Pressure compliance of the optic nerve head in low tension glaucoma.

Twenty eyes of 10 healthy subjects, 11 eyes of seven patients with low tension glaucoma, and three eyes of three patients with ischaemic optic neuropathy were investigated. Visual evoked responses were recorded under stepwise artificially increased intraocular pressures. The results of the visual evoked response recording (pressure compliance test) allow a clear distinction to be made between healthy subjects, patients with low tension glaucoma, and patients with ischaemic optic neuropathy. In the groups investigated a lack of autoregulation of the optic nerve head circulation was found in patients with low tension glaucoma only. Patients with anterior ischaemic optic neuropathy showed the same pressure compliance behaviour as healthy subjects. The methods used here seem to provide a practicable clinical tool in the differential diagnosis of low tension glaucoma.     

Toxic retinopathy in cyclosporin A therapy

A bone marrow transplantation was performed in a 17-year-old male patient suffering from acute undifferentiated leukemia. The patient received Cyclosporin A--a powerful immunosuppressive agent--to prevent a severe, chronic graft-versus-host disease. While undergoing this therapy the patient suffered a loss of visual acuity in both eyes 17 months after bone marrow transplantation. The substrates of the visual acuity loss were multiple retinal changes. Cotton-wool spots, intraretinal and preretinal hemorrhages were found in both eyes, and a macula edema in the left eye. The possible role of the immuno-suppressive agent Cyclosporin A in the pathogenesis of these changes is discussed.     

Efficacy and safety of tafluprost 0.0015% versus latanoprost 0.005% eye drops in open‐angle glaucoma and ocular hypertension: 24‐month results of a randomized,double‐masked phase III study

Purpose: The objective of the study was to compare the long‐term efficacy and safety of tafluprost 0.0015% with latanoprost 0.005% eye drops in patients with open‐angle glaucoma or ocular hypertension. Methods: This double‐masked, active‐controlled, parallel‐group, multinational, multicentre, phase III study was conducted at 49 centres in 8 countries. Eligible patients were assigned to treatment administered once daily at 20:00 hrs for up to 24 months. Change from baseline intraocular pressure (IOP) was the primary efficacy variable. Adverse events were recorded and ocular safety was evaluated. Both tafluprost and latanoprost were preserved with benzalkonium chloride. Results: From 533 patients randomized, 402 patients completed 24 months of therapy. Both treatments had a substantial IOP‐lowering effect which persisted throughout the study (?7.1 mmHg for tafluprost and ?7.7 mmHg for latanoprost at 24 months). Although the IOP‐lowering effect during the study was slightly larger with latanoprost, this difference was clinically small and the noninferiority of tafluprost to latanoprost over all diurnal IOP measurements was shown with anova and almost reached with ancova (upper limits of the 95% confidence intervals 1.38 and 1.52 for the overall period, respectively). The noninferiority limit was 1.5 mmHg. Conclusions: Tafluprost is a new effective and well‐tolerated treatment for glaucoma and ocular hypertension.     

Netzhautdickenmessung mit dem Heidelberg Retina Tomograph bei Patienten mit Makula?dem und bei Gesunden

Background

This study was carried out to test the reliability of a defined cut-off value for retinal thickness with estimation of the sensitivity, specificity and formation of an edema index in comparison to retinal thickness.

Materials and methods

This was a single center prospective clinical non-blinded study of 100 eyes, including 22 eyes with central vein or branch vein occlusions, 20 eyes with diabetic macular edema, 6 eyes with postoperative macular edema, 2 eyes with uveitis and 50 healthy eyes. Detection of macular edema was carried out by third generation optical coherence tomography. Using the latest version of the Heidelberg retina tomograph (HRT 3) series of five images were produced and evaluated. The 9-zone circle of the HRT was used as the analysis contour.

Results

The reliability of measuring retinal thickness with the HRT in the subjects showed an intraclass correlation between 0.248 and 0.740 and patients with macular edema showed values between 0.515 and 0.949. The reliability of the edema index with the HRT in the subjects showed an intraclass correlation between 0.461 and 0.826 and patients with macular edema showed values between 0.383 and 0.826. The calculated cut-off values were between 285?μm and 360?μm. The corresponding sensitivity values were between 74.7% and 95.9% with a corresponding specificity of 74.7-90.2%. There was also a highly significant correlation between the edema index and retinal thickness (p?Conclusions The retina module of the latest generation HRT is capable of reproducible measurement of the retinal thickness in micrometers. The defined cut-off values correspond to expectations and can be used in this form in the clinical practice.     

Effect of upper eyelid blepharoplasty on corneal biomechanical,topographic and tomographic parameters 4 weeks after surgery

International Ophthalmology - To investigate the effect of “skin-only” upper eyelid blepharoplasty on corneal biomechanics and central as well as peripheral topographic/tomographic...