We observed the breakdown of the blood-aqueous barrier after trabeculectomy with mitomycin C by using laser flaremeter. There were 20 patients (25 eyes) of which 9 patients(11 eyes) were applied 0.02% MMC for 3minutes during the trabeculectomy and 11 patients (14 eyes) were not applied MMC. All patients were diagnosed as primary open angle glaucoma and underwent trabeculectomy. The preoperative, postoperative 1 day and 3 months aqueous flare intensity were 10.8+/- 5.05, 15.6+/- 5.32, 10.1+/- 4.55(photon count/msec)in group with MMC and 10.6+/-4.04,15.9+/-3.30, 9.2+/-3.94(photon count/msec) in group without MMC Anterior chamber flares were highest on the first postoperative day, declining rapidly in the first week with more gradual recovery to preoperative level by 1 month postoperatively, which shows the breakdown of blood-aqueous barrier by surgery. There was no statistically significant difference between the two groups in postsurgical aqueous flare intensity. 0.02% MMC does not appear.
Anterior Chamber ; Aqueous Humor ; Blood-Aqueous Barrier* ; Glaucoma, Open-Angle ; Humans ; Mitomycin* ; Trabeculectomy*

We compared the effects of diode laser (DL) irradiation of the iris with those of argon laser (AL). Histopathologic examination of laser-induced lesion, measurements of aqueous flare and prostaglandin (PG) E2 were performed. DL was applied in one eye of each animal and the fellow eye received ALwith the same parameters in 49 pigmented rabbits. At 1 hour after irradiation, the mean flare count was higher in the DL-treated eyes than in AL-treated eyes(p<0.05). However, the concentrations of PG E2 and intraocular pressures were similar between the DL- and AL-treated eyes(p>0.05). On histopathologic examinations, iris defect by DL was wider and shallower than that by AL. The extent of coagulation of the iris tissue was more extensive in the DL-irradiated iris. Our results suggest that the DL irradiation may be more harmful to the blood-aqueous barrier and iris tissue than AL. Further development of the laser equipment or the treatment regimen for diode laser iridotomy may be necessary.
Animals ; Aqueous Humor ; Argon* ; Blood-Aqueous Barrier ; Intraocular Pressure ; Iris* ; Lasers, Semiconductor ; Rabbits*

The purpose of the study is to investigate the changes of the blood aqueous barrier, the flow rate and IOP after cyclocryotherapy in the white rabbits. After cyclocryotherapy we injected intravenously a dose of 25mg/kg of fluorescein sodium and sampled the aqueous humor at 1 and 2 hour and measured the concentration of flouorescein sodium by means of HPLC(High Performance Liquid Chromatography). By the comparision study among the control group, 4 times cyclocryotherapy application group and 8 times cyclocryotherapy applications group during experimental period, the results were summarized as follows. 1. In the control group, the mean aqueous amount was 0.297+0.020ml, the flow rate was 3.282+0.426 ul/min. 2. In the cyclocryotherapy group, IOP was significantly decreased during experimental period. It was found that the IOP in the 8 times cyclocryotherapy application group was more decreased than that in the times cyclocryotherapy application group after 2 weeks. 3. There was marked increase of the concentration of fluorescein sodium in aqueous humour after acute cyclocryotherapy, but it was decreased to normal level at 4 weeks. The difference between the two groups was not found. 4. The flow rate was markedly decreased after acute cycrocryotherapy and was almost back to normal 4 weeks in two groups. There was difference between the two groups. 5. In Electron microscopic study, many wide intercellular gaps between the nonpigmented and pigmented epithelium are observed but the nucleus of the nonpigmented and pigmented epithelium are well preserved on the day of experiment. From 7 days the nucleus, and both nonpigmented and pigmented epithelium are markedly decreased in number. By 28 days the cytoplasm is shrunken, nucleus has disappeared, and a capillary near pig-ment epithelium obstructed but the basement membrane of thest cells is well pres-erved. 6. After cyclocryotherapy, The IOP decreased progressively during experimental period, but the flow rate was almost back to normal at 4 weeks. From the result we can deduce the outflow facility was not influenced by cyclocryotherapy. And so it was suggested from electron microscopic study that IOP lowering effect of cyclocryotherapy was due to quantitiative destruction of aqueous production.
Aqueous Humor ; Basement Membrane ; Blood-Aqueous Barrier* ; Capillaries ; Cytoplasm ; Epithelium ; Fluorescein ; Rabbits* ; Sodium

BACKGROUNDAhmed Glaucoma Valve implantation (AGVI) is used to treat refractory glaucoma. Breakdown of the blood-aqueous barrier (BAB) has been noted after some surgical techniques. The current study was designed to assess BAB disruption after AGVI.

METHODSAnterior chamber protein content was measured by the laser flare cell photometry in 22 eyes of 22 patients with refractory glaucoma before AGVI and at each postoperative visit up to 1 month.

RESULTSBefore AGVI the mean aqueous flare values in all eyes were (15.17 ± 9.84) photon counts/ms. After AGVI, the values significantly increased at day 1, day 3, and week 1 compared to those before AGVI (all P < 0.05) with a peak at day 3. They returned to pre-operative levels at week 2, and were lower than preoperative level at month 1. Eyes with previous intraocular surgery history had greater aqueous flare values than those without previous intraocular surgery history, but there were no significant differences at all time points postoperatively (all P > 0.05). Furthermore, eyes with shallow anterior chambers had greater aqueous flare values at day 3 and week 1 (all P < 0.05). When comparing eyes with other refractory glaucoma conditions, neovascular glaucoma combined with intravitreal bevacizumab injection resulted in lower aqueous flare values after AGVI, but no significant differences were observed at all time points, postoperatively (all P > 0.05).

CONCLUSIONSThe BAB was impaired and inflammation was present in the anterior chamber in refractory glaucomatous eyes following AGVI. However, such conditions were resolved within 1 month postoperatively. Intravitreal bevacizumab treatment in neovascular glaucoma eyes before AGVI may prevent BAB breakdown.

Adult ; Aqueous Humor ; physiology ; Blood-Aqueous Barrier ; pathology ; Female ; Glaucoma Drainage Implants ; adverse effects ; Humans ; Male ; Middle Aged ; Prospective Studies

The adjunctive use of 5-fluorouracil and mitomycin C remarkably improves the success rate of glaucoma filtering surgery, but these antiproliferative agents may be toxic to other ocular tissues. The authors evaluated the effect of 5-FU and MMC on the blood-aqueous barrier. Sixteen pigmented rabbits were used, 7 for 5-FU group and 9 for MMC group. Five milligrams of 5-FU(0.1ml) was injected subconjunctivally in one eye of each animal in 5-FU group. In MMC group, we made limbus-based conjunctival flap on superotemporal area and applied MMC(0.4 mg/ml) soaked Week-cell sponge on subconjunctival-scleral space for 5 minutes and irrigated with 200 ml of normal saline. The contralateral eyes of each animal in both groups were used for control. We measured protein concentration in anterior chamber with the laser flare-cell meter(Kowa, FM-500). At 7 hours after operation, protein concentration in anterior chamber was significantly higher in 5-FU injected eyes(11.22 +/- 1.98 photons/msec, mean +/- S.D.) than control eyes(7.78 +/- 0.96 photons/msec) in the 5-FU group. There was no difference between MMC treated eyes and control eyes. MMC soaking is thought to be less harmful on the blood-aqueous barrier than 5-FU subconjunctival injection.
Animals ; Anterior Chamber ; Blood-Aqueous Barrier* ; Filtering Surgery ; Fluorouracil* ; Glaucoma ; Mitomycin* ; Porifera ; Rabbits

PURPOSE: The eyeball has 2 blood-ocular barriers, i.e., the blood-retinal and blood-aqueous barriers. The purpose of this study was to evaluate if triolein emulsion could disrupt the barriers, and we wanted to suggest as an experimental model for future blood-ocular barrier studies. MATERIALS AND METHODS: The triolein emulsion was made of 0.1 ml triolein and 20 ml normal saline, and this was infused into the carotid artery of ten cats (the experimental group). As a control group, only normal saline was infused in another ten cats. Precontrast and postcontrast T1-weighted MR images were obtained at 30 minutes and 3 hours after embolization in both groups. The signal intensities were evaluated qualitatively and quantitatively in the anterior and posterior chambers and also in the vitreus fluid. Statistical analysis was performed by employing the Kruskal Wallist test, Dunn's Multiple Comparison test and the Wilcoxon signed rank test. RESULTS: In the control group, no contrast enhancement was demonstrated in the anterior or posterior chamber or in the vitreus fluid of the ipsilateral or contralateral eyeball on the 30 minutes MR images. The anterior chambers of the ipsilateral and contralateral eyeballs revealed delayed contrast enhancement on the 3 hour MR images. In the experimental group, the 30 minute-postembolization MR images were not different from those of the control group. The 30 minute-postembolization MR images demonstrated delayed contrast enhancement in the anterior chamber of the ipsilateral and contralateral eyeballs and in the posterior chamber of the ipsilateral eyeball. The delayed contrast enhancement of the posterior chamber of the ipsilateral eyeball was statistically significant (p<0.05). CONCLUSION: The present study demonstrated significant contrast enhancement in the posterior chamber with infusion of the triolein emulsion, and this can serve as a model for blood-aqueous barrier studies.
Animals ; Anterior Chamber ; Blood-Aqueous Barrier ; Carotid Arteries ; Cats ; Embolism, Fat ; Models, Theoretical* ; Triolein

The effects of clonidine that is an alpha2-adrenergic agonist are complex in that the intraocular responses are biphasic and dose dependent. The mechanisms of the ocular hypotensive responses to clonidine in the treated and the contralateral untreated eyes seemed to be dependent on the central activity of clonidine and the intact peripheral adrenergic system. Apraclonidine is a clonidine derivative which penetrates into the blood-brain barrier minimally and lowers the intraocular pressure significantly not accompanied by systemic side effects such as change in blood pressure and pulse rate. The main purpose of the present study is to use apraclonidine to elucidate the influence of the central and peripheral sympathetic activity in the change of the morphology of the ciliary nonpigmented epithelium in the pigmented rabbits 0.1 cc of 1% apraclonidine was injected into the vitreous cavity of pigmented rabbits after removal of 0.1 cc of aqueous humor from the anterior chamber and the eyes were enucleated on 1, 3, 5, 7 days after injection. The eyes were observed with light microscopic examination. 1. In the 1st day's specimen, swollen nonpigmented epithelium and increased pigments were noted in the treated eye. 2. In the treated eye on the 5th day, vacuole like appearances under the nucleus of the nonpigmented epithelium were noted. 3. Except for the appearance of slightly increased pigmented granules in the 3rd and 5th day's specimen, there were no significant changes in any of the nontreated eyes. 4. The mechanism of the hypotensive response of apraclonidine seemed to be dependent on the alpha2-adrenergic receptors which are located in the eye, not on the central nor on the peripheral adrenergic system.
Anterior Chamber ; Aqueous Humor ; Blood Pressure ; Blood-Brain Barrier ; Clonidine ; Epithelium* ; Heart Rate ; Intraocular Pressure ; Intravitreal Injections* ; Rabbits* ; Vacuoles

The purpose of this paper is to study the effects of anti-inflammatory agents on the blood-aqueous-berrier in experimentally induced uveitis. 10% solution of sodium fluorescein was injection intravenously in the ear vein of rabbits (0.25 ml/kg) and fluorescein curve was drawn after the method of Amsler and Huber. Experimental uveitis was induced by the injection of 0.2 ml of human serwn into the vitreous body. After uveitis had been induced. three kinds of anti-inflammatory agents-Prednisolone, Benzyron and Methotrexate-were Biven oralIy. In control animals in which no uveitis was induced, no changes in fluorescein curve were demonstrated before and after the administrations of drugs. In animals with uveitis, maked increases of the blood-aqueous barrier were noted. When Benoyron and Prednisolone were given to these animals, normaliration of the fluorescein curves were demonstrated. Methotrexate had no effects on the fluorescein curves in uveitis animals, showing no improvements in the permeability of uveal vessela. This ineffectiveness seemed to be due to the resistance of rabbits to methotrexate.
Animals ; Anti-Inflammatory Agents ; Blood-Aqueous Barrier ; Ear ; Fluorescein ; Humans ; Methotrexate ; Permeability ; Prednisolone ; Rabbits ; Uveitis* ; Veins ; Vitreous Body

OBJECTIVE: The purpose of this study is to evaluate the effect of dexamethasone on the damaged blood-ocular barrier caused by triolein emulsion, using contrast-enhanced MR imaging. MATERIALS AND METHODS: An emulsion of 0.1-mL triolein in 20 mL of saline was infused into the carotid arteries of 32 cats, 12 cats were placed in the treatment group and 18 cats were placed in the Control group. Thirty minutes after the infusion of triolein emulsion, a set of orbital pre- and post-contrast T1-weighted MR images (T1WIs) were obtained. Infusion of 10 mg/kg dexamethasone into the ipsilateral carotid artery of each of the cats in the treatment group cats and 20 mL saline in each of the cats in the control group was given. A second set of pre- and post-contrast orbital T1WIs were obtained three hours following triolein emulsion infusion. Qualitative analysis was performed for the the anterior chamber (AC), the posterior chamber (PC), and in the vitreous humor of the ipsilateral and contralateral eyes. The signal intensity ratios of the ipsilateral eye over the contralateral eye were quantitatively evaluated in the three ocular chambers on the first and second set of T1WIs, and were then statistically compared. RESULTS: Qualitatively, the AC, the PC or the vitreous did not show immediate contrast enhancement on the first and the second set of post-contrast T1WIs. However, the AC and the PC showed delayed contrast enhancement for both groups of cats on the second pre-contrast T1WIs. No enhancement or minimally delayed enhancement was seen for the vitreous humor. Quantitatively, the signal intensity ratios in the PC of the treatment group of cats were statistically lower than the ratios of the control group of cats for the second set of T1WIs (p = 0.037). The AC and vitreous showed no statistically significant difference between the feline treatment group and control group (p > 0.05). CONCLUSION: Contrast-enhanced MR images revealed increased vascular permeability in the PC of the eye after infusion of triolein emulsion. Dexamethasone seems to decrease the breakdown of the blood-aqueous barrier in the PC.
Animals ; Blood-Aqueous Barrier/*drug effects ; Blood-Retinal Barrier/*drug effects ; Capillary Permeability/drug effects ; Cats ; Contrast Media ; Dexamethasone/*pharmacology ; Emulsions ; Glucocorticoids/*pharmacology ; Image Enhancement ; Magnetic Resonance Imaging/*methods ; Triolein/*adverse effects