No abstract available.
Chronic Disease ; Cryopyrin-Associated Periodic Syndromes/*complications/diagnosis ; Gonioscopy ; Humans ; *Intraocular Pressure ; Male ; Microscopy, Acoustic ; Middle Aged ; Ocular Hypertension/diagnosis/*etiology/physiopathology ; Rare Diseases

PURPOSE: To evaluate the expression of the Na(+)-K(+)-2Cl(-)-cotransporter 2 (NKCC2) in the ischemic rat retina. METHODS: Retinal ischemia was induced by pressures 90 to 120 mmHg, above systemic systolic pressure. Immunohistochemistry and western blot analysis were performed. RESULTS: NKCC2 is expressed in the normal retina and its expression is increased by ischemia caused by intraocular pressure elevation. NKCC2 immunoreactivity was observed mainly in axon bundles of ganglion cells and horizontal cell processes in the retina. NKCC2 expression continuously increased with a peak value 3 days (to 415% of normal levels) after ischemic injury, and then gradually decreased to 314% of controls until 2 weeks post injury. The mean density of NKCC2-labeled ganglion cells per mm2 changed from 1,255 +/- 109 in normal retinas to 391 +/- 49 and 185 +/- 37 at 3 days and 2 weeks after ischemia, respectively (p < 0.05), implying cell death of ganglion cells labeled with NKCC2. CONCLUSIONS: Taken together, these results suggest that NKCC2, which is expressed in retinal ganglion and horizontal cells, may contribute to cell death by ischemic injury in the retina, although the molecular mechanisms involved remain to be clarified.
Animals ; Blotting, Western ; Disease Models, Animal ; Immunohistochemistry ; Intraocular Pressure ; Ischemia/etiology/*metabolism ; Male ; Microscopy, Confocal ; Ocular Hypertension/*complications/metabolism/physiopathology ; Rats ; Rats, Sprague-Dawley ; Retinal Diseases/etiology/*metabolism ; Retinal Ganglion Cells/*metabolism/pathology ; Sodium-Potassium-Chloride Symporters/*biosynthesis

PURPOSE: To evaluate the surgical outcomes on the combined procedures of phacoemulsification, intraocular lens (IOL) implantation, and vitrectomy, and to compare clinical results with sequential surgery results in Korean patients with idiopathic epiretinal membrane. METHODS: The present retrospective study included 20 eyes of 19 patients with idiopathic epiretinal membrane who underwent combined phacoemulsification, IOL implantation, and pars plana vitrectomy (combined surgery), and 18 eyes of 18 patients who underwent phacoemulsification and IOL implantation subsequent to vitrectomy (sequential surgery). Postoperative clinical results and intra- and postoperative complications were compared between the 2 groups. RESULTS: Postoperative best corrected visual acuity (BCVA) (logMAR) was 0.41 +/- 0.42 in the combined group, and 0.35 +/- 0.37 in the sequential group. There was no significant difference in BCVA between the 2 groups (p = 0.675). The mean refractive prediction error was -0.46 +/- 0.88 diopters (D) in the combined group, and -0.06 +/- 0.68 D in the sequential group, showing no statistically significant difference between the 2 groups (p = 0.147). The present study showed no major differences between the 2 groups in complications such as intraoperative mild corneal edema, postoperative ocular hypertension, and lens capsular opacity. CONCLUSIONS: Combined phacoemulsification, IOL implantation, and pars plana vitrectomy as well as the two-step procedure are safe and effective for treating patients with idiopathic epiretinal membrane.
Corneal Edema ; Epiretinal Membrane ; Eye ; Humans ; Lens Implantation, Intraocular ; Lenses, Intraocular ; Ocular Hypertension ; Phacoemulsification ; Postoperative Complications ; Retrospective Studies ; Visual Acuity ; Vitrectomy

OBJECTIVETo evaluate the impact of hyphema secondary to high intraocular pressure on corneal pathology in rabbits.

METHODSThirty adult New Zealand rabbit were randomized into 3 equal groups, and in each rabbit, one eye served as the experimental eye with the other as the control eye. In the experimental eye, autoblood was injected into the anterior chamber to induce high intraocular pressure maintained for 3, 5, or 8 days. Only saline was injected into the control eye. After the injections, the cornea was observed with slit-lamp microscopy, and at 3, 5, or 8 days, the experimental and control eyes were taken from the 3 groups for microscopic examination of the corneas to detect the occurrence of cornea bloodstain with prolonged high intraocular pressure. Corneal edema, elastic fibers changes, growth of new blood vessels, changes of eosinophils, fibroblasts, lymphocytes and plasma cells, as well as the pathological changes of the corneal layers were observed and compared between the experimental and control eyes.

RESULTSMaintenance of high intraocular pressure for 8 days resulted in the most severe corneal edema and thickening, and histopathologically, the corneal stroma showed widened space between the elastic fibers and obvious fiber distortion. Neovascularization was seen in the marginal cornea where eosinophil infiltration occurred with a small number of lymphocytes, plasma cells and fiber cells. All the three groups showed more obvious edema in the posterior than in the anterior cornea.

CONCLUSIONProlonged hyphema with ocular hypertension results in aggravation of corneal edema, and corneal blood staining does not occur until 8 days of high intraocular pressure but corneal elastic fiber disruption can be seen, suggesting the impending irreversible pathological changes of cornea.

Animals ; Cornea ; pathology ; Edema ; pathology ; Female ; Hyphema ; complications ; pathology ; Male ; Ocular Hypertension ; complications ; pathology ; Rabbits ; Random Allocation

OBJECTIVETo investigate the neuroprotective effect of human brain-derived neurotrophic factor gene transfection into rabbit retina against acute high intraocular pressure (HIOP).

METHODSAcute HIPO was induced in one eye of 24 white rabbits via saline perfusion into the anterior chamber (model group), and the contralateral eye without treatment served as the control group. In another 24 rabbits, 10 microl recombinant adeno-associated virus (rAAV) vector containing human BDNF gene (rAAV-BDNF) was injected into the vitreous body of one of the eyes 3 days before the operation for HIPO (BDNF group). At 1, 3, 7, and 14 days after HIOP model establishment, 6 eyes in each group were excised to observe the number of retinal ganglion cells (RGCs) and the thickness of the inner retina layer. For the eyes dissected on day 14, electroretinogram b (ERG-b) wave was detected 30 min before (baseline) and on days 1, 3, 7 and 14 after HIOP. Another 5 rabbits were used for ultrastructural observation of the RGCs using transmission electron microscopy, including 1 without treatment, 2 with unilateral HIOP and 2 with rAAV-BDNF transfection before HIOP.

RESULTSThe amplitude of ERG-b wave showed no significant difference between the 3 groups before HIOP (P>0.05). In HIOP model group and BDNF group, the amplitude decreased to the lowest at 1 day after HIOP and failed to recover the baseline level at 14 days (P<0.01); at the end of the observation, the amplitude was significantly higher in BDNF group than in the model group (P<0.01). Decreased number of RGCs and thickness of inner retina layer occurred in the model group, but these changes were milder in BDNF group (P<0.05, P<0.01). Electron microscopy revealed ultrastructural changes in the RGCs following acute HIOP, and transfection with rAAV-BDNF ameliorated these changes.

CONCLUSIONrAAV-BDNF transfection protects the retinal structure and improves the amplitude of ERG-b wave after acute high IOP suggesting its neuroprotective effects.

Animals ; Brain-Derived Neurotrophic Factor ; biosynthesis ; genetics ; Dependovirus ; genetics ; metabolism ; Genetic Therapy ; methods ; Genetic Vectors ; genetics ; Humans ; Ocular Hypertension ; complications ; therapy ; Rabbits ; Retina ; pathology ; Retinal Diseases ; etiology ; prevention & control ; Transfection

OBJECTIVETo investigate the protective effect of progesterone against high intraocular pressure-induced ischemia-reperfusion (IR) injury.

METHODSTwenty-four SD rats were randomly divided into normal control, IR model, dimethyl sulfoxide (DMSO) solvent treatment group, and progesterone treatment group. In the latter 3 groups, retinal IR injury was induced by intraocular injection of saline. In the progesterone group, intraperitoneal injections of 4 mg/kg progesterone were administered 30 min before and 2 h after ischemia, and an equivalent volume of DMSO was used in the DMSO group. The content of malondialdehyde (MDA) and superoxide dismutase (SOD) activity were measured by spectrophotometer after the treatment, and the pathological changes of the retina were observed by transmission electron microscope and light microscope.

RESULTSSix hours after reperfusion, the content of MDA in the model group was significantly higher than that in the normal control group (P<0.01), but lower than that in progesterone treatment group (P<0.01); reverse changes in SOD activity was observed. In the model group, the inner nuclear layer and nerve fiber layer became thinner with obvious cellular pathologies including nuclear condensation, mitochondria vacuolization and endocytoplasmic reticulum swelling. Progesterone treatment markedly alleviated these pathologies in the inner nuclear layer and nerve fiber layer of the retina.

CONCLUSIONProgesterone offers protection of the retina against IR injury in SD rats by increasing SOD activity and decreasing MDA content in the retina.

Animals ; Dimethyl Sulfoxide ; Female ; Ischemia ; etiology ; pathology ; Male ; Malondialdehyde ; metabolism ; Ocular Hypertension ; complications ; Progesterone ; pharmacology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; etiology ; prevention & control ; Retina ; metabolism ; Retinal Vessels ; physiopathology ; Superoxide Dismutase ; metabolism

INTRODUCTIONPrimary angle-closure glaucoma (PACG) is a major cause of blindness among Asians. A better understanding of the disease will improve the treatment and outcome of this condition.

METHODSA literature review of all recent publications on PACG was carried out. Articles were retrieved using a key word search of MEDLINE, PubMed and Science Citation Index databases.

RESULTSFollowing laser peripheral iritodomy for acute angle-closure, Asians were found to have a higher tendency to develop a subsequent rise in intraocular pressure compared to Caucasians. Furthermore, the extent and severity of visual field damage was more severe in Asians than Caucasians, particularly in eyes that presented insidiously with chronic PACG. Prophylactic laser iridotomy in the contralateral eye was found to be highly effective in preventing acute angle-closure attacks.

CONCLUSIONPACG is more difficult to manage and is associated with more severe long-term visual morbidity in Asians than Caucasians. Regular follow-up of patients with PACG is important for the early detection of progression of the disease and visual field deterioration.

Asian Continental Ancestry Group ; European Continental Ancestry Group ; Glaucoma, Angle-Closure ; complications ; physiopathology ; surgery ; Humans ; Intraocular Pressure ; Iridectomy ; adverse effects ; Ocular Hypertension ; etiology ; Visual Fields

PURPOSE: To investigate the efficacy and safety of selective laser trabeculoplasty (SLT) in pregnant and lactating women who have primary open-angle glaucoma and ocular hypertension. METHODS: From January 2006 to August 2006 SLT was performed in fertile female patients with primary open-angle glaucoma and ocular hypertension. Intraocular pressure (IOP) was measured at 1 hour, 1 day, 1 week, 1 month, 3 months, and 6 months after SLT. Anterior chamber reaction and ocular pain were checked on postoperative day 1. Peripheral anterior synechia was examined at postoperative 6 months. Any anti-glaucoma drug was discontinued after SLT procedure, and restarted when needed. RESULTS: 22 patients (40 eyes) of primary open-angle glaucoma (40 eyes) and ocular hypertension (10 eyes) were included. The mean baseline intraocular pressure was 31.6 mmHg. The mean IOP was 15.7 mmHg and the mean number of anti-glaucoma drug was 1.3+/-0.6 preoperatively. There was successful IOP decrease at postoperative 1 day (17.9 mmHg), 1 week (16.3 mmHg), 1 month (17.7 mmHg), 3 months (18.4 mmHg), and 6 months (19.0 mmHg). The mean number of anti-glaucoma drug was 0.43+/-0.7 (p=0.000) postoperatively. There were no significant postoperative complications in the 6-month follow-up period. CONCLUSIONS: SLT seems to be a safe and effective procedure for fertile female patients who need to discontinue or reduce the anti-glaucoma drugs.
Anterior Chamber ; Female ; Fertility ; Follow-Up Studies ; Glaucoma, Open-Angle* ; Humans ; Intraocular Pressure ; Lactation ; Ocular Hypertension* ; Postoperative Complications ; Pregnancy ; Trabeculectomy*

PURPOSE: To report a case of bilateral spontaneous anterior lens dislocation associated with retinitis pigmentosa (RP). METHODS: A 45-year-old male with RP presented with elevated intraocular pressure (IOP) in the right eye and was treated with laser iridotomy (LI). After LI, complete crystalline lens dislocation into the anterior chamber occurred. Surgical intervention, including anterior vitrectomy, intracapsular cataract extraction (ICCE), and IOL scleral fixation was performed. Two years later, the same episode occurred in his left eye and a similar treatment was done. RESULTS: Surgery was successful in both eyes. CONCLUSIONS: This is the first report of bilateral spontaneous anterior lens dislocation in a RP patient.
*Anterior Chamber ; Cataract/complications/diagnosis ; Cataract Extraction ; Electroretinography ; Follow-Up Studies ; Humans ; Iris/surgery ; Laser Therapy/adverse effects ; Lens Implantation, Intraocular/methods ; Lens Subluxation/diagnosis/*etiology/surgery ; Male ; Middle Aged ; Ocular Hypertension/complications/physiopathology/surgery ; Retinitis Pigmentosa/*complications/diagnosis/surgery ; Sclera/surgery ; Suture Techniques ; Visual Fields ; Vitrectomy

PURPOSE: To evaluate the advantages and complications of triamcinolone acetonide (TA)-assisted pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). METHODS: We retrospectively examined 110 eyes with vitreous hemorrhage or tractional retinal detachment resulting from a PDR after surgery. The TA-assited PPV [TA(+)] consisted of 58 eyes, and the conventional PPV[TA(-)]group consisted of 52 eyes. The improvement in vision, residual vitreous cortex (VC) pattern, and postoperative complications were studied. RESULTS: The residual VC pattern was divided into 3 groups: the focal type in 34 eyes (58.6%): the diffuse type in 22 eyes (37.9%): and no residual VC, seen in 2 eyes (3.4%). The TA (+) group had a lower incidence of rebleeding (p=0.0149) and of a preretinal membrane (p=0.0138) than the TA (-) group. No apparent persistant ocular hypertension occurred in any eyes. CONCLUSIONS: Triamcinolone-assisted PPV appears to be potentially useful to remove residual VC and to protect from postoperative complications.
Diabetic Retinopathy* ; Incidence ; Membranes ; Ocular Hypertension ; Postoperative Complications ; Retinal Detachment ; Retrospective Studies ; Traction ; Triamcinolone Acetonide ; Vitrectomy* ; Vitreous Hemorrhage