To evaluate the expression of vascular endothelial growth factor (VEGF) in pterygia and seek the reciprocal relationships between VEGF and nitric oxide (NO) in development of pterygia. Conjunctiva sampled during conjunc-tival transplantation of pterygial operation and pterygia were used in this study. OCT compound-fixed-cryopreserved tissues consisted normal conjunctiva and pterygia were used to study the expression of VEGF and iNOS with immunohistochemistry. For confirmation of NOS activity, NADPH-diaphorase staining was done. ELISA for detection of VEGF amounts was performed. The expression of VEGF and iNOS were revealed in the epithelium of pterygia, although there were not expressed in the epithelium of normal conjunctiva. The epithelium of pterygia was stained with NADPH-diaphorase. The results of ELISA showed the higher amount of VEGF inpterygia compared with conjunctiva. These findings suggest that VEGF and NO play an important role in fibrovascular development of pterygia.s
Conjunctiva ; Enzyme-Linked Immunosorbent Assay ; Epithelium ; Immunohistochemistry ; Nitric Oxide ; Vascular Endothelial Growth Factor A*

PURPOSE: To report the expression of decorin and TGF-beta in partial myotomy of the extraocular muscle in rats. METHODS: Partial myotomy of the superior rectus muscle was performed on the right eye of 10 Sprague-Dawley rats followed by exposure of the left superior rectus muscle and a simple suture of the conjunctiva. The bilateral superior rectus muscle was obtained from all rats at 2 weeks postoperatively. The tissues were observed under light microscopy with hematoxylin-eosin, Masson's trichrome staining and immunohistochemistry. RESULTS: Histological examinations of the surgical area at 2 weeks after postoperatively showed irregularly concentrated fibrosis on light microscopy with hematoxylin-eosin and Masson's trichrome staining of the experimental eyes. Immnohistochemistry showed that expression of decorin was in the same location as TGF-beta in the experimental group. CONCLUSIONS: The expression of decorin was found in the healing process after partial myotomy of the extraocular muscle in rats. Immunohistochemistry showed that expression of decorin was in the same location as with TGF-beta.
Animals ; Conjunctiva ; Decorin* ; Fibrosis ; Immunohistochemistry ; Microscopy ; Rats* ; Rats, Sprague-Dawley ; Sutures ; Transforming Growth Factor beta*

PURPOSE: To evaluate whether TGF-alpha, beta1, beta2 are expressed in pterygial mast cell and the difference between each growth factor exists. METHODS: We prepared 10 pieces each of excised normal conjunctiva, primary pterygium, recurrent pterygium from human eyes and then fixed those in 4% paraformaldehyde solution. The tissues were embedded in paraffin and slide samples taken from those. After that, we observed mast cells stained by immunohistochemistry against each of TGF-alpha,beta1 ,beta2 and compared the staining features between them, and we also confirmed metachromatic staining of the mast cell with toluidine blue. RESULTS: As compared with normal conjunctiva, in primary and recurrent pterygia, those counts of mast cells expressing TGF-alpha, beta1, beta2 were increased respectively with statistical significance and especially, those counts for TGF-beta1 in primary pterygium were 9 times as high as in normal conjunctiva. CONCLUSIONS: Pterygial mast cells are considered to play an important role in fibrovascular proliferation of pterygium by synthesizing and secretion of TGF-alpha, beta1, beta2 . Especially, TGF-beta1 is thought to play a more important role than TGF-alphaandbeta2 in primary pterygium.
Conjunctiva ; Humans ; Immunohistochemistry ; Mast Cells* ; Paraffin ; Pterygium ; Tolonium Chloride ; Transforming Growth Factor alpha* ; Transforming Growth Factor beta1

Myiasis of different organs has been reported off and on from various regions in the world. We report a human case of external ophthalmomyiasis caused by the larvae of a sheep nasal botfly, Oestrus ovis, for the first time from Meerut city in Western Uttar Pradesh, India. A 25-year-old farmer presented with severe symptoms of conjunctivitis. The larvae, 3 in number, were observed in the bulbar conjunctiva, and following removal the symptoms of eye inflammation improved within a few hours.
Adult ; Animals ; Conjunctiva/parasitology ; Conjunctivitis/*parasitology ; *Diptera/growth & development ; Eye Infections, Parasitic/*parasitology ; Humans ; India ; Larva ; Myiasis/*parasitology

The inhibitory mechanism of interferon-gamma (IFN-gamma) on the fibroblasts from Tenon's capsule was studied. By using immunohistochemical SP method and pathological image system, the inhibitory effects of IFN-gamma on the expression of transforming growth factor beta receptor I in the in vitro cultured fibroblasts from Tenon's capsule were quantitatively analyzed. The results showed that IFN-gamma could reduce the expression of transforming growth factor beta receptor I in the fibroblasts with the following dose-effect relationship: Y = 1937.5-134.2 Igx (r=-0.971, P<0.01). It was concluded that IFN-gamma could inhibit the expression of transforming growth factor beta receptor I in the fibroblasts from Tenon's capsule. The modulation of the transforming growth factor beta receptor I expression by IFN-gamma may be beneficial to the alleviation of the hyperplasia of scar after trabeculectomy.
Conjunctiva ; metabolism ; pathology ; Connective Tissue ; drug effects ; Fibroblasts ; metabolism ; pathology ; Filtering Surgery ; Glaucoma ; pathology ; surgery ; Humans ; Interferon-gamma ; biosynthesis ; genetics ; Receptors, Transforming Growth Factor beta ; analysis

PURPOSE: To report a case of fibrotic obstruction of scleral orifice in Ex-PRESS shunt. CASE SUMMARY: A 57-year-old male presented with elevated intraocular pressure in his left eye. In the past, laser photocoagulation was performed at a local clinic due to retinal venous occlusion in his left eye. During observation, he was transferred to our hospital due to uncontrolled intraocular pressure despite antiglaucoma medications. He was diagnosed with neovascular glaucoma in the left eye. Since intravitreal injection of anti-vascular endothelial growth factor with maximal medical therapy did not lower the intraocular pressure, an Ex-PRESS shunt device was implanted. Two weeks postoperatively, the bleb was flat and diffuse with shallow anterior chamber and intraocular pressure was below 5 mm Hg. Therefore, we performed scleral flap revision and intraocular pressure was sustained between 10 and 15 mm Hg. Two months postoperatively, the patient experienced high intraocular pressure and no elevated bleb, thus we performed bleb revision. During the surgery, although we removed fibrotic adhesions between the conjunctiva and episclera using a 30-gauge needle, aqueous outflow was not observed. Therefore, we opened the scleral flap and found the scleral orifice of the Ex-PRESS shunt was obstructed by fibrous scar tissue. After scar tissue removal and achieving aqueous outflow through the scleral opening, intraocular pressure decreased to a satisfactory level. CONCLUSIONS: In patients with elevated intraocular pressure after implantation of the Ex-PRESS shunt, the scleral opening of the Ex-PRESS shunt should be examined for obstruction.
Anterior Chamber ; Blister ; Cicatrix ; Conjunctiva ; Endothelial Growth Factors ; Glaucoma, Neovascular ; Humans ; Intraocular Pressure ; Intravitreal Injections ; Light Coagulation ; Male ; Middle Aged ; Needles ; Retinaldehyde

PURPOSE: In the field of ophthalmology, the conjunctival autograft is a useful therapeutic material in many cases, but the small size of the autograft is a disadvantage. Therefore, we evaluated the feasibility of taking an expanded sample of conjunctival tissue using a subtenon's silicone implant. MATERIALS AND METHODS: We included a total of nine rabbits; eight rabbits were operative cases, and one was a control. A portion of conjunctival tissue from the control rabbit, which did not undergo surgery, was dissected and examined to determine whether it was histologically different from the experimental group. The surgical procedure was performed on eight rabbits via a subtenon's insertion of a silicone sponge in the left superior-temporal portion; after surgery, we dropped antibiotics into the eyes. We sacrificed a pair of rabbits every three days (on days 3, 6, 9, and 12) after surgery, removed the expanded conjunctival tissues with the silicone sponge implants, and measured their sizes. RESULTS: The mean size of the expanded conjunctival tissues was 194.4mm(2). On the third day, we were able to harvest a 223.56mm(2) section of conjunctival tissue, which was the most expanded sample of tissue in the study. On the twelfth day, we removed a 160.38mm(2) section of conjunctival tissue, which was the least expanded sample of tissue. Statistically, there were no significant differences in the mean dimensions of the expanded conjunctival tissues for each time period. Microscopic examinations showed no histological differences between the expanded conjunctival tissues and the normal conjunctival tissues. CONCLUSION: The results reveal that this procedure is a useful method to expand the conjunctiva for grafting and transplantation.
Animals ; Conjunctiva/*growth & development/*surgery/transplantation ; Corneal Diseases/surgery ; Feasibility Studies ; Female ; *Prostheses and Implants ; Rabbits ; Silicones ; Tissue Expansion/*methods ; Transplantation, Autologous/methods

PURPOSE: To introduce 2 cases of trichomegaly associated with the use of systemic epidermal growth factor receptor (EGFR) inhibitors for the treatment of lung cancer. CASE SUMMARY: An 82-year-old female visited our clinic for ocular pain in both eyes. She was suffering from metastatic lung cancer and was under daily treatment with gefitinib (Iressa(R), AstraZeneca, London, UK) for 6 months. On ophthalmologic examination, she presented with abnormally elongated eyelashes, hyperemic conjunctiva and dense corneal erosion. A 52-year-old male who was diagnosed with non-small cell lung cancer 7 months before and treated with erlotinib (Tarceva(R) OSI Pharmaceuticals, Inc., Melville, NY, USA) was referred to our clinic for injection and foreign body sensation in both eyes. Although there were no remarkable changes in eyelashes at the initial visit, long, curly, uneven eyelashes were observed after 3 months. CONCLUSIONS: Due to the increased use of EGFR inhibitors in anti-cancer treatment, ophthalmologists should be aware of these chemotherapeutics' adverse effects.
Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung ; Conjunctiva ; Eyelashes* ; Female ; Foreign Bodies ; Humans ; Lung Neoplasms ; Male ; Middle Aged ; Receptor, Epidermal Growth Factor ; Sensation ; Erlotinib Hydrochloride

This prospective observational case series study included 6 eyes of 6 consecutive glaucomatous patients. Each patient underwent trabeculectomy with mitomycin C, and received a 1.25 mg of subconjunctival bevacizumab injection at completion of the trabeculectomy. Study eyes included two with neovascular glaucoma, three with uveitic glaucoma, and one with secondary glaucoma following vitrectomy. All eyes had undergone failed glaucoma laser/surgical treatment or an intraocular surgical procedure. Intraocular pressure (IOP) at the following postoperative visits: preoperative, 1 week, 1 month, 2 months, 3 months, and 6 months, was measured. We also evaluated postoperative bleb findings and complications. IOP measured at each visit was 37.5+/-14.4 mmHg, 6.2+/-3.4 mmHg, 8.3+/-7.2 mmHg, 12.0+/-4.4 mmHg, 10.8+/-3.1 mmHg, and 12.2+/-3.3 mmHg, respectively, for each visit. All eyes had functioning blebs with normal IOP at postoperative 6 months with no additional IOP-lowering medication.
Adult ; Aged ; Angiogenesis Inhibitors/*administration & dosage ; Antibodies, Monoclonal/*administration & dosage ; Conjunctiva ; Female ; Glaucoma/*drug therapy/etiology/*surgery ; Glaucoma, Neovascular/drug therapy/surgery ; Humans ; Injections, Intraocular ; Male ; Middle Aged ; Prospective Studies ; Trabeculectomy/*methods ; Uveitis/complications ; Vascular Endothelial Growth Factor A/*antagonists & inhibitors ; Vitrectomy/adverse effects