1/41. Cystoid macular edema associated with latanoprost therapy in a case series of patients with glaucoma and ocular hypertension.OBJECTIVE: To identify coexisting ocular diagnoses in a case series of eyes that developed cystoid macular edema (CME) associated with latanoprost therapy. DESIGN: Retrospective observational case series. PARTICIPANTS: Seven eyes of seven patients who developed CME possibly associated with latanoprost treatment were studied. INTERVENTION: When these patients, all of whom were treated with latanoprost in addition to other glaucoma medications, described blurred vision or eye irritation, ocular examination revealed CME, which was confirmed by fluorescein angiography. Latanoprost was discontinued, and in three cases topical corticosteroids and nonsteroidal anti-inflammatory agents were used to treat the CME. MAIN OUTCOME MEASURES: visual acuity and intraocular pressure were determined before latanoprost use began, during therapy, and after latanoprost use ceased. In these cases, resolution of CME was documented clinically after discontinuing latanoprost. RESULTS: Clinically significant CME developed after 1 to 11 months of latanoprost treatment, with an average decrease of 3 lines in Snellen visual acuity. intraocular pressure decreased an average of 27.9% during treatment. Cystoid macular edema was confirmed in all cases by fluorescein angiography. In these seven patients, the following coexisting ocular conditions may have placed these eyes at risk for prostaglandin-mediated blood-retinal barrier vascular insufficiency: history of dipivefrin-associated CME, epiretinal membrane, complicated cataract surgery, history of macular edema associated with branch retinal vein occlusion, history of anterior uveitis, and diabetes mellitus. In all cases, the macular edema resolved following discontinuation of latanoprost, in some instances with concomitant use of steroidal and nonsteroidal anti-inflammatory agents. CONCLUSIONS: In this case series of pseudophakic, aphakic, or phakic eyes, the temporal relationships between the use of latanoprost and developing CME, and the resolution of CME following cessation of the drug, suggest an association between latanoprost and CME. In all cases, coexisting ocular conditions associated with an altered blood-retinal barrier were present.- - - - - - - - - - ranking = 1keywords = hypertension (Clic here for more details about this article) |
2/41. Ockham's glaucoma.The combination of characteristic optic nerve head cupping, arcuate visual field loss and ocular hypertension would usually be thought sufficient to diagnose glaucoma. Only in the absence of elevated intraocular pressure, when normal tension glaucoma may be suspected, would intracranial imaging normally be performed to exclude occult pathology. A case is presented which illustrates the continuing need for vigilance, and an open mind, years after an apparently straight-forward diagnosis has been made.- - - - - - - - - - ranking = 0.25keywords = hypertension (Clic here for more details about this article) |
3/41. intraocular pressure elevation in a child due to the use of inhalation steroids--a case report.inhalation steroid therapy can cause ocular hypertension or open angle glaucoma. The authors describe the case of a young girl who presented with raised intraocular pressure and headaches due to the prolonged administration of nasal and inhalation steroids. The ophthalmologist should monitor the intraocular pressure in patients who use inhalation or nasal steroid therapy on a regular base. The physician or paediatrician should be aware of this complication in children with headaches or diminished visual acuity.- - - - - - - - - - ranking = 0.25keywords = hypertension (Clic here for more details about this article) |
4/41. cytomegalovirus as a cause of anterior uveitis with sectoral iris atrophy.OBJECTIVE: To report two cases of recurrent anterior uveitis with sectoral iris atrophy and ocular hypertension during attacks caused by cytomegalovirus (CMV). DESIGN: Two observational case reports. PARTICIPANTS: Two immunocompetent patients with a history of recurrent unilateral hypertensive anterior uveitis with sectoral iris atrophy were referred to us with the presumptive diagnosis of herpetic uveitis. MAIN OUTCOME MEASURES: Comprehensive ophthalmic examination, aqueous humor polymerase chain reaction (PCR), and peripheral blood serologic studies were performed on both patients. RESULTS: Examination of aqueous humor by PCR was positive for CMV and negative for herpesvirus. serum IgG/IgM titers disclosed past CMV infection. Both patients responded well to antiviral therapy with ganciclovir. The final visual acuity level was 20/20 in both eyes of both patients. CONCLUSIONS: CMV infection can produce recurrent attacks of anterior uveitis with clinical characteristics indistinguishable from those previously considered highly suggestive or even pathognomonic for herpetic infection. This observation has implications for the therapeutic management of such patients.- - - - - - - - - - ranking = 0.25keywords = hypertension (Clic here for more details about this article) |
5/41. Delayed hypersensitivity to brimonidine tartrate 0.2% associated with high intraocular pressure.PURPOSE: To report the late presentation of an allergic reaction to brimonidine tartrate 0.2% associated with an elevation of intraocular pressure. methods: During a 6-month period six Caucasian patients (three were male), with primary open angle glaucoma (POAG) or ocular hypertension, with an allergic reaction to brimonidine tartrate eye drops were identified. Brimonidine was initiated as additional medical therapy in four patients and monotherapy in two patients. The median age of the patients was 67 years (range 57-73 years). RESULTS: There were nine eyes with a follicular conjunctivitis; three patients received brimonidine in one eye only. In two patients an additional redness of the periocular skin was present. The median duration on brimonidine therapy before the onset of the allergic reaction was 12 months (range 5-15 months). The median intraocular pressure (IOP) before the onset of the allergy was 18 mmHg (range 16-21 mmHg). There was a significant elevation of IOP at the time of the allergy with a median IOP of 28 mmHg (range 20-44 mmHg) (P = 0.007, Wilcoxon sign rank test). The cessation of brimonidine allowed the resolution of the allergic reaction. The intraocular pressure was then controlled with alternative medication in eight eyes. One patient went on to have filtering surgery. CONCLUSIONS: A delayed hypersensitivity reaction to brimonidine tartrate eye drops resembles a viral follicular conjunctivitis. It is imperative that it is recognised as such, as it may occur many months after brimonidine is initiated. This allergy has been found to be associated with a loss of control of the IOP. Though this is a small cohort of patients, it is not unreasonable to suggest that patients on brimonidine eye drops should be instructed to report promptly to their ophthalmologist the onset of redness of their eyes so that their glaucoma control may be reassessed.- - - - - - - - - - ranking = 0.25keywords = hypertension (Clic here for more details about this article) |
6/41. Visual-field loss with optic nerve drusen and ocular hypertension: a case report.BACKGROUND: patients with optic nerve drusen are often asymptomatic and free of visual symptoms. However, ocular complications such as visual-field defects may develop. This article presents the case of a patient with optic nerve drusen, ocular hypertension, and a visual-field defect. The diagnosis and management of patients with such findings will be presented. CASE REPORT: A 75-year-old man came to the eye clinic with a history of being treated for glaucoma. On examination, optic nerve drusen were found in both eyes. Subsequent testing revealed ocular hypertension and a visual-field defect that could be related to either optic nerve drusen or glaucoma. After re-establishment of baseline intraocular pressures (IOP) and re-initiation of treatment, the patient is being monitored for IOP control and visual-field progression. CONCLUSION: optic nerve drusen and glaucoma can both cause visual-field defects. When a patient manifests optic nerve drusen, ocular hypertension, and visual-field defects, a diagnostic and management dilemma exists. Regardless of the etiology for the field defects, a treatment regimen designed to reduce the intraocular pressure to a level that potentially reduces the risk of ocular sequelae is recommended.- - - - - - - - - - ranking = 1.75keywords = hypertension (Clic here for more details about this article) |
7/41. Ocular complications of the Fernand-Widal triad and its therapy.BACKGROUND: The Fernand-Widal triad (FWT) is the association of non-allergic intrinsic asthma, nasal polyposis and sensitivity to aspirin. The aim of this paper is to describe the possibility of ocular complications, which we found in 3 cases: in 1 case due to the FWT itself and in the other 2 as a result of corticosteroid treatment. methods: Three cases of the FWT with ocular complications were studied, and the pertinent literature was reviewed. RESULTS: No previous description of ocular involvement in individuals with FWT was found in the literature. In the first case, episodes of orbital cellulitis due to superinfected nasal polyposis were found as a complication produced by the disease. In the other 2 cases, corticosteroid treatment created complications: ocular hypertension in both cases and bilateral subcapsular cataracts in 1 case. CONCLUSIONS: Although not rare, the diagnosis of the FWT is often missed. This perhaps explains why no report of ocular complications has yet been published in the literature. Because of the serious clinical consequences, physicians involved in the treatment of these patients should be aware of this diagnosis.- - - - - - - - - - ranking = 0.25keywords = hypertension (Clic here for more details about this article) |
8/41. Falsely elevated intraocular pressure due to an abnormally thick cornea in a patient with nevus of ota.BACKGROUND: Several ocular complications, including glaucoma and ocular hypertension, have been reported in patients with nevus of ota. CASE: A 12-year-old boy with nevus of ota on the left side of his face was referred for further examination of elevated intraocular pressure in his left eye. OBSERVATIONS: intraocular pressure measured with Goldmann tonometry was 19 mm Hg OD and 25 mm Hg OS. No visual field defects were detected by Goldmann or Humphrey perimetry. With ultrasonic pachymetry, the mean /- SD of central corneal thickness was 560 /- 4 microm in the right eye and 652 /- 9 microm in the left. CONCLUSION: Ophthalmologists should be aware that the abnormally thick cornea of patients with nevus of ota may produce falsely elevated intraocular pressure readings.- - - - - - - - - - ranking = 0.25keywords = hypertension (Clic here for more details about this article) |
9/41. Dermatological side effects of brimonidine: a report of three cases.Brimonidine is a potential first line therapy for primary open angle glaucoma (OAG) and ocular hypertension (OHT). It is known to cause various ocular and systemic side effects. Being a newer drug, the whole spectrum of its adverse effects is not known. The dermatological side effects caused by brimonidine have rarely been reported before. We present three OAG patients who presented to us with contact dermatitis of periorbital skin and lichen planus of nail following the use of topical brimonidine (0.2% twice a day) for more than six months. These side effects slowly disappeared on discontinuing the drug but reappeared on reintroducing topical formulation. Such side effects from the use of brimonidine have not been reported before.- - - - - - - - - - ranking = 0.25keywords = hypertension (Clic here for more details about this article) |
10/41. intraocular pressure profile of a child on a systemic corticosteroid.PURPOSE: To report the ocular hypertensive response to high-dose systemic corticosteroid in a pediatric patient. DESIGN: Observational case report. methods: A 9-year-old patient with leukemia received oral prednisolone at a dosage of 2.3 mg/kg/d for 5 weeks, followed by a 4-month break and then a 4-week course of oral dexamethasone at 10 mg/d. Detailed ocular examination was performed for both eyes before and regularly throughout the two courses of treatment. RESULTS: The intraocular pressure in both eyes rose to almost 40 mm Hg after only 8 days of oral corticosteroid. On stopping systemic corticosteroid, the intraocular pressure rapidly returned to baseline level within 2 days. A similar intraocular pressure profile was recorded for both eyes during the course of oral dexamethasone. The patient remained largely asymptomatic throughout. CONCLUSIONS: Systemic corticosteroid may give rise to significant but asymptomatic ocular hypertension in pediatric patients.- - - - - - - - - - ranking = 0.25keywords = hypertension (Clic here for more details about this article) |
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