Ocular pseudoexfoliation syndrome and life span: Act 2

Non peer reviewe

Expression of the HNK-1 carbohydrate epitope in human retina and retinoblastoma. An immunohistochemical study with the anti-Leu-7 monoclonal antibody.

Fifty formalin-fixed and paraffin-embedded retinoblastoma specimens and five normal human eyes were studied with the monoclonal anti-Leu-7 antibody, directed against the HNK-1 carbohydrate epitope that is shared by human natural killer cells and many neuronal, glial and neuroectodermal cells. The laboratory method was a sensitive immunohistochemical staining procedure, and neuroectodermal tumours that usually express this epitope were used as positive controls. In the human retina, Müller cell membranes were positively stained, but additional staining of neuronal cells was not excluded at the light microscopical level. A positive cytoplasmic reaction was also seen in ciliary and retinal pigment epithelial cells. All but one intraocular retinoblastomata studied contained cells staining positively for the HNK-1 epitope, but these cells were probably not neoplastic. Although positive reaction has previously been reported in three retinoblastomata, the present results suggest that positive cells are derived from entrapped and infiltrated retina. Staining of adjacent sections against leukocyte common antigen suggested that the positively staining cells were not natural killer cells.Peer reviewe

Trends in Keratoplasty Procedures During 2 Decades in a Major Tertiary Referral Center in Finland : 1995 to 2015

Purpose:The purpose of this study was to analyze trends in number, age-adjusted frequency, and type of keratoplasty in a major tertiary referral center, relative to patient and graft characteristics.Methods:A retrospective registry study of 1574 patients who in 1995 to 2015 underwent keratoplasty in the Helsinki University Eye Hospital (HUEH). Graft type and sequence, patient characteristics, and date of surgery were recorded. Main outcome measures were annual number, type, and age-adjusted frequency of keratoplasty; patient and graft characteristics; graft procurement; and national population-adjusted frequency of keratoplasty.Results:In HUEH, from 1995 to 2015, a total of 2191 keratoplasties were performed with 48% of the grafts procured intramurally; 76% were primary and 24% regrafts. The age-adjusted frequency of primary penetrating keratoplasty decreased by 52% from 0.96 to 0.46 per 100,000. The corresponding frequency of primary Descemet stripping automated endothelial keratoplasty increased by 367% from 0.3 to 1.4 after 2006, finally accounting for 68% of primary grafts. Men underwent primary penetrating keratoplasty (median 48 vs. 67 yrs, P = 0.0001) and anterior lamellar keratoplasty (median 37 vs. 46 yrs, P = 0.0015) at a younger age than women. Interval to the first regraft was comparable between sexes (median 2.2 vs. 1.9 yrs, respectively, P = 0.17). The national median population-adjusted frequency of keratoplasties was 3.2 per 100,000 from 2009 to 2015, and HUEH accounted for a median of 69% of them.Conclusions:The increased frequency of keratoplasty in HUEH resulted from rapid adoption of Descemet stripping automated endothelial keratoplasty after 2006 and was facilitated by centralizing graft procurement to HUEH and the National Cell and Tissue Center Regea.Peer reviewe

A lectin cytochemical study of glycoconjugates in the human retina

The binding to morphologically normal human retina of eleven biotin- or peroxidase-coupled lectins with different carbohydrate specificities was studied. Eight formalin-fixed and paraffin-embedded eyes were examined. Photoreceptor cells bound Lens culinaris (LCA), wheat germ (WGA), peanut (PNA) and Ricinus communis (RCAI) agglutinins, and concanavalin A (ConA). The outer segment region was labeled more strongly that the inner segment region, and PNA labeled only cones. All these lectins except PNA bound to both plexiform layers, and all but PNA and RCAI to the nuclear layers. Pretreatment with neuraminidase to remove sialic acid resulted in increased binding of RCAI and PNA, which now labeled both rods and cones, and in decreased binding of WGA. Bandeiraea simplicifolia (BSAI), Dolichos biflorus (DBA), soybean (SBA), Ulex europaeus (UEAI), and Lotus tetragonolobus (LTA) agglutinins, as well as pokeweek mitogen (PWM) reacted only with retinal vascular endothelial cells, which were also labeled with the other lectins. The results indicate that alpha-mannose, alpha-glucose, beta-galactose, N-acetyl-D-glucosamine and N-acetylneuraminic acid are present in glycoconjugates of human neuroretina.Peer reviewe

Kroonisen avokulmaglaukooman lääkehoito

Vertaisarvioitu. Näin hoidan.Kroonisen avokulmaglaukooman riskitekijöihin kuuluvat ikääntyminen, likitaittoisuus ja suvussa esiintyvä glaukooma. Tärkein riskitekijöistä on kuitenkin kohonnut silmänpaine. Se on lisäksi ainoa, jota voidaan ja jota pitää hoitaa. Sairaus on oireeton, joten diagnoosiin tarvitaan silmätautien erikoislääkärin tutkimus. Hoito aloitetaan silmänpainetta alentavilla tipoilla, mutta vastaanotolla ei riitä pelkkä reseptin kirjoittaminen. Potilaalle on selvitettävä perustiedot sairaudesta. On opetettava tiputustekniikka sekä kerrottava lääkkeiden vaikutuksista ja haittavaikutuksista - onhan tavoitteena näkökyvyn säilyminen elämän loppuun saakka. Näin toimimalla pyritään sitouttamaan potilas hoitoon. Tavoitteena on peruuttamattoman näköhermovaurion synnyn estäminen tai jo syntyneen vaurion etenemisen pysäyttäminen. Onneksi myös lääkehoidon mahdollisuudet ovat kaiken aikaa lisääntyneet