A new form of retinopathy associated with myocardial infarction treated with percutaneous coronary intervention.

AIM: To report a new form of retinopathy that was observed in patients who had undergone percutaneous coronary intervention (PCI) following acute myocardial infarction (AMI). METHODS: Serial ophthalmological examinations were conducted in 40 patients who underwent PCI. Thirty patients were diagnosed with AMI, and another 10 had stable angina pectoris. RESULTS: Cotton wool spots developed in 17 (57%) patients from the group with AMI undergoing PCI (n = 30) within 2 months. Of these, 41% (seven patients) also developed superficial haemorrhages. Retinopathy was most prominent 1-2 months after AMI and then tended to become quiescent afterwards, without treatment. CONCLUSION: We have identified a new form of retinopathy in patients with AMI that spontaneously subsides without treatment.

[The difference between right and left eyes in the values obtained with a laser flare-cell meter].

The difference in various values, measured with a laser flare cell meter (FC1000: KOWA), between the right and left eyes was determined in 28 eyes of 14 healthy males, 18 to 23 years of age (group A), and in 60 eyes of 30 out-patients, 6 to 68 years of age (group B). None of the eyes had any ocular pathology except for refractive error. Both groups of eyes were first evaluated without any treatment, and the eyes in group A were measured again after the instillation of mydriatics. The flare, signal, and background values were all statistically higher in the right eye than in the left in all subjects; the difference in the flare value between the two eyes was approximately 1 photon count/millisecond on the average. A regression analysis of the difference of the signal and the background values between the two eyes suggests that variation of the light scattered from behind the iris is responsible for the difference in the flare intensity between the right and the left eyes.

[The effect of viscoelastic substances on postsurgical blood aqueous barrier].

A postsurgical flare was evaluated with a flare-cell meter and the effect of residual viscoelastic substances on the blood aqueous barrier function was studied. The materials consisted of 100 eyes undergoing extracapsular cataract extraction and posterior chamber lens implantation using sodium hyaluronate products (Healon:Pharmacia and Opegan:Santen). The molecular weight is 1.9-3.6 million daltons in Healon and 0.9-1.2 million daltons in Opegan. According to the aqueous warm current on the 1st postoperative day, the eyes were divided into two groups; the poor current group and the normal current group. The poor current group consisted of 13 eyes had static aqueous current, probably due to residual viscoelastic substances from the clinical findings, namely a little pain, foggy general corneal edema and spontaneous recovery of the warm current without specific administrations of antibiotics. Eyes with poor current were recognized in 18% (11/62) among cases with Healon and 5% (2/38) in case with Opegan. Flare values of the poor current group were higher in 7 eyes than the highest of the normal current group on the 1st postoperative day. After the 2nd postoperative day, the median flare value of the poor current group was higher than that of the normal current group. The difference was statistically significant throughout the first week (p less than 0.02). The cell number was also higher in the poor current group on the 1st and 2nd postoperative day (p less than 0.02). These findings suggest that the residual viscoelastic materials may increase the breakdown of blood-aqueous barrier and/or interfere the barrier recovery.

Effects of residual sodium hyaluronate on postsurgical blood-aqueous barrier.

The effects of residual sodium hyaluronate (HA) on the postsurgical blood-aqueous barrier (BAB) function were investigated in 79 posterior chamber lens (PCL)-implanted eyes after both extracapsular cataract extraction and PCL implantation using HA products. The amount of residual HA was classified according to the status of the aqueous warm current on the 1st postoperative day. The eyes with static warm current were classified into the static current group and the other eyes into the normal current group. Aqueous flare intensity and cell number were measured in all eyes daily from the 1st to the 7th postoperative day using the flare-cell meter. Of the 79 eyes, 11 eyes (14%) were classified into the static current group. Flare intensity showed the most marked difference between the two groups on the 1st postoperative day. The difference was statistically significant from the 1st to the 7th postoperative days (P less than 0.05). Cell count was also higher in the static current group throughout the observation period except for the 3rd and 4th postoperative days (P less than 0.05). These findings suggest that residual HA exacerbated the postoperative inflammation and that its effects on the BAB continued for at least a week.

New quantitative method to determine protein concentration and cell number in aqueous in vivo.

We have developed a new quantitative method to determine protein concentration and number of cells in the aqueous in vivo. The principal instruments in the system were a He-Ne laser and a detection system for measuring scattered light intensity. The power of the He-Ne laser was 25 microW and the focused beam diameter was 20 microns. The laser beam was operated by an optical scanner. The sampling window, 0.3 X 0.5 mm, was fixed in the center of the laser path. For the protein concentration measurement, the laser beam was scanned for a length of 0.6 mm vertically, covering the sampling window. To minimize signal contamination by background laser scattering, scattered light intensity produced by aqueous protein (Sp) was calculated as follows. Sp = Si - (S'o + S''o)/2, where Si indicates scattered light intensity when the beam passed in the sampling window and S'o and S''o indicate scattered light intensity when the beam passed above and below the sampling window. For the cell counts, the laser beam (0.25 X 0.6 mm) was scanned over the sampling window and the detected peaks were counted. Each measurement mode took 0.5 seconds. The operation of the instrument and data analysis were performed by a personal computer. In in vitro measurements with human plasma solution in diluting factors ranging from 1/50 to 1/10(4), and bovine serum albumin solution in concentrations ranging from 1 g/100 ml to 1 mg/100 ml, significant linear correlations between the values for concentration and photon counts (/msec) were obtained in each solution (r, ranging from 0.987 to 0.998, P = 0.000). In in vitro experiments with latex particles with diameters of 2.02 or 2.95 microns, significant correlations between the number of detected peaks and latex particles were also obtained. However, as the number of latex particles decreased, the variation in the number of detected peaks was large. In 31 normal young adults, with an average age of 23 years, the average photon count was 4.1 +/- 1.0, which corresponded to 27 mg/100 ml according to the in vitro bovine albumin solution measurement, and there was no definite relation in photon counts between eyes with and without mydriatics. Twenty patients with incipient or immature cataract, whose ages averager 70 years, showed significantly higher average photon counts, 6.2 +/-2.5, than the above young adults.We concluded that this new method of determining protein concentration and cell number in the aqueous enabled us to make a noninvasive and quantitative evaluation of the inflammation in the anterior segment of the eye.(ABSTRACT TRUNCATED AT 400 WORDS)