Posttraumatic temporal TGF-ß mRNA expression in lens epithelial cells of paediatric patients.

The aim of the study was to determine temporal TGFB1, TGFB2 and TGFB3 gene expression profiles in the anterior lens capsule of paediatric patients with posttraumatic cataract. The patient group comprised 22 children selected with a fragment of anterior lens capsule obtained during elective cataract surgery and sampled for molecular analysis. The levels of TGF-ß isoforms in the anterior lens capsule were determined based on the number of mRNA copies per 1 µg total RNA by real-time qRTPCR. Three time-related result clusters were identified based on hierarchical cluster analysis: 2.2, 4.4 and 15.0 months (time span from injury to anterior capsule sampling during surgery) and compared with regard to temporal gene expression profile and quantitative relations of TGF-ß1, 2 and 3 mRNAs. TGF-ß1, TGF-ß2, and TGF-ß3 mRNAs were detected in all anterior lens capsule samples. A comparative analysis revealed: TGF-ß1>TGF-ß2>TGF-ß3 during the entire observation period. The TGF-ß mRNA levels continued to increase up to four months after injury, then returning close to the base levels after around 15 months. The expression patterns of TGF-ß isoforms showed a similar tendency. Differences in the expression levels of TGF-ß1 and TGF-ß2 between the particular clusters were statistically significant. Posttraumatic transcriptional activities of TGF-ß1 and TGF-ß2 in the anterior lens capsule of paediatric patients depend on the time elapsing from injury. Our findings indicate that the transcriptional activities of TGFB family genes show a transient period of over-expression during the months after injury. TGF-ß1 is a dominant isoform expressed in lens epithelial cells following injury.

[Use of a diode laser for glaucoma in children and adolescents]. / Zastosowanie lasera diodowego w jaskrze u dzieci i mlodziezy.

OBJECTIVE: To present the results of the use of diode laser in the treatment of secondary glaucoma in children. MATERIAL AND METHODS: The study was performed on 15 eyes in 14 children (7 males and 7 females) with glaucoma resistant to pharmacotherapy. Transscleral contact cyclophotocoagulation (TSCPC) was performed using SLx diode laser (Iris Medical Instrument). The number of photocoagulations performed within the circumference of 270 degrees ranged from 18 to 30 and the energy depended on "pop sound". RESULTS: In one child visual acuity decreased from 0.5/50 to light perception, while in the remaining children it did not change. Prior to coagulation, the mean intraocular pressure was 37.67 +/- 3.2 mm Hg, and 6 months after coagulation it was 22 +/- 3.74 mm Hg. CONCLUSIONS: TSPC is a well tolerated method of treatment in children with pharmacotherapy-resistant glaucoma. In order to assess the late outcomes of the therapy, prolonged observation of the patients is required.

[Trabeculectomy as the initial procedure in primary congenital glaucoma]. / Trabekulektomia jako pierwszy zabieg w pierwotnej jaskrze wrodzonej.

PURPOSE: To estimate the effectiveness of trabeculectomy performed in buphthalmic eyes. MATERIAL AND METHODS: 42 eyes of 24 children, 14 boys and 10 girls. There were 18 children (32 eyes) operated on at the age from 7 days to 12 months (group I) and 6 patients (10 eyes) at the age from 3 to 7 years (group II) with primary congenital glaucoma. Corneal diameter ranged from 11.5 to 15 mm in infants, in 10 eyes of 6 children elder than 2 years it was from 13 to 15 mm. The axial length of eyeballs was from 19 to 23.5 mm. Forty five trabeculectomies were performed, in 3 cases they were repeated two and six years after the first procedure. Follow up was from 1 year to 22 years, mean 82 months, 7 years of group I, 6 years of group II. RESULTS: 29 of 42 eyes (64.2%) with intraocular pressure varied between 8 and 21 mm Hg, other eyes required additional local antiglaucoma treatment. Normal IOP was obtained in 95.2% of eyes. Trabeculectomy normalized IOP in 68.9% eyes of infants (group I), whereas in elder children the percentage came up to 50 (group II). In other eyes pharmacological agents decreased IOL to values below 21 mm Hg, in the group I in 97% of eyes and in the group II in 90% of cases. CONCLUSION: Trabeculectomy performed as a first procedure in primary congenital glaucoma is effective in infants and older children with buphthalmos in long-term follow-up. The necessity to perform this operation in very small children and even neonates does not always mean poor prognosis, and intraocular pressure can be stabilized at safe level for many years.

[Scanning laser tomography in the diagnosis of juvenile glaucoma]. / Skaningowa tomografia laserowa w diagnostyce jaskry mlodzienczej.

The aim of our research was to evaluate the optic nerve head parameters of children with juvenile glaucoma with the scanning laser ophthalmoscope from Laser Diagnostic Technologies Inc. The material consisted of 46 eyes of 25 children aged from 7 to 18 years. There were 18 glaucomatous eyes (I group) and 28 eyes without glaucoma (II group) as a control group. The three examinations were repeated every three months. Mean values of Vol. B in the glaucomatous group were -0.327 +/- 0.098, first visit; -0.390 +/- 0.130, second visit; 0.344 +/- 0.096 mm3, third visit. These values in the control group were--0.234 +/- 0.73; -0.224 +/- 0.071; -0.252 +/- 0.069 mm3. The difference was statistically significant. Mean values of Volume A were significantly lower in the I group: 0.216 +/- 0.034, 0.207 +/- 0.033, 0.203 +/- 0.030 mm3 than in the II group: 0.269 +/- 0.039, 0.283 +/- 0.032, 0.271 +/- 0.042 mm3. CD ratio was higher in the glaucomatous eyes: 0.447 +/- 0.080; 0.491 +/- 0.069; 0.484 +/- 0.074 in comparison with the control group: 0.376 +/- 0.060; 0.368 +/- 0.067; 0.399 +/- 0.056. It was significant difference. More changes of biomorphometric parameters of the optic nerve head were observed in the glaucomatous group during follow-up period. The role of laser scanning ophthalmoscopic tomography is very important in the diagnosis of early forms of juvenile glaucoma in the youth.

[Cataract in uveitis in children]. / Zacma w zapaleniu blony naczyniowej oka u dzieci.

PURPOSE: To evaluate the anatomical and functional state of eyeballs after cataract extraction in uveitis in children and to analyze the factors affecting visual outcome. MATERIAL AND METHODS: Among 182 examined eyes with uveitis we have observed cataract in 22 eyeballs of 17 children (12%). Before operation in 72.7% cases visual acuity was less or equal 0.02, in the others it was not more than 0.2. The age of patients ranged between 2 and 18 years, the mean age 8 years. The cause of uveitis was: chronic tonsillitis or sinusitis in 6 patients, juvenile rheumatoid arthritis in 2 patients, heterochromic Fuchs iridocyclitis in 2 children, in the others the cause was unknown. In 4 eyeballs (18%) we have observed increased intraocular pressure before operation. Follow-up ranged from 6 months to 15 years, the mean was 5 years. RESULTS: We have obtained normal visual acuity in 31.8% cases and better than 0.1 in 68.2% od eyes. In children with juvenile rheumatoid arthritis, 2 eyeballs lost light perception as a result of corpus vitreous fibrosis and in one case we have observed only light perception. Optic nerve glaucomatous neuropathy was the cause of poor functional result in 2 eyes (0.02 and 0.04). Another causes of not satisfactory visual acuity were: corneal dystrophy (2 eyes), cystoid macular oedema (2 eyes) and amblyopia ex anopsia (2 eyes). CONCLUSIONS: We have obtained normal or good visual acuity in majority of the operated eyes. The causes of poor vision were the anatomical changes after uveitis before the cataract extraction.

[Laser scanning laser ophthalmoscopy in diagnosis of juvenile glaucoma cases with myopia]. / Laserowa tomografia skaningowa glowy nerwu wzrokowego w diagnostyce jaskry mlodzienczej w oczach krótkowzroczynch.

UNLABELLED: The diagnosis of the open angle glaucoma in myopic eyes remains one of the major problems, as the changes of the optic head in myopia may be similar to glaucomatous changes. The aim of the study was to analyse biomorphometric parameters of the optic nerve head in myopic eyes with glaucoma with scanning laser ophthalmoscope from Laser Diagnostic Technologies Inc. There was 29 children examined and among them 12 children with glaucoma and myopia as a study group (I) and 17 children with myopia as a control group (II). RESULTS: TCA means values; group I: 1.994 +/- 0.158, group II:2.028 +/- 0.200 CD means values; group I; 0.315 +/- 0.072, group II: 0.247 +/- 0.057 Rim means values; group I: 1.366 +/- 0.164, group II: 1.511 +/- 0.136 Vol. A mean values; group I: +0.205 +/- 0.03, group II: +0.83 +/- 0.03 Vol. B mean values; group I: -0.159 +/- 1.608, group II: -0.117 +/- 0.08. Average values of the biomorphometric parameters of the optic nerve head were worse in group I than in group II, but there was not statistical significance between the differences. Scanning laser ophthalmoscopy may be used as very important additional examination in juvenile glaucoma cases with myopia.

[The significance of myopia and birth weight in prematurity]. / Wartosc krótkowzrocznosci a urodzeniowa masa ciala u wczesniaków.

AIM: The relation between myopia and birth weight of premature newborns was assessed in this study. MATERIAL AND METHODS: There were 90 children (180 eyes) involved in the study, their birth weight ranged between 580 and 2450 g (mean 1698), and myopia ranged from -1.5 to -22.5 D (mean -9.8 D). Children were divided into two groups: group I: 38 children (76 eyes) with birth weight from 580 to 1500 g (mean 1158 g), group II: 52 children (104 eyes) with birth weight from 1501 to 2450 g (mean 2093 g). Mean value of myopia in group I was -10.4 D and -9.4 D in group II. RESULTS: The results were assessed with Statgraphics software. The analysis of mean values regression showed no relation between myopia and birth weight in group I (regression coefficient b = 0.003, p = 0.24) and no relation in group II (regression coefficient b = 0.008, p = 0.016) at significance level alpha = 0.01.

[The computer as an assistant to the physician]. / Komputer pomocnikiem lekarza.

BACKGROUND: The possibilities of using computer in physician's research work are presented as an example of statistical analysis of axial eyeball length in relation to the age in myopic children with low birthweight. MATERIAL AND METHODS: The study group consisted of 100 children aged from 3 to 15 years, with birthweight from 580 to 2450 g, where in 180 eyes myopia ranging from -1.5 to -22.0 Dsph and axial length of the eye from 20.0 to 30.9 mm were present. The dynamics of eyeball's axial length increase was compared between two groups: one-in which no symptoms of retinopathy of prematurity were present (no-RROP), and the second--in which signs of regressed retinopathy of prematurity were observed (RROP). RESULTS: The results of the analysis are shown in analytical and graphical modes. Statistically significant differences were shown between axial lengths of eyeball's in the analysed groups of mean 9-year-old premature children (no-RROP: 25.19 mm and RROP: 24.33 mm). It was shown that the use of a computer reduces the time of performing statistical analysis of large amount of data.

[Condition of the posterior capsule in pseudophakia in children]. / Stan tylnej torebki soczewki w pseudofakii u dzieci.

PURPOSE: Evaluation of the posterior capsule transparency in children after congenital cataract surgery with posterior intraocular lens implantation. MATERIAL AND METHODS: Examination comprised 41 eyes of 29 patients with posterior IOLS, aged 5-17 years (mean 10.3). In all cases, posterior capsule was unimpaired during surgery. RESULTS: During follow-up, (mean 27 months), 36.6% the eyes showed posterior capsule opacity of various degree. Neodymium YAG laser capsulotomy was performed in 13 cases and instrumental capsulotomy in 2. Opacity of the posterior capsule caused a decrease of visual acuity below 0.4. It improved after capsulotomy in all cases. No serious complications were observed.

[Eyeball axis changes in children's myopia]. / Zmiennosc osi galki ocznej w krótkowzrocznosci u dzieci.

The aim of study was to assess changes in eyeball axial length in myopic children depending on age in comparison with hyperopic and emmetropic groups. The study group consisted of 200 children (100 girls and 100 boys), from 3 to 17 years old (mean 9.8). Myopia was diagnosed in 376 eyes (-4.0 D to -24.0 D, mean -9.64 D) with axial length from 21.0 to 30.95 mm (mean 26.05 mm). Control group consisted of 334 eyes (167 children) with mean refraction +0.53 D and axial length from 20.0 to 23.9 mm (mean 22.36 mm). We have used the Statgraphics program for statistical analysis. A statistically significant difference was found between mean eyeball axial length within myopic group of girls (mean 25.77 mm) and boys (mean 26.31 mm) with p = 0.321 and significance level alpha = 0.05. The axial length increases irregularly over time. The axis of the eyeball in myopic children aged between 3 and 17 increases more than in emmetropic and hyperopic (up to 1.0 D) children.

[Primary intraocular implants in congenital cataract]. / Pierwotne wszczepy w zacmie wrodzonej.

Analysis of 47 eyes in 31 patients, aged 5-17 years with posterior or anterior IOL's implantation performed during cataract surgery was done. Visual acuity examined 7 days after surgery was 0.02-0.4 in the cases with cataract in one eye and 0.2-1.0 in those with cataract in both eyes. After the mean period of 2.5 years, visual acuity of at least 0.5 was achieved in all cases with binocular pseudophakia and in 20% of those with one pseudophakic eye. Uveitis was the most frequent complication in early postoperative period (25.5% of eyes) and posterior capsule opacities were observed later (31.9% of eyes).

[Ocular changes in Down's syndrome]. / Objawy oczne w zespole Downa.

The authors analyzed the kind of ocular changes and methods of therapy in 34 children, aged 5 months to 14 years, treated in the clinic in the years 1982-1992. The most frequent change was congenital cataract. The other signs observed were: Brushfield's spots, alternate esotropia, nystagmus, partial optic atrophy, retinal detachment, congenital glaucoma, ectropion and keratoconus. Occurrence of several anomalies were frequent. The adequate surgical treatment was applied depending on the kind of changes. Cataract extraction was made by aspiration method. Visual acuity improved in 58.8% of eyes.

[Occurrence of glaucoma in phakomatosis]. / Wystepowanie jaskry w fakomatozach.

Our clinical material of the last 10 years comprised 8 cases of phakomatosis with glaucoma: 6 children with Sturge-Weber-Krabbe's syndrome and 2 with Recklinghausen's disease. The age of the children was 15 months to 16 years. In 5 children with Sturge-Weber-Krabbe's syndrome glaucoma was found in one eye, in all cases with Recklinghausen disease it was bilateral. The following surgical methods of treatment were applied: trabeculectomy, trabeculectomy with cataract aspiration, cyclo-cryo-application and perforative cyclo-diathermy. The normalisation of the intraocular pressure was achieved in 88.9% of cases.

[Myopia as a complication of retinopathy of prematurity]. / Krótkowzrocznosc jako powiklanie retinopatii wczesniaków.

Studies were carried out on a total of 103 children, aged 3-15 years, with birth weight 580-2450 g (mean 1710 g), with myopia of various degree. Relationships between axial length of the eye, birth weight, gestational age, duration of oxygen exposure and the degree of myopia were evaluated. Analyses of vascular and retinal changes in the fundus of the eye typical of regressed retinopathy of prematurity were performed. The values of myopia ranged from 1.5 D to 22.0 D (mean (9.78 D) and axial length from 20.36 to 30.9 mm (mean 25.08). The studies revealed that myopia in retinopathy of prematurity is not associated with the axial elongation of the eyeball. No relationship between the degree of myopia and other examined parameters was found.

[Tumors of the eye in childhood]. / Guzy nowotworowe oka w wieku dzieciecym.

Cases of benign and malignant tumors treated in Children's Ophthalmological Clinic of Silesian Medical Academy in Katowice in the years 1982-1991 were presented. The clinical material comprises 135 eyes in 129 children. The benign tumors occurred in 83 children (64.3%) and malignant tumors in 46 children (35.7%). The most often observed benign tumor was naevus pigmentosus (23.7%) and the malignant tumor was mainly retinoblastoma (34.8%).

[Diagnostic and therapeutic problems of juvenile glaucoma]. / Problemy diagnostyki i leczenia jaskry mlodzienczej.

The material comprised 27 patients, aged 6-15 years, treated for juvenile glaucoma. Non-typical first symptoms, good visual acuity in the majority of the cases, the lack of anatomical changes of anterior segment of the eye and the elongation of the anatomic axis, difficulties in the evaluation of optic disc changes, especially in myopic eyes, and the lack of correlation of these changes with the results of visual field examination, little reliable in children, and also very often the normal intraocular pressure values, delay the diagnosis and make it much more difficult. The repetition of tests and the indication of the C factor make the diagnosis much easier. During the follow-up, intraocular pressure was well-controlled in 87% of the cases, 10% of them with additional optic treatment.