Chamber In Patients Research Articles

Penetrating Keratoplasty With Sutureless Intrasclerally Fixated Intraocular Lens.

In this retrospective study, we reviewed the use of penetrating keratoplasty with sutureless intrasclerally fixated intraocular lens implantation in a closed anterior chamber in patients with several corneal pathologies and aphakia. The medical records of 6 patients, who underwent the procedure, were reviewed. In the procedure, lamellar scleral tunnels at the 2- and 8-o'clock positions were created with a microvitreoretinal blade, 1.5 mm away from the limbus. Two 27-gauge bent needles were passed, first horizontally, through these tunnels, and then vertically, which allowed them to enter the posterior chamber and to be left in position. Partial thickness trephination was made, and anterior stroma was removed where necessary. An incision was made at the 11-o'clock position, where the trephination was made, which was then extended to both sides for about 6 mm with corneal scissors. From the superior incision, the anterior haptic of a 3-piece intraocular lens was pushed through the needle at the 2-o'clock position, then the posterior haptic was pushed through the needle at the 8-o'clock position, and both haptics were removed through the sclera. Both ends were cauterized and placed into the sclera. Residual stroma was removed, and the donor graft was sutured. At the last follow-up visit, the mean bestcorrected visual acuity was significantly increased. No serious complications were seen, with the exception of increased intraocular pressure in 3 patients. Penetrating keratoplasty with sutureless intrasclerally fixated intraocular lens implantation can be used safely in patients with aphakia. With this technique, the globe stabilization can be maintained, and the trauma to the donor graft endothelium can be minimized.

MicroRNAs in the Vitreous Humor of Patients with Retinal Detachment and a Different Grading of Proliferative Vitreoretinopathy: A Pilot Study.

PurposeAlthough the expression of microRNAs (miRNAs) in retinal pigment epithelial (RPE) cells undergoing epithelial-mesenchymal transition (EMT) is involved in the pathogenesis of proliferative vitreoretinopathy (PVR), its expression in the vitreous of patients with primary retinal detachment (RD) and different PVR grading has not yet been investigated. We assessed the expression of miRNAs in the vitreous humor (VH) of patients diagnosed with RD and different grading of PVR.MethodsThe VH was extracted from the core of the vitreous chamber in patients who had undergone standard vitrectomy for primary RD. RNA was extracted and TaqMan Low-Density Arrays (TLDAs) were used for miRNA profiling that was performed by single TaqMan assays. A gene ontology (GO) analysis was performed on the differentially expressed miRNAs.ResultsA total of 15 eyes with RD, 3 eyes for each grade of PVR (A, B, C, and D) and 3 from unaffected individuals, were enrolled in this prospective comparative study. Twenty miRNAs were altered in the comparison among pathological groups. Interestingly, the expression of miR-143-3p, miR-224-5p, miR-361-5p, miR-452-5p, miR-486-3p, and miR-891a-5p increased with the worsening of PVR grading. We also identified 34 miRNAs showing differential expression in PVR compared to control vitreous samples. GO analysis showed that the deregulated miRNAs participate in processes previously associated with PVR pathogenesis.ConclusionsThe present pilot study suggested that dysregulated vitreal miRNAs may be considered as a biomarker of PVR and associated with the PVR-related complications in patients with RD.Translational RelevanceThe correlation between vitreal miRNAs and the pathological phenotypes are essential to identify the novel miRNA-based mechanisms underlying the PVR disease that would improve the diagnosis and treatment of the condition.

Intraindividual comparison of cytokine and prostaglandin levels with and without low-energy, high-frequency femtosecond laser cataract pretreatment after single-dose topical NSAID application.

To investigate interleukin (IL)-1β, IL-6, and total prostaglandin (PG) levels in the anterior chamber in patients undergoing low pulse energy femtosecond laser-assisted cataract surgery. Forty patients undergoing immediate sequential cataract surgery received randomized low-energy femtosecond laser pretreatment in 1 eye and conventional phacoemulsification in the other. Aqueous humor was collected precisely 5 minutes after femtosecond laser pretreatment and before conventional phacoemulsification from all 80 eyes. IL-1β, IL-6, and total PG (including PGE1, PGE2; PGF1a, PGF2a) levels were analyzed using enzyme-linked immunoassay kits. One drop of ketorolac 0.5% was administered 30 minutes preoperatively. Mean concentrations of IL-1β, IL-6, and total PG were 0.87, 0.67, and 32.19 pg/mL in the femto group compared with 0.10 (P = .36), 0.78 (P = .79), and 19.66 pg/mL (P < .05) in the nonfemto group. Levels of IL-1β and IL-6 were not statistically significantly different when compared between groups. There was a small but statistically significant increase of PG levels in the femto group. There were no statistically significant correlations between levels of 1β, IL-6, or total PG and suction time or lens density (P > .05). Low pulse energy femtosecond laser pretreatment did not trigger any additional IL and only a small but statistically significant increase of PG release in the anterior chamber after a single-dose of topical nonsteroidal antiinflammatory drug administered 30 minutes before the start of cataract surgery. The findings indicated that the minor inflammatory reaction was due to the lower pulse energy concept applied by the femtosecond laser.

Predictors of Spontaneous Echo Contrast in Left Heart Chambers in Patients with Dilated Cardiomyopathy: Slowing Down Might not Always Mean Enjoying Life.

Introduction:Spontaneous echo contrast(SEC) is usually detected in heart chambers as a result of reduced flow velocity in the cavity. The clinical importance of SEC lies in its association with embolic events. The aim of our study was to determine the frequency of SEC in left heart chambers in sinus rhythm patients with dilated cardiomyopathy and predictors for its emergence.Materials and Methods:This was a prospective cross-sectional transesophageal echocardiography study conducted in 101 sinus rhythm patients with dilated heart and mild-to-moderate systolic dysfunction.Results:Moderate-degree SEC was found in the left ventricle(LV) in around 9% of patients, in the left atrium(LA) in 12% and in left atrial appendage(LAA) in 40%. Multiple regression analysis showed that lower heart rate(95% confidence interval[CI]: 0.845–0.978; P = 0.011) and larger LV end-systolic diameter(LVESD)(95% CI: 1.034–1.394; P = 0.017) were independent predictors for LV SEC presence. Lower LV ejection fraction(LVEF) (95% CI: [−0.079]–[−0.037]; P = 0.0001) was the only independent predictor for SEC in the LA. Whereas, independent predictors for SEC in LAA were lower heart rate(95% CI:[−0.030]–[−0.003]; P = 0.018), greater LA indexed diameter (95% CI: 0.016–0.116; P = 0.010), and higher value of C-reactive protein(CRP)(95% CI: 0.0026–0.031; P = 0.027).Conclusions:SEC in left heart chambers is a frequent finding in patients with dilated cardiomyopathy in sinus rhythm. Lower heart rate and LVEF, larger LVESD and LA, as well as higher CRP, predict the presence of SEC in left heart chambers. Lower heart rate might be an essential predictor for SEC presence and severity in these patients.

Diyabetik Makuler Ödem Tedavisinde İntravitreal Aflibercept ve Ranibizumab Enjeksiyonunun Kornea Endoteline ve Ön Kamaraya Etkisi

Amaç: İntravitreal ranibizumab ve aflibercept enjeksiyonu yapılan gözlerdeki kornea endotel sayısı ve morfolojisinin ve ön kamara anatomisinin incelenmesidir. Gereç ve Yöntemler: Bu prospektif ve kesitsel çalışmaya, diyabetik makuler ödem nedeni ile tedavi edilen 51 hastanın 102 gözü dâhil edildi. Hastaların tek gözüne 1 ay ara ile üç doz intravitreal ranibizumab ya da aflibercept enjeksiyonu uygulandı. Ranibizumab enjeksiyonu yapılan hastalar ranibizumab grubuna (n=26), aflibercept enjeksiyonu yapılan hastalar aflibercept grubuna (n=25) dâhil edildi. Her iki grupta da hastaların tedavi edilmeyen gözleri kontrol grubu olarak alındı. Hastaların endotel hücre sayısı (EHS), hücre alanı değişim katsayısı (CV), altıgen şekilli hücre (HKZ) yüzdesi, merkezi kornea kalınlığı (MKK), ön kamara derinliği (ÖKD), ön kamara hacmi (ÖKH), iridokorneal açı (İKA) ve horizontal ön kamara çapı (HÖKÇ) değerlendirmeleri yapıldı. Bulgular: Aflibercept ve ranibizumab grubunda hem tedavi edilen gözlerde hem de kontrol gözlerde tedavi öncesi ve sonrasında ortalama korneal endotel hücre sayısı, CV ve HKZ yüzdesi bakımından istatistiksel olarak anlamlı fark yoktu. Her iki gruptaki ortalama MKK değeri hem tedavi edilen gözlerde hem de kontrol gözlerde tedavi öncesinde tedavi sonrasına göre anlamlı olarak daha fazla idi (p<0,05). Her iki grupta, tedavi edilen ve kontrol gözlerde ortalama ÖKD, ÖKH, İKA ve HÖKÇ değerleri arasında tedavi öncesi ve sonrası anlamlı bir fark izlenmedi. Sonuç: Çalışmamız, intravitreal aflibercept ve ranibizumab enjeksiyonunun kornea endotelinde ve ön kamara yapısında herhangi bir değişikliğe sebep olmadığını göstermiştir.

Coagulation factors and fibrinolytic activity in the left atrial appendage and other heart chambers in patients with atrial fibrillation: is there a local intracardiac prothrombotic state? (HEART-CLOT study)

IntroductionAtrial fibrillation (AF), a risk factor for stroke and systemic thromboembolism, is associated with unfavorable fibrin clot properties and increased thrombus formation in peripheral blood. The left atrial appendage (LAA) is known to be the primary site of thrombus formation. AimWe investigated the relative differences in plasma fibrin clot features including plasma fibrin clot permeability (Ks) and clot lysis time (CLT) between the right atrium (RA), right ventricle (RV), left atrium (LA), left ventricle (LV), LAA, and peripheral blood. MethodsSixteen patients with nonvalvular AF who stopped oral anticoagulant therapy at least 2 days before a LARIAT procedure participated in a single-center prospective study. We measured fibrinogen and plasminogen levels along with Ks, CLT, and endogenous thrombin potential (ETP) during the LARIAT procedure in blood obtained from the right femoral vein, RA, RV, LA, LV and LAA. ResultsLAA clot porosity was reduced by 16.2% compared to peripheral blood (p = 0.026), also after adjustment for fibrinogen levels (p = 0.038). Ks was similar for the RA, RV, LA, LV, and LAA (all p > 0.05). We found 14.7% prolonged CLT for clots prepared from blood samples obtained from the LAA compared to those prepared from peripheral blood, but no differences between the RA, RV, LA and LV (all p > 0.05) were found. There were no significant differences in other parameters, including ETP, between heart chambers. ConclusionsPatients with AF are characterised by a local prothrombotic state as reflected by formation of compact fibrin clots in the LAA compared to peripheral blood, which may contribute to LAA thrombus formation and device-related thrombi.

Study of angle of anterior chamber in patients with Type 2 Diabetes Mellitus

Introduction: Open angle Glaucoma is one of the causes of blindness in diabetic patients. Whether diabetes is a risk factor for angle closure glaucoma also is less thoroughly studied. Objectives: To assess the angle of anterior chamber in patients with type 2 diabetes mellitus. Materials and Method: 125 patients (250 eyes) who met the inclusion criteria were taken up for the study. Patients of both sexes and more than 40 years of age with Type 2 Diabetes Mellitus who do not come under the exclusion criteria were included. Results: In subjects with duration of diabetes &lt;5 years, Grade 4 angle was found in 47.41% of eyes which was comparatively more than the other grades. When the duration of Diabetes was 5-10 years, 40% of the eyes had Grade 4 angle and 37.27% had Grade 3 angle. In subjects with &gt;10 years duration of diabetes, 33.33% had Grade 3 angle. Grade 2 and Grade 4 angles were of equal distribution with 29.16% and Grade 1 was found to be less. The association of Grade 1 and Grade 3 angle with severe non-proliferative diabetic retinopathy was found to be statistically significant. Whereas, in patients with mild diabetic retinopathy and in moderate non-proliferative diabetic retinopathy Grade 4 angle is statistically significant. Conclusion: This study thus concludes the grade of angle of the anterior chamber decreases as the diabetic retinopathy advances.

Thrombogenic and Arrhythmogenic Roles of the Left Atrial Appendage in Atrial Fibrillation.

Understanding the anatomy, physiology, and arrhythmogenic and thrombogenic roles of the left atrial appendage (LAA) has become very important. The potential deleterious effects of this chamber in patients with atrial fibrillation have led to the development of specific treatments for this structure. It has been established that the LAA is the area where the vast majority of thrombi in nonvalvular atrial fibrillation are formed and that some LAA morphologies may actually facilitate thrombi formation and risk stratification for thromboembolic events in patients with low CHA2DS2-VASc scores. Likewise, clinical data supporting the role of LAA electric isolation to improve freedom from all-atrial arrhythmias are rapidly growing. Acute LAA electric isolation can be achieved in most cases of catheter ablation for atrial fibrillation. However, late LAA reconnections are frequent. Special considerations should be taken when this procedure is performed to avoid myocardial perforation, left phrenic nerve, and left circumflex coronary artery damage. LAA electric isolation is a safe procedure that does not increase the risk of stroke as long as patients remain compliant with lifelong anticoagulation regardless of CHA2DS2-VASc score. Finally, ligation of the LAA has recently been associated with modulation of the renin-angiotensin-aldosterone system with clinical implications in blood pressure control.

Morphologic and Functional Changes in Right-Sided Cardiac Chambers in Patients With Chronic Liver Disease and Normal Pulmonary Artery Pressure.

To investigate the effects of chronic liver disease (CLD) on the structural and functional characteristics of right-sided heart chambers in patients with normal pulmonary artery pressure. Fifty-one patients with known CLD but without pulmonary hypertension or other cardiovascular conditions were consecutively enrolled, along with 25 age- and sex-matched participants. Patients with CLD were classified according to the Model of End-Stage Liver Disease score and Child-Pugh classification. Right ventricular (RV) and right atrial (RA) dimensions, indices of RV systolic/diastolic function, and myocardial strain were measured by standard echocardiographic methods. Patients in the study group had similar RV end-diastolic, end-systolic, and RA dimensions compared to controls. Similarly, neither the conventional indices of RV systolic/diastolic function nor the strain imaging findings were different between groups (P > .05). Only RV free wall thickness was significantly higher in the study group (mean ± SD, 4.15 ± 0.64 versus 3.75 ± 0.37 mm; P < .001). Right ventricular end-diastolic diameter (P = .018; r = 0.334) and RA area (P = .017; r = 0.335) had a significant correlation with RV free wall thickness in patients with CLD. Patients treated with beta blockers were found to have a significant reduction in mean RV free wall strain compared to patients who did not receive beta blocker treatment (-20.37 ± 6.6 versus -24.07 ± 6.52; P = .04). Patients with CLD had increased RV free wall thickness despite normal systolic pulmonary pressure, presumably secondary to cirrhotic cardiomyopathy. In the absence of pulmonary hypertension, however, cirrhotic cardiomyopathy did not cause impaired RV systolic or diastolic function.

Remodeling the left heart chambers in patients with arterial hypertension and chronic kidney disease

Remodeling the left heart chambers in patients with arterial hypertension and chronic kidney disease

Correlation between intraocular pressure and the biometric structure of the anterior chamber in patients of chronic renal failure with hemodialysis

Correlation between intraocular pressure and the biometric structure of the anterior chamber in patients of chronic renal failure with hemodialysis

Role of immunological factors in the development of myopic choroidal neovascularization

To study the concentration of cytokines in the aqueous humor of the anterior chamber in patients with myopic choroidal neovascularization (mCNV) and to compare the results to their ophthalmic status. A total of 19 patients (19 eyes) with mCNV treated with intravitreal ranibizumab were included in the study. The control group consisted of 15 patients (15 eyes) with myopia who had cataract surgery. Age, sex, and refractive error distribution were similar to that in the study group. All patients underwent a detailed ophthalmic examination as well as immunological study of the aqueous humor for cytokines concentrations using flow fluorometry (Bio-Plex Pro Human Cytokine Panel, 27-Plex, Bio-Rad Laboratories, USA). Significant differences in concentrations of 10 cytokines were found between the mCNV and study groups. Vascular endothelial growth factor (VEGF) level was twice as low in patients with mCNV as that in the controls (191.15±142.3 pg/ml and 320.06±170.05 pg/ml, respectively) (p<0.05). The other 9 cytokines were higher in mCNV, namely, platelet-derived growth factor (PDGF-BB), inflammatory and anti-inflammatory cytokines (IL-2, IL-15, IL-17А and IL-5, IL-13, respectively), tumor necrosis factor (TNFα), and chemokines (IL-8, RANTES). The degree of myopia as well as morphological and functional changes in the macular zone were shown to be in close correlation with cytokines involved in inflammation and VEGF. VEGF level appeared to be negatively related to axial eye length, refractive error, and three cytokines: IL-13, INF-γ, and RANTES. At the same time, numerous (6, 8 and more) close correlations were established between inflammatory and anti-inflammatory cytokines, chemokines, and growth factors. Patients with mCNV have been found to have higher than usual levels of inflammatory and anti-inflammatory cytokines, chemokines, and growth factors as well as a significantly decreased VEGF concentration. Immunological status of these patients differs from that in other ocular neovascular diseases suggesting possible involvement of alternative pathogenetic mechanisms.

Evaluation of Ocular Side Effects in the Patients on Topiramate Therapy for Control of Migrainous Headache.

Topiramate, a sulfa-derivative monosaccharide, is an antiepileptic drug which is administered in the control of migraine. It is reported to cause various ocular side effects such as visual field defect and myopic shift. To investigate the alterations in refractive error, properties of the cornea and changes in the anterior chamber in patients that receive Topiramate for migraine control. This is a hospital-based, non-interventional, observational study that is conducted at Imam Hossein Hospital, affiliated to Shahid Beheshti University of Medical Sciences, Department of Neurology, in collaboration with the department of Ophthalmology. Thirty three consecutive patients with the diagnosis of migraine that were candidate for Topiramate therapy were recruited. Patients with history of ocular trauma or surgery, keratoconus, glaucoma, congenital ocular malformations and any history of unexplained visual loss were excluded. After thorough ophthalmic examination, all the patients underwent central corneal thickness (CCT) measurement, and Pentacam imaging (Scheimpflug camera) at the baseline. Various parameters were extracted and used for analysis. Anterior chamber volume (ACV), anterior chamber depth (ACD), and anterior chamber angle (ACA) measurement was performed. These measurements were repeated on day 30(th) and 90(th) after the initiation of Topiramate therapy. According to the normality tests, parameters with normal distribution were analysed using the repeated measures test and the remaining parameters (with non-normal distribution) were analysed using the non-parametric k-sample test. A p-value< 0.05 was considered statistically significant, according to Bonferroni post hoc correction. There were 66 eyes of 33 patients under the diagnosis of migrainous headache, that Topiramate was initiated for headache control, included in the study. The mean value of refractive error had a statistically significant myopic change, from -0.23 diopters (D) at the baseline to -0.61 D at the 90(th) day of follow-up period (p-value < 0.001). Mean CCT was 531.43 μm at the baseline and increased to 534.72 μm at the 30(th) day, and 537.51 μm at the 90(th) day after the administration of Topiramate (p-value=0.001). Mean value of other parameters, ACV, ACD, and ACA, did not reveal statistically significant change. Myopic shift and gradually increasing CCT in the patients after Topiramate administration should be considered before any refractive surgery. We found no gradual change in the anterior chamber and angle parameters in our patients in the 90 days of follow up. More studies with a longer duration of follow-up are needed to elucidate dose-dependent ocular manifestations.

Glaucoma Schlemm's canal stent insertion: a systematic review

Schlemm's canal stent insertion is a procedure for controlling the intraocular pressure by inserting a stent in the anterior chamber in patients with open-angle glaucoma. The objective of this review is to evaluate the safety and effectiveness of Schlemm's canal stent insertion for glaucoma. Searches of key databases, including 8 Korean databases, Medline, Embase, and Cochrane Library, were searched. Among 249 articles located in the search, a total of 14 studies (4 randomized controlled trials and 10 case series) were included in this review. Two review authors independently selected the studies and assessed their quality. On the basis of current data, we recommend that Schlemm's canal stent insertion is safe and effective for reducing intraocular pressure and the number of anti-glaucoma medications being administered for patients with open angle glaucoma.

The injection of air/oxygen bubble into the anterior chamber of rabbits as a treatment for hyphema in patients with sickle cell disease.

Purpose. To investigate the changes of partial oxygen pressure (PaO2) in aqueous humour after injecting air or oxygen bubble into the anterior chamber in sickle cell hyphema. Methods. Blood samples were taken from the same patient with sickle cell disease. Thirty-two rabbits were divided into 4 groups. In group 1 (n = 8), there was no injection. Only blood injection constituted group 2 (n = 8), both blood and air bubble injection constituted group 3 (n = 8), and both blood and oxygen bubble injection constituted group 4 (n = 8). Results. The PaO2 in the aqueous humour after 10 hours from the injections was 78.45 ± 9.9 mmHg (Mean ± SD) for group 1, 73.97 ± 8.86 mmHg for group 2, 123.35 ± 13.6 mmHg for group 3, and 306.47 ± 16.5 mmHg for group 4. There was statistically significant difference between group 1 and group 2, when compared with group 3 and group 4. Conclusions. PaO2 in aqueous humour was increased after injecting air or oxygen bubble into the anterior chamber. We offer to leave an air bubble in the anterior chamber of patients with sickle cell hemoglobinopathies and hyphema undergoing an anterior chamber washout.

EComment. Misdiagnosis of intravenous leiomyomatosis with cardiac extension

We read with great interest the article by Li et al. [1]. They performed a comprehensive literature search including 194 cases of intracardiac leiomyomatosis. We also would like to add some comments on misdiagnosis of this complicated pathology. Intravenous leiomyomatosis (IVL) is a rare neoplastic disease, which is characterized by intravenous growth of histologically benign, smooth muscle tumours arising from either a uterine myoma or from the wall of a uterine vessel [2, 3]. The tumour usually enters through the lumen of the iliac vein and extends upward to varying locations, including the inferior vena cava, adrenal and renal veins, right heart (intracardiac leiomyomatosis) and pulmonary artery. It is an insidious process and may lead to heart failure, pulmonary embolization, or even sudden cardiac death. Intracardiac extension may be easily misdiagnosed as either a primary cardiac tumour or a venous thrombus-in-transit. Misdiagnosis subsequently may lead to improper treatment [2, 4, 5]. Differential diagnosis of right-sided cardiac masses includes thrombi-in-transit, right atrial myxomas, vegetations on the tricuspid valve, primary caval leiomyosarcoma, intracardiac electrodes, and tumour thrombi from malignancies such as hepatocellular carcinoma, renal cell carcinoma, Wilms' tumour (in children), and others [3, 4]. IVL may be diagnosed by echocardiography, abdominal ultrasound, magnetic resonance imaging, enhanced chest and abdominal computed tomography, and venography. The diagnosis is confirmed intraoperatively or by postoperative histopathological examination [3, 5]. A thrombus-in-transit appears as an elongated mobile mass of venous cast giving a popcorn appearance within the right-sided cardiac chamber, whereas there are multiple points of attachment in the inferior vena cava and right-sided cardiac chambers in patients with IVL [8]. A correct diagnosis depends on a high index of suspicion. This pathology should be considered in young women with a right-sided cardiac mass and a pelvic mass or those who have previously undergone hysterectomy for uterus leiomyoma [2, 3, 5]. Finally, we think that IVL is an underdiagnosed pathology and a huge index of clinical doubt with the modern diagnostic imaging tools will lead to an increased number of reported cases in the future. Conflict of interest: none declared.

Дослідження впливу діодної лазерної трабекулопластики у режимі мікроімпульсу аЬ ехіето на вміст трансформуючого фактору росту р2 у волозі передньої камери ока пацієнтів із відкритокутовою первинною глаукомою

Дослідження впливу діодної лазерної трабекулопластики у режимі мікроімпульсу аЬ ехіето на вміст трансформуючого фактору росту р2 у волозі передньої камери ока пацієнтів із відкритокутовою первинною глаукомою

Morphologic changes in the anterior chamber in patients with cortical or nuclear age-related cataract

To assess and compare the morphologic changes in the anterior segment in eyes with nuclear or cortical age-related cataract using Scheimpflug imaging. Peking University People's Hospital, Beijing, China. Case-control study. Patients with nuclear or cortical age-related cataract were recruited. The grade of nuclear opalescence or cortical opacity was assessed using the Lens Opacities Classification System III (LOCS III). A group of elderly subjects with a clear lens and normal vision served as the control group. Anterior chamber depth (ACD), anterior chamber volume (ACV), and lens thickness were evaluated using Scheimpflug imaging (Pentacam). Two hundred sixty-nine patients (330 eyes) were recruited. Thirty eyes were enrolled for each nuclear opalescence and cortical grade. The control group comprised 30 eyes (19 subjects). In eyes with age-related cataract, lens thickness increased with an increase in cortical opacity, whereas the ACD and ACV values decreased. The ACD was inversely correlated with LOCS III grades for nuclear opalescence (r = -0.197, P = .004), nuclear color (r = -0.195, P = .005), and cortical opacity (r = -0.508, P<.005). There were significant differences in lens thickness, ACD, and ACV between nuclear color, nuclear opalescence, and cortical opacity for LOCS III grades 3, 4, and 5, respectively. There were significant differences in lens thickness, ACD, and ACV between nuclear and cortical age-related cataracts. The ACD decreased more in eyes with cortical cataract, suggesting that the risk for angle-closure glaucoma may be greater in cases of cortical opacity in which lens expansion is greater. No author has a financial or proprietary interest in any material or method mentioned.

Diminished tyrosine hydroxylase immunoreactivity in the cardiac conduction system and myocardium in Parkinson’s disease: an anatomical study

Clinical and autopsy studies have consistently reported cardiac sympathetic dysfunction in the left ventricular wall in patients with Parkinson's disease (PD). Whether the nerve fibers of the cardiac conduction system or the atrial walls are equally affected in this disease process has not yet been well documented. Therefore, the aim of this study was to investigate sympathetic nerves in the cardiac conduction system as well as in the walls of all four heart chambers in patients with PD, in incidental Lewy body disease (iLBD), and in controls. Heart tissue from five PD patients, two iLBD cases, and seven controls were investigated immunohistochemically using antibodies directed against tyrosine hydroxylase (TH) and alpha-synuclein (syn-1). A marked diminution of TH immunoreactivity (IR) within nerve fibers was observed in four PD patients and in both individuals with iLBD. In contrast, all control subjects displayed dense TH-IR nerve structures. The depletion in TH-IR involved not only the ventricles, but also the conduction system and the atrium showing a global change within cardiac TH-IR nerve fibers in the course of PD. In conclusion, the alterations in cardiac sympathetic nerves of patients with PD or in individuals with iLBD are homogeneous and global within the heart. The clinical implications related to this complete cardiac sympathetic dysfunction, including clinical correlates, diagnostic implications, and treatment, however, remain to be determined in a larger autopsy-controlled cohort of prospectively followed individuals.

Уровень кортизола во влаге передней камеры у оперированных больных первичной глаукомой

Уровень кортизола во влаге передней камеры у оперированных больных первичной глаукомой