Ultrasound biomicroscopic findings in aniridia.

PURPOSE: To describe the ultrasound biomicroscopic features of eyes with aniridia. DESIGN: Observational case series. METHODS: Nineteen eyes of 10 patients with aniridia (six males and four females) ranging in age from 3 months to 53 years (21.0 +/- 16.4, mean +/- SD), and 50 normal subjects (30 men and 20 women) ranging from 16 to 56 years (31.1 +/- 13.2) were evaluated. Ultrasound biomicroscopic findings were recorded in the 3-, 6-, 9-, and 12-o'clock directions. Adult patients (aged 16 years or older) with aniridia were compared with the age-matched controls. RESULTS: Ultrasound biomicroscopy (UBM) detected extremely tiny irises in all eyes with aniridia. The eyes with aniridia showed significantly smaller values than the controls in ciliary body length (4.49 +/- 0.63 versus 5.79 +/- 0.44 mm, P <.001, unpaired Student t test), ciliary body thickness (0.75 +/- 0.17 versus 1.24 +/- 0.22 mm, P <.001), iris root thickness (0.47 +/- 0.14 versus 0.61 +/- 0.07 mm, P <.001), scleral-ciliary process angle (31.7 +/- 3.26 versus 43.1 +/- 4.48 degree, P <.001), and anterior chamber depth (1.99 +/- 0.43 versus 2.94 +/- 0.34 mm, P <.001). In the aniridia eyes, there was a significantly positive correlation between iris thickness and ciliary body thickness (Pearson r = 0.829, P =.001). CONCLUSION: Ultrasound biomicroscopic imaging demonstrated that not only iris hypoplasia but also ciliary body hypoplasia exist in aniridia. Anterior inclination of the ciliary process was also found, which was thought to be at least partly responsible for the shallow anterior chamber.

High-frequency ultrasonographic imaging in suprachoroidal hemorrhage after filtering surgery.

A 64-year-old woman with glaucoma had suprachoroidal hemorrhage approximately 6 hours after trabeculectomy. High-frequency ultrasonography revealed high reflectivity in the inner space of a kissing choroidal detachment, which facilitated the differential diagnosis of suprachoroidal hemorrhage resulting from serous choroidal detachment. The ciliary process and iris were anteriorly displaced due to the ciliary detachment and forward pressure of the anterior vitreous. On the basis of the diagnosis, transscleral choroidal drainage was performed without delay and the patient's vision was preserved. After surgery, suprachoroidal hemorrhage disappeared clinically, but high-frequency ultrasonography detected persistence of the choroidal detachment in the peripheral area.

Detection of CMV DNA in the aqueous humor of AIDS patients with CMV retinitis by AMPLICOR CMV test.

The present study was performed to detect the cytomegalovirus (CMV) DNA in the aqueous humor from the eyes of acquired immunodeficiency syndrome (AIDS) patients with CMV retinitis. Detection of CMV DNA in the aqueous humor in the eyes with active CMV retinitis was compared with detection of CMV DNA in inactive retinitis. CMV DNA in the aqueous humor was evaluated before and after treatment with intravitreal injection of ganciclovir. CMV DNA in the aqueous humor was measured by AMPLICOR CMV test. Forty-two eyes of 35 AIDS patients were diagnosed ophthalmoscopically as having CMV retinitis that was subclassified as either active or inactive. The active and inactive CMV retinitis cases were distinguished based on clinical evaluations and fundus photographs. The results showed that 37 of the 42 eyes (88.1%) were positive for CMV DNA prior to treatment, while in 29 of these 37 eyes (78.4%), the aqueous humor became CMV DNA-negative after the treatment. Successful treatment with the intravitreal injection of ganciclovir was associated with a reduction in the detection of CMV DNA in the aqueous humor. CMV DNA was not detected in the aqueous humor of patients with quies cent CMV retinitis. In conclusion, the AMPLICOR CMV test was found to be a reliable tool for differentiating active and inactive CMV retinitis, and is useful for helping to select the optimal treatment regimen. The intravitreal injection of ganciclovir is highly effective in reducing detectable CMV DNA in the aqueous humor.

Detection of CMV in plasma and aqueous humor specimens from AIDS patients with CMV retinitis using the amplicor CMV test.

A DNA hybridization test (the Amplicor CMV test) for CMV DNA was used to detect CMV DNA in paired plasma and aqueous humor specimens from 37 AIDS patients with ophthalmoscopically diagnosed CMV retinitis. CMV was detected in 25/37 (67.6%) plasma specimens and in 32/37 (86.5%) aqueous humor specimens. Thus, the Amplicor CMV test using aqueous humor specimens seems to be a useful diagnostic test for CMV retinitis and one that is more sensitive than determination of CMV DNA in plasma specimens.

Up-regulation of Hrk, a regulator of cell death, in retinal ganglion cells of axotomized rat retina.

Hrk, a regulator of cell death, belongs to the family of pro-apoptotic BH3-only proteins and is known to induce apoptosis in nerve tissue. We examined Hrk gene expression to clarify the role of BH3-only proteins in apoptosis of retinal ganglion cells (RGCs) after optic nerve transection in the adult rat. Reverse transcription-polymerase chain reaction showed that Hrk was up-regulated in retina from 12 h after axotomy, and continued to be elevated for 1 week. In situ hybridization histochemistry revealed that Hrk was expressed in a sub-population of axotomized RGCs. These results suggest that Hrk is involved in the induction of apoptosis in RGCs after optic nerve transection.

Measurement of axial length of eyes with incomplete filling of silicone oil in the vitreous cavity using x ray computed tomography.

AIMS: To establish a reliable method for measuring the axial length of the eye with incomplete filling of silicone oil in the vitreous cavity in order to determine the IOL power before executing combined cataract surgery and silicone oil removal. METHODS: 12 eyes of 12 patients undergoing combined cataract extraction and silicone oil removal between October 1998 and June 2000 were entered prospectively into this study. All eyes were examined using an x ray computed tomography (CT) scanner. Each axial length of a silicone oil injected eye was measured on the best CT slice among eyeball cuts, which showed both the insertions of the medial and lateral rectus muscle, the thickest slice of the lens, and the optic nerve. The IOL power for the eyes was determined using the SRK/T formula based on the CT data. The deviation of postoperative refraction from the goal refraction was evaluated for each eye. RESULTS: The CT slices demonstrated that the vitreous cavity was not completely filled with the oil in all of the silicone oil injected eyes. The deviation of postoperative refraction from the goal refraction was less than 1 dioptre (D) error in six of 12 eyes (50%), and was less than 2 D error in nine eyes (75%). In the other three eyes having more than 2 D error, the axial length was 27 mm or more. CONCLUSION: The CT measurement of axial eye length for determining IOL might be a useful method for evaluating silicone oil injected eyes before combined cataract surgery and silicone oil removal.

Thallium-201 SPECT of orbital tumors.

Thallium-201 ((201)Tl) SPECT is utilized as a diagnostic imaging tool for a variety of tumors, such as lung cancer, brain tumors, etc., but there is hardly any literature on this type of imaging in orbital lesions. We examined 22 patients with orbital lesions and unilateral exophthalmos to evaluate the usefulness of (201)Tl-SPECT in the diagnosis of orbital tumors. All 22 cases had a confirmed histopathological diagnosis. The patients underwent (201)Tl-SPECT imaging before therapy. Early images were obtained 15 minutes after the intravenous administration of 74 MBq (201)Tl-chloride, and delayed images were taken 3 hours later. The intensities of (201)Tl accumulation in the early and delayed images were measured. Three out of four patients with cavernous hemangiomas, one of two with neurinomas, all three with pleomorphic adenomas, one with lipoma, and one with dermoid cyst had negative scans, but the other 13 patients all displayed ( 201)Tl accumulation in the area of the tumor. Four malignant lymphomas, two reactive lymphoid hyperplasias, one meningioma, one neurinoma, one adenoid cystic carcinoma and one plasmacytoma showed increased uptake, especially in the early phase. The most intense uptake was seen in the metastic renal cell carcinoma, in both early and delayed phases. We conclude that (201)Tl-SPECT can be useful in predicting the histopathological diagnosis of orbital tumors, especially by comparing the accumulation rate in the early and delayed phases.