Lesión macular bilateral tras la manipulación de un láser femtosegundo / Bilateral macular injury caused by a femtosecond laser

CASO CLÍNICO: Se describe el caso de un varón de 35 años de edad diagnosticado en Urgencias de lesión macular bilateral tras la exposición de forma accidental a la luz de un láser femtosegundo industrial. DISCUSIÓN: Los trabajadores que usan láseres industriales deben proteger sus ojos de forma adecuada cuando manejen estos instrumentos. Si no es así, pueden producirse lesiones en la retina, que aunque se suelen resolver, en ocasiones son causa de pérdida de visión mantenida

CASE REPORT: We describe the case of a 35-year-old man who arrived in the Emergency Department with bilateral macular injury caused by accidental exposure to an industrial femtosecond laser. DISCUSSION: Workers operating industrial lasers must protect their eyes properly when handling these devices. Otherwise, retina damage may occur which usually is recoverable. However, sometimes this damage causes permanent visual loss

Síndrome de pseudo-duane paraneoplásico secundario a tumor de mama / Pseudo-duane's paraneoplasic syndrome secondary to breast tumor

Se describe el caso clínico de una mujer de 50 años con antecedentes personales de cáncer de mama, que refiere alteraciones de los movimientos oculares. En la exploración se observa una limitación de la abducción y estrechamiento de la hendidura palpebral en aducción en ambos ojos. RMN craneal y orbitaria normales. Marcadores tumorales con títulos bajos. Se realiza el diagnóstico de Síndrome de pseudo- Duane, ya que se trata de un síndrome restricitivo adquirido. En este caso, su presentación clínica es similar al síndrome Duane tipo I, siendo contradictorio a lo descrito en publicaciones previas. Por otra parte, este síndrome está relacionado en el tiempo con su patología oncológica y la RMN es normal, por lo que lo consideramos un síndrome paraneoplásico. Destacamos la originalidad del caso debido a su inusual etiología, y clínica (AU)

We report the case of a 50 years-old woman with history of breast tumor and anormal ocular motility. An examination of ocular motility revealed limited abduction and narrowing of the palpebral fissure on adduction. Orbital and cranial nuclear magnetic resonance were normal. Tumor markers had low levels. We think about her oncologic history because of the beginning of the sintomatology in this period of time. The diagnosis was Pseudo-Duane syndrome, wich is a restrictive acquired syndrome. Despite clinical presentation was similar to Duane I syndrome, it is enterely different from it. We highlight the originality of the case due to its inusual ethiology(only one case published previously) and its clinical presentation (AU)

Bilateral macular injury caused by a femtosecond laser.

CASE REPORT: We describe the case of a 35-year-old man who arrived in the Emergency Department with bilateral macular injury caused by accidental exposure to an industrial femtosecond laser. DISCUSSION: Workers operating industrial lasers must protect their eyes properly when handling these devices. Otherwise, retina damage may occur which usually is recoverable. However, sometimes this damage causes permanent visual loss.

Perforación corneal como primera manifestación de síndorme de Sjören secundario a artritis reumatoide / Corneal melts as the initial manifestation of sjögren syndrome secondary to rheumatoid arthritis

La artritis reumatoide es una enfermedad sistémica inflamatoria crónica frecuente, de etiología desconocida. El síndrome de Sjögren puede ir asociado a dicha patología. El curso clínico de la artritis reumatoide a nivel ocular es muy variable y el diagnóstico temprano es determinante para prevenir graves complicaciones. Presentamos el caso de una mujer de 64 años de edad que acudió al Servicio de Urgencias por presentar ojo rojo bilateral con fotofobia, lagrimeo continuo, dolor y disminución de la agudeza visual. En la exploración se objetivó importante adelgazamiento del estroma corneal en OD y perforación corneal OI, que requirió recubrimiento tectónico con membrana amniótica. Los análisis serológicos mostraron los siguientes resultados: Factor Reumatoide+, ANA+, ENA Anti-Ro/SSA+, ENA Anti-La/SSB+. La paciente fue diagnosticada de Artritis Reumatoide y Síndrome de Sjögren secundario. Desde entonces, sigue un tratamiento sistémico con corticoides y azatioprina. Aproximadamente, el 25% de los pacientes desarrollan enfermedad oftalmológica, esencialmente queratoconjuntivitis seca (25%), epiescleritis, escleritis y queratitis. Estas manifestaciones son en general poco severas, pero hay un pequeño porcentaje de pacientes, como el caso que aquí presentamos, que sufren una inflamación ocular grave y que sin tratamiento inmunosupresor precozmente instaurado, pueden desarrollar úlceras corneales estériles, centrales o periféricas, que les puede llevar incluso a la perforación y destrucción del globo (AU)

Rheumatoid arthritis(RA) is a common chronic inflammatory autoinmune disease, with unknown etiology. Approximately 11-31% of RA patients have secondary Sjögren´s syndrome. Ophthalmologic manifestations of these diseases can cause corneal scarring, ulceration, infection, and even perforation; thus, although the prognosis is good for most patients with Sjögren syndrome and ophthalmologic features, individuals with complications have much guarded prognosis. We report the case of a 65 years old woman with photophobia, pain, tearing and blurred vision in both eyes. Slit lamp exam showed an important corneal melting right eye, and corneal perforation left eye, which required amniotic membrane transplantation. The diagnosis was: Rheumatoid Arthritis and secondary Sjögren´s Syndrome. Azathioprine treatment was started in combination with oral steroids. Approximately 25% of patients have ocular involvement, and keratoconjunctivitis sicca is the most frequent ocular complication. Although the prognosis is good in most cases, an early diagnosis is necessary to avoid several complications (AU)

Cambios morfométricos de las células del endotelio corneal en el síndrome pseudoexfoliativo y glaucoma pseudoexfoliativo / Morphometric changes of corneal endothelial cells in pseudoexfoliation syndrome and pseudoexfoliation glaucoma

Objetivo: Analizar el patrón morfométrico de las células endoteliales de la córnea y el espesor corneal central (ECC) en los ojos con pseudoexfoliativo (PEX) con y sin glaucoma, y compararlos con ojos normales y con glaucoma primario de ángulo abierto (GPAA). Método: Se incluyeron 166 pacientes en el estudio: 36 sujetos con síndrome seudoexfoliativo, 30 con glaucoma seudoexfoliativo (GPEX), 40 con GPAA y 60 pacientes normales. Los parámetros evaluados con el microscopio especular de no contacto fueron la densidad de células endoteliales (DCE), el coeficiente de variación ( CV ) del tamaño celular y el porcentaje de hexagonalidad. El ECC se midió con paquimetría de contacto. Resultados: La DCE y el porcentaje de hexagonalidad celular fueron menores en los sujetos con PEX y GPAA respecto al grupo control, mientras que el CV del tamaño celular fue mayor. Considerando los 2 grupos de ojos con PEX, se observó una tendencia hacia una mayor pérdida de células endoteliales y de modificaciones en los parámetros morfométricos en los ojos con GPEX. Las alteraciones en el patrón especular aumentaron progresivamente con la edad. No hubo diferencias significativas en el valor medio de ECC entre los 4 grupos. Conclusión: La densidad de células endoteliales está significativamente disminuida y el pleomorfismo y polimegatismo celular incrementado en los ojos con PEX, especialmente cuando la presión intraocular es alta (AU)

Objetive: To evaluate the corneal endothelial morphometry and central corneal thickness (CCT) in pseudoexfoliative (PEX) eyes with and without glaucoma and to compare with normal eyes and eyes with primary open-angle glaucoma (POAG).Method: A total of 166 patients were included in this study: 36 eyes with pseudoexfoliation syndrome (PXS), 30 eyes with pseudoexfoliation glaucoma (PXG), 40 eyes with POAG, and 60normal eyes. Corneal endothelial cell density (ECD), coefficient of variation (CV) in cell size, and percentage of hexagonal cells, were measured using a non-contact specular microscope, whereas CCT was measured with an ultrasonic pachymeter. Results: ECD and percentage of hexagonal cells were lower in PEX groups and in the POAG group compared with normal eyes, while the CV in cell size was greater. There was a tendency for greater cell loss and morphological abnormalities of the corneal endothelial cells in PXG eyes compared to PXS eyes, when all pseudoexfoliative eyes were analyzed together. Changes in endothelial cells increased with age. There were no significant differences in mean CCT between the four groups. Conclusion: Endothelial cell density is significantly decreased, and pleomorphism and polymegathism of cells are increased in PEX eyes, particularly when intraocular pressure is high (AU)

[Morphometric changes of corneal endothelial cells in pseudoexfoliation syndrome and pseudoexfoliation glaucoma]. / Cambios morfométricos de las células del endotelio corneal en el síndrome pseudoexfoliativo y glaucoma pseudoexfoliativo.

OBJECTIVE: To evaluate the corneal endothelial morphometry and central corneal thickness (CCT) in pseudoexfoliative (PEX) eyes with and without glaucoma and to compare with normal eyes and eyes with primary open-angle glaucoma (POAG). METHOD: A total of 166 patients were included in this study: 36 eyes with pseudoexfoliation syndrome (PXS), 30 eyes with pseudoexfoliation glaucoma (PXG), 40 eyes with POAG, and 60 normal eyes. Corneal endothelial cell density (ECD), coefficient of variation (CV) in cell size, and percentage of hexagonal cells, were measured using a non-contact specular microscope, whereas CCT was measured with an ultrasonic pachymeter. RESULTS: ECD and percentage of hexagonal cells were lower in PEX groups and in the POAG group compared with normal eyes, while the CV in cell size was greater. There was a tendency for greater cell loss and morphological abnormalities of the corneal endothelial cells in PXG eyes compared to PXS eyes, when all pseudoexfoliative eyes were analyzed together. Changes in endothelial cells increased with age. There were no significant differences in mean CCT between the four groups. CONCLUSION: Endothelial cell density is significantly decreased, and pleomorphism and polymegathism of cells are increased in PEX eyes, particularly when intraocular pressure is high.

Influence of CFH, HTRA1 and ARMS2 haplotype polymorphisms in the development of age-related macular disease.

OBJECTIVE: To demonstrate genetic influence on the onset of age-related macular disease (AMD), analyzing genotype distribution of haplotypes, including polymorphisms of genes with proved relationships with AMD risk (CFH, ARMS2, HTRA1) in patients with AMD and in healthy people. METHODS: We took 101 consecutive patients with an AMD diagnosis following Wisconsin international classification. For our control group, we took 91 patients without AMD or any significant macular changes. We analyzed CFH rs1410996, ARMS2rs 10940923 polymorphisms using real time PCR with taqman probes, and HTRA1 -625 using restriction endonuclease digestion. We studied haplotypes by simultaneously combining genotypes which, in previous studies, had been shown to have relationship with AMD (CFH, ARMS2, HTRA1) in patients with AMD and healthy people. RESULTS: There was a statistically significant higher proportion of patients with AMD simultaneously expressing CFH GG (rs1410996) and ARMS2 TT (rs10940923) (P=.037; OR: 7.742 [1.010-63.156]); ARMS2 TT (rs10940923) and HTRA1-625 TT (P=.001; OR: 9.006 [2.019-40.168]) and CFH GG (rs1410996), ARMS2 TT (rs1040923) and HTRA1 -625 GG (P=.043; OR: 6.702 [1.003-55.565]) genotypes. CONCLUSIONS: Haplotypes which combine "risk genotypes", demonstrated in previous studies, of our analyzed polymorphisms are more frequent in patients with AMD than in the control group, and they seem to increase the risk of suffering the disease in our population.

Influencia de haplotipos de polimorfismos de CFH, HTRA1 y ARMS2 en la aparición de degeneración macular asociada a la edad / Influence of CFH, HTRA1 and ARMS2 haplotype polymorphisms in the development of age-related macular disease

Propósito: Demostrar la influencia genética en el desarrollo de degeneración macular asociada a la edad (DMAE) analizando las distribuciones genotípicas de haplotipos de polimorfismos de genes con relación demostrada con la aparición de DMAE (CFH, ARMS2, HTRA1) en pacientes con DMAE y personas sanas. Método: Se tomaron 101 pacientes diagnosticados de DMAE (74 exudativa y 27 atrófica) según las normas del sistema internacional de clasificación Wisconsin. Como control se tomaron 91 pacientes sin DMAE ni otras alteraciones maculares. Se analizó el polimorfismo rs 1410996 del gen CFH, el rs 10940923 de ARMS2 mediante PCR a tiempo real con sondas Taqman y el HTRA1 -625 mediante digestión con endonucleasas de restricción .Se estudió la presencia de haplotipos que combinaban los genotipos que habían demostrado aumentar el riesgo de DMAE de los polimorfismos estudiados de CFH, HTRA1 y ARMS2 en estudios previos en nuestro grupo de pacientes y el grupo control. Resultados: Se demostró que es más frecuente en el grupo de pacientes, de forma estadísticamente significativa, la expresión simultánea de los genotipos GG de CFH (rs 1410996) y TT de ARMS2 (rs 10940923) (p=0,037; OR: 7,742 [1,010-63,156]); TT de ARMS2 (rs 10940923) y GG de HTRA1-625 (p=0,001; OR: 9,006 [2,019-40,168]) y GG de CFH (rs1410996), TT de ARMS2 (rs 1040923) y GG de HTRA1 -625 (p=0,043; OR: 6,702 [1,003-55,565]). Conclusiones: La presencia de haplotipos que combinan genotipos, considerados de riesgo en estudios previos, de los polimorfismos analizados es más frecuente en pacientes con DMAE y parece aumentar el riesgo de padecer la enfermedad en nuestra población(AU)

Objective: To demonstrate genetic influence on the onset of age-related macular disease (AMD), analyzing genotype distribution of haplotypes, including polymorphisms of genes with proved relationships with AMD risk (CFH, ARMS2, HTRA1) in patients with AMD and in healthy people. Methods: We took 101 consecutive patients with an AMD diagnosis following Wisconsin international classification. For our control group, we took 91 patients without AMD or any significant macular changes. We analyzed CFH rs 1410996, ARMS2 rs 10940923 polymorphisms using real time PCR with taqman probes, and HTRA1 -625 using restriction endonuclease digestion. We studied haplotypes by simultaneously combining genotypes which, in previous studies, had been shown to have relationship with AMD (CFH, ARMS2, HTRA1) in patients with AMD and healthy people. Results: There was a statistically significant higher proportion of patients with AMD simultaneously expressing CFH GG (rs 1410996) and ARMS2 TT (rs 10940923) (P=0.037; OR: 7.742 [1.010-63.156]); ARMS2 TT (rs 10940923) and HTRA1-625 TT (P=0.001; OR: 9.006 [2.019-40.168]) and CFH GG (rs 1410996), ARMS2 TT (rs 1040923) and HTRA1 -625 GG (P=0.043; OR: 6.702 [1.003-55.565]) genotypes. Conclusions: Haplotypes which combine «risk genotypes», demonstrated in previous studies, of our anlyzed polymorphisms are more frequent in patients with AMD than in the control group, and they seem to increase the risk of suffering the disease in our population(AU)

[Impact of Nd: YAG capsulotomy on quality of life in pseudophakic patients]. / Impacto de la capsulotomía Nd: YAG en la calidad de vida de pacientes pseudofáquicos.

OBJECTIVE: To determine whether visual acuity (VA) improvement in patients with posterior capsule opacification (PCO), accepted after the capsulotomy, is followed by positive changes in the perception of their quality of life. METHOD: A total of 130 patients with PCO were examined before and after capsulotomy. In addition to the ophthalmic examination, the EuroQol questionnaire was completed. We analyzed the influence of demographic characteristics on the outcome of the test. RESULTS: The mean binocular visual acuity (BVA) and the mean scores in the EuroQol dimensions and EQ-VAS improved significantly after capsulotomy. VA did not have the same effect on daily common tasks. After treatment, the problems in the usual activities dimension have seen the largest reduction. Mobility is still the dimension with more problems regarding patients after capsulotomy. CONCLUSIONS: Decreased VA induced by PCO is associated with difficulties performing daily living activities. Capsulotomy results in a gain in VA and functional ability of the majority of patients, improving the perception of their quality of life.

Impacto de la capsulotomía Nd: YAG en la calidad de vida de pacientes pseudofáquicos / Impact of Nd: YAG capsulotomy on quality of life in pseudophakic patients

Objetivo: Determinar si la mejoría de agudeza visual (AV) en los pacientes con opacificaciónde cápsula posterior del cristalino (OCP) que se acepta tras la capsulotomía, se traduce encambios positivos en la percepción de su calidad de vida.Método: Se evaluaron 130 pacientes con OCP antes y después de la capsulotomía. Ademásde la exploración oftalmológica se recogieron las respuestas del cuestionario EuroQol y seestudió la influencia de factores demográficos en el resultado del test.Resultados: La agudeza visual binocular (AVB) media y las puntuaciones medias de las cincodimensiones del cuestionario EuroQol y de la EVA mejoraron en el conjunto de pacientesde forma estadísticamente significativa tras la capsulotomía. No todas las tareas de la vidadiaria se afectan en el mismo grado por el estado de la AV. Las limitaciones en la dimensiónde actividades cotidianas son las que más disminuyen con el tratamiento. La dimensión enla que más dificultades continúan relatando los pacientes tras la capsulotomía es en la demovilidad.Conclusiones: La deficiencia visual ocasionada por la OCP conlleva dificultades para realizarlas actividades cotidianas. La capsulotomía supone un incremento en la AV y en lafuncionalidad de la mayoría de los pacientes, mejorando la percepción sobre su estado desalud(AU)

Objective: To determine whether visual acuity (VA) improvement in patients with posteriorcapsule opacification (PCO), accepted after the capsulotomy, is followed by positive changesin the perception of their quality of life.Method: A total of 130 patients with PCO were examined before and after capsulotomy. In addition to the ophthalmic examination, the EuroQol questionnaire was completed. We analyzed the influence of demographic characteristics on the outcome of the test. Results: The mean binocular visual acuity (BVA) and the mean scores in the EuroQol dimensionsand EQ-VAS improved significantly after capsulotomy. VA did not have the same effecton dailycommontasks. After treatment, the problems in the usual activities dimension haveseen the largest reduction. Mobility is still the dimension with more problems regardingpatients after capsulotomy.Conclusions: Decreased VA induced by PCO is associated with difficulties performing dailyliving activities. Capsulotomy results in a gain in VA and functional ability of the majorityof patients, improving the perception of their quality of life

[Orbital manifestation of Wegener's granulomatosis]. / Manifestación orbitaria de la enfermedad de Wegener.

CASE REPORT: Patient who consults for a recidivant orbital mass. Preliminary clinical and image studies suggested an initial differential diagnosis between a lachrymal gland tumor or an orbital located pseudotumor. However, the clinical evolution of the case required a re-evaluation of the preliminary diagnosis. The clinical, histologic and serologic findings were key in the final diagnosis. DISCUSSION: Wegener's granulomatosis is a necrotizing vasculitis. Classically it affects the upper airways, lungs and kidneys. Between 30% and 70% of patients present ophthalmic symptoms during the course of the illness. Ophthalmic affectation prior to systemic manifestations is less frequent and could delay final diagnosis.

Opacificación de la cápsula posterior: alternativas frente al pragmatismo del láser de Nd: Yag / Posterior capsule opacification: alternatives versus the pragmatism of Nd: Yag laser

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[Effectivity versus toxicity of minoxidil as antiproliferative agent for lens epithelial cells. In vitro study]. / Efectividad versus toxicidad del minoxidil como agente antiproliferativo de células epiteliales de cristalino. Estudio in vitro.

PURPOSE: To evaluate the inhibitory effect of minoxidil on cultured proliferating lens epithelial cells (LECs) versus cytotoxic effect over corneal endothelial cells in culture, because minimum side effects over anterior chamber structures and particularly on corneal endothelium are required for successful therapy and prevention of posterior capsular opacification (PCO). METHODS: New Zealand Rabbit LECs and corneal endothelium were cultured in DMEM at 35 degrees C in 5% CO2 in multiwells during 7 days. Both types of cells were exposed to minoxidil (1, 2 and 4 mM) for 1 and 24 hours. Control group and balanced salt solution group were included. After seven days multiwells were processed for light microscopy study. Morphometric study of cellular population of LECs and corneal endothelium cells were done using a computed planimetry system. RESULTS: Dose-dependent effect on LECs proliferation was noted and non-confluent colonies of cells were observed on all treated groups. Morphologic changes in normal appearance of corneal endothelial cells after 1 hour of minoxidil treatment was observed and intracellular alterations were confirmed even with the lowest dose exposure. CONCLUSIONS: Although effectiveness of minoxidil suppressing in vitro LECs proliferation could be suggest as a useful therapeutic agent to prevent PCO, however the inhibitory effect of different concentrations on corneal endothelial cells conditioned its possible use on ocular surgery.

Efectividad versus toxicidad del minoxidil como agente antiproliferativo de células epiteliales de cristalino. Estudio in vitro / Effectivity versus toxicity of minoxidil as antiproliferative agent of lens epithelial cells. In vitro study

Objetivo: Evaluar el efecto inhibitorio del minoxidil sobre la supervivencia de células epiteliales de cristalino (CEC) en cultivo versus el efecto sobre el endotelio corneal, ya que para un eficaz tratamiento y prevención de la opacificación capsular posterior (OCP), se requiere una mínima afectación de las estructuras de la cámara anterior y especialmente del endotelio corneal. Métodos: Las células de epitelio de cristalino y de endotelio corneal procedentes de ojo de conejo New Zealand fueron cultivadas en medio de DMEM a 35 ºC y 5 por ciento de CO2 en portas multipocillos durante 7 días. Ambos tipos de células fueron expuestos a minoxidil (1,2 y 4 mM) durante 1 y 24 horas. Se incluyeron igualmente un grupo control y un grupo expuesto a solución salina balanceada. Las placas fueron procesadas para estudio con microscopía óptica a las 24 horas y a los 7 días de seguimiento. El estudio morfométrico de la población de CEC y del endotelio corneal se realizó con un sistema de planimetría computarizado. Resultados: El efecto observado sobre la supervivencia fue dosis-dependiente en los cultivos celulares de CEC y se observaron colonias no confluentes en todos los grupos tratados. Se observaron cambios morfológicos en el endotelio corneal después de 1 hora de tratamiento con minoxidil y se confirmaron alteraciones intracelulares incluso en la dosis más baja empleada. Conclusiones: La efectividad del minoxidil como inhibidor del crecimiento in vitro de CEC podría sugerir su uso como agente preventivo en la OCP sin embargo el efecto inhibitorio que igualmente se observa sobre las células de endotelio corneal a las concentraciones utilizadas, condiciona su posible utilización en cirugía ocular (AU)

Efecto de la mitomicina c sobre el endotelio corneal. Estudio in vitro / Effect of mitomycin C on corneal endothelium cells. In vitro study

Objetivo: La mitomicina C es un antibiótico con capacidad antimitótica que ha demostrado su eficacia como inhibidor de la proliferación fibroblástica y su uso se ha extendido en la cirugía del glaucoma. En el presente estudio se evaluó el efecto de la mitomicina sobre cultivos monocapa de endotelio corneal de conejo albino. Métodos: La fuente de células endoteliales para los cultivos fueron ojos de conejo albino raza New Zealand. El aislamiento de las células se realizó mediante disociación mecánico-enzimática a partir del complejo endotelio corneal-membrana de Descemet. El medio de cultivo empleado fue EMEM. Se realizó el tratamiento de tres grupos de placas expuestas a mitomicina C a tres concentraciones de 2x10 (AU)

[Effect of mitomycin C on corneal endothelium cells. In vitro study]. / Efecto de la mitomicina C sobre el endotelio corneal. Estudio in vitro.

PURPOSE: Mitomycin C is an antibiotic with a demonstrated antiproliferative capacity as an inhibitor of fibroblastic cells proliferation. Its use has been extended in glaucoma surgery. In the present study, we evaluated mitomycin C effect on cell culture monolayer of rabbit corneal endothelium. METHODS: The source of corneal endothelium for cell culture was New Zealand albino rabbit eyes. Desegregation of cells was carried out with mechanic and enzymatic dissociation from corneal endothelium and Descemet membrane. Culture medium was EMEM. Three treatment groups of plates were exposed to three different concentrations of mitomycin C 2x10(-3) mg/ml, 2x10(-2) mg/ml and 2x10(-1) mg/ml. Control and witness plate groups were also established. The morphometric study was performed through quantitative analysis with a video system connected to the light microscope. RESULTS: Different morphological changes related with cell size, cytoplasm and dyeing were seen at the morphological study and several degenerative signs were established indicating cellular death and a very decrease of the cellular population. In the groups treated with minimal dose (2x10(-3) mg/ml) and 3 days evolution time, cellular population was 434 cels/mm(2), 7 evolution days group cell density was 300.97cels/mm(2), and at 14 days it was 201.88 cels/mm(2). The percentage of survival in all the groups of treated cells was under 50%. CONCLUSIONS: Mitomycin C in concentrations and exposure time as used in this study has a potent lethal effect on this cellular type that compromises to a greater or smaller extent their function and integrity.

Measurement error in assessing the size of cortical cataracts from retroillumination photographs.

This study describes a new method of quantifying anteriorly located cortical cataracts using retroillumination photographs and computer planimetry. Cortical cataracts were graded clinically and then photographed using the Neitz retroillumination camera twice by each of 2 photographers. The cataract outlines were traced onto a transparent overlay, and computer planimetry was performed using a Scan Maker 600ZS, a MAC II Computer and specially developed software. We estimated the measurement error of the method and its associated effect on sample size estimates for clinical studies. We calculated that the variability in this technique would contribute about 21 additional subjects to overall sample size estimates in studies comparing the mean areas of cortical opacities. In many studies this would be a small addition to total sample size requirements. This technique provides clinically useful measurements of the size of a cortical opacity as seen on a retroillumination photograph. This may be useful for future clinical studies on natural progression of cortical cataracts as well as for clinical trials of anticataract drugs.