A Histopathologic Study of the Iris in a Patient with Exfoliation Syndrome

The pathogenesis of the exfoliation syndrome is still unknown. To clarify the etiology of the exfoliation syndrome, we examined the iris taken from a patient with exfoliative glaucoma during cataract surgery using light microscope, polarization microscopy and electron microscopy. The amorphous substance around the iris pigment epithelium and stroma were stained purplish red in PAS staining and showed purplish red metachromasia in toluidine blue staining. In electromicroscopic examination, we observed that many fibrillar materials were deposited at basement membrane and partially detached basement membrane around the pigment epithelium of the iris. Therefore we concluded that the exfoliative materials in this syndrome is a sort of glycoprotein and originated from the abnormal synthesis and metabolism of the basement membrane in the eye.

The 2 Cases of Surgical Treatment for Retinal Detachment with Macular Hole after Ocular Trauma

In two patients with macular hole, retinal detachment in the posterior pole and commotio retinae, we performed pars plana vitrectomy, fluid-air exchange, intravitreal injection and removal of 0.04cc autologous serum, and air-gas exchange. These patients absolutely maintained prone position during the two-week postoperative period. As a result, anatomical and functional success about macular hole was accomplished in both cases through a long term of observation over a year. In traumatic macular hole with retinal detachment, we suppose that anatomical and functional success will be accomplished through pars plana vitrectomy, intravitreal injection and removal of autologous serum and gas injection into the vitreous cavity.

Histological Changes of the Retinal Following High dose Intravitreal Ganciclovir Injection in Rabbit

Authors evaluated the retinal toxicity of high dose (2mg/0.1ml, 4mg/0.1ml) intravitreal ganciclovir injection in rabbit eye with light microscopy and electron microscopy. The results were as follows: In twenty-four hours after 2.0mg/0.1ml intravitreal injection group, edema of outer cells in inner nuclear layer were visualized under electron microscopy. These findings were disappeared after 3 days. In 4.0mg/0.1ml intravitreal injection group, edema of outer cells in inner nuclear layer were visualized at 24 hours after injection. Edema of outer cells in inner nuclear layer and axonal swelling of outer plexiform layer and upper border cells of outer nuclear layer were demonstrated at third and seventh day after injection. We observed more severe changes at seventh day than third day, and fragmentation of inner and outer segments in photoreceptor cells and presence of macrophage corresponding site of subretinal space. So, it suggests that 4.0mg/0.1ml intravitreal ganciclovir injection has mild reversible retinal toxicity.

The Significance of Fundus Photography Without Mydriasis During Health Mass Screening

We have reviewed the usefulness of the fundus photography in ophthalmological mass screening by investigating 8391 cases of fundus photography by non-midriatic fundus camera at Seoul Paik Hospital Health Clinic. In the reported close examination cases of 783(9.3%), it turned out that actual cases closey examined in the eye clinic were 142(18.1%), and among them 54 cases were diagnosed as eye diseases. Out of the 75 cases who were examined for glaucoma suspect, 13(17.3%) were diagnosed as glaucoma. Among the 13 cases of glaucoma, 10(76.9%) were normal tension glaucoma. As the result of this study, fundus photography appears to be effective for the detection of glaucoma, especially normal tension glaucoma. However, it is necessary to raise the rate of close examinations in order to enhance the usefulness of fundus photography.

Vitreous Seeding Associated with Melanocytoma of the Optic Disc

Melanocytoma is defined as a specific variant of nevus, located on the optic disc or anywhere in the uveal tract, characterized clinically by a dark brown to black color, and composed histopathologically of deeply pigmented, plump, round to polyhedral nevus cells with small, round, uniform nuclei. The case of a 52-year-old woman with presumed melanocytoma of the left optic disc associated with vitreous seeding is presented. Fluorescein angiography, perimetry, magnetic resonance imaging and bone scan were performed. These findings are consistent with melanocytoma of the optic disc. No interval change of the tumor during the following periods was observed. The possible mechanisms responsible for this vitreoua seeding of melanocytoma of the optic disc are disscuased.

Full-Field and Focal Macular Electroretinography in Normal Subjects using MacADIOS 411 and Maculoscope

Specific values for amplitude and implicit time may differ among laboratory due to normal variations in recording electrodes, equipment, and protocol. We presented the results of fulHield and focal macular electroretinography in normal subjects using MacADIOS 411 and Maculoscope. Full-field electroretinograms were obtained in 87 normal subjects (65 males, 22 females) and focal macular electroretinograms were recorded in 33 valunteers(18 males, 15 females) under controlled condition. Age-matched norms were given in table, and for the purpose of clinical application, range of values was given for each group.

Changes in Corneal Curvature and Histopathology following Scleral Cauterization in Rabbits

This study was carried out to evaluate the effect of cauterization on histopathology of sclera and corneal astigmatism. All rabbit eyes had corneal steepening in the vertical meridian after cauterization. The greatest astigmatism was noticed immediately after cauterized eyes and then was reduced gradually for a period of 2 months. Under light microscope, necrosis of collagen fibrils and inflammatory cells were found immediately after cauterization of the eyes. After 2 months, treated sclera was recovered to normal structure. Under electron microscope, tissue defect was found immediately after cauterization. At the 1st month, tissue defect was replaced by small collagen fibrils, however, these changes were much improved during a period of 2 months. This study suggest that gradual loss of corneal astigmatism following cauterization was correlated with the histopathologic healing process of cauterization. The author recommends usage of the lightest and briefest application of wet field bipolar cautery at the lowest power setting capable of achieving hemostasis for minimal astigmatism.

Short-term Observation of Histological Changes on the Rabbit Retina after Endocryopexy

The aim of this study was to evaluate the histopathologic changes of the pigmented rabbit ratina after endocryopexy. We investigated the differences or similarity among endocryopexy, transscleral cryopexy and laser phocoagulation. Their ultrastructural changes were observed with light and electron microscope. The results were as follows; 1. The first day after endocryopexy, we observed rupture of the internal limiting membrane, breakdown the inner and outer retina, separation of intercellular gap junction of pigment epithelial cells, and accumulation of exudation within subretinal space. 2. In the 8th days, there are mull iplication of retinal pigment epithelial cell layer and development of basal infolding. 3. The present study suggested that effects of endocryopexy on the retina to cause chorioretinal adhesion was similar to transscleral cryopexy or laser photocoagulation However it should be operated on the premise that in requires technical skill for the purpose of clinical application.

Morphological Studies on the Rabbits Ciliary Epithelium by Bunazosin

Bunazosin is a alpha-1 blocker that is more selective and effective than other alpha-1 receptor blockers. Bunazosin has been shown to lower intraocular pressure but it's mechanism is uncertain. The purpose of this study is to know the morphological changes in the ciliary epithelium by bunazosin. 0.1% Bunazosin was instilled on the eye of the rabbits and the eyes were enucleated on 1, 2, 6 and 24 hours after instillation to find out the tissue response under the electronmicroscopy. As a result, widening of the cell membranes and swelling of the mitochondria were observed in the pigmented and non-pigmented epithelium and these changes were recovered with time and seem to be the morphological changes of bunazosin against aqueous formation in the ciliary body.

Electronmieroscopic Findings of the Rat Retina Following Intraperitoneal Injection of 2,4-Dichlorophepoxyacetie Acid

2,4-Dichlorophenoxyacetic acid is a component of agent orange, which was spread during Vietnam War. Due to the toxicity of this agent, several diseases may be occuring today, potentially causing social problem. The author tried to take as preliminary information for a further clinical study by examining whether 2,4-dichlorophenoxyacetic acid makes any change in the retina of a white rat histopathologically. The objects were 6 white rats of 200-300 gm in weight. After diluting 40% 2,4dichlorophenoxyacetic acid, it was injected intraperitoneally into the rats at the levels of 5 mg/kg, 10 mg/kg, 15 mg/kg of agent. The eyeballs of the each groups were enucleated on 24 hours and 3 days and examinated with an electron microscope. Histopathological changes in the retina were characterized by the degeneration of the retinal pigment epithelial cells, the photoreceptor cells, and the choriocapillaris. To prove that 2,4-dichlorophenoxyacetic acid injures human retina, experiments with futher various plans and epidemiological surveys should be provided.

A case of Conjunctival Tuberculosis

Conjunctival tuberculosis has become a rare disease in these days along with decreased incidence of systemic tuberculosis. We experienced a 43-year-old patient with large pinguecula-like protruding mass on the medial bulbar surface which was later diagnosed as conjuctival tuberculoma histopathologically. Evidence of systemic tuberculosis could not be found from any other organs of the body. This case raises the possibility that conjunctival tuberculoma may be misdiagnosed as a simple pingueculum unless histopathologic examination is performed. Brief history and clinical findings will be presented with pictures of the pathology findings, and some literatures will be reviewed.

Electronmicroscopic Study of the Effect of Hexamethonium on Serous Choriretinopathy in Rabbits

Stress has been regrarded as one of the causes of central serous chorioretinopathy. We studied the effect of Hexamethonium (ganglionic blocking agent) on experimentaI serous chorioretinopathy following epinephrine injection in rabbits. In group 1, we injected the 0.1 % epinephrine into the rabbits through IV route for 10 days and in group 2, we addited Hexamethonium subcutaneously prior to injection of the epinephrine same term of gorup 1. We could find slight histological changes in gorup 2 as com paired with group 1, which produced serous chorioretinopathy, under the electronmicroscopic study so we would expect the preventive effect of Hexamethonium on the stress-induced serous chorioretinopathy.

Electronmicroscopic Study of the Effect of Hexamethonium on Serous Choriretinopathy in Rabbits

Stress has been regrarded as one of the causes of central serous chorioretinopathy. We studied the effect of Hexamethonium (ganglionic blocking agent) on experimentaI serous chorioretinopathy following epinephrine injection in rabbits. In group 1, we injected the 0.1 % epinephrine into the rabbits through IV route for 10 days and in group 2, we addited Hexamethonium subcutaneously prior to injection of the epinephrine same term of gorup 1. We could find slight histological changes in gorup 2 as com paired with group 1, which produced serous chorioretinopathy, under the electronmicroscopic study so we would expect the preventive effect of Hexamethonium on the stress-induced serous chorioretinopathy.

Ultra-Structural Changes of the Chorioretina Following Intra-Vitreal Injection of Ornithine in Rabbit

The ultrastructural changes of the chorioretina following the intravitreal injection of ornithine in rabbit eyes at 1,2,4,8 week time intervals were investigated employing electron microscopy in this animal experiment. 1. 1 week after injection, swelling of the mitochondria in the cytoplasm of the pigment epithelium was seen. 2. 2 weeks after injection, phagosomes and phagolysosomes were present in the cytoplasm of the pigment epithelium and nerve elements in the inner nuclear layer disappeared and were replaced by Muller cell. 3. 4 weeks after injection, stroma of the choroid was atrophied and abundant melanocytes were aggregated, and papillary formed pigment epithelium with detachment of the retina was seen. 4. 8 weeks after injection, stromal atrophy and attenuated choriocapillaries of the choroid were present, and proliferation of the microvilli of the pigment epithelium after detachment of the retina was seen. 5. In summary intravitreal injection of ornithine in rabbits initially caused marked changes in the pigment epithelium with subsequent degeneration of the choroid and sensory retina.

Effect of Fibrin Glue(Tissel(R))in Experimental Corneal Perforation

Fibrinogen is converted into fibrin by the action of thrombin under presence of calcium. In addition to its hemostatic effect, fibrin coagulum has tissue adhesive effect and fibroblast stimulating effect in the healing process. Perforating wounds about 1mm X 3mm in size were made in the center of rabbit corneas, and then were treated with fibrin glue. Simple full-thickness lacerations were also made in the central cornea of the other eye without any treatment as a control group. These eyes were enucleated after various periods of interval and the wound sites were studied with light and electron microscope. Tissue defect of perforated cornea was closed well by fibrin glue and active proliferation of the fibroblasts was seen near the glue. From these results, fibrin glue may be useful in the treatment of human corneal perforation and it will be used for the other ocular surgery.

Effect of Fibrin Glue(Tissel(R))in Experimental Corneal Perforation

Fibrinogen is converted into fibrin by the action of thrombin under presence of calcium. In addition to its hemostatic effect, fibrin coagulum has tissue adhesive effect and fibroblast stimulating effect in the healing process. Perforating wounds about 1mm X 3mm in size were made in the center of rabbit corneas, and then were treated with fibrin glue. Simple full-thickness lacerations were also made in the central cornea of the other eye without any treatment as a control group. These eyes were enucleated after various periods of interval and the wound sites were studied with light and electron microscope. Tissue defect of perforated cornea was closed well by fibrin glue and active proliferation of the fibroblasts was seen near the glue. From these results, fibrin glue may be useful in the treatment of human corneal perforation and it will be used for the other ocular surgery.

A Statistical Observation on Transferred Ocular Perforation Injuries

The authors statistically analysed transferred patients among 110 ocular perforation injury patients who were admitted to the Seoul Paik Hospital between January 1, 1984 and December 31, 1988. Male was 85.9% and third decade was most common decades(30.5%). Left eye was more affected(59.8%) than right eye. The most common cause was traffic accident(37.%) and perforated site was corneo-sclera(43.%). Subconjunctival hemorrhage was the most common accompanied ocular manifestation(47.0%). Most of the perforated eyes were treated with primary closure of the wound. The final visual acuity was better in patients who were treated at only one hospital two or more hospitals before being transferred. With the above results, the final visual acuity may be related with the number of the hospital which the patients were treated before transferred.

Histological Study in Choroidal Vascular Occlusion Induced by Laser Irradiation Combined with Fluorescein Injection

The purpose of this study is to observe the choroidal vascular occlusion by photocoagulation under intravenous administration of fluorescein sodium. Argon laser photocoagulation(intensity: 50 mW, duration: 0.05 sec., spot size: 200 micrometer) was applied to the retina of the left eye(control group) and the same method was repeated to the right eye combined with intravenous infusion of 2 ml of fluorescein sodium in the pigmented rabbit(experimental group). The photocoagulated rabbit eyes were enucleated after 2 hrs, 1, 3 and 5 days and the retina and choroid were observed under electron microscopy. The result were as follows. 1. In the control group, loss of melanin pigments in the retinal pigment epithelium and destruction of outer segments of the photoreceptor were observed but endothelial cells of choriocapillaris and Bruch's membrane were intact. 2. In the experimental group, two hours after irradiation, endothelial cells of choriocapillaries were destroyed and capillary lumen was occupied with thrombus components, the retinal pigment epithelium and outer segment of the photoreceptor cells were also destroyed. One day after irradiation, occupied materials in lumen were absorbed but residual debris of thrombus was demonstrated. Three days after irradiation, newly formed endothelial cel1 processes were extended in the area of destroyed choriocapilJaries. Five days after irradiation, long processes of newly fonned endothelial cells extended in the area of choriocapillaries. The outer part of retina was repaired with newly formed pale pigment epithelium and proliferated Miil1er cells. 3. In conclusion, argon laser-provoked vascular change was more easily recognized by intraluminal fluorescein sodium which probably acted as an energy absorbent.

A Case of Atypical Idiopathic Central Serous Chorioretinopathy

The authors experienced a case of atypical type of idiopathic central serous chorioretinopathy that has bullous retinal pigment epithelium detachment and multiple leaking points. So, we report this case with the review of the literatures.

A Case of Atypical Idiopathic Central Serous Chorioretinopathy

The authors experienced a case of atypical type of idiopathic central serous chorioretinopathy that has bullous retinal pigment epithelium detachment and multiple leaking points. So, we report this case with the review of the literatures.