Subtle signs of an intact anterior vitreous face during pediatric cataract surgery

We describe the subtle signs of the anterior vitreous face as a bulging structure, a homogenous staining pattern of 3 buttonholes, and a lamellar or fibrillar pattern intact. This should help surgeons correctly recognize the intact anterior vitreous face. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.     

Fluorescein and fluorescein glucuronide in the vitreous body of diabetic patients

Fluorescein (F) and fluorescein glucuronide (FG) were determined in the vitreous of four diabetic patients by a double-filter slit-lamp fluorophtometric technique. Determinations were performed 60–80 min after i.v. injection of fluorescein. F and FG were also determined in plasma ultrafiltrate 5, 15, 30, 60 and 120 min after injection by high-pressure liquid chromatography. The concentration of FG in the vitreous was 3 times that of F. After correction for plasma concentrations of FG higher than those of F, the penetration index of FG through the blood-retinal barrier was found to be twice the penetration index of F. This is not what would be expected if passive transport alone were involved. Accordingly, it is suggested that active transport mechanisms contribute to the movement of F and FG across the blood-retinal barrier.Presented at the XVth Meeting of the Club Jules Gonin, Copenhagen, 10–15 August 1986     

Contrast sensitivity function in pseudophakics and aphakics.

PURPOSE: To study the effect of posterior chamber intraocular lenses and aphakic spectacles on contrast sensitivity. METHODS: Contrast sensitivity was evaluated in 20 patients in each group of pseudophakics with post chamber IOL (group I), aphakics with spectacle correction (group II), and age and sex-matched normal subjects (group III) using the Pelli-Robson chart. RESULTS: The mean values of log contrast sensitivity in pseudophakics (1.665+/-0.105) and aphakes with spectacle correction (1.5075+/-0.1) were found to be statistically significantly low (t: 5.186, p < 0.001; t: 11.302, p < 0.001, respectively) as compared to the mean value of normal phakic subjects (1.8075+/-0.0576). Further, mean values of log contrast sensitivity in aphakes with spectacles correction were also found to be statistically significantly low (t: 4.727, p < 0.001) when compared to that in pseudophakes. CONCLUSION: From observations of the present study, it can be concluded that posterior chamber IOL implantation offers an added advantage of higher contrast sensitivity, over and above the well documented advantages of increased field of vision, negligible effect on image size and elimination of prismatic effect and spherical aberration of thick glasses.     

人工晶状体术后瞳孔区残留玻璃体的治疗

目的　探讨人工晶状体术后瞳孔区残留玻璃体的治疗方法及作用。方法　对 36例 (36只眼 )人工晶状体术后瞳孔区残留玻璃体者行 YAG激光治疗加高渗脱水药治疗 ,对结果进行分析。结果　治疗后瞳孔恢复圆形。视力比治疗前增加 0 .5 4± 0 .13(P <0 .0 1)。眼压高的 19例在治疗后 2周眼压下降 1.92± 0 .5 4k Pa,比治疗前显著降低 (P <0 .0 1)。结论　对人工晶状体术后瞳孔区残留玻璃体用 YAG激光治疗加高渗脱水药治疗 ,有使瞳孔恢复圆形、增加视力、降低眼压等作用     

Fluorescein and fluorescein glucuronide in vitreous: fluorescence and binding properties in vitro

The total and ultrafiltrable fluorescence were measured after disodium fluorescein and fluorescein monoglucuronide were added to aliquots of human and porcine vitreous, and to aliquots of phosphate buffer with and without 0.2% sodium hyaluronate. No significant binding or quenching of F or FG by vitreous or sodium hyaluronate could be found, indicating that vitreous binding is not a source of error in vitreous fluorometry.     

Anterior vitreous face behavior with AcrySof in pediatric cataract surgery

PURPOSE: To describe anterior vitreous face behavior when AcrySof (Alcon, Fort Worth, TX) intraocular lenses come in contact with the anterior vitreous face after posterior continuous curvilinear capsulorhexis without anterior vitrectomy in pediatric patients undergoing cataract surgery. METHODS: This study comprised 14 eyes of 12 children whose mean age was 9.6 years (range, 2.3 to 16.0). All eyes underwent primary posterior continuous curvilinear capsulorhexis without anterior vitrectomy and had AcrySof IOLs implanted in the bag. Changes on the anterior vitreous face were documented, and visual acuity was recorded. Statistical analysis was performed using Student group t and Mann Whitney tests. RESULTS: Mean length of follow-up was 21.1 +/- 7.4 months (range, 15.0 to 36 months). Nine eyes (64.3%) had a clear visual axis, whereas 5 eyes (35.7%) developed anterior vitreous face changes. Of those with anterior vitreous face changes, 60% (3 of 5) eyes showed a fine meshwork-like reticular response termed "anterior vitreous reticular response" (AVR); 20% (1 of 5) eyes showed a scaffold response; and 20% (1 of 5) eyes showed a mixed response at the last follow-up examination. The difference in visual acuity before and after the development of the AVR response was not significant (P =.712). The mean age of patients with eyes having a clear visual axis was 12.1 +/- 2.3 years (median = 11.0; range, 9.1 to 16.0), and the mean age of patients with eyes having anterior vitreous face changes was 5.1 +/- 3.4 years (median = 3.6; range, 2.3 to 11.6) (P =.0098). CONCLUSION: The results suggest that when the AcrySof intraocular lenses come in contact with the anterior vitreous face, they produce the AVR response during the early postoperative period in younger eyes. This does not seem to have any significant impact on visual acuity.     

Vascular tufts of the pupillary border causing a spontaneous hyphaema

In 3 patients a spontaneous haemorrhage in the anterior chamber originated from vascular tufts at the pupillary border. These vascular tufts were hardly visible by slitlamp observation, but could be visualized well with fluorescein angiography. The patients were aged 50 years or more and in 2 of them the vascular tufts were found in both eyes. The haemorrhages disappeared spontaneously under conservative therapy and only in 1 case caused a transient glaucoma. Of 115 randomly chosen out-patients, 4 cases were found with the same vascular tufts on the pupillary border, but without any symptom. All the patients who had vascular tufts, with or without haemorrhage in the anterior chamber, were in the sixth decade or older. We think that these vascular lesions are caused by cardiovascular diseases and by elevated venous pressure caused by intrathoracic processes. Diabetes and intraocular diseases were excluded in our patients.     

Shifting crystalline pseudohypopyon secondary to lens absorption with spontaneous openings in the anterior lens capsule

This is the first reported case of a crystalline pseudohypopyon presenting as a layer of "snowdrift deposits" that settled inferiorly in the anterior chamber of the eye of a 55-year-old man and was associated with freely floating crystals in the aqueous humor, producing a "snowy Christmas Eve" appearance. The cause was spontaneous openings in the center of the anterior capsule with leaching of the crystalline substance into the anterior chamber. A dense membranous cataract was left after the lens material was partly absorbed. There was no history of trauma, surgery, or known systemic disease, and the patient presented with a unilateral, mobile, 4.0 mm white pseudohypopyon with no global pain, photophobia, or lacrimation. Although the eye was not injected on admission, repetitive head shaking resulted in dusky-red perilimbal hyperemia. A B-mode ultrasound revealed an advanced retinal detachment, and electroretinographic recordings were undetectable. Visual acuity decreased to hand motions in the affected eye, and the patient ultimately required anterior chamber paracentesis. Such sediments should be differentiated from other forms of true or pseudohypopyons because the course, treatment, and prognosis are different for each.     

Light-evoked release of endogenous glycine into the perfused vitreous of the intact rat eye.

Glycine, a putative neurotransmitter, is released into the perfused vitreous of anesthetized pigmented rats when the eye is stimulated by intermittent flashes of bright light. Other amino acids do not show stimulated release. This result provides further evidence for the role of glycine as a neural transmitter in the retina.     

Posterior vitreous findings in cases of spontaneous retinal reattachment

PURPOSE: To describe the posterior vitreous findings in two patients with retinal detachment who experienced spontaneous retinal reattachment. DESIGN: Two observational case reports. TESTING: Biomicroscopic and high-resolution echographic evaluation of the vitreoretinal relationships. MAIN OUTCOME MEASURES: Retinal reattachment and echographic vitreoretinal relationships. RESULTS: Two patients, one with a rhegmatogenous retinal detachment and one with a tractional retinal detachment, were noted to have a partial posterior vitreous detachment with vitreoretinal adherence at the time of presentation. Spontaneous retinal reattachment occurred in both cases, with echography showing complete vitreous separation from the retina. CONCLUSIONS: Complete posterior vitreous detachment may release tractional components in retinal detachment and contribute to spontaneous retinal reattachment.     

永存原始玻璃体增生症与先天性纤维血管瞳孔膜临床特征的比较

目的：分析永存原始玻璃体增生症(PHPV)和先天性纤维血管瞳孔膜(CFPM)的临床特征异同。

方法：回顾性分析2006-03/2021-12在空军军医大学西京医院眼科接受手术治疗的PHPV(PHPV组)和CFPM患儿(CFPM组)的眼部生物测量参数、临床表现、病变的形态学特点。

结果：纳入PHPV患儿56例61眼,CFPM患儿24例25眼; PHPV和CFPM的发病年龄相似、无性别差异,均以单眼患病为主,其占比分别为91%和96%。PHPV合并白内障患眼可有多种并发症和眼发育异常,CFPM主要为不同程度的瞳孔区堵塞及形态异常。PHPV组和CFPM组单眼患病患儿患眼前房深度(ACD)均小于对侧眼,手术年龄≤24月龄患儿患眼眼轴长度(AL)均小于对侧眼(P<0.05); PHPV组单眼患病患儿患眼角膜直径(CD)小于对侧眼、眼压高于对侧眼(均P<0.05); CFPM组单眼患病患儿患眼与对侧眼CD、IOP比较均无显著差异(P>0.05)。PHPV组患儿患眼ACD小于CFPM组患眼(P<0.05)。术中发现PHPV纤维血管膜组织位于晶状体后、玻璃体腔内,而CFPM纤维血管膜位于虹膜与晶状体前囊膜之间,很少累及晶状体。

结论：PHPV和CFPM有非常相似的临床特点,提示PHPV和CFPM可能是永存胚胎血管(PFV)的不同表现形式,但PHPV病变范围更广、病情更复杂。     

Atypical rubeosis iridis in congenital cyanotic heart disease. Report of a case with microhaemangiomas at the pupillary margin causing spontaneous hyphaemas

Neovascularisation of the iris developed in a woman with congenital cyanotic heart disease. This neovascularisation was predominately in the form of microhaemangiomas at the pupillary margin causing spontaneous hyphaemas. Proliferative vascular alterations did not develop in the retina and secondary glaucoma did not occur.