Jonathan Herschler

Orbital haemorrhage and prolonged blindness: a treatable posterior optic neuropathy.

Two patients developed traumatic orbital haemorrhage resulting in prolonged blindness. Orbital decompression successfully reversed the visual loss, though both eyes had no light perception for at least 3 1/2 hours. The clinical findings suggest damage to the posterior optic nerve as cause of the visual loss. The optic nerve tolerance time to ischaemic injury may be longer than previously thought.

Delivery of Antifibroblast Agents as Adjuncts to Filtration Surgery - Part II: Delivery of 5-Fluorouracil and Bleomycin in a Collagen Implant: Pilot Study in the Rabbit

A pilot study was performed in order to determine if filtration bleb longevity could be enhanced in rabbits by delivery of 5-fluorouracil or bleomycin in a collagen sponge implant. Results showed that both agents prolonged bleb longevity and lowered intraocular pressure when compared to controls. Bleomycin treated animals had the best bleb appearance and function at the longest postoperative intervals.

Subconjunctival injection of 5-fluorouracil following trabeculectomy for congenital and infantile glaucoma. Commentary

Trabeculectomy and subsequent subconjunctival injections of 5-fluorouracil (5-FU) were performed in four eyes (two children) with congenital glaucoma. Each of these eyes had previously undergone either goniotomy, trabeculotomy, or both; these procedures, however, had failed to control intraocular pressure (IOP) and progressive optic nerve damage. Sixteen and a half months (+/- 1.5 months) after the trabeculectomy and 5-FU treatments, the IOP in these eyes was in the low teens and there was no evidence of further optic-nerve or visual-field deterioration. Although trabeculectomy has been shown to be unsuccessful in managing congenital glaucoma, when it is done with the adjunct of subconjunctival injections of 5-FU, it may be advisable in these cases after previous surgery has failed.

Congenital Glaucoma Associated With Cutis Marmorata Telangiectatica Congenita: Two Case Reports

Two cases of cutis marmorata telangiectatica congenita are described in association with nevus flammeus and congenital glaucoma. Approximately 65 cases have been reported and the association with nevus flammeus and congenital glaucoma has only been reported in one of those cases. Unlike the glaucoma associated with nevus flammeus of Sturge-Weber, this type of congenital glaucoma appears to be associated with an abnormal filtration angle rather than an increased episcleral venous pressure.

Effect of Antineoplastic Drugs on Cell Proliferation - Individually and in Combination

Three antineoplastic agents, bleomycin, cytosine arabinoside and 5-fluorouracil, were studied individually and in combination to determine their effectiveness in controlling cell growth in the presence of fetal bovine serum. All three drugs were effective individually in specifically controlling proliferation (as measured by 3H-thymidine uptake) of human Tenons capsule fibroblasts while bleomycin is effective at the lowest concentration. However, bleomycin alone rather than in combination with cytosine arabinoside or 5-fluorouracil was most effective in preventing division by these fibroblasts.

Biochemical Abnormalities in the Aqueous in Chronic Open-Angle Glaucoma

We studied gel electrophoretic patterns of proteins in the aqueous humor of patients undergoing cataract or glaucoma surgery. Of special interest was a protein doublet present in the range of 130,000 to 135,000 daltons. Analysis of the relative concentration of these two proteins in a given sample revealed statistically significant differences in aqueous humor obtained from patients with chronic open-angle glaucoma compared with that obtained from patients with non-chronic open-angle glaucoma or those with cataract. These differences could not be accounted for by other factors, such as preoperative medicines or age. It is possible that the outflow obstruction in chronic open-angle glaucoma somehow may be related to abnormalities in the protein distribution in the aqueous humor of susceptible individuals.

Silver staining of human aqueous humor proteins resolved by gel electrophoresis.

The detection of aqueous humor proteins resolved by sodium dodecyl sulfate-polyacrylamide gel electrophoresis was achieved using an ultrasensitive silver staining technique. This procedure permitted the detection of more than 35 different protein bands in human aqueous humor on a one-dimensional gel. Most of the stained proteins had an apparent molecular weight greater than 45,000 daltons.

Aqueous humor-stimulated protein biosynthesis in ocular tissue fibroblast culture☆

Dilute concentrations of aqueous humor stimulate DNA synthesis and cell division in monolayer fibroblast culture of rabbit skin and human and rabbit Tenons capsule. We used [35S]-methionine to study 20% aqueous humors effect on protein biosynthesis. A non-specific stimulator, 10% fetal bovine serum, was also used for comparison. Incorporation of radioactivity into acid-precipitable material was measured in both the fibroblasts and the media containing extracellular labeled proteins. The extracellular and intracellular labeled proteins were resolved by gel electrophoresis. Both 20% aqueous humor and 10% fetal bovine serum stimulated increased incorporation of [35S]-methionine into intracellular proteins relative to control values (from fibroblasts maintained in 0.5% fetal bovine serum-supplemented medium). However, 20% aqueous humor caused only a slight increase in labeling of proteins exported into the medium, whereas 10% fetal bovine serum stimulated a several-fold increase in extracellular labeled proteins relative to control values. Gel electrophoresis of labeled proteins showed that the quantitative distribution of extracellular proteins varied depending on the growth stimulator present. We conclude that the protein biosynthesis modulation by aqueous humor differs from that by fetal bovine serum. Aqueous humor may selectively stimulate the synthesis of discrete proteins while a general stimulation occurs with fetal bovine serum.

Delivery of Antifibroblast Agents as Adjuncts to Filtration Surgery. Part I - Periocular Clearance of Cobalt-57 Bleomycin in Experimental Drug Delivery: Pilot Study in the Rabbit

Antitumor and antifibroblast agents show promise as adjuncts after glaucoma filtration surgery in reducing postoperative scarring and failure. We used nuclear imaging in rabbits to investigate periocular clearance of one such agent (57Co-bleomycin). Sub-Tenon injection was compared to other delivery techniques. Our results showed that a collagen sponge and a silastic disc implant with a microhole prolonged drug delivery when compared to sub-Tenon injection alone or injection with a viscosity enhancing agent (0.5% sodium hyaluronate). We theorize that if an antifibroblast agent can be delivered in small and sustained amounts after filtration surgery, this may prolong bleb longevity and avoid unnecessary drug toxicity.

Heat and protease treatment of aqueous humor: effect on cell DNA synthesis and growth.

Rabbit skin and Tenons capsule fibroblasts were cultured in media containing 20% rabbit aqueous humor as a stimulatory agent. Cell stimulation was quantitated by3H-thymidine uptake. The aqueous humor was either: (1) untreated; (2) heated at 37° C for 60 min; (3) boiled for 2 min; or (4) heated at 37° C for 60 min with 0.025% trypsin, followed by boiling. The effects of the various treatments of aqueous humor on cell stimulation were compared among themselves and to 10% fetal bovine serum. It was found that: (1) heating of aqueous humor at 37° C for up to 60 min had no apparent effect on its ability to stimulate DNA synthesis in culture; (2) boiling and trypsin plus boiling reduced the ability of 20% aqueous humor to promote thymidine uptake to varying degrees; (3) 20% untreated aqueous humor was more effective than 10% fetal bovine serum in stimulating DNA synthesis in Tenons capsule fibroblasts; skin fibroblasts responded similarly to both media.