[Eye injuries in Finnish children].
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Adolescent↗
Biomedical subjects
K M Saari
Publications and source records attributed to K M Saari.
Lysozyme content of tears in normal subjects and in patients with external eye infections.
We studied the lysozyme content of tears in 267 subjects (521 eyes), including 241 healthy subjects, 7 patients (14 eyes) with bilateral blepharitis, 8 patients (12 eyes) with conjunctivitis, and 11 patients (16 eyes) with keratitis. The concentration of lysozyme in the tears rises with age between childhood and maturity. The highest values were seen in the age group of 21-40 years, and a decrease of lysozyme concentration occurred with an increase in age from 30-40 years. The mean lysozyme content of tears was 1,768 micrograms/ml in healthy subjects; no significant differences occurred between the sexes. Patients with blepharitis, conjunctivitis, and keratitis had normal mean lysozyme content of tears. The tears of patients with herpes simplex keratitis had low lysozyme values.
Adolescent↗
Determination of protein content in aqueous humour by high-performance gel filtration chromatography.
High-performance liquid chromatography (HPLC) was used to study the protein content of aqueous humour in 17 cataract patients. High-performance gel filtration chromatograms (HPGFC) of the aqueous humour showed 7-12 peaks with low concentrations (mean 0.085 micrograms/microliter) of high molecular weight proteins (peak 1, MW 250 000 or more) and low levels (0.01 micrograms/microliter or less) of IgA (peak 2) and of IgG (peak 3). The fourth peak (MW about 65 000) containing albumin and obviously also trasferrin was the major peak (mean 0.596 micrograms/microliter) at HPGFC of a normal aqueous humour. Lysozyme (peak 6, MW 35 000) occurred in small amounts in the aqueous humour (mean 0.064 micrograms/microliter). The last 6 peaks matched for peptides and amino acids (MW 10 000 or less). It is concluded that HPLC may be a useful preparative method in characterization, separation, and partial purification of immunoglobulins, immune complexes, and other proteins of aqueous humour.
Aged↗
Demonstration of intraocular synthesis of immunoglobulin G toxoplasma antibodies for specific diagnosis of toxoplasmic chorioretinitis by enzyme immunoassay.
By using a modified enzyme immunoassay we have conducted a detailed study on the intraocular synthesis of toxoplasma antibodies during ocular toxoplasmosis. In control patients operated on for cataracts, the ratio of immunoglobulin G (IgG) toxoplasma antibodies in serum to those in aqueous humor was more than 100. In eight of the nine patients with clinically diagnosed toxoplasmic chorioretinitis, the ratio ranged between 6 and 56. In five patients with some other type of uveitis, the ratio was comparable with that in controls. Parallel determinations of mumps IgG antibody ratios were carried out to prove that the increased intraocular toxoplasma antibody levels were not a result of increased diffusion or polyclonal antibody stimulation. In all patients, mumps antibody ratios were within normal range. We also tested the samples of aqueous humor for IgM and IgA antibodies, but the antibodies in the aqueous humor were found to be exclusively IgG. Our results indicate that IgG-class anti-toxoplasma antibodies are produced locally within the eye in cases of toxoplasmic chorioretinitis. The determination of these antibodies can offer a valuable aid to make a specific etiological diagnosis of ocular toxoplasmosis.
Adolescent↗
Bilateral acute retinal necrosis.
Four patients who experienced the sudden onset of anterior uveitis with large keratic precipitates and dense vitreous opacities developed confluent yellow-white swellings and exudates in the peripheral retina and sheathing and obliteration of retinal arteries. After absorption of the exudates, atrophic patches in the peripheral retina and a funnel-shaped retinal detachment with many tears appeared. Angiograms showed retinal edema, fluorescein leakage from the choroid in the affected areas, and perivasculitis of the retinal arteries. Although treatment seemed unable to alter the course of the disease, in one case the retina reattachment after vitrectomy and filling of the vitreous space with silicone oil. Histopathologic studies disclosed extensive atrophy and degeneration of the outer retinal layers and pigment epithelium and occlusion of the retinal vessels. An infection may trigger the uveitis, leading to an autoimmune sensitization against rods and cones that causes severe local immune-complex disease and retinal vasculitis.
Adult↗
Association of ophthalmoplegic migraine with familial acute anterior uveitis.
In a family with 3 cases of acute anterior uveitis (AAU) the proband had 13 episodes of recurrent AAU associated 4 times with severe, throbbing ipsilateral headache. During one such episode he had an oculomotor palsy, hyperaesthesia of the cornea, and lack of spontaneous pulsations of the central retinal vein in the eye with AAU. An oculomotor palsy occurred twice intermittently between the AAU episodes. Carotid and vertebral angiographies confirmed the diagnosis of ophthalmoplegic migraine. Prostaglandins liberated by trauma, AAU, or other inflammation may be involved as mediators in ophthalmoplegic migraine attacks. All 3 patients with AAU had sacroiliitis and seronegative polyarthritis. One of their siblings had polyarthritis and one incomplete Reiter's disease. All of them were HLA-B27 positive whereas one healthy sibling was HLA-B27 negative. These findings support the hypothesis that HLA-B27 itself or a pleiotropic HLA-B27 linked gene predisposes the carrier to AAU, sacroiliitis, ankylosing spondylitis, and Reiter's disease.
Adult↗
Frequency of rheumatic diseases in patients with acute anterior uveitis.
The frequency of associated rheumatic diseases was studied in 271 patients with acute anterior uveitis (AAU). In a retrospective examination of 154 patients with AUU (mean follow-up period of 6 years) associated rheumatic symptoms were observed in 64 (41.6%). Forty-one patients (26.6%) had ankylosing spondylitis and 39 (25.3%) manifestations of Reiter's disease. Radiographic sacro-iliitis was seen in 35 (34%) of 103 consecutive x-ray examined patients with AAU. Furthermore, in another series of 38 patients, who all, in addition to having AAU, also complained of low back pain or had manifestations of Reiter's disease, 23 (60.5%) had radiographic sacro-iliitis. Classical ankylosing spondylitis was more frequent in men with AAU whereas milder forms of the disease occurred more equally in both sexes. HLA-B27 occurred in 35 (87.5%) of 40 HLA-typed patients with AAU. Associated rheumatic diseases occurred in 18 (51.4%) of the 35 HLA-B27 positive patients but in none of the HLA-B27 negative patients. The results support the hypothesis that a pleiotropic HLA-B27 associated gene may determine the susceptibility to AAU, sacro-iliitis, ankylosing spondylitis, and Reiter's disease.
Acute Disease↗
Chlamydial infection in a family.
In a family comprising parents and two daughters, Chlamydia trachomatis (CT) was observed to be the infective agent causing urethritis in the father and conjunctivitis in the newborn. CT was probably a trigger factor in Reiter's syndrome (RS) in the mother, who suffered from arthritis, microscopic pyuria and hematuria, cervicitis and ocular manifestations. The elder daughter's mucocutaneous manifestations, probably keratodermia blennorrhagica, broke out simultaneously with chlamydial infections in the other members of the family. Later she developed joint pains, conjunctivitis and vulvitis. The elder daughter and the father are HLA-B27 negative, whereas the mother is HLA-B27 positive. With this study we would like to emphasize the importance of observing the microbial environment in the family in the etiology of rheumatic disease. Simultaneous treatment of infections in family members might benefit the clinical course of rheumatic disease.
Adult↗
[Eye injuries in agricultural workers].
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Adult↗
HLA-B27 frequency and MLC reactions in acute anterior uveitis.
HLA-A and B antigens were determined in 37 unrelated patients with acute non-granulomatous anterior uveitis (AAU) and in 114 control subjects. HLA-B27 was identified in 31 patients with AAU (83.8%) and in 15 control subjects (13.2%). Fifteen patients (40.5%) had associated rheumatic diseases and all of them (100%) had HLA-B27. Of the 22 patients without any associated disease, 16 (72.7%) had HLA-B277. To study the HLA-D composition MLC tests were done as one-way microcultures between members of four groups consisting of 10, 10, 8, 8 patients with AAU and two or three healthy controls in each test group. No difference between patient-to-patient reactions as compared with the control reactions could be observed. The results show that AAU is very closely associated with HLA-B27 but not with any of the HLA-D antigens.
Adult↗
Alpha 1-antitrypsin and acute anterior uveitis.
To test the pathogenetic role of the phenotype MZ of alpha 1-antitrypsin/alpha 1-protease inhibitor (PI) in acute anterior uveitis (AAU), 156 patients with AAU were examined. Sera of all patients and 120 healthy controls were PI-typed using isoelectric focusing. There were no significant differences in PI MZ frequencies either between the patients with AAU (4.5%) and the controls (4.2%), or between AAU patients with associated rheumatic diseases (4.8%) and AAU patients with no associated disease (4.3%). The results indicate that the PI MZ type is not closely associated with AAU among Finns.
Acute Disease↗
Tranexamic acid in the prevention of secondary haemorrhage after traumatic hyphaema.
The occurrence of secondary haemorrhage after traumatic hyphaema was studied in 239 patients treated in the Department of Ophthalmology, Tampere Central Hospital during the years 1972 to 1980. From 1972 to 1976, 126 patients with traumatic hyphaema were confined to bed and treated without antifibrinolytic agents; nine (7.1%) of these patients developed secondary haemorrhage. From 1977 to 1980, none of 58 patients with traumatic hyphema treated with tranexamic acid developed secondary haemorrhage which was seen in 3 (5.5%) of 55 patients treated without antifibrinolytic agents; the activities of these patients were not restricted and the eyes were not patched. The resorption of the hyphaema was significantly delayed in the tranexamic acid treated patients. It is concluded that tranexamic acid delays resorption of the blood-clot sealing the damaged vessel and preventing secondary haemorrhage after traumatic hyphaema without bed-rest and binocular patching.
Adolescent↗
Pars plana vitrectomy in the management of intraocular inflammation.
To evaluate the role of pars plana vitrectomy in the management of intraocular inflammation with dense vitreous opacification, vitrectomy was performed in 14 patients with chronic uveitis, 6 eyes with retinal periphlebitis, and in 8 cases of endophthalmitis. Visual acuity improved in 21 eyes, remained unchanged in 3, and deteriorated in 4 cases (follow-up period 2 months to 3 years). Pre-existing retinal damage such as cystoid macular oedema or degeneration restricted final visual acuity. In most eyes inflammation (aqueous flare and cells) diminished, except in hypotonic eyes with chronic iridocyclitis, which also gained little in vision. The results indicate that vitrectomy is valuable in the treatment of chronic uveitis with vitreous opacification due to cellular invasion and membrane formation, in periphlebitis with vitreous hemorrhages, and in endophthalmitis.
Adult↗
Bilateral central retinal vein occlusion in a patient with scleroderma.
A 53-year-old man with scleroderma, pulmonary fibrosis, cardiac decompensation and secondary polycythaemia, but no arterial hypertension, developed central retinal vein occlusion (CRVO) in the left eye. 1.5 years later, during the treatment with systemic steroids and anticoagulants, he developed CRVO in the right eye, and a further half year later, secondary glaucoma in the left eye and loss of the visual acuity to counting fingers at 2.5 m in the right eye and at 0.5 m in the left. Retinal vascular changes, pulmonary and cardiac insufficiency and secondary polycythemia, symptoms of scleroderma, most probably contributed to the development of bilateral CRVO.
Glaucoma↗
Ocular inflammation associated with Yersinia infection.
We studied characteristics of ocular inflammation associated with Yersinia infection in 23 patients. After an acute onset with fever, diarrhea, and abdominal pain, 22 patients developed arthritis, 11 patients developed myalgia, 11 patients developed Reiter's syndrome, 17 patients developed acute anterior uveitis, and nine patients developed conjunctivitis. Sacroiliitis was found in 12 patients. The patients had high erythrocyte sedimentation rates, leukocytosis, and lack of antinuclear antibodies and rheumatoid factor. All 17 patients tested had HLA-B27 antigen. The patients with acute anterior uveitis showed aqueous flare, cells, fine keratic precipitates, and often exudates, posterior synechiae, vitritis, and macular edema. Acute anterior uveitis was mostly unilateral and resolved during corticosteroids on the average during the first six weeks; recurrences were seen in about half of the cases. Conjunctivitis was generally mild with no chemosis, follicles, or keratitis; and it resolved in one week without treatment. Our results indicate that in HLA-B27 positive patients infective agents can trigger acute anterior uveitis or conjunctivitis, which often occur together with rheumatic diseases.
Adolescent↗
Ocular inflammation in Reiter's syndrome associated with Campylobacter jejuni enteritis.
An 18-year-old woman developed acute polyarthritis one week and bilateral, acute, mucopurulent conjunctivitis and sterile pyuria two weeks after onset of Campylobacter jejuni enteritis. The conjunctivitis resolved spontaneously in one week and the arthritis in two months. The patient had HLA-B27 antigen. Campylobacter organisms may lead to Reiter's syndrome in a patient with HLA-B27 antigen.
Adolescent↗
Ocular inflammation in Reiter's disease after Salmonella enteritis.
We studied characteristics of ocular inflammation in Reiter's disease after Salmonella enteritis in eight patients. After an acute onset with diarrhea, fever in six patients, and headache in three patients, all patients developed arthritis; six patients had myalgia; six patients, urethritis; and one patient, carditis. Sacroiliitis was found in four patients. All patients had HLA-B28 antigen. Conjunctivitis occurred in seven patients. It was mostly mild with no chemosis, follicles, or keratitis, and resolved in ten days. In one case palpebral edema, chemosis in the conjunctiva, and purulent exudate were seen. One patient had transient episodes of keratitis and corneal erosion for two months and episodes of conjunctivitis for 11 months. Three patients developed unilateral acute anterior uveitis with aqueous flare, cells, fine keratic precipitates, and fibrinous exudation from three to four years after the onset of the illness. One of these patients had vitritis and macular and papillary edema.
Adolescent↗
Anterior segment fluorescein angiography in inflammatory diseases of the cornea.
To study the vascular changes in inflammatory diseases of the cornea 22 patients with various corneal inflammations were examined by means of anterior segment fluorescein angiography. Simple avascular central and marginal corneal ulcers stained with fluorescein in the late phase of angiography. An inflamed limbus and an early microscopic pannus adjacent to the ulcer were seeen in simple corneal ulcers. Progressive pannus with pronounced fluorescein leakage was observed in chronic corneal ulcer, disciform keratitis, Mooren's ulcer, and complicated acute keratoconus. In sclerokeratouveitis and in gutter associated with rheumatoid arthritis the corneal vessels showed less leakage. The iris vessels showed fluorescein leakage as a sign of irritative iritis during the active stage of simple and chronic corneal ulcers, in disciform keratitis, Mooren's ulcer, and in graft rejection. It is concluded that anterior segment fluorescein angiography gives valuable information of the vascular architecture, flow and leakage in inflammatory diseases of the cornea.
Adult↗