A Case of Recurrent Myxomatous Corneal Degeneration Treated by Interferon Alpha-2b

PURPOSE: To report a case of recurrent myxomatous corneal degeneration after pterygectomy. CASE SUMMARY: A 65-year-old man with a history of abdominal keloid was referred to our hospital for assessment of a well-circumscribed, gelatinous, whitish corneal mass on the nasal corneal area of the left eye that appeared one month prior. The patient had undergone pterygectomy on his left eye 2 years ago. The patient experienced mild foreign body sensation. The other anterior segment and fundus examination of the left eye were both normal. We diagnosed the case as keloid and we performed excisional biopsy of the corneal mass. Histologic findings revealed proliferation of myxoid-appearing material in the anterior corneal stroma. On immunohistochemical examination, sections were stained positive for actin and calretinin, and negative for S-100. We diagnosed the tumor as myxomatous corneal degeneration. After six months, a recurrent mass was found on the previously excised site. Re-excisional biopsy and topical interferon α-2b treatment were then performed in response. After re-excision, there was no recurrence or complications during one year follow-up. CONCLUSIONS: Myxomatous corneal degeneration should be considered during differential diagnosis of an elevated, whitish, gelatinous lesion of the cornea with previous history of trauma or operation, such as pterygectomy. An interferon α-2b topical treatment is useful for recurrent corneal myomatous degeneration.

Intramyocardial Injection of Stem Cells in Pig Myocardial Infarction Model: The First Trial in Korea

Although cell therapy is emerged for cardiac repair, its efficacy is modest by intracoronary infusion. Therefore, we established the intramyocardial delivery technique using a left ventricular (LV) mapping system (NOGA® XP) using 18 pigs. After adipose tissue-derived mesenchymal stem cells (ATSCs) were delivered intramyocardially to porcine infarcted heart, LV ejection fraction (EF) was increased, and LV chamber size was decreased. We proved the therapeutic effect of intramyocardial injection of ATSC through a LV mapping system in the porcine model for the first time in Korea. The adoption of this technique may accelerate the translation into a clinical application in the near future.

Steroid-Induced Ocular Hypertension Model in the Mice

PURPOSE: To determine whether rat eyes develop increases in intraocular pressure (IOP) in response to a topically applied corticosteroid and to investigate the relationship between ocular hypertension and apoptosis of retinal ganglion cells. METHODS: IOP was monitored by rebound tonometry in a group of 10 rats that received topically administered dexamethasone in both eyes (experimental) and in another group of 5 rats that received artificial tears (control) three times daily for 4 weeks after the establishment of baseline IOP values. Only eyes that increased by more than 50% compared with the basal IOP were administered once per day for 5 weeks. After 8 weeks, selective immunofluorescence stain for retinal ganglion cells and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) stain were conducted. RESULTS: Among 20 experimental eyes, 11 eyes (55%) showed a greater than 50% increase in IOP compared with basal IOP. After 8 weeks, the mean IOPs for the experimental and control groups were 11.8 +/- 1.4 mm Hg and 18.5 +/- 1.0 mm Hg, respectively (p < 0.01). The counts of central retinal ganglion cells (RGCs) were 2718 +/- 240 and 2612 +/- 443, respectively (p = 0.294). The results of the TUNEL stain also showed no differences. CONCLUSIONS: Rat eyes exhibit a steroid-induced ocular hypertensive response with no local complications. However, maintaining ocular hypertension increased by 50% for two months was not enough to detect changes in RGCs.

The Change of Tear Film in Classification of Diabetic Retinopathy

PURPOSE: To determine the relationship between changes in the tear film according to the classification of diabetic retinopathy in patients with diabetes. METHODS: A total of 117 newly detected diabetic patients were included in this study. The classification of diabetic retinopathy was performed based on the Early Treatment Diabetic Retinopathy Study (ETDRS). The duration of diabetes and HbA1c were also investigated in patients who had undergone panretinal photocoagulation or insulin treatment. To examine the tear film function, we performed the tear break-up time test, the Schirmer I test, and the diagnostic fluorescein staining test of the ocular surface. The Cochet-Bonnet esthesiometer was also employed to examine the corneal sensitivity. RESULTS: As the severity of diabetic retinopathy progressed, the degree of ocular surface fluorescein staining increased significantly. There was no relationship between the duration of diabetes and the results of the tear film function test. Patients who had high blood HgA1c levels showed significant increases in tear break-up time and degree of ocular surface fluorescein staining. The patients who had undergone panretinal photocoagulation showed significant differences in tear break-up time and degree of ocular surface fluorescein staining. CONCLUSIONS: The diabetic patients with progressed diabetic retinopathy, uncontrolled blood HgA1c levels and who had previously undergone panretinal photocoagulation should be managed more carefully since those patients are more susceptible to ocular surface disorder with aggravation of tear film function.

Angiopoietin-Like 4 Is Involved in the Poor Angiogenic Potential of High Glucose-Insulted Bone Marrow Stem Cells

BACKGROUND AND OBJECTIVES: Diabetes is reported to reduce the function or number of progenitor cells. We compared the gene expression patterns of bone marrow-derived mesenchymal stem cells from diabetic (DM-BMCs) and healthy (non-DM-BMCs) rats and suggested Angiopoietin-like 4 (Angptl4) could be a responsible factor for impaired angiogenesis of DM-BMCs. SUBJECTS AND METHODS: BMCs were isolated from DM or non-DM rat, and in vitro angiogenesis activity was compared by tube formation assay on Matrigel and complementary deoxyribonucleic acid expression was analyzed by microarray with or without oxytocin treatment. Human BMCs (hBMCs) were treated with high glucose, and were performed polymerase chain reaction, Western blot, and enzyme-linked immunosorbent assay. Angptl4 plasmid DNA and micro ribonucleic acid-132 (miR-132) were transfected to immortalized hBMCs. RESULTS: In vitro angiogenesis assay showed the impaired tube formation in DM-BMCs, and slightly recovery by oxytocin treatment. Angptl4, an adipokine, was upregulated in DM-BMCs compared to non-DM-BMCs. Oxytocin treatment reduced Angptl4 in DM-BMCs. In hBMCs, overexpression of Angptl4 attenuated the tube formation. In addition to Angptl4, miR-132 was increased by high glucose treatment. Collectively, high glucose resulted in impaired tube formation through miR-132 induction and Angptl4 upregulation in BMCs. CONCLUSION: Our results show that the angiogenic activity of BMCs is impaired by high glucose stress, which would be mediated by Angptl4 and miR-132.

The Effects of Epiblepharon Surgery on the Improvement of Astigmatism

PURPOSE: To evaluate the changes in visual acuity and astigmatism after epiblepharon surgery regarding preoperative age and astigmatism. METHODS: We retrospectively reviewed the charts of 37 patients with epiblepharon surgery. Preoperative best-corrected visual acuity and degree of astigmatism were obtained. Postoperative data were collected at 6 and 12 months. RESULTS: The mean patient age was 5.7 +/- 2.5 years. In the 5-9 year-old group and < or =3D group, significant improvement of mean BCVA was demonstrated (p = 0.02, p = 0.039, respectively). In the cylinder groups, 1-2 D, 2-3 D, and < or =3D showed decreased mean astigmatism (p = 0.006, p = 0.034, p = 0.015, respectively). CONCLUSIONS: Significant astigmatic reduction was found after surgical correction in epiblepharon patients with higher baseline astigmatism. These results suggest that an epiblepharon surgery should be considered in patients with a high levels of astigmatism.

A Case of Nasolacrimal Duct Obstruction after Two-Jaw Surgery

PURPOSE: To describe a case of nasolacrimal duct obstruction after two-jaw surgery. CASE SUMMARY: A 22-year-old woman presented with a 1-year history of epiphora after two-jaw surgery. Orbital CT showed 5 mm of focal soft tissue at the level of the distal nasolacrimal duct. Dacryocystography showed complete obstruction at the nasolacrimal duct level. Thus a nasolacrimal duct obstruction was diagnosed by physical and radiologic examination. CONCLUSIONS: In patients with epiphora who have undergone two-jaw surgery, precise examination and treatment is required in order to exclude nasolacrimal duct obstruction.