Fractionated beta-irradiation of a conjunctival lymphangioma.

Fractionated beta-radiation was applied on a conjunctival lymphangioma, which had been known for several years. Histological diagnosis was established 3 years previously. Excision was not possible because the tumor had involved a considerable part of the conjunctiva. Using a strontium-90 applicator a total dose of 30 Gy was applied in 6 fractions with 5 Gy each. The initial tolerance was satisfactory. No radiogenic damage occurred, an involution of the tumor could be observed. During a follow-up time of nearly 2 years no further progression was noted. We consider the beta-radiation as an interesting therapeutic alternative for conjunctival lymphangiomas which are difficult to treat surgically due to their size.

[Relevance of ocular pressure tonometry and classical tonometry with reference to prognosis in suspected glaucoma and ocular hypertension]. / Relevanz von Okulopressionstonometrie und klassischer Tonometrie hinsichtlich der Prognose bei Glaukomverdacht und okulärer Hypertension.

A total of 44 eyes of patients with suspected glaucoma or ocular hypertension were examined both by ocular pressure tonometry (OPT) according to Ulrich and by tonography according to Leydhecker. The visual fields of these eyes were prospectively followed up for 3 years to compare the prognostic value of the two methods. In 30 of the 44 eyes a worsening visual field loss was observed, while in 14 the visual fields showed no change. Much better correlation was noted between values obtained by OPT and changes in visual field than between values obtained by tonography and visual field loss. Conventional tonography yielded 39% of false-negative values, but only 11% were recorded with OPT. Therefore, according to results of these and further investigations, OPT appears to be a more helpful and reliable method for assessment and decisions on therapy in patients with suspected glaucoma or ocular hypertension.

[Occlusive retinal vasculopathy with subsequent secondary glaucoma. Demonstration of typical findings and therapeutic references]. / Okklusive retinale Vaskulopathie mit nachfolgendem Sekundärglaukom. Demonstration typischer Befunde und Therapiehinweise.

The etiology of occlusive vascular retinopathy with subsequent neovascular glaucoma has not been clarified even today. If not diagnosed in the early stage therapy is often unsuccessful. Men and women aged between 35 and 65 years are affected with equal frequency. In a group of nine patients presenting at our clinic within three years four had irreversible functional loss by the time of the initial examination. In eyes with better visual function at the time of diagnosis only minimal vision and visual field can be preserved. Even this is only possible with intensive therapeutic efforts. Besides a rapid diagnosis to exclude prior vascular processes that can be treated areas of the retina with reduced perfusion always need to be treated by means of cryo- or lasercoagulation. Adjacently inhibitors of thrombocyte-aggregation to improve perfusion should be administered. Any delay of coagulation should be avoided since resulting secondary glaucoma is very difficult to treat.

[Experimental tyrosine keratopathy in rabbits]. / Experimentelle Tyrosinkeratopathie bei Kaninchen.

Tyrosine was given to White New Zealand and Chinchilla bastard rabbits. The corneal epithelium showed pinpoint lesions and a pseudokeratitis dendritica from the fourth day on. In spite of continued tyrosine dosage these lesions disappeared clinically within 6 days. Scanning electron microscopy revealed necrosis of isolated epithelial cells even after the twentieth day of tyrosine dosage. Specular microscopy sporadically revealed glittering pre-endothelial structures. It was found by light microscopy that there was a tendency to focal proliferation of corneal epithelial cells and a vacuolization in the basal epithelial cell layers. Endothelial defects may be responsible for circumscribed edema of the corneal stroma.

Experimentally induced cystine keratopathy in rabbits.

L-Cystine was administered orally to albino and nonalbino rabbits in order to study cystine-induced corneal lesions. Contact and noncontact specular microscopy revealed opaque preendothelial structures similar to those found in benign cystinosis in humans. Light microscopy showed cytoplasmatic vacuoles in the basal cell layer of the corneal epithelium. Using scanning electron microscopy, increased desquamation of the corneal epithelial cells and massive deposition of proteinic material on the surface of the corneal endothelium were demonstrated.

Experimentally induced calcium oxalate keratopathy in rabbits.

In a period of 21 days, six subcutaneous injections of calcium chloride and dibutyloxalate solution produced a flecklike, polymorphous corneal opacity and a slight stromal clouding in chinchilla rabbits, as seen with the slit lamp. In front of the endothelium, opaque structures could be seen with the specular microscope. New Zealand white rabbits showed only a diffuse corneal clouding. Light microscopy revealed a reticular alteration of the cytoplasm in the basal layers of the corneal epithelium primarily in chinchilla bastard rabbits. In central corneal areas an irregular structure of the basal epithelial cells and a papillalike alteration of the stromal-epithelial border was seen. In the endothelium an increased formation of vacuoles was observed in both species. Scanning electron microscopy demonstrated endothelial cell loss.

[Clinical course in Bietti crystalline tapetoretinal degeneration]. / Klinischer Verlauf bei Biettischer kristalliner tapetoretinaler Degeneration.

The course of Bietti's crystalline retinopathy, which has an autosomal-recessive mode of inheritance, is described with reference to three families. Initially, crystals appear in the inner and middle layers of the retina; in the third decade of life atrophy of the retinal pigment epithelium and of the choroid sets in. Secondary degeneration of the center of the retina results in the disappearance of the crystals in the degenerated areas.

[Iris angiography and endothelium microscopy in dysgenesis mesodermalis iridis et corneae]. / Irisangiographie und Endothelmikroskopie bei Dysgenesis mesodermalis iridis et corneae.

Three patients with endothelialization of the anterior chamber - 2 with Chandler's syndrome and 1 with Cogan-Reese syndrome - were followed up by means of iris angiography and specular microscopy over a period of several years. The endothelial angiographic changes occurred simultaneously in all cases; the more pronounced the endothelial changes, the more severe the iris changes. Since iris stroma and corneal endothelium develop from a common mesenchymal origin, and the extent of the changes they undergo is similar in the course of the diseases in question, a close relationship between Rieger's mesodermal dysgenesis, Chandler's syndrome and Cogan-Reese syndrome is postulated.

[Rubinstein-Taybi syndrome and juvenile glaucoma]. / Rubinstein-Taybi-Syndrom und juveniles Glaukom.

In a six-year-old girl with Rubinstein-Taybi syndrome the ophthalmological findings were as follows: bushy brows, hypertelorism, epicanthus, an antimongoloid slant to the eyelids and hyperopia with an alternating convergent squint. In the sixth year of life juvenile glaucoma with deep cupping of the disk was found.

[Endothelial changes in posterior polymorphous corneal dystrophy]. / Endothelveränderungen bei hinterer polymorpher Hornhautdystrophie.

Posterior polymorphous dystrophy of the cornea (Schlichting) was found in a 51-year-old male. In addition, the patient had a cerulean cataract and myopia. The PPD, which was thought to have been caused by endothelial degeneration, exhibited extremely variable expressivity. Of the patient's 3 children only the 19-year-old son, who is also myopic, has cerulean cataract; on specular microscopic examination he was also found to be suffering from endothelial changes.

[Variability of iris fluorescence angiograms]. / Variabilität der Irisfluoreszenzangiogramme.

Fluorescein angiography of the iris vascular system is more difficult in heavily pigmented irides of the coloured races; in light skinned patients it is easy to perform and even more details are demonstrated in patients with atrophies of the mesodermal iris structure. In congenital albinism very fine vascular structures are demonstrated in younger patients; a similar picture is seen in pupillotonia if there is atrophy of the iris stroma. In senile iris atrophies, Adie's syndrome and congenital albinism the iris vascular structure is basically normal, but atrophy of the iris stroma may lead to increased fluorescein permeability in the elderly.