c-erbB-3 protein expression in ovarian tumours.

In this study the expression of c-erbB-3 protein was investigated in a range of human ovarian tumours using a monoclonal antibody (RTJ1) raised to a synthetic peptide from the cytoplasmic domain of the human c-erbB-3 protein. A total of 73 samples from 71 patients were graded as negative, weak, moderate or strong according to the intensity of immunohistochemical staining observed, and this was related to tumour characteristics and other clinical parameters. In terms of positivity vs negativity, of the 73 samples examined, 62 (85%) showed positive immunohistochemical staining for c-erbB-3. The majority of all ovarian tumours studied were positive for c-erbB-3 regardless of whether they were malignant (89%), borderline (100%) or benign (61%), however the incidence of positivity was significantly less in the benign group than in overtly malignant tumours (P = 0.03). c-erbB-3 positivity was not significantly associated with either age at diagnosis, tumour stage, differentiation, ploidy, percentage in S-phase or post-operative tumour bulk in malignant tumours. In terms of intensity of staining no significant difference was observed either within the common epithelial group or between this group and tumours of a benign nature. A significantly more intense pattern of c-erbB-3 staining was observed in tumours of borderline malignancy when compared with their overtly malignant counterparts (P = 0.002). Patients presenting with early-stage malignant tumours (I/II) were more likely to display intense tumour staining than those with late-stage disease (III/IV) (P = 0.04). These investigations suggest that c-erbB-3 protein is frequently expressed in both benign and malignant ovarian tumours, and that overexpression is more common in borderline and early invasive lesions.

Sport-related eye trauma: a survey of the presentation of eye injuries to a casualty clinic and the use of protective eye-wear.

The study investigated the workload offered by sport-related trauma to a busy casualty clinic and was carried out in two parts. The first part concerned compiling information about sport-related injuries presenting in 1 year to the outpatient eye clinic at Bradford Royal Infirmary. The second part attempted to investigate the awareness and the use of eye-protectors for squash by the student community of Bradford University, using a questionnaire. The sport-related injuries presenting to the casualty department were classified according to the sport involved. Analysis of the data shows that racquet sports, namely tennis, badminton and squash, jointly formed the highest percentage of presentations. In the case of squash and tennis injuries, follow-up treatment and/or admission to hospital was required in 100% of cases. These injuries could be reduced by wearing adequate eye-protectors. The questionnaire survey showed that only 9% of the squash players wore eye protection whilst playing, of whom 3.37% of the total had suffered lacerating injuries previously. Comparison with previous studies indicates that the pattern of eye injuries presenting to casualty departments, and the awareness of the general public concerning the use of eye-protectors, has not altered in recent years. Unless steps are taken, in terms either of mandatory use of eye-protectors and/or of educating the general public on the possible devastating effects of injury, these preventable injuries will continue to burden already overworked hospital casualty departments, draining both resources and expertise.

Loss of visual function associated with microalbuminuria in diabetes mellitus: a pilot study.

Visual function loss has been documented in diabetes mellitus in relation to flicker and contrast. However, no direct correlation between the degree of loss in sensitivity and the level of retinopathy has been established. It has been suggested that such non-invasive psychophysical procedures actually reflect metabolic disturbances within the diabetic retina. This study investigates the possibility of whether early nephropathy demonstrated by microalbuminuria, is an indicator of microangiopathy which may be a cause of retinal disturbance leading to a loss of visual function. The visual function of a group of diabetics showing microalbuminuria was studied. Contrast and flicker threshold were measured and the results compared with those obtained with an age-matched control diabetic group. The procedures used effectively separated the two groups and raises the issue of incorporating psychophysics in retinal screening programmes.

Comparing clinical tests of visual function in cataract with the patient's perceived visual disability.

Conventional techniques for assessing the visual function of cataract patients include visual acuity (VA), contrast sensitivity (CS) and glare disability (GD). The extent to which these measurements provide accurate information about a patient's perceived visual disability is not known. In this study, binocular and monocular VA and CS and monocular GD measurements were made using commercially available techniques on 33 cataract patients. VA was measured using a Ferris-Bailey LogMAR chart and CS by the Pelli-Robson letter CS chart. Glare disability was measured using the Mentor Brightness Acuity Tester in conjunction with both the LogMAR and Pelli Robson charts. Each patient's perceived visual disability was quantified using a 20-point questionnaire about the effect of vision on everyday activities. There was little correlation between subjective visual disability and monocular or binocular VA measurements. Measurements of binocular CS, however, were highly correlated with the patient's perceived visual disability, particularly their subjective assessment of the effect of vision on their mobility-orientation. We suggest that binocular CS measurements using the Pelli-Robson chart provide useful additional information regarding the need for surgery in cataract patients.

Do intraocular lenses with ultraviolet absorbing chromophores protect against macular oedema?

In a prospective study, designed to test the effect of intraocular lenses containing an ultraviolet absorbing chromophore on the incidence of post-operative cystoid macular oedema, 55 patients undergoing extracapsular cataract extraction were randomly allocated to receive intraocular lenses with or without an ultra-violet absorbing chromophore. Post-operative fluorescein angiography showed no difference in the incidence of macular oedema in those patients receiving an intraocular lens with an ultraviolet absorbing chromophore compared with patients receiving a standard posterior chamber intraocular lens.

Causes of blindness and partial sight in the Bradford Metropolitan District from 1980 to 1985.

A retrospective review of the BD8 forms submitted for the period 1980-85 in the Bradford Metropolitan District was conducted to ascertain the incidence and causes of blindness and partial sight. A total of 1485 cases were registered in this period of which 755 (50%) were included in the Blind register and 730 (49.2%) in the Partially Sighted register. Age-related macular degeneration was the most important cause of visual handicap, accounting for 43.9% of all registrations, followed by glaucoma (16.2%), diabetic retinopathy (6.3%), myopic degeneration (6.1%), optic atrophy (4.4%), cerebrovascular disease (3.8%), cataracts (3.6%), retinal vascular occlusive disease (3.2%), corneal opacities (3.0%), congenital anomalies (2.7%), retinitis pigmentosa/tapeto-retinal degeneration (1.9%), retinal detachment (1.8%) and others (3.1%). The ratio of female to male registrations was 1.8:1. Eighty-four per cent of this sample population was above the age of 60 years at the time of registration.

The subjective assessment of cataract.

The medical treatment of cataract now appears to be a distinct possibility. A number of anti-cataract formulations are being clinically tested, and more clinical trials are being planned. To obtain a true assessment of a drug's efficacy, a battery of tests are needed which can accurately assess cataract progress. A clinical trial of the proposed anti-cataract drug Bendalina is being conducted. The six subjective methods used to assess cataract progression in the trial are presented. These are refractive error, LogMAR visual acuity, contrast sensitivity, glare sensitivity, retinal visual acuity and displacement threshold hyperacuity. The reasons for using each technique and their method of measurement is explained.

Contrast sensitivity and pattern ERG in Waldenstrom's macroglobulinaemia.

Patients with Waldenstrom's macroglobulinaemia (WM) and age matched controls have been examined using tests of contrast sensitivity and pattern electroretinography. The patients with WM were in remission on maintenance treatment and had only moderately elevated plasma viscosity. They showed evidence of abnormal contrast sensitivity but there was no significant difference in amplitude of the pattern ERG between patients and controls.

Psychophysical measurement of the foveal avascular zone.

The size of the foveal avascular zone (FAZ) reflects the condition of the microcapillary circulation in the foveal area. A number of studies have shown a significant increase in FAZ size in conditions of vascular pathology including diabetes. A non-invasive method of estimating FAZ size may be a valuable addition to a psychophysical test battery. We used a blue-light field to reveal the activity of the retinal leucocytes to two groups of normal subjects with average ages 24 and 61 years. Two methods were used to estimate the FAZ size, making use of the fact that subjects could see their own FAZ as the area free of leucocyte activity. The first method required subjects to indicate when leucocyte activity stopped as the field size was decreased and when it reappeared as field size was increased. The second required subjects to match the size of the leucocyte-free area with a white circle superimposed on the field. A search algorithm was used to change circle size according to subjects' responses. Results show a significant difference in FAZ size between the two age groups with both methods of measurement, and estimates were comparable to those reported using angiographic methods.

Visual performance in pseudophakia with standard and ultraviolet-absorbing intraocular lenses: a preliminary report.

There is currently considerably interest in the vulnerability of the pseudophakic eye ultraviolet light. Contrast sensitivity was measured in patients receiving UV-absorbing and standard posterior chamber intraocular lenses (IOLs) and in normal age-matched observers. The results suggest that in the relative short-term there is no difference in visual performance with either type of IOL. Modulation Transfer Function studies on 3 batches of IOLs (2 standard and 1 UV-absorbing) showed slight variations in optical performance within and between batches. Spectral sensitivity testing demonstrated increased macular protection from short wave-length blue light by the crystalline lens when compared with both types of IOL.

Contrast sensitivity in pseudophakia and aphakia.

Contrast sensitivity was measured in pseudophakic and aphakic patients. No difference could be demonstrated between the contrast sensitivities of patients with anterior chamber/iris-supported and posterior chamber intraocular lenses (IOLs). Little difference was found between pseudophakics and aphakics. Interocular contrast ratios in five pseudophakic patients with normal fellow eyes revealed a range of contrast attenuation characteristics which may be attributed to the IOL and corneal and posterior capsule transmission.

Recovery of contrast sensitivity following bilateral orbital decompression: a case report.

Contrast sensitivity (CS) was measured in a patient with bilateral optic nerve compression resulting from thyroid ophthalmopathy. Initially both right and left contrast sensitivity functions (CSF's) were markedly attenuated over the spatial frequency range measured. CS improved significantly after surgical decompression although distance visual acuities remained unchanged during most of the period of observation. Sensitivity to medium- and high-spatial frequencies remained attenuated compared to the level achieved by a normal group of subjects of a similar age decade.