Ewa Mrukwa-Kominek

Intraorbital foreign bodies - 5 own cases and review of literature

Five patients were surgically treated for intraorbital foreign body: a 14-year-old girl had a door glass splinter, a 23-year-old man a metallic foreign body--gunshot pellet, a 55-year-old man a splinter from a metallic bar, a 48-year-old patient the splinters of circular saw and 61-year-old man with shot. Two foreign bodies were removed using the Krönlein-Reese-Berk lateral orbitotomy, two others by Sewell medial orbitotomy and one with superior orbitotomy of Dandy-Naffziger. Radiographs and CT scans were used to identify and localize intraorbital foreign bodies. In one case we found coexistence foreign body (shot) and tumor--inflammation pseudotumor of the orbita. It is possible, that in this case long-time occupy foreign body in the orbita was a cause of that tumor. All foreign bodies were successfully removed, and postoperative course was uneventful. The Krönlein-Reese-Berk orbitotomy provides a satisfactory access to the lateral and posterior orbit, which is of particular importance in the case of a deeply penetrating foreign body (metallic or glass). Surgical removal of intraorbital foreign bodies is a classic example of an interdisciplinary therapeutic approach. Best outcome is usually a result of a team of an ophtalmologist, ENT surgeon, maxillary surgeon and possibly also neurosurgeon performing the operation.

Primary orbital tumors: A review of 122 cases during a 23-year period: A histo-clinical study in material from the ENT Department of the Medical University of Silesia

Background The aim of this study was to investigate the distribution of different types of primary orbital tumors, histopathological diagnosis, and postoperative complications. Material/Methods We analyzed 122 patients (68 women and 54 men) with orbital tumors, hospitalized in the ENT Department of the Medical University of Silesia in Katowice during 1990–2013. The patients were characterized in terms of anatomic, topographical, histopathological, and clinical parameters. The role of diagnostic imagining such as CT, NMR, and fine-needle aspiration (FNB) in preoperative diagnostics is discussed. Results of FNB, cytological, and histopathological examination of the postoperative specimens were compared. Results There were 56 (46%) patients with malignant tumors, 42 (34%) with benign tumors, 19 (16%) with inflammatory tumors, and 5 patients (4%) had other tumors. In cases of malignant tumors, local recurrence up to 5 years was found in 36 (64.3%) cases. In the other 20 (35.7%) cases of malignant tumors, the patients remained under close follow-up in the outpatient clinic, without signs of local recurrence (follow-up 1–17 years). According to histopathological examination, malignant tumors were detected in 45.9% of patients and non-malignant tumor in 34.4% of patients. In 19.7% of patients, inflammatory and other types of tumors were diagnosed. Conclusions We characterized the occurrence and pathological profiles of orbital tumors. The tumor location, histopathological diagnosis, and postoperative complications give us important information for the diagnosis of tumor prior to biopsy or tumor resection and for the determination of the treatment strategy and possible complications after surgery.

von Willebrand factor in iris vasculature of glaucoma patients

Background Previous reports have indicated the role of endothelium disturbances, as expressed by von Willebrand factor (vWF) release, in pathophysiology of glaucoma. The objective of this study was to investigate the vWF expression in iris vasculature of patients with primary open-angle glaucoma (POAG). Material/Methods Immunohistochemistry of vWF expression was performed on cryostat sections of samples collected at the time of peripheral iridectomy and controls collected from dead donors. Results Twenty-seven Caucasians age 66.6±3.7 with 5.8±3.7-year history of treated PAOG and 10 controls age 62.2±1.92 with no history of glaucoma. The percentage of patients who presented normal and up-regulation of vWF phenotype expression differed statistically between examined and control groups: 48% versus 100% (p=0.035, chi-square test with Yates’ correction). Sex, age, glaucoma duration, and visual field quantitative indices had no impact on vWF expression. A significant correlation between mean pre-surgery intraocular pressure and vWF expression was found (Spearman r=0.42, p=0.03). Conclusions Considering the results, it may be suggested that vWF is actively involved in the pathophysiology of glaucoma.

Effect of Selected Dietary Compounds on Extracellular Superoxide Dismutase in the Vitreous of Chinchillas

Purpose: The purpose of this study was to evaluate the effect of diet on the extracellular superoxide dismutase (EC-SOD) activity in the vitreous of chinchillas. Methods: Seventy-eight male chinchillas were randomly divided into 7 subgroups: controls, receiving a standard basal diet, and 6 experimental groups additionally receiving 10% nonoxidized and 10% oxidized olive oil, a garlic extract and lipoic acid in their diet. The activities of EC-SOD were measured. Results: The highest EC-SOD activity was similar in the controls [2.17 ± 0.27 nitric units (NU)/mg protein] and in rabbits fed oxidized olive oil (2.29 ± 0.31 NU/mg protein; p = 0.519). Nonoxidized olive oil appeared to be the strongest antioxidant component of diet (1.58 ± 0.20 NU/mg protein) as compared with the subgroups above (p = 0.008 and p = 0.012, respectively). Administration of garlic and lipoic acid decreased the SOD activity only inthe groups fed oxidized olive oil (p = 0.014). Conclusions: The SOD activity in laboratory animals is possibly modulated by diet. Work will be continued to extrapolate these results to humans.

Differences in serum oxidative status between glaucomatous and nonglaucomatous cataract patients

BackgroundOxidative stress contributes to both intraocular pressure regulation and glaucomatous neuropathy. The systemic redox status (solitary determination) was examined in primary open-angle glaucoma (POAG) patients with cataract and nonglaucomatous cataract patients. Cataract-matched group comparisons appear more precise in the context of oxidative stress evaluation. The aim of this study was to establish if systemic oxidative status in POAG patients was elevated compared with the cataract only subjects.MethodsThe study included patients with primary open angle glaucoma (POAG group, n = 30) and controls (non POAG group, n = 25). Serum concentration of lipofuscine (LPS), malondialdehyde (MDA) and activity of total superoxide dismutase (SOD), and its mitochondrial (Mn-SOD) and cystolic (Cu,Zn-SOD) isoform were measured. Total oxidant state (TOS) and total antioxidant capacity (TAC) in blood were also evaluated.ResultsSignificant increase of LPS (p = 0.0002) and MDA (p = 0.005) concentration was observed in glaucomatous patients as compared with controls. Total SOD activity was significantly lowered in the glaucoma group (p = 0.003); serum level of Mn-SOD was significantly lower in glaucoma patients (p = 0.048) however, Cu,Zn-SOD was not. Glaucoma patients presented elevated mean TOS (p = 0.016). Both groups presented with comparable TAC.ConclusionSystemic redox balance of cataract patients was significantly altered in the course of glaucoma.

Co‐occurrence of Jalili syndrome and muscular overgrowth

Jalili syndrome is a rare disorder inherited in an autosomal recessive pattern manifesting as a combination of cone‐rod dystrophy including progressive loss of visual acuity, color blindness, photophobia, and amelogenesis imperfecta with hypoplastic, immature, or hypocalcified dental enamel. It is caused by mutations in CNNM4, which encodes the ancient conserved domain protein 4. Here we report three brothers with Jalili syndrome and muscle overgrowth of the legs. Myopathic changes were found in needle electromyography. Mutational analysis showed in all three brothers a novel likely pathogenic homozygous missense substitution in exon 1 (c.1076T>C, p.(Leu359Pro)) of CNNM4. Both parents were carriers for the variant. In order to exclude other causative variants that could modify the patients’ phenotype we performed exome sequencing and MLPA analysis of the DMD gene in Patient 1. These analyses did not identify any additional variants. Our results expand the mutational spectrum associated with Jalili syndrome and suggest that mild myopathy with muscle overgrowth of the legs could be a newly identified manifestation of the disorder.

Quality of Life and Mental State After Sight Restoration by Corneal Transplantation

BACKGROUND Quality of life has frequently been reported to improve after corneal transplantation. However, mental status before and after surgery has until now been less well investigated. OBJECTIVE The aim of this study was to investigate quality of life and mental status before and after corneal transplantation including postoperative immunosuppression and visual acuity. METHODS A total of 45 patients were assessed before, and 3 weeks and 4 months after transplantation using the following questionnaires: Visual Function Questionnaire, Beck Depression Inventory, and Hamilton Anxiety Rating Scale. Assessment included a visual acuity test using the logMAR chart, and recognition of the role of postoperative immunosuppression. Finally, patients were asked if they would be willing to have the surgery again. RESULTS In the candidates for surgery, quality of life was reduced, and symptoms of depression and anxiety were present. Corneal transplantation improved their quality of life and reduced symptoms of depression and anxiety. Changes in quality of life and in mental state were associated with a change in visual acuity in the grafted eye. Higher doses of prednisone were associated with a worse quality of life and with more severe symptoms of depression and anxiety after transplantation. Further, 82.5% of patients would have the surgery again. CONCLUSION Assessment for psychiatric symptoms should be considered in individuals facing corneal surgery.

Effect of Resveratrol, a Dietary-Derived Polyphenol, on the Oxidative Stress and Polyol Pathway in the Lens of Rats with Streptozotocin-Induced Diabetes

Resveratrol is found in grapes, apples, blueberries, mulberries, peanuts, pistachios, plums and red wine. Resveratrol has been shown to possess antioxidative activity and a variety of preventive effects in models of many diseases. The aim of the study was to investigate if this substance may counteract the oxidative stress and polyol pathway in the lens of diabetic rats. The study was conducted on the rats with streptozotocin-induced type 1 diabetes. After the administration of resveratrol (10 and 20 mg/kg po for 4 weeks), the oxidative stress markers in the lens were evaluated: activity of superoxide dismutase, catalase and glutathione peroxidase, as well as levels of total and soluble protein, level of glutathione, vitamin C, calcium, sulfhydryl group, advanced oxidation protein products, malonyldialdehyde, Total Oxidant Status and Total Antioxidant Reactivity. The obtained results indicate that the administration of resveratrol to the diabetic rats shows antioxidative properties. It is not a result of antiglycaemic activity but resveratrol probably directly affects the antioxidative system. Resveratrol did not affect the polyol pathway in the lens of diabetic rats. Our results may indirectly indicate benefits of consumption of foods as well as dietary supplements containing resveratrol in diminishing oxidative stress in lenses of individuals suffering from diabetes mellitus.

The effect of macular pigments on vision

Klinika Oczna 2017, 119 (4) ISSN 0023-2157 Index 362646 Proces widzenia Działanie narządu wzroku opiera się na procesie, w który są zaangażowane liczne elementy związane ze zjawiskami fizycznymi i fizjologicznymi (1). U człowieka ten proces przebiega z udziałem jednego z głównych zmysłów, za pośrednictwem którego jest odbierane około 90% ogółu napływających informacji. Proces widzenia składa się z fazy postrzegania określonego zjawiska, a następnie z fazy jego identyfikacji i analizy. Gałka oczna jest narządem, w którym obraz jest zarejestrowany i wstępnie przetworzony przez siatkówkę, a następnie nerwem wzrokowym (n. II) kierowany do ośrodkowego układu nerwowego. Zjawiskiem fizycznym, niezbędnym w procesie widzenia, jest emisja światła o określonych własnościach fizycznych. Światło jest widzialnym promieniowaniem (elektromagnetycznym) zdolnym do wywoływania u człowieka i zwierząt bezpośrednio wrażeń wzrokowych. Przyjmuje się, że to widzialne promieniowanie jest częścią widma fal elektromagnetycznych o bardzo wąskim przedziale długości fal – od 380 do 780 nm. Oko natomiast jest narażone na znacznie szerszy zakres promieniowania – od nadfioletowego do podczerwonego (ryc. 1.). Promieniowanie krótkofalowe jest wysokoenergetyczne, długofalowe natomiast, niosące kwanty niskoenergetyczne (>600 nm), wykazuje zdolność Wpływ barwników plamki na proces widzenia

Determination of Serum Ceruloplasmin Concentration in Patients with Primary Open Angle Glaucoma with Cataract and Patients with Cataract Only: A Pilot Study

Background The aim of this article was to describe the role of ceruloplasmin and to report preliminary results of ceruloplasmin concentrations in patients with primary open-angle glaucoma (POAG) with cataract and in patients with only cataract. Glaucoma, a neurodegenerative disease, is a heterogeneous group of conditions characterized by loss of retinal ganglion cells (RGC), their axons, progressive optic nerve damage, and visual field deterioration. Material/Methods The POAG group included 30 patients and the cataract group included 25 patients. Results Ceruloplasmin plays an essential role in iron metabolism and inactivating free radicals. In the presented pilot study, serum ceruloplasmin level was lower in the POAG group in comparison to the group with only cataract. Conclusions In treating persistent inflammation in the course of glaucoma, antiglaucoma drugs may increase the permeability of the blood-ocular barrier, which may be connected with the lower concentration of serum ceruloplasmin in the glaucoma patients group.