Mefenamic acid-induced bilateral transient myopia, secondary angle closure glaucoma and choroidal detachment

Drug-induced secondary angle closure is quite common and in the majority of cases simply stopping the medication leads to rapid reversal of the condition and resolution of glaucoma. We describe here a patient who presented with secondary angle closure glaucoma and myopia following mefenamic acid ingestion which was managed successfully by stopping the medication, symptomatic treatment and reassurance.     

外引流术后的白内障超声乳化手术

目的：探讨抗青光眼餐引流术后的白内障患眼进行超声乳化吸除术的手术入路，操作方式及临床效果。方法：避开功能性滤过泡，选择角巩膜隧道切口或透明角膜切口，瞳孔麻痹性散大时，做一个完美的直径约5mm的连续环形撕囊以补偿之；恰当处理虹膜后粘连后，在病理性小瞳孔下完成超声乳化手术；眼压失控者行青光眼白内障人工晶体植入三联术。结果：无后囊破裂，人工晶体全部囊袋内植入，术后1周视力≥0．5者20只眼（64．5％），0．1－0．4者8只眼（25．8％），＜0．1者3只眼（9．7％）。随访1－16个月，眼压均在20.55mmHg以下。结论：体外流术后的白内障患眼，超声乳化手术因其切口小，并发症少，不破坏功能性滤过泡，不损伤瞳孔，是目前各种手术方法中的最佳选择。     

派立明与贝特舒联合应用对降眼压的临床观察

目的评价1.00%派立明(AZOPT)与0.25%贝特舒点眼液每日两次点眼对原发性开角型青光眼、高眼压症及抗青光眼术后高眼压的降眼压效果及安全性。方法31例患者51只眼纳入为期2个月的前瞻性研究。在停用其他抗青光眼药物足够长的时间后测量基础值,用药后每2周复查一次共4次,同时观察眼局部及全身副作用。结果用药前眼压为23.85±1.80 mmHg,4次随访眼压下降均值6.55 mmHg(6.06～7.04),眼压下降率27.50%(26.62～28.59%)。少数病例出现烧灼感、视物模糊、口苦等症状,均为轻度能耐受,对视力、眼底无影响。结论派立明与贝特舒联合用药具有稳定的降眼压效果,具良好耐受性。     

Pattern electroretinogram as a function of spatial frequency in ocular hypertension and early glaucoma

Pattern electroretinograms (PERGs) in response to 8.3 Hz alternating gratings (16.6 rev/sec) of different spatial frequencies were recorded in normal subjects as well as in patients affected by early glaucoma and ocular hypertension. In normal subjects the PERG response is spatially tuned, with a maximum at about 1.5 cycles/deg and attenuation at higher and lower spatial frequencies. In all cases of early glaucoma and in the great majority of cases of ocular hypertension the PERG was reduced, as compared with that of normal subjects, mainly in the medium range of spatial frequencies (at which the PERG has its maximal amplitude).     

小梁切除联合丝裂霉素术后晚期滤泡相关并发症的临床分析

目的：探讨小梁切除联合丝裂霉素术后晚期滤泡相关并发症的发生率及处理。 方法：1994-05／2000．05接受小梁切除手术联合丝裂霉素治疗青光眼65例65眼，采用Kaplan-Meier生存分析法估计晚期滤过泡渗漏、滤泡炎、眼内炎的发生概率。 结果：随访2．5～7．1（平均5．6）a，发生滤过泡渗漏16眼（16／65，24．6％），出现滤泡炎5眼（5／65，7．7％），发生眼内炎1眼，出现复合性滤泡并发症1眼，出现持久性低眼压9眼（9／65，13．8％）。Kaplan-Meier生存分析法估计晚期滤泡并发症5a发生概率为40．0％。多数眼通过门诊处理获得成功，部分眼需手术治疗。 结论：小梁切除联合丝裂霉素术后晚期滤泡相关并发症的发生率可高达40．0％，单纯滤过泡渗漏是一相对良性的状况，只要及时处理，可被修复，滤泡炎或眼内炎可以被控制，而获得正常眼内压。一相对良性的状况，只要及时处理，可被修复，滤泡炎或眼内炎可以被控制，而获得正常眼内压。     

Frequency Doubling Technology perimetry and standard automated perimetry in migraine

The literature suggests that visual field defects may be more common in people who experience migraine. The Humphrey frequency doubling (FDT) visual field instrument selectively examines the magnocellular visual pathway, but has not previously been used to investigate visual function in migraine. In a masked controlled study we compared Humphrey FDT and Humphrey Swedish Interactive Threshold Algorithm fields of 25 migraine sufferers with 25 age- and gender-matched controls. Although both mean deviation and pattern standard deviation were a little worse in the migraine group, these differences did not reach statistical significance. There were no inter-eye visual field differences in the migraine group compared with controls. Comparing the mean of all the contrast thresholds in each hemisphere, there were no more inter-hemifield visual field differences in the migraine group compared with controls. There was no significant difference between the migraine and control groups in intra-ocular pressures. The visual field parameters were not correlated with the interval since the last migraine headache, the severity of migraine headache, the duration of migraine headache or the number of migraine headaches per annum. In our data, there was no evidence of visual field deficits, a magnocellular deficit, or indications of glaucomatous pathology.     

丝裂霉素C在复发性青光眼中的应用

目的 :观察丝裂霉素C(MMC)在抗青光眼手术中应用的近期及远期效果。方法 :4 2只复发性青光眼在二次手术中一次性应用MMC术后观察及随访。结果 :术前眼压 34.0 5± 4 .0 5mmHg ,明显高于随访半年期 13.13± 3.30mmHg以及随访 2年期 14 .33± 3.30mmHg ,差异有显著性 (P <0 .0 1)。术后近期眼压 6 .75± 1.4 3mmHg ,明显低于随访半年期 (P <0 .0 1)。功能性滤过泡所占比率为 95 .2 %。结论 :术中一次性应用MMC ,远期观察其降压效果明显 ,且无严重并发症发生     

非穿透性小梁切除术治疗开角型青光眼

目的 研究非穿透性小梁切除术治疗开角型青光眼的手术效果。方法 对20例26眼开角型青光眼行非穿透性小梁切除术,术后观察眼压、结膜滤枕及前房反应等情况,随访1～12个月。结果 术后各期平均眼压均低于术前平均眼压,差异有显著性(P<0.05)术。前平均眼压26.26mmHg,术后3个月、6个月、9个月、12个月平均眼压分别为15.47mmHg、16.89mmHg、19.14mmHg、18.50mmHg。16眼结膜形成滤性手术典型滤过泡,10眼结膜疏松无滤过泡形成。26眼均无前房出血,术后前房反应轻。结论 非穿透性小梁切除术能有效地降低开角型青光眼的眼压,术后并发症少,可作为此类青光眼病人手术的选择。     

Ocular perfusion pressures in different types of glaucoma

Summary It is widely accepted that a disturbed blood supply of the optic disc may cause (in addition with an increased intraocular pressure) optic nerve fibre damage. Therefore we measured ocular perfusion pressures in 79 healthy subjects. In 18 patients with low tension glaucoma, in 27 patients suffering from ocular hypertension and in 49 glaucoma (OAG) patients. For measuring perfusion pressures we used the technique of oculooscillo-dynamography (OODG) as described by Ulrich. Additionally we measured intraocular pressure and systemic blood pressure. In OODG the IOP is simultaneously increased in both eyes by application of a suction cup. After increase of the IOP the negative pressure in the suction cup is slowly and linearly decreased. During this decrease the pulse-depending oscillations of each eye are recorded on a strip-chart-recorder. By means of this method retinal and ciliary perfusion pressures can be separated. As a result we could show that mean arterial blood pressure and systolic retinal perfusion pressure were comparable and not statistically significantly different between the groups examined. The systolic ocular perfusion pressures in patients with low tension glaucoma showed a highly statistically significant reduction compared with the other groups. Between healthy subjects, OAG-patients and patients suffering from ocular hypertension there was no difference in systolic ciliary perfusion pressure detectable.     

Extrapolating global visual field indices from local parameters in the nasal region

The local mean and the average difference of four pairs of test locations within the 26° visual field, situated above and below the horizontal nasal meridian, were used to predict the global field indices MD and CLV of the Gl glaucoma program. Out of 539 examinations (194 eyes suspected of having glaucoma), the local indices NDIFF (describing asymmetrical behavior around the nasal horizontal meridian), ND0 (the mean defect in the nasal region), and the global indices MD and CLV were calculated. Seven hundred fifty-five examinations (446 normal eyes) served as a control group. First and second examinations of 146 glaucoma suspect eyes were used to calculate the retest reliability scores for the indices in question. When analyzing the glaucoma suspects, the local index NDIFF, together with the local mean defect, ND0, yielded highly reliable estimates of the global indices MD and CLV, with a retest correlation r = 0.86 for NDIFF, and r = 0.96 for ND0. The covariance of NDIFF with CLV was r = 0.67, while the co-variance of MD with ND0 was r = 0.95.The ranges of the local indices ND0 and NDIFF were each classified into normal range and range of suspected pathology, in analogy to the normal and pathological ranges of the global field indices. Equivalence of the local indices with the corresponding ranges of MD and CLV was investigated and the results are shown. The establishment of local indices may prove to be a powerful tool in early detection of glaucomatous damage.