[Potential of ultrasound biomicroscopy in diagnosis of ocular trauma with intraocular metallic foreign bodies].

A detailed analysis of ultrasound biomicroscopy (UBM) scanogramms of 4 patients with a history of trauma and signs of metallosis is performed. In all cases foreign body was found and its precise localization in relation to anterior segment structures was identified. The following changes were revealed and described: pathological changes of cornea, lens and its fibers, uveal tract in silent zone, zone of retinal periphery and secondary vitreous changes due to trauma itself and chemically active foreign body invasion and long persistence. UBM is recommended to be the part of examination algorithm in patients with penetrating ocular trauma and screening of latent metallosis.

Sympathetic ophthalmia : a blinding complication of ocular injury.

Sympathetic Ophthalmia is a rare and blinding ocular complication due to ocular injury. This condition in a male patient aged 25 years, is reported. The role of early recognition and management of this condition to preserve good vision is discussed.

The uvea in ocular trauma.

The uveal tissue is frequently affected in ocular trauma. Its anatomic and physiologic changes are responsible for many of the early and late clinical manifestations seen in the traumatized eye. Together with the retina, the uvea may be the tissue most responsible for the final visual and functional outcomes of the eye. Understanding its pathophysiology is the first step leading to proper management and ultimately to vision preservation.

[Clinical and immunomorphological parallels in posttraumatic uveitis]. / Kliniko-immunomorfologicheskie paralleli pri posttravmaticheskikh uveitakh.

Parallels between the clinical diagnosis, immunological parameters of the leukocyte migration inhibition test (LMIT) to eye tissue antigens (uveoretinal, lenticular, and retinal), and morphological picture are studied in patients with posttraumatic uveitis and consequences of grave penetrating injuries to the eye without uveitis symptoms. Cell sensitization to uveoretinal antigen is detected only in posttraumatic uveitis but not in consequences of injuries without uveitis. The authors come to a conclusion that only positive LMIT with uveoretinal or a combination of uveoretinal and lenticular antigens may be considered as an immunological validation of autoimmune posttraumatic uveitis. Further improvement of LMIT with purified fractions of uveoretinal antigens is needed.

Serum sialic acid levels in patients with sympathetic ophthalmitis.

Serum sialic acid levels were measured in 16 patients with sympathetic ophthalmitis, 36 with neglected traumatic uveitis following penetrating injury and 40 healthy subjects. There was no significant alteration of its level in patients with traumatic uveitis. However, its level was significantly elevated in patients with sympathetic ophthalmitis. It was high even in the early stage of the disease. It decreased significantly at the remission stage. It is proposed that measurement of sialic acid level in serum can be used as a diagnostic aid when the diagnosis of sympathetic ophthalmitis remains doubtful on clinical grounds. The extent of rise in its level may be considered a good parameter of the degree of severity of sympathetic ophthalmitis. It may also act as a useful tool to evaluate the drug efficacy in this disease.

The initiation of inflammation in uveitis.

The initiation of uveitis is related in every instance to some form of injury. This may be transient, as in the case of an axon reflex, or long-lasting and destructive as in the case of progressive granulomatous disease. The early responses to injury appear to be histamine-mediated, while the later responses are mediated by prostaglandins and kinins. Cellular injury may be caused by contusion, by antibody- or cell-mediated cytotoxic reactions, or by direct invasion of cells by micro-organisms. The deposition of immune complexes and complement in the uveal tract appears to be one of the most important mechanisms for the initiation of uveitis, but the mere finding of elevated levels of immune complexes in the serum has no special significance.

Sympathetic ophthalmia. A long-term follow-up.

Seventeen cases of sympathetic ophthalmia have been followed up for as long as 23 years (average 10.6 years). Sixty-five percent of those patients treated with corticosteroids retained a visual acuity of 20/60 or better. Complications were frequent and included secondary glaucoma, cataract, exudative retinal detachment, and choroidal scarring. Uneventful cataract extraction was difficult to manage, requiring frequent changes in the steroid dosage, and in one patient two glaucoma procedures. The duration of steroid therapy was quite variable and ranged from a few months to six years or longer. Relapses were common and several occurred many years after the initial episode had resolved. If the histopathologic picture were moderate or severe, the clinical course most often would be difficult and protracted.