Cataract Formation In Patients Research Articles

1H-NMR analysis of amino acid metabolism in aqueous humor of patients with cataract, according to diabetes status.

ObjectiveTo investigate the differences in amino acid metabolism in aqueous humor of patients with cataract, according to diabetes status, using a 1H-nuclear magnetic resonance approach.MethodsAqueous humor samples from patients with age-related cataract, with or without diabetes, were collected during cataract surgery. All samples underwent nuclear magnetic resonance spectra analysis to characterize their metabolic function. Potential metabolic pathways were analyzed via MetaboAnalyst 3.0.ResultsThis study included eight aqueous humor samples from patients with cataract and diabetes and eight aqueous humor samples from age- and sex-matched patients with cataract alone. Four metabolites were found to significantly differ in the aqueous humor of patients with cataract and diabetes, relative to patients with cataract alone; these metabolites were glucose (higher in patients with diabetes), valine, lysine, and tyrosine (all lower in patients with diabetes). Aminoacyl-tRNA biosynthesis was presumed to be involved in the metabolic differences observed in patients with cataract, according to diabetes status.ConclusionsThe amino acid metabolic profile in the aqueous humor differed among patients with cataract, according to diabetes status. Disturbance of amino acid metabolism in the aqueous humor may be related to cataract formation in patients with diabetes.

The Evaluation of TUNEL, PCNA and SOX2 Expressions in Lens Epithelial Cells of Cataract Patients with Pseudoexfoliation Syndrome

ABSTRACT Purpose This study aims to determine the expression patterns of terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL), proliferating cell nuclear antigen (PCNA) and SOX2 in lens epithelial cells (LEC) of cataract patients with pseudoexfoliation syndrome (PEX), and to determine the effect of apoptosis, proliferative activity and stem/progenitor cells on cataract formation in patients with PEX. This is a prospective, randomized clinical trial. Materials and Methods Setting: institutional. 50 eyes of 50 patients were included. Anterior capsule samples were obtained during phacoemulsification surgery. The specimens of LEC were also examined using the TUNEL, PCNA and SOX2 immunohistochemical staining method. To detect the number of immunopositive cells, the total number of cells in a 3 mm2 area was counted using a microscope under x20 magnification and the percentage of cells stained positive was determined. Results In Group 1, increased expression was observed with TUNEL, while decreased expression was detected with PCNA (p = .008, p = .015). The average percentage of TUNEL immunopositive cells was significantly higher in Group 1 than in Group 2, but there was no statistically meaningful SOX2 expression in Group 1 and Group 2 (P = .44). Apoptosis rates were 61.75 ± 14.5% and 36.91 ± 14.6% in Groups 1 and 2, respectively. Proliferation rates were 40.96 ± 16.8% and 65.45 ± 16.9% in Groups 1 and 2, respectively. Conclusion We found increased apoptosis and decreased proliferation of LECs in cataract patients with PEX. We suspected that this could be related to oxidative stress.

Steroid cataract in patients with hemoblastosis

Modern technologies of treatment of children with oncohaematological diseases allowed to noticebly increase the survival indexes in this group of patients, enhancing the value of maintenance of their life quality. More than half of those who received long-term steriod and radiation treatment develop cataract that causes decrease in vision. In this review we represent data concerning mechanisms of cataract formation in patients after steriod and radiation treatment, results of anatomical, physiological and biochemical studies of the lens as well as metabolic changes in aqueous humor leading to cataract formation.

The Manchester Uveitis Clinic: The first 3000 patients, 2: Uveitis Manifestations, Complications, Medical and Surgical Management

Purpose: To demonstrate the manifestations and complications of uveitis, and their medical and surgical management, in a very large group of patients attending the Manchester Uveitis Clinic (MUC), a specialist uveitis clinic in the Northwest of England, UK.Methods: Retrospective retrieval of data on a computerized database incorporating all new referrals to MUC from 1991 to 2013.Results: A total of 3000 new patients with uveitis were seen during a 22-year period, of which 25.2% had a single acute episode, 13.6% had acute recurrent uveitis, 20.2% had chronic fluctuating uveitis, and 41.0% had chronic unremitting uveitis. The commonest complications were cataract (35% of patients), macular edema (20.5%), and glaucoma (19.5%). Oral steroids were required in 36% of patients, oral immunosuppression in 16%, and biologic treatment in 2%. Major intraocular surgery was required in 28%.Conclusions: Oral steroid usage is not an independent risk factor for cataract formation in patients with uveitis. Oral immunosuppression usage has increased 4-fold during this study period.

Radiation therapy for orbital lymphoma

To describe radiation techniques and evaluate outcomes for orbital lymphoma. Forty-six patients (and 62 eyes) with orbital lymphoma treated with radiotherapy between 1987 and 2003 were included. The majority had mucosa-associated lymphoid tissue (48%) or follicular (30%) lymphoma. Seventeen patients had prior lymphoma at other sites, and 29 had primary orbital lymphoma. Median follow-up was 46 months. The median dose was 30.6 Gy; one-third received <30 Gy. Electrons were used in 9 eyes with disease confined to the conjunctiva or eyelid, and photons in 53 eyes with involvement of intraorbital tissues to cover entire orbit. Local control rate was 98% for all patients and 100% for those with indolent lymphoma. Three of the 26 patients with localized primary lymphoma failed distantly, resulting in a 5-year freedom-from-distant-relapse rate of 89%. The 5-year disease-specific and overall survival rates were 95% and 88%, respectively. Late toxicity was mainly cataract formation in patients who received radiation without lens block. A dose of 30 Gy is sufficient for indolent orbital lymphoma. Distant relapse rate in patients with localized orbital lymphoma was lower than that reported for low-grade lymphoma presenting in other sites. Orbital radiotherapy can be used for salvage of recurrent indolent lymphoma.

Intravitreal triamcinolone-induced elevated intraocular pressure is associated with the development of posterior subcapsular cataract

To investigate the association between elevated intraocular pressure (IOP) and accelerated cataract formation in patients treated with intravitreal triamcinolone. Analysis of longitudinal data from a randomized, double-masked, placebo-controlled trial of intravitreal triamcinolone for age-related macular degeneration (the Intravitreal Triamcinolone Study). Patients with phakic eyes who participated in a randomized clinical trial of intravitreal triamcinolone for age-related macular degeneration were studied. There were 57 phakic eyes in the treatment group and 54 phakic eyes in the control group. One eye per patient was studied. Four milligrams of intravitreal triamcinolone or 1 ml subconjunctival saline. Intraocular pressure rise of at least 5 mmHg (IOP responders) and progression of posterior subcapsular cataract by 2 or more grades using photographic standards from the Age Related Eye Disease Study. Progression of posterior subcapsular cataract (PSC) by 2 or more grades in the treatment group was significantly higher among 16 IOP responders (51% after 2 years) than among 37 nonresponders (3%; P<0.0001, log-rank test). There was no significant progression of PSC in the placebo group or the opposite eye of the treatment group. Progression of cortical cataracts also was significantly higher among responders than nonresponders (15% vs. 3%; P = 0.015, log-rank test). The progression of nuclear cataracts (13% vs. 3%) was not significantly different between IOP responders and nonresponders (P = 0.3, log-rank test). Although steroid-related cataracts are unlikely to develop in eyes that do not experience elevated IOP after intravitreal triamcinolone, those eyes that do also have a very high risk of rapidly experiencing posterior subcapsular lens opacification. This strong association suggests that the mechanism responsible for the development of steroid-induced PSC cataract and raised IOP may be similar.

Suppression of Post-Vitrectomy Lens Changes in the Rabbit by Novel Benzopyranyl Esters and Amides

This study reports for the first time a therapeutic modality for the suppression of posterior subcapsular cataract (PSC) formation in an animal model (rabbit) of vitrectomy. This therapeutic modality may also have the potential to attenuate/prevent the high incidence of loss of vision due to cataract formation in patients that undergo vitrectomy. Unilateral, partial vitrectomy was performed on 2.5 month old Dutch Belted rabbits with vitreous replaced by either commercially available BSS® or BSS PLUS® (n=16). Alternatively, vitreous was replaced with a proprietary, modified BSS PLUS® irrigating solution containing 1.25μM AL-8417 (n=12), 5.0μM AL-12615 (n=5) or 5.0μM AL-17052 (n=9). Age matched, non-operated rabbits were used as controls (n=16). Lenses were analysed by correlative structural (light, scanning electron microscopic and three-dimensional computer-assisted drawings) and optical (low power helium-neon laser scan) quality analysis 6 months following surgery. Results demonstrate that vitreous replacement with an irrigating solution that contains the ester-linked benzopyran, AL-8417, the amide-linked benzopyran pro-drug, AL-17052, or its active metabolite, AL-12615, prevented abnormal post-vitrectomy lens growth, or fiber formation. Focal length variability (FLV) assessments (sharpness of focus) confirmed the beneficial drug effects detected morphologically, with FLV being essentially equal to that of age-matched, non-surgical controls. In contrast, lenses of animals with vitreous replaced solely with BSS® or BSS PLUS® exhibited significantly higher FLV than both age-matched controls and animals that underwent vitrectomy with drug-containing irrigating solutions. The ability of AL-8417, AL-17052 and its active metabolite, AL-12615, to suppress vitrectomy-induced posterior lens fiber changes appears to reside in their unique pharmacological profile, acting as antioxidant, anti-inflammatory and cytostatic agents.

Abnormalities in Serum Lipids and Leukocyte Superoxide Dismutase and Associated Cataract Formation in Patients With Atopic Dermatitis

Because lipid peroxides are believed to play a role in cataract formation, we examined serum lipid and lipid peroxide levels in patients with atopic dermatitis (AD) complicated by cataract formation in comparison with AD patients without cataracts and patients with other forms of dermatitis, taking into account any treatment with corticosteroids. Since reactive oxygen species play an important role in lipid peroxide formation, the induction of leukocyte superoxide dismutase, which scavenges reactive oxygen species and inhibits lipid peroxidation, was also examined. Most of the patients with AD and cataract were older than 13 years, and had severe, treatment-resistant dermatitis. Serum levels of chylomicrons, very-low-density lipoprotein, and lipid peroxide levels were increased, and superoxide dismutase activity was markedly less inducible in patients with cataracts. These abnormalities demonstrated were irrespective of previous topical corticoid treatment. Although AD patients without cataracts also showed significant abnormalities in all of the parameters measured, these were less marked than in the AD patients with cataracts. In contrast, these findings were not observed in patients with other forms of dermatitis who had been receiving prolonged topical corticosteroid therapy. High levels of serum lipids and decreased superoxide dismutase inducibility thus appear to be correlated with AD and also independently with attendant cataract formation. From the observation that most of the patients originated from areas of high environmental pollution whose products are known to produce great amounts of reactive oxygen species, excessive lipid peroxide formation, perhaps in part environmentally induced, seems to correlate to severe, adult-type AD with cataract formation.

Abnormalities in serum lipids and leukocyte superoxide dismutase and associated cataract formation in patients with atopic dermatitis

<h3>Background and Design:</h3> Because lipid peroxides are believed to play a role in cataract formation, we examined serum lipid and lipid peroxide levels in patients with atopic dermatitis (AD) complicated by cataract formation in comparison with AD patients without cataracts and patients with other forms of dermatitis, taking into account any treatment with corticosteroids. Since reactive oxygen species play an important role in lipid peroxide formation, the induction of leukocyte superoxide dismutase, which scavenges reactive oxygen species and inhibits lipid peroxidation, was also examined. Most of the patients with AD and cataract were older than 13 years, and had severe, treatment-resistant dermatitis. <h3>Results:</h3> Serum levels of chylomicrons, very-low-density lipoprotein, and lipid peroxide levels were increased, and superoxide dismutase activity was markedly less inducible in patients with cataracts. These abnormalities demonstrated were irrespective of previ- ous topical corticoid treatment. Although AD patients without cataracts also showed significant abnormalities in all of the parameters measured, these were less marked than in the AD patients with cataracts. In contrast, these findings were not observed in patients with other forms of dermatitis who had been receiving prolonged topical corticosteroid therapy. <h3>Conclusions:</h3> High levels of serum lipids and decreased superoxide dismutase inducibility thus appear to be correlated with AD and also independently with attendant cataract formation. From the observation that most of the patients originated from areas of high environmental pollution whose products are known to produce great amounts of reactive oxygen species, excessive lipid peroxide formation, perhaps in part environmentally induced, seems to correlate to severe, adult-type AD with cataract formation. (Arch Dermatol. 1994;130:1387-1392)

Bovine lens aldehyde dehydrogenase. Purification and preliminary characterization.

Cytoplasmic aldehyde dehydrogenase from bovine lens was purified to apparent homogeneity by using ion-exchange and affinity chromatography. Sedimentation-equilibrium ultracentrifugation, gel-filtration chromatography and sodium dodecyl sulphate/polyacrylamide-gel electrophoresis show that the enzyme is a dimer of Mr 114000, with subunits of Mr 57000. The enzyme does not dissociate into monomers in the presence of Ca2+ or Mg2+. The enzyme has a pI of 5.0, an activation energy of 35.1kJ/mmol and a pK value of 8.6 with acetaldehyde as substrate. The enzyme is a prolate ellipsoid with a Stokes radius of 4nm. Progesterone, deoxycorticosterone and chlorpropamide inhibited enzyme activity, and this inhibition may play a role in cataract formation in patients maintained on systemic corticosteroids and in tablet-dependent diabetics.

Aspirin effect on cataract formation in patients with rheumatoid arthritis alone or combined to diabetes

The prevalence of cataracts is significantly lower in patients with rheumatoid arthritis receiving aspirin (mean of 2,700 mgs daily for an average of 10.4 years) as compared to the matched population not receiving aspirin. Similarly, fewer cataracts were found among a population with diabetes and rheumatoid arthritis receiving aspirin (mean of 2,340 mgs daily for an average of 8.8 years) as compared to the matched population on no aspirin. The effects of aspirin on cataract formation may result from 1) lowering of plasma tryptophan levels and increased excretion of tryptophan metabolites, 2) inhibition of aldose reductase and sorbitol formation in the diabetic lens, 3) inhibition of tryptophan or kynurenine binding to lens protein.

Ocular toxicity of commonly used systemic drugs.

The eye a complex organ with multiple enzyme systems often reflect s untoward side effects of drugs. Retinal edema associated with a visual field defect and blurring of vision has been reported in patients using oral contraceptives. Cataract formation in patients receiving long-term steroid therapy has been reported. Discontinuing the steroid avoids progress of the cataracts. Rise in intraocular pressure and decr eased resistance to infection may also occur with steroid therapy. Topical application of steroid drops or ointment to the eye is dangerous especially when herpes simplex keratitis is present. Ocular problems found with tranquilizers phenothiazide digitalis chloroquine and belladonna alkaloids are also detailed.