Lens epithelial apoptosis and cell proliferation in human age-related cortical cataract.

PURPOSE: To probe the presence of apoptosis in the epithelium of human lenses with age-related cortical cataract as well as to assess cell proliferation, a predicted consequence of apoptotic cell death, in this specific cell population. METHODS: DNA fragmentation was assessed using terminal digoxigenin-labeled dUTP nick end labeling (TUNEL) in capsulotomy specimens obtained from patients who underwent either extracapsular cataract extraction for the removal of adult-onset cortical cataract (n=27) or clear lens extraction for the correction of high myopia (n=25). Cell proliferation was assayed in 23 epithelia of cataractous lenses, and 20 epithelia of non-cataractous lenses with the proliferation marker MIB1, a monoclonal antibody against the nuclear antigen Ki-67 that is detected throughout the cell cycle but is absent in the resting (G0) cell. RESULTS: TUNEL staining was observed in 25 (92.6%) specimens of cataractous lenses, whereas cells undergoing apoptosis were identified in 2 (8%) of the epithelia from non-cataractous lenses. Only two MIB1-positive samples were detected, one of which was a capsule obtained during intracapsular cataract extraction. CONCLUSIONS: The epithelium of human lenses with cortical cataract undergoes low rate apoptotic death. This limited epithelial apoptosis is unlikely to result in any significant cell density decrease since epithelial gaps are likely to be replaced by cell proliferation at the germinative zone of the anterior lens capsule. Nevertheless, the accumulation of small-scale epithelial losses during lifetime may induce alterations in lens fiber formation and homeostasis and result in loss of lens transparency.

Elastic cord-induced ocular injuries.

PURPOSE: To evaluate the incidence and severity of ocular injuries caused by elastic cords. PATIENTS AND METHOD: A retrospective review of patients' records from the Emergency Department was conducted to identify cases of elastic cord-induced ocular injuries. Over a 67-month period starting in October 1996, 28 patients (24 males and 4 females, mean age 38.6 years) with elastic cord-associated ocular trauma were identified. Patient demographics, mechanism of injury, presenting and final visual acuity, ocular injuries, medical and surgical intervention and length of follow-up were noted. RESULTS: The most common anterior and posterior segment injuries were hyphaema/microhyphaema (71.4%) and commotio retinae (60.7%), respectively. The most severe injuries sustained were corneal or scleral lacerations (7.1%), formation of retinal tears (10.7%) or retinal detachment (3.6%), lens subluxation (7.1%) and traumatic cataract (7.1%). Eight patients (28.6%) were admitted for surgical or medical treatment. Mean visual acuity was 20/40 on presentation and 20/25 at the end of the follow-up period. CONCLUSIONS: Elastic cords may cause a wide range of ocular traumas of varying severity. Appropriate design modifications that would prevent the spontaneous release of their hooks are likely to make their use significantly safer.

Nyctalopia in antiquity: a review of the ancient Greek, Latin, and Byzantine literature.

OBJECTIVE: To investigate the original definition and use of the term nyctalopia in ancient medical literature in view of the controversy between the English and some continental European literatures. DESIGN: Historical manuscript. METHODS: We review the use of the term in ancient Greek, Roman, and early Byzantine medical literature (5th century BC-7th century AD) and include a quick reference to the theories on its etymology. RESULTS: Physicians of antiquity defined as nyctalopia the symptom of defective dark adaptation, most commonly in the clinical setting of vitamin A deficiency. An alternative definition, the improvement of vision at night, is not recorded before the 2nd century AD and seems to result from a broader interpretation of the word, lacking medical acceptance at that time. CONCLUSIONS: We propose to the ophthalmic community the use of the term nyctalopia exclusively for the description of defective dark adaptation.

Bcl-2 expression as an apoptotic index in non small cell lung carcinomas.

To evaluate the bcl-2 protein expression in non small cell lung carcinomas (NSCLC) as an index of apoptosis of these tumors, in fine needle aspiration biopsies (FNABs) of the lung, we studied thirty-eight cases of NSCLC (25 bronchogenic adenocarcinomas and 13 squamous. carcinomas. Bcl-2 protein was used as the primary antibody (monoclonal, DAKO) by Alkaline-phosphatase method. Very light haematoxylin was performed as the counterstain. The results were compared and confirmed histologically. A cytoplasmatic expression of the bcl-2 protein was found in 72% (18 out of 15) of the bronchogenic adenocarcinomas while 61.54% (8 out of 13) of squamous carcinomas showed bcl-2 expression. For the quantitative analysis of our results, we used the t-test and the difference between those two histologic types was regarded as statistically significant with p < 0.001.

Dacryocystosclerotherapy.

PURPOSE: To introduce a less invasive therapeutic method in selected patients with primary nasolacrimal duct obstruction. METHODS: Noncomparative interventional case series. Seven patients with primary acquired nasolacrimal duct obstruction who were poor candidates for dacryocystorhinostomy because of underlying medical conditions and two symptomatic patients with previous incomplete dacryocystectomy were included. Ethanolamine oleate 5% was slowly injected through the puncta into the patent portion of the lacrimal drainage apparatus. RESULTS: After a mean follow-up period of 26 months, the lacrimal pathway was permanently obliterated in 6 cases (66.7%). In two cases, the procedure was repeated successfully and in one case, the patient refused to repeat the procedure after the initial failure. CONCLUSIONS: In selected patients, ethanolamine oleate dacryocystosclerotherapy appears to offer a simple, low-cost, less invasive alternative to dacryocystectomy.

Ethmoidal sinus adenocarcinoma with orbital invasion.

PURPOSE: To report a rare case of massive ethmoidal adenocarcinoma with orbital invasion but minimal ophthalmic symptoms on presentation. METHODS: Case report of a 69-year-old, otherwise healthy, retired carpenter who was referred for treatment of bilateral senile cataract. RESULTS: A relative afferent pupillary defect and sectorial disc atrophy on ophthalmic examination led to further investigation and identification of an extensive ethmoidal neoplasm with orbital invasion. An incisional biopsy was performed and histopathologic examination revealed an adenocarcinoma of low-grade malignancy. CONCLUSION: Ethmoidal adenocarcinomas with orbital involvement may occasionally be relatively asymptomatic and masked by coexisting ocular disease.