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Biomedical subjects

R W Yee

Publications and source records attributed to R W Yee.

48 records · Page 3Linked to original sources

Comparison of the corneal endothelium in an American and a Japanese population.

We compared the corneal endothelial morphology between an age-matched population of American and Japanese persons. Endothelial specular photographs were subjected to a computer-assisted morphometry of the area and shape of individual cells. The endothelium in the Japanese population showed a significantly higher cell density when compared with an age-matched American population. However, there was no difference in the degree of variations in cell area and cell shape between the two populations. The results suggest that higher endothelial cell density in the Japanese population could be related to the lower incidence of aphakic bullous keratopathy in the Japanese population.

Adolescent↗

Pump function of the human corneal endothelium. Effects of age and cornea guttata.

The specific binding of tritiated ouabain to endothelial Na/K ATPase was used to quantitate the density of pump sites in the human corneal endothelium. Donor eyes, unsuitable for use in keratoplasty, were obtained from the Wisconsin Lions Eye Bank. The endothelium of each donor eye was examined using wide-field specular microscopy, and the specular micrographs were traced and digitized for the determination of cell density. Ouabain binding was measured in matched pairs of isolated endothelial sheets. A total of 26 pairs of donor eyes, ranging in age from 11 through 91 years, were studied. Twenty pairs, determined to have normal endothelia, were found to have a constant pump site density which was independent of donor age. Six donor pairs had moderate guttata; in this group pump site density was significantly increased. These results indicate that, although pump site density is normally constant in the human corneal endothelium, conditions which increase endothelial permeability, such as guttata, can cause a compensatory increase in pump site density and presumably pump function.

Adolescent↗

Long-term survival of cryopreserved corneal endothelium.

Corneas of five patients who received cryopreserved penetrating grafts 15 years previously were evaluated by regional specular microscopy and computer-assisted morphometric analysis. This technique quantitates changes in cell size and shape as well as cell number. Comparisons were made with five eyes in four patients 15 years after penetrating keratoplasty utilizing fresh grafts. In three patients, fresh and frozen tissue were transplanted in the same host. These examinations showed no difference in structure or function comparing cryopreserved tissue with fresh donor tissue.

Cornea↗

Changes in the normal corneal endothelial cellular pattern as a function of age.

Human endothelial morphologic changes were quantitated by specular microscopy and computer-assisted morphometry to establish normal baselines of various morphologic parameters. Cellular polymegethism and cellular pleomorphism increases with age, and normal baseline parameters are detailed. Furthermore, no significant difference in any morphologic parameters between the right and left eye and between central and peripheral endothelium was detected in the normal corneas examined. These normal morphologic baselines can possibly be utilized to detect early corneal endothelial pathology and/or cell loss nondetectable by cell density measurement.

Adolescent↗

Corneal endothelial changes in diabetic dogs.

The corneal endothelium of alloxan diabetic dogs was examined by wide-field specular microscopy and compared to that of age-matched non-diabetic dogs. Computer-assisted morphometry of individual cells showed that the diabetic dog endothelium had marked polymegethism and pleomorphism similar to that previously described in diabetic patients. There also appeared to be a positive correlation between the degree of these endothelial changes and the diabetic control as demonstrated by HbA1 concentration.

Alloxan↗

Correlation of corneal endothelial pump site density, barrier function, and morphology in wound repair.

After transcorneal freezing, physiologic function (pump and barrier) of the regenerating rabbit corneal endothelium was evaluated and compared with the morphologic differentiation that occurs during wound healing. Endothelial pump function was investigated utilizing the specific binding of tritiated ouabain to endothelial Na+/K+ ATPase (pump sites); the permeabilities of isolated de-epithelialized corneas to labeled inulin and dextran were measured to determine endothelial barrier function. Endothelial recovery after transcorneal freezing can be described as a three-stage process. Stage one is characterized by the establishment of an initial coverage of the wound by pleomorphic spindle-shaped cells which form a functional but incomplete barrier and minimal pump site density. In stage two, the cells assume a flattened configuration consisting of irregular polygons and establish nearly normal pump capacity. In stage three, a significant remodeling of the monolayer continues despite the layer's early physiologic recovery.

Animals↗

Corneal endothelial changes in type I and type II diabetes mellitus.

Forty-six corneas from 25 patients who had had type II (adult-onset) diabetes for more than ten years were examined by specular microscopy with quantitative morphometric analyses of individual endothelial cells. Thirty-four corneas from 21 age-matched nondiabetic subjects were examined for comparison. We also examined 31 corneas from 17 patients with type I (juvenile-onset) diabetes and compared them to 41 corneas from 23 age-matched normal volunteers. The corneal endothelium in type II diabetes showed no difference in cell density but demonstrated a significantly higher coefficient of variation, a decrease in the percentage of hexagonal cells, and a low figure coefficient compared to an age-matched nondiabetic population. Type I diabetes produced similar cell changes, but these changes occurred in the earlier decades. Moreover, we detected a significantly higher rate of cell loss in type I diabetes, resulting in a significant decrease in cell density in the fourth and fifth decades. These results clearly indicate that the diabetic endothelium is morphologically abnormal. The observed anatomic changes result in a less stable and more vulnerable cell layer, possibly explaining some of the persistent clinical changes in the diabetic cornea after surgical trauma.

Adult↗

Solitary retinal astrocytoma.

The clinicopathologic features of retinal or optic disc astrocytomas are discussed based on eighteen reported cases. In addition, a new case of solitary retinal astrocytoma in a patient without other stigmata of phakomatosis is described. The tumor was prominently vascular and caused total exudative retinal detachment. It doubled in diameter over the seven months prior to enucleation, which was dictated by the occurrence of neovascular glaucoma. The astrocytic nature of the lesion was confirmed by immunohistochemical techniques (glial fibrillary acidic protein stain) and by electron microscopy.

Adolescent↗

Detection of uric acid in aqueous humor by high pressure liquid chromatography.

The uric acid peak among the compounds in aqueous humor separated by high pressure liquid chromatography was identified by its retention time, the UV absorbance characteristics, and the effect of uricase. The uric acid concentration in the aqueous humor of normal monkey, human eyes with cataract, and human eyes with glaucoma are less than 0.05, 1.7 +/- 0.3, and 3.8 +/- 0.4 respectively. The significance of high uric acid concentration in glaucoma is discussed.

Animals↗

Corneal aberrations and visual performance after radial keratotomy.

BACKGROUND: Refractive surgery and videokeratography have allowed us to study the effects on visual performance of relatively large changes in corneal aberration structure induced by surgical changes in corneal shape. METHODS: We quantified in one eye of nine normal and 23 radial keratotomy patients, the area under the log contrast sensitivity function (AULCSF) and corneal first surface wavefront variance for two artificial pupil sizes (3 and 7 mm). Contrast sensitivity was measured with sine-wave gratings at six spacial frequencies. Wavefront variance was derived from videokeratographs using Zernike polynomials. RESULTS: For normals eyes there were no significant changes over time. For eyes that had radial keratotomy, there were significant pupil size-dependent changes. For the 3 mm pupil, there were significant surgery-induced changes in the corneal wavefront variance which became large (approximately 30 times preoperative values) at 7 mm. Significant correlated changes in AULCSF for the 7 mm pupil but not for the 3 mm pupil occurred immediately following surgery and remained. CONCLUSIONS: Radial keratotomy, like photorefractive keratectomy, shifts the distribution of aberrations from third order dominance (coma-like aberrations) to fourth order dominance (spherical-like aberrations). Radial keratotomy-induced aberrations and loss in contrast sensitivity are reduced with increasing clear zone diameter. Radial keratotomy induces an increase in the optical aberrations of the eye and the increase for large pupils (7 mm) but not small (3 mm) is correlated to a decrease in contrast sensitivity.

Contrast Sensitivity↗

Intrastromal photorefractive keratectomy with a new optically coupled laser probe.

BACKGROUND: Intrastromal photorefractive keratectomy is a new procedure in which compact linear or area regions of the corneal stroma can be vacuolized, yielding changes in corneal curvature. METHODS: Diffraction-limited 1064-nanometer light pulses from a high rep rate Q-switched Nd-YAG laser were coupled through novel means into a probe with index-matched optical contact with the cornea. The resulting extremely reduced focal region initiated a plasma point that was free of shock front effects where tissue was reduced to liquid. This probe process was applied to the corneas of eye-bank eyes, and to living rabbit and primate eyes. The refractive effects were evaluated with slit-lamp microscopy, keratoscopy light and electron microscopy. RESULTS: Refractive effects similar to refractive keratotomy were observed immediately after treatment. Intrastromal highly localized vacuolized regions were observed at the depth of focus with variability of only 20 microns. The plasma point vacuoles were about 100 microns in diameter. Stromal material that occupied the vacuole space appeared completely reduced to liquid. The transition region between vacuole and normal tissue was less than 0.5 microns. The treatment vacuoles disappeared to the unaided eye 24 to 48 hours after treatment. CONCLUSIONS: Corneal refractive power can be achieved with intrastromal keratectomy.

Animals↗