RESUMEN
The aim of our study was an evaluation of Bcl-xl and Bak protein expressions in optic nerve axons in eyeballs after severe injury and absolute glaucoma. We examined a series of 41 eyeballs, which were enucleated, following extensive injury and a series of 19 eyeballs from patients with absolute glaucoma. The immunohistochemical reaction was performed, using antibodies against human Bcl-xl and Bak protein with LSAB and DAB. In the injured eyeballs in Group I, Bcl-xl protein expression was observed in 53.8%, Bak in 38.5%, in Group II, Bcl-xl in 40%, Bak 55%; in Group III, Bcl-xl in 62.5%, Bak in 62.5%. Nine (9), out of 19 (47.4%) cases showed Bcl-xl protein positivity, Bak 15, out of 19 (78.9%). The percentage of cases with Bak protein positivity was statistically higher than that for Bcl-xl (Bak/Bcl-xl p=0.0356). The results showed that there may be a dominance expression of proapoptotic proteins in optic nerve axons in glaucoma.
Asunto(s)
Apoptosis , Axones/patología , Lesiones Oculares/patología , Glaucoma/patología , Proteínas de la Membrana/análisis , Nervio Óptico/patología , Proteínas Proto-Oncogénicas c-bcl-2/análisis , Humanos , Proteína Destructora del Antagonista Homólogo bcl-2 , Proteína bcl-XRESUMEN
The aim of our study was to evaluate the immunohistochemical expression of Bcl-2 and Bax protein in optic nerve axons after severe eyeball injury and in the eyes with absolute glaucoma. A series of 19 eyeballs, enucleated because of absolute glaucoma and 41 eyeballs, enucleated, following extensive injury, at the Department of Ophthalmology of the Medical University of Bialystok, were taken into our study. The immunohistochemical reaction was performed with Bcl-2 and Bax protein antibodies and by the LSAB technique. DAB was used in order to visualise the reaction. The optic nerve axons in glaucomatous eyeballs showed statistically significant higher Bax protein expressions than those of Bcl-2 proteins. In the optic nerve axons after severe eyeball injury, a non-significantly higher Bcl-2 protein expression was observed.
Asunto(s)
Axones/patología , Lesiones Oculares/patología , Glaucoma/patología , Nervio Óptico/patología , Proteínas Proto-Oncogénicas c-bcl-2/metabolismo , Enucleación del Ojo , Lesiones Oculares/cirugía , Glaucoma/cirugía , Humanos , Inmunohistoquímica , Estudios Retrospectivos , Proteína X Asociada a bcl-2RESUMEN
The aim of the study was to evaluate the expression of cell proliferation markers (PCNA and Ki-67) in posterior uveal melanomas in adults. Thirty-six enucleated eyes (without prior treatment) were included in histopatological study. A series of 15 cases of spindle cell type melanomas, 12 epithelioid and 9 of a mixed type were assessed, using the immunohistochemical method with monoclonal PCNA and Ki-67 antibodies. PCNA expression was observed in 75% and Ki-67 in 13.8% of all the examined tumours. The mean score of PCNA and Ki-67 index were the highest in tumours, which contained epithelioid cells and in large, more advanced (pT3, pT4) uveal melanomas. The results showed that the evaluation of expression of PCNA and Ki-67 may provide an additional infonnation about the progression of tumor process.
Asunto(s)
Antígeno Ki-67/metabolismo , Melanoma/patología , Antígeno Nuclear de Célula en Proliferación/metabolismo , Neoplasias de la Úvea/patología , Adulto , Anciano , Anciano de 80 o más Años , Progresión de la Enfermedad , Enucleación del Ojo , Femenino , Humanos , Melanoma/cirugía , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias de la Úvea/cirugíaRESUMEN
PURPOSE: A follow-up assessment of the visual system in patients who had undergone close head injury and in whom simple atrophy of the optic nerve occurred several months after the trauma. PATIENTS: Among patients treated in Department of Ophthalmology in Bialystok in the years 1984-1995 there were 2 women and 3 men, aged 19-61 years, who suffered from advancing simple atrophy of the optic nerve and who had undergone severe closed head trauma 3-5 months earlier. In one case the time interval between trauma and the visual sequelae amounted to 11 years. METHODS: The patients underwent a follow-up examination at 3 to 11 years after their initial treatment in the Department of Ophthalmology. Besides a conventional ophthalmologic examination, a static perimetry was performed as well as ultrasonography in projection B and Colour-Coded Doppler sonography (TCCD) of the orbital vessels. RESULTS: When compared to the findings at discharge, in 2 patients visual acuity improved to 5/12, in the remaining 3 no improvement was noted. In all patients the optic discs were white, while other structures of the globe appeared within normal limits. Blood flow in the central retinal artery, ophthalmic artery and in the long posterior cilliary arteries remained undisturbed, as assessed with TCCD. CONCLUSIONS: 1. Lack of visual disturbances immediately after head injury does not preclude their development in the protracted period after the trauma. 2. The reason of the late development of visual sequelae after head trauma is not clear. Normal flow, found in the major vessels of the globe, might indirectly suggest disturbances of microcirculation within the optic nerve with a consequent optic atrophy.
Asunto(s)
Traumatismos Cerrados de la Cabeza/complicaciones , Atrofia Óptica/diagnóstico , Atrofia Óptica/etiología , Traumatismos del Nervio Óptico/complicaciones , Adulto , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Tiempo , Trastornos de la Visión/diagnósticoRESUMEN
PURPOSE: Analysis of selected clinical parameters in patients with various types of retinitis pigmentosa. PATIENTS AND METHODS: We examined 51 patients aged 8-67 suffering from different genetic forms of RP identified on the ground of pedigree analysis. We analyzed onset of nyctalopia, degree of retinal degeneration, degree of visual field loss, dark adapted electroretinographic testing flicker (ERG) and presence of posterior subcapsular cataract. CONCLUSIONS: XLRP is one of the most severe RP forms. In the groups with ADRP and sRP, the patients have varied expression of disease.
Asunto(s)
Retinitis Pigmentosa/genética , Adolescente , Adulto , Anciano , Catarata/diagnóstico , Niño , Electrorretinografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Retinitis Pigmentosa/diagnóstico , Estudios Retrospectivos , Índice de Severidad de la EnfermedadRESUMEN
PURPOSE: To determine Doppler flow parameters in ocular vessels of glaucomatous patients. MATERIAL AND METHODS: 38 glaucomatous patients, aged 64 +/- 16, and 57 healthy volunteers were examined with 7.5 MHz linear-array probe. Consistently identified arterial structures included ophthalmic artery, central retinal artery and short posterior ciliary arteries. The peak systolic, end-diastolic and mean velocities were measured from Doppler spectra. Resistance and pulsatility indices were also determined. RESULTS: End-diastolic and mean velocities in central retinal artery of glaucomatous eyes were: 1.5 +/- 1.9 cm/s, 4.0 +/- 2.0 cm/s, whereas in healthy eyes they were significantly higher: 3.5 +/- 1.0 cm/s, 5.4 +/- 1.5 cm/s, respectively. These velocities in short posterior ciliary arteries in glaucomatous patients were significantly lower: 2.4 +/- 2.3 cm/s, 5.6 +/- 2.2 cm/s, comparing to healthy subjects: 4.8 +/- 1.7 cm/s, 7.3 +/- 2.2 cm/s. Resistance and pulsatility indices in central retinal artery and short posterior ciliary arteries were significantly higher in the group of patients: RI = 0.85 +/- 0.18, PI = 2.11 +/- 0.92--in central retinal artery and RI = 0.81 +/- 0.18, PI = 1.96 +/- 0.91--in short posterior ciliary arteries, comparing to healthy subjects: RI = 0.61 +/- 0.08, PI = 1.20 +/- 0.17--in central retinal artery, RI = 0.61 +/- 0.09, PI = 1.13 +/- 0.18--in short posterior ciliary arteries. Impedance indices were increasing progressively with intraocular pressure elevation. There were no significant differences of Doppler blood flow parameters in ophthalmic artery between patients and control group. CONCLUSIONS: Blood flow velocities in central retinal and short posterior ciliary arteries are lower, and resistance and pulsatility indices are higher in glaucomatous eyes in comparison to healthy subjects, whereas in ophthalmic artery doppler parameters are similar in both groups.
Asunto(s)
Ojo/irrigación sanguínea , Glaucoma de Ángulo Abierto/diagnóstico por imagen , Arteria Oftálmica/diagnóstico por imagen , Arteria Retiniana/diagnóstico por imagen , Adulto , Anciano , Anciano de 80 o más Años , Velocidad del Flujo Sanguíneo/fisiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ultrasonografía Doppler/métodosRESUMEN
The problem of pathogenesis and effective treatment of traumatic optic neuropathy (TON) is still an open question. According to current opinions the immediate results of conservative treatment with megadose corticosteroids are similar to those obtained with surgical decompression. No data on late results of both modes of treatment are at present available. This study was undertaken to assess the late results of conservative treatment of traumatic optic neuropathy. The clinical material comprised 15 patients (3 women and 12 men, age 14-64 years), who developed clinical symptoms of TON as a consequence of closed head trauma. All were treated conservatively with megadose steroid therapy. 10 patients presented to follow-up examination performed 3-11 years after the injury. A full ophthalmologic survey and colour-coded Doppler (CCD) examination of the orbital vessels were performed in all subjects. In 6 patients there was full blindness of the affected eye since the injury. Their visual acuity did not improve despite vigorous treatment and their eyes were still blind at the late follow-up examination. No flow found with CCD in their central retinal arteries at follow-up might suggest structural disruption of the nerve. In 5 of these patients ocular atrophy evolved between the injury and follow-up examination. 4 patients, who on admission displayed merely light sensation, responded to 2-3 weeks of steroid therapy with improvement of visual acuity to 3/50, 5/50, 5/10, 5/7. After 4-6 years however, visual acuity of all these patients deteriorated again to mere light perception in three and 1/50 in another one. Optic atrophy was diagnosed in all the affected eyes. Our results indicate that conservative treatment of TON, even if giving satisfactory relief of the symptoms, may not be reliable in permanent restrainment of the sequela of traumatic optic neuropathy.
Asunto(s)
Lesiones Oculares/tratamiento farmacológico , Lesiones Oculares/etiología , Traumatismos Cerrados de la Cabeza/complicaciones , Traumatismos del Nervio Óptico , Esteroides/uso terapéutico , Adolescente , Adulto , Ceguera/etiología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
PURPOSE: To discuss results and possible complications of combined, simultaneous operations of cataract and glaucoma. MATERIAL: 21 patients suffering from cataract and glaucoma; 16 women, aged from 59 to 88 years, and 5 men from 66 to 84 years. The patients were treated in the Department of Ophthalmology, Medical Academy in Bialystok in the years 1991 to 1996. METHODS: Intracapsular extraction of cataract with lens implantation to the anterior chamber and trabeculectomy was performed in 3 patients with simple glaucoma and hypermatured or brown cataract. In 7 patients only extracapsular cataract extraction was carried out along with trabeculectomy, whereas in 11 remaining ones--trabeculectomy with extracapsular removal of cataract followed by implantation of lens to the posterior chamber (10 subjects) or anterior chamber (1 subject). RESULTS: Postoperative visual acuity was 5/50-5/16 in 28% of patients. In the remaining 72% it amounted to 5/12 or more. Intraoperative and early postoperative complications occurred in 15 patients (71%), but they were only transitory. Delayed follow-up demonstrated that visual acquity had not worsened as compared to the preoperative status, though visual field deteriorated in 3 cases. Intraocular pressure was within normal limits in all patients. CONCLUSIONS: Combined, simultaneous operation of glaucoma and cataract does not seem to give rise to more complications than both procedures performed separately.
Asunto(s)
Extracción de Catarata/métodos , Catarata/complicaciones , Glaucoma/cirugía , Trabeculectomía/métodos , Anciano , Anciano de 80 o más Años , Femenino , Glaucoma/complicaciones , Humanos , Masculino , Persona de Mediana EdadRESUMEN
PURPOSE: Evaluation of the effectiveness of laser trabeculoplasty in 23 eyes with pseudoexfoliative syndrome and glaucoma. METHODS: Visual acuity, intraocular pressure, outflow facility coefficient, visual field using static perimetry, gonioscopy and evaluation of the anterior and posterior segment of the eye. RESULTS: In the first day after treatment, a satisfactory result was found in 70% of eyes; after 6 months in 50%, and after 12 in 48% of cases. Laser trabeculoplasty is an effective method but the results are not long-lasting.
Asunto(s)
Síndrome de Exfoliación/cirugía , Glaucoma/cirugía , Trabeculectomía/métodos , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Humanos , Terapia por Láser , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
We present a case of Kearns-Sayre syndrome diagnosed in a boy with retinitis pigmentosa ophthalmoplegia, ancephalomyopathy and cardiomyopathy. A single large-scale mtDNA deletion at very low level in the blood sample using Southern blot analyses and multiprimer DNA amplification was detected. This case demonstrates that retinitis pigmentosa may be due to genetic mitochondrial disturbances.
Asunto(s)
Deleción Cromosómica , ADN Mitocondrial/genética , Síndrome de Kearns-Sayre/genética , Retinitis Pigmentosa/genética , Adolescente , Southern Blotting , ADN Mitocondrial/química , Amplificación de Genes , Humanos , Masculino , MutaciónRESUMEN
Ophthalmological examination was performed in 350 consecutive inpatients with closed head injury, treated in the Neurosurgical Department, Bialystok over a period of two years. The group comprised 266 men and 84 women, aged between 16 and 90 years. The purpose of the study was to screen for the symptoms of damage to cranial nerves II-VII. In 12% of cases internal, external or total III nerve palsy was identified. In 2% of cases there were symptoms of damage to the VII nerve, in 1.4% of damage to the V nerve and in 1.1% to the II nerve. In 0.6% of cases damage was observed to the VI nerve. There were no cases of damage to the IV nerve. Thus the III nerve was found to be the most susceptible to damage in head-injured patients.
Asunto(s)
Traumatismos del Nervio Craneal , Traumatismos Craneocerebrales/complicaciones , Heridas no Penetrantes/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Parálisis/etiología , Heridas no Penetrantes/complicacionesRESUMEN
39 patients selected at random from 130 operated on in the years 1987-1989 on account of retinal detachment in one eye were examined. The results of ERG and visual field examinations, performed at 10-12 days and 4-6 years and 4-6 years after surgery, were analysed in 30 patients with attached retina. The studies revealed an improvement of function of bipolar and glial cells and none in that of retinal photoreceptors. Significantly worse visual function was found in operated eyes in comparison with the fellow ones.
Asunto(s)
Desprendimiento de Retina/cirugía , Adolescente , Adulto , Anciano , Electrorretinografía , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Desprendimiento de Retina/diagnóstico , Desprendimiento de Retina/fisiopatología , Resultado del Tratamiento , Agudeza Visual , Pruebas del Campo VisualRESUMEN
Aniridia and coloboma iridis are congenital defects which are inherited in common as an autosomal dominant trait. The study presents an analysis of 15 pedigrees of 15 patients from 3 families; it confirms the hereditary character of aniridia and iris coloboma and indicates the variability of the genetic expression.