Hans-Jürgen Thiel

Colour vision disturbances in chronic smokers

Abstractu2002· Purpose: The aim of the present study was to test the influence of smoking on colour perception. · Subjects and methods: At the University Eye Hospital Tübingen, 76 generally healthy smokers with inconspicuous ophthalmological findings (visual acuity, refraction, intraocular pressure, morphology) were examined by the cap-sorting test, Roth 28-hue desaturated. Group 1 was comprised of smokers (n=20; M 9, F 11; mean age 28.1±10.3 years) with a smoking consumption of less than one packet of cigarettes per day (8.4±5.3 cigarettes/day) for 9.1±8.3 years. Group 2 consisted of smokers (n=32; M 22, F 10; mean age 28.6±9.7 years) with a smoking consumption of one or more than one packet per day (30±8.4 cigarettes/day) for 9.5±8.3 years. Generally healthy and ophthalmologically normal non-smokers served as a control group (n=76; M 41, F 35; mean age 30±9 years).u2002· Results: The average error score of the control group was (median±mean absolute deviation) 42±18. Group 1 showed no difference to the control group (51±27; P=0.42). On the other hand, group 2 had a significantly higher error score than the control group (102±45; P<0.0001).u2002· Conclusion: Otherwise healthy smokers with a cigarette consumption of less than 20 cigarettes per day do not show any disturbances in colour vision. Smokers who consume more than 20 cigarettes per day may suffer colour vision defects as a result.

A novel keratin 12 mutation in a German kindred with Meesmann's corneal dystrophy.

AIM To study a kindred with Meesmanns corneal dystrophy (MCD) to determine if a mutation within the cornea specific K3 or K12 genes is responsible for the disease phenotype. METHODS Slit lamp examination of the cornea in four members of the kindred was carried out to confirm the diagnosis of MCD. The region encoding the helix initiation motif (HIM) of the K12 polypeptide was polymerase chain reaction (PCR) amplified from genomic DNA derived from affected individuals in the kindred. PCR products generated were subjected to direct automated sequencing. Restriction enzyme analysis employingBan I was used to confirm the presence of the mutation in affected individuals of the family. RESULTS Sequencing of the K12 gene in an affected individual from the family revealed a novel heterozygous missense mutation (413A→C), predicting the substitution of a proline for a glutamine at codon 130 (Q130P) in the HIM of the K12 protein. The mutation was excluded from 50 normal, unaffected individuals by restriction enyzme analysis and was therefore unlikely to be a common polymorphism. CONCLUSION A novel missense mutation in the K12 gene leads to MCD in a German kindred. Missense mutations have now been identified within the region encoding the helix initiation motif of the K12 protein in eight of 11 MCD kindreds analysed at the molecular level.

Psychological characteristics of patients with normal-tension glaucoma

Abstractu2002· Background: A study was carried out to evaluate the extent of psychosomatic complaints in patients with normal-tension glaucoma. · Methods: Twenty-four patients (M:F=3:21; mean age 58±15.3 years) with normal-tension glaucoma were rated according to the von Zerssen Symptom List (psychosomatic discomfort), the Maudsley Personality Inventory (MPI-N, emotional status and MPI-E, extroverted–introverted), the Beck Depression Inventory (BDI), and the Sixteen Personality Factor Questionnaire (16PF). An age- and sex-matched control group (n=24; M:F=3:21; mean age 56±13 years) without any ocular or other general chronic disease was selected. · Results: In comparison with the control group the patients with normal-tension glaucoma showed significantly more complaints (von Zerssen Symptom List) and were more emotionally unstable (MPI-N). No group differences were found regarding extroversion–introversion (MPI-E) and depression (BDI). In the 16PF, patients with normal-tension glaucoma were remarkable, only for a significant negative correlation between the duration of illness and psychic endurance. · Conclusion: The results demonstrate that patients with normal-tension glaucoma show evident psychosomatic involvement. However, the sequence of the pathogenetic development remains unclear. Therefore, it is not known whether these psychological disturbances are factors contributing to the development of normal-tension glaucoma or whether they are a result of normal-tension glaucoma. Nevertheless, some patients with normal-tension glaucoma had these disturbances. Besides reduction of intraocular pressure and improvement of vascular condition, those who display psychological disturbances should receive psychological support, such as autogenic training.

The psychology of the glaucoma patient.

Under physiological conditions, intraocular pressure (IOP) is controlled by the autonomic and central nervous systems. Correspondingly, nerve fibers and neurotransmitters are present in ciliary body and trabecular meshwork. IOP responds to physical as well as psychological stimuli in healthy individuals. In patients with dysregulated IOP, eg, in those with primary openangle glaucoma, emotional instability without a specific personality pattern could be found. Whereas the statistical association between emotional changes and glaucoma is obvious, the causal relationship remains to be clarified. It is at least plausible that psychic stress may have an influence on IOP. However, the sequence of the events is unknown (emotional disturbance can be the result of the disease or it can be a primary sign of a nervous dysfunction). Therefore, it seems meaningful-in addition to standard glaucoma therapy-to try to improve the patients emotional condition, both for treatment of the glaucoma and for the patients general quality of life.

Proliferative response of cultured human tenon's capsule fibroblasts to platelet-derived growth factor isoforms

Abstract• Background: Although platelet-derived growth factor (PDGF) has been thought to be critical in the wound-healing response of Tenons capsule fibroblasts after glaucoma filtration surgery, no information is currently available concerning the proliferative effect of PDGF isoforms on this cell type. The aim of the present study was to evaluate the proliferative effect of PDGF-AB heterodimer and PDGF-AA and -BB homodimers on cultured human Tenons capsule fibroblasts. • Methods: Human Tenons capsule fibroblasts, cultured under serum-free conditions, were stimulated with PDGF-AA, -AB and -BB isoforms in concentrations ranging from 1 to 100 ng/ml. Cell numbers were determined on days 1, 3, 5 and 7, using a cell counter. • Results: Addition of PDGF-AB and -BB led to a dosedependent increase in cell proliferation. A maximal response (79.9% over control) was obtained after 7 days with 30 ng/ml of PDGF-BB, with an EC50 of 8.9 ng/ml. The maximal increase in cell proliferation caused by PDGF-AB (30 ng/ml) was 54.9%, with an EC50 of 12.5 ng/ml. Stimulation with PDGF-AA revealed a significant effect only with concentrations higher than 30 ng/ml. • Conclusion: Our results indicate that PDGF-AB and -BB isoforms are potent stimulators of proliferation of human Tenons capsule fibroblasts, suggesting that PDGF-AB and -BB isoforms play an important role in the wound-healing response after glaucoma filtration surgery.

Adenocarcinoma of the lacrimal gland with sebaceous differentiation. A clinical study using light and electronmicroscopy.

A case of metastasizing adenocarcinoma of the lacrimal gland with sebaceous differentiation is described, which probably originated in a benign mixed tumour (BMT), with infiltration of the orbital muscles, the bony orbital wall, the neck lymph nodes, and the parotid gland. The patient was a 69-year-old male with a proptosis that had persisted for 31 years. An orbital exenteration was performed. Death occurred due to cerebral tumour infiltration. In view of the sebaceous pattern meibomian gland carcinoma has to be ruled out in the differential diagnosis.

Argon laser therapy of benign tumors of the eyelid

PURPOSEnTo report the therapy of benign eyelid tumors with an argon laser as an alternative to surgery.nnnMETHODSnForty-one patients with 47 benign tumors of the eyelid were included in this study. In all patients, the eyelid tumor was eliminated by argon laser. In 24 cases the lower eyelid and in 23 cases the upper eyelid was involved, including the lid margin in 17 cases. Laser spot size ranged from 150 to 500 microm. Argon laser power density varied between 4.1 and 61.1 W/mm2. Spots were counted between 40 and 1204. Twenty-seven of 41 patients treated were followed up; the mean follow-up period was 5.8 months (range, 3 to 24 months). Postoperatively, histologic confirmation was obtained in 42 cases of the 47 treated tumors.nnnRESULTSnAll patients were satisfied regarding the laser therapy and the cosmetic result. Remarkably, the wounds were dry after argon laser therapy. No infections of the wounds occurred; wounds were epithelialized after 2 to 3 weeks by a normal-appearing epithelium. The area of argon laser treatment was less pigmented than the surrounding skin and showed no obvious remarkable notches. As a complication, one patient developed a viral conjunctivitis. No relapses occurred during follow-up.nnnCONCLUSIONSnArgon laser therapy of benign eyelid tumors may result in very satisfactory wound healing. Taking the short follow-up and the limited number of cases into account, it seems to be a useful alternative to traditional surgery, especially for tumors positioned close to the lacrimal papillae.

Colour vision in normal subjects tested by the colour arrangement test ‘Roth 28-hue desaturated’

The aim of the study was to obtain normal values for the colour-arrangement test, Roth 28-hue desaturated. In 146 healthy non-smokers colour vision was tested monocularly. The subjects were divided into four age groups: 0-19, 20-39, 40-59, and 60-79 years. The overall error score for all groups was 54 +/- 24 (median +/- mean absolute deviation). The values for the 20-39 year group were significantly lower than those for the other groups (Kruskal-Wallis: P < 0.0001 with subsequent multiple Mann-Whitney test). An increasing predominance of errors along the blue-yellow-axis was observed with increasing age. The error scores of normal subjects tested by the Roth 28-hue desaturated were comparable with those on the well-known Farnsworth-Munsell 100-hue (FM-100). Because the Roth 28-hue desaturated is shorter and simpler to administer, it is an alternative to the FM-100 in situations that need to assess colour discrimination and error axis quantitatively and quickly.

Pupillary distortion after contact transscleral diode laser cyclophotocoagulation

Editor,—In recent years, transscleral contact diode laser cyclophotocoagulation (TCDLC) has been shown to be efficient in successfully lowering the intraocular pressure in different types of glaucoma.1-5 Reported success rates by various criteria ranged from 38% to 85%. Mostly, a fixed distance from the corneoscleral limbus with a specially designed contact probe without visualisation of the ciliary body is used.nnComplications reported so far include phthisis, chronic hypotony, corneal graft decompensation, macular pucker, cystoid macular oedema, hyphaema, vitreous haemorrhage, loss of visual acuity, retinal detachment, conjunctival burns, uveitis, and ocular pain.1-5 nnHowever, with the increasing use of TCDLC, more complications may be observed. This report describes pupillary distortion, a previously unreported complication.nn### CASE REPORTnnA 32 year old man with bilateral juvenile glaucoma since 1987 was referred …

Cataract Extraction in Uveitis

Cataract extraction in uveitis is still controversial. In this brief review, preoperative and postoperative problems as well as functional results are described. Special emphasis is placed on the question of intraocular lens (IOL) implantation. The procedure of cataract extraction and the postoperative course is mainly influenced by the underlying type of uveitis.