Intravitreal injection of dispase causes retinal hemorrhages in rabbit and human eyes.

PURPOSE: To check the effects of intravitreally injected dispase in the vitreo-retinal region. METHODS: Dispase, 0.05 to 2.5 units dissolved in 100 microl of phosphate-buffered saline, was injected into the midvitreous of rabbits which were killed from 15 to 120 min afterwards. The enzyme was also injected into four human eyes of patients with orbital tumors 15 min before enucleation during orbital exenteration surgery. The eyes were examined in vivo as well as by light and electron microscopy. RESULTS: Hemorrhages were detected by fundus observations and confirmed by microscopical analysis in nearly all rabbits and in half of the human eyes. The red blood cells were observed in the vitreous and retina. Breaches in the inner limiting membrane were visualized in human eyes and ruptures of small blood vessels in rabbit eyes. In spite of that, vitreous detachment was not verified. In fact, the cortical-vitreous collagen-fibril network was conspicuous on scanning electron micrographs. CONCLUSIONS: Retinal hemorrhages were evident as early as 11 min after injection. It is suggested that this enzyme degraded selectively basement membrane components without affecting other proteins involved in the vitreous-retinal junction.

Síndrome de Íris Plateau: relato de 3 casos / Plateau Iris Syndrome: report of 3 cases

Objetivo: Relatar 3 casos de síndrome de íris plateau, um tipo incomun de glaucoma de ângulo fechado. Local: Departamento de Oftalmologia do Hospital de Clínicas da Universidade Federal do Paraná (HC-UFPR). Métodos: Descrição de 3 casos de síndrome de íris plateau, diagnosticados através da evolução clínica, gonioscopia e biomicroscopia ultrassônica (UBM). Resultados: Os achados gonioscópicos foram: ângulo estreito ou fechado com câmara anterior de profundidade central próxima do normal e íris plana, mesmo com iridotomia ou iredectomia patente. A UBM mostrou anteriorização dos processos ciliares, ausência de sulco ciliar e raiz da íris aposta ao trabeculado. Conclusões: O diagnóstico da síndrome de íris plateau baseia-se, fundamentalmente, nos achados clínicos (gonioscópicos) e nos achados da UBM. A iridoplastia a laser e/ou o uso de pilocarpina são os métodos terapêuticos de eleição.

Estudo do comportamento da pressão intra-ocular em pacientes diabéticos, hipertensos e normais (Projeto Glaucoma) / Analysis of the intraocular pressure in diabetes hypertensive and normal patients (Glaucoma Project)

Objetivo: Analisar os valores da pressão intra-ocular (PIO) entre diferentes grupos de pacientes (diabéticos, hipertensos com ou sem retinopatia) e a população normal. Métodos: Realizou-se a aferição da pressão intra ocular (PIO) em um total de 924 olhos de 482 pacientes com idade igual ou maior que 40 anos (x=56,70;dp=11,89) examinados segundo um protocolo de estudo que incluiu medida da PIO, pressão arterial e glicemia, além da fundoscopia. A determinação da PIO foi obtida pelo tonômetro de aplanação de "Goldmannn" e a glicemia foi aferida por meio de tiras reativas (Destrostix-Bayer). Em seguida os pacientes foram divididos em 7 (sete) grupos: hipertensos, hipertensos com retinopatia, diabéticos, diabéticos com retinopatia, hipertensos e diabéticos, hipertensos e diabéticos com retinopataia e a população controle.

Purpose: To correlate the values of intraocular pressure (IOP) obtained by applanation tonometer (Haag-Streit, Bern, Switzerland) in patients with diabetes mellitus (with or without diabetic retinopathy), hypertension (with or without hypertensive diabetic retinopathy) and the normal population. Patients and Methods: Subjects participating in the Glaucoma Project (n = 924, 40 or more years old) were examined according to standard protocols including IOP measurement, fundoscopy, blood pressure and glucose determination. Patients were divided into seven groups: diabetic patients without diabetic retinopathy, hypertensive patients without hypertensive retinopathy, diabetic hypertensive patients without retinopathy, diabetic patients with diabetic retinopathy, hypertensive patients with hypertensive retinopathy, diabetic hypertensive patients with retinopathy and population-based control. Results: Applying the one-way ANOVA test to a normal distribution at 5% significance, it was observed that IOP values were higher in the groups of hypertensive patients without retinopathy (mean = 16.10), hypertensive patients with hypertensive retinopathy (mean = 16.33) and diabetic hypertensive patients with retinopathy (mean = 16.95) when compared with the other groups. Conclusion: The mean IOP value increases progressively with the evolution of systemic hypertensive disease and when it is associated with diabetes.