[High-energy ocular trauma and changes in vision: a reason for a careful search for an intraocular foreign body]. / Hoogenergetisch oogletsel en visusveranderingen: reden voor nauwkeurig onderzoek naar een intraoculair corpus alienum.

A 50-year-old man visited his family physician one day after he had felt something entering his left eye following the blow of a metal hammer on metal, after which he began to see black spots. After the eye had been occluded for 4 days, his visual acuity had decreased to 0.1. Ophthalmologic examination revealed a defect in the cornea and iris, a foreign body in the vitreous and local cataract. Following surgical removal of the metal splinter and the lens, the visual acuity was restored to 0.8. Implantation of an artificial lens was planned. Ocular trauma is a major cause of permanent visual loss or blindness in (young) adults in the western world. Traumas in which a foreign body is propelled into the eye with high energy are most likely to penetrate the sclera. Damage and complications due to intraocular foreign bodies may lead to loss ofvision. The entry site of an intraocular foreign body may be difficult to find and the diagnosis may be missed. Therefore, an ophthalmologist should be consulted in case of a high-energy trauma in combination with visual loss.

Formation of proliferative vitreoretinopathy in primary rhegmatogenous retinal detachment.

Proliferative vitreoretinopathy (PVR) is the only cause of ultimate failure following retinal detachment surgery. This study aimed to review the rate of postoperative PVR in a series of 186 consecutive patients with primary rhegmatogenous retinal detachments. All 186 detachments were repaired with a scleral buckling procedure combined with cryotherapy. Drainage of subretinal fluid was done at the discretion of the surgeon. The mean follow-up was 12 months. In this series 152 (82%) of primary detachments were repaired succesfully with a single operation. Sixty-eight percent of patients regained 0.3 or better visual acuity, and 3% of patients were left with visual acuity of 1/60 or less. After two or more operations the retina was attached in 96% of the cases. In 12 (6%) eyes PVR was responsible for the initial surgical failure. In 4 cases PVR (grade B and limited C) was present prior to surgery. In 3 cases PVR developed within 2 days postoperatively, in 3 cases after 3-6 weeks and in another 2 cases after 8-10 months. Eight out of 12 (66%) PVR patients had undergone cataract surgery. One PVR case had preoperative intraocular inflammation. An association between the duration of retinal detachment, or drainage of subretinal fluid and the development of PVR could not be demonstrated. In conclusion, the rate of postoperative PVR in primary rhegmatogenous retinal detachments was low. PVR preoperatively present and pseudophakia may be risk factors.

Acute bacterial endophthalmitis after cataract extraction: results of treatment.

In order to evaluate the results, we reviewed all 34 patients treated in our hospital for endophthalmitis after cataract surgery between January 1994 and January 1998. After cultures were taken, all patients received intraocular, subconjunctival and topical vancomycin and ceftazidime. Additionally, twelve patients received the same antibiotics systemically. Besides steroids were administered in all patients. In 79% of the patients the bacterial culture was positive. Coagulase negative Staphylococcus was the most frequently isolated microorganism (48%). After treatment a visual acuity of 0.1 or more was achieved in 62% of the patients. The best final results were achieved in the patients with an initial visual acuity of 1/300 or more, and in the patients from whom a coagulase negative Staphylococcus was isolated.

Axial length as a risk factor to branch retinal vein occlusion.

PURPOSE: To determine whether axial length is a factor in branch retinal vein occlusion. METHODS: Axial length measurements in a group of 24 patients with a unilateral branch retinal vein occlusion were compared with the axial length measurements in a control group. Axial length measurements were taken with an A-scan; affected and unaffected eyes were measured. The control group consisted of 24 individuals who matched the patients in the branch retinal vein occlusion group in age, systemic hypertension status, and diabetes mellitus status. RESULTS: The affected and fellow eye in patients in the branch retinal vein occlusion group did not differ statistically in axial length (P = 0.26). The mean axial length of affected eyes in the branch retinal vein occlusion group was 22.76 +/- 0.92 mm, and the mean axial length of control eyes was 23.36 +/- 1.08 mm. The difference in axial length between the eyes with a branch retinal vein occlusion and the eyes in the control group was statistically significant (P = 0.023). CONCLUSION: The axial length of affected eyes of patients with branch retinal vein occlusion was on average 0.60 mm shorter than that of eyes of matched controls (95% confidence interval, 0.30-0.90 mm). The shorter axial length could be a local risk factor in the pathogenesis of a branch retinal vein occlusion.

Familial congenital grouped pigmentation of the retina.

Congenital grouped pigmentation of the retina is an uncommon disorder characterized by a grouping together of round to oval spots of pigment in one or more quadrants of the retina, except for the macula. Detection is usually coincidental during routine ocular examination. We examined a mother and daughter with bilateral grouped pigmentation of the retina. Visual acuity, visual fields, and results of electrophysiologic examination were normal. Autosomal dominant inheritance with variable expression was likely.

Cellular migration, proliferation, and contraction. An in vitro approach to a clinical problem--proliferative vitreoretinopathy.

Presently used animal models of proliferative vitreoretinopathy reflect only cell proliferation and contraction. We used an in vitro model that measured cell migration, proliferation, and contraction. The following four drugs were assayed on this system: daunomycin, taxol, colchicine, and cytochalasin B. Daunomycin was the most effective drug against cell proliferation and cell migration but had no effect on cell contraction; taxol and colchicine affected all three parameters. Cytochalasin B was the least effective drug tested.

Ornithine decarboxylase activity during formation of experimental epiretinal membranes.

This study demonstrates in a rabbit model of epiretinal membrane formation that retinal-associated ODC activity increases during this pathological process. These changes in retinal-associated ODC activity most likely occur in relationship to the proliferative lesion itself, since the retina consists primarily of nonproliferative tissues. Further knowledge of intraocular polyamine metabolism during epiretinal membrane formation which can result in retinal detachment may lead to the development of an effective pharmacological treatment.