ABSTRACT.Purpose: Chemokines have been implicated in the control of leucocyte infiltration in uveitis and in modulating angiogenesis in several ocular conditions. Toxoplasmic retinochoroiditis is a common cause of posterior uveitis. This study aimed to evaluate the serum concentrations of CC and CXC chemokines in patients with acute toxoplasmic retinochoroiditis. Methods: The levels of five chemokines (CCL2, CCL11, CXCL9, CXCL8 and CXCL10) were evaluated in the serum of patients with active toxoplasmic retinochoroiditis (n ¼ 55) and control subjects (n ¼ 40). In a subset of patients (n ¼ 18), a second measure of serum levels of chemokines was performed after the completion of oral treatment with pyrimethamine (25 mg ⁄ day), sulphadiazine (1 g, four times per day), folinic acid (7.5 mg ⁄ day) and prednisone (initial dose: 1 mg ⁄ kg ⁄ day) for approximately 30 days. Results: Patients with toxoplasmic retinochoroiditis, notably those presenting with vasculitis, had increased serum levels of CXCL8 (mean ± standard error of the mean [SEM] 35.1 ± 6.5 pg ⁄ ml) compared with control subjects (mean ± SEM 16.0 ± 2.3 pg ⁄ ml; p ¼ 0.01). There were no differences between patients and controls in serum levels of the other chemokines measured. The size of ocular lesions correlated significantly with serum levels of CXCL8 and CXCL9. After treatment, there was a significant reduction in serum levels of CXCL8. Severity of vitreous opacities did not correlate with serum levels of these chemokines. Conclusions: These data suggest a role for CXCL8 in the inflammatory process of acute toxoplasmic retinochoroiditis. Furthermore, CXCL8 may be a useful marker for patient follow-up.
PURPOSE.To evaluate the eye-tracking-based follow-up (EBF) function in the reproducibility of the peripapillary retinal nerve fiber layer (RNFL) thickness measurements obtained with Fourier-domain optical coherence tomography (Fd-OCT).METHODS. Thirty healthy subjects were imaged on an Fd-OCT device at the same visit by two examiners. Peripapillary circular scans in ''high-speed'' (HS) mode with the ''automatic real time'' (ART) set at 16 and in ''high-resolution'' (HR) mode with the ART off were obtained without and with the EBF function activated.RESULTS. Mean (6SD) global RNFL thickness was 105.1 (69.5) lm on HS mode and 105.4 (69.6) lm on HR mode. Interobserver analysis for global RNFL thickness revealed an intraclass correlation coefficient (ICC) greater than or equal to 0.96 for all but the HR mode without the use of EBF function (ICC ¼ 0.73). Intraobserver analysis for global RNFL thickness revealed an ICC greater than 0.98 for all but the HR mode without the use of EBF function (ICC ¼ 0.86). The interobserver and intraobserver analyses revealed the lowest ICC values for the temporal region on both HS and HR modes. Higher ICC values were obtained with the HS mode and when the EBF function was activated, particularly when using the HR mode.CONCLUSIONS. The EBF function had no influence in the reproducibility of the global peripapillary RNFL thickness measurements in healthy subjects on HS mode with ART on. However, reproducibility of the global RNFL thickness measurements on HR mode as well as of the temporal and temporal superior regions in both HS and HR modes was greater with the EBF function. (Invest Ophthalmol Vis Sci.
In megalopapilla, the optic disc is abnormally large. The RNFL thickness is normal. These findings are essential for distinguishing megalopapilla from the optic glaucomatous neuropathy.
A 34-year-old white man presented with a sudden unilateral recurrent visual loss. Fundus examination and fluorescein angiography revealed severe retinal vein occlusion. An antiphospholipid syndrome was discovered during etiological check up. A mutation of Leiden V factor was discovered and the patient started long term anticoagulation after the second occlusive event. However, secondary neovascular glaucoma has developed and despite treatment the affected eye had an important reduction of visual acuity. The purpose of this case report is to demonstrate that retinal vascular occlusion can be the initial manifestation of the antiphospholipid syndrome and that its diagnosis is important because this disease generally affects young people and may endanger ocular and vital prognosis. This diagnosis may imply a long lasting anticoagulative or antiaggregative treatment to reduce the risk of recurrent thrombotic events.
RESUMOObjetivo: Comparar discos ópticos de pacientes normais com história familiar de glaucoma primário de ângulo aberto (GPAA) com um grupo controle sem histórico familiar de glaucoma através da oftalmoscopia confocal a laser (HRTII). Métodos: Análise retrospectiva da morfometria dos discos ópticos de pacientes com e sem história familiar de GPAA. Cada paciente foi submetido a exame oftalmológico completo, perimetria computadorizada, paquimetria e HRTII. Os pacientes foram classificados em três grupos de acordo com o grau de parentesco: primeiro grau (grupo 1), segundo grau (grupo 2) e grupo controle sem história familiar de glaucoma (grupo 3). Foram analisados: área total do disco óptico (Área Total), área de faixa neural (FxN), área da escavação (Esc.), relação escavação/disco (E/D) e relação E/D linear (L). Para a análise estatística, utilizou-se o programa SPSS 12.0. considerando-se apenas um dos olhos de cada paciente selecionado aleatoriamente. Resultados: Foram incluídos setenta e quatro pacientes com idade média de 42,58 anos. Comparando-se os grupos 1 e 2, encontrou-se diferença estatisticamente significativa na variável Área Total, observando-se discos ópticos maiores no grupo 1. Comparando-se os grupos 1 e 3, as diferenças entre as variáveis Área Total, Esc, E/D e L foram estatisticamente significativas com predominância de valores mais elevados no grupo 1. Comparando-se os dados estereométricos entre os grupos 2 e 3 não foram encontradas diferenças de valores estatisticamente significantes. Conclusão: Pacientes normais parentes de primeiro grau de glaucomatosos apresentam maiores valores das variáveis topográficas do disco óptico quando comparados aos dos pacientes sem histórico familiar de glaucoma.
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