Morphology and Distribution of Motoneurons Innervating the Lateral Rectus and the Retractor Bulbi Muscles in Cat : A Retrograde Study Utilizing Horseradish Peroxidase

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Morphology and Distribution of Motor Neurons in Cat Innervating the Orbicularis Oculi Muscle by Retrograde Horseradish Peroxidase

The facial nerve is mainly composed of motor fibers and is distributed to the muscles of facial expressions. In ophthalmology clinics, orbicularis oculi muscle innervated by the facial nerve is involved in spontaneous and voluntary blinking, winking, and more forceful eyelid closure. To understand pathophysiogy of facial nerve palsy due to brain stem lesion involving nucleus, 50% Horseradish Peroxidase (HRP) was injected into nerve stump innervating orbicularis oculi muscle of cat and serial sections of midbrain were studied with light and dark field of light microscope to examine morphology and distribution of the facial nuclei. The HRP-labelled motor neurons were located exclusively within the intermediate division of the ipsilateral facial nuclei and no labelled neurons were found in the contralateral facial nuclei, in the nuclei of the trigeminal nerve, or any other brain stem nuclei. The mean diameter of HRP-labelled motor neurons was 45 micrometer. Most of them were multipolar in shape containing many dendrites. These result suggest that the intermediate division of ipsilateral facial nuclei play an important role in innervating orbicularis oculi muscle.

A Case of Oculocutaneous Albinism

Oculocutaneous albinism resulting from genetic defect of melanin synthesizing system is characterized by pale skin, straw-colored hair, hypopigmentation of the iris, hypoplasia of fovea, photophobia, low visual acuity and strabismus. In general, oculocutaneous albinism can be distinguished by its clinical feature and hair follicle incubation test but should be diagnosed by electron microscopic findings of the skin which is exposed to sunlight. We experienced a case of 6-year-old female oculocutaneous albinism that showed clinical typical features and was diagnosed through electron microscopic finding of many immature melanosomes of the skin in the back of the hand. We report this unusual case with literature review.

A Case of Adenoma of Nonpigmented Ciliary Epithelium

Acquired tumors of the nonpigmented ciliary epithelium are rare diseases. They are difficult to diagnose and present as pseudoadenomatous hyperplasia, adenoma or adenocarcinoma. They exhibit slowly progressive enlargement leading to a subluxated lens, cataract, and secondary glaucoma. And some of the more malignant tumors may extend extrasclerally. We report a case of adenoma of nonpigmented ciliary epithelium which produced a cataract.

Electron Microscopic Examination of the Cat Oculomotor Nucleus Innervating the Medial Rectus Muscle

Oculoinotor nerve is a very important nerve in the ophthalornology, innervating the medial rectus, inferior rectus, inferior oblique, superior rectus, levator palpebrae superioris, and the presynaptic parasyrnpathetic outflow to the internal muscles of eye (the ciliary muscle and the sphincter muscle of the iris) . To examine the fine structure of neurons and synapses in the oculomotor nucleus projecting the rnedial rectus Hiuscle, 50% horseradish peroxidase (HRP) solution was injected into the rnedial rectus rnuscle of the cat, and serial sections of midbrain were studied with electron microscopes. Large motor neuron, small motor neuron and spindleshape motor neuron were examined. Cell body contained rich organells that. were nucleus, rough endoplasmic reticulum, HRP containing lysosorne, mitochondria and ribosome etc. Three kinds of synapses that are axosomatic synapse, axo-dendritic synapse and axo-axonic synapse were examed. Moreover, the nerve terminals had spherical-shaped synaptic vesicles. These results suggest that the function of inotorneurons related to the medial rectus muscle is not. defined by the shape and distribution of nerve terrninals but. depends on the shape of synaptic vesicles.

Squamous Cell Carcinoma Involving Lacrimal Apparatus

Squamous cell carcinomas arising from the paranasal sinuses are often accompanied by eyeball pain, proptosis, decreased visual acuity and diplopia because of the proximity to the orbit. We report a case of squamous cell carcinoma of maxillary sinus mimicking chronic dacryocystitis and orbital cellulitis due to destruction of lacrimal apparatus.

Low tear production in patients with Diabetes Mellitus

To evaluate the realtionship of neural regulation of tear production and autonomic neuropathy, this study was assessed using Schirmer test, tear film break up time and diabetic autonomic neuropathy based on cardiovascular responses. 50 patients were recruited. The results were as follows. The more degree of autonomic neuropathy was present, the less tear production was found. There was a statistically significant difference between mean Schirmer test of normal group with autonomic neuropathy and mean Schirmer test of definitive group with autonomic neuropathy. The more degree of autonomic neuropathy was well correlated with the less tear film break up time. there was no statistically significant difference of mean tear film break up time among 3 groups with autonomic neuropathy. If the definitive group with autonomic neuropathy was screened by Schirmer test, the high sensitivity above 80% was achieved.

A Case of Superior Oblique Myokymia

Superior oblique myokymia is an unusual disorder of ocular motility characterized by rapid, small ampulitude and rotary oscillations limited to one eye. Symptoms of monocular oscillopsia and torsional diplopia are experienced by the patient, and the cause remains obscure. We experienced a case of superior oblique myokymia that developed in a 53-year-old male. We report this unusual case with literature review.

The Measurement of the Apparent Accommodation with AA-2000 Accommodometer

We compared the apparent accommodative power of 35 pseudophakic patients(43eyes) receiving posterior chamber lens in the bag with 34 normal persons(34eyes) by using AA-2000 accommodometer and evaluated the correlation between apparent accommodation and various factors like age, corrected visual acuity, refractive error, pupillary diameter, anterior chamber depth, or change of the anterior chamber depth in pseudophakic eyes. The mean apparent accommodative power was 1.41 +/- 0.62 diopter(D) in pseudophakic eyes and 1.58 +/- 1.71 D in phakic eyes and there was no stastistically significant difference between two groups. However, in cases younger than 55 years old, the apparent accommodative power was 1.34 +/- 0.48 D in 17 pseudophakic eyes and 2.51 +/- 2.31 D in 14 phakic eyes and there was statistically significant(p<0.05). Among the various factors, pupillary diameter appeared to be correlative to the apparent accommodative power in pseudophakic eyes. The smaller pupillary diameter, the greater accommodative power. Otherwise, another factors were not correlative to the apparent accommodative power.

A Cytologic Diagnosis of Bilateral Orbital Malignant Lymphoma

Malignant lymphoma is a malignant tumor involving the lymphoid cells in lymph node, which also involve the gastrointestineal tract, skin, respiratory system and orbit etc. Malignant lymphoma rarely involves the orbit, furthermore, both orbital involvememt is very rare, whether it is primary or systemic. We experienced a case of systemic malignant lymphoma involving both orbits in a 66-year-old female which was diagnosed with needle aspiration cytology and improved with systemic anticancer drugs. We report this unusual case with literature review.

Pupillary Responses to Dilute Pilocarpine in Brain Death and Comatous Patients

Recently, it is reported that preganglionic oculomotor nerve palsies shows denervational supersensitive pupillary responses to dilute parasympathomimetic agents and this phenomenon is in inverse proportion to consciousness level. We measured pupillary diameters of 10 brain death patients(20 eyes) and 10 comatous patients (20 eyes). After we instilled 0.06% pilocarpine to patients that initial pupillary diameter is over 4.0mm(13 eyes in brain death group, 5 eyes in comatous group), we compared pupillary responses of two groups to evaluate whether this helps diagnosis of brain death. If pupillary diameter was changed over 25%(compared to initial diameter), we considered it positive. In comatous group, no one was positive. But in brain death group, 11 cases were positive(84.6%). It revealed significant difference statistically(P<0.05). Mean change of pupillary diameter to 0.06% pilocarpine was 0.46mm(9.35%) in comatous group, and 2.62mm(47.72%) in brain death group. With above results, we concluded that pupillary response to dilute parasympathomimetic agents is a useful indicator for diagnosis of brain death.

A Case of Posterior Involvement of Eye in Leprosy Patient

Leprosy is a chronic systemic disease with ocular complications including lagophthalmos, uveal diseases, and corneal diseases. Blindness may result unless appropriate treatment is done. The authors report the ocular leprosy with generalized systemic nodules associated with severe proptosis, corneal opacity and retinal pathology.

Primary Localized Amyloidosis of Bulbar Conjunctiva and Cornea

The major forms of amyloidosis affecting the eye are primary systemic and localized amyloidosis. Primary Amyloidosis localized to the conjuctiva is relatively rare, especially involved to bulbar conjunctiva and corn eo scleral limbus and is consiccered to be in the differential diagnosis of other conjunctival diseases. We diagnosed a amyloidosis in which the biopsy from the superior bulbar conjunctiva and superior cornea of the left eye of 68-year-old woman showed histopathologic findings of amyloidosis. There were no evidences of amyloid deposit except conJuntiva and cornea on physical and other systemic examination, including immunelectrophoresis, and cornea on physical and other systemic examination, including immunelectrophoresis, and no evidences of underlying disease that can cause amyloidosis. So we concluded that it was primary localized amyloidosis of bulbar conjunctiva and cotnea.

Primary Localized Amyloidosis of Bulbar Conjunctiva and Cornea

The major forms of amyloidosis affecting the eye are primary systemic and localized amyloidosis. Primary Amyloidosis localized to the conjuctiva is relatively rare, especially involved to bulbar conjunctiva and corn eo scleral limbus and is consiccered to be in the differential diagnosis of other conjunctival diseases. We diagnosed a amyloidosis in which the biopsy from the superior bulbar conjunctiva and superior cornea of the left eye of 68-year-old woman showed histopathologic findings of amyloidosis. There were no evidences of amyloid deposit except conJuntiva and cornea on physical and other systemic examination, including immunelectrophoresis, and cornea on physical and other systemic examination, including immunelectrophoresis, and no evidences of underlying disease that can cause amyloidosis. So we concluded that it was primary localized amyloidosis of bulbar conjunctiva and cotnea.

A Case of Posterior Involvement of Eye in Leprosy Patient

Leprosy is a chronic systemic disease with ocular complications including lagophthalmos, uveal diseases, and corneal diseases. Blindness may result unless appropriate treatment is done. The authors report the ocular leprosy with generalized systemic nodules associated with severe proptosis, corneal opacity and retinal pathology.

Bilateral Innervations to Superior Oblique by Trochlear Nucleus in cats: Retrograde Tracer Study by Horseradish Peroxidase

Trochlear motorneurons were identified by applying horseradish peroxidase(HRP) to superior oblique muscle in cats. Ninety five to ninety seven percent of the contralateral trochlear nucleus were stained 3-5% of ipsilateral side also labelled by HRP. These findings showed that superior oblique muscle was innervated by trochlear nuclei on both side.

A Case of Malignant Peripheral T-cell Lymphoma of the Lid

Malignant T-cell lymphoma is an abnormal tumor of the immune system which generally involves not only the lymphatic system but also the stomach, respiratory system, skin, orbit and, occasionally, the eyelids. The authors experienced a case of eyelid malignant T-cell lymphoma with skin involvement whose characteristic symptoms are anorexia, severe weight loss and systemic lymphadenopathy. Biopsy and immunohistochemical stain to UCHL-1 are the only diagnostic methods for differentiating the diagnosis from Hodgkin's disease. The patient was treated with cyclophosphamide, vincristine and prednisolone with a good prognosis and a 21 month-survival at present.

Solitary Neurofibroma in the Orbit

Neurofibroma is the most important component of neurofibromatosis and may occur as solitary lesion. Solitary neurofibroma is common in the skin but solitary neurofibroma of the orbital region is unusual, whether or not it is associated with von Recklinghausen's disease. In 53-year-old woman who had exophthalmos, we experienced a solitary tumor between right medial rectus muscle and lamina papyracea. The histopathologic evaluation revealed the tumor to be a neurofibroma.