The results of simulating congenital pathology of the extraocular muscles

The paper describes results after calculating the distribution of tensions in the cornea in case of anomalies in the action and insertion of oculomotor muscles. The calculation was made on the basis of theories of thin coats considering the gradient of corneal thickness. By the results of the calculation, the lines of equal tensions (isochroms) were built, the forms of which is well correlated with clinical results. The calculation has shown that the rounding of one of the angles of interference rhombus and its displacement towards the centre of the picture speak about either a functional deficiency of a muscle inserted into the eye ball in this place or about displacement of the point of its insertion from the limbus along the meridian of its action; displacement of one the angles of interference rhombus from the meridian speaks about displacement of the point of efforts exertion of the corresponding muscle into the same direction. The calculation made confirms correctness of our knowledge about the nature and properties of interference pictures observed on the cornea in a polarised light.     

Changes in gas metabolism in the anterior chamber during the treatment of experimental uveitis

Examined was the dependence of the pH of the aqueous, the oxygen pressure pO2, the pressure of CO2, the content of bicarbonate ions--HCO3- and the balance of energy--from the intensity of uveitis provoked experimentally in rabbits by application of 5 mg of albumin fraction of the cattle protein treated by topical cortisone. It seems that the physicochemical indexes and the energy balance may be an essential source of information of the intensity and character of the process of uveitis. Their normalization proceeds together with the improvement of the clinical condition of the examined eyes.     

The effect of trental and actovegin on the organs of vision when administered into the end periorbital branches of the ophthalmic artery (experimental research)]

Specific features of the delivery and the possible side affects of intraarterial infusions of trental and actovegin on the retina, vessels, and the optic nerve in administration of these drugs into the peripheral periorbital branches of the orbital artery were under study. Contrast angiography and fluorescent angiography have confirmed in all the cases the correctness of the catheter position and its functional competence, as well as the possibility of rapidly creating the necessary concentration of the drugs in the retinal and choroidal vessels for a sufficiently long time. Electroretinogram recording before and after intraarterial infusions of the before drugs has demonstrated the functional intactness of the retina, and morphologic studies have shown the absence of any injurious effect of the drug on the organ of vision in such a method of administration. Results of experimental trials permit recommending starting the clinical trials of the intraarterial infusion of trental and actovegin into the periorbital branches of the orbital artery.     

Posterior commissural connections of area pretectalis and neighboring structures in cat, with special reference to pupilloconstrictory pathway via posterior commissure

The overall distribution of posterior commissural connections of the area pretectalis and the neighboring structures was studied in the cat, by the methods of anterograde fiber degeneration and retrograde axonal transport of horseradish peroxidase (HRP). After a localized lesion was made within the posterior commissure, dense degenerated terminals were distributed in the most rostral part of the nucleus pretectalis posterior, the nucleus of posterior commissure, the interstitial nucleus of Cajal, and the central tegmental field. A medium amount of degenerated terminals were observed in the nucleus pretectalis anterior (pars reticularis), the dorsal part of the periaqueductal grey at its most rostral levels, the caudolateral parts of the nucleus pretectalis posterior and the nucleus of optic tract, the H field of Forel, parts of the somatic cell columns of the oculomotor nucleus and the trochlear nucleus. A small amount of degenerated terminals were seen in the ventromedial part of the caudal periaqueductal grey, the ventral lateral geniculate nucleus and the zona incerta. However, the amount of degenerated terminals was very small in the nucleus pretectalis medialis and the nucleus pretectalis olivaris. Following an HRP (dissolved in 5% alkyl-phenol ethylene oxide) injection into the unilateral area pretectalis where fibers of the posterior commissure fan out, retrogradely labeled cells were observed in all of the above described (posterior commissural fiber recipient) regions of the pretectal and neighboring structures, with the exception of the somatic cell columns of the oculomotor nucleus and the trochlear nucleus. The number of labeled cells appeared roughly proportional to the amount of degenerated terminals of the posterior commissural fibers described above with the apparent exception of the nucleus pretectalis anterior, pars reticularis, where only a few labeled cells were identified. The findings were discussed with special reference to the pupilloconstrictory pathway via the posterior commissure.     

RCS大鼠视细胞超微结构观察

目的 观察遗传性视网膜变性大鼠视细胞超微结构改变。方法 电子显微镜观察出生后9－60天皇家外科学院（RCS）大鼠及正常SD大鼠视网视细胞超微结构。结果 与正常SD大鼠相比,RCS大鼠从出生后15天,视细胞相继出现视杆外节脱落的膜盘堆集,外节膜盘排列紊乱,视杆内节椭圆体线粒体空泡化,视肌样质结构消失,细胞核浓缩,浓缩的染色质沿核膜排列呈“新月形”,最终细胞体消失。结论 RCS大鼠遗传性视网膜变性中视细胞死亡具有细胞凋亡的形态特征。     

A laser coagulation technic in central retinal vein occlusion

The authors analyze the method of laser therapy in venous retinal occlusions. In view of the different therapeutic approach in occlusion of the branch and the trunk of the retinal vein, the paper has two parts. In occlusion of the branch of the retinal vein the authors describe the applied techniques of laser photocoagulation recommended by L'Esperance--quadrant barrage, barrier of the macula and arteriolar constriction. Technical data on photocoagulation are presented. In the treatment of occlusions of the trunk of the retinal vein the authors use panretinal photocoagulation, however, only in the ischaemic form of occlusion as a prevention of neovascular glaucoma. The authors mention some of their own experience with the treatment of venous occlusions of the retina by argon laser photocoagulation and they present their own therapeutic schedule.     

Bioavailability of drugs applied to the eye externally

There are following forms of the most frequently used ocular therapeutics: eye drops, ointments and inserts. In dependence on the physico-chemical properties of the therapeutical substance and the kind of disease one has to formulate the form of the drug in the manner to obtain its maximal bioavailability. By increasing their viscosity one can keep the watery solutions in the conjunctival sac for around 60 min. The time of the contact of the drug given in the form of suspension is limited mainly by the viscosity of the solution and the size of the molecules suspended in it. The ointments stay on the surface of the eye up to 2 hours. The ocular inserts secure a steady flow of the therapeutical substance up to 7 days. The compounds penetrate to the anterior chamber aqueous mainly through the cornea. Therefore the physiological factors of the lacrimal fluid, the properties of the cornea are influencing the penetration of the corneo-chamber barrier by the therapeutical substance.     

Scleral spur and ciliary muscle in man and monkey

The development of the human scleral spur and the role of the scleral spur in human and monkey eyes were studied by measuring the height of the scleral spur, the thickness of the uveal meshwork and the thickness of the longitudinal ciliary muscle. In an attempt to study how the tension of the ciliary muscle is transmitted to the inner wall of the Schlemm's canal, interconnections within the trabecular meshwork were also studied. The results indicate that after 40 weeks of gestation there is little or no further change with aging in the height of the scleral spur but there is a change in shape. The scleral spur is much less developed in monkey eyes than in human eyes. The corneoscleral meshwork predominates over the uveal meshwork in most human eyes while in monkey eyes the situation is the opposite. In man the thickness of the meridional part of the ciliary muscle attached to the scleral spur varies greatly in eyes with a well developed scleral spur. Interconnecting trabecular beams composed of elastic-like fiber were observed in the uveal and corneoscleral meshwork, as well as in the juxtacanalicular meshwork, extending to the cells of the inner wall of the Schlemm's canal. These findings and the dense structure of the scleral spur suggest that in monkey eyes, and at least in some human eyes, contraction of the ciliary muscle causes unfolding of the trabecular meshwork, not so much through the movement of the scleral spur as by movement of the interconnecting trabecular beams and fibers. One important role of the scleral spur is probably to keep the corneoscleral meshwork open when the ciliary muscle relaxes, and another is to enable inward-forward movement of the circular part of the ciliary muscle by pulling the posterior tip of the ciliary muscle anteriorly when the ciliary muscle contracts. A rigid scleral spur is an advantage for these two functions.     

Insertion anomalies of the horizontal muscles and dysfunctions of the oblique muscles in the A-V patterns

Insertion anomalies of the horizontal rectus muscles and dysfunctions of the oblique muscles were studied in 141 cases with A-V patterns of 824 patients with horizontal strabisums. The frequency of insertion anomaly among all cases of A-V pattern studied was 49.6%, there were more V pattern insertion anomalies than in those of A pattern, but the ratio of insertion anomalies in each type of A-V pattern was more in the A pattern than in the V pattern. In the oblique muscles, overaction of the inferior oblique muscle in the V pattern and of the superior oblique muscle in the A pattern were frequently encountered and insufficient action of the oblique muscles occurred more frequently in cases A-V esotropia than in cases of exotropia. In cases of combination of insertion anomaly of the horizontal rectus muscles with dysfunction of the oblique muscles, insertion anomaly was involved in 91.3% of cases of overaction of the superior oblique muscles, but only in 37.4% of cases of overaction of the inferior oblique muscles. The combination of insertion anomalies with dysfunction of the oblique muscles suggests a possible existence of simulated dysfunction of the oblique muscles in some cases of dysfunction of the oblique muscles diagnosed preoperatively. At the choice of a procedure in surgical correction, a confirmation of insertions of the horizontal muscles during operations is needed, and for this purpose the perilimbal incision is more appropriate than the fornix incision.     

Aesthetic surgery of the aging neck: options and techniques

As the surgeon learns to address the aging changes of the forehead, brows, eyelids and cheeks, the natural progression is to understand aging of the lower one-third of the face and aging of the neck. An understanding of surface anatomy, a review of the underlying anatomical changes of aging and an overview of the palette of procedures applicable to the aging of the neck are presented to introduce the surgeon to this important part of the aging face.     

The structure of the developing and adult ciliary complex of the rabbit eye: A gross,light, and electron microscopic study

Summary The chief aim of this study has been to develop a clearer understanding of the developing and adult ciliary complex in order to correlate its structure with the normal formation of aqueous humor. The eyes of prenatal, neonatal and adult albino and pigmented rabbits were studied by light and electron miscroscopy. Since studies by earlier investigators indicated that regional differences in the structure of the adult ciliary complex are functionally important, temporal and regional differences in the ciliary epithelium and capillaries were examined. Particular attention was paid to the development of the basal and lateral interdigitations; the junctional complexes and the ciliary channels of the epithelium and to the formation of the capillaries within the ciliary complex.Gross structural changes in the development of the rabbit ciliary complex are apparent relatively late in gestation and continue during neonatal life. The primary ciliary processes are grossly visible between the 20th and the 22nd day of gestation at which time they appear as a series of radial folds arising from the inner surface of the optic cup. More than half the length of the primary ciliary processes remains attached to the posterior surface of the iris. These attachments which make up the iridial portion of the primary ciliary processes appear between the 26th and 28th day of gestation. They arise from the inner surface of the ciliary body as a series of radial folds and are not attached directly to the posterior surface of the iris. By term the distal portion of the primary processes is convoluted and the iridial portion is prominent. The ciliary pocket is grossly visible around the 2nd postnatal day, but does not become a prominent characteristic of the ciliary complex until the end of the 2nd postnatal week. The eyelids open between the 10th and 12th postnatal day, and the pupillary membrane and hyaloid vasculature, which are functionally active at birth, regress by the end of the 2nd postnatal week. By the 14th postnatal day the structure of the rabbit ciliary complex is similar to that of the adult, except that the pars plana is smaller and the distal portions of the ciliary processes are not as convoluted. At the end of the 4th postnatal week, the structure of the ciliary complex is indistinguishable from that of the adult.The ultrastructural appearance of the ciliary complex undergoes relatively few changes. The fine structure of the ciliary epithelium and blood vessels is surprisingly similar in the fetus and adult. The basal and lateral interdigitations of the nonpigmented epithelium develop during the prenatal and postnatal period. They are present in the earliest stages (18–19 days gestation), but only in the valleys of the processes, where they are associated with large extracellular spaces. During postnatal development the interdigitations appear in the middle and then in the summits (6–8 days old) of the processes. Although they develop first in the proximal portion of the ciliary complex, in the adult they are more highly developed in the distal region, especially in the iridial portion of the ciliary processes.The ciliary channels located between the apices of the nonpigmented and pigmented epithelium appear early in the development of the ciliary complex. The simple type of ciliary channel appears first around the 20th day of gestation and is located principally in the pars plicata and pars plana. Elaborate ciliary channels begin to appear between the 26th and 28th day in the distal portion of the ciliary processes.Fenestrations in the capillary endothelium first appear in the proximal portions of the ciliary processes (21–23 days gestation) and are especially numerous in the large blood vessels of the summits. Later they also develop in the distal portions of the ciliary processes. The blood vessels of the iridial portions seem to be of two types: relatively thick walled vessels with no fenestrations, similar to those of the iris, and thin walled vessels with fenestrations, like those of the pars plicata.These and other observations concerning the structural development of the rabbit ciliary complex are correlated with respect to known biochemical and physiological evidence concerning maturation of the blood-aqueous barrier and secretion of aqueous humor. In addition the ultrastructural development of the non-melanized premelanosomes in the pigmented epithelium of albinos is compared with the development of premelanosomes and melanosomes of pigmented animals.Submitted in partial fulfillment of the requirements for the degree of doctor of philosophy, in the faculty of pure science, Columbia University, 1969.Dedicated to my friend and colleague George K. Smelser, Ph. D., Professor of Anatomy, Assigned to Ophthalmology, College of Physicians and Surgeons of Columbia University.     

Detection of early cataract changes in the crystalline lens by using in vivo spectrophotometry of the eye]

The aim of the paper was to study with the use of in vivo spectrophotometry of the eye the threshold values of the registered light above which one can observe clinically visible opacities of the lens. The performed experiments did not however show any major differences in the values of the registered light between persons with early cataract and control group because of considerable scattering of the results in both these groups. In order to explain the prognostic value of the in vivo spectrophotometry of the eye it is necessary to perform long-term observations of the further fate of persons with high values of the registered light.     

Electroretinogram c-wave and slow PIII of the rabbit: Changes in peak time and amplitude under various stimulus durations

Changes in peak time and amplitude of the direct current registered c-wave of the electroretinogram of the albino rabbit were investigated with various stimuli of duration ranging from 0.25 to 10 sec. The stimulus intensity was 500 lux at the surface of the cornea. Slow PIII was isolated by administrations of sodium iodate and sodium aspartate.The peak time of the c-wave was longer than that of the slow PIII in the range of stimulus duration less than 3.5 sec, but peak times were almost the same in the range above 3.5 sec. The amplitude of the c-wave at peak was larger than the corresponding amplitude of the slow PIII in the range less than 1 sec, but the slow PIII became larger than the c-wave at more than 1 sec. For stimuli less than 4 sec, the smaller the stimulus duration, the smaller was the negative slow PIII which affected the height of the c-wave.We conclude that in order to minimize the influence of the slow PIII on the c-wave, the duration of stimuli with intensity of 500 lux for recording the c-wave of the rabbit should be less than 4 sec.     

Histiocytosis X and the orbit in children]

Histiocytosis X, a clinical entity which was not defined and classified exactly so far, is manifested by a varied range of clinical manifestations. In rare instances the affection of the orbit is the only and first symptom of the disease. The authors present an account of three children. In one isolated affection of the orbit with a non-inflammatory swelling of the external portion of the upper eyelid was the first symptom of the disease. In the other two patients with the acute multifocal form of histiocytosis X exophthalmos developed only 3 and 7 months resp. after establishment of the diagnosis. In the discussion of symptoms, the prognosis and treatment the authors are inclined to believe that at present the prognosis of multifocal form of the disease is not always adverse. In the frequently difficult differential diagnosis of orbital lesions histiocytosis X should be considered as one of the possible causes of affections of the orbit in children.     

晶体铜质异物眼内铜离子浓度与自由基代谢的实验研究

利用家兔晶体内铜异物动物模型测定不同时间角膜、房水、晶体、玻璃体铜离子浓度及丙二醛（ＭＤＡ）和超氧化物歧化酶（ＳＯＤ）含量。结果晶体内铜离子浓度和ＭＤＡ含量随病程进展呈上升趋势，ＳＯＤ活性逐渐下降，并导致异物周围晶体不同程度混浊；玻璃体在初期受到一定影响，１２天后恢复正常。表明晶格内铜异物可引起晶体内自由基代谢紊乱并导致晶体混浊，角膜、房水的自由基代谢亦有影响，对玻璃体影响不大。     

Standardization of color images of the fundus of the eye

The development of the programs analyzing the image of the fundus of the eye has aroused considerable interest in computer-aided diagnostic tools. At present the majority of such programs is based mainly on the analysis of information of the brightness and color of an image. The paper proposes a procedure for correcting the color images of the fundus of the eye, by lowering the impact of color differences caused by external causes, such as the spectrum of a light source, the spectral characteristics of ocular optical medium transmission, and those of a photo receiver. The procedure for correcting the color retinal images is to standardize the color of an image and makes it possible to use information on color with more confidence to recognize diseases of the eye grounds and the natural course of a pathological process.     

视网膜脱离术毕眼压测定的临床观察

目的 通过对视网膜脱离术毕及术后眼压测量。探讨视网膜脱离术后眼压的变化及对预后的影响。方法 41例视网膜脱离患者术毕时在手术台及术后1-5天用Perkins压平眼压计测量眼压,每次测量眼压时连续测量两次,取平均值。结果 41只眼术毕与术后第1天及第2天眼压与健眼比较,术眼明显高于健眼。从第3-5天眼压与健眼比较,两眼眼压无显著性差异。术眼术后第1天因眼压高引起的并发症有12只眼（29.2%)。结论 视网膜脱离术毕眼压控制在2.8kPa,有利于视网膜复位。术后第1-2天有可能产生一时性的眼压增高,由此而产生的并发症很快会消失,不影响预后。     

The SRK formula for calculating the power of intraocular anterior-chamber lenses]

Presented is the evaluation of the usefulness of the SRK formula for the calculation of the power of the intraocular anterior chamber lens of Pannu type. This accuracy is characterised by the value of the postoperative deviation of refraction of the operated eye. It has been noticed that the value of this deviation is fluctuating in the early postoperative period. Its stabilization comes out not before the 6th-9th month after surgery. This points out to the necessity of calculating the correcting coefficient A for the SRK formula into the late postoperative period.     

Movement of corneal endothelium after penetrating keratoplasty. Observation of sex chromatin as a cell marker

There is a hypothesis that corneal endothelial cells migrate after penetrating keratoplasty from the areas of higher cell density to the lower cell density areas. In order to confirm this hypothesis, the author performed exchange penetrating keratoplasty in normal albino rabbits using four combinations of sex and age and examined the movement of the endothelium between donors and recipients by observing the density and sex chromatin of the endothelial cells. As a result, there was no significant difference of the rate of decrease of the endothelial cell density of the postoperative grafts between young and old grafts. In the experiment using the sex chromatin of the endothelial cells as a cell marker, it was concluded that the endothelium of the rabbit cornea migrate from the young grafts to the old recipients or from the young recipients to the old grafts. In the control study exchanging rabbit grafts between animals of different sex but the same age the count of the sex chromatin of the endothelium of the grafts and recipients did not change postoperatively. The results confirmed the above hypothesis concerning the migration of the transplanted corneal endothelial cells in the rabbit cornea.     

Use of the Foucault's test for determining the contrast sensitivity of the visual system]

The authors present the thesis that in apperception of the Foucault's test in condition of a threshold contrast only the first harmonic component is decisive; in connection with this one can replace the sinusoidal tests applied for the demarcation of the sensitivity curve of the visual system to contrast by Foucault's test. They point to the eventual possibility--if the influence of the following components would prove to be essential--of using the Foucault's test together with the sinusoidal test in order to make the diagnosis of pathological conditions more selective. The CSF function was designated by means of the sinusoidal and Foucault's tests seen on a monitor screen using the methods of contrast increase. In 8 subjects observing simultaneously one discovered that for the frequencies larger or equal to 1.5 stop-1 one can apply the Foucault's test instead of the sinusoidal test. Below the space frequency of 1.5 stop-1 one observed differences between the values of sensitivity to contrast demarcated by means of both tests; these differences result probably from the influence of the higher harmonics of the Foucault's test on the apperception of the test.