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Background: Recent studies have shown how the topical application of nerve growth factor (NGF) has led to the repair of neurotrophic corneal ulcers with recovery of corneal surface sensitivity. The biological effect of NGF, at a corneal level, is mediated by the presence of specific receptors localized on the surfaces of the corneal and conjunctival cells. Objectives: To evaluate the efficacy of NGF to promote corneal wound healing after cataract surgery. Methods: Thirty patients were divided into two groups (groups A and B) and underwent cataract surgery. After surgery patients in group A received 1 drop of NGF solution (10 µg of NGF dissolved in 50 µl of saline solution, 0.9% of sodium chloride) in the conjunctival fornix every 2 h (from 6 a.m. to 12 p.m.) for 2 weeks and then 4 times a day for another week. The patients in group B received 1 drop of hyaluronic acid 0.2% eye drops in the conjunctival fornix every 2 h for 2 weeks and then 4 times a day for another week. With optical coherence tomography (OCT) we evaluated the corneal thickness at the side of the surgical wound, the endothelial cell count and the incision line in the stroma 1, 7 and 21 days after surgery. Results: Before surgery in group A and in group B, the endothelial cell count was 2,607.4 ± 261.0 versus 2,602.0 ± 266.6 (p < 0.991), and the temporal cornea edge thickness was 639.2 ± 24.7 versus 644.4 ± 31.9 µm (p < 0.605), respectively. At 24 h after surgery, the results were: 2,523.2 ± 280.5 versus 2,528.2 ± 235.7 (p < 0.988) and 804.4 ± 29.5 versus 802.6 ± 35.0 µm (p < 0.953). After 7 days the cell count values were: 2,511.4 ± 229.8 versus 2,490.0 ± 230.4 (p < 0.361) and corneal thickness 713.6 ± 16.5 versus 771.4 ± 36.5 µm (p < 0.047). Finally, 21 days after surgery, the number of endothelial cells was 2,540.2 ± 237.3 versus 2,503.4 ± 224.5 (p < 0.382) and corneal thickness 645.2 ± 22.6 versus 704.2 ± 11.8 µm (p < 0.002). In the patients treated with NGF, on day 21, we found with OCT a complete wound healing, and the stromal incision was not visible. Conclusions: This clinical experience shows that the topical administration of NGF is effective in accelerating the healing of surgical corneal wounds.

Trabecular meshwork (TM) cells are now considered to play an active role in the aqueous outflow mechanism, since they exhibit smooth muscle-like contractile properties. Endothelin-1 (ET-1), a potent vasoconstrictor peptide, has been proposed to play a role in the local regulation of aqueous outflow and intra-ocular pressure control. We propose an in vitro culture model as a method in the study of ET-1-induced human trabecular meshwork (HTM) cell contractility. Experiments were performed on semi-confluent HTM cells (primary cultures established from normotensive human donor eyes) at the 2nd passage with PBS as control, ET-1, sarafotoxin 6c (a selective endothelin B receptor agonist) and Y-27632 (a selective inhibitor of rho-associated kinase). The contractile status of the cells was evaluated by a morphometric analysis of the cell area, assuming that HTM cells in culture are able to reduce their area as a consequence of cytoskeletal contraction rather than regulatory volume decrease. Our data indicate that image analysis of the HTM cell area can be a reliable method in the study of TM cell contractility, since it utilizes human cells and offers versatile opportunities for the pharmacological evaluation of drugs controlling HTM cell status.

Purpose: To report the diagnostic and therapeutic data obtained from 1,200 patients suffering from dry eye symptoms not due to Sjögren’s syndrome or other auto-immune diseases. Methods: Schirmer test I, ferning test, breakup time, vital dye staining, brush and imprint cytology were performed; data were grouped into diagnostic profiles, and the therapy was prescribed according to these. Results: Eight diagnostic profiles were identified. Dry eye was diagnosed in 57.1% of patients; the remaining 42.9% were found to suffer from eye discomfort or conjunctivitis of different aetiologies. Conclusions: Subjective symptoms of dryness can hide diseases other than dry eye; combined clinical and laboratory tests are requested to make a diagnosis. Our experience indicates that a therapy prescribed on the basis of diagnostic profiles provides relief in 79.1% of cases.

Purpose: To investigate the interactions occurring at the interface between some currently used vitreous tamponading substances and the ocular tissues, in an early follow-up after surgery. Methods: Adult albino rabbit eyes underwent vitrectomy and were injected intravitreally with silicone oils at 1,000 or 3,000 cSt, fluorosilicone oil and perfluorodecalin. Different morphological techniques (light microscopy, scanning and electron microscopy, immunohistochemistry) were applied. Results: All the tested materials, although non-toxic, penetrate the ocular tissues also at the anterior segment level, and in the long-term follow-up this can yield functional impairment. No massive inflammation has been detected in the zones in contact with the materials, but immunoglobulins and complement fractions are anyway present in the stroma of various tissues and around the droplets of emulsified materials, suggesting a local immune reaction. Conclusions: Data from this study confirmed that a permanent vitreous substitute, showing a perfect biocompatibility, still does not exist. The indication to remove the tamponading substance within 2 months after the surgery emerges from this investigation, confirming previous studies. Despite some negative features, silicone oil still appears the most biocompatible material for vitreous replacement.

The authors investigated the effect of ketanserin 0.5% eye drops on intraocular pressure and orbital blood flow in some healthy volunteers. Ketanserin is a selective antagonist of serotonin S2 receptors; moreover, it produces an α1-blocking effect. It causes a systemic reduction of blood pressure and capillary vasodilatation. Three hours after topical administration of ketanserin 0.5%, the intraocular pressure was decreased by about 14% from the baseline. At the same time, we observed by color Doppler imaging that the mean percent increase in the peak systolic velocity in the ophthalmic artery (OA) was 5.18% (p < 0.161) and 23.18% (p < 0.001) in the posterior ciliary arteries (PCAs). The mean resistance index of the OA was in contrast reduced by 1.16% (p < 0.669) and by 32.14% (p < 0.003) in the PCAs. These data show that ketanserin 0.5% eye drops may be useful not only to decrease intraocular pressure but also to improve blood flow in the PCAs that supply the optic nerve head.

Discomfort eye syndrome (DES) comprises a series of ‘minor’ subjective symptoms in patients where no relevant clinical signs are observed suggesting ocular disease. Our study includes 100 DES patients, excluding video terminal users, selected from the First Aid Service of our Department over two peak periods in both winter and summer time. The Schirmer test I, ferning test, breakup time and conjunctival cytology (scraping and imprint) were performed and data were related to sex, age and air pollution indexes, recorded in the patients’ living zones. Our results demonstrate that: (i) the ocular surface cytology and the analysis of tear film changes provide significant information in those patients where no other clinical signs are evident; (ii) DES symptoms are more frequent in women than in men (ratio about 2:1), both with ages over 51 years; (iii) DES is significantly associated with ocular surface inflammation, as detected by cytological methods, and (iv) ocular surface subclinical inflammation and ocular dryness are related to high concentrations of atmospheric polluters, in both sexes.

To assess any alteration of the blood flow in the ophthalmic artery, in the posterior ciliary arteries and in the choroid of the glaucomatous eye.We studied 15 patients, 11 males and 4 females (mean age 62.4 years), with chronic open-angle glaucoma in good tonometric control by medical therapy. All patients underwent colour Doppler examination of the ophthalmic artery, posterior ciliary artery and choroid. The data for peak systolic velocity (Pv) and resistance index (RI) were compared with those of healthy control subjects.The Pv in the ophthalmic artery of glaucomatous patients was 32.961 +/- 3.045 cm/s (p0.033) and RI 0.789 +/- 0.018 (p0.001). The Pv of posterior ciliary arteries was 8.720 +/- 1.645 cm/s (p0.001) and RI 0.722 +/- 0.024 (p0.005). In the choroid the Pv was 10.637 +/- 1.401 cm/s (p0.001) and RI 0.643 +/- 0.051 (p0.022).Our data indicate that in a chronic open-angle glaucoma there is an alteration in the eye blood flow especially in the posterior ciliary arteries and the choroid.