Age-Related Macular Degeneration is Not Macular Process Only – Peripheral Retina is Attacked Too

A B S T R A C T On a small island of Rab, geographical latitude 44°40\u27 N, with the highest solar radiation among Adriatic islands, 1371 patients were examined in 2003–2005 period, with the aim of estimating the frequency of the patients number with Age-related Macular Degeneration (AMD), and further if the peripheral retina is damaged similarly as the macular region. In the first group of agriculturists and fishermen (n=1300) we estimated the AMD, initial and middle stage of AMD, in 18% of population, but in urban population only by 2 patients. Perimetric analysis with computerized Kowa perimeter, estimated that the peripheral retina is affected similarly as the macular region. Author concludes that for this reason, the usual term of »Age-related Macular Degeneration« should necessarily be named with the suffix »Peripheral«, or »Age-related Retinopathy«

Prednisolone Neuroprotective Therapy in Age-Related Macular Degeneration

134 patients with Age-related Macular Degeneration (AMD) (aging 47–75 years) were treated in therapy procedure with parabulbar injections of Methylprednisolone Acetate and Prednisolone Acetate. In the first group of patients with AMD (n=71 patients) were treated with Methylprednisolone acetate, and second group (n=63 patients) with Prednisolone acetate. Each patient was given doses of 60 mg, through two weeks, l0 mg every second day. It\u27s estimated in all patients ameliorate in macular threshold, so that it\u27s in the group with Methylprednisolone treatment, ameliorate effect begins after first week, than in second group, treated with Prednisolone, initial ameliorate effect is after second week. Complete effect in both groups is after 2 months. It can be concluded that the treatment of AMD with glucocorticoids has the ameliorate effect in vision loss and it is decided that earlier effect in the group treated with Methylprednisolone, is probably of higher affinity for glucocorticoid receptors

Sun Exposure and Visual Field Damage among Children on the Adriatic Island Rab – Possible Initial Risk Factor in Development of Age-Related Macular Degeneration

The Adriatic Island Rab, situated in the northern part of the Croatian sea, is more strongly exposed to sunlight (especially from May to October) than the other parts of Croatia and most of the European countries. As consequences of higher solar radiation, significant percentage of Pseudoexfoliation of lens capsula occurs in 15% and fundus picture of AMD (Age-Related Macular Degeneration) in 18% of agriculturalists and fishermen (45–70 years old). We previously presented the first clinical study showing that in AMD the peripheral visual field is also damaged. In this clinical study we examined 68 children (8–15 years old), including following procedures: vision correction, slit lamp examination, visual field in technic of isopters and profile quantitative perimetry (meridian retinal thresholds examination) using Kowa automated perimeter. In 15% of examinees we found strictly foveal »degeneration«, and changes of visual fields: higher meridian thresholds and typical changes with invagination of isopters. It is very interesting that these children with damaged visual field and fundus picture do not protect their eyes from the sunlight during summertime. We suggest the possibility of the influence of higher sun radiation as one of the risk factors in the earlier development of future AMD

Histopathological Analysis of UV-B Irradiated Retina by Cavia Coba’ya and with Protection of Transmission Light l 550–600 nm

In 14 experimental Cavia Coba’ya eyes were irradiated with UV-B light, lambda 312 nm, 25 J/cm2 in 15 minute exposure. Including the transmission of light through optical media: cornea, lens, humor aqueous and vitreous body, and pupil surface of 7 mm2, we can calculate that in these conditions retina can be really irradiated with 10 J/cm2. The half number of Cavia Coba’ya was simultaneously irradiated with visible light, lambda of 550–600 nm (1000 Lx). Control group was 5 Cavia Coba’ya. Two months after irradiation, eyes were enucleated and fixed in 4% formaldehyde. Histopathological findings showed alterations of all retinal layers: loss of ganglion cells, axons, reduction of photoreceptors, vacuolar degeneration and hyperplasia of retinal pigment epithelium. In the second group of irradiance, the eyes with visible light lambda 550–600 nm, all retinal alterations were in 50% decreased

Development and Progression of Age-Related Macular Degeneration after Cataract Surgery – In the Near Future It Could Become a Forensic Medicine Problem

After testing all types of implanted IOLs with spectrophotometer, author estimated that filtering of sun light is not successful, leaving open the possibility of development of AMD after cataract surgery. This is especially serious problem in implantation of IOLs to children. Until recently, implantation of intraocular lenses without or with inappropriate UV protection was not considered a serious problem. Nowadays we know that, especially in children, such treatment is no longer acceptable and results in AMD. It is only a matter of time when the first lawsuit will appear on it. We suggest obligatory eye protection after cataract surgery (aphakic and pseudophakic eyes) with Medical filters (Yellow-Green: 550–600 nm) and regular ophthalmic controls

Expression of Cell Cycle and Apoptosis Regulatory Proteins and Telomerase in Melanocitic Lesions

To gain insight into the role and association of cell cycle and apoptosis regulatory proteins and telomerase activity in the course of progression of melanocitic lesions we have examined immunohistochemicaly, expression and the distribution of p53, bcl-2, Ki-67 and telomerase in 25 samples of common and dysplastic nevi, and 45 samples of primary invasive melanomas. Protein p53 expression was significantly increased in dysplastic as compared with common nevi and melanomas (p<0.001). Bcl-2 protein expression was significantly increased in melanomas as compared with common aquired and dysplastic nevi (p=0.001). Nevi and melanomas exhibited clear-cut differences in terms of Ki-67 expression. Telomerase expression was significantly increased in melanomas as compared with common acquired (p=0.014) and dysplastic nevi (p<0.001). Enhanced telomerase activity in association with increased bcl-2 expression in the course of melanoma progression could contribute to development and progression of melanoma

Long Term Results of Age-Related Macular Degeneration Therapy with Prednisolone Acetate – Special Refer to Peripheral Visual Field Changes

In the north Croatian Adriatic area in the period of seven years (from January 2001 to September 2007) 475 patients (39 to 80 years of age) with dry form of age related macular degeneration (AMD) were diagnosed. Complete ophthalmologic examination with special reference to visual field testing (Perimetric analysis) was performed. Peripheral visual field defects were found in 85% of patients. Elderly patients with more advanced forms of macular degeneration had more peripheral visual field defects. In 400 patients corticosteroid therapy (5 mg Prednisolonacetate, anterior H-inject, Winthorp) was administered via parabulbar injections every day/five days. Control group consisted of 75 patients treated with regular polyvitamine therapy (Lutein, Beta Karoten, Vitamin E). Patients treated with corticosteroids had peripheral visual field improvements from 10 to 25 degrees and central field improvements from 5 to 20 %. In the control group treated with vitamins, central visual field showed improvements from 0.5 to 1% in 43 patients but without peripheral visual field improvements after 6 months

Sunlight and Incidence of Pterygium on Croatian Island Rab – Epidemiological Study

The aim of this epidemiologic study, on small island Rab, in North Adriatic Sea, is to estimate correlation between climatic factors, specially chronic exposure to strong visible and UV light, and appearance of pterygium and exfoliation syndrome. In the first group of population which live in a village and who are agriculturists and fishermen (480 persons) appearance of pterygium is in 23% (16% in males and 7% in females), but 0.0% in urban people (61 people). The appearance of exfoliation syndrome was in the first group of agriculturists and fishermen population in 21%, of which 19% of males and 2% of females, and in urban people 0.0%. The higher intraocular pressure in exfoliation syndrome was 92%. All population in this examination were in the highest age (mean age is 65–80 years). Chronic exposure to sunlight caused the high percentage appearance of pterygium and exfoliation syndrome