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PubMed1989

Accumulation of lipid peroxidation products in human cataracts.

The role of free-radical-induced lipid peroxidation (LPO) in the development of human lens opacity was investigated. 130 human crystalline lenses impaired with cataract of various etiology (senile, traumatic, complicated cataracts) at different stages of cataract development as well as 18 transparent human lenses were studied. Primary products of LPO (diene conjugates), secondary products (ketodienes) and the end products (Schiff bases) were distinctly accumulated in cataractous lenses. Initial stages of cataract were characterized by the accumulation of primary LPO products, while in the latest stages there was a prevalence of fluorescent end products of LPO. It was concluded that the accumulation of polar hydroxy groups in the lipid bilayer of plasma membranes of lenticular fibers is one of the possible causes of their injury in cataracts.

Aged↗
PubMed1991

Long-term outcome following trabeculectomy: I Retrospective analysis of intraocular pressure regulation and cataract formation.

Decrease of intraocular pressure (IOP) and the occurrence of cataract were analysed in 75 patients of a community-based material followed for 6-12 years after trabeculectomy. IOP was controlled (less than or equal to 21 mmHg) with or without additional treatment in approximately 90% of the eyes, both at 5 years and at the last visit. The share of eyes requiring no medication for IOP control decreased linearly with time from approximately 90 to 60% between one and 10 years postoperatively. Thirty-eight per cent of the patients without cataract at the time of operation suffered from cataract development during follow-up. The prevalence of dense cataract producing severe visual loss at the last visit was 47%. The occurrence of cataract was correlated with the age of patients at operation. Cataract formation showed no relationship of statistical significance with preoperative treatment, with time since surgery, the magnitude of preoperative IOP and the reduction of postoperative IOP.

Aged↗
PubMed1987

An association between 'desert lung' and cataract--a new syndrome.

Sixteen cases of desert lung with cataracts were previously reported on, and an additional 14 cases have now been encountered from the same area of which 13 had cataracts. The association of cataract with desert lung was not commented on in the previous report, because it was thought to be coincidental. It now appears to be real rather than coincidental. Analysis of these 33 patients showed the following: none had significant clinical signs; x-ray findings were mainly those of micronodular miliary infiltrates; 88% were found to have cataracts; 85% were females. The frequency of cataract among patients over the age of 50 years coming to the hospital for eye problems was 26%. These figures showed a distinct relationship between desert lung and cataract in the Arabian desert. The causal relationship is not as yet clear, but 'tandoor' baking is suggested as the main factor.

Aged↗
PubMed1991

Postinflammatory cataracts in the mouse: induction by human mycoplasma-like organisms.

Cataracts often occur in humans secondary to uveitis. Uveitis may be caused by various infectious agents, but rarely is the agent detected in the cataract. Mycoplasma-like organisms (MLO) were recently reported to cause human uveitis and retinitis. Cataracts were often present in those inflamed eyes. MLO are intracellular cell wall deficient pathogenic bacteria. They are pleomorphic tubulospherical and filamentous organisms with a characteristic ultrastructural appearance. No MLO culture system has been found despite 20 years of effort. The diagnosis of MLO disease rests on detection of the organisms in parasitised cells by a transmission electron microscope and response to antibiotics. In human intraocular inflammatory disease MLO are detectable in parasitised leucocytes and retinal pigment epithelial cells at the disease sites. Inoculation of MLO from a human source into mouse eyelids produced intraocular, chronic, progressive, inflammatory disease, with intraocular leucocytes parasitised by MLO in 15 of 100 mice versus 0 in 200 controls (p less than 0.05). This report describes the cataracts with MLO-parasitised intralenticular leucocytes in the inflamed eyes of 14 of those 15 mice versus 0 in 200 control mice (p less than 0.05). The results indicate that MLO penetrated the lens capsules to produce the cataracts, and they suggest that MLO could cause human cataracts. Alternative methods for detection of MLO and rifampin treatment of MLO intraocular disease are discussed.

Animals↗
PubMed1997

Relation between postoperative blood-aqueous barrier damage and LOCS III cataract gradings following routine phacoemulsification surgery.

AIM: To examine the relation between cataract density, the phacoemulsification energy required for its removal, and blood-aqueous barrier (BAB) damage on the first day after surgery. METHODS: A prospective study recruiting patients with normal eyes apart from senile cataract. Preoperatively, visual acuity, anterior chamber laser flare, and cell values were measured using the Kowa laser flare meter, and the LOCS III grading of the cataract defined. The patients all underwent standardised phacoemulsification surgery through a superior scleral tunnel incision, with confirmed in the bag placement of a one piece PMMA IOL; all surgical complications were excluded. The phaco power delivered was recorded as the cumulative delivered energy, CDE. On day 1 visual acuity and laser flare and cell readings were taken. RESULTS: 101 patients were recruited and all completed the protocol. Older patients had a higher preoperative flare value (p = 0.003); preoperative cell values were significantly related to nuclear opacity (p = 0.021) and colour (p = 0.011). Postoperative flare was related to preoperative flare (p = 0.001) and nuclear colour (p = 0.038). CDE was related to nuclear colour (p = 0.031) and opacity (p = 0.022), but not to aqueous flare. CONCLUSIONS: Damage to BAB after routine phacoemulsification surgery is predicted by the preoperative flare values and the density of the cataract nucleus. The amount of phacoemulsification energy required to remove a cataractous lens is related to the density of the cataract but affects postoperative flare to a minimal degree. Other factors such as surgical technique are probably more important. Laser photometry is a useful tool for objectively assessing surgical technique.

Blood-Aqueous Barrier↗
PubMed2002

Knowledge about cataract, glaucoma, and age related macular degeneration in the Hong Kong Chinese population.

AIMS: Patients' knowledge and participation in their care are important in prevention of blindness from common eye diseases such as cataract, glaucoma, and age related macular degeneration (AMD). The aim of this study was to measure knowledge of these conditions in the Hong Kong Chinese population. METHODS: Subjects aged 40 and above in the Shatin district of Hong Kong were randomly selected as part of a larger study of causes of adult visual loss. The subjects received eye examinations in which the primary cause of visual disability was recorded. The respondents were asked by trained interviewers in a standardised fashion about their knowledge of cataract, glaucoma, and AMD. Their answers were rated for accuracy by a senior ophthalmologist. RESULTS: Out of the 2538 eyes examined, 7.0% had visual acuity less than 6/18. Fully 69.6% of the visual disability for those aged 60 or above was caused by cataract, AMD, or glaucoma. Awareness of cataract in particular was high, in that over 90% of respondents had heard of it. However, only 22.9% of them could describe cataract symptoms correctly, and these percentages were even lower in glaucoma (10.2%) and AMD (<1%). Over 40% of subjects did not know that surgery was an appropriate treatment for cataract. CONCLUSION: This sample of the Hong Kong Chinese population had limited knowledge of common eye diseases. Educational programmes to enhance public awareness may be needed to improve the effectiveness of health promotion and thus prevent unnecessary blindness.

Adult↗
PubMed2002

TGFbeta induces morphological and molecular changes similar to human anterior subcapsular cataract.

BACKGROUND: Transforming growth factor beta (TGFbeta) has been shown to induce subcapsular plaques in cultured rat lenses as well as in lenses of transgenic mice. In the present study the authors have extended their analysis of these cataract models to determine how closely they mimic human cataract. In particular, they studied the maturation of cataract in the transgenic model to determine if it develops similar features as previously described for anterior subcapsular cataract (ASC) in humans. Furthermore, they investigated whether both of these animal models express the range of molecular markers that have now been shown to be present in human ASC. METHODS: Histology and periodic acid Schiff staining were used to study the development and maturation of subcapsular plaques in transgenic mice overexpressing TGFbeta1 in the lens. Immunolabelling methods were used to identify the molecular markers for ASC in both the transgenic mouse model and in rat lenses cultured with TGFbeta2. RESULTS: Histological analysis showed that the subcapsular plaques that develop in adult transgenic mouse lenses bear a striking similarity to mature human ASC, including the formation of a new epithelial-like layer extending between the subcapsular plaque and the underlying fibre mass. All known molecular markers for human ASC were induced in both rodent models, including collagen types I and III, tenascin, and fibronectin. They also identified the presence of desmin in these plaques, a putative novel marker for human cataract. CONCLUSIONS: In both transgenic mouse and rat lens culture models TGFbeta induces markers similar to those found in human ASC. Atypical expression of these cataract markers is also characteristic of posterior capsular opacification (PCO). The molecular markers expressed are typical of a myofibroblastic/fibroblastic phenotype and suggest that a common feature of ASC and PCO may be induction of an epithelial-mesenchymal transition by TGFbeta.

Animals↗
PubMed2003

Visual outcome after high volume cataract surgery in Pakistan.

AIM: To determine the visual outcome and factors influencing visual outcome after cataract surgery in an urban charity hospital in Pakistan. METHODS: A series of selected outpatients were examined who had undergone cataract surgery in the preceding 24 months. RESULTS: 181 patients aged 45-82 years were examined. The type of cataract operations they had had were extracapsular cataract extraction (ECCE) only in 50% (91), phacoemulsification (phaco) only in 11% (20), ECCE with intraocular lens (IOL) in 17% (31), and phaco with IOL in 22% (39). At presentation, 49.7% (90) had poor functional vision; after refraction 68% (123) had a good visual outcome. Functional vision in eyes undergoing ECCE with IOL was good in 77% (22) and with phaco with IOL in 71.8% (28). After refraction a higher proportion of eyes with IOL surgery (93%) had a good outcome than those with non-IOL surgery (53%). Uncorrected refractive error, present in 75.5% (68), was the commonest cause of poor functional vision. CONCLUSION: This study demonstrates that it is possible to obtain good results with IOL surgery in the developing world. Increasing cataract surgery with IOL implantation should reduce the number of eyes with poor functional vision after cataract surgery. More attention should be directed towards ensuring that successful outcomes are indeed being realised by continued visual monitoring postoperatively.

Aged↗
PubMed2006

[Hyperferritinemia-cataract syndrome associated to the HFE gene mutation. Two new Spanish families and a new mutation (A37T: "Zaragoza")].

BACKGROUND AND OBJECTIVE: Nuclear congenital cataracts associated with hyperferritinemia--hereditary hyperferritinemia cataract syndrome (HHCS)--without clinical or biochemical signs of iron overload have been recently described in several Spanish families. This HHCS is associated with mutations in the gene of ferritin subunit L, located in chromosome 19. We describe 2 new families with HHCS, one of them presenting a new L-ferritin mutation (A37T: -Zaragoza-). PATIENTS AND METHOD: Patients and probands were studied according to the Anemia Unit protocol: complete blood count, biochemical profile (diabetes, hepatic and renal), hepatic serologies, iron metabolism (iron, transferrin, ferritin, transferrin saturation, reactive C protein) and mutation HFE gene studies (C282Y, H63D). All of them were sent to the Ophthalmology Service for cataract study. L-ferritin mutational scanning was performed by denaturing high performance liquid chromatography (DHPLC). Samples displaying an altered elution profile, as compared to a wild type control, were directly sequenced for the precise characterization of the L-ferritin mutation. RESULTS: Family A proband was a 54 year-old-female, with cataracts, ferritin level: 942 pg/I, transferrin saturation: 14%, HFE gen study: H63D/H63D; L-ferritin gene study: C33T mutation/-. Her two sons had cataracts, hyperferritinemia (1607, and 1188 pg/I, respectively), normal transferrin saturation (40% and 9%), HFE gene study: H63D/N; and L-ferritin gen study: C33T/-. Family B proband was a 39 year-old-female, with cataract, ferritin level: 636 pg/I, transferrin saturation: 25%, HFE gene study: H63D/N; and L-ferritin gene study: A37T/-. Her two sons, sister, brother and nephew, who were affected with A37T mutation, showed hyperferritinemia (883, 747, 835, 613 and 1396 pg/I) with normal transferrin saturation levels (17%, 34%, 25%, 18% and 24%); but the ferritin levels of those non-affected were normal (35 and 50 pg/I). CONCLUSIONS: HHCS is a dominant autosomic condition, with a possible world-wide distribution,which should be included in the differential diagnosis of hyperferritinemia studies. It is important to suspect it in order to avoid wrong treatment.

Adolescent↗
PubMed2001

Localization of a recessive juvenile cataract mutation to proximal chromosome 7 in mice.

OBJECTIVE: To localize the chromosomal position of a novel cataract mutation (juvenile recessive cataract; jrc) in mice. METHODS: A mapping population was developed by crossing cataract males (albino MH) to wild-type females (black C57BL/6J). F1 females were backcrossed to albino MH males with cataracts. RESULTS: The results were consistent with a model of a single autosomal recessive gene [153 cataract, 169 wild-type; chi2 = 0.8, 1 degree of freedom (d.f.), p > 0.35]. Linkage with the albino (tyrosinase; Tyr) locus was evident (chi2 = 61.5, 1 d.f., p < 0.0001), implicating chromosome 7 as the location of jrc. Recombination percentages (+/- SE) between jrc and D7Mit340 (1.2 cM location), D7Mit227 (16.0 cM) and D7Mit270 (18.0 cM) were 17.1 +/- 2.1, 3.7 +/- 1.1 and 6.2 +/- 1.3%, respectively. Multi-point mapping determined that the most likely order of these loci is D7Mit340 - jrc - D7Mit227 - D7Mit270 - Tyr. Although animals with the mutant phenotype appeared to have little or no sense of sight, their growth was not different (p >0.20) from that of normal mice. CONCLUSION: The jrc mutation model may be useful in the study of the genetics of cataracts in other animal species, including humans.

Animals↗
PubMedDate not supplied

Establishment of the mouse as a model animal for the study of diabetic cataracts.

The purpose of the present study was to investigate the suitability of using the mouse, a species known to have a low lens aldose reductase activity, as a model animal for studying the pathogenesis of diabetic cataract. Earlier studies with diabetic rats whose cataract development is much faster can only partially explain the etiology of cataracts in humans where lens aldose reductase is substantially low. CD-1 mice were injected intraperitoneally with streptozotocin according to Rossini's method. Blood glucose levels were estimated after 7 days, and animals having blood glucose between 300 and 400 mg/dl were selected for further experiments. Development of lenticular opacity was followed by examining the animals every 3-4 weeks by direct ophthalmoscopy, slitlamp examination and Scheimpflug photography. Additionally, the animals were sacrificed at appropriate intervals, eyes enucleated and subjected to morphological studies. The presence of refractive changes and early cataract in the diabetic mice was initially ascertained by the distorted appearance of the grid pattern when seen through the isolated lenses. Early cataracts were visible on slitlamp examination and by ophthalmoscopy as early as 3-4 weeks after the establishment of diabetes. Advanced opacity was clearly documentable by photography after 5-6 months. Similar to that in other species, a single layer of anterior epithelial cells abutting the anterior capsule was seen in the histological sections of normal mouse lenses. On the contrary, the epithelium in the diabetic lens was multilayered, and numerous nucleated cells were visible in the superficial anterior cortex. These studies therefore suggest that further studies with mice may throw additional light on the contribution of diabetes in the pathogenesis of cataracts in low lens aldose reductase models.

Animals↗
PubMed1983

Studies on glutathione S-transferase, glutathione peroxidase and glutathione reductase in human normal and cataractous lenses.

The cause(s) for decreased reduced glutathione (GSH) content of human senile cataracts were investigated by determination of three enzymes of GSH metabolism: GSH S-transferase, GSH peroxidase and GSH reductase. There are significant decreases in activities of GSH S-transferase of early cataracts (-76%) and of dark advanced cataracts (-73%) as compared to clear age-matched lenses. However, the activities of GSH peroxidase were only slightly decreased in cataracts as compared to clear age-matched lenses. The decrease in enzymes of GSH metabolism does not account for increased GSH degradation. Thus decreased GSH synthesis and leak out from cataractous lenses may account for the GSH loss in cataracts.

Adult↗
PubMed1988

Ganglioside composition in human cataractous nuclei.

Gangliosides were isolated from human cataractous nuclei by solvent extraction, dialysis, and thin-layer chromatography and compared to gangliosides present in human whole normal and cataractous lenses. Three predominant gangliosides were tentatively identified as GM1, GM3, and GD1a, and several other resorcinol-positive components were observed in each of the sets of lens tissue. Thin-layer chromatographic patterns were similar, although some minor and possibly significant differences in band intensities were observed when chromatograms of gangliosides from cataractous nuclei and cataractous whole lenses were visually compared with those of whole normal lenses. Total ganglioside extracts were methanolyzed and the fatty acid methyl esters extracted with hexane and resolved by gas chromatography. Nervonic acid (C-24:1) content was increased in cataractous nuclei as compared to normal and cataractous whole lenses.

Cataract↗
PubMed1989

Bendazac lysine in selected types of human senile cataract. A long-term double-masked placebo-controlled clinical trial with multilinear densitometric image analysis of Scheimpflug photographs.

A double-masked placebo-controlled clinical trial with hard data evaluation by image analysis of Scheimpflug photographs taken at baseline and 6, 12 and 18 months after starting treatment was performed to assess the efficacy of bendazac lysine in four different types of senile cataract. The study had a classical split-plot design. For statistical evaluation, the analysis of variance and covariance for repeated measures were used for three different lens sections: anterior capsule and superficial layer, anterior cortex and nucleus. In the entire group of 53 evaluable patients (without separation into cataract-type subgroups), there was a significantly less increase over time in light scattering (i.e. film blackening) of the anterior cortex and nucleus with bendazac lysine than with placebo. There was also a strong trend in favour of the active drug at the anterior capsular level. Patients with water clefts and spokes showed a significantly less light scattering of the anterior capsule and cortex when treated with bendazac lysine. Those with nuclear changes also showed significantly less light scattering of the anterior cortex and nuclear region with the active drug than with placebo. The number of patients with subcapsular and wedge-shaped (cuneiform) cataracts was too small to be adequately assessed by statistical procedures. Nevertheless, there were indications of a beneficial effect of bendazac lysine on all the lens sections in patients with subcapsular cataracts and on the anterior cortical region in those with wedge-shaped cataracts. In conclusion, this study showed that the increase in light scattering over time, i.e. the progression of cataract, is less in bendazac lysine-treated patients than in those treated with placebo.

Adult↗
PubMed1991

Glutathione and glutathione-related enzymes in human cataractous lenses.

Glutathione and its related enzymes were measured for normal and cataractous human lenses. Glutathione decreased progressively with the development of cataracts. This decrease was more pronounced in the nucleus than in the capsule-epithelia of cataractous lenses. Glutathione reductase in nuclear extracts was relatively unchanged during cataract progress, while glutathione synthetase was significantly low in the advanced stages of cataracts. gamma-Glutamylcysteine synthetase was not measurable in the nuclei of cataractous lenses.

Aged↗
PubMed1995

Distribution of water-soluble crystallins in microsectioned cataractous lenses from one hundred Egyptian patients.

Morphologically classified lenses from 100 cataract patients from the Mansoura Eye Hospital (Egypt) were microdissected and the crystallin composition and distribution were analyzed by thin-layer isoelectric focusing (IEF). The IEF profiles of cataractous lenses were compared with each other, with those of sclerotic lenses and with a normal lens profile. The alterations in the composition of high-molecular-weight (HMW)-, alpha-, beta H-, beta L-, beta s-, and gamma-crystallins along with normal aging, are superimposed by pronounced cataract-related changes which are different for the various types of cataracts. The general feature includes a continuous loss of gamma-, beta s- and beta L-crystallins of higher IEPs and an increase of HMW material. This is highly pronounced in the nucleus of nuclear cataractous lenses. In cortical cataractous lenses, changes start in the cortical layers. No differences could be observed between alterations in Caucasian lenses and this extended Egyptian lens population.

Adult↗
PubMed1996

Measured changes in cataract over six months: sensitivity of the Nidek EAS-1000.

Lens opacities in 98 eyes from 63 consecutive outpatients with cataract were recorded by both retroillumination and Scheimpflug slit methods by one operator. This was repeated at 26 +/- 1 weeks. Image analysis used the EAS-1000 software. Cortical and posterior subcapsular (PSC) cataracts were measured in retroillumination images as density more than 14 cct units below background density. Linear densitometry of white scattered light along the optical axis was measured for slit images by both peak density and mean density ('area under the curve'). Retroillumination images showed no discernible change over 6 months (the regression coefficient being as for the intersession reliability). Half of the Scheimpflug slit images could not be analysed because overlying cortical changes masked the more posterior parts of the lens. The other 49 eyes showed a significant increase in nuclear white scatter after 6 months, with greater degrees of change occurring in those eyes with the greatest amount of nuclear cataract initially. This is reflected by the decreased intraclass correlation coefficient (R = 0.42). The area of lens showing greatest change was the anterior fetal nucleus. The Nidek EAS-1000 is able to detect changes over a 6-month period in nuclear density but not in cortical or PSC cataract. The rate of progression of nuclear white scatter increases as the lens opacity becomes more dense. The ability to detect change in cataract over 6 months has implications for epidemiological studies and for trials of anti-cataract drugs.

Cataract↗
PubMed1987

Cataract survey in the local area using photographic documentation.

An epidemiological survey of cataract was performed in a limited local population. 1,020 individuals over 40 years of age were examined. The crystalline lens findings were documented by both Scheimpflug and retroillumination photography. Cataractous changes were classified into three groups according to early senile changes, incipient cataractous changes and only prominent cataractous changes. Forms of opacification were classified as cortical, subcapsular, nuclear, mixed type and others. The percent prevalence of cataracts including early senile changes was 33.9% in the 40-year-old population, 62.8% in the 50, 76.2% in the 60, 84.0% in the 70 and 100% for those in their 80s. Prominent cataractous opacification was 1.6% in the 40-year-old population, 3.1% for those in their 50s, 19.0% in their 60s, 28.6% in their 70s and 57.1% in their 80s, respectively. Until age 60, the type of opacification was mainly cortical alone; however, after age 70, cortical opacity accompanied by nuclear and/or capsular opacities increased. The pure nuclear type increased in individuals over 70.

Adult↗