[Visual system function in patients after surgery for intracranial tumors]. / Ocena stanu funkcjonalnego narzadu wzroku u pacjentów po przebytych operacjach guzów wewnatrzczaszkowych.

UNLABELLED: Visual function was studied in patients after operations for brain tumours. The study group comprised 7 cases. Visual acuity, field of vision by kinetic and static methods and visual evoked potentials were studied before and after operations. The follow up time was from 1 to 51 months, mean 20 months. In all patients decreased visual acuity, visual field defects and VEP abnormalities were found, before operation. The first control examination after operation showed improvement of visual acuity in 2 cases after removal of pituitary tumours, and worsening of vision in all the remaining ones. In two cases of tumours spreading to the basis of the frontal lobe blindness of one eye developed. Static and kinetic perimetry showed in all cases enlarged visual field defects. VEP confirmed that removal of pituitary tumours compressing visual tract can improve vision: P100 amplitudes increased and latencies become shorter. Further VEP improvement occurred even 6-20 months after achieving of good visual acuity. No improvement of vision developed if the visual pathway had been damaged during the operation. CONCLUSIONS: Pituitary tumours can be removed without damage to the surrounding structures and vision can improve after that. Meningiomas and gliomas lying in immediate vicinity of optic nerves and their chiasma or growing out from them are usually large and often their removal is associated with damage to the visual pathway leading to visual field defects to blindness. The assessment of vision should be based on static and kinetic perimetry and visual evoked potentials (VEP) since these methods are mutually complementary and only their comparison provides a full result.

[Electroretinogram and electrooculogram in retinal degeneration]. / Elektroretinogram i elektrookulogram w zwyrodnieniach siatkówki.

Electroretinogram (ERG) and electrooculogram (EOG) are fundamental for proper early diagnosis of retinal dystrophies and degenerations. The most characteristic changes of ERG and EOG in such retinal dystrophies as Stargardt's disease, Best's disease, fundus flavimaculatus, fundus albipunctatus, retinitis pigmentosa, choroideremia, iuvenile retinoschisis, congenital stationary night blindness, progressive cone dystrophy and in some of retinal degenerations for differential diagnosis were described. Electrophysiological state of retina in retinal dystrophy depends on patient's age and pattern of inheritance. Very often typical for dystrophy changes in ERG and EOG without any visible pathology on eye fundi are found. On the other hand there are some of degenerations similar to dystrophies in clinical examination. In such cases only ERG and EOG allow to be sure which diagnosis should be done.

[The seasonal course of recurrent uveitis in children and youth]. / Sezonowy przebieg nawrotowego zapalenia blony naczyniowej u dzieci i mlodziezy.

PURPOSE: To analyse the etiology, localisation of inflammation, frequency of recurrences and the visual function in the course of uveitis in children. MATERIAL AND METHODS: Sixteen children aged 4-18 years with uveitis were analysed for 2 to 15 years (mean 6.3 years) from the occurrence of the first symptoms. The ophthalmological examination, laboratory investigations, pediatric, stomatology and laryngology consultations were performed in all children. The medical topical and general treatment in all patients was applied. RESULTS: The certain etiological factors were found in 9 patients, the probable ones in 2 children and in 5 cases the cause of the illness was not established. Clinical inflammation was located in different parts of uvea, in 10 children it appeared in one eye and in 6 children in both. The course of illness showed a recurrent character (from 1 to 8 recurrences) in most children. We have established three seasonal occurrences of the disease, mainly in spring and autumn, less at the beginning of summer. After treatment the visual acuity improved in 17 eyes (77.3%), in 3 eyes (13.6%) it did not change and in 2 eyes (9.1%) got worse. CONCLUSIONS: The chronic, recurrent uveitis in children has a seasonal character (three times a year). The rheumatic disease is the main cause of multiple recurrences of uveitis in children. The early diagnosis of illness and careful medical supervision until the children are 16-18 years old may improve the final results of treatment.

[The effect of prenatal exposure to cadmium on flash visual evoked potentials in rat offspring before and after injection of norepinephrine into the lateral brain ventricle]. / Wplyw kadmu stosowanego prenatalnie na wywolane blyskami wzrokowe potencjaly kory potylicznej potomstwa szczurów przed i po podaniu norepinefryny do komory bocznej mózgu.

AIM: It is known that norepinephrine (NE) in low doses increases the amplitude of flash visual evoked potential (FVEP). The purpose of this paper was to find out if cadmium (Cd) intoxication changes the NE effect on FVEP. MATERIAL AND METHODS: 18 Wistar albino rats were divided into 3 groups: 6 received 5 ppm, next 6 received 50 ppm cadmium in drinking water since time of conception and during 21 days after delivery and 6 as a control group received tap water only. Newborns were examined when they were 3 to 6 months old. FVEP were recorded before and after injection of 10 microliters saline and then NE into the right lateral brain ventricle. Two doses of NE 25 and 50 nmols were used. Amplitudes of the first deep negative wave (N1) and the next positive one (P2) were measured from isoelectric line to peaks. For statistic analysis the Student t-test was performed with statistical significance by p < 0.05. RESULTS: The prolongation of N1 and P2 latencies of FVEP was observed in all groups after both doses of NE, the differences were statistically significant after doses of 25 nmols NE. The amplitude of N1 increased after NE in all groups, in the control one till 205-225% and 143-151% in Cd groups. The amplitude of P2 in control group was higher (109-113%) after NE compared to initial value (100%). Cadmium caused the decrease (of 56-90%) after both doses of NE. The differences of amplitudes were statistically significant. The prenatal treatment by cadmium caused the lower sensitivity of FVEP to NE.

[The effect of gamma-aminobutyric acid injected into lateral brain ventricle of rats after prenatal cadmium intoxication on flash visual evoked potentials (FVEP)]. / Wplyw kwasu gamma-aminomaslowego (GABA) podanego do komory bocznej mózgu szczurów po prenatalnej intoksykacji kadmem na odpowiedzi wzrokowych potencjalów wywolanych blyskami (FVEP).

PURPOSE: To find out any influence of gamma-aminobutyric acid (GABA) injected into lateral brain ventricle in newborn rats prenatally exposed to cadmium (Cd). METHOD: 18 white, Wistar, offspring rats were divided into 3 groups, each consisting of 6 rats (control, 5 ppm and 50 ppm of Cd in drinking water). Newborns were examined when they were 3-6 months old. FVEP were recorded before and after GABA injections. Two doses of GABA were used, 10 and 100 nmols. The statistic analysis with the test of t-Student was performed to estimate the amplitudes and latencies of the negative wave N1 and the next positive one P2. p < 0.05 was used to indicate significant difference. RESULTS: No significant changes in the latencies of peak N1 and P2 in the control and Cd 5 ppm groups (101-103%) after 10 nmols GABA were observed. However, the shortened (91-97%) of them was observed after both doses of GABA in Cd 50 ppm group. The mean value of amplitude of N1 in control rats increased to 127% after 10 nmols GABA and 142% after 100 nmols GABA. Moreover, the mean amplitude of P2 in this group increased to 108% and 146%, respectively. The high significant increase of the amplitudes of N1 (181-280%) and P2 (160-177%) waves were received after both doses of GABA in Cd groups. CONCLUSION: Cadmium increased the sensitivity of GABA-receptors in the OUN.

[The effect of serotonin on flash visual evoked potential in the rat prenatally exposed to cadmium]. / Wplyw kadmu stosowanego prenatalnie na wywolane blyskami wzrokowe potencjaly kory potylicznej mózgu potomstwa szczurów przed i po podaniu serotoniny do komory bocznej mózgu.

AIM: The purpose of this paper was to find out any influence of cadmium (Cd) on the effect of serotonin (5-HT) in the central nervous system (CNS). METHOD: 18 Wistar albino strain female rats were divided into 3 groups: 6 received 5 ppm, 6 one 50 ppm cadmium in tap water since time of conception and during next 21 days after delivery. Control group of 6 rats received tap water only. Newborns were examined when they were 3 to 6 months old. Flash visual evoked potential (FVEP) was recorded before and after injection of 10 microliters saline and then 5-HT into the right lateral brain ventricle. Two doses of 5-HT 125 and 250 nmols were used. Amplitudes of the first deep negative wave (N1) and the next positive one (P1) were measured from isoelectric line to peaks. For statistic analysis the t-test of Student was used with statistical significance by p < 0.05. RESULTS: Shortened latencies (89-99%) of the peaks N1 and P1 of FVEP in the control and Cd 50 ppm groups after both doses of 5-HT were observed, however, they slightly prolonged (103-105%) in the Cd 5 ppm group. The highly significant increase of amplitude of the waves N1 and P1 in all observed groups was received. The only differences were observed in the Cd 5 ppm group; the amplitude of P1 peak was of the same value (100-101%) after 125 nmols and decreased (91%) after 250 nmols of 5-HT compared to the initial values in this group. CONCLUSION: Cadmium increases the serotonin sensibility in the CNS.

[The effect of dopamine injected into the lateral brain ventricle on flash visual evoked potential (FVEP) after prenatal intoxication with cadmium]. / Wplyw dopaminy podawanej do komory bocznej mózgu szczurów na modulowanie odpowiedzi wzrokowych potencjalów wywolanych blyskami (FVEP) po prenatalnej intoksykacji kadmem.

PURPOSE: Earlier studies demonstrated that exposure, especially prenatal, of mammalians to cadmium (Cd) results in disorders of visual evoked potentials (FVEP). The purpose of this study is to find out any influence of cadmium intoxications on the effect of dopamine (DA) on FVEP. METHOD: 18 Wistar albino rats in 3-6 months of age were divided into 3 groups: control (drinking tap water only), prenatal exposure of 5 ppm, and 50 ppm Cd. Flash visual evoked potentials (FVEP) were recorded before and after injections of dopamine (DA) 100 and 200 nmols into the lateral brain ventricle. The amplitude and latency of N1 and P2 were statistically analysed by the test of t-Student. p < 0.05 was used to indicate significant difference. RESULTS: There were no statistical differences of mean latency of P2 waves between initial records of FVEP and after both doses of DA in all observed groups. The amplitudes of both waves increased after DA injections compared to initial values in all groups. The differences were statistically significant. The mean latencies of N1 peak were prolonged after both DA doses (106-109%) compared to the initial records (100%) in the control group; however, there were no changes of it in the Cd-treated groups before and after DA injections. CONCLUSION: Cadmium blocked the dopamine effect on the latencies of N1 and P2 of FVEP (because it prolonged them alone); however, cadmium increased the stimulative effect of dopamine on their amplitudes.

[The long-term follow up after trabeculectomy]. / Dlugoterminowe wyniki operacyjnego leczenia jaskry metoda trabekulektomii.

THE AIM OF THE STUDY: To estimate the efficacy of trabeculectomy for primary open angle glaucoma. MATERIAL AND METHODS: Since 1990 to 2000 we observed 91 eyes of 79 patients (53 women and 26 men) aged 39-86. The results of performed surgery were valued directly after the trabeculectomy and in period of over 8 years. We carried out the examinations of visual acuity, intraocular pressure, visual field, state of optic nerve head, type of bleb following trabeculectomy and the necessity of applying additional topical treatment. The trabeculectomies were performed in a typical way. Some surgeons made a square or triangular superficial scleral flap based at the limbus, measuring from 2.5 x 3.0 to 4 x 4 mm or 3 x 3 mm. The deep block of scleral tissue with trabeculum (from 0.5 x 1.0 to 2.5 x 3.0 mm) was excised, the superficial cauterisation and the peripheral iridectomy were performed in every case. The scleral flap and conjunctiva were sutured with 10/0 Ethilon, 8/0 Vicryl or 6/0 Mersilk. RESULTS: The patients were divided into 3 groups depending on observation period: I--up to 4 years, II--from 5 to 8 years, III--over 8 years. We confirmed the normalisation of IOP in 80%, 73%, 90% and the successful control of visual field (no progress) in 82%, 77%, 70% of adequate groups. In the first and second group 45-50% of patients could resist from topical treatment, but after 8 years as many as 80% required additional pharmacological treatment. CONCLUSION: The trabeculectomy is the effective surgery in most patients with open angle glaucoma. The effectiveness of trabeculectomy can be controlled by the size of extracted deep scleral flap with trabeculum. For the stability of visual field it is necessary to keep the intraocular pressure at 13-18 mm Hg level.