The clinico-morphologic foundation of the modern pathogenetically oriented surgery of hydrophthalmos simplex

On materials of 45 biopsies dissected at the time of antiglaucomatous operations and 10 eyes of newborns, a detailed morphologic analysis of the state of the drainage apparatus of the in norm and at relatively early stages of hydrophthalmos simplex is presented, and considering results of clinical investigations (105 eyes, of them 45 eyes mentioned) a foundation of modern surgery of congenital glaucoma is given. It is shown that the basis of congenital pathology of retinocorneal angle is disturbance of anatomotopographic relationships of its structures as well as expressed trabeculodysgenesis and dysgenesis of scleral sinus. The paper describes three main variants of combinations of pathologic changes in the drainage apparatus, characterized by a common gonioscopic picture and reflecting the degree of severity of congenital pathology (3 degrees of goniodysgenesis). It is noted that the presence of a coarse congenital pathology of trabecular plexus in hydrophthalmus, incompatible with the possibility of its functioning, and at the same time a satisfactory enough state of the "scleral sinus-emissary" link allow to consider the basic element of surgical reconstruction of anterior outflow passage to be trabeculotomy from outside. Indications in the choice of adequate surgical intervention and its volume are shown (the degree of goniodysgenesis and the state of functional preservation of scleral sinus and emissaries). The approved, within 15 years, system of operations in case of hydrophthalmos simplex and their results are presented.     

The results of panphotocoagulation laser treatment in retinopathy of prematurity in the West Pomeranian Region in 2003-2005 years

PURPOSE: ROP--retinopathy of prematurity is a disease of the retina and the vitreous body of premature infants, especially born before 28 weeks of intrauterine life (71%), rare till 33 weeks of pregnancy (7.6%). The pathogenesis is involved with damage of immature vessels of the retina. The disease seems to self-regress in 80%. According to stage of changes of the retina there could be some complications of the organ of vision like: refractive errors, disturbances of eyeball movement, poor vision or even blindness (19.01%). ROP is now second (after atrophy of the optic nerve) cause of blindness in children (3). Aim of our study was the analysis of the results of laser-treatment in ROP in West Pomeranian region in years 2003-2005 and estimation of the risk factors of advanced stages of ROP. MATERIAL AND METHODS: Since January 2003 to June 2005 in Outpatients Clinic for Premature Infants of the Ophthalmology Department of The West Pomeranian Medical University in Szczecin we have examined 708 children. 40 premature infants (78 eyes) were treated with panphotocoagulation of the retina because of advanced ROP We have used the Ocu-Lights SL laser, manufactured by Iris Medical. RESULTS: Laser treatment caused regression of ROP in 88.5% of children. In 11.5% the progression of ROP caused secondary retina detachment. CONCLUSIONS: Respiratory failure, anemia, infections and multi-organ inflammations increase the risk of ROP Good results of laser treatment depend of beginning of the therapy in the right stage of ROP On the final results of treatment could have got the influence both: immaturity of the child and the showed risk of factors.     

泪腺上皮性肿瘤α-1抗胰蛋白酶的免疫组化研究

应用α－１抗胰蛋白酶多克隆抗体对１０例多形性腺瘤和１０例腺样囊腺癌进行原位免疫标记研究。结果表明，１０例多形性腺瘤均呈阳性反应；１０例腺样囊腺癌中，７例呈阴性反应，３例阳性反应。但腺样囊腺癌的阳性反应程度明显低于多形性腺瘤。说明泪腺腺样囊腺癌的蛋白酶抑制物活性明显降低是该肿瘤具有较强的组织浸润力的原因之一。而且，α－１抗胰蛋白酶的免疫组化测定有助于泪腺上皮性肿瘤的良、恶性判断。     

A new pyrimidine-series preparation in the treatment of experimental chemical eye burns

The effectiveness of a substance of a group of pyrimidine derivatives LUS-3 has been studied in 87 rabbits (174 eyes) with chemical burns of the cornea of degree III. In parallel series of experiments, its action was compared with one of traditional methods of treatment of eye burns using sodium sulfacetamide in combination with subconjunctival injections of autologous blood with penicillin as well as with a pyrimidine derivative--methyluracil. The assessment of the effectiveness of the preparations was made by the picture of the clinical course as well as by data of histologic investigations. The results obtained have shown a pronounced effectiveness of the preparation LUS-3: it accelerated regenerative processes, prevented development of secondary infection, and, as a result, conditioned formation of low-intensive opacifications of the cornea.     

Radiation pathomorphosis of malignant melanoma of the uveal tract of the human eye

The paper describes peculiarities of changes in uveal melanomas after beta application. It is shown that the degree of changes depends on the intensity of action, the cellular type of the tumor and the degree of its pigmentation. The most radiosensitive proved to be spindle cell B, mixed and epithelioid melanomas. Less radiosensitive are pigmented tumourous cells. The most intensive postradiation changes, were characterized by development of long-term existence of coagulation necrosis, growing of cellular polymorphism, hyperploidy, polynucleosis, appearance of apoptosis. The study of the reaction of monolayer culture of uveal melanomas on beta application has confirmed different radiosensitivity of melanoma cells of a different kind as well as has revealed that the growing of cellular polymorphism is a morphologic manifestation of a postradiation degeneration. The degree of postradiation changes correlated with the duration of monolayer culture of the tumor.     

An ellipsoidal trajectory model for measuring the line of sight

The relationship between the amount of rotation of the eyeball and the amount of rotation of the line of sight was investigated. The planar model and ellipsoidal model were compared as the trajectory of the center of the pupil. An evaluation of precision was carried out by measuring the discrepancy between the direction of the target and the estimated direction of the line of sight. The experimental results showed that the planar model was more precise than the ellipsoidal model. The center of rotation of the eyeball seems to translate along the oblique rotation of the eyeball.     

深圳市放射作业人员晶状体浑浊情况调查

目的调查分析深圳市医疗行业放射作业人员晶状体浑浊情况,为保护放射作业人员的健康提供依据。方法按国家卫生部颁发的《职业健康监护技术规范》对1060例深圳市医疗单位放射作业人员进行职业健康检查,并选用非放射岗位的医务工作者316例作为对照。结果放射作业人员晶状体浑浊率与工龄、年龄呈正相关关系。核医学放射人员晶状体浑浊率较其他工种高。放射作业人员晶状体浑浊率较低。结论放射性晶状体损伤与接触放射线时间的长短、工种及防护条件有关。     

Treatment of disturbances in the stability of pre-ocular tear film

Discussed are the methods of treatment of the disturbances of stability of the pre-ocular tear film and the compounds which are used. In spite of introduction of a considerable amount of new pharmaceutics in the last period the treatment of disturbances of this kind needs a large amount of patience as well from the side of the patient as from the ophthalmic specialist.     

Diagnostic difficulties in cases of opticochiasmatic arachnoiditis

Clinical signs and the methods of radiological diagnosis in optochiasmatic arachnoiditis are discussed. Difficulties in the interpretation of results of examinations may stem from the physiological fluctuations of the size and the form of the region and the situation of the chiasma and also from an insufficient precision of orientation of the tomographical cross-section. In spite of coordination of the angiography of carotis artery, of pneumocysternoencephalography and computer tomography one may receive faulty negative results. Presentation by means of a magnetic resonance seems to open quite new perspectives.     

Human capsule epithelial cell degeneration A LM,SEM and TEM Investigation

The degeneration of the capsule epithelium of cataractous lenses has been studied with LM, SEM en TEM with emphases on TEM. The observed degeneration of the epithelial cells can be described as follows: The cell nucleus becomes picnotic and desintegrates as result of change of the chromatin. Degeneration of the cytoplasm starts with swelling of the mitochondria, coming into existence of filamentous networks and balloon-like bulges of the nucleus. Repelling of the cell nucleus due to a porosity of the plasm membrane. Collapse of the cell due to degeneration of the cell and loss of the cytoplasmic contents, leaving finally only a swollen framework of cell walls.     

Characteristics of the immune status of patients with uveal melanoma during the performance of organ-preserving treatment

The paper presents data about changes in the immune status of patients with uveal melanoma in the process of organ-preserving treatment. The presence of 2 types of reaction on the treatment are shown. They are characterized by intensification or depression of the cellular immunity, in particular of its T-cellular link. The type of reaction depends on the initial state of the immune reactivity of the body, the size of the tumor and the type of the injurious factor. The increase of immune reactivity correlates with the best clinical outcomes of the treatment. This allows to use the determination of the immune status in prognosticating the outcome of treatment.     

Retinal vein occlusion. III. Initial experience with therapy of retinal vein occlusion with an argon laser]

The authors report the results of laser treatment in 11 patients with chronic oedema of the macula and 6 patients with neovascularizations of the retina and disk of the optic nerve in occlusion of a branch of the retinal vein. In the treatment of chronic oedema of the macula they used their own modification of quadrant barrage suggested by L'Esperance and grid photocoagulation. After a mean follow up period of 3.2 years they achieved a resulting vision of 6/12 or better in 9 of 11 patients, i.e. in 82%, the poorest results were 6/18 in two patients of 11, i.e. in 18%. In the treatment of neovascularizations they used the method of sector photocoagulation. In all six patients, i.e. in 100% they observed regression of neovascularizations. During 2.5-3 years after photocoagulation they did not observe a relapse of neovascularization or haemorrhage into the vitreous body. The results of photocoagulation treatment in chronic oedema of the macula and treatment of neovascularization are of a long-term character.     

The biomechanical properties of the crystalline lens capsule in emmetropia and myopia

Morphometric and electronmicroscopic studies of the capsule of a clear lens depending on the degree of myopia and age as compared with the capsule of a clear lens in emmetropia and myopia have shown that with age the anterior capsule of a clear lens becomes thicker, while the posterior capsule becomes thinner and increases in length. This is connected with the weakening of accommodation in the presence of different curvature of the anterior and posterior surfaces of the lens on the background of the lowering of the metabolic level in elderly persons. In myopia, with the development of age changes the thickness of the lens capsule remains almost unchanged. The degree of myopia doesn't influence the thickness and the length of the anterior capsule of the lens, while with the rise of myopia the thickness of the posterior capsules increases. No dystrophic changes in the structure of such a capsule in high myopia were revealed. Hypertrophy of the posterior capsule speaks about the increase of its mechanic strength in a clear lens and is connected with the weakness of accommodation. Such a capsule can serve as a support for IOL implants in patients with myopic refraction.     

The principles of the primary surgical treatment of fragmentation eye wounds

On the grounds of the analysis of results after treatment of 280 patients (25 women, 255 men), aged from 9 to 62 years, with fragmentation wounds of the eye a system of primary surgical treatment of such patients is worked out. The analysis of personal investigations carried out on the basis of studying variants of intraocular pathology in penetrating fragmentation injuries of the eye, succession and volume of surgical interventions allowed to work out a tactics of treatment for such patients using primary surgical treatment of the wound. removal of a foreign body, operations of phacoemulsification, phacofragmentation, vitrectomy and operations on the retina depending on the localization of the fragment, the size of the penetrating wound and associated changes in the eye. As a result of primary surgical treatment, foreign bodies were removed in 235 patients, reconstructive interventions were made in 208 patients.     

Investigation of complex and hypercomplex receptive fields of visual cortex of the cat as spatial frequency filters

The stripedness of stimulus moving through complex or hypercomplex receptive field of the visual cortex (VCRF) of the cat defines characteristics of the response of the field. Optimal stimulus for such a field is not the edge or a slit of a definite orientation but rather a complex stimulus consisting of one, two, three or more slits. For any particular RF it is possible to find an optimal stimulus evoking a maximal response. The greater the number of slits in optimal stimulus the narrower are mean widths of slits and corresponding intervals between the slits. The effective area of stimulus is independent of the number of slits in it and is equal, on an average, to 2.6° (in cross-section). In a column made up from neurons of uniform orientation, the RFs with optimal stimuli consisting of the different number of slits were found to exist. These data allow VCRFs to be considered as narrow-band filters of spatial frequencies serving to execute piece-wise Fourier analysis of image.The network comprising such neurons is also able to extract the border between textures. The nervous network of this kind can perform the first step in image recognition i.e. the extraction of figure from its background.The comparative characteristics of organization of inhibitory zones of RFs of various levels have been obtained. In RFs of LGB the inhibition of response appears only at simultaneous stimulation of the inhibitory and excitatory zones of the field. In VCRF stimulation of the inhibitory zone is effective after a long time (about some hundred msec) after onset of stimulation of the excitatory zone. In complex VCRFs increase in width of slit, stimulating the inhibitory zone, beyond optimal size results in diminishing the inhibitory effect; this phenomena has not been observed in simple RFs.The functional and the structural models of VCRFs have been considered.     

端粒酶相关因素对培养的视网膜色素上皮细胞增生的影响

目的探讨端粒酶相关因素对培养的视网膜色素上皮（retinal pigment epithelium，RPE）细胞增生的影响。方法用常规培养法培养人RPE细胞后，分别用端粒酶抑制剂二甲基亚砜、热休克蛋白90抑制剂、无血清培养、端粒酶反义寡核苷酸、P16反义寡核苷酸处理，然后提取细胞mRNA，PCR扩增后电泳检测端粒酶mRNA表达。然后用MTT法检测无血清培养组、端粒酶反义寡核苷酸处理组、P16反义寡核苷酸处理组与常规培养组细胞增生状况。结果二甲基亚砜组、热休克蛋白90抑制剂组、无血清培养组、端粒酶反叉寡核苷酸处理组，端粒酶mRNA表达受到抑制，凝胶分析系统软件分析结果电泳H值分别为80、116、90、81，而P16反义寡核苷酸处理组端粒酶mRNA表达增强，电泳H值为255。常规培养组H值为162，阴性对照组为0，阳性对照组（胃癌细胞）为255。MTT法显示：无血清培养组，端粒酶反义寡核苷酸处理组细胞活性下降，细胞生长抑制率上升。而P16反义寡核苷酸处理组细胞活性上升，细胞生长抑制率下降。结论端粒酶抑制剂二甲基亚砜、热休克蛋白90抑制剂、无血清培养、端粒酶反义寡核苷酸可抑制RPE细胞端粒酶mRNA表达，从而抑制RPE细胞增生；P16反义寡核苷酸可促进RPE细胞端粒酶mRNA表达，从而促进RPE细胞增生。     

A method for determining peroperative centering and monitoring the development of postoperative decentration of intraocular lenses]

After implantation of intraocular lenses (IOL) Purkinje images 3 and 4 (Pi3 and Pi4) are clearer on the anterior and posterior surface of its optical part (subsequently only lens). Along with the corneal Pil this phenomenon was already used in clinical work for more accurate calculations of the degree of decentration and tilt of the lens in the eye. The authors describe a simplified method for assessment of the position of the lens by means of Pil, 3 and 4, using apparatuses with an approximately coaxial light. The method uses overlapping of Pi1, 3 and 4 in perfect centering of the lens in the axis of the eye (it is assessed by drawing a perpendicular line on the centre of the cornea) and marked dislocation of Pi3 in the direction of decentration of the planoconvex lens with the convexity facing the cornea. The inclination of the lens must be eliminated according to positions Pi1 and Pi4. The method is suitable for peroperative centering and for assessment of the direction and extent of decentration of these lenses. The authors discuss the possible use of this method also in biconvex and planoconvex lenses with the convexity facing the retina. In a group of 10 implanted planoconvex lenses the authors demonstrate the possibility of perfect peroperative centring of the lens and other applications of the method. Incorrect position of the IOL at the end of the operation, which can be one of the factors of later complications, did not change during the early postoperative period.     

Immunoreactive disorders and their correction in patients with rhegmatogenous retinal detachment complicated by vitreoretinal proliferation

Examination of the immunologic state of 73 patients with rhegmatogenous retinal detachment complicated by vitreoretinal proliferation has revealed correlation between the severity of the latter and disturbances in the immune state of the patient's body. 44% of patients with the stage C and 62% of patients with the stage D have immunodeficiency expressed by reduced level of T- and B-lymphocytes and their subpopulation. It is shown that disturbances in immunoreactivity can serve as an unfavourable sign for prognosis of effectiveness of surgical intervention in patients with rhegmatogenous retinal detachment. In 70% of the patients these disturbances lead to unfavourable outcome of the operation. For normalization of the revealed disturbances in the immune state, immunomodulator thymaline was used in a complex treatment of 17 patients. The preparation rose the effectiveness of the treatment in 78% of patients and reduced the number of postoperative complications. It is recommended to study the immunologic state of the patient with rhegmatogenous retinal detachment complicated by vitreoretinal proliferation for the purpose of its further correction and a higher effectiveness of surgical treatment of such patients.     

AN OPTOMETRIC TREATMENT OF STRABISMUS

ABSTRACT: Calder Gillie (1958) suggested that certain cases of strabismus may be due to an abnormal pattern of appreciation of physiological diplopia. From this proposal a system of treatment of some cases of strabismus has been developed which is ideally suited to private optometric practice. This system is utilised in some of the orthoptic clinics of the London Refraction Hospital. Members of the Refraction Hospital staff have made major contributions to the development of the system described and have been instrumental in bringing the system to members of the optometric profession. Simple home and consulting room tasks involving the use of coloured strings, knitting needles, lights and pages from magazines are used as a means of making the patient aware of the normal physiological diplopia pattern. The importance of the cover test as a means of diagnosing and assessing progress in the treatment of squint is considered. Refractive correction and over-and-under correction as ‘tools’ in the treatment of squint are considered. A review of the results obtained in the treatment of 105 squinters in a private practice is mentioned.     

近距隐斜视与屈光不正的关系研究

目的 探讨近距隐斜视的发生、类型与屈光不正的关系.方法 连续收集近距隐斜视患者267例,男145例,女122例,年龄(8.05+5.0)岁(3～44岁),分别进行近距隐斜视检测,静态检影.结果 正视者63例,其中发生近距外隐斜60例,近距内隐斜3例,近距外隐斜所占比重明显高于内隐斜(P=0.000).近距内隐斜47例,其屈光状态构成分别为正视和近视各3例,远视41例;近距外隐斜220例,其屈光状态构成分别为正视60例,近视64例,远视96例,经卡方检验,近距隐斜视类型与屈光状态有关(X2=29.47,P=0.000).就137例远视患者而言,发牛近距内隐斜41例,其不同程度屈光构成分别为轻度远视12例,中度远视18例,重度远视11例;发生近距外隐斜96例,其不同程度屈光构成分别为轻度远视56例,中度远视27例,重度远视13例,经卡方检验,对远视患者而言,近距隐斜视类型与远视的程度有关(X2=16.61,P=0.000),近距内隐斜多发生于中度远视,而近距外隐斜多发生于轻度远视.结论 近距隐斜视类型与屈光状态相关,其中近距内隐斜主要为远视眼未经屈光矫正引致;一定范嗣内的近距外隐斜可能是一种,圭理性眼位,而近距内隐斜则可能是一种病理性眼位,并与近视的发生发展相关.