1/186. Optic disc topographic changes post-trabeculectomy visualized by anaglyphs.BACKGROUND: publications on changes of optic disc topography usually illustrate their findings with two-dimensional images. methods: With the introduction of computerized imaging, anaglyphs of stereo images can be produced for illustrations. Anaglyphs are viewed three-dimensionally with red-green spectacles that are included in refraction sets and are normally used to assess phoria. An anaglyph of progressive, glaucomatous progression is included to demonstrate the method, along with conventional colour images. RESULTS: We present two cases of severely altered optic disc topography post-trabeculectomy and illustrate these cases with anaglyphs that can be viewed three-dimensionally. CONCLUSION: Three-dimensional viewing of illustrations assists with the visualization, perception and interpretation of optic disc changes.- - - - - - - - - - ranking = 1keywords = optic (Clic here for more details about this article) |
2/186. Juvenile glaucoma in the rubinstein-taybi syndrome.A 10-year-old retarded child was seen by an ophthalmologist because of strabismus. Examination of the optic nerve heads revealed cupping consistant with glaucoma and initiated a referral. The appearance of this girl, with flat-broad based thumbs and toes, small head, low set ears, high arched brows, antimongoloid slant to the eyes, high arched palate, associated with mental retardation, and strabismus suggested the Rubinstein-Tabyi Syndrome. gonioscopy revealed a high iris insertion, while tonometry indicated mildly elevated pressures in the right eye. Examination of the optic nerve heads showed large glaucomatous type cups, more so on the right with compromise of the temporal rim. trabeculectomy was effective in controlling the intraocular pressure in the right eye. The association of juvenile glaucoma with the rubinstein-taybi syndrome requires that ophthalmic referral to assess glaucoma be an essential part of the evaluation.- - - - - - - - - - ranking = 0.66666666666667keywords = optic (Clic here for more details about this article) |
3/186. Ophthalmic findings in GAPO syndrome.BACKGROUND: The main manifestations of GAPO syndrome are growth retardation (G), alopecia (A), pseudoanodontia (P), and optic atrophy (O). CASES: This syndrome has been described in 21 patients from 16 different families. Four cases are from turkey and have been presented by Sayli and Gul. The purpose of our study is to document the cases from turkey and discuss the ophthalmological and neuro-ophthalmolgical findings of these and other reported GAPO cases. OBSERVATIONS: All patients in the literature and our 4 cases have severe growth retardation with delayed bone age in infancy, characteristic facial appearance (high and bossed forehead, midface hypoplasia), alopecia or severe hypotrichosis, and pseudoanodontia. optic atrophy was present in 1 of our cases and in 5 previous cases. glaucoma was present in 5 cases, including 2 of ours. Buphthalmia and keratopathy secondary to glaucoma were also observed. White eyelashes, seen only in our cases, may be a sign of "early senility." CONCLUSIONS: optic atrophy is not a constant finding in GAPO syndrome. glaucoma may accompany the ocular findings. This syndrome has been attributed to either ectodermal dysplasia or the accumulation of extracellular connective tissue matrix, due to an enzyme deficiency involved in its metabolism. Current studies show that an elastin defect and secondary changes in collagen may be important in the pathogenesis of the disease.- - - - - - - - - - ranking = 0.33333333333333keywords = optic (Clic here for more details about this article) |
4/186. Irreversible corneal decompensation in patients treated with topical dorzolamide.PURPOSE: To describe irreversible corneal decompensation after topical dorzolamide hydrochloride (Trusopt; Merck and Co, Inc, West Point, pennsylvania) therapy in nine patients who had histories consistent with corneal endothelial compromise. METHOD: Multicenter review of patients' charts. RESULTS: Nine eyes of nine patients developed overt corneal decompensation after starting topical dorzolamide, a condition that did not resolve with drug cessation. This occurred after 3 to 20 weeks (mean, 7.8) of therapy. All nine patients had undergone intraocular surgery. Eight patients had undergone cataract surgery; three were aphakic and three had posterior chamber intraocular lenses. Two patients had anterior chamber intraocular lenses and also had undergone trabeculectomies. Four patients had undergone penetrating keratoplasties, each case complicated by episodes of corneal allograft rejection that were successfully treated. Two patients had asymptomatic Fuchs endothelial dystrophy. Seven patients have since undergone successful penetrating keratoplasties. CONCLUSION: The reports suggest that dorzolamide can cause irreversible corneal edema in a subset of glaucoma patients with endothelial compromise. The findings suggest a rationale for research into the long-term effects of dorzolamide on the corneal endothelium.- - - - - - - - - - ranking = 0.0088421564598351keywords = edema (Clic here for more details about this article) |
5/186. Malignant glaucoma after diode laser cyclophotocoagulation.PURPOSE: To report a case of malignant glaucoma after diode laser cyclophotocoagulation. METHOD: Case report. RESULTS: A 45-year-old man with uncontrolled secondary glaucoma in his right eye after corneoscleral graft and cataract extraction underwent diode laser cyclophotocoagulation. The right eye was aphakic, with an intact posterior capsule. Two weeks later, the patient presented with blurred vision, edematous cornea, and flat anterior chamber. The posterior capsule was touching the endothelium. intraocular pressure was 20 mm Hg. Repeated Nd:YAG laser capsulotomy was effective in reversing the malignant glaucoma attack, and the anterior chamber deepened. CONCLUSION: Malignant glaucoma can occur after diode laser cyclophotocoagulation.- - - - - - - - - - ranking = 0.0088421564598351keywords = edema (Clic here for more details about this article) |
6/186. Clinical and histopathologic findings of iris nevus (Cogan-Reese) syndrome.PURPOSE: To report a case of Cogan-Reese syndrome. METHOD: Case report. A 37-year-old man presented with Cogan-Reese syndrome. RESULTS: visual acuity was 0.5 in the right eye and 1.0 in the left eye. There were corneal edema and pigmented nodules on the anterior surface of the iris, iris atrophy and ectropion uvea in the right eye. The intraocular pressure was 42 mmHg in the right eye and there was glaucomatous optic atrophy of the optic disk. trabeculectomy with mitomycin C has been performed as the intraocular pressure did not decrease with the maximum medical treatment. Electron microscopic examination of the trabeculum and the iris tissue revealed a lot of melanocytic cells in the stroma. CONCLUSION: trabeculectomy with mitomycin C might be effective in Cogan-Reese cases with glaucoma resistant to medical treatment.- - - - - - - - - - ranking = 0.96651964539672keywords = optic, optic disk, disk, edema (Clic here for more details about this article) |
7/186. Confocal microscopy in the iridocorneal endothelial syndrome.AIMS: To report the appearances of iridocorneal endothelial (ice) syndrome from real time, white light confocal microscopy. methods: Three consecutive patients, each with ice syndrome, were examined prospectively. Corneal specular and confocal microscopic examinations were performed in all three patients. In the first patient, a penetrating keratoplasty was performed and the cornea was examined by light and scanning electron microscopy. No surgery was performed in the remaining two patients. RESULTS: In the first patient corneal oedema prevented endothelial specular microscopy. Confocal microscopy performed before penetrating keratoplasty successfully revealed abnormal epithelial-like endothelial cells. Histological examinations of the cornea following penetrating keratoplasty revealed the presence of multilayered endothelial cells with epithelial features (microvilli). In the remaining two patients, specular microscopy showed the presence of ice cells with typical dark/light reversal. Confocal microscopy demonstrated groups of endothelial cells with epitheloid appearances. In all three patients, the contralateral endothelial appearance was normal by specular and confocal microscopy, except for moderate endothelial polymegathism in one patient. Epithelial-like endothelial cells were characterised by prominent nuclei on confocal microscopy. CONCLUSIONS: The application of confocal microscopy indicates that the ice syndrome is characterised by epitheloid changes in the endothelium. Confocal microscopy may be used to diagnose the ice syndrome by demonstrating epithelial-like endothelial cells with hyperreflective nuclei. This technique is especially of value in cases of corneal oedema, since specular microscopy may fail to image the endothelium in such cases.- - - - - - - - - - ranking = 0.01768431291967keywords = edema (Clic here for more details about this article) |
8/186. New technologies for diagnosing and monitoring glaucomatous optic neuropathy.BACKGROUND: Recently, instruments have been developed to provide real-time, quantitative measurements of the optic disc and retinal nerve fiber layer (RNFL) for use in glaucoma management. Our objective is to (1) provide an overview of two of these instruments, the confocal scanning laser ophthalmoscope (Heidelberg Retina Tomograph, HRT) and scanning laser polarimeter (Nerve Fiber Analyzer, NFA) and (2) compare measurements obtained with these instruments to clinical features used in the diagnosis of glaucoma. methods: Twenty glaucoma patients, 4 normal subjects and 20 glaucoma subjects were included. All subjects had images obtained with the HRT and NFA, and RNFL and optic disc photography completed within 5 weeks of each other. The HRT results were compared with qualitative evaluation of stereophotographs of the optic disc, and NFA results were compared against a semi-quantitative RNFL photograph severity score. RESULTS: Twenty-five (57%) subjects had thinning of the neuroretinal rim identified by evaluation of stereoscopic optic disc photographs. Despite overlap, HRT measurements of rim volume, rim area, and rim/disc ratio were significantly smaller in eyes with evidence of rim thinning than in eyes with no evidence of rim thinning. Moderate to severe RNFL damage was detected by evaluation of photographs in 25 (57%) of subjects. NFA RNFL thickness measures were smaller in eyes with moderate to severe RNFL damage than in relatively healthy eyes. CONCLUSIONS: Previous studies have documented the reproducibility of these instruments and suggested analytic techniques for improving their ability to differentiate between normal and glaucoma eyes. Our results indicate that despite overlap in values, these instruments provide measurements that reflect clinically relevant features of the optic disc and RNFL. Whether these technologies can improve our ability to detect glaucomatous progression over time needs to be determined with well-designed longitudinal studies and comparison with established diagnostic techniques for evaluating glaucomatous optic neuropathy.- - - - - - - - - - ranking = 3.3333333333333keywords = optic (Clic here for more details about this article) |
9/186. Venous collateral remodeling in a patient with posttraumatic glaucoma.PURPOSE: To photographically document venous collateral development, remodeling, and regression in a patient with traumatic glaucoma. methods: Consecutive fundus photographs were evaluated, labeled, and correlated with the clinical history of a patient with unilateral posttraumatic glaucoma. RESULTS: This report photographically documents the appearance, remodeling, and subsequent disappearance of collateral vessels from venous occlusion on the surface of the optic disk in an eye with increased intraocular pressure and progressive glaucomatous cupping. CONCLUSIONS: Asymptomatic chronic obstruction of a branch retinal vein on the optic disk may cause venous collaterals to develop in the absence of retinal hemorrhages or other signs of venous occlusive disease. Increased intraocular pressure, arteriolarsclerosis, and glaucomatous cupping are risk factors for these occlusions.- - - - - - - - - - ranking = 1.2486883112071keywords = optic, optic disk, disk (Clic here for more details about this article) |
10/186. Ocular toxicity of systemic medications: a case series.BACKGROUND: There are many visually threatening conditions that may result from long-term use of systemic medications. Many of these adverse side effects can be greatly reduced or prevented with close monitoring of patients. In view of current knowledge, updated clinical guidelines for appropriate monitoring of ocular toxicity from systemic medications need to be developed for the eye care practitioner. CASE review: There have been many reports of ocular toxicity from isoniazid, thioridazine, steroids, and amiodarone therapy. Clinical cases illustrating possible adverse ocular side effects are presented, which include INH-induced optic neuropathy, phenothiazine-induced retinopathy, steroid-induced glaucoma, and vortex epitheliopathy secondary to amiodarone. CONCLUSION: Optometrists should be aware of the potential for ocular side effects from systemic medications. Eye care guidelines for monitoring ocular side effects from thioridazine, INH, steroids, and amiodarone use are suggested.- - - - - - - - - - ranking = 0.33333333333333keywords = optic (Clic here for more details about this article) |
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