Search

To evaluate peripapillary retinal nerve fiber layer (RNFL) changes in patients with diabetes mellitus (DM) and compare them with those of normal population. In addition, this study aims to determine potential factors, affecting RNFL changes in patients with DM. Participants in this study were 107 patients (211 eyes) with DM and 100 healthy controls (200 eyes). Diabetic patients were further classified into four groups depending on severity of diabetic retinopathy (no retinopathy, mild, moderate, severe nonproliferative diabetic retinopathy, and proliferative diabetic retinopathy, while presence of macular edema was also assessed. All participants underwent spectral-domain optical coherence tomography (SD-OCT) to measure RNFL thickness, while demographic and clinical characteristics of the participants were also recorded. Patients with DM with or without DR presented significantly decreased peripapillary RNFL thickness in all quadrants. In the diabetic group, the multivariate analysis showed a significant association between decreased average RNFL thickness and increased HbA1c (p < 0.001), longer DM duration (p = 0.007), and more severe diabetic retinopathy status (p = 0.016), while presence of DME, age, gender, hypertension, and hyperlipidemia were not found to be associated with RNFL thickness decrease. Diabetes mellitus seems to affect RNFL thickness, suggesting that early neurodegenerative changes may occur, potentially before microvascular alterations. Since duration of disease, DR severity, and HbA1c levels were associated with RNFL thinning, modifying glycemic control seems to be important to potentially prevent the development of DM complications. [ABSTRACT FROM AUTHOR]

. Purpose: To assess the efficacy of the Allegretto Wave and the wavefront-optimized ablation profile (WFO) in non-anterior astigmatism correction, in both LASIK and photorefractive keratectomy (PRK) treatments. Methods: Seventy-four refractive surgery candidates were recruited prospectively in a non-randomized trial. Only one eye from each candidate was randomly enrolled in the study. Of them, 40 eyes underwent LASIK treatment (LG group), while 34 eyes underwent PRK treatment (PG group). Preoperatively, the ocular residual astigmatism (ORA) was calculated for each eye, according to which each astigmatism fault was characterized as primarily anterior or non-anterior. Twenty LG eyes and 16 PG eyes presented primarily anterior astigmatism (LG-A and PG-A subgroups, respectively), while 20 LG eyes and 18 PG eyes demonstrated primarily non-anterior astigmatism (LG-NA and PG-NA subgroups, respectively). Postoperatively, vector analysis of astigmatism correction was conducted. The following indexes were calculated: (i) correction index (CI), (ii) difference vector (DV) and (iii) index of success (IOS). Results: Preoperatively, mean differences between manifest and topographic astigmatisms for the LG and the PG subgroups were significant (p:0.006 and p < 0.001, respectively), while postoperatively, aforementioned differences were non-significant (p:0.18 and p:0.09, respectively). Regarding vector analysis in the LG group, mean CI, IOS and DV were 1.39 ± 1.26, 0.37 ± 1.06 and 0.30 ± 0.51, respectively. Differences in CI, IOS and DV between LG-A and LG-NA subgroups were non-significant. Regarding vector analysis in the PG group, mean CI, IOS and DV were 1.22 ± 0.33, 0.47 ± 0.46 and 0.27 ± 0.25, respectively. Differences in CI, IOS and DV between PG-A and PG-NA subgroups were non-significant. Conclusions: Our results suggest that the Allegretto Wave and WFO profile seem to be equally effective in both anterior and non-anterior astigmatism correction, regardless of treatment type. [ABSTRACT FROM AUTHOR]

Objective: To evaluate 24-hour intraocular pressure (IOP) efficacy of latanoprost versus travoprost, each given every evening, in exfoliative glaucoma patients. Design: Prospective, observer-masked, crossover comparison. Participants: Forty patients with exfoliation glaucoma. Methods: Patients with a pressure of >24 mmHg were randomized to latanoprost or travoprost for an 8-week treatment period after a 6-week medicine-free period. Patients were then switched to the opposite treatment for the second period. At untreated baseline and at the end of each treatment period the IOP was measured at 6 am, 10 am, 2 pm, 6 pm, 10 pm, and 2 am. Main Outcome Measure: Diurnal IOP. Results: The mean 24-hour IOP was 25.1±2.5 mmHg at baseline, 17.8±2.1 mmHg on latanoprost, and 17.3±2.2 mmHg on travoprost (P = 0.001). Individual time points were similar between treatments, except at 6 pm when travoprost provided lower IOP (16.7±2.6 vs 17.9±2.5 mmHg, P<0.001). Adverse events showed more conjunctival hyperemia with travoprost (n = 15) than latanoprost (n = 6; P = 0.03). Conclusions: Latanoprost and travoprost both significantly reduce the 24-hour IOP from baseline in exfoliative glaucoma, but travoprost may demonstrate a greater hypotensive efficacy in the late afternoon. [Copyright &y& Elsevier]

: PurposeTo prospectively compare the influence of fornix-based and limbus-based conjunctival flaps on the final outcome and complications of 2-site phacotrabeculectomy with mitomycin-C in fellow eyes of patients with bilateral open-angle glaucoma (OAG).: SettingGlaucoma Unit, Department of Ophthalmology, University of Crete, Crete, Greece.: MethodsTwenty-two patients with bilateral primary OAG and 8 patients with bilateral exfoliative glaucoma had 2-site phacotrabeculectomy in both eyes. Eyes were randomly assigned to the fornix-based flap or limbus-based flap group by the use of random tables.: ResultsThe intraocular pressure (IOP) decreased significantly in both groups (P < .01); however, there was no statistically significant difference between the groups in the amount of IOP decrease or the number of postoperative antiglaucoma medications after a 1-year follow-up. Faster improvement in visual acuity was observed in the fornix-based group during the first week. The mean time of surgery was 3.5 minutes less in the fornix-based group. An increased incidence of fibrin exudation, pupillary membrane formation, and capsule opacification was found in eyes with exfoliative glaucoma. The early bleb leakage was 3 times more frequent in the fornix-based group.: ConclusionThe type of conjunctival flap in a 2-site phacotrabeculectomy did not seem to influence the final outcome. The main advantage of the fornix-based conjunctival flap is the shorter surgical time and the relatively faster improvement in vision postoperatively. The main disadvantage is more frequent early bleb leakage. [Copyright &y& Elsevier]

Background: The purpose of this study is to examine the repeatability of Pentacam-derived anterior chamber volume measurements, and assess the level of agreement of anterior chamber volume measurements obtained with the Visante and the Pentacam imaging devices. Methods: Anterior chamber volume was calculated with the Pentacam device and the Visante using the Wang formula. Results were analysed by means of the Wilcoxon signed rank test, Bland-Altman analysis, Cronbach's alpha test and intraclass correlation coefficient. P-values <0.01 were considered statistically significant. Results: One randomly selected eye from each of 20 persons was analysed. Spherical equivalent ranged between −2.50 and +1.50 D, and their age ranged from 25 to 79 years (mean ± SD: 54.4 ± 19.2 years). Mean anterior chamber volume measured with Pentacam was 171.1 ± 39.6 µL (minimum: 103.0 µL, maximum: 236.0 µL), and mean anterior chamber volume measured by Visante was 171.4 ± 42.4 µL (minimum: 96.4 µL, maximum: 245.5 µL). There was no statistically significant difference between Pentacam and Visante measurements of the anterior chamber volume ( P = 0.691, Wilcoxon signed rank test). Cronbach's alpha and intraclass correlation coefficient for Pentacam were 0.998 and 0.991, respectively. Conclusions: Anterior chamber volume measurements obtained with the Visante using the Wang formula were in good agreement with the corresponding ones obtained with Pentacam. This recently described method is easy to perform and might contribute to both clinical and research settings. [ABSTRACT FROM AUTHOR]

Purpose: To determine the efficacy of brimonidine tartrate 0.2% drops given 2 times a day in reducing intraocular pressure (IOP) spikes during the first 24 hours after phacoemulsification cataract surgery.Setting: Department of Ophthalmology, General Hospital of Patras Agios Andreas, Patras, Greece.Methods: In this prospective double-blind placebo-controlled study, 1 eye of 40 consecutive normotensive cataract patients having small-incision cataract surgery was randomized into 1 of 2 treatment arms. Twenty patients received a placebo (artificial tears) and 20 patients received brimonidine tartrate 0.2% drops 2 times a day the day before and the day of surgery. Diurnal IOP variation was the primary efficacy variable; IOP was measured at baseline, before surgery, and 4, 6, 12, and 24 hours postoperatively.Results: The placebo group had higher IOPs at every time point after surgery. Peak elevation of IOP occurred 6 hours after surgery. The mean IOP in the placebo group (27.71 mm Hg ± 3.75 [SD]) was statistically significantly higher than in the brimonidine group (21.45 ± 1.32 mm Hg) (P<.001). A major IOP rise (≥20 mm Hg above baseline IOP) occurred in 1 patient (5%) in the placebo group who required emergency hypotensive therapy. Twenty-four hours after surgery, 11 eyes (55%) in the brimonidine group and 4 eyes (20%) in the placebo group had an IOP lower than baseline.Conclusion: Prophylactic treatment with brimonidine tartrate 0.2% 2 times a day for 2 days was effective in reducing IOP peaks throughout the first 24 hours after phacoemulsification surgery. [Copyright &y& Elsevier]

To describe a case of conjunctival hyperaemia and proptosis of the right eye.Three-dimensional computed tomography (CT) was performed to reveal the size and position of a lesion of osseous density extending into the right orbit. The lesion was then excised using a right paranasal transcutaneous approach.The pathology report suggested ethmoidal osteoma. The postoperative course was uncomplicated and the lesion did not recur during a 5-year follow-up period. Repeated postoperative ophthalmic examinations revealed preservation of visual acuity and visual fields postoperatively.Diagnosis is based on imaging studies, especially CT and three-dimensional CT scans. A three-dimensional CT scan is critical in understanding the actual dimensions of the tumour and its relations with other structures. Surgical removal is indicated in cases with orbital matrix compression and displacement. A transcutaneous paranasal approach allows for increased exposure of affected structures. [ABSTRACT FROM AUTHOR]