We report a case of complicated cataract aggravated after taking herbal medication for atopic dermatitis. An 11-yr-old boy was referred for the evaluation of decreased visual acuity in both eyes for 2 months. Past history showed that he had been diagnosed with atopic dermatitis when he was 1 yr old. He had been treated only with herbal medication for a period of 8 months prior to visiting our clinic. He had his visual acuity checked in a local ophthalmic clinic one year before, and the visual acuity was 20/20 in both eyes at that time. When attending our clinic the ophthalmologic examination showed that his best corrected visual acuity was 20/200 in both eyes. Lenses of both eyes had severe posterior subcapsular and posterior capsular opacity. Phacoemulsification, posterior chamber intraocular lens implantation, and posterior continuous curvilinear capsulectomy were performed in both eyes. After 3 months postoperatively, the best corrected visual acuity was recovered to 20/20 in both eyes without any complication. Our case suggests that there may be a risk of aggravation of cataract or development of cataract after treatment with some unidentified herbal medication in a patient with atopic dermatitis.
Cataract/*chemically induced ; Cataract Extraction ; Child ; Dermatitis, Atopic/*drug therapy ; Drugs, Chinese Herbal/*adverse effects ; Humans ; Male ; Visual Acuity/drug effects

A 64-year-old woman was referred to our clinic for the treatment of chronic uveitis in her left eye, which had started two weeks after an uncomplicated cataract extraction. She was treated with topical steroids with an initially good response, yet she subsequently developed severe inflammation and plaque-like material around the intraocular lens, despite continuous steroid therapy. She underwent pars plana vitrectomy, smear and culture of the aqueous and vitreous fluids, and intravitreal antibiotic injection under the impression of Propionibacterium acne (P. acne) endophthalmitis. As a result of the smear and culture of the vitreous fluid identified as an Acremonium species, she was treated with intravenous amphotericin B injections for five days, followed by oral voriconazole administration. During the post-operative 18-month follow-up, she was stable without significant relapse of uveitis. In this case, the best correction of visual acuity was an improvement from 20/40 to 20/20.
Acremonium/*isolation & purification ; Antifungal Agents/therapeutic use ; *Cataract Extraction ; Endophthalmitis/drug therapy/*microbiology ; Eye Infections, Fungal/drug therapy/*microbiology ; Female ; Humans ; Middle Aged

PURPOSE: To evaluate the long-term visual outcomes and complications of cataract surgery in eyes previously treated for retinoblastoma. METHODS: We reviewed the medical records of patients who underwent cataract extraction and intraocular lens implantation at Seoul National University Children's Hospital for a secondary cataract that developed after retinoblastoma treatment. RESULTS: During the period between 1990 and 2014, 208 eyes of 147 patients received eye-salvaging treatment (radiotherapy, chemotherapy, and local therapy) for retinoblastoma at Seoul National University Children's Hospital. Among these eyes, a secondary cataract was detected in 17 eyes of 14 patients, and five eyes of five patients underwent cataract surgery. The median age of cataract formation was 97 months (range, 38 to 153 months). The medial interval between the diagnosis of retinoblastoma and cataract formation was 79 months (range, 29 to 140 months). All patients received posterior chamber intraocular lens insertion after irrigation and aspiration of the lens through a scleral tunnel incision. Anterior vitrectomy and posterior capsulotomy were performed in two eyes and a laser capsulotomy was subsequently performed in one eye. No intraoperative and postoperative complications occurred. The median follow-up after surgery was 36 months (range, 14 to 47 months). The final best corrected visual acuities were improved in all five eyes. No intraocular tumor recurrences or metastases occurred. CONCLUSIONS: After retinoblastoma regression, cataract extraction in our series was not associated with tumor recurrence or metastasis. Visual improvement was noted in every patient.
Capsule Opacification ; Cataract Extraction ; Cataract* ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Humans ; Lens Implantation, Intraocular ; Lenses, Intraocular ; Medical Records ; Neoplasm Metastasis ; Posterior Capsulotomy ; Postoperative Complications ; Radiotherapy ; Recurrence ; Retinoblastoma* ; Seoul ; Visual Acuity ; Vitrectomy

PURPOSE: To report MALT (mucosa associated lymphoid tissue) type lymphoma in ocular adnexa. METHODS: This retrospective study included 11 patients (13 cases) of MALT type lymphoma between August 1995 and July 2000. We identified 11 lymphoma cases with MALT characteristics by conventional examination and immunohistochemical staining. Twelve cases were treated with partial excision and radiotherapy, one case with partial excision and chemotherapy. RESULTS: The patients consisted of 4 females and 7 males with an age range of 29~88 (average 48) years old. Mean follow up period was 24.8 (6~60) months following treatment. Eleven patients had ocular adnexal involvement at presentation; 7 eyes in conjunctiva, 5 eyes in orbit and one in eyelid. All cases represented extranodal marginal zone B-cell lymphoma by REAL classification. Control of lymphomas was achieved in all but 4 cases which developed recurrence after irradiation and chemotherapy, and were salvaged with further radiotherapy. Complications such as cataract, radiation retinopathy, ptosis and alopecia developed later in 4 eyes. CONCLUSIONS: Surgical excision and radiotherapy seemed to be effective for the treatment of primary ocular adnexal MALT lymphoma. Long-term follow up should be warranted.
Alopecia ; Cataract ; Classification ; Conjunctiva ; Drug Therapy ; Eyelids ; Female ; Follow-Up Studies ; Humans ; Lymphoma* ; Lymphoma, B-Cell, Marginal Zone ; Male ; Orbit ; Radiotherapy ; Recurrence ; Retrospective Studies

This study investigated the inhibitory effect of grape seed proanthocyanidin extract (GSPE) on selenite-induced cataract formation in rats and the possible mechanism. Eighty 8-day-old Sprague-Dawley rats were divided randomly into 5 groups: control group, model group, three GSPE groups (low dose, medium dose and high dose). Control group received subcutaneous injection of physiological saline. Model group was given subcutaneous injection of sodium selenite (20 μmol/kg body weight) on the postpartum day 10, and once every other day for consecutive three times thereafter. GSPE treated groups were respectively administered GSPE at doses of 50, 100, and 200 mg/kg body weight intragastrically 2 days prior to the selenite injection (that was, on the postpartum day 8), and once daily for fourteen consecutive days thereafter. The opacity of lenses was observed, graded and photographed under the slit lamp microscopy and the maximal diameter of the nuclear cataract plaques was measured. The lenses were analyzed for superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-PX), malondialdehyde (MDA), calcium (Ca(2+)), nitric oxide (NO) and anti-hydroxyl radical ability (anti-OH(-)). The histomorphology of lenses was observed with HE staining under a light microscope. The levels of calpainII, and iNOS protein and mRNA expression in lenses were detected by using immunohistochemistry and real-time quantitative RT-PCR. The results showed subcutaneous injection of sodium selenite led to severe nuclear cataract in model group, and the achievement ratio of model group was 100%. As compared with model group, the degree of lenses opacity and the maximal diameter of nuclear cataract plaques were significantly reduced in GSPE-treated groups. Moreover, we observed selenite treatment caused a significant decrease in the activities of antioxidative enzymes (SOD, CAT, GSH-PX) and anti-OH(-) ability, accompanied by a significant increase in the levels of MDA, NO, Ca(2+) as well as iNOS, and calpainII protein and mRNA expression. Administration of GSPE could dose-dependently preserve the activities of these antioxidative enzymes and anti-OH(-) ability, accompanied by a significant reduction in the levels of MDA, NO, Ca(2+) as well as iNOS, and calpainII protein and mRNA expression. These results suggested that GSPE markedly prevented selenite-induced cataract formation probably by suppressing the generation of lipid peroxidation and free radicals as well as the activation of iNOS, and calpainII in the lenses.
Animals ; Cataract ; chemically induced ; drug therapy ; Grape Seed Extract ; pharmacology ; Plant Extracts ; pharmacology ; Proanthocyanidins ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Selenious Acid ; adverse effects

Two schizophrenic patients who had been taking medication for a long period presented with visual disturbance of 6-month duration. Slit-lamp examination revealed fine, discrete, and brownish deposits on the posterior cornea. In addition, bilateral star-shaped anterior subcapsular lens opacities, which were dense, dust-like granular deposits, were noted. Although we strongly suspected that the patient might have taken one of the drugs of the phenothiazine family, we were unable to obtain a history of medications other than haloperidol and risperidone, which were taken for 3 yr. We performed a drug profiling test using urine samples and detected methotrimeprazine. The patient underwent surgery for anterior subcapsular lens opacities. Visual acuity improved in both eyes, but the corneal deposits remained. We report an unusual case of methotrimeprazine-induced corneal deposits and cataract in a patient with psychosis, identified by using the urine drug profiling test.
Adult ; Antipsychotic Agents/*adverse effects/therapeutic use/urine ; Cataract/*chemically induced ; Corneal Diseases/*chemically induced ; Female ; Humans ; Male ; Mental Retardation/diagnosis/drug therapy ; Methotrimeprazine/*adverse effects/therapeutic use/urine ; Middle Aged ; Schizophrenia/diagnosis/drug therapy ; Visual Acuity

PURPOSE: To evaluate the effectiveness of cyclosporine 0.05% for dry eye after cataract surgery. METHODS: Thirty-two newly diagnosed patients with dry eye syndrome 1 week after cataract surgery received a twice-daily treatment of cyclosporine 0.05% for one eye and normal saline 0.9% for the other. Disease severity was measured at 2 weeks, 1 month, 2 months, and 3 months by Schirmer test I (ST-I), tear film break-up time (tBUT), corneal temperature and dry eye symptom questionnaire (Ocular Surface Disease Index). RESULTS: Both groups increased in ST-I and tBUT over time. ST-I in the cyclosporine 0.05% group showed a significant increase at 3 months and tBUT in the cyclosporine 0.05% group showed an increase at 2 and 3 months. The dry eye symptom score was significantly reduced in the cyclosporine 0.05% group. CONCLUSIONS: Cyclosporine 0.05% can also be an effective treatment for dry eye after cataract surgery.
Aged ; Aged, 80 and over ; *Cataract Extraction ; Cyclosporine/*administration & dosage ; Dry Eye Syndromes/*drug therapy ; Female ; Humans ; Immunosuppressive Agents/administration & dosage ; Male ; Middle Aged ; Ophthalmic Solutions/*administration & dosage ; Postoperative Complications/*drug therapy ; Treatment Outcome

OBJECTIVETo evaluate the aldose reductase inhibitory (ARI) activity of different fractions of Hybanthus enneaspermus for potential use in diabetic cataract.

METHODSTotal phenol and flavonoid content of different fractions was determined. ARI activity of different fractions in rat lens was investigated in vitro.

RESULTSThe results showed significant level of phenolic and flavonoid content in ethyl acetate fraction [total phenol (212.15±0.79 mg/g), total flavonoid (39.11±2.27 mg/g)] and aqueous fraction [total phenol (140.62±0.57 mg/g), total flavonoid (26.07±1.49 mg/g)] as compared with the chloroform fraction [total phenol (68.56±0.51 mg/g), total flavonoid (13.41±0.82 mg/g)] and petrolium ether fraction [total phenol (36.68±0.43 mg/g), total flavonoid (11.55±1.06 mg/g)]. There was a significant difference in the ARI activity of each fraction, and it was found to be the highest in ethyl acetate fraction [IC50 (49.26±1.76 µg/mL)] followed by aqueous extract [IC50 (70.83±2.82 µg/mL)] and it was least in the petroleum ether fraction [IC50 (118.89±0.71 µg/mL)]. Chloroform fraction showed moderate activity [IC50 (98.52±1.80 µg/mL)].

CONCLUSIONSDifferent fractions showed significanct amount of ARI activity, where in ethyl acetate fraction it was found to be maximum which may be due to its high phenolic and flavonoid content. The extract after further evaluation may be used in the treatment of diabetic cataract.

Aldehyde Reductase ; antagonists & inhibitors ; Animals ; Cataract ; drug therapy ; prevention & control ; Diabetes Complications ; drug therapy ; prevention & control ; Diabetes Mellitus ; pathology ; Flavonoids ; analysis ; Lens, Crystalline ; enzymology ; Phenols ; analysis ; Plant Extracts ; pharmacology ; Rats ; Rats, Wistar ; Violaceae ; metabolism

This is a report of an atypical case of progressive outer retinal necrosis (PORN) and the effect of highly active antiretroviral therapy (HAART) on the clinical course of viral retinitis in an acquired immunodeficiency syndrome (AIDS) patient. A 22-year-old male patient infected with human immunodeficiency virus (HIV) presented with unilaterally reduced visual acuity and a dense cataract. After cataract extraction, retinal lesions involving the peripheral and macular areas were found with perivascular sparing and the mud-cracked, characteristic appearance of PORN. He was diagnosed as having PORN based on clinical features and was given combined antiviral treatment. With concurrent HAART, the retinal lesions regressed, with the regression being accelerated by further treatment with intravenous acyclovir and ganciclovir. This case suggests that HAART may change the clinical course of PORN in AIDS patients by improving host immunity. PORN should be included in the differential diagnosis of acute unilateral cataract in AIDS patients.
AIDS-Related Opportunistic Infections/complications/*drug therapy ; Acyclovir/therapeutic use ; Adult ; *Antiretroviral Therapy, Highly Active ; Antiviral Agents/*therapeutic use ; Cataract/complications ; Disease Progression ; Drug Therapy, Combination ; Fluorescein Angiography ; Ganciclovir/therapeutic use ; Herpes Zoster Ophthalmicus/*drug therapy/etiology ; Humans ; Male ; Phacoemulsification ; Retinal Necrosis Syndrome, Acute/*drug therapy/etiology ; Visual Acuity

PURPOSE: To investigate the effect of catechin on apoptotic cell death in the lens epithelium of rats with cataract. METHODS: Cataract was induced by intraperitoneal injection of 100 mg/kg N-methyl-N-nitrosourea (MNU) to ten day-old Sprague-Dawley rats. The neonatal rats were randomly divided into five groups (n=15 in each group): a control group, and four cataract-induction groups, treated with either 0, 50, 100, 200 mg/kg catechin. We performed slit-lamp biomicroscopic analysis, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay, Western-blot for Bcl-2 and Bax, and immunohistochemistry for caspase-3. RESULTS: Apoptotic cell death in lens epithelial cells that increased following cataract formation in rats was suppressed by cathechin. CONCLUSIONS: Catechin inhibited cataract-induced apoptotic cell death in the lens epithelium and may prove useful for the prevention of cataract progression.
Analysis of Variance ; Animals ; Animals, Newborn ; Apoptosis/*drug effects ; Blotting, Western ; Caspase 3/metabolism ; Cataract/chemically induced/*drug therapy ; Catechin/*pharmacology ; Immunoenzyme Techniques ; In Situ Nick-End Labeling ; Lens, Crystalline/*drug effects ; Random Allocation ; Rats ; Rats, Sprague-Dawley