German journal of ophthalmology最新文献

{"title":"Flow-cytometric analysis of peripheral lymphocytes in the rat following penetrating keratoplasty and immunosuppressive treatment.","authors":"S Klebe,&nbsp;S E Coupland,&nbsp;L Krause,&nbsp;F Hoffmann","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Flow cytometry has been found to be a useful tool in the clinical monitoring of patients following solid organ transplantation. Despite the easier assessibility of corneal graft acceptance or rejection, flow-cytometric evaluation of peripheral lymphocytes following systemic immunosuppression is important in the evaluation of therapeutic efficacy. The systemic effect of penetrating keratoplasty (PKP) and of immunosuppression with cyclosporin A (CsA), leflunomide (LF), and the nondepleting anti-CD4 antibody, RIB 5/2, on peripheral lymphocytes was investigated in the rat model. Corneal buttons were grafted from Lewis/Brown Norway rats to Lewis recipients. Animals were randomly assigned to the following treatment groups: (1) untreated; (2) CsA, 10 mg/kg; (3) LF, 10 mg/kg; (4) LF, 5 mg/kg; (5) LF, 2.5 mg/kg; (6) LF, 10 mg/kg; combined with CsA, 10 mg/kg; and (7) RIB 5/2, 4 mg/kg, combined with CsA, 1.5 mg/kg. Controls included the following groups: (8) unoperated, CsA-treated at 10 mg/kg; (9) unoperated, LF-treated at 10 mg/kg; (10) unoperated, LF-treated at 10 mg/kg and CsA-treated at 10 mg/kg; (11) unoperated, RIB 5/2-treated at 4 mg/kg and CsA-treated at 1.5 mg/kg; (12) syngeneic grafts; and (13) normal Lewis rats. Cells from blood and spleen samples were enriched using Ficoll density centrifugation, and lymphocytic surface markers CD 3, CD 4, CD 8, and RT 1b (Ia) were analyzed by direct immunofluorescence using flow cytometry. In the untreated allogeneic PKP, a decrease in the percentage of serum CD 3+, CD 4+, CD 8+, and CD 4+ RT 1b+ lymphocytes was apparent from the 5th to the 9th postoperative day. At corneal graft rejection, a normalization of serum CD 3+ and CD 4+ levels occurred, whereas the percentage of serum CD 8+ lymphocytes remained slightly raised. Significantly enhanced decreases in levels of CD 4+ lymphocytes were observed following treatment with CsA, LF, and, particularly, therapy with RIB 5/2 and a subtherapeutic dose of CsA. Concomitant decreases were also apparent following treatment with CsA or LF. In contrast, the combination of RIB 5/2 and CsA (1.5 mg/kg) resulted in a reactive increase in levels of CD 8+ lymphocytes as well as an increased expression of RT 1b by the remaining CD 4+ lymphocytes. The latter alterations corresponded to indefinite acceptance of the corneal grafts, which was observed only in the animals treated with RIB 5/2 and CsA. PKP in the rat model is accompanied by alterations in peripheral lymphocytes. Additional influences are exerted by immunosuppressive therapy, with the most specific and predictable alterations being achieved with anti-CD4 monoclonal antibody therapy.</p>","PeriodicalId":77146,"journal":{"name":"German journal of ophthalmology","volume":"5 3","pages":"137-45"},"PeriodicalIF":0.0,"publicationDate":"1996-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19773278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contractile response of the isolated trabecular meshwork and ciliary muscle to cholinergic and adrenergic agents.","authors":"M Wiederholt,&nbsp;R Schäfer,&nbsp;U Wagner,&nbsp;A Lepple-Wienhues","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>To characterize the contractile properties of isolated trabecular meshwork strips, we measured the effect of various cholinergic and adrenergic substances on the contractility of trabecular meshwork (TM) strips in comparison with the effects on ciliary muscle (CM) strips. Using an electromagnetic force length transducer we performed measurements of isometric tension on isolated bovine TM and CM strips. Isolated strips were contracted by cholinergic agonists, the relative potency being carbachol > pilocarpine > acetylcholine. The half-maximal effective concentration was 2 x 10(-7) mol l(-1) for carbachol and 2 x 10(-6) mol l(-1) for pilocarpine. To characterize muscarinic receptors, we tested selective antagonists for M1 (pirenzepine) and M3 (4-DAMP). Pharmacologically, the functional muscarinic receptors are of the M3 subtype in TM as well as CM. The M1 subtype seems to be less important. The alpha 1-agonist phenylephrine was more effective in inducing contractions in TM than in CM. The alpha 2-agonist brimonidine induced contractions only in TM. In precontracted tissues the beta-agonist isoproterenol induced a relaxation in both tissues. This relaxation could be inhibited by metipranolol. Epinephrine (or dipivefrin) induced small contractions in TM and CM, which became more prominent, especially in TM, when the beta-adrenoreceptors were inhibited by metipranolol. The data indicate the presence of functional muscarinic, alpha-adrenergic, and beta-adrenergic receptors in bovine TM and CM. The contractile properties of TM and CM are differently modulated by the various drugs. Cholinergic and alpha-adrenergic agonists induced contraction, whereas beta-agonists induced relaxation.</p>","PeriodicalId":77146,"journal":{"name":"German journal of ophthalmology","volume":"5 3","pages":"146-53"},"PeriodicalIF":0.0,"publicationDate":"1996-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19773279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Photoablative Nd: YAG-laser goniotomy enhancing trabecular outflow facility in porcine cadaver eyes.","authors":"P C Jacobi,&nbsp;T S Dietlein,&nbsp;G K Krieglstein","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Mid-infrared laser technology opens new perspectives in experimental glaucoma surgery. The aim of this study was to investigate the potential effectiveness of photoablative Nd: YAG-laser goniotomy in increasing trabecular outflow facility as a surgical alternative to conventional goniotomy. Eye cups of 19 freshly enucleated porcine cadaver eyes were fixed in an anterior-segment perfusion system, and outflow facility was measured under constant pressure conditions (7-13 mmHg) over a period of 45 min. Trabecular laser goniotomy was performed using a continuous-wave Nd: YAG (1.06 microns) laser. Radiation (1.8 J) was delivered in several pulses (200 microns) through an articulated delivery system. Photoablative Nd:YAG-laser treatment yielded reproducible ablation zones, with the depths varying between 600 and 750 microns. Collateral thermal damage extended to a depth of 130-260 microns. Outflow facility measurements revealed an increase (mean +/- SD) from the baseline value of 0.128 +/- 0.041 microlitter mm Hg-1 in control eyes (n = 11) to 0.366 +/- 0.128 microlitter min-1 mm Hg-1 in treated ones (n = 8). Application of photoablative Nd: YAG-laser goniotomy yielded reproducible ablation zones within the anterior-chamber angle, resulting in a significant reduction (72%) in outflow resistance in perfused anterior segments of freshly enucleated porcine cadaver eyes. Contact low-thermal laser goniotomy might offer a feasible alternative to surgical goniotomy.</p>","PeriodicalId":77146,"journal":{"name":"German journal of ophthalmology","volume":"5 3","pages":"154-9"},"PeriodicalIF":0.0,"publicationDate":"1996-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19773280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trabeculectomy in subconjunctival anesthesia.","authors":"N Pfeiffer,&nbsp;E Sell,&nbsp;F Grehn","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77146,"journal":{"name":"German journal of ophthalmology","volume":"5 3","pages":"182-3"},"PeriodicalIF":0.0,"publicationDate":"1996-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19772538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral activity during visual stimulation: a positron emission tomography and functional magnetic resonance imaging study.","authors":"U Schiefer,&nbsp;M Skalej,&nbsp;R Kolb,&nbsp;W Grodd,&nbsp;M Fahle,&nbsp;H Herzog","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Stimulation of cerebral areas induces a regional increase in blood flow and metabolism. Positron emission tomography (PET) is an established procedure to localize cerebral regions of enhanced activity. Exposure to a radioactive indicator and limited spatial and temporal resolution are disadvantages of this method as compared with other imaging techniques, but anatomical orientation can be improved by matching PET images with high-resolution magnetic resonance imaging (MRI) scans. Recently, functional MRI (fMRI) has arisen as an alternative method. This procedure presumably detects changes in the paramagnetic properties of hemoglobin, depending on its oxygenation state, as well as an increased regional blood flow in activated cerebral areas. These structures can be visualized using sensitive scanning techniques and appear with bright signal intensities. Visual stimulation was performed with the help of a high-resolution color VDU for PET registration and of an LCD video projector for fMRI (1.5 T). Hemifield stimulation as well as subtraction between images of flickering and stable random dot stimuli showed a preferential activation of the primary visual cortex. In addition, the first MRI results obtained during stimulation with moving gratings are demonstrated; hereby, preferentially extrastriate regions presumably responsible for motion detection were activated.</p>","PeriodicalId":77146,"journal":{"name":"German journal of ophthalmology","volume":"5 2","pages":"109-17"},"PeriodicalIF":0.0,"publicationDate":"1996-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19713342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of cataract surgery on the diabetic eye: a prospective study.","authors":"T Wagner,&nbsp;D Knaflic,&nbsp;M Rauber,&nbsp;U Mester","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The course of diabetic retinopathy following phacoemulsification and in-the-bag implantation of an intraocular lens (IOL) was studied prospectively in 223 patients (223 eyes). A total of 205 eyes were followed for 6 months. The nonoperated fellow eyes served as a control group. At the time of surgery, 158 patients had no diabetic retinopathy, 45 showed untreated background retinopathy, and 20 had more serious retinopathy with previous coagulation therapy. At 6 months of follow-up, 18.4% of the operated eyes without preoperative retinopathy developed background retinopathy, as did 14.3% of the untreated fellow eyes. Worsening of preexisting diabetic retinopathy during the observation period occurred in 27.6% of the operated eyes and in 29.3% of the non-operated eyes. Although the final visual acuity achieved in our patients was poorer than that reported for nondiabetics, our functional results were satisfying: 94.1% of the operated eyes showed improved visual acuity 6 months postoperatively, 2.4% deteriorated, and 3.4% were unchanged. We therefore conclude that cataract surgery in diabetic patients can be performed with an acceptable risk of complications. Furthermore, worsening of diabetic retinopathy seems to be correlated not with the cataract surgery but with the natural course of diabetic vascular disease.</p>","PeriodicalId":77146,"journal":{"name":"German journal of ophthalmology","volume":"5 2","pages":"79-83"},"PeriodicalIF":0.0,"publicationDate":"1996-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19714010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sympathetic ophthalmia: an immunohistochemistry study of four cases.","authors":"C Auw-Haedrich,&nbsp;K U Loeffler,&nbsp;H Witschel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We present histological and immunohistochemical data on four cases of sympathetic ophthalmia, a disease that is believed to occur predominantly after perforating injury to the eye. Only a few cases without previous perforation have been reported. Nevertheless, sympathetic ophthalmia should be taken into consideration if there is a bilateral intraocular inflammation, even without trauma, as in two of our cases (cases 1 and 2). An unusual case after uneventful intracapsular cataract extraction and a posttraumatic \"classic\" case are also presented (cases 3 and 4). We found a granulomatous infiltration of the uveal tract by lymphocytes, plasma cells, and epithelioid cells, particularly of the choroid. Dalen-Fuchs nodules were found in all cases, the second case also being associated with phacoanaphylaxis. Case 1 and 4 showed immunohistochemically a predominance of CD3-positive cells (T-lymphocytes), whereas in cases 2 and 3, many cells surprisingly stained positively for L26 (B-lymphocytes). In case 2 the immune response may have been altered by the additional phacoanaphylaxis. In all four cases, scattered epithelioid cells stained positively for CD 68. We conclude that in cases of bilateral uveitis, even without previous penetrating injury or after common intraocular surgery, sympathetic ophthalmia as a possible cause should be taken into consideration because an early diagnosis with subsequent enucleation of the exciting eye is of decisive influence on the course of the disease.</p>","PeriodicalId":77146,"journal":{"name":"German journal of ophthalmology","volume":"5 2","pages":"98-103"},"PeriodicalIF":0.0,"publicationDate":"1996-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19714016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morphological and biomorphometrical observations on laser thermal keratoplasty. Histological and biomorphometrical examination of the relationship between refractive change and the volume following Cr:Tm:Ho:YAG laser treatment.","authors":"G Gerling,&nbsp;A Vogel,&nbsp;el-Hifnawi el-S,&nbsp;N Koop,&nbsp;G Dröge,&nbsp;R Birngruber,&nbsp;R Brinkmann","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Laser thermal keratoplasty (LTK) is currently under clinical trial for the correction of hyperopia and hyperopic astigmatism by means of collagen coagulation in the peripheral cornea. The purpose of our study was to optimize the ratio between the volume of damaged corneal stroma and the refractive effect so as to minimize potential side effects such as endothelial damage or induction of glare phenomena. We therefore performed histological and morphometrical examinations of enucleated pig eyes to determine the relationship between the coagulated stromal volume and the refractive change after LTK using a pulsed Cr:Tm:Ho:YAG laser (wavelength 2.12 microns) on enucleated pig eyes. The refractive change was documented with a Littman ophthalmometer. Morphometrical analysis was performed using polarized light microscopy of sirius red-stained specimens. This special stain separated the thermally changed stroma into a dark nonbirefringent center and a birefringent peripheral zone. The volume of both zones was positively correlated with the refractive change induced. The volume was in turn influenced by the choice of laser parameters. From the ratio of the volume to the refractive change it was found that pulse energies above 30 mJ let to an enlargement of the coagulation volume without increasing the refractive change effectively. The use of high pulse energies did not improve the effect of LTK but only increased the risk of unwanted side effects. However, an increase in the laser repetition rate at a constant pulse number per spot led to refractive changes with minimal coagulation volume. The highest relative refractive change was achieved with a dark central zone and a birefringent zone, each having a volume of about 50-80 x 10(-3) mm3.</p>","PeriodicalId":77146,"journal":{"name":"German journal of ophthalmology","volume":"5 2","pages":"84-91"},"PeriodicalIF":0.0,"publicationDate":"1996-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19714014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A ray tracer for ophthalmological applications.","authors":"W Fink,&nbsp;A Frohn,&nbsp;U Schiefer,&nbsp;E W Schmid,&nbsp;N Wendelstein","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Ray tracing with a personal computer allows realistic simulation of optical properties of the human eye. Patterns of point sources are used as objects. The path of light rays is calculated between the point source and the retina for a Gullstrand eye model with improved parameters; the normal eye model has a resolution limit close to the natural resolution limit of the human eye. The image formed on the retina is projected back to a screen at the distance of the object so as to simulate image interpretation by the brain. Refractive errors are modeled by a change in eye parameters and corrected by eyeglasses or/and contact lenses or by an artificial intraocular lens. For optic correction the parameters of seeing aids can be fitted automatically by a least-squares routine. The effect of faulty eye correction on image quality is visualized by using a photograph of a realistic scene as an object.</p>","PeriodicalId":77146,"journal":{"name":"German journal of ophthalmology","volume":"5 2","pages":"118-25"},"PeriodicalIF":0.0,"publicationDate":"1996-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19713344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of retinal redetachment following silicone-oil removal.","authors":"S Bodanowitz,&nbsp;L Hesse,&nbsp;S Poller,&nbsp;P Kroll","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The aim of the present investigation was to study the clinical course of eyes presenting with retinal redetachment after silicone-oil removal (SOR), with special regard being paid to the long-term visual outcome. Between October 1989 and September 1994, SOR was performed on a consecutive series of 262 eyes that had previously undergone vitrectomy combined with silicone-oil injection for complex retinal detachments. The records of these patients were analyzed retrospectively. The mean follow-up period after redetachment following SOR was 26.3 (range 6-45) months. Redetachment occurred in 35 eyes (13.4%), mostly within 1-3 months of SOR. Redetachment was not dependent on the surgical procedure or the underlying disease. A total of 24 eyes were revitrectomized and a stable flat retina was the result in 23 eyes (65.7%). At the latest follow-up visit, 18 eyes (51.4%) had a visual acuity (VA) of > or = 0.02 and 14 eyes (40%) had a VA of > or = 0.1. In 12 eyes (34.3%) the final VA equalled the best VA recorded before redetachment; an increase in VA occurred in 6 eyes (17.1%) and a deterioration was noted in 17 eyes (48.6%). Only 6 of the 17 eyes that deteriorated had displayed a VA of > or = 0.02 prior to SOR and lost formed vision due to redetachment; these 6 eyes represent 17.1% of the eyes presenting with redetachment after SOR and 2.3% of all 262 eyes that had undergone SOR. These observations demonstrate that revitrectomy is an effective treatment for retinal redetachment after silicone-oil removal. The final failure rate does not appear high enough to justify a contraindication for routine removal of silicone oil, especially since it remains a matter of speculation as to whether these eyes would have fared better had removal of silicone oil been avoided.</p>","PeriodicalId":77146,"journal":{"name":"German journal of ophthalmology","volume":"5 2","pages":"67-72"},"PeriodicalIF":0.0,"publicationDate":"1996-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19714079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}