Erkki Tuovinen

RETINOBLASTOMA IN FINLAND 1912–1964

The present study is based on a series of retinoblastoma patients diagnosed in Finland within a period from 1912 to 1964. A complete accumulation of cases was attempted for the assessment of relative frequencies of retinoblastoma during the period of study. The data were primarily intended for cancer demographers for the construction of incidence-rates of retinoblastoma in various parts of the world. Furthermore, as it has been suggested by Davies (1967) that retinoblastoma might be used as an index cancer to which the frequency of other cancers might be compared, special efforts to bring this cancer to light in different countries should be made.

ON HYPOTONY FOLLOWING CYCLODIALYSIS SURGERY

Surgery is always a somewhat rough procedure in which the effect of the extent of intervention is difficult to predict. Especially in the eye, it is understable how easily one can go from one extreme to the other. Thus, hypotension following glaucoma surgery occasionally presents a problem. Kronfeld (1954), in his discussion of cyclodialysis, stated that wits final result is less controllable by the ophthalmologist than is the final result of any other glaucoma operationu. Hypotony, however, may not have been a frequent complication of cyclodialysis. O’Brien and Weih, in their publication of 1949, found it in only one percent of their cases. They consider hypotony more infrequent after cyclodialysis than after external filtering operations. In 1952 Vannas and Bjorkenheim published a study from this clinic of three cases of hypotony following cyclodialysis in which an elevation procedure was performed. Their material, collected during ten years from 1940, consisted of 750 cyclodialysis operations, of which 27 resulted in hypotony. A rule in our hospital, as in several other clinics has been that cyclodialysis has been employed only as a first measure and later, after other operations, only in special hopeless cases where other surgical measures are not indicated. I t is therefore appropriate to consider first what was the result and especially how often a hypotony followed the first cyclodialysis operation. The material in this paper was collected from cyclodialysis patients chiefly during the period 1951-1955. It comprises 200 cases in which 291 cyclodialyses were performed on 255 eyes suffering from glaucoma. The study includes a total of 24 patients with hypotony in 24 eyes. The eyes had not been operated upon earlier. Thus the hypotony followed the first cyclodialysis. We should

Clinical trial of the topical use of disodium cromoglycate in vernal, allergic and chronic conjunctivitis.

Thirty‐three patients were treated with disodium cromoglycate (DSCG). Of these 5 had vernal conjunctivitis, 18 had allergic conjunctivitis and 10 had mild chronic conjunctivitis in which the exact aetiology could not be determined. 70% of patients with DSCG as the only medication achieved at least some beneficial effect being almost exlusively in the groups of either vernal or allergic conjunctivitis. The basic trend seemed to indicate a reduction in severity during the treatment with DSCG in allergic diseases.—

Orbital sarcoidosis. A case report.

A case of ophthalmic sarcoidosis with systemic sarcoid involvement was examined. The case presented a large firm tumour of the right orbit with only minor ocular involvement. The diagnosis was based on histological verification at various sites.

Contact lenses in hypoxia

Abstract. Seven women with soft contact lenses were examined during a 4 h period in a decompression chamber. The atmospheric pressure was lowered from the normal value of 1000 millibars (750 mmHg) to 560 millibars (420 mmHg), which corresponds to the altitude of 4000 m above sea level. The humidity, temperature, percentage of carbon acid and illumination were attempted to be kept even. Five test subjects developed subjective, and all the 7 also developed objective eye symptoms. It was concluded that hypoxia itself may cause eye discomfort for aircraft passengers with contact lenses. The most serious objective findings were corneal erosions in 3 and opacities of corneal stroma in 5 test persons. The control group without contact lenses did not develop any symptoms during the test.

EXPERIENCE OF THE USE OF INDOMETHACIN IN INFLAMMATORY EYE DISEASES1

In 1963, Shen and his co-workers reported that they had synthetised a new non-steroid, anti-inflammatory agent with an antiedemic, analgetic and antipyretic effect. The first to study the effect of this drug, indomethasin (1-(pchlorobenzoyl)-5-methoxy-2-methylindole-3-acetic acid) were Winter et al. (1963, 1964), Paul and Strottman (1963), Norcross (1963). These and later studies established that indomethacin enhances the action of corticosteroids, making it possible to reduce the steroid dosage for some chronic rheumatoid arthritis patients; in some cases indomethacin has even made it possible to discontinue steroid administration completely. The mechanism of effect of indomethacin is not fully known, but it has been shown that its effect does not resemble that of corticotrophin as adrenalectomised test animals respond to it equally well as intact animals (Winter et al., 1963). Indomethancin had many side effects in the first clinical studies, e. g. headache, giddiness, nausea, vomiting, tinnitus, dyspepsia, and diarrhea. But most of these were found to be due to excessively high doses, as much as 900 mg/ 24 hours even. Hart and Boardman (1964) recommended an initial dose of 25 mg/24 hours to be given postprandially, increased subsequently to 75-100 mg/24 hours, and even to 300 mg/24 hours if there were no side effects. As the authors have found no reports of the effect of indomethacin in eye diseases, they made a trial use of the drug in some eye inflammations.

Low power argon laser trabeculoplasty

Abstract. Sixtyseven consecutive argon laser trabeculoplasties to as many patients were retrospectively followed‐up for 3 to 12 (mean 7) months. The laser power used was substantially lower than originally proposed by Wise & Witter (1979) ranging from 100 mW to 500 mW. Factors influencing the outcome of low power trabebuloplasty were evaluated. The statistical analysis of the data was performed using multiple regression analysis, analysis of variance, t‐test and χ2‐test. The mean success rate remained relatively low (33%). In the high power capsular glaucoma group it was 50%.

Poikilodermatomyositis with retinal haemorrhages and secondary glaucoma.

Poikiloderma is a relatively rare skin disorder of unknown etiology. Typical features of the affection are atrophy of the skin and the striated muscles. I t was first described by Wagner in 1863. The skin changes involve teleangiectasis, pigmentation and sharp-edged ulcerations. The eye symptoms presented by this disease have been described by many authors. I n 1923, Oppenheim reported paresis of the eye muscle, iritis and uveitis; Wagner 1863, and Marinescu et al. 1951, nystagmus; Heyn 1924, exophthalmus; Bruse 1938, Lisman 1947, and de Vries 1951, retinitis; and Sament and Klugman 1957, edema and retinal pigmentation. As we have encountered no mention of glaucoma in the literature on poikilodenna this case in which difficult secondary glaucoma was associated with massive retinal hemorrhages may be of a certain interest.

THE EFFECT OF ASCORBIC ACID ON THE INTRAOCULAR PRESSURE AND THE AQUEOUS HUMOUR OF THE RABBIT EYE

The regulation of intraocular pressure obviously depends on several factors. Attention was paid back in the 19th century to the 24-hour variations in intraocular pressure (Huguenin, 1899), and the subject has subsequently been studied extensively (see e. g. Newel1 and Krill, 1965). The 24-hour variation in intraocular pressure might be attributable to the 24-hour fluctuations in adrenal hormones (e. g. Boyd, McLeod, Hassard and Patrick, see Linnkr and Wistrand, 1962). The mechanism of regulation of the pressure, however, is not known. The hypothesis advanced by Linnkr (1 964) is that ascorbic acid might participate in the regulation of intraocular pressure as a corticoid antagonist. The effect of topical administration of ascorbic acid on the intraocular pressure, outflow coefficient and ascorbic, potassium, sodium and protein concentrations of the aqueous humour of rabbits was studied.

[14C]6‐METHOXY‐1,2,3,4‐TETRAHYDRO‐β‐CARBOLINE IN RETINAL AND OTHER TISSUES AFTER INTRAVASCULAR AND INTRAVITREAL INJECTIONS IN MICE AND RATS

6‐Methoxy‐1,2,3,4‐tetrahydro‐β‐carboline (6‐MeO‐THBC) is a condensation product of 5‐methoxytryptamine and formaldehyde. It possesses diverse biochemical and pharmacological properties and has been suggested to act as a neuromodulator. 6‐MeO‐THBC has been shown to occur in various tissues including the retina in animals and human beings. The present results show that the mouse and rat retina as well as other tissues take up 14C‐labelled 6‐MeO‐THBC injected intravenously or intravitreally. The retinal concentrations show a prompt rise after the injection and significant levels are maintained after 2 days.