Subjective health expectations of patients with age-related macular degeneration treated with antiVEGF drugs.

BACKGROUND: Subjective expectations regarding future health may influence patients' judgement of current health and treatment effects, as well as adherence to therapies in chronic diseases. We aimed to explore subjective expectations on longevity and future health-related quality of life (HRQOL) of patients with age-related macular degeneration (AMD) treated with antiVEGF injections and analyse the influencing factors. METHODS: Consecutive AMD patients in two ophthalmology centres were included. Demographics, clinical characteristics and informal care utilisation were recorded. Current health was evaluated by the EQ-5D generic health status questionnaire and time trade-off (TTO) methods. Happiness was measured on a visual analogue scale (VAS). Subjective life-expectancy and expected EQ-5D status at ages 70, 80 and 90 were surveyed. T-test was applied to compare subgroups and Pearson correlations were performed to analyse relationships between variables. RESULTS: One hundred twenty two patients were involved (females 62%) with a mean (SD) age of 75.2 (7.9) years and disease duration of 2.9 (2.5) years. The majority were in AREDS-4 state, the better eye's ETDRS was 64.7 (15.4). EQ-5D and TTO revealed moderate deterioration of health (0.66 vs. 0.72, p = 0.131), happiness VAS was 6.3 (2.2). Correlation between EQ-5D and ETDRS was moderate (R = 0.242, p < 0.05) and having both versus one eye in AREDS-4 resulted lower TTO (0.68 vs. 0.83; p = 0.013). Subjective life-expectancy did not differ significantly from statistical life-expectancy and had no significant impact on TTO. The self-estimated mean EQ-5D score was 0.60, 0.40 and 0.24 for ages 70, 80 and 90 which is lower than the population norm of age-groups 65-74, 75-84 and 85+ (0.77, 0.63 and 0.63, respectively). Age, gender, current EQ-5D, need for informal care and happiness were deterministic factors of subjective health expectations. CONCLUSION: AMD patients with antiVEGF treatment have comparable HRQOL as the age-matched general public but expect a more severe deterioration of health with age. Older patients with worse HRQOL have worse subjective expectations. Exploring patients' health expectations provides an opportunity for ophthalmologists to correct misperceptions and improve the quality of AMD care. Further studies should provide evidences on the relationship between subjective expectations and actual health outcomes, and on its impact on patients' AMD-specific health behaviour.

Passage through the Ocular Barriers and Beneficial Effects in Retinal Ischemia of Topical Application of PACAP1-38 in Rodents.

The neuropeptide pituitary adenylate cyclase activating polypeptide (PACAP) has two active forms, PACAP1-27 and PACAP1-38. Among the well-established actions are PACAP's neurotrophic and neuroprotective effects, which have also been proven in models of different retinopathies. The route of delivery is usually intravitreal in studies proving PACAP's retinoprotective effects. Recently, we have shown that PACAP1-27 delivered as eye drops in benzalkonium-chloride was able to cross the ocular barriers and exert retinoprotection in ischemia. Since PACAP1-38 is the dominant form of the naturally occurring PACAP, our aim was to investigate whether the longer form is also able to cross the barriers and exert protective effects in permanent bilateral common carotid artery occlusion (BCCAO), a model of retinal hypoperfusion. Our results show that radioactive PACAP1-38 eye drops could effectively pass through the ocular barriers to reach the retina. Routine histological analysis and immunohistochemical evaluation of the Müller glial cells revealed that PACAP1-38 exerted retinoprotective effects. PACAP1-38 attenuated the damage caused by hypoperfusion, apparent in almost all retinal layers, and it decreased the glial cell overactivation. Overall, our results confirm that PACAP1-38 given in the form of eye drops is a novel protective therapeutic approach to treat retinal diseases.

Combined cataract surgery on a Marfan-syndrome patient (case report).

Combined cataract surgery of an ectopic lens was performed on a 10 years old girl with Marfan-syndrome. A Cionni capsular tension ring was implanted into the capsular bag, and the bag was pulled to its place and fixed with a scleral suture. Because of the young age of the patient a primary posterior capsulorhexis was performed, through which anterior vitrectomy was carried out and the artificial lens was implanted into the capsular bag. In the literature several surgical solutions are advised for the treatment of the ectopic lens in patients with Marfan-syndrome. We have performed a successful surgery combined with posterior capsulorhexis in our case. Because of its rarity and special surgical solution, we think this case report is interesting and can be helpful in such cases to be published.

Assessing Changes in the Distribution Patterns of the European Wildcat in Hungary.

The European wildcat (Felis silvestris Schreber, 1777) is an endangered and elusive carnivore that is slowly recovering in Central Europe after persecution and a decline in its distribution over the past two centuries, and specific conservation plans are needed in most of its range. Knowledge of the continent-wide distribution and status of this species is still poor. Using an online questionnaire, we evaluated the nationwide distribution of wildcats across three time periods (2004, 2014, and 2022) in Hungary. The species' reported occurrence was analyzed according to binominal logistic regression using the percent cover of land cover categories as explanatory variables. We found that the spatial cover of broad-leaved forest was positively associated with the occurrence of wildcats, and the analysis revealed a positive trend in the larger 2004-2022 time frame. We also recorded that although wildcats have disappeared from areas of the central, southern, and western parts of Hungary, regions in the eastern, northern, and south-western areas appear to retain stable populations.

Correction: Otgontamir et al. Assessing Changes in the Distribution Patterns of the European Wildcat in Hungary. Animals 2024, 14, 785.

In the original publication [...].

Surgical stress and cytoskeletal changes in lens epithelial cells following manual and femtosecond laser-assisted capsulotomy.

AIM: To study the effect of mechanical stress on the cytoskeleton in lens epithelial cells following conventional phacoemulsification surgery (CPS) and femtosecond laser-assisted cataract surgery (FLACS). METHODS: The cytoskeleton of the epithelial cells of the anterior lens capsules (ALC) removed by CPS and FLACS was examined by immunohistochemistry. Expression of the intermediate filament, glial fibrillary acidic protein (GFAP), and glutamine synthetase (GS) immunoreactivity were detected. In order to map the actin network of cells, fluorescently labeled phalloidin was used. The samples were examined using confocal laser scanning microscopy. RESULTS: GFAP expression was visible in a larger number of the epithelial cells after CPS compared to FLACS. In CPS sample's epithelial cells, GFAP immunoreactivity indicated robust morphological change. Regarding the actin filaments, the presence of tubular elements connecting epithelial cells, regular actin pattern and marked cortical network after CPS were found. Following FLACS, the actin cytoskeleton of the epithelial cells remained densely structured, and the tubular elements were undetectable, however, the above-mentioned regular actin pattern and the marked cortical network were visible. CONCLUSION: The conventional removal of the ALC induces more robust changes of the cytoskeleton of the lens epithelial cells.

Foveal and perifoveal retinal thickness measured by OCT in diabetic patients after phacoemulsification cataract surgery.

PURPOSE: The aim of the study was to measure the change of the foveal and perifoveal thickness of the retina in diabetic patients after uneventful phacoemulsification and PC-IOL implantation. METHODS: Retinal thickness values of the foveal and perifoveal (fovea + 3.0 mm, fovea + 6.0 mm) sectors and the minimum values were measured in a prospective study using optical coherence tomography (OCT) in 18 eyes of 18 diabetic patients who underwent cataract surgery. Phacoemulsification and "in the bag" implantation of a foldable posterior chamber intraocular lens (PC-IOL) was performed under topical anaesthesia. Data were collected one day before the operation, and postoperatively at 1, 7, 30, and 60 days. Contralateral eyes of each patient served as controls. Student's t-test was used for statistical analysis, and p < 0.05 value was considered significant. RESULTS: No significant change of the thickness values could be measured one day after surgery. However, a significant increase could be detected on the postoperative 7, 30, and 60 days in the perifoveal 3.0 mm and 6.0 mm sectors either calculated alone or averaged together with the foveal values. The initial (preoperative) average value of 232.7 +/- 3.5 microm (mean +/- SEM, n=144) in the 6.0 mm perifoveal region increased to 246.0 +/- 8.2 microm (mean +/- SEM, n=120, p < 0.05) one week, to 249.9 +/- 5 1 microm (n=112, p < 0.01) one month, and to 249.5_+6.2 pm (n=104, p < 0.01) 2 months after surgery, which proved to be significant. DISCUSSION: Our results indicate that diabetes did not influence significantly the thickening of the macular regions after uncomplicated cataract surgery. However, the postoperative perifoveal macular thickness change was found to be nonsignificantly higher in the diabetic group compared to the nondiabetic group, which might be attributed to the high sensitivity of the OCT method.

Cell death and survival following manual and femtosecond laser-assisted capsulotomy in age-related cataract.

AIM: To study molecular and morphological changes in lens epithelial cells following femtosecond laser-assisted and manually performed continuous curvilinear capsulotomy (CCC) in order to get information about these methods regarding their potential role in the induction of development of secondary cataract. METHODS: Anterior lens capsules (ALC) were removed from 40 patients with age-related cataract by manual CCC and by femtosecond laser-assisted capsulotomy (FLAC). Samples removed by manual CCC were assorted in group 1, FLAC samples were classified in group 2. Morphology of lens epithelial cells was examined with light and electron microscopes. Following capsulotomy, expressions of p53, Bcl-2 and cyclin D1 genes were analyzed with reverse transcriptase polymerase chain reaction. Immunohistochemistry was used to detect the pro-apoptotic p53 in the epithelial cells. RESULTS: Light and electron microscopic examination showed that ALC of group 1 contained more degenerating cells following manual CCC than after FLAC. The expression level of p53 was higher after manual than laser-assisted surgery. Immunocytochemistry indicated significantly higher number of cells containing p53 protein in the manual CCC group than following FLAC. Bcl-2 and cyclin D1 gene expression levels were slightly lower following manual CCC than after FLAC, but the difference was not significant. CONCLUSION: Manually removed ALC shows slightly, but not significantly larger damage due to the mechanical stretching and pulling of the capsule than those removed using FLAC.

Ultrastructure of neurovascular changes in human diabetic retinopathy.

The previous concept regarding diabetic retinopathy assigned a primary role to hyperglycemia-induced microvascular alterations, while neuronal and glial abnormalities were considered to be secondary to either ischemia or exudation. The aim of this study was to reveal the potential role of neuronal and glial cells in initial and advanced alterations of the retinopathy in human type 2 diabetes. Electron microscopy and histochemical studies were performed on 38 surgically removed human eyes (28 obtained from diabetic patients and 10 from non-diabetic patients). Morphometric analysis of basement membrane material and lipids was performed. An accumulation of metabolic by-products was found in the capillary wall with aging: this aspect was significantly more pronounced in diabetics. Müller glial cells were found to contribute to alterations of the capillary wall and to occlusion, as well as to the development of proliferative retinopathy and cystoid degeneration of the retina. Our results showed morphological evidence regarding the role of neuronal and glial cells in the pathology of diabetic retinopathy, prior and in addition to microangiopathy. These morphological findings support a neurovascular pathogenesis at the origin of diabetic retinopathy, thus the current treatment approach should be completed by neuroprotective measures.

Anterior segment changes with age and during accommodation measured with partial coherence interferometry.

PURPOSE: To evaluate anterior segment alterations with age and during accommodation in different age groups. SETTING: Department of Ophthalmology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary. METHODS: Fifty-three subjects (101 normal eyes) were enrolled in this study and divided into 3 age groups: younger than 30 years (Group 1), between 31 years and 44 years (Group 2), and older than 45 years (Group 3). The total amplitude of accommodation was determined with a defocusing technique, and anterior segment measurements were performed by partial coherence interferometry. RESULTS: Group 1 comprised 32 eyes; Group 2, 37 eyes; and Group 3, 32 eyes. The total amplitude of accommodation decreased with age (P<.0001). With the target position at infinity, the lens thickness (LT) and anterior segment length (ASL) increased and the anterior chamber depth (ACD) decreased significantly with age (P<.0001). During accommodation in the youngest group, the mean change in LT was 36.3 mum/diopter (D) and in ACD, -26.7 mum/D. The mean accommodation-induced ACD change was -0.08 mm +/- 0.06 (SD) in Group 1, -0.064 +/- 0.087 mm in Group 2, and -0.03 +/- 0.06 mm in Group 3 (P = .0004). The mean LT change during near fixation was 0.109 +/- 0.063 mm in Group 1, 0.103 +/- 0.136 mm in Group 2, and 0.006 +/- 0.05 mm in Group 3 (P<.0001). The mean ASL change during accommodation was 0.029 +/- 0.037 mm, 0.039 +/- 0.114 mm, and -0.023 +/- 0.051, respectively (P<.0001). CONCLUSIONS: In addition to forward movement of the anterior lens surface with age, the posterior surface moved backward. Alterations in LT and ACD sufficient for a unit of refractive power change during accommodation might be smaller than previously thought. Anterior shifting of the lens may also participate in the accommodative response.

Histological examination of primary posterior capsule plaques.

PURPOSE: To understand the source and evolution of the cellular elements of posterior capsule plaques. SETTING: Department of Ophthalmology, University of Sciences, Faculty of Medicine, Pécs, Hungary. METHODS: In 24 eyes of 24 patients, the primary fibrotic plaques were carefully peeled off the posterior capsule with forceps and sent for histological examination. The samples were stained with hematoxylin-eosin and with picrosirius to demonstrate collagen content. RESULTS: Most plaques were found in elderly patients with mature cataracts. However, one was found in a patient with congenital cataract. The histological examination revealed different stages of plaques, permitting discrimination of early (cellular), transitional, and late (fibrotic) stages. The plaques in the early stage contained cuboidal cells with nuclei; collagen deposition led to the development of the transitional stage; and further collagen deposition led to the fibrotic stage. There was no significant correlation between the maturity of the cataract and the plaque stage, but other factors such as previous eye surgery (vitrectomy, glaucoma surgery), long-standing diabetes mellitus (DM), and a high degree of myopia appeared to contribute to the development of plaques. CONCLUSIONS: Primary posterior capsule plaques were found primarily in elderly patients with mature cataracts but were also present post vitrectomy in those who had DM from a young age and had early stages of cataract. In the early plaque stage, cells with nuclei were found. It follows that plaques are capable of proliferation at this stage, aggravating visual disturbance. Therefore, removing the plaques by peeling from the posterior capsule or by posterior capsulorhexis during surgery is suggested.

Change in intraocular pressure within 1 week of phacoemulsification and intraocular lens implantation using Adatocel.

PURPOSE: To examine the change in intraocular pressure (IOP) within 1 week of phacoemulsification and foldable posterior chamber intraocular lens (PC IOL) implantation using Adatocel (hydroxypropyl methylcellulose 2% [HPMC]). SETTING: Department of Ophthalmology, University of Sciences, Faculty of Medicine, Pécs, Hungary. METHODS: In this prospective study, the IOP in 118 eyes of 118 patients (57 men, 61 women, mean age 68 years +/- 7.8 [SD]) with no history of glaucoma was assessed by Goldmann applanation tonometry 2 to 3, 6 to 8, and 22 to 24 hours and 1 week after uneventful phacoemulsification and PC IOL implantation. The effect of the removal of Adatocel ("partial removal" from the anterior chamber [AC] only versus "complete removal" from behind of the IOL as well), the lens type (Medicontur 601 HP versus Bausch & Lomb Hydroview), and the type of anesthesia (topical versus parabulbar) were compared. Statistical analysis was performed using the Student t test, and P< or =.05 was considered statistically significant. RESULTS: The mean preoperative IOP was 13.83 +/- 2.5 mmHg. There were no significant differences at any time in postoperative IOP measurements between the 2 IOL types and the 2 modes of anesthesia. At 2 to 3 hours, 6 to 8 hours, and 22 to 24 hours, the IOP was significantly higher in the 30 eyes in which the Adatocel was partially removed (from the AC only) than in the 88 eyes in which it was completely removed (from behind the PC IOL as well) (P< or =.05, P< or =.01, and P< or =.001, respectively). CONCLUSION: Severe postoperative IOP spikes in nonglaucomatous patients after uneventful phacoemulsification cataract surgery are rare. The type of implanted PC IOL and the mode of anesthesia had no significant effect on postoperative IOP. Total removal of the ophthalmic viscosurgical device, even when using HPMCs such as Adatocel, is necessary to prevent postoperative IOP spikes.

Ocular Delivery of PACAP1-27 Protects the Retina From Ischemic Damage in Rodents.

Purpose: Pituitary adenylate cyclase activating polypeptide (PACAP) is neuroprotective in neuronal injuries. Bilateral common carotid artery occlusion (BCCAO) causes chronic hypoperfusion-induced degeneration in the rat retina, where we proved the retinoprotective effect of intravitreal PACAP. Although this route of administration is a common clinical practice in several diseases, easier routes are clinically important. Our aim was to investigate the potential retinoprotective effects of PACAP eye drops in BCCAO-induced ischemic retinopathy. Methods: After performing BCCAO in rats, the right eyes were treated with PACAP1-27 eye drops (1 µg/drop, 2 × 1 drops/day for 5 days), containing different vehicles: saline, water for injections, thiomersal or benzalkonium solution for ophthalmic use (SOCB). Histology and immunohistochemistry were performed 2 weeks after surgery, while molecular analysis was performed 24 hours after BCCAO. Passage of PACAP1-27 through the ocular layers was tested with radioactive PACAP-SOCB in mice. Results: Bilateral common carotid artery occlusion led to a severe degeneration of all retinal layers. Solution for ophthalmic use was the most effective vehicle for delivering PACAP (PACAP-SOCB), significantly ameliorating BCCAO-induced damage. The massive upregulation of GFAP was not observed in retinas treated with PACAP-SOCB eye drops. PACAP-SOCB treatment also increased activation of the protective Akt and ERK1/2 in hypoperfused retinas. The cytokine profile showing upregulation in different cytokines was attenuated by PACAP-SOCB. Radioactive PACAP reached the retina when delivered in SOCB-containing eye drops. Conclusions: PACAP1-27, delivered in the SOCB vehicle as eye drops, was retinoprotective in ischemic retinopathy, providing the basis for future therapeutic administration.

Modeling long-term diabetes and related complications in rats.

INTRODUCTION: Accurate preclinical modeling of diabetic complications such as retinopathy, nephropathy and neuropathy is crucial to enable the development of novel preventative therapies. The aims of this study were to establish a model of long-term diabetes with sustained medium scale hyperglycemia and characterize the pathological changes detectable after 4months, with particular respect to dependence on the degree of hyperglycemia. METHODS: Streptozotocin-induced diabetic CFY rats were subjected to four different insulin substitution protocols to achieve different levels of glycemic control (Diabetic 1-4 groups). Eyes were investigated by ophthalmoscopy, kidney function by urine analysis, and neuropathy by functional tests. Retinal and renal morphological evaluations were performed by histology, immuno-histochemistry and electron microscopy. RESULTS: Rats of the Diabetic 3 group showed massive hyperglycemia-dependent anterior segment neovascularization, enhanced total retinal score and retinal apoptotic cell number, degeneration of dopaminergic amacrine cells, increased glomerular PAS-positivity, altered excreted total protein/creatinine ratio and cold allodynia, parallel with medium scale hyperglycemia (blood glucose level between 22 and 25mmol/L) and satisfying state of health. DISCUSSION: We established a treatment protocol in rats enabling complex investigation of diabetic retinopathy, nephropathy and neuropathy on a long-term period. Clearly hyperglycemic dependent parameters of these complications serve as good outcome measures for preclinical trials. Our results provide a useful basis for designing studies for testing preventative treatments as well as other translational medical research in this field.

Accumulation of the hydroxyl free radical markers meta-, ortho-tyrosine and DOPA in cataractous lenses is accompanied by a lower protein and phenylalanine content of the water-soluble phase.

Post-translational modifications of lens proteins play a crucial role in the formation of cataract during ageing. The aim of our study was to analyze protein composition of the cataractous lenses by electrophoretic and high-performance liquid chromatographic (HPLC) methods. Samples were obtained after extracapsular cataract surgery performed by phacoemulsification technique from cataract patients with type 2 diabetes mellitus (DM CAT, n = 22) and cataract patients without diabetes (non-DM CAT, n = 20), while non-diabetic non-cataractous lenses obtained from cadaver eyes served as controls (CONTR, n = 17). Lens fragments were derived from the surgical medium by centrifugation. Samples were homogenized in a buffered medium containing protease inhibitor. Soluble and insoluble protein fractions were separated by centrifugation. The electrophoretic studies were performed according to Laemmli on equal amounts of proteins and were followed by silver intensification. Oxidized amino acid and Phe content of the samples were also analyzed by HPLC following acid hydrolysis of proteins. Our results showed that soluble proteins represented a significantly lower portion of the total protein content in cataractous lenses in comparison with the control group (CONTR, 71.25%; non-DM CAT, 32.00%; DM CAT, 33.15%; p < 0.05 vs CONTR for both). Among the proteins, the crystallin-like proteins with low-molecular weight can be found both in the soluble and insoluble fractions, and high-molecular weight aggregates were found mainly in the total homogenates. In our HPLC analysis, oxidatively modified derivatives of phenylalanine were detected in cataractous samples. We found higher levels of m-Tyr, o-Tyr and DOPA in the total homogenates of cataractous samples compared to the supernatants. In all three groups, the median Phe/protein ratio of the total homogenates was also higher than that of the supernatants (total homogenates vs supernatants, in the CONTR group 1102 vs 633 micromol/g, in the DM CAT group 1187 vs 382 micromol/g and in the non-DM CAT group 967 vs 252 micromol/g; p < 0.05 for all). In our study we found that oxidized amino acids accumulate in cataractous lenses, regardless of the origin of the cataract. The accumulation of the oxidized amino acids probably results from oxidation of Phe residues of the non-water soluble lens proteins. We found the presence of high-molecular weight protein aggregates in cataractous total homogenates, and a decrease of protein concentration in the water-soluble phase of cataractous lenses. The oxidation of lens proteins and the oxidative modification of Phe residues in key positions may lead to an altered interaction between protein and water molecules and thus contribute to lens opacification.

Telemedical diabetic retinopathy screening in Hungary: a pilot programme.

Our aim was to introduce the Hungarian pilot telemedical screening program for diabetic retinopathy (DRP) and also to evaluate the efficacy of non-mydriatic fundus photographs. A total of 502 eyes of 251 diabetic patients were photographed with a non-mydriatic digital fundus camera in a tertiary diabetology care center. These three 45°-field images were transmitted to the reading center via Internet, where they were graded by two independent ophthalmologists. After non-mydriatic photography (NM method), 28 patients were also examined in mydriasis by an ophthalmologist (O method) and were also photographed in mydriasis (M method). For the comparison of the three methods the kappa statistic was used. With non-mydriatic imaging of 502 eyes no retinopathy was found in 74.5%, DRP was detected in 15.5%, while 10.1% of the photos were ungradable. The rates of DRP severity levels were: 13.55% mild/moderate non-proliferative, 0.59% severe and 1.39% proliferative DRP. Comparing the results of the gradable non-mydriatic photos by the two independent graders, perfect intergrader agreement was found (k = 1.00). The measure of intermethod agreement between NM and M method was also perfect, with a kappa value of 1.00 (grader A and grader B). Based on the results of the O method, there were no misdiagnosed cases nor with the NM-, neither with the M method. Non-mydriatic cameras could be ideal tools of an extended countrywide retinopathy screening program which may serve to reduce the high prevalence of diabetes-related blindness in Hungary.

Results of cataract surgery in previously vitrectomized eyes.

PURPOSE: To evaluate the difficulties and results of manual extracapsular cataract extraction (ECCE) and phacoemulsification cataract surgery performed in previously vitrectomized eyes. SETTING: Pécs University of Sciences, Faculty of Medicine, Department of Ophthalmology, Pécs, Hungary. METHODS: This retrospective case-control study comprised a series of 84 cataract extractions with or without intraocular lens implantation. Forty-three patients had manual ECCE and 41, phacoemulsification. The intraoperative and postoperative complications and visual outcomes in the 2 groups were analyzed and compared. RESULTS: Cataract extractions were performed a mean of 15.8 months (range 1 to 86 months) after the pars plana vitrectomy. The indications for vitrectomy were diabetic retinopathy, retinal detachment, proliferative vitreoretinopathy, giant retinal tear, macular hole, eye trauma, vitreous hemorrhage after central retinal vein occlusion, and uveitis. Primary posterior capsule fibrosis was the most common intraoperative complication, occurring in 24% of eyes. Posterior capsule rupture occurred in 5 eyes in the ECCE group and 3 in the phacoemulsification group. Zonulysis occurred in 2 and 1 eyes, respectively. A dropped nucleus occurred in 3 cases in the phacoemulsification group. Posterior capsule opacification and secondary glaucoma were the most common postoperative complications, occurring in 5 and 3 cases in the ECCE group, respectively, and in 3 and 4 cases in the phacoemulsification group. Visual acuity 6 weeks postoperatively improved or remained within 2 Snellen lines in 95% of eyes, which is comparable to data in the recent literature. CONCLUSIONS: Phacoemulsification gave better results than manual ECCE in previously vitrectomized eyes. Underlying retinal disease limited the final visual acuity.

In vitro antioxidant properties of pentoxifylline, piracetam, and vinpocetine.

Oxygen-free radicals play an important role in several physiologic and pathophysiologic processes. In pathologic circumstances, they can modify and damage biologic systems. Because oxygen-free radicals are involved in a wide range of diseases (cerebrovascular, cardiovascular, etc.), scavenging these radicals should be considered as an important therapeutic approach. In our in vitro study, we investigated the antioxidant capacity of three drugs: pentoxiphylline (Sigma Aldrich, St. Louis, MO, USA) piracetam (Sigma Aldrich), and vinpocetine (Richter Gedeon RT, Budapest, Hungary). Phenazine methosulphate was applied to generate free radicals, increasing red blood cell rigidity. Filtration technique and potassium leaking were used to detect the cellular damage and the scavenging effect of the examined drugs. According to our results, at human therapeutic serum concentration, only vinpocetine (Richter Gedeon RT) had significant (p < 0.01) scavenging activity with a protective effect that increased further at higher concentrations. Pentoxiphylline (Sigma Aldrich) and piracetam (Sigma Aldrich) did not have significant antioxidant capacity at therapeutic concentrations, but increasing their concentrations (pentoxiphylline at 100-times, and piracetam at 10-times higher concentrations) led to a significant (p < 0.01) scavenger effect. Our findings suggest that this pronounced antioxidant effect of vinpocetine and even the milder scavenging capacity of pentoxiphylline and piracetam may be of value in the treatment of patients with cerebrovascular disorders, but merits further investigations.

[Scavenger effect of various cerebrovascular drugs]. / Cerebrovascularis támadáspontú gyógyszerek szabadgyökfogó hatásának vizsgálata.

INTRODUCTION: Oxygen free radicals play an important role in several physiological and pathophysiological processes. In pathological circumstances they can modify and damage biological systems. As oxygen free radicals are involved in a wide range of diseases (cerebrovascular, cardiovascular, etc.), scavenging these radicals should be considered as an important therapeutic approach. AIM: In our in vitro study the antioxidant capacity of three cerebrovascular drugs (pentoxiphylline, piracetam and vinpocetine) was investigated. METHODS: Phenazine methosulphate (PMS) was applied to generate free radicals and thus increased red blood cell rigidity. Filtration technique and potassium leaking were used to detect the cellular damage and the scavenging effect of the examined drugs. RESULTS: At therapeutic serum concentration only vinpocetine had significant (p < 0.01) scavenging activity which protective effect was even better at higher concentrations. Pentoxiphylline and piracetam did not have significant antioxidant capacity at therapeutic concentrations, but increasing the concentrations (pentoxiphylline at hundred times, while piracetam at ten times higher concentrations) led to a significant (p < 0.01) scavenger effect. CONCLUSION: The authors' findings suggest that this pronounced antioxidant effect of vinpocetine and even the milder scavenging capacity of piracetam which tends to cumulate in the cerebral tissue may be of value in the treatment of patients with cerebrovascular disorders.

Investigation of PACAP Fragments and Related Peptides in Chronic Retinal Hypoperfusion.

Pituitary adenylate cyclase activating polypeptide (PACAP) has neuroprotective effects in different neuronal and retinal injuries. Retinal ischemia can be effectively modelled by permanent bilateral common carotid artery occlusion (BCCAO), which causes chronic hypoperfusion-induced degeneration in the entire rat retina. The retinoprotective effect of PACAP 1-38 and VIP is well-established in ischemic retinopathy. However, little is known about the effects of related peptides and PACAP fragments in ischemic retinopathy. The aim of the present study was to investigate the potential retinoprotective effects of different PACAP fragments (PACAP 4-13, 4-22, 6-10, 6-15, 11-15, and 20-31) and related peptides (secretin, glucagon) in BCCAO-induced ischemic retinopathy. Wistar rats (3-4 months old) were used in the experiment. After performing BCCAO, the right eyes of the animals were treated with PACAP fragments or related peptides intravitreal (100 pM), while the left eyes were injected with saline serving as control eyes. Sham-operated (without BCCAO) rats received the same treatment. Routine histology was performed 2 weeks after the surgery; cells were counted and the thickness of retinal layers was compared. Our results revealed significant neuroprotection by PACAP 1-38 but did not reveal retinoprotective effect of the PACAP fragments or related peptides. These results suggest that PACAP 1-38 has the greatest efficacy in ischemic retinopathy.