Current Issue : July - September Volume : 2013 Issue Number : 3 Articles : 6 Articles
Objective. To compare 18-fluorodeoxyglucose (FDG) uptake by positron emission tomography (PET) in extraocular muscles (EOMs) of patients with Graves'' ophthalmopathy (GO) versus patients without GO. Design. Prospective, observational, comparative, and cross-sectional study. Participants. Thirty-two eyes of patients with GO and seventy eyes of patients without GO. Methods. We prospectively included patients older than 18 years of age with and without GO. FDG-PET imaging study was performed; standardized unit value (SUVmax) was quantified in EOMs. Standard deviation and significant statistical difference (P < 0.05) were calculated. Results. Thirty-two eyes of sixteen patients of the GO group were included, with a mean age of 44.31 (20-71) years. Seventy eyes of thirty-five patients of the group without GO were included, with a mean age of 49.20 (24-77) years. EOMs average uptake of the groups with and without GO were 3.38 �± 1.31 and 1.89 �± 0.51 SUVmax (P < 0.05), respectively. Conclusion. FDG uptake was significantly increased in EOMs of patients with GO. PET gives valuable information and may be a helpful tool in detecting, localizing, and quantifying GO inflammation. Further research is needed to define the role of PET in detecting, grading, and following up GO in order to optimize treatment in the inflammatory stage....
Background: Cataract and glaucoma are both common comorbidities among older patients. Combining glaucoma\r\nsurgery with minimal invasive phacoemulsification (phaco) is a considerable option to treat both conditions at the\r\nsame time, although the combination with filtration surgery can produce a strong inflammatory response.\r\nCombined non-penetrating procedures like canaloplasty have shown to reduce intraocular pressure (IOP)\r\ncomparable to trabeculectomy without the risk of serious bleb-related complications. The purpose of this\r\nretrospective study was to compare the outcomes of phacotrabeculectomy and phacocanaloplasty.\r\nMethods: Thirty-nine eyes with concomitant cataract and glaucoma who underwent phacotrabeculectomy (n = 20;\r\n51.3%) or phacocanaloplasty (n = 19; 48.7%) were included into this trial on reduction of IOP, use of medication,\r\nsuccess rate, incidence of complications and postsurgical interventions. Complete success was defined as IOP\r\nreduction by 30% or more and to 21 mmHg or less (definition 1a) or IOP to less than 18 mmHg (definition 2a)\r\nwithout glaucoma medication.\r\nResults: Over a 12-month follow-up, baseline IOP significantly decreased from 30.0 �± 5.3 mmHg with a mean of\r\n2.5 �± 1.2 glaucoma medications to 11.7 �± 3.5 mmHg with a mean of 0.2 �± 0.4 medications in eyes with\r\nphacotrabeculectomy (P < .0001). Eyes with phacocanaloplasty had a preoperative IOP of 28.3 �± 4.1 mmHg and\r\nwere on 2.8 �± 1.1 IOP-lowering drugs. At 12 months, IOP significantly decreased to 12.6 �± 2.1 mmHg and less\r\nglaucoma medications were necessary (mean 1.0 �± 1.5 topical medications; P < .05). 15 patients (78.9%) with\r\nphacotrabeculectomy and 9 patients (60.0%) in the phacocanaloplasty group showed complete success according\r\nto definition 1 and 2 after 1 year (P = .276). Postsurgical complications were seen in 7 patients (36.8%) of the\r\nphacocanaloplasty group which included intraoperative macroperforation of the trabeculo-Descemet membrane\r\n(5.3%), hyphema (21.1%) and bleb formation (10.5%). Although more complications were observed in the\r\nphacotrabeculectomy group, no statistically significant difference was found.\r\nConclusions: Phacocanaloplasty offers a new alternative to phacotrabeculectomy for treatment of concomitant\r\nglaucoma and cataract, although phacotrabeculectomy yielded in better results in terms of IOP maintained\r\nwithout glaucoma medications....
Background: To investigate the effects of microvascular compromise on the expression of oxidative proteins in the\r\noptic nerve head.\r\nMethods: Endothelin-1 (0.1 �µg/day) was delivered to the perineural region of the anterior optic nerve by\r\nosmotically driven minipumps for two, four, and eight weeks in ten rabbits, respectively. As a control, a balanced\r\nsalt solution was delivered for two and eight weeks in five rabbits, respectively. Expression of oxyproteins in the\r\ncornea, vitreous, retina, and optic nerve head for each time period was determined using the OxyBlot protein\r\noxidation detection kit. Retina was stained with H&E and TUNEL for histological examination.\r\nResults: There was a significant increase in the expression of oxyproteins in the optic nerve head after two weeks\r\nof endothelin-1 administration (p < 0.001, Mann Whitney U test). In contrast, there was no expression of oxyproteins\r\nin the cornea, retina, or vitreous. The number of cells in the retinal ganglion cell layer, inner nuclear layer, and outer\r\nnuclear layer decreased remarkably with time in the endothelin-1-treated group. Furthermore, the inner and outer\r\nnuclear layers, as well as the inner and outer plexiform layers, became thinner over time.\r\nConclusions: Administration of endothelin-1 to the microvasculature of the optic nerve leads to increased\r\nexpression of oxyproteins in the optic nerve head and loss of retinal ganglion cells....
Ocular bacterial infections are universally treated with antibiotics, which can eliminate the organism but cannot reverse the damage caused by bacterial products already present. The three very common causes of bacterial keratitisââ?¬â?Pseudomonas aeruginosa, Staphylococcus aureus, and Streptococcus pneumoniaeââ?¬â?all produce proteins that directly or indirectly cause damage to the cornea that can result in reduced vision despite antibiotic treatment. Most, but not all, of these proteins are secreted toxins and enzymes that mediate host cell death, degradation of stromal collagen, cleavage of host cell surface molecules, or induction of a damaging inflammatory response. Studies of these bacterial pathogens have determined the proteins of interest that could be targets for future therapeutic options for decreasing corneal damage....
Background: Meningeal carcinomatosis (MC) is a rare complication associated with hematologic and solid tumors.\r\nMC develops when malignant cells gain access to the leptomeningeal space, producing several clinical symptoms.\r\nLoss of vision and ocular motility deficit are the most frequent ocular symptoms reported. Fundus examination\r\nusually appears normal, although optic nerve alterations like optic atrophy or papilledema have been described. MC\r\ndiagnosis is usually completed by magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) analysis.\r\nIndicated treatment for MC usually involves intrathecal chemotherapy combined with radiotherapy, although\r\nsurvival rate is extremely low.\r\nCase presentation: A 66-year old man with stage IV metastatic lung adenocarcinoma, presented to the\r\nOphthalmology Department with a two-month history of double vision, soft headaches and dizziness episodes. The\r\npatient presented a best visual corrected acuity of 0.7 in his right eye and 0.8 in his left eye. Diplopia was corrected\r\nwith 6-prism diopters base-out prism in right eye. Funduscopy showed a bilateral papilledema, juxtapapillary\r\nexudates and splinter hemorrhages. Brain MRI showed a diffuse leptomeningeal enhancement in cortical sulcus.\r\nLumbar puncture was performed and cerebrospinal fluid (CSF) cytology revealed malignant cells compatible with a\r\ndiagnosis of MC. Intrathecal chemotherapy was administered.\r\nConclusion: MC is a serious complication of systemic cancer patients, involving a poor prognosis. Early diagnosis is\r\nextremely important, although treatment is frequently aimed to reduce the symptoms and extend survival. Eye\r\nsymptoms may be the chief complaint, so MC should be considered in any patient with vision loss or diplopia\r\naccompanied by neurologic symptoms and in the absence of an intraocular cause, especially in the context of\r\nsystemic cancer....
Background: To report a case of spontaneous malignant glaucoma in an Asian female. To propose the term\r\nââ?¬Å?positive vitreous pressure glaucomaââ?¬Â to reflect the pathophysiology, treatment and prognosis of the condition.\r\nCase presentation: A 56-year old Chinese female was diagnosed of primary angle closure glaucoma and had\r\nbilateral laser peripheral iridotomy one year ago. She presented with spontaneous onset of malignant glaucoma\r\ninvolving the left eye. The condition was treated successfully; the final best corrected visual acuity was 0.67\r\n(decimal notation).\r\nConclusion: This case highlights that acute angle closure attack can occur in an eye with patent peripheral\r\niridotomy. Early recognition and treatment is essential for good visual prognosis....
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