[Optic nerve head analysis using the confocal scanning laser ophthalmoscope (CSLO) of big cups versus normal cups]. / Analyse de la tête du nerf optique par microscope confocal à balayage laser (CSLO) de larges excavations papillaires comparée aux normales.

PURPOSE: To comparatively evaluate the optic nerve head (ONH) using the confocal scanning laser ophthalmoscope (CSLO) in normal eye subjects (NE) versus big cup (BC) patients. MATERIALS AND METHODS: A total of 83 NEs (43 subjects) and 44 BC eyes (22 patients) were evaluated in this prospective study. The ONH was imaged using the CSLO (HRT-II; Heidelberg Engineering, Heidelberg, Germany). Disc area, cup area, rim area, rim volume (horizontal integrated rim volume), cup/disc ratio, and cup volume were evaluated. Additionally, cup depth and retinal nerve fiber layer thickness (RNFL th) and csa (RNFL csa) of the ONH were also measured. These ONH parameters were compared between normal subjects and eyes with a big cup. We used the t test for statistical analysis. RESULTS: The mean age was 46 and 44 years in the NE and BC groups, with a sex ratio of 1.26 and 0.69 (p=0.381), respectively. There was a significant difference in disc area (2.07+/-0.38, 2.73+/-0.45, p<0.01), cup area (0.52+/-0.8, 1.26+/-0.3, p<0.01), cup volume (0.14+/-0.14, 0.44+/-0.16, p<0.01), cup/disc ratio (0.24+/-0.1, 0.69+/-0.1, 0.46+/-0.06, p<0.01), Me cup disc (0.24+/-0.1, 0.37+/-0.1, p<0.01), rim volume (0.44+/-0.1, 0.34+/-0.09, p<0.01), rim area (1.56+/-0.27, 1.45+/-0.27, p=0.345), RNFL th (0.28+/-0.05, 0.23+/-0.05, p<0.001) and CSM-0.19+/-0.14,-0.08+/-0.06, p<0.001), RNFL csa (1.43+/-0.25, 1.37+/-0.29, p=0.849) in normal vs big cup eyes, respectively. DISCUSSION: There is correlation between the cup and disc areas. Parameters evaluating the retinal nerve fiber were comparable in the two groups, except the RNFL thickness, which was lower in the BC group. This may be explained by the larger surface of the optic disc in this group. CONCLUSION: HRT parameters might be part of the criteria favoring the physiologic character of big cups.

Immunohistochemical analysis of cellular adhesion molecules (ICAM-1, VCAM-1) and VEGF in fibrovascular membranes of patients with proliferative diabetic retinopathy: preliminary study.

PURPOSE: Diabetic fibrovascular membranes are the main pathological changes of proliferative diabetic retinopathy that can cause serious complications leading to blindness. Since the mechanism of fibrovascular membrane development is still unknown, the aim of our study was to identify potential biomarkers for this pathology. To this end, we analyzed the simultaneous expression of ICAM-1, VCAM-1 and VEGF within tissues of diabetic fibrovascular membranes. PATIENTS AND METHODS: Fibrovascular membranes were taken from nine diabetic patients with proliferative diabetic retinopathy. The fibrovascular membrane specimens were analyzed by immunohistochemistry to determine ICAM-1, VCAM-1 and VEGF expression. Controls were collected on nine normal conjunctivas removed during senile cataract surgery. RESULTS: Coexpression of ICAM-1, VCAM-1 and VEGF was found in most of the diabetic fibrovascular membranes studied. Thus, ICAM-1 was positive in eight of nine membranes (82%), VCAM-1 in seven of nine membranes (78%) and VEGF in all the membranes. CONCLUSIONS: The substantial overexpression of adhesion molecules ICAM-1, VCAM-1 and of VEGF suggests that these molecules might contribute to the development of fibrovascular membranes in patients with proliferative diabetic retinopathy, and that they could constitute suitable markers of this pathology.