The Effect of Cartilage on Corneal Neovascularization

Corneal neovascularization is a major complication of several corneal diseases and many investigations have been performed to inhibit the ingrowth of vessels in the corneal tissue. In this experiment, the author investigate the clinical effect of cartilage to corned neovascularization. Using 12 albino rabbits, corneal neovascularization was induced by alkali burns, and cartilage was implanted subconjunctivally at the limbus before or after the alkali burns. Except 2 eyes which showed inhibition of neovascularization after implantation of cartilage, there was no demonstrable difference between control and cartilage-implanted eyes.

The Sterilizing Properties of the Vitreous

Studies were performed on the sterilizing properties of the vitreous removed from human, bovine and rabbit eves. Nutrient agar was seeded with Staphylococcus aureus and Pseudomonas aeruginosa and 5mm plugs were removed from the plate and the wells were filled with about 0.2ml of sterile vitreous which had been kept in refrigerator for 24 hours. Various antibiotic solution were also added to the well for the comparative purpose. The plates were incubated for 24 hours at 37 degrees C. The vitreous from human, bovine and rabbit who had not be given antibiotics did not inhibit bacterial growth. The vitreous from rabbit injected subconjunctivally 200mg of chloramphenicol or 20mg of gentamicin also showed no inhibition of the growth. When rabbit was given intravitreal injection of chlorampheicol (10mg) or gentamicin (4mg) , the vitreous inhibited bacterial growth. It can be concluded from the studies that the so-called sterilizing properties of the vitreous is due to the contamination of the vitreous with antibiotics.

Experimental Studies on the Lens-Induced Uveitis

This experiment was performed in an attempt to reproduce endophthalmitis phacoanaphylactica in guinea-pigs sensitized to lens protein. Twenty-four albino guinea-pigs were immunized with soluble proteins of beef lenses with complete Freund's adjuvant. The immunizations were repeated 4 times at intervals of 5 days. Three days after the last injection, the lens capsule was ruptured and stirred with Ziegler's knife. The eyes were removed at various intervals and histological sections were studied. Ten animals, not sensitized, were used as controls. Biomicroscopy revealed mild to severe inflammations of the anterior uvea and the cornea in treated animals, whereas no definite reactions in control animals. Histological studies showed reactions in the cornea, iris and ciliary body but no sign of inflammation in the choroid or the retina. These reactions consisted mainly of the infiltrations with polymorphonuclear neutrophils, eosinophils, lymphocytes and plasma cells, and occasional epitheloid cells and macrophages. These findings were similar to the histology found in human endophthalmitis phacoanaphylactica.

Distribution of the Bovine Lens Antigen in the Ocular Tissues

Distribution of the antigens of soluble lens protein in the bovine ocular tissues was studied by Ouchterlony's double agar diffusion technique. Guinea pig anti-bovine-lens-serum was prepared by 4 weekly injections of the soluble protein of the bovine lens with complete Freund adjuvant. Three precipitation lines were observed between lens antigen and antiserum after 36 hours diffusion, and two precipitation lines on iris antigen and two precipitation lines on antigen mixture of the pigment epithelium and the choroid were observed after 36 hours diffusion. No precipitation line was observed on cornea antigen, vitreous antigen and retina antigen.

Studies on the Cellular Transfer of Autoimmune Uveitis

After the immunization of pigmented guinea pigs with bovine rod outer segments in complete Freund's adjuvant, the regional lymph nodes were excised, teased and sedimented by centrifugation. These fresh lymphocytes were injected intravitreally (a single injection of 10 X 10 cells in 50 micro l) in 18 eyes. The involvement of the ciliary body and the choroid with polymorphonuclear leucoytes and later with round cells was noted in 16 eyes. Destructions of the visual cells of the retina were demonstrated in 8 eyes. When the fresh lymphocytes were injected subconjunctivally (50 X 10 cells in 30 micro l) four times. four of the 8 eyes showed slight infiltrations of the ciliary body and the choroid with round cells. No retinal lesion was found. Following repeated freezing and thawing of the lymphocytes. transfer experiments wereperformed with the nonviable cells and their extracts respectively. In 8 eyes injected intravitreally with nonviable cells. 2 eyes showed the infiltration of the uvea with round cells, whereas. of 6 eyes injected subconjunctivally, only one eye showed such changes. The extracts of lymphocytes were injected intravitreally in 8 eyes of which 5 eyes demon-strated moderate degree of infiltration of the uvea. Of 2 eyes injected subconjunctivally, 2 eyes. showed slight histological changes. As control experiments, lymphocytes taken from animals immunized. only with the adjuvant were treated as before and transferred to normal animals. Only one eye of 3 eyes received single intravitreal injection of fresh cells showed slight degree of infiltration of the uvea. Thus it can be concluded that the experimental autoimmune uveitis in guinea pigs could be transferred to normal animals by the transfer of non-viable lymphocytes and especially by their extracts.

Fluorographic Findings of Normal Optic Disc

One hundred normal optic discs were analysed by fluorographic fundus pictures. Horizontal diameter of optic disc was set as 10. The following results were obtained. 1) The vertical diameter of optic disc was larger than the horizontal one. (10.77 : 10). 2) The ratio of diameters of cenitral retinal vein(CRV) was 1 : 1.51 before and 1 : 1.47 after fluorescein injection. 3) The central retinal artery(CRA) located nasal to the CRV in most cases. 4) In nearly half of cases, physiologic cups located at the nasal portion of optic discs. 5) The average size of physologic cup was 2.90. 6) The cilioretinal artery was detected in 58% of cases in which one cilioretinal artery was found in 42%, two was found in 16%. 7) The CRA made branchings more than retinal veins (7.74 : 5.48) and total sum of diameters of retinal artery was larger than that of retinal vein at the disc margin.

A Case Report of Human Thelaziasis

The authors preEented the 6th human thelaziasis case in Korea with the review of the literatures. The patient was 18 years old high-school girl who had lived in Seoul since birth. She experienced epiphora and moving foreign body Eensation of the right eye since one week prior to examination, and extracted 2 living worms from the right eye by herEelf on 1 and 2 days prior to examination. Morphological features of an extracted worm are as follows; Gross appearance of the worm is slender milky, white nematode, and microscopic measurements are 12.51mm in length. 0.34mm in maximum width, 15.5micro in depth of oral cavity, 0.667mm in length of the esophagus, 180~220 cuticular striations per mm, anal-opening on 0.088 mm from posterior end, and vulvar-opening on 0.544mm from anterior end. From the above findings it was confirmed as female worm of Thelazia callipaeda Railliet and Henry 1910.

Transfer of Experimental Autoimmune Uveoretinitis by Serum

Passive transfer experiments were performed by local administrations of sera from guinea pigs hyperimmunized by bovine rod outer segments with complete Freund's adjuvant in random-bred guinea pigs. Routes of administrations were(1) single intravitreal injection of serum (25 micrl l, in 18 eyes), (2) the intravitreal injection associated with 2 subconjunctival injections (150 micrl l, in 9 eyes), (3) three subconjunctival injections of serum (150 micrl l, in 6 eyes), (4) five subconjunctival injections of serum with 2 paracenteses (in 14 eyes) and (5) four injections into the anterior chamber (50 micrl l) with 2 subconjunctival injections (in 4 eyes). Clinically animals showed cells in the anterior vitreous in 50-83% of cases. Histologically infltrations of round cells, focal or diffuse, were noted in the choroid with scattered polymorphonuclear, eosino and plasma cells. In the retina disappearance of visual cells was found, sometimes complicated by the involvement of the bipolar cells in severe cases. These findings were quite similar to the lesions produced in actively immunized animals. Choroidal lesions were most frequently found. Serum taken from the enucleated donors, and concentrated serum were more effective in the production of this transfer disese. The control experiments in which normal serum or serum immunized by adjuvant alone, revealed very low incidence of ocular lesions which were generally mild in degree. It can be concluded that humoral immunity also plays very important roles in the pathogenesis of autoimmune uveoretinitis.

Experimental Studies on the Vitreous Substitutes

Experimental replacements of rabbit vitreous by air, normal saline, dextran and Haemaccel were tried in albino rabbits. After aspiration of 0.7ml of liquid vitreous from the central portion of vitreous, 0.5ml of substitutes were injected. Clinically, these substitutes were well tolerated with slight uveal inflammation which subsided within one week. Intraocular pussure returned to normal value after 5 days. Hexosamine content of the whole vitreous samples showed moderate increase after Haemaccel injection which decreased slowly thereafter, whereas no significant changes were observed with other substitutes. Hydroxyproline content of the whole vitreous also showed marked increase after injection of Haemaccel, owing to the high hydroxyproline content of HaemacceJ. After 6 weeks 22.9% of the injected hydroxyproline remained in the vitreous. With other substitutes no change was observed.

Effects of Smoking and Drinking on the Critical Fusion Frequency

Critical fusion frequency was measured in young subjects before and after smoking and drinking. The test light is directed to a round opaque plate, 40mm in diameter, which the subject views at a distance of 50cm in a semi-darkend room, the light-dark ratio being 1 : 1. Nineteen subjects were investigated on the effect of cigarette smoking. Of these, an increases in frequency was noted in 10, a decrease in 3, and no alteration in 1. The frequency returned to the normal level in about 10 minutes. After drinking 35ml of 90 proof whisky, 11 out of 16 subjects revealed a increase, 1 revealed a decrease, and 4 showed no alteration. There is no definite relationship between the habit of smoking or drinking and the behavior of the changes in the frequency.

Principles of Cataract Surgery

In surgical removal of cataractous lens the following principles should be kept in mind. (1) Remove the lens as completely as possible, without leaving the lens remnants in the pupillary area in order to achieve the best vision as possible. (2) Ocular tissues should suffer the minimum injury during the operation. This precaution can be applied especially to the corneal endothelium and the iris. (3) No derangement of the vitreous surface should occur. (4) Secure the corneo-scleral wound as tight as possible with care not to incarcerate lens tissues nor vitreous. Application of these principles to the individual cases was discussed.

Experimental Glaucoma Induced by The Use of Alpha-Chymotrypsin

Glaucoma was attempted to induce in rabbits by the injection of alpha-chymotrysin into the poster ior chamber. The enzyme solution, 80 units and 375 units, dissolved in 0.2 ml, were used and the changes in the intraocular pressure were recorded. Of 7 eyes injected with 80 units, three eyes showed moderate elevations which lasted 4 to 7 days. Of 3 eyes which received 375 units solution, two eyes showed moderate rise in the intraocular pressure with the duration of 2 to 4 days. There can be found nothing characteristic for the glaucoma...cupping of the disk and degeneration of the optic nerve fiber, etc...in eyes with elevated intraocular pressure. The possible explanations of these transient rise in the intraocular pressure were discussed.

Farnsworth-Munsell 100 Hue Test:in Detection of the Color Defective Subjects

The Farnsworth-Munsell 100 Hue Test is very useful clinical color discrimination test for detecting color deficient person in quantitative and qualitative diagnosis. In this study 45 subjects were examined by the F-M Test and of these 22 were diagnosed as normal and 23 as color anomalous. The 23 anomalous persons were composed of 6 deutans, 9 protans and 8 unclassified red-green defects. These 23 color anomalous subjects were examined by the three kinds of pseudoisochromatic plates), Ishihara (15 plates), Dvorine (15 plates) and Ao H-R-R (20 plates), and their results were compared with the results of the Farnsworth-Munsell test.

Changes in the Corneal Curvature after Pterygium Surgery

In 24 pterygium patients, the corneal curvature was measured before and after surgical removal. The norizontal curvature increased more than 0.5 D in 66.7% of cases on the 2 to 3 weeks postoperatively. The vertical curvature, however, showed no marked tendency to changes, and only 25% of cases showed more than 0.5 D increase on the 2 to 3 weeks postoperatively. As the pterygium invades the cornea extensively, the horizontal corneal curvature increased more markedly.

Experimental Investigations on the Effects of Ocular Tissues upon the Ultrasonic Waves

The purpose of this report is to investigate experimentally how the corea, sclera, crystalline lens and focusing lens influence the ultrasound intensity and beam width and to find characteristic differences due to the transducer parameters; frequency and size. A time-amplitude ultrasonic diagnostic apparatus, Aloka Model SSD-2D was used with transcucers of 10 MHz and 5 MHz, 10 mm and 5 mm diameters. The metal ball, 1 mm in diameter, was served as the echo-reflecting target which was immersed in water and moved horizontally under the transducer with a micrometer screw. The distances between the transducer and the metal ball varied from 10 mm to 50 mm in 10 mm step. The amplitudes curves of the echoes so obtained were represented by relative values. In water control experiment, the nearer the metal ball from the transducer, the more irregular the curves, with multiple amplitudes maxima and minima. These irregular curves became homogeneous as the transducer moved away from the target. The multiple peak curves were more marked when measured with transducers of higher frequency and larger diameter. At the end of the near field only a single peak was found in the axial portion of the sound field. In the far field, the beam width reduced slightly due to the divergence of the beam accompanied by slight attenuation of the echo amplitudes. When the sound beam passed through the cornea and sclera, the form of the curves remained almost unchanged, but the amplitudes decreased slightly due to the absorption of the sound energy. Scleral tissue absorbed the energy more strongly then the corneal tissue. When the crystalline lens was placed under the transducer, divergence of the beam and themoderate absorption took place. This effect was more pronounced with the use of transducers of higher frequency and smaller diameter. When a focusing lens, 25 mm focal length, was attached to the transducer surface, sound beam converged to a narrow zone, followed by later scattering. These results suggest that the transducer should be selected as to the frequency and diameter according to the site of the lesion suspected and the nature of the pathology.

Some Experiences in Clinical Ultrasonography

Ultrasonography in the diagnosis of ocular pathology was introduced in 1956 and received great attentions throughout the world. Its fields of applications have been extended to almost all pathological conditions of eyeball and its adnexa. During the past two years I have used this method for the diagnosis in ophthalmology, and some comments on experiences in the diagnosis of intraocular tumor, intraocular foreign body, retinal detachment, vitreous opacities, orbital tumor and ocular biometry were discussed.

Experimental Cyclocryothermy in Rabbits

The effects of Cryosurgery of the ciliary body on the aqueous humor dynamics of ten albino rabbits were studied by perfusion experiments. The cryo-probe (tip diameter, 3 mm) was frozen by dry ice and alcohol mixture and applied over the full circumference of the eye 2 mm from the limbus for 30 seconds. Eight applications were made in each eye. Intraocular pressure fell during the first 10 days after surgery, the amount of fall averaged 2.5 mmHg (12.6% of the pre-treatment level). Thereafter the intraocular pressure rose gradually in all eyes and reached almost to the original level 3 weeks after surgery. Facility of outflow changed inconsistently, showing no definite pattern. Aqueous flow showed significant reductions during the 2 to 3 weeks after treatment, then gradually recovered. There was no significant reduction in flow after the end of 3 weeks. No complications were encountered except mild iridocyclitis during the first week. The unsatisfactory outcome of this cryotherapy is considered to be due to the insufficient freezing of the ciliary body, and more applications is recommended in order to produce more sustained reduction of intraocular pressure.

Ultrasonography in experimental vitreous Opacities

Vitreous hemorrhages of white rabbit eyes were obtained by the following three methods and their ultrasonographies were checked several times for four weeks. 1 st group: fresh human blood was injected into the vitreous cavity through the sclera, 2 nd group: oxalated human blood was injected into the vitreous cavity in the same way, 3 rd group: a 26 gauge needle was inserted into the vitreous cavity and retinal vessels were mechanically ruptured to cause vitreous hemorrhage. Ultrasonography of the above groups revealed no definite differences between groups, but a high echo from the vitreous hemorrhages in initial stage changed to several low echoes in later stage. This fact was well matched with funduscopic observation for gradual absorption of the vitreous hemorrhage.

Neosporin in the Treatment of Pseudomonas Infections of the Eye

The effect of Neosporin eye drop against Pseudomonas infections of the eye was investigated experimentally in rabbits. Experimental Pseudomonas conjunctivitis was produced in 8 eyes by instillation of suspensions of the organism cultured in broth medium for 24 hours. All eyes developed severe purulent conjunctivitis. Untreated control eyes (2 eyes) showed copious discharge which persisted for one week. When treated with Neosporin drop every 2 hours beginning from 24 hours after the inoculation, discharge disappeared markedly and promptly and all ocular signs became normal by two days of treatment. Induction of Pseudomonas corneal ulcer was effectively carried out by passing through the superficial corneal stroma with a fine needle thread with 6-0 silk which had dipped into a broth culture solution previously, combined with cauterization of a lacrimal punctum. Within 24 hours, there appeared corneal ulcer with conjunctivitis. Untreated two eyes showed hypopyon and extensive ulceration which finally perforated and became atrophic after one week. Instillation of Neosporin every two hours was done 24 hours after the inoculation resulted in moderate improvement of corneal ulcer which was apparent after couple days of treatment. At the end of 20 days of treatment, 4 eyes of 6 showed good response (localized corneal opacity), 1 eye was bad (extensive corneal scarring) and 1 eye was lost due to atrophy of eyeball. Colistin, also effective against Pseudomonas infection, was also instilled in 4 rabbit's eyes with Pseudomonas corneal ulcer in a concentration of 100,000 units/ml every 2 hours. The results seemed to be inferior to that obtained by Neosporin. The final outcome after 20 days of treatment was, good in one eye, bad in 2 eyes and lost in 1 eye. Neosporin was tried in clinical patients with various ocular infectious diseases. Shortening of treatment period and milder course were noted in bacterial infections, namely, 8 cases of acute catarrhal conjunctivitis due to Pneumococcus and Koch-Weeks bacillus, 4 cases of angular blepharoconjunctivitis, 5 cases of hordeolum, 2 cases of gonococcal conjunctivitis and one case of Pseudomonas corneal ulcer. No effect was noted in viral diseases......epidemic keratoconjunctivitis and pharyngoconjunctival fever.

Effect of Alpha-Chymotrypsin on the Outflow Facility in Rabbit Eyes

Alpha-chymotrypsin solutions, 200 unit/ml and 1,000 unit/ml, were injected into the anterior chamber of albino rabbit eyes fonowed by irrigation with normal saline after 3 minutes. Intraocular pressure was recorded by pressure transducer and pressure decay curve analysis was made to calculate the outflow facility according to the method of Eisenlohr and Langham. The follow-up periods were 30 days after the injection of the enzyme solution. By the injection of 0.25 ml of 200 unit/ml solution in 7 eyes, intraocular pressure showed almost no changes throughout the observation period. Outflow facility showed transient decrease during the first 3 to 5 days in some eyes. After the injection of 0.25 ml of 1,000 unit/ml solution in 3 eyes, transient elevation of the intraocular pressure was noted associated with decrease in outflow facility. In one eye, a marked rise in ocular pressure was found All the changes in intraocular pressure and outflow facility returned to the pre-treatment level within 30 days. It was concluded that high concentration of the alpha-chymotrypsin solution injected into the anterior chamber might cause disturbances in trabecular function causing elevation in intraocular pressure.