ABSTRACT
PURPOSE: The objective of this study was the identification, characterization and in vitro replication of the human corneal stem cells, taking into consideration the difficulties in obtaining sufficient corneal material from living donors. The study explored a variety of stem cell markers, usually found in embryonic or adult mesenchymal stem cells. Culture medium and replication substrates had to be identified, with no data available on this subject in our country (there are no other reports on corneal stem cells in Romania, to our knowledge). MATERIALS AND METHODS: Corneal epithelial limbus was harvested from an enucleated eye, containing also a choroid malignant melanoma. Stem cells from the limbus were isolated and cultivated in vitro. Expression of specific stem cell markers was evaluated with immunocytochemistry. RESULTS: Corneal stem cell expansion in primary culture was slow, achieving 70-80% confluence after 28 days. Stem cells were easily isolated in standard medium, showed fibroblastoid morphology and were positive for certain stem cell specific markers in immunocytochemical staining: Oct3÷4, SOX2, Nanog, SSEA4, CD44, CD90, CD133, and CD34. They also expressed pan-cytokeratin. Donor age (72 years) and the presence of a malignant tumor close to limbal stem niche could have had an impact on the proliferation rate and the characteristics of the corneal stem cells. CONCLUSIONS: Isolated limbal cells were adult type stem cells with an epithelial orientation. The characterization of these cells with immunocytochemistry allowed us to observe surface markers that other stem cells also express.
Subject(s)
Cornea/cytology , Epithelium, Corneal/cytology , Melanoma/pathology , Neoplastic Stem Cells/pathology , Stem Cells/cytology , Aged , Cells, Cultured , Cornea/pathology , Epithelium, Corneal/metabolism , Female , Humans , Immunohistochemistry , Melanoma/metabolism , Stem Cells/metabolism , Stem Cells/pathologyABSTRACT
A variety of corneal pathology can lead to corneal ulcers and perforations. A deep corneal ulcer may need surgical treatment to allow good volume restoration and reepithelisation. Corneal perforation must be sealed and when the perforation is large, the task of repairing the defect can be underwhelming. The elegant solution is the corneal transplant, but this is not always readily available, especially in undeveloped countries. We present here two cases with different solutions to seal the perforated cornea: the first one has a large peripheral defect and it is successfully sealed with scleral patch and the second one is central with small perforation and is successfully sealed with multilayered amniotic membrane. Both cases are followed for over 12 months and demonstrate good corneal restoration (both on clinical examination and corneal topography). Sclera and amniotic membrane can be used to seal corneal defects when corneal transplant is not readily available.
Subject(s)
Amnion/transplantation , Corneal Perforation/surgery , Sclera/transplantation , Aged , Corneal Perforation/etiology , Corneal Perforation/pathology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Ophthalmologic Surgical Procedures , Treatment Outcome , Visual Acuity , Wound HealingABSTRACT
Corneal stem cells are adult type stem cells located in the basal layer of the epithelium at the sclero-corneal limbus. Modern concepts regarding corneal stem cells are discussed, focusing on stem niche location, corneal healing mechanisms, methods to cultivate stem cells in vitro or genetic and structural characterization. Most of the research in this area was performed in the last decade.
Subject(s)
Adult Stem Cells , Epithelium, Corneal/cytology , Limbus Corneae/cytology , Adult , Cell Differentiation , Cells, Cultured , Corneal Diseases/pathology , Corneal Diseases/therapy , Epithelium, Corneal/metabolism , Humans , Limbus Corneae/metabolism , Stem Cell Transplantation/methods , Tissue Engineering/methodsABSTRACT
The basic principles of conjunctival reconstruction are similar in all pathologies that inflict conjunctival tissue loss. Large conjunctival defects are difficult to treat, with little conjunctival reserve that can be used to close the defect. The study had the objective to find alternatives to conjunctival autograft. Frozen amniotic membrane was investigated. From 27 cases, 22 cases were reconstructed using amniotic membrane alone, but in 5 cases conjunctival autograft was also needed. Bulbar conjunctiva was reconstructed in 23 cases, of which 19 with pterygium, 3 with conjunctival tumors, one operatory plague. Fornix reconstruction was carried out in 4 cases, one tumor and 3 symblepharons (2 after conjunctival burns and one pemfigus). The rate of pterygium recurrence was 7,14%. Amniotic membrane can heal large defects of the conjunctiva, either bulbar or forniceal.
Subject(s)
Amnion/transplantation , Conjunctival Neoplasms/surgery , Eye Burns/surgery , Ophthalmologic Surgical Procedures/methods , Pemphigoid, Benign Mucous Membrane/surgery , Pterygium/surgery , Conjunctiva/transplantation , Conjunctival Neoplasms/pathology , Eye Burns/pathology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pemphigoid, Benign Mucous Membrane/pathology , Prospective Studies , Pterygium/pathology , Recurrence , Transplantation, Autologous , Treatment OutcomeABSTRACT
Dry eye syndrome remains a constant health problem while more and more patients are being involved and final data concerning the etiopathology is still missing. This study investigates the hypothesis that ocular surgery inflicts damage on the tear production (regarding quantity, quality or the compositional aspect). Ocular symptoms were registered with the help of a questionnaire. Lacrimal tests were applied before and after surgery at 6 weeks. Basic and reflex tear secretion was differentiated through Schirmer tests and tear quality was assessed with BUT. Proteomic analysis (global proteins, electrophoresis) and conjunctival biopsy was realized before surgery. Open eye surgery altered tear secretion in 91% of the 22 patients examined.
Subject(s)
Dry Eye Syndromes/etiology , Ophthalmologic Surgical Procedures/adverse effects , Tears/metabolism , Aged , Dry Eye Syndromes/epidemiology , Dry Eye Syndromes/pathology , Dry Eye Syndromes/physiopathology , Eye Diseases/surgery , Female , Humans , Lacrimal Apparatus/injuries , Lacrimal Apparatus/physiopathology , Postoperative Period , Preoperative Care , Prospective Studies , Surveys and QuestionnairesABSTRACT
Retinal angiomas represent a rare condition consisting of hamartomas isolated or associated with a systemic disease (Von Hippel-Lindau Disease). We present a patient with multiple retinal angiomas, with atypical fluorescein angiography possible due to vascular thrombotic phenomena. Visual acuity was slightly diminished because of hemorrhagic complications. Systemic involvement was excluded with imaging studies.
Subject(s)
Angiomatosis/diagnosis , Fluorescein Angiography , Retinal Diseases/diagnosis , von Hippel-Lindau Disease/complications , Angiomatosis/diagnostic imaging , Angiomatosis/etiology , Diagnosis, Differential , Female , Fluorescein Angiography/methods , Humans , Middle Aged , Radiography , Retinal Diseases/diagnostic imaging , Retinal Diseases/etiology , Vision Disorders/etiology , Visual Acuity , von Hippel-Lindau Disease/diagnosis , von Hippel-Lindau Disease/diagnostic imagingABSTRACT
We present the case of a patient with an uncommon diagnosis in ophthalmologic practice. Clinical exam and complex investigations, including ocular echography and Doppler established the diagnosis of non-Hodgkin orbital and parotid lymphoma. With specific therapy (cytostatics) the evolution has been favorable.
Subject(s)
Lymphoma, Non-Hodgkin/diagnosis , Neoplasms, Second Primary/diagnosis , Orbital Neoplasms/diagnosis , Parotid Neoplasms/diagnosis , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Diagnosis, Differential , Female , Glucocorticoids/therapeutic use , Humans , Lymphoma, Non-Hodgkin/drug therapy , Middle Aged , Neoplasms, Second Primary/drug therapy , Orbital Neoplasms/drug therapy , Parotid Neoplasms/drug therapy , Treatment OutcomeABSTRACT
Acute multifocal placoid pigment epitheliopathy is a fairly rare disease with unknown etiology and pathogenesis, possibly a focal response to a systemic inflammatory process. We present the case of a young patient who developed bilateral placoid retinal lesions, in different stages of evolution - cicatriceal lesions of the right eye and mixed cicatriceal and active lesions of the left eye. Investigations showed old immunity to cytomegalovirus and toxoplasma. Fluorescein angiography showed the typical fluorescein pattern (hypoflurecence in early phases and hyperfluorescence in late phases). The case is unique because of the atypical findings: choroidal neovascularization in the left eye (rarely occurs in acute multifocal placoid pigment epitheliopathy but more commonly in serpiginous choroidopathy), recurrences, asymmetry between the two eyes (at the time of investigations visual acuity is markedly depressed in the right eye - 1/10 and the left macula is threatened by the choroidal neovascularization).
Subject(s)
Chorioretinitis/pathology , Pigment Epithelium of Eye , Acute Disease , Adult , Chorioretinitis/diagnosis , Chorioretinitis/drug therapy , Fluorescein Angiography , Glucocorticoids/therapeutic use , Humans , Male , Treatment OutcomeABSTRACT
PURPOSE: The purpose of this issue is to create an experimental animal model of dry eye and study the alteration of lachrymal secretion in time. MATERIALS AND METHODS: We used a group of 8 rabbits in which the Meibomian gland orifices of the right eye were individually closed by cauterization, the results being related to the sound left eye. RESULTS: We studied: the quantitative alteration of the lachrymal secretion using Schirmer 1 test; the alteration of lachrymal film using rose-bengal and fluorescein staining; the variation in tear protein concentration and histopathological changes in conjunctiva. CONCLUSIONS: We found histopathological changes in conjunctiva and in the lachrymal secretion consisting in conjunctival goblet-ceil density decrease and watery secretion increase, probably due to lachrymal viscosity decrease mechanism.
Subject(s)
Dry Eye Syndromes/metabolism , Meibomian Glands/metabolism , Tears/metabolism , Animals , Conjunctiva/metabolism , Conjunctiva/pathology , Disease Models, Animal , Dry Eye Syndromes/diagnosis , Female , Fluorescein , Fluorescent Dyes , Fluorophotometry , Lacrimal Apparatus/metabolism , Meibomian Glands/pathology , Rabbits , Reproducibility of Results , Sensitivity and Specificity , Tears/chemistry , Time FactorsABSTRACT
Choroidal hemangiomas are benign vascular hamartomas developed from birth, but undetected until the 4th and 5th decade. They have been seldom described in association with epiretinal membranes. Here we present a patient with associated pathology choroidal hemangioma with atypical fluorescein angiography pattern, undetected on ocular echography hence the difficulties in establishing a positive diagnosis and epiretinal membrane observed both clinically and on fluorescein angiography. Visual acuity is impaired by cystoid macular edema, with a complicated pathogenetic mechanism.
Subject(s)
Choroid Neoplasms/complications , Epiretinal Membrane/complications , Hemangioma/complications , Macular Edema/etiology , Choroid Neoplasms/diagnosis , Choroid Neoplasms/surgery , Diagnosis, Differential , Epiretinal Membrane/diagnosis , Epiretinal Membrane/surgery , Fluorescein Angiography , Hemangioma/diagnosis , Hemangioma/surgery , Humans , Laser Therapy , Macular Edema/diagnosis , Macular Edema/surgery , Male , Middle Aged , Treatment OutcomeABSTRACT
Optic nerve head drusen represents a frequent condition, with unknown pathogenesis, mostly asymptomatic. Here, we present a patient with visual impairment, who has reacted well to anti-inflammatory and vasodilator treatment.
