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PurposeTo evaluate the treatment of central serous chorioretinopathy (CSC) with either subthreshold diode laser MicroPulse (SDM) or intravitreal bevacizumab (BCZ).MethodsThis comparative, controlled, prospective study conducted over a period of 10 months examined 52 eyes of 52 patients with (a) treatment with SDM at the active leakage site guided by fluorescein angiography (FA) (n=16 eyes), (b) intravitreal injection of 1.25 mg BCZ (n=10 eyes), or (c) observation (n=26 eyes). Outcome measures included changes in retinal pigment epithelium (RPE) leakage at FA, central macular thickness (CMT), best-corrected visual acuity (BCVA), and 10° macular perimetry.ResultsAt the end of the study, there was 12.5% persistent leakage in the SDM, compared with 60% in the BCZ and 92% in the control group. Mean CMT decreased by 94 μm in the SDM, 38 μm in the BCZ, and did not change in the control group. Mean BCVA improved more than 6 early treatment of diabetic retinopathy study letters in the SDM, decreased by one letter in the BCZ, and by two letters in the control group. In the SDM group, mean perimetric deficit improved by 1.5 decibels and corrected lost variance by 2.6. In the BCZ, it improved by 0.6, and in the control group by 0.5. Retreatment was required in 7/16 eyes of the SDM group (43.75%), and in 5/10 eyes of the BCZ group (50%).ConclusionSDM photocoagulation was superior to intravitreal injections of 1.25 mg BCZ in the treatment of CSC, which resulted in enhanced visual acuity and macular perimetry. [ABSTRACT FROM AUTHOR]

Background: The increasing use of light-emitting diodes (LEDs) for lighting applications and displays is giving rise to public and professional concern that blue LED emissions could damage the retina or via the proven influence on the melatonin levels disrupt the human day-night rhythm., Objective: The study aimed to measure the emission of LEDs and other relevant light sources and evaluate the results comparatively with the help of suitable evaluation functions in order to recognize whether LEDs differ considerably from other light sources in their hazard potential., Material and Methods: The spectra of a cold white and a warm white LED, a white tablet LED display, a fluorescent tube and a halogen lamp were measured and evaluated together with a sunlight spectrum relative to each other using the blue light hazard retina weighting function and the circadian action function., Result: Since LEDs can be very different, relative LED ratings also vary greatly. The warm white LED is the one with the lowest risk of blue light retinal damage and the lowest potential for inhibition of melatonin formation and in this respect even gentler than halogen lamps. For cold white LEDs, the values for photochemical retinal danger as well as for the expected inhibition of melatonin formation are much greater. The values for the tablet LED display are even higher., Conclusion: Not only LEDs but all examined light sources emit in the blue spectral range, so that in principle they represent a retinal hazard. Depending on the employed LED type, this hazard may be greater or less compared to conventional light sources but even cold white LEDs are rated slightly better than sunlight at noon. To support consumers it might be helpful to classify LEDs and other illuminants by their potential hazard to the eye, as they are already labelled with respect to their energy efficiency.

Diaphanoscopy is an almost 150-year-old diagnostic procedure based on the transillumination of the wall of the eyeball. One of the most important fields of application is the detection of tumors, which can be distinguished from the rest of the tissue by their reduced light transmission. Other fields of application include the diagnosis of retinal tears and holes, the detection of foreign bodies in the vitreous body and the control of coagulative measures in the ciliary body. In comparison to other techniques, diaphanoscopy requires only little effort and is very gentle on patients.

Background: Currently available chandelier endoilluminators for pars plana vitrectomy consist of conventional optical fibers coupled to a light source. The light probes of these fibers now provide wide emittance angles but it is still often not possible to illuminate the whole intraocular space via just one incision. Therefore, several light probes or additional handheld endoilluminators have to be used simultaneously or the lights have to be repositioned during surgery., Objective: The presented prototype of a fiberless chandelier light-emitting diode (LED) endoilluminator aims at illuminating the whole intraocular space with just one incision while reducing the risk of harming the retina., Material and Methods: The light source is a white LED with a conical tip that allows stable fixation within an incision. The physical properties of these LEDs were determined and used for calculating the relevant irradiance to assess the risk of causing harm to the eye. The illumination of the intraocular space was investigated using porcine eyes., Results: The illumination of porcine eyes with the modified LEDs was bright and homogeneous. Measurements and subsequent calculations proved that the expected thermal load and photochemical hazard were very low for human eyes., Conclusion: The hitherto existing experimental results on porcine eyes and the theoretical considerations on human eyes were found to be positive; therefore, it is expected that this new fiberless chandelier LED endoilluminator will prove to be advantageous for human patients. It promises a reduced number of incisions with a simplified handling and need to add handheld light sources only if minimal intensity oblique illumination is helpful together with the chandelier illumination. This contributes to a significant reduction of phototoxicity risks and additionally there is a chance for a cost reduction because expensive xenon or mercury lamps are no longer necessary. These expectations have to be verified by further studies on human eyes.

In pest risk assessment it is frequently necessary to make time-critical decisions regarding management of expanding pest populations. When an invasive pest outbreak is expanding rapidly, preemptive quarantine of areas that are under imminent threat of infestation is one of only a few available management tools that can be implemented quickly to help control the expansion. The preemptive quarantine of locations that surround an infested area also acts as a safeguard to counteract the risk of failed detections of the pest in field surveys. In this paper, we present a method that assesses the suitability of preemptive quarantine measures at the level of small geographical subdivisions (U.S. counties). The cost of a preemptive quarantine in a given county is weighed against the protective benefit of delaying the spread of an outbreak to other neighboring counties. We demonstrate the approach with a decision support model that estimates the suitability of preemptive quarantine across multiple counties that surround areas infested with the emerald ash borer (Agrilus planipennis Fairmaire (EAB), Coleoptera: Buprestidae), an emerging major threat to ash tree species (Fraxinus spp.) in North America. The model identifies the U.S. counties where the installation of preemptive quarantine would most effectively slow the spread of EAB populations and reduce risk to high-value areas., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Purpose: The aim of this study was to determine cytokine levels from vitreous samples of treatment-naive patients with diabetic retinopathy (DRP), retinal vein occlusion (RVO) and exudative age-related macular degeneration (ARMD)., Methods: In this study 187 patients (median age 67 years, 101 males) were treated with a combined drug therapy including a 23-gauge core vitrectomy. Interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1) and intravitreal vascular endothelial growth factor (VEGF-A) levels were determined a using cytometric bead assay (CBA) and compared to those of the control group., Results: Compared to the control group all diseases had significantly elevated cytokine levels, except VEGF in ARMD. In DRP samples of patients with diffuse diabetic macula edema (DME) higher VEGF-A and MCP-1 levels were found than in patients with focal DME. Ischemic DRP had higher VEGF levels than non-ischemic DRP. All measured cytokines were significantly higher in central retinal vein occlusion (CRVO) than in branch retinal vein occlusion (BRVO)., Conclusions: Differences in intravitreal cytokine levels in DRP, RVO and ARMD could be demonstrated. The knowledge of depicted specific characteristic dysregulation of cytokines could allow more targeted future therapies.

Aim: The aim was to investigate the efficacy and safety of combined intravitreal therapy in patients with occult choroidal neovascularization (CNV) secondary to wet age-related macular degeneration (AMD) over 6 months., Methods: In this prospective pilot study of a case series, 106 patients (mean age 75.4 years) with predominantly occult CNVs were treated with a 1.5-ml core pars plana vitrectomy with intravitreal injections of triamcinolone (8 mg), bevacizumab (1.25 mg) and balanced salt solution. The best-corrected visual acuity (BCVA; logMar), central macular thickness (optical coherence tomography), and intraocular pressure (IOP; Goldmann tonometry) were assessed at baseline and follow-up visits., Results: Statistically significant increases in BCVA (vs. baseline) were observed at 2 months (mean +0.9; standard deviation +/-0.6 lines), 4 months (+1.3; +/-0.7), and 6 months (+1.2; +/-0.7) after the initial combined intravitreal therapy in 96/106 patients. At 6 months, BCVA had deteriorated in 20 of 96 (20.8%) patients by <2.5 lines, remained stable in 38 of 96 (39.6%) and improved in 31 (32.3%) patients by 1-3 lines, and in 7 (7.3%) patients by >3 lines. The mean central retinal thickness decreased by -41.2% (-195; +/-46 microm) over 6 months. 55% demanded intravitreal anti-vascular endothelial growth factor (VEGF) treatment after initial therapy. Increases in IOP were managed by eye drops in 11 (10%) patients with no other adverse event occurring., Conclusion: After the combined intravitreal therapy, including two drugs and a limited core vitrectomy, a significant and sustained improvement in vision of patients with occult CNVs was observed over 6 months. In 45% of the initially treated patients, anti-VEGF therapy did not have to be continued, which might be attributed to both the pharmacological effects of the drugs and the physiological changes induced by the vitrectomy (posterior vitreous detachment, liquefaction, and oxygen redistribution)., ((c) 2009 S. Karger AG, Basel.)

The non-native redbay ambrosia beetle, Xyleborus glabratus Eichhoff (Coleoptera: Curculionidae: Scolytinae), has recently emerged as a significant pest of southeastern U.S. coastal forests. Specifically, a fungal symbiont (Raffaelea sp.) of X. glabratus has caused mortality of redbay (Persea borbonia) and sassafras (Sassafras albidum) trees in the region; several other Lauraceae species also seem susceptible. Although the range of X. glabratus continues to expand rapidly, little is known about the species' biology and behavior. In turn, there has been no broad-scale assessment of the threat it poses to eastern U.S. forests. To provide a basic information framework, we performed analyses exploiting relevant spatio-temporal data available for X. glabratus. First, we mapped the densities of redbay and sassafras from forest inventory data. Second, we used climate matching to delineate potential geographic limits for X. glabratus. Third, we used county infestation data to estimate the rate of spread and modeled spread through time, incorporating host density as a weighting factor. Our results suggest that (1) key areas with high concentrations of redbay have yet to be invaded, but some are immediately threatened; (2) climatic conditions may serve to constrain X. glabratus to the southeastern U.S. coastal region; and (3) if unchecked, X. glabratus may spread throughout the range of redbay in <40 yr. Disruption of anthropogenic, long-distance dispersal could reduce the likelihood of this outcome.

Purpose: The authors report their surgical experience after sustained-release ganciclovir treatment, as well as replacing empty ganciclovir implants in patients with acquired immune deficiency syndrome (AIDS) and cytomegalovirus (CMV) retinitis., Methods: Between November 1995 and August 1998, 79 eyes of 49 patients received 99 intravitreal ganciclovir implants. Patients were examined monthly after implant surgery. Follow-up periods ranged from 6 to 128 weeks., Results: At the first 3-week postoperative visit, 73 eyes (97.2%) of 46 patients exhibited stable conditions. In 6 eyes (3.8%) of 3 patients, further progression was noted due to resistance to ganciclovir. The most common early complication (within 6 weeks after implantation) was cystoid macular edema, observed in 7 eyes receiving implants. Retinal detachment was the most common late complication (over 6 weeks after implantation) in 11 eyes. In almost all eyes with CMV retinitis and retinal detachment, involvement of more than 25% of the retina was observed. Additional severe complications included extrusion of the first pellet in 2 eyes and cataract as a late complication in 5 eyes. A total of 28 eyes (35.4%) of 16 patients receiving a second implant did not experience significant three-line loss by the end of the follow-up period., Conclusion: In the treatment of CMV retinitis, sustained-release ganciclovir implantation seems to be an alternative to intravenous ganciclovir. Early implantation and additional replacement of the device has the potential to decrease the risk of developing retinal detachment. We would recommend additional systemic antiviral CMV therapy to avoid infection of the fellow eye and CMV disease.

Background: The recent development of 20- and 19-gauge diameter endoscopes allows an excellent direct intravitreal visualization of intraocular morphology. A gradient index (GRIN) endoscope (Insight Instruments, Lake Mary, FL, USA), which combines a small diameter (0.89 mm, 20 gauge) and an exceptional optical resolution, can be used as a diagnostic tool for the assessment of the safety and vitreous interaction of sustained release intraocular devices which have been designed to deliver ganciclovir (Vitrasert) over a period of 8-12 months and were successively implanted in several eyes., Patients and Methods: 78 eyes of 49 patients received 100 ganciclovir implants between November 1995 and July 1998. In six patients who received additional implants, the GRIN endoscope was used as an optical control of wound healing processes and Vitrasert positioning after implantation of prior devices (two-point suturing technique)., Results: In all of these six eyes, a clinical stabilization of the cytomegalovirus retinitis was noted. Endoscopic observation of the scleral 5-mm incision revealed no gaps after two-point suturing of the device. Only one of six eyes showed significant vitreous tractions around the Vitrasert. However, the struts of all pellets were completely covered by a fibrous membrane. Occasional fibrous plaques were noted on the surface of devices which presumably had been damaged by surgical manipulations. In one case, the endoscopic examination disclosed the suprachoroidal implantation of a device. In this eye, no signs of retinal toxicity or recurrence of CMV retinitis were observed., Conclusions: High resolution endoscopy of the vitreous cavity appears to be an effective method for the control of intraocular drug delivery devices. Basically, the repeated implantation of intraocular ganciclovir implants can be considered a safe method in the management of relapsing CMV retinitis. However, the endoscopic observation of fibrous membranes covering the struts suggest that the explanation of an intraocular device has the potential for various intraoperative complications (e.g. hemorrhages, traction, tears, retinal detachment). Therefore, we would recommend the additional implantation of further implants rather than a replacement.

Purpose: In angiogenesis, matrix degradation is an important step in endothelial cell migration and proliferation. There is evidence that serine proteases, such as tissue plasminogen activator (TPA), urokinase-type plasminogen activator (UPA), and plasminogen activator inhibitor (PAI), are involved in this process. We hypothesized that in eyes in which neovascularization is active, such as in proliferative diabetic vitreoretinopathy (PDVR), vitreous levels of these proteases are increased. Furthermore, correlation was sought between intraocular concentrations of serine proteases and vascular endothelial growth factor (VEGF), a multifunctional cytokine that has been shown to play a major part in mediating active neovascularization in patients with ischemic retinal diseases., Methods: Undiluted samples of vitreous fluid were obtained from patients who underwent vitreoretinal surgery for PDVR or retinal detachment. Vitreous levels of VEGF, TPA, UPA, and PAI were determined by enzyme-linked immunosorbent assay., Results: We found a statistically significant correlation between levels of VEGF and TPA (P<0.01) and VEGF and PAI (P<0.026) in the vitreous fluid of patients with PDVR. Concentrations of VEGF (P<0.03), TPA (P<0.042), and PAI (P<0.0098) in diabetic eyes were significantly higher than in nondiabetic eyes. Of 14 eyes with PDVR, 6 contained detectable levels of UPA., Conclusions: A correlation between increased levels of VEGF and TPA or PAI in the vitreous fluid of eyes with PDVR reflects the possible role of plasminogen activators in the progression of this disease. An understanding of the endogenous inhibition of matrix degradation in ocular angiogenesis may be useful in the development of new treatment strategies.

The ischemic type of central retinal vein occlusion (CRVO) is associated with a poor visual and ocular prognosis. Although several reports have indicated that hemodilution or thrombolytic therapy may be of benefit, there is still no consensus among ophthalmologists about the management of this disorder. In our study, we retrospectively evaluated the visual outcome after medical treatment in 58 patients with ischemic CRVO and severe visual loss (< or = 20/50). We separately investigated three different groups, depending on the following criteria: onset of symptoms within 11 days prior to admission and thrombolytic treatment with 50 mg of recombinant tissue plasminogen activator (rtPA) and intravenous heparinization (n = 23) or hemodilution therapy (n = 22) or onset of symptoms >11 days before the initial visit and hemodilution (n = 13). An advancement of 2 or more lines on the logarithmic visual acuity chart was noted in 10 cases (44%) in the rtPA group and in 3 subjects (14%) in the early-phase hemodilution group, whereas only 1 patient in the late-phase hemodilution group showed a comparable improvement. Our findings suggest that treatment with low-dose rtPA or hemodilution aimed at early restoration of blood flow has the potential to improve the visual prognosis in ischemic CRVO. The finding that thrombolysis had a favorable outcome supports the hypothesis that specific subgroups of patients may benefit from this therapeutic approach. Further investigation will be required to definitively prove the effectiveness of fibrinolytic agents., (Copyright 1999 S. Karger AG, Basel)

The intravascular oxygen tension (pO2) of the pig retina was determined by measuring the phosphorescence lifetime of an intravenously injected dye. Pseudocolor images of the intravascular retinal pO2 were obtained. The method is noninvasive except for the application of the dye. The measurement system was adapted to a fundus camera. The systemic arterial oxygen pressure (PaO2) as well as the intraocular pressure (IOP) were altered. In the measurements the pO2 of the choriocapillaris was close to the systemic PaO2. Under normoxia, the retinal veins showed a lower pO2 of about 40 mm Hg. We found evidence of an autoregulation of the retinochoroidal pO2. The retina and the optic nerve head showed an autoregulation of the intravascular pO2 at low IOP, but were more sensitive to a moderate elevation of the IOP of about 40 mm Hg, as compared to the choroidal pO2. The pO2 of the choriocapillaris seemed to change little until the considerably high IOP value of about 50 mm Hg was attained. This behavior is due to either the high perfusion reserve capacity of the choroid or to autoregulation. Although our experiments refer to the perfusion of the pig eye, the results provide indirect evidence that even during a glaucoma attack the human choroid might be able to maintain a reasonable oxygen supply to the retina, whereas the intravascular pO2 of the retinal vessels and of the optic nerve head decrease strongly. The adaptation to a fundus camera facilitates a future clinical application if a nontoxic dye can be developed.

State-of-the-art subretinal surgery involves a standard three-port pars plana entry, followed by an iatrogenic retinotomy to access the subretinal space. Subretinal manipulations through a small retinotomy are made possible by specially designed instruments. As the surgeon looks through the vitreous cavity, all subretinal maneuvers are obscured by the overlying retina. Consequently, the surgeon is operating 'blindly' and has to rely on 'feeling' rather than direct visualization. Micro-endoscopic viewing systems are the ideal solution for visualization during subretinal surgery. Until now, such endoscopes were either too large for intraocular use or lacked sufficient resolution, especially at a short working distance. Recently, a gradient index (GRIN) endoscope was developed (Insight Instruments, Inc., Lake Mary, Fla., USA) combining a small diameter (0.89 mm, 20 gauge) and incorporating excellent optical resolution, even at extremely close working distances. After ballooning a limited part of the retina without creating a retinal hole, the 20-gauge GRIN endoscope can be introduced into the subretinal space through the sclera and choroid, posterior to the pars plana. Surgical instruments can then be introduced into the subretinal space through a second neighboring sclerotomy. Thus, subretinal surgery can be performed under direct endoscopic control. As a result of direct visualization, the surgeon may perform certain surgical procedures with greater accuracy, i.e., subretinal neovascular membranes may be dissected meticulously from the neurosensory retina and retinal pigment epithelium, minimizing damage to both structures. The feeding choroidal vessel can be identified and directly coagulated, which is usually very difficult during conventional subretinal surgery. Endoscopic subretinal surgery is thus a significant improvement over conventional methods, avoiding the need for a retinotomy and increasing the safety and facility of the surgery itself.

For evaluation of the effects of different free-radical scavengers on biochemical changes in lens-induced uveitis (LIU), ten male Wistar rats were sensitized for 8 weeks using bovine lens protein and Freund's adjuvant. The uveitis was induced by disruption of the lens capsule. One group of animals received superoxide dismutase and catalase (SOD/CAT); a second group of animals was treated with vitamin E. Lipid peroxides (LPO) of the retinal tissue and aqueous humor served as parameter of oxidative tissue damage. Glutathione (GSH/GSSG) of the aqueous humor was evaluated as a parameter of the tissue's redox state. For evaluation of the inflammatory response, myeloperoxidase activity (MPO) was determined in the iris/ciliary-body complex. SOD/CAT produced no improvement in the significantly (P < 0.05) elevated MPO and LPO values recorded for untreated control animals. Following vitamin E treatment the GSH/GSSG and LPO values in aqueous humor were markedly improved as compared with controls. Retinal LPO values were significantly (P < 0.05) reduced as compared with controls. No change in MPO levels was observed. The results demonstrate that enzymes such as SOD and CAT do not influence tissue damage at a significant level, whereas radical chain breakers such as vitamin E can do so. However, the inflammatory response itself is not reduced. To achieve global results, drugs are necessary that act on both free radicals produced by noninflammatory pathways and those originating from inflammation.

In this article, the development and application of a modified technique of impression cytology for the electron-microscopic examination of corneal epithelium is presented. Corneal epithelium of controls and diabetic patients was obtained using millipore filters, which had been presoaked with EDTA to weaken intercellular adhesions. Light and electron microscopy (EM) of the control samples showed sheets of well-preserved corneal epithelial cells. Therefore, this modified technique is supposed to be useful for the analysis of alterations of the corneal epithelium. EM of corneal cells of diabetic patients showed irregularly formed epithelial cells. The corneal epithelium of diabetic patients revealed thickening of the basement membrane and a decreased number of hemidesmosomes. The alterations observed in specimens of diabetic patients represent the morphological equivalent of an impaired epithelial barrier function, an increased fragility of epithelial lining and the disturbed healing properties occurring in diabetic keratopathy.

Purpose: To evaluate whether products of oxidative and inflammatory reactions are detectable in the tear fluid of patients suffering from dry eyes., Methods: The tear fluid of 217 patients (397 eyes) was sampled. Criteria for grouping of the patients were (1) basic secretion test ("sicca 1": BST = 0-5 mm, n = 78 eyes; "sicca 2": BST = 6-10 mm, n = 109 eyes) and (2) subjective symptoms (normal BST, burning, foreign body sensations, tearing, dryness of the eyes: n = 78 eyes). One group of healthy patients (normal BST, n = 132 eyes) served as controls. Lipid peroxide levels and myeloperoxidase activity, as parameters for oxidative tissue damage and inflammatory activity, were determined in the tear fluid. Those patients whose consent could be obtained were subjected to the rose bengal test (sicca 1: 56 eyes; sicca 2: 97 eyes; subjective symptoms: 44 eyes; controls: 49 eyes). The correlation between BST and rose bengal test results was calculated., Results: Lipid peroxides were significantly (P < 0.05) higher in the groups sicca 1 and subjective symptoms than in healthy controls, as was the inflammatory activity in groups sicca 1, sicca 2 and subjective symptoms. Additionally, the inflammatory activity in the group sicca 1 was significantly (P < 0.05) higher than in the groups sicca 2 and subjective symptoms. No evidence of a significant correlation between BST and rose bengal test results was observed., Conclusions: Both oxidative tissue damage and polymorphonuclear leukocytes indicating an oxidative potential occur in the tear film of patients suffering from dry eyes. These reactions lead to severe damage of the involved tissue. Free radicals and inflammation may be involved in the pathogenesis or in the self-propagation of the disease.

Purpose: To clarify whether the prolonged presence of perfluorochemicals (PFC) in the vitreous cavity causes oxidative tissue damage and inflammatory response of the retina and, if so, what the process is., Methods: After three different perfluorochemicals [perfluorodecalin (C10F18), perfluorooctane (C8F18) and Fluosol-DA (corresponding to a 20% emulsion of 70% PFD and 30% perfluorotripropylamine, C9F21N)] had been in the vitreous cavity of rabbits for 2 weeks, lipid peroxide concentration and myeloperoxidase activity in the retina were determined., Results: Whereas only Fluosol-DA showed significant oxidative damage, the inflammatory activity was significantly increased in all groups., Conclusion: The increased myeloperoxidase activity and the observed oxidative damage of the retina seem to be the effect of both perfluorochemical-loaded macrophages and inflammatory-induced lipid peroxidation.

Purpose: An intravitreal injection of Fluosol-DA leads to a higher alteration of the macrophage system of the retina than perfluorooctane and perfluorodecalin administered by the same route. The difference may be due to different kinds of oxidative damage caused by the three chemicals. To test the validity of this assumption, the degree of cell alteration, expressed as reduction of cytoplasmic motility, caused by these three perfluorochemicals was examined., Methods: Using the hepatic macrophage system of the rat, cell alteration was examined by magnetometry after intravenous application of various perfluorochemicals [emulsified perfluorodecalin (C10F18), perfluorooctane (C8F17Br) and Fluosol-DA (corresponding to a 20% emulsion of 70% perfluorodecalin and 30% perfluorotripropylamine, C9F21N)]., Results: After administration of high doses, all perfluorochemicals led to cytoskeleton alteration. This alteration, expressed as retardation of the relaxation period of ferromagnetic iron oxide particles, was most pronounced after administration of Fluosol-DA., Conclusion: The compromising effect of perfluorochemicals is dose dependent and differs among the three compounds tested, with Fluosol-DA showing the greatest decrease in cytoplasmic motility.

To clarify the mechanical difficulties experienced when performing anterior capsulorhexis in vitrectomized eyes filled with silicone oil. Five anterior lens capsules removed from eyes with a silicone oil history were submitted to light and electron microscopic analysis and then compared to two capsules from eyes with trauma history and seven capsules from eyes without silicone oil or trauma history. Comparable abnormalities of the inner and outer surface of the anterior lens capsule were consistently observed after silicone oil fill of the vitreous cavity or after traumatic impact to the lens: patches of multilayer epithelial cells with interspersed capsule material and connective tissue were observed on the posterior surface of the anterior lens capsule. The development of this anterior subcapsular tissue plaque is obviously influenced not only by the PVR process or by side effects of the surgical procedure but also by the silicone oil tamponade or a trauma history. The plaque can be considered primarily responsible for the increased mechanical resistance of the lens capsule in all eyes with silicone oil / trauma history examined in this study.

Purpose: This study was conducted to examine possible adverse effects on lens transparency caused by pneumatic retinopexy using sulfur hexafluoride gas., Methods: In a prospective study, both lenses of 33 patients undergoing pneumatic retinopexy in one eye were monitored up to 24 months postoperatively by slit-lamp examination and Scheimpflug photography., Results: Pneumatic retinopexy does not cause significant lens opacifications up to 2 years after surgery., Conclusion: Temporary gas tamponade for pneumatic retinopexy is not associated with permanent changes in lens transparency.

The multiport illumination system was developed as a fiberoptically illuminated pars plana cannula system for vitreous surgery. The retinal irradiance of the multiport illumination system and several other commonly used endoilluminators (light pipes) measured at 5 mm are comparable, ranging from 94 to 256 mW/cm2. In the actual surgical setting, however, the retinal irradiance of the multiport illumination system is far less (56 mW/cm2) because the end of the fiberoptic cables are fixated in the pars plana 16.5 mm away from the retinal surface. A reduction in the maximal intensity (100%) to 50% reduces the retinal irradiance by approximately two thirds to 3.7 mW/cm2. The light emitted by the multiport illumination system used in conjunction with a long-wave pass filter with a cutoff wavelength of 420 nm reduces the amount of short-wavelength light by one third to about 4% of the overall irradiance.

Retinal vascular manifestation is the most common form of ophthalmic involvement in patients with systemic lupus erythematosus (SLE). Most frequently these consist of cotton-wool spots with or without intraretinal hemorrhages. Although rare, a more severe retinal vaso-occlusive disease, termed retinal vasculitis, has been described. We report on a 37-year-old white female with a 13-year follow-up of chronic discoid lupus erythematosus, which suffered massive bilateral visual loss coincident with the systemic exacerbation of her disease (proteinuria, pneumonia, serositis, leucopenia). The diagnosis of SLE was established with reference to the revised ARA-criteria (American Rheumatism Association). Ophthalmoscopy and fluorescein angiography revealed the typical aspect of a SLE-associated vaso-occlusive retinopathy on both eyes with marked ischemia of the macula. Immediate maximal immuno-suppressive therapy, early performed panretinal photocoagulation and subsequent cryoretinopexy did not stop the progression of the disease. Six months after the initial event vascularisations of the disc and rubeosis iridis occurred, but no secondary glaucoma up to date. In this patient, the almost complete absence of characteristic autoantibodies and immunological markers was striking. The correlation with other lupus manifestations, different therapeutic concepts and prognostic factors in SLE-associated retinal vasculitis are discussed.

A multiport illumination system (MIS) suitable for use during microsurgery of the vitreous body is presented. The MIS consists of several thin, illuminated pilot tubes, which are secured in the pars plana region and emit bright light at a wide angle. Through their lumen interchangeable 20 gauge instruments for active bi-manual vitreous surgery and an infusion pipe can be introduced. The system illuminates the entire field of wide-angle observation devices without the need for an additional hand-held light source.