Detection of Alzheimer peptides and chemokines in the aqueous humor.

Purpose: Alzheimer disease (AD) and age-related ocular diseases are characterized by inflammation and accumulation of insoluble proteins. We aimed to investigate the detectability and clinical relevance of a panel of AD-related markers, such as Alzheimer peptides and chemokines, in the aqueous humor (AH) samples taken from patients with cataract only, or cataract and 1 other ocular disease.

Methods: The AH samples were obtained during cataract surgery from patients with cataract only (n=162), cataract and glaucoma (n=21), cataract and exfoliation (PEX) (n=31), cataract and macular degeneration (n=36), and cataract and diabetic retinopathy (n=16).

Secreted leukocyte protease inhibitor is present in aqueous humours from cataracts and other eye pathologies.

Previous studies identified serine, cysteine and metalloproteases in normal aqueous humours (AH) and suggested that a balance between proteases and their inhibitors may play a role in the modulation of the AH outflow. We aimed to determine whether secretory leukocyte protease inhibitor (SLPI), a serine protease inhibitor, is present in AH of patients with cataract and other eye pathologies. AH was collected from 117 cataract patients of which 55 were diagnosed with more when one eye disease: cataract only (n=62), pseudoexfoliation (PEX) (n=26), glaucoma (n=6), diabetes retinopathy (n=4), iritis-uveitis (n=4) and macular degeneration (n=28).

Alzheimer's peptide and serine proteinase inhibitors in glaucoma and exfoliation syndrome.

The occurrence of inflammation with accompanying amyloid formation in pseudoexfoliation syndrome (PEX) resembles other inflammation-associated amyloidoses such as Alzheimer's disease (AD). To test whether the same proteins can be identified in PEX as in AD, we qualitatively analysed for Alzheimer's peptide (Abeta1-42) and the proteinase inhibitors alpha1-antichymotrypsin (ACT) and alpha-antitrypsin (AAT) in the aqueous humor of patients with and without PEX material. Ninety aqueous humor samples were collected from patients in the age group between 46 and 95 during cataract surgery.

Disc haemorrhages, precursors of open angle glaucoma.

In a long-term study of 1270 patients with at least one of the findings, open-angle glaucoma, disc haemorrhages or retinal vein occlusions, disc haemorrhages were witnessed in approximately 20% of the cases with open-angle glaucoma, and were a precursor of glaucomatous disc changes and associated visual field defects. Disc haemorrhages also preceded a rising intraocular pressure (IOP) in the destructive process among open-angle glaucoma cases. Similar glaucomatous development appears among cases independent of IOP or detection of exfoliation syndrome.

Impaired dark adaptation in polycythemia. Improvement after treatment.

Purpose: To determine if dark adaptation is reduced in individuals with polycythemia and if so whether there is any improvement in dark adaptation after treatment.

Methods: Dark adaptation was recorded monocularly by automatic dark adaptometry in ten consecutive patients with polycythemia before and after treatment. Analogue investigations were performed in 31 healthy control subjects.

Human ocular vasodynamic changes in light and darkness.

Purpose: To determine whether changes in the retinal blood flow in light and darkness occur in humans. METHODS; The systolic and diastolic flow velocities were measured by color Doppler in the ophthalmic and the central retinal arteries in 12 healthy individuals in light and darkness.

Results: In the ophthalmic artery there was a trend toward lower systolic velocity in darkness compared with that in the light, but there was no change in diastolic velocity.

II. Improved dark adaptation after carotid endarterectomy. Evidence of a long-term ischemic penumbra?

We have reported that dark vision is impaired in symptomatic carotid artery disease and that the impairment correlates with internal carotid artery stenosis. To find out whether this impairment is reversible after carotid endarterectomy, dark adaptation was examined pre- and postoperatively. Twenty-one consecutive patients were examined by dark adaptometry.

I. Impaired dark adaptation in symptomatic carotid artery disease.

It has been known for more than a century that even slight hypoxemia reduces dark adaptation. We studied dark adaptation in symptomatic carotid artery disease. Twenty-one consecutive patients scheduled for first-time carotid endarterectomy and 31 age-matched control subjects with normal carotid arteries were examined by dark adaptometry monocularly and were tested repeatedly on consecutive days.

Intraocular pressure-dependent light sensitivity in glaucoma.

The intraocular pressure-dependent light sensitivity of discrete retinal points was measured using the Heijl-Krakau automated light-emitting diode perimeter with an appropriate software program. A total of 300 measurements of light sensitivity were recorded from six retinal points during the test period of 8-10 min; increased intraocular pressure was induced using a Langham scleral suction-cup system. The ocular pulsatile blood flow and the ophthalmic arterial pressure were measured in the same patients.

Disc haemorrhages and the etiology of glaucoma.

As a consequence of the hypothesis that all open angle glaucomas at some time exhibit a disc haemorrhage, it is proposed that both low and high tension glaucomas have the same etiology. That the primary lesion should be sought in the small vessels of the optic disc seems to be a reasonable suggestion.