Vision loss under silicone oil tamponade.

PURPOSE: We aimed to investigate frequency, time course and pathophysiology of vision loss in eyes with macula-on rhegmatogenous retinal detachment operated with vitrectomy and silicone oil tamponade. PATIENTS AND METHODS: Fifteen eyes of 15 patients who had been operated with 5,000 centistoke silicone oil between 2006 and 2014 were included in a retrospective case series. Examinations included logMAR best corrected visual acuity (BCVA), visual field testing (VF), spectral domain optical coherence tomography (OCT), electrophysiology, and fluorescein angiography. RESULTS: Vision loss was seen in eight (53 %) eyes of 15 patients with symptomatic central scotoma, which was confirmed by VF (5/6). Preoperative median BCVA of these patients was 0.15 (0.5 to 0), prior to oil removal 0.7 (1.0 to 0.5), and 6 weeks post oil removal 1.0 (1.5 to 0.2). BCVA recovered in five patients to a median of 0.15 (0.5 to 0.1), and it remained 1.0 in three (20 %) out of 15 eyes. OCT revealed significant thinning of the foveal and parafoveal combined nerve fiber, ganglion cell and inner plexiform layers in affected eyes (mean 58.3 µm +/-13, horizontal scan through fovea, 500 µm radius) compared to their healthy fellow eyes (mean 84.5 µm +/-12.3; p < 0.01, n = 6 patients, 12 eyes) and compared to eyes with no vision loss under silicone oil. CONCLUSIONS: We find persisting vision loss in three out of 15 patients treated for macula-on rhegmatogenous retinal detachment with silicone oil tamponade. Thinning of inner retinal layers possibly evoked by silicone oil tamponade might be a pathophysiological explanation for vision loss in these patients.

Secretory phenomena in the non-lactating human mammary gland.

The normal non-lactating premenopausal human mammary gland has been shown by immunohistochemistry and transmission electron microscopy to secrete a number of antimicrobial peptides such as beta-defensins, the cathelicidin LL37, lactoferrin and adrenomedullin. In addition, the non-lactating gland elaborates a prominent glycocalyx at the apical membrane of the glandular epithelial cells, parts of which are shed into the lumen of endpieces and ducts. This glycocalyx includes the mucins MUC 1 and MUC 4, a strongly Alcian Blue positive palyanionic component and sulfated material stained with Aldehyde Fuchsin. MUC 1 and the Alcian Blue positive material are considered to play an antimicrobial role, too. Lactalbumin and lipid droplets also occur in the non-lactating gland. At the EM-level secretory phenomena operating by exocytosis and by means of the apocrine mechanism have been observed. Cytoskeletal components presumably play a role in apocrine secretion. Apart from secretion at the cellular apex, secretion at the cellular basis also occurs regularly, which may represent the production of para- or endocrine factors.