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Cook, S. D.; Hill, J. M.; Lynas, C.; Maitland, N. J.
doi: 10.1136/bjo.75.11.644pmid: 1661140
Herpes simplex virus (HSV) establishes latent infection in the sensory neuron and possibly in non-neuronal tissue, particularly the cornea. During latency only one region of the HSV genome is transcribed, producing RNAs known as latency associated transcripts (LAT). The gene for LAT overlaps with the HSV gene for the protein ICPO in the downstream regions of both genes. Latency can occur in the absence of LAT. This study reports the detection of ICPO/LAT and thymidine kinase (TK) gene fragments by the polymerase chain reaction in DNA extracted from the corneas and trigeminal ganglia of latently infected rabbits. Both genes were detected in four of four trigeminal ganglia tested and in three of five corneas tested. More importantly, this study reports the first detection of LAT in RNA extracted from 9% of corneas from latently infected rabbits (n = 22) by the polymerase chain reaction. LAT was detected in RNA from 100% of the corresponding trigeminal ganglia (n = 22). Although LAT is not essential for latency, it remains the only known molecular marker for latent HSV infections. Detection of LAT in these rabbit corneas suggests that HSV latency may occur in this non-neuronal tissue and that reactivation from non-neuronal tissue may occur at a low frequency in animals in which HSV latency has been established.
Power, W. J.; Benedict-Smith, A.; Hillery, M.; Brady, K.; Collum, L. M.
doi: 10.1136/bjo.75.11.649pmid: 1751456
The results of a randomised double-blind clinical trial of 0.1% bromovinyldeoxyuridine (BVDU) and 1% trifluorothymidine (TFT) in 60 patients with corneal dendritic ulceration are presented. There was no significant difference between BVDU and TFT in terms of numbers of ulcers healed (p = 0.61), mean healing time (p = 0.065), and cumulative healing rate (p = 0.058). No serious side effects were observed, though transient stinging was recorded in five patients receiving TFT and in three patients receiving BVDU. One patient in the group treated with TFT developed a punctate epitheliopathy.
Yamabayashi, S.; Aguilar, R. N.; Hosoda, M.; Tsukahara, S.
doi: 10.1136/bjo.75.11.652pmid: 1751457
The effect of body position on the intraocular and blood pressures of normal volunteers and of patients with ocular hypertension and low tension glaucoma was studied. Changing from the sitting to the supine position increased the intraocular pressure by an average of 4.4 (SD 2.0) mm Hg in the control group, 4.0 (SD 2.0) mm Hg in the ocular hypertension group, and 4.1 (SD 1.8 mm Hg) in the low-tension glaucoma group. After 30 minutes in the supine position the intraocular pressure in normal volunteers and patients with low tension glaucoma remained stable. In contrast patients with ocular hypertension showed a further significant increase in intraocular pressure of 1.6 (SD 2.8) mm Hg (p = 0.004). This was accompanied by an equally significant decrease in blood pressure (p less than 0.001). We believe that these are manifestations of different mechanism of intraocular pressure regulation between these groups.
Brittain, G. P.; McIlwaine, G. G.; Bell, J. A.; Gibson, J. M.
doi: 10.1136/bjo.75.11.656pmid: 1751458
Plasma viscosity (PV) has replaced the erythrocyte sedimentation rate (ESR) as a routine laboratory test in many hospitals. The finding of a normal PV but raised ESR in a case of biopsy proved giant cell arteritis (GCA) cast doubt on this substitution in cases of suspected GCA. To assess the equivalence of PV and ESR in the diagnosis of this disease 40 suspected cases were prospectively investigated with both tests. The correlation between the two tests was good (r = 0.742, p less than 0.0001). The substitution of one test for the other would appear to be justified in most cases of suspected GCA. In the presence of biopsy proved disease, however, the PV and ESR each produced 13.3% false negatives. These occurred both in combination with and independently of the other test showing that, when in error, the two tests may not be equivalent. In cases of doubt the performing of both PV and ESR tests together improves but does not achieve complete diagnostic accuracy. Clinical judgment based on careful assessment of all available symptoms and signs must remain the foundation of diagnosis.
doi: 10.1136/bjo.75.11.660pmid: 1751459
A prospective study of 75 patients undergoing cataract surgery was conducted to identify the cause of postoperative conjunctival chemosis seen in patients with cataracts in this department. The patients were split in three groups of 25 each. Group G patients were given a subconjunctival injection of gentamicin at the end of the cataract procedure; group W patients did not receive subconjunctival gentamicin, but a cellulose wick drain was used during the procedure; and Group GW patients received a subconjunctival injection of gentamicin and a wick drain was also used. The incidence, severity, and the duration of chemosis were observed in the three groups. Chemosis was seen only in groups G and GW, and the difference between the number of patients who received gentamicin and those who did not receive gentamicin was significant (p less than 0.001).
doi: 10.1136/bjo.75.11.663pmid: 1751460
Three groups of patients who had undergone cataract extraction through a corneal incision closed with 10/0 nylon sutures one, two, and three years previously were recalled to determine the incidence of suture related complications. Broken corneal sutures were found in 87.5% of patients after two years and 90% after three years and were causing symptoms in over half the patients. It is recommended that 10/0 nylon corneal sutures be routinely removed no later than one year after surgery.
doi: 10.1136/bjo.75.11.665pmid: 1751461
A retrospective study of all plain radiographs taken of optic foramina during the six years 1984-9 inclusive, comprising a total of 318 examinations, was carried out in order to determine the role of this investigation in patients with ophthalmic disorders. All but one of the radiographs were reported as showing no abnormality. However, for this exception, review of the radiographs showed that the optic foramina were asymmetrical but fell within the normal range. This study indicates that plain radiographs of the optic foramina have little or no useful function. Abandoning the use of these views as a routine will result both in a reduction in radiation hazard and in considerable financial saving.
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