1/14. Vitreous opacities affect scanning laser polarimetry measurements.PURPOSE: To assess the effect of vitreous opacities on retinal nerve fiber layer retardation measurements obtained during scanning laser polarimetry. methods: scanning laser polarimetry was performed in two eyes of two patients with vitreous opacities. RESULTS: The presence of a vitreous opacity within the measurement ellipse during scanning caused a marked, localized increase in polarization in the area of the opacity. This falsely increased the value obtained for the mean retinal nerve fiber layer thickness. Retinal nerve fiber layer thickness values were reduced when the opacity was not incorporated into the measurement ellipse. CONCLUSION: Artifact introduced by the presence of vitreous opacities can affect scanning laser polarimetry measurement reliability.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
2/14. Pseudophakic pupillary block caused by pupillary capture after phacoemulsification and in-the-bag AcrySof lens implantation.We describe a 50-year-old patient who developed pupillary block caused by pupillary capture 1 week after uneventful phacoemulsification and implantation of an AcrySof foldable intraocular lens (IOL). The patient had a large but intact capsulorhexis with the haptics lying in the bag; the optic lay in the pupillary area anterior to the capsulorhexis. This case was successfully managed by a neodymium: YAG laser iridotomy, IOL explantation, and subsequent implantation of a poly(methyl methacrylate) posterior chamber IOL. To prevent this complication, we suggest the optic be larger than the capsulorhexis and advocate correct, gentle insertion of the foldable IOL.- - - - - - - - - - ranking = 20.593140268197keywords = optic (Clic here for more details about this article) |
3/14. Severe ocular and orbital toxicity after intracarotid injection of carboplatin for recurrent glioblastomas.BACKGROUND. glioblastoma is a malignant tumor that occurs in the cerebrum during adulthood. With current treatment regimens including combined surgery, radiation and chemotherapy, the average life expectancy of the patients is limited to approximately 1 year. Therefore, patients with glioblastoma sometimes have intracarotid injection of carcinostatics added to the treatment regimen. Generally, carboplatin is said to have milder side effects than cisplatin, whose ocular and orbital toxicity are well known. However, we experienced a case of severe ocular and orbital toxicity after intracarotid injection of carboplatin, which is infrequently reported. CASE. A 58-year-old man received an intracarotid injection of carboplatin for recurrent glioblastomas in his left temporal lobe. He complained of pain and visual disturbance in the ipsilateral eye 30 h after the injection. Various ocular symptoms and findings caused by carboplatin toxicity were seen. RESULTS. He was treated with intravenous administration of corticosteroids and glycerin for 6 days after the injection. Although the intraocular pressure elevation caused by secondary acute angle-closure glaucoma decreased and ocular pain diminished, inexorable papilledema and exudative retinal detachment continued for 3 weeks. Finally, 6 weeks later, diffuse chorioretinal atrophy with optic atrophy occurred and the vision in his left eye was lost. CONCLUSION. When performing intracarotid injection of carboplatin, we must be aware of its potentially blinding ocular toxicity. It is recommended that further studies and investigations are undertaken in the effort to minimize such severe side effects.- - - - - - - - - - ranking = 10.296570134098keywords = optic (Clic here for more details about this article) |
4/14. Chronic angle closure glaucoma secondary to frail zonular fibres and spherophakia.PURPOSE: We describe a 39-year-old Japanese woman with chronic angle closure glaucoma secondary to spherophakia and frail zonular fibres. The patient was 143 cm in height with short fingers and had no family history of eye problems. High intraocular pressure, total optic disc cupping and severe visual field constriction were found in the right eye. methods: The patient was treated successfully with trabeculectomy in the right eye and laser iridotomy in the left eye. CONCLUSION: The clinical findings imply that this was a borderline case of Weil-Marchesani syndrome.- - - - - - - - - - ranking = 10.296570134098keywords = optic (Clic here for more details about this article) |
5/14. Visualization of anterior chamber angle dynamics using optical coherence tomography.PURPOSE: To describe the technology of optical coherence tomography (OCT) in imaging the anterior chamber angles and its impact on understanding the pathophysiology of angle-closure glaucoma (ACG). DESIGN: Observational case series. PARTICIPANTS: Three subjects with, respectively, impending angle-closure attack, plateau iris syndrome, and phacomorphic glaucoma were recruited. methods: The anterior chamber angle in each patient was imaged with a commercially available OCT unit. The angle configurations were assessed and compared before and after laser peripheral iridotomy (LPI) and argon laser peripheral iridoplasty (ALPI). MAIN OUTCOME MEASURES: Visualization of the changes in the anterior chamber angle configurations and normalization of the intraocular pressure (IOP). RESULTS: A patient with impending angle-closure attack precipitated by a topical mydriatic agent was treated with LPI. Optical coherence tomography imaging of the anterior chamber angles was performed before and after the laser procedure. Conversion of anterior iris bowing and angle crowding to iris straightening and angle opening after LPI was demonstrated. intraocular pressure became normalized with the change in angle configuration. The second patient presented with symptoms of intermittent angle-closure attacks and was initially diagnosed with primary ACG. Despite successful LPI, the angles remained occludable, and the IOP continued to be elevated. Optical coherence tomography was used to review the anterior chamber angle configuration and demonstrated a typical pattern compatible with the diagnosis of plateau iris syndrome. Subsequent ALPI converted the plateau configuration to open angle, with normalization of IOP and disappearance of symptoms. The third patient presented with an acute angle-closure attack and was diagnosed with phacomorphic glaucoma. argon laser peripheral iridoplasty was performed successfully to open the angle, as evident by the OCT images, and the IOP was brought under control, together with relief of symptoms. CONCLUSIONS: The commercially available OCT unit can be practically employed for anterior chamber angle imaging. The different patterns of angle configurations are correlated with the underlying pathophysiology in different forms of ACG.- - - - - - - - - - ranking = 51.482850670492keywords = optic (Clic here for more details about this article) |
6/14. High-speed optical coherence tomography of laser iridotomy.PURPOSE: To describe high-speed (4000 axial scans/s) optical coherence tomography (OCT) findings in a patient with narrow angles. DESIGN: Interventional case report. methods: A 56-year-old woman was found to have occludable narrow angles on OCT screening. This was confirmed by gonioscopy. Bilateral iridotomy was performed. Imaging of the angles was performed with a high-speed OCT prototype before and after iridotomy. RESULTS: OCT showed narrow angle bilaterally. cornea, sclera, scleral spur, trabecula, iris, and iris recess were visualized. After iridotomy, the OCT showed reduction of iris concavity and patent iridotomies. Quantitative measurements of trabecula-iris space area on the OCT images showed widening of the angles to nonoccludable values. CONCLUSIONS: A 1.3-microm wavelength OCT allows noncontact quantitative assessment of the angle and may be useful in the management of narrow-angle glaucoma.- - - - - - - - - - ranking = 51.482850670492keywords = optic (Clic here for more details about this article) |
7/14. Long-term complications of iris-claw phakic intraocular lens implantation in weill-marchesani syndrome.PURPOSE: This study was designed to report the long-term complications of iris-claw phakic intraocular lens implantation in a patient with weill-marchesani syndrome. methods: Case report and literature review. RESULTS: A 26-year-old man with a history of glaucoma had bilateral phakic lens implantation for high myopia 10 years previously. Two years later, the left implant dislocated and was repositioned. Slit-lamp examination of both eyes revealed phakic implants of the iris-claw variety. There were moderate iridocorneal adhesions in the areas in which the lens haptics pinched the iris in both eyes and moderate epithelial and stromal edema over the temporal one-third of the left cornea. The crystalline lenses were clear with 3 phacodonesis OU. Dilated fundus examinations revealed bilateral severe optic nerve cupping. Crystalline lens diameters were measured at 7.5mm in the right eye and 8 mm in the left. anterior chamber depths were 2.63 mm OD and 2.40 mm OS. Specular microscopy revealed central endothelial cell counts of 1133 and 587 cells/mm OD and OS, respectively. Axial lengths were 23.3 mm OD and 25 mm OS. Gonioscopic examination revealed bilateral angle closure with marked peripheral anterior synechiae. Based on our findings of short stature, shortened and thickened fingers, relatively normal axial length, microspherophakia, high myopia, and glaucoma, we diagnosed the patient with weill-marchesani syndrome. CONCLUSION: iris claw-lens phakic lenses may be an effective surgical alternative to correct high myopia in select patients; however, it may produce long-term complications in eyes with specific features.- - - - - - - - - - ranking = 10.629903467432keywords = optic, nerve (Clic here for more details about this article) |
8/14. Awan's syndrome (primary orbital hypertelorism, narrow-angle glaucoma and lean physique) in two women.Awan's syndrome, characterized by a lean physique, orbital hypertelorism and angle-closure glaucoma, is a distinct clinical entity which should be more widely recognized. The patients, usually women in their sixth decade, may suffer several self-limiting and misdiagnosed episodes of angle-closure before a definite diagnosis is made. The general physical appearance and hypertelorism in two women, one aged 56 and the other 59 years, with Awan's syndrome aroused the suspicion of angle-closure glaucoma. The timely confirmation of diagnosis and proper management prevented further visual loss in both patients. Some patients with Awan's syndrome may show advanced damage to the optic nerve without ever having had an acute attack of glaucoma or any other symptoms, which makes it important that all patients with orbital hypertelorism and suspected glaucomatous optic discs should undergo gonioscopic evaluation to rule out glaucoma.- - - - - - - - - - ranking = 20.92647360153keywords = optic, nerve (Clic here for more details about this article) |
9/14. Angle-closure glaucoma in a patient with systemic lupus erythematosus.A patient is described known with ITP, who developed an attack of angle-closure glaucoma secondary to posterior scleritis. This condition reacted well to corticosteroid treatment and antiglaucomaleus therapy serologically SLE was highly probable. In fundo there was the picture of a central retinal vein occlusion. Later the patient developed neovascularisation of the optic disc, which did not diminish after panretinal photocoagulation. In spite of cryocoagulation, a vitreous haemorrhage resulted.- - - - - - - - - - ranking = 10.296570134098keywords = optic (Clic here for more details about this article) |
10/14. The ultrastructure of parapapillary chorioretinal atrophy in eyes with secondary angle closure glaucoma.BACKGROUND: The present study was performed to investigate the ultrastructure of deep retinal layers and choroid corresponding to the parapapillary chorioretinal atrophy in eyes with secondary angle-closure glaucoma. methods: The glaucomatous eyes included two eyes enucleated due to iris ring melanoma with high intraocular pressure and one eye with neovascular glaucoma enucleated due to ocular pain. The control eyes included one eye enucleated due to choroidal malignant melanoma with normal intraocular pressure and one eye enucleated during surgery for supramandibular carcinoma. These eyes were studied with light and electron microscopy. RESULTS: In the region of parapapillary chorioretinal atrophy of glaucomatous eyes, the retinal pigment epithelial cells showed degenerative changes, such as loss of basal infoldings and microvilli, degenerated mitochondria, vacuolar degeneration and irregular distribution of melanin granules. The photoreceptors were decreased in number in this area of glaucomatous eyes. The lumen of the choriocapillary vessels adjacent to the optic nerve was collapsed. CONCLUSION: These results elucidate the fine structures of deep retina and choroid in the region of parapapillary chorioretinal atrophy of glaucomatous eyes, and suggest that the reduced choroidal perfusion might be the pathogenetic mechanism of glaucomatous parapapillary chorioretinal atrophy.- - - - - - - - - - ranking = 10.629903467432keywords = optic, nerve (Clic here for more details about this article) |
| | Next -> |