Polypoidal choroidal vasculopathy

Polypoidal choroidal vasculopathy was first described as a peculiar hemorrhagic disorder of the macula, characterized by recurrent sub-retinal and sub-retinal pigment epithelium bleeding in middle aged black women. The use of indocyanine green angiography and subsequently of optical coherent tomography has widened our ability to study and understand the pathophysiology of this disorder. The primary abnormality involves the choroidal circulation, and the characteristic lesion is an inner choroidal vascular network of vessels ending in an aneurysmal bulge or outward projection, visible clinically as a reddish orange, spheroid, polyp-like structure. We have also recognized that individuals of African-American and Asian descents are more at risk for developing polypoidal choroidal vasculopathy as the disorder seems to preferentially affect pigmented individuals. However, it has been shown that while that still holds true, patients of other racial backgrounds may be afflicted. Particularly, polypoidal choroidal vasculopathy has been found to be present in about 8-13% of white patients with clinical appearance of exudative age-related macular degeneration. Polypoidal choroidal vasculopathy has also been reported in Irish, French, German, and Italian patients. The natural course of the disease often follows a remitting-relapsing course, and clinically, it is associated with chronic, multiple, recurrent serosanguineous detachments of the retinal pigment epithelium and neurosensory retina with long-term preservation of good vision. Photodynamic treatment appears to be a promising alternative to conventional laser therapy, for the treatment of polypoidal choroidal vasculopathy. In conclusion, polypoidal choroidal vasculopathy seems to be a distinct clinical entity that should be differentiated from other types of choroidal neovascularization associated with age-related macular degeneration and other known choroidal degenerative, inflammatory, and ischemic disorders.     

Comparison of subretinal fluid levels of two 0.3% ciprofloxacin-containing eye drops

Purpose : Two ophthalmic solutions of 0.3% ciprofloxacin eye drops are available in Turkey: Ciloxan and Siprogut. A previous study by the same authors was the first to report vitreous penetration of ciprofloxacin‐containing eye drops. The aim of the present study was to compare the levels of drug found in the subretinal fluid by the two products following local administration. Methods : Forty‐three patients undergoing conventional retinal detachment surgery received either Ciloxan (22 patients) or Siprogut (21 patients). Beginning 6 h before surgery, two drops of solution were instilled onto the operative eye every 30 min for the first 3 h and then hourly for the next 3 h. Subretinal fluid samples were collected 30 min after administration of the last dose and were assayed for ciprofloxacin levels using a method involving high‐ performance liquid chromatography with fluorometric detection. Results : The minimum and maximum subretinal fluid concentrations measured were 0.11 μg/mL and 0.65 μg/mL, respectively, with Ciloxan, and 0.08 μg/mL and 0.62 μg/mL, respectively, with Siprogut. There was no statistical difference between the subretinal fluid ciprofloxacin levels of the two products. The subretinal fluid drug levels attained by both products were below the minimum inhibitory concentrations of common ocular pathogens. Conclusions : Ciloxan and Siprogut can penetrate subretinal fluid. The ocular bioavailability of ciprofloxacin after local administration is equivalent for both pharmaceutical products.     

指标鉴别诊断结核性与恶性胸水的评价

目的评价检测胸水标本阿拉伯糖甘露糖脂IgG抗体（LAM—IgG）、腺苷脱氨酶（ADA）和癌胚抗原（CEA）指标鉴别诊断结核性与恶性胸水的应用价值。方法对象包括恶性胸水（恶性组）、结核性胸水（结核组）各40例，采集胸水为检测标本，应用斑点免疫金渗滤试验技术检测LAM—IgG、酶促反应终点法检测ADA、磁酶免技术检测CEA。结果LAM—IgG、ADA和CEA的阳性结果分别为：结核组59．5％、81．1％和5．4％，恶性组8．1％、13．5％和56．8％。结论在鉴别诊断结核性与恶性胸水方面，LAM—IgG和CEA具有高度特异性和较高敏感性，ADA特异性较低但敏感性较高，3个指标共同应用对鉴别诊断结核性与恶性胸水具有较高的应用价值。     

Resolution of chicken pox neuroretinitis with oral acyclovir: A case report

It is usual to consider chicken pox as a benign infectious disease with a few anterior segment ocular complications like conjunctivitis, keratitis, episcleritis, scleritis, iridocyclitis, and glaucoma. The retinal manifestations are necrotising retinitis, vitritis, neuroretinitis, and retinal detachments. We report a case of neuroretinitis following chicken pox in a 23-year-old male. The complication was resolved by treatment with oral acyclovir in combination with systemic steroids. This report highlights the necessity for fundus examination in cases of chickenpox exhibiting visual symptoms.     

Proteins of the bovine interphotoreceptor matrix: Tissues of origin

Soluble material from the interphotoreceptor matrix of adult bovine eyes was isolated by gentle washing of the retina and of the apical pigment epithelium surface. Sugar and protein analyses of the macromolecules present in this extracellular layer showed that proteins outweigh glycosaminoglycans by a factor of about 50. (Glycosaminoglycans are the only matrix components previously examined.) The matrix proteins were characterized with respect to their molecular weights, tissues of origin and relationship to the subretinal fluid formed in retinal detachment.SDS-polyacrylamide gel electrophoresis of dithiothreitol-reduced bovine interphotoreceptor matrix revealed a limited and specific set of proteins: a major Coomassie blue-staining band at 140 000 daltons (a glycoprotein) plus several proteins between 21 000 and 64 000 with the most prominent band at 47 000. This pattern was completely different from those of serum, vitreous or pathological subretinal fluid; even serum albumin was totally absent from the matrix. Furthermore, the matrix proteins bore little resemblance to supernatants from tissue homogenates of retina or pigment epithelium. Thus the proteins found in the matrix do not appear to arise from general decomposition of surrounding tissues or from serum infusion.However, most of the matrix proteins can be accounted for as products of either the retina or pigment epithelium, as seen by their similarity to proteins retrieved from the conditioned culture media when bovine retinas or pigment epithelial cells were incubated overnight. These proteins were newly synthesized, as shown by incorporation of labeled leucine and glucosamine. Subretinal fluid contained none of these product proteins. The findings are discussed with respect to the physiological state of ocular tissues during retinal detachment.A procedure is described for obtaining bovine pigment epithelium cells with good yield and viability. The method involves trypsin treatment of the eyecup, without brushing out the cells.     

玻璃体术后玻璃体腔液蛋白成分及其含量分析

目的：研究成功的玻璃体视网膜下后，玻璃体腔再形成液内蛋白成分含量与视网膜病变性质的关系，探讨气体充填对眼内组织的影响，方法：采用双缩脲法测定样本总蛋白，溴甲酚绿法测定白蛋白。并与同期孔源性视网膜脱离患者前房液和视网膜下液（ＳＲＦ）对比。结果：玻璃体腔液总蛋白含量介于ＳＲＦ和前房液之间；并与裂孔大小和摄液次数呈显著相关（ｒ１＝０．８１，Ｐ〈０．０１，ｒ２＝－０．６３，Ｐ〈０．０５）；巨大裂孔显著高于     

External drainage of subretinal fluid with a contact Nd:YAG laser

We used a Nd:YAg laser fit with a fiberoptic cord and sapphire tip to drain subretinal fluid externally in patients with rhegmatogenous retinal detachment. The direct contact between the laser and the choroid allowed for controlled cutting and coagulation of the intervening choroidal vasculature. The drainage was successfully achieved with no complication.Supported in part by a grant from Research to Prevent Blindness, Inc., New York City, and by Core grant EY1972 from the National Eye Institute, Bethesda, MD.     

肝硬化腹水病人的临床护理体会

目的通过对肝硬化腹水患者护理难点的剖析,提出相应对策。方法对住院的肝硬化病人在积极治疗的同时呆取了精心的护理。结果通过精心的护理,使出血病人、胸腹水病人、继发感染病人、肝性脑病等病人及时发现病情变化得到及时处理和治疗,控制了病情的发展,减轻了病人的痛苦,提高了病人的生活质量。结论针对肝硬化腹水患者护理的难点问题,提出护理的对策,及时发现患者的病情变化,采取相应的积极治疗,防止了病情的发展,提高了患者的生活质量。