This review describes a scheme for diagnosis of glaucoma in population based prevalence surveys. Cases are diagnosed on the grounds of both structural and functional evidence of glaucomatous optic neuropathy. The scheme also makes provision for diagnosing glaucoma in eyes with severe visual loss where formal field testing is impractical, and for blind eyes in which the optic disc cannot be seen because of media opacities.

https://bjo.bmj.com/content/bjophthalmol/86/2/238.full.pdf

The definition and classification of glaucoma in prevalence surveys

Tissue sections from aggressive human intraocular (uveal) and metastatic cutaneous melanomas generally lack evidence of significant necrosis and contain patterned networks of interconnected loops of extracellular matrix. The matrix that forms these loops or networks may be solid or hollow. Red blood cells have been detected within the hollow channel components of this patterned matrix histologically, and these vascular channel networks have been detected in human tumors angiographically. Endothelial cells were not identified within these matrix-embedded channels by light microscopy, by transmission electron microscopy, or by using an immunohistochemical panel of endothelial cell markers (Factor VIII-related antigen, Ulex, CD31, CD34, and KDR[Flk-1]). Highly invasive primary and metastatic human melanoma cells formed patterned solid and hollow matrix channels (seen in tissue sections of aggressive primary and metastatic human melanomas) in three-dimensional cultures containing Matrigel or dilute Type I collagen, without endothelial cells or fibroblasts. These tumor cell-generated patterned channels conducted dye, highlighting looping patterns visualized angiographically in human tumors. Neither normal melanocytes nor poorly invasive melanoma cells generated these patterned channels in vitro under identical culture conditions, even after the addition of conditioned medium from metastatic pattern-forming melanoma cells, soluble growth factors, or regimes of hypoxia. Highly invasive and metastatic human melanoma cells, but not poorly invasive melanoma cells, contracted and remodeled floating hydrated gels, providing a biomechanical explanation for the generation of microvessels in vitro. cDNA microarray analysis of highly invasive versus poorly invasive melanoma tumor cells confirmed a genetic reversion to a pluripotent embryonic-like genotype in the highly aggressive melanoma cells. These observations strongly suggest that aggressive melanoma cells may generate vascular channels that facilitate tumor perfusion independent of tumor angiogenesis.

Vascular Channel Formation by Human Melanoma Cells in Vivo and in Vitro: Vasculogenic Mimicry

Background Ocular trauma or disease may lead to severe corneal opacification and, consequently, severe loss of vision as a result of complete loss of corneal epithelial stem cells. Transplantation of autologous corneal stem-cell sources is an alternative to allograft transplantation and does not require immunosuppression, but it is not possible in many cases in which bilateral disease produces total corneal stem-cell deficiency in both eyes. We studied the use of autologous oral mucosal epithelial cells as a source of cells for the reconstruction of the corneal surface. Methods We harvested 3-by-3-mm specimens of oral mucosal tissue from four patients with bilateral total corneal stem-cell deficiencies. Tissue-engineered epithelial-cell sheets were fabricated ex vivo by culturing harvested cells for two weeks on temperature-responsive cell-culture surfaces with 3T3 feeder cells that had been treated with mitomycin C. After conjunctival fibrovascular tissue had been surgically removed from the ocular surfa...

https://www.nejm.org/doi/pdf/10.1056/NEJMoa040455

Corneal reconstruction with tissue-engineered cell sheets composed of autologous oral mucosal epithelium.

An Integrated Hypothesis That Considers Drusen as Biomarkers of Immune-Mediated Processes at the RPE-Bruch's Membrane Interface in Aging and Age-Related Macular Degeneration

https://oftalmologiarafaelcaiado.files.wordpress.com/2012/04/anchor-study.pdf

Ranibizumab versus Verteporfin Photodynamic Therapy for Neovascular Age-Related Macular Degeneration: Two-Year Results of the ANCHOR Study

Over a period of 14 months (from October 1985 to December 1986) 152 potential cornea donors were evaluated for human immunodeficiency virus (HIV) and hepatitis B surface (HBs) antigen. In three clinically normal donors (two deaths due to natural causes, one as a result of an automobile accident), HIV seroconversion was found by ELISA techniques in two cases and a positive Western Blot test in one. The two elderly patients had previously undergone multiple blood transfusions during major abdominal surgery in smaller community hospitals before blood donors were routinely tested for HIV; one 20-year-old patient was probably a homosexual, as in-depth interviews with his family doctor revealed. Hepatitis B serology was positive in four potential cornea donors. The authors conclude that interdisciplinary work-ups of potential cornea donors should include screening for infectious diseases.

Virologische Gesichtspunkte bei der Spenderauswahl für allogene Keratoplastik

Iron lines of the corneal epithelium are well-described phenomena in both normal and pathologic conditions. We found a bilateral corneal epithelial iron line at the inner edge of a juvenile corneal arcus lipoides in an otherwise normal eye of a 38-year-old white man. Possible mechanisms that may have led to the development of this new iron line are discussed.

Epithelial iron line in juvenile corneal arcus lipoides.

The principal indications for extra- and intraocular surgery are similar to those of surgery for other purposes. However, surgical procedures inside the eye are associated with a unique pattern of complications. They not only affect the site of entry but tissue distant to this location.

General Ophthalmic Pathology: Principal Indications and Complications, Comparing Intra- and Extraocular Surgery

In a prospective study, 244 patients who were scheduled to undergo extracapsular cataract extraction with implantation of the intraocular lens (ECCE/IOL) under local anesthesia were examined to evaluate the risk factors for vis a tergo (VAT) at the "open eye". The intraoperative blood pressure was found to be the most important factor for the occurence of VAT. We think that a reversible suprachoroidal effusion syndrome is responsible for this effect. In order to minimize intraoperative complications, we recommend routine monitoring and treatment if the intraoperative blood pressure is too high during cataract surgery with local anesthesia.

[Risk factors for the vis a tergo of the "open eye" in cataract extraction with local anesthesia].

Optic disc morphometry is a method of quantitatively evaluating the optic nerve. This study was undertaken to examine whether the optic disc morphology changes with a short-term increase in intraocular pressure. In 46 eyes with chronic open-angle glaucoma and 20 normal eyes, optic disc photographs were taken at a baseline pressure ranging between 15 and 20 mm Hg and 1 and 8 s after pressure elevation of 10 and 20 mm Hg, respectively. In the normal and glaucoma eyes the size and form of the optic disc, optic cup, and alpha and beta zones of the parapapillary chorioretinal atrophy did not change significantly with pressure elevation. We conclude that two-dimensional papillomorphometric data are not dependent on a short-term increase in intraocular pressure.

Gottfried O. H. Naumann

Papers

Virologische Gesichtspunkte bei der Spenderauswahl für allogene Keratoplastik

Epithelial iron line in juvenile corneal arcus lipoides.

General Ophthalmic Pathology: Principal Indications and Complications, Comparing Intra- and Extraocular Surgery

[Risk factors for the vis a tergo of the "open eye" in cataract extraction with local anesthesia].

[Relation of 2-dimensional papilla morphology to current intraocular pressure].