[Influence of light scattering in the opaque lens on the ability to focus--examination utilizing opacified model lenses].

In order to objectively evaluate the relationship between the quality of images which will be reflected on the retina, through opaque lenses and the grade of opacification, model lenses of nuclear cataract and subcapsular cataract were manufactured. The nuclear cataract model lenses were made of polymethylmethacrylate (PMMA) with and without a cut off wavelength below 380 nm. The lens shape was the biconvex intraocular lens (IOL) type and the opacification was achieved by polymerization of both hydrophile and lyophobic monomers. The model of subcapsular opacification was composed of ultraviolet (UV)-cut IOL and a hard contact lens (HCL). The HCL was attached behind the IOL and whitish corpuscles (T1O2, mean diameter of particle = 0.2 micron) were inserted into the gap between the lenses. Utilizing a still camera with 35 mm film, images were photographed through the nuclear opacified model lenses and evaluated. The model of the subcapsular opacified lens was examined by a simulation camera (CCD) in which the lens was held in water. The image quality obtained from the non-UV absorbed nuclear opacification type lens was markedly poor compared with that from the UV absorbed type lens. Although image contrast became worse with increased nuclear opacification, the worsening of image quality was slight in the opacified lens with a 20% reduction of light transmission. It was even possible to recognize photographed subjects through an opacified lens with 60% transmission. Images through the subcapsular opacified model lenses were not influenced by the opacified area in the models with up to 130 cct light scattering intensity at the central part of opacification. Although the study aimed to simply simulate images reflected on the retina through two types of cataractous lenses, the results obtained showed useful objective information concerning images seen through cataractous eyes.

Early lens changes seen in patients with atopic dermatitis applying image analysis processing of Scheimpflug and specular microscopic images.

In order to know the initial lens changes that accompany atopic dermatitis (AD), 99 patients diagnosed dermatologically to have AD without any or with slight external ocular inflammations and with no habit of rubbing the eyelid due to severe itching were examined opthalmologically. Clinically, none of them showed any cataractous changes in their eyes. For the sake of comparison with the above population, 4 AD patients with cataractous eyes, 49 renal transplantation patients who were administered steroids over a long period of time but clinically had no cataractous lenses, and 94 healthy individuals with transparent lenses were also selected as subjects. The crystalline lenses of the subjects were examined using an anterior eye segment analysis system and specular microscopy. From Scheimpflug slit images of the lens, light scattering intensity of different lens layers was measured as an indicator of lens transparency changes. The subcapsular basement membrane and changes in the lens epithelial layers were analyzed from specular images of these areas by image processing. Results and considerations from the investigations were: (1) Initial lens changes in cases with AD which may be occult cataractous findings were often detectable. (2) Cataract associated with AD can be accelerated by steroid administration or the habit of strongly rubbing the eyelid, but this may not be the original cause of cataract formation. (3) Two types of cataract are seen in patients with AD: (a) anterior subcapsular plaque formation and (b) anterior and posterior subcapsular opacity formation. The latter type, however, is also accompanied by epithelial damage from the early stage. (4) Significant numbers of patients with AD who have not yet shown manifest lens changes were found among the subjects.

[Long-term survival of a patient with lung cancer with skip metastasis to supraclavicular lymph nodes].

A case of lung cancer with skip metastasis to supraclavicular lymph nodes is described. The patient had undergone radical resection for gastric cancer about nine years ago. For about one year, chemotherapy had been done by Tegafur (600 mg/day) after operation. Radical resection for lung cancer (p/d squamous cell carcinoma) was performed about seven years ago. Pathologically, mediastinal lymph node metastasis could not be detected. The needle aspiration biopsy of supraclavicular lymph node revealed metastasis. Then, radical neck lymph nodes dissection involving supraclavicular lymph nodes and radiation therapy were added. There has been no sign of recurrence so far.

[Cataract epidemiology survey in the three climatically different areas in Japan--prevalence of cataracts and types of lens opacification].

A cataract epidemiology study of 1,615 subjects from three climatically different places in Japan, village S in Hokkaido, town M in Noto and village Y in Okinawa, was conducted by one study group. Cataract diagnosis and grading of cataracts were objectively done with a photo-documentation system. The percentages of cataracts of over grade I classified by the Japanese Cooperative Cataract Epidemiology Study Group were 46.6%, 64.6% and 38.0% in village S, town M, and village Y, respectively. Those in their 50s, 60s, and 70s in the above places were 24.3%, 51.1% and 71.4% (village S), 38.4%, 65.3% and 84.6% (town M), and 25.2%, 42.9% and 65.4% (village Y), respectively. Cortical cataract was the most common, followed by nuclear and subcapsular types. Although the highest percentage of nuclear cataracts was seen in the subjects of village Y, subcapsular cataract was seen almost equally in the three areas. Lens transparency changes were evaluated by the light scattering intensities in the lens layers through photographed images. Intensity increased with ageing either linearly or exponentially.

In vivo observation of the axial movement of intraocular lenses through an anterior eye segment analysis system.

The small axial movement of the anterior surface of implanted intraocular lenses (IOLs) were examined in pseudophakic eyes with one-piece and three-piece IOLs using an anterior eye segment analysis system. The movement was calculated as the distance between the posterior surface of the cornea and the anterior surface of an IOL under a normal pupil size, following the instillation of 1% pilocarpine and 1% cyclopentolate solutions, respectively. The axial movement including movement after instillation of pilocarpine and cyclopentolate was 0.17 +/- 0.06, 0.05 +/- 0.07 and 0.13 +/- 0.06 mm, in phakic eyes and eyes with one-piece and three-piece IOLs, respectively. Image analysis techniques using Scheimpflug images proved its usefulness in the research field of IOL implantation.

DNA autosensitivity in two Japanese sisters.

Two cases of DNA autosensitivity in Japanese sisters are reported. Both patients developed painful ecchymoses and other bleeding disorders. Skin tests with autologous leukocyte lysates and calf thymus DNA produced intermediate-type reactions that were identical to spontaneous skin reactions. Pretreatment of DNA with either DNase or chloroquine sulfate inhibited these reactions. Our studies suggest that anti-DNA antibodies might contribute to the clinical symptoms of this disorder.

Measurement of postoperative intraocular lens tilting and decentration using Scheimpflug images.

A three-dimensional, in vivo method for determining the position of implanted intraocular lenses (IOLs) using an image-processing technique has been developed. Two images of the anterior segment of the eye with an implanted IOL were photographed with a Scheimpflug camera at slit-lamp angles of 90 degrees and 180 degrees. After geometrical correction, the contours of the original images were enhanced using binarization and curve-fitting techniques. These images afforded calculation of the angle of tilt of the IOL optic axis relative to a standard reference line which connected the center of anterior corneal surface curvature with the geometrical center of the pupil. The extent and direction of IOL decentration could also be shown. The IOL image in the posterior chamber was expressed as a wire-frame figure. This method provides several kinds of biometry in pseudophakic eyes.

Specular microscopy of the anterior lens capsule after endocapsular lens implantation.

Endocapsular phacoemulsification and complete in-the-bag intraocular lens (IOL) fixation was performed on 77 eyes. Specular microscopy of the anterior lens capsule was performed postoperatively, and the process of anterior capsule opacification after endocapsular cataract surgery was classified. Lens epithelial cells on the inner surface of the anterior lens capsule, facing the optical portion of the IOL, underwent a diffuse fibrosis. In more peripheral areas, where the anterior and posterior capsules were tightly adherent, the regularly proliferating lens epithelial cells retained their polygonal shape. These findings suggest the possibility of retaining the transparency of the anterior lens capsule postoperatively by refilling the capsular bag to apply internal pressure.

Specular microscopic findings of lattice corneal dystrophy.

A Japanese family with 4 members suffering from lattice dystrophy of the cornea is reported. Their central corneas were affected leaving the peripheral zone clear. Corneal lesions were found in the superficial stroma of younger cases and in the deeper stroma of older cases. The proband was a 75 year-old woman who underwent a penetrating keratoplasty. Her corneal specimens revealed amyloid deposits stained with Congo red in the stroma. In specular microscopy, the probands central cornea had a crateriform appearance which had not been reported in the literatures. A few fine short branching lines and crateriform lesions were shown in the superficial stroma of the proband's daughter and only crisscrossing lines could be seen in her granddaughter's cornea.

TV indirect ophthalmoscope.

A prototype of TV indirect ophthalmoscope (black-and-white type) was developed to enhance education in ophthalmology. Its weight is 450 g, and pictures obtained were fairly satisfactory. The authors have used this ophthalmoscope not only for practicing indirect iphthalmoscopy by students, but also as monitoring device during retinal surgery.