Combined cataract surgery on a Marfan-syndrome patient (case report).

Combined cataract surgery of an ectopic lens was performed on a 10 years old girl with Marfan-syndrome. A Cionni capsular tension ring was implanted into the capsular bag, and the bag was pulled to its place and fixed with a scleral suture. Because of the young age of the patient a primary posterior capsulorhexis was performed, through which anterior vitrectomy was carried out and the artificial lens was implanted into the capsular bag. In the literature several surgical solutions are advised for the treatment of the ectopic lens in patients with Marfan-syndrome. We have performed a successful surgery combined with posterior capsulorhexis in our case. Because of its rarity and special surgical solution, we think this case report is interesting and can be helpful in such cases to be published.

PACAP improves functional outcome in excitotoxic retinal lesion: an electroretinographic study.

Pituitary adenylate cyclase-activating polypeptide (PACAP) and its receptors occur throughout the nervous system, including the retina. PACAP exerts diverse actions in the eye: it influences ocular blood flow, contraction of the ciliary muscle, and has retinoprotective effects. This has been proven in different models of retinal degeneration. The in vivo protective effects of PACAP have been shown in retinal degeneration induced by kainic acid, optic nerve transection and ischemia. We have previously shown by morphological, morphometrical and immunohistochemical analyses that intravitreal PACAP administration protects against monosodium glutamate (MSG)-induced damage in neonatal rats. The question was raised whether these apparent morphological improvements by PACAP administration also lead to functional amelioration in MSG-induced retinal damage. The aim of the present study was to investigate the functional consequences of MSG treatment and the subsequent PACAP administration using electroretinographic measurements. The histological and morphometrical analyses supported the earlier findings that PACAP protected the retina in MSG-induced excitotoxicity. ERG recordings revealed a marked decrease in both the b- and a-wave values, reflecting the function of the inner retinal layers and the photoreceptors, respectively. In retinas receiving intravitreal PACAP treatment, these values were significantly increased. Thus, the functional outcome, although not parallel with the morphology, was significantly improved after PACAP treatment. The present observations are important from the clinical point of view showing, for the first time, that PACAP treatment is able to improve the functional properties of the retina in excitotoxic damage.

Association of apolipoprotein E polymorphism with age-related macular degeneration and Alzheimer's disease in south-western Hungary.

BACKGROUND: Age-related macular degeneration (AMD) and Alzheimer dementia (AD) show similarities (advanced age, formation of deposits of similar content). Recently apolipoprotein E 2 (apoE 2) has been associated with AMD, while apoE4 with AD. The question of coexistence, especially with respect to the genetic background has not been studied earlier. We investigated, therefore, the occurrence of AMD in AD patients and compared their lipid profile and apoE polymorphism. METHODS: - 49 AMD, 32 AD and 27 control patients were examined (risk factors, visual acuity, slit lamp biomicroscopy, fundoscopy). Following measurement of triglyceride, total and HDL cholesterol levels, apoE mutation analysis was performed. RESULTS: AMD was found in 8% of the cooperating AD patients. The prevalence of the apoE 4 isoforms in the AMD, AD and the control patients was 2%, 47% and 22%, while that of apoE 2 was 17%, 6% and 7%, respectively. The prevalence of apoE 3 isoform was 82%, 41% and 71%, respectively. Triglyceride, total and HDL cholesterol were in the reference range; however, AD patients were characterized by a lower total cholesterol value. CONCLUSION: The new finding of this publication is the rare occurrence of AMD among AD patients. The higher frequency of apoE 4 among the AD population, and the higher frequency of apoE 2 among AMD patients in the South-Western region of Hungary confirms the findings of other investigators.

[Transpupillary thermotherapy for choroidal metastases]. / Chorioidealis metastasisok transpupillaris termoterápiája.

PURPOSE: To present three cases with choroidal metastases treated with transpupillary thermotherapy (TTT). PATIENTS AND METHODS: Five choroidal metastases of three patients were treated with infrared laser thermotherapy (TTT). In all cases the distorted vision, caused by serous retinal detachment joining the posterior pole metastasis, led the patients to an ophthalmologist. In our first case an intraductal breast carcinoma led to bilateral multifocal choroidal metastases. In the second case a squamous cell carcinoma of the hypopharynx caused a rapidly growing choroidal metastasis. The primary tumor of the third patient was urothelial carcinoma. The efficacy of treatment and systemic (general health) outcomes are discussed. RESULTS: Three of the tumors regressed to a flat scar, and led to improved vision after one session of treatment, one tumor needed two sessions of treatment to regress. The metastasis from the squamous cell carcinoma grew very fast and caused an early death not allowing follow-up. CONCLUSIONS: TTT can be a safe therapeutic option for small choroidal metastases. This one-session treatment leads to tumor regression, improves vision and positively affects quality of life of the patient suffering from metastatic cancer.