamide, adriamycin, vincristine, prednisolone and rituximab (CHOP + R) regimen. Both patients reached a complete response, and there is no evidence of recurrence after 4.5- and 5-year followup periods. Based on our experience and other recently published studies, we recommend the combination of CHOP + rituximab as the elective treatment for this disease. To our knowledge, this is the longest followup period with a complete response that has been reported with this modality of treatment.

Role of metalloproteases in retinal degeneration induced by violet and blue light.

INTRODUCTION: An essential role for metalloproteases (MMPs) has been described in blood vessel neoformation and the removal of cell debris. MMPs also play a key role in degenerative processes and in tumors. The participation of these enzymes in light-induced phototoxic processes is supported by both experimental and clinical data. Given that patients with age-related macular degeneration often show deposits, or drusen, these deposits could be the consequence of deficient MMP production by the pigment epithelium. OBJECTIVE: To gain insight into the regulation of metalloproteases in the pathogenia of retinal degeneration induced by light. MATERIALS AND METHODS: We examined the eyes of experimental rabbits exposed for 2 years to circadian cycles of white light, blue light and white light lacking short wavelengths. For the trial the animals had been implanted with a transparent intraocular lens (IOL) and a yellow AcrySof((R)) IOL, one in each eye. After sacrificing the animals, the retinal layer was dissected from the eye and processed for gene expression analyses in which we examined the behavior of MMP-2, MMP-3 and MMP-9. RESULTS: MMP-2 expression was unaffected by the light received and type of IOL. However, animals exposed to white light devoid of short wavelengths or those fitted with a yellow IOL showed 2.9- and 3.6-fold increases in MMP-3 expression, respectively compared to controls. MMP-9 expression levels were also 3.1 times higher following exposure to blue light and 4.6 times higher following exposure to white light lacking short wavelengths or 4.2 times higher in eyes implanted with a yellow IOL. CONCLUSION: Exposure to long periods of light irrespective of its characteristics leads to the increased expression of some MMPs. This alteration could indicate damage to the extracellular matrix and have detrimental effects on the retina.