Background-There is evidence that altered ocular blood flow is involved in the development and progression of diabetic retinopathy. However, the nature of these perfusion abnormalities is still a matter of controversy. Ocular haemodynamics were characterised with two recently introduced methods. Methods-The cross sectional study was performed in 59 patients with type 1 diabetes with a diabetes duration between 12 and 17 years and an age less than 32 years and a group of 25 age matched healthy controls. Scanning laser Doppler flowmetry and laser interferometric measurement of fundus pulsation amplitude were used to assess retinal and pulsatile choroidal blood flow, respectively. In addition, colour contrast sensitivity along the tritan axis was determined. Results-Fundus pulsation amplitude, but not retinal blood flow, increased with the progression of diabetic retinopathy. Retinal blood flow was influenced by plasma glucose levels (r = 0.32), whereas fundus pulsation amplitude was associated with HbA 1c (r = 0.30). In addition, a negative correlation between the colour contrast sensitivity along the tritan axis and retinal blood flow was observed. Conclusions-The present study indicates that pulsatile choroidal blood flow increases with the progression of diabetic retinopathy. Increased retinal blood flow appears to be related to loss of colour sensitivity in patents with type 1 diabetes. (Br J Ophthalmol 2000;84:493-498) Altered ocular blood flow may contribute to the development and progression of diabetic retinopathy. However, the exact nature of ocular blood flow abnormalities in diabetes has not yet been established and the results obtained in patients with type 1 diabetes and type 2 diabetes strongly depend on the technique used for the assessment of ocular haemodynamics. Both, increased 1-3 and decreased retinal blood flow 4 5 have been observed in patients with diabetes compared with healthy controls. A recent study using laser Doppler velocimetry for the assessment of retinal blood flow indicates that retinal perfusion is already increased in patients with type 1 diabetes before the clinical onset of diabetic retinopathy.6 This observation has further supported the concept that increased retinal blood flow may have a key role in the development of diabetic retinopathy. 8The purpose of the present study was to determine whether retinal and choroidal blood flow are altered in the early stages of diabetic retinopathy. Retinal blood flow was assessed with scanning laser Doppler flowmetry.9 Pulsatile choroidal blood flow was assessed with laser interferometric measurement of fundus pulsation. 10Ocular haemodynamic factors were compared with the results of colour contrast sensitivity testing. This was done in an eVort to establish a relation between alterations in ocular haemodynamics and loss of colour contrast sensitivity. In order to minimise the eVect of potentially confounding factors such as duration of diabetes or age we focused on a study population with type 1 diabetes with a duration of 1...

The intracameral injection of 25 microg r-tPA proved to be a safe, efficient, and low-risk supplement in the treatment of severe postoperative fibrinous reactions.

The introduction of HAART had a major impact on the medical history of patients with HIV-related eye disease with improved survival time and decreased morbidity.

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Cytomegalovirus (CMV) is the most common pathogen of opportunistic viral infections in patients with the acquired immunodeficiency syndrome. In this study, we assessed the therapeutic outcome of our treatment regimen of CMV retinitis by analysing retrospectively 33 consecutive patients. The clinical utility of CMV cultures from blood, urine and throat specimens obtained at the time of diagnosis was additionally evaluated. Treatment started with ganciclovir (GCV) therapy. In case of relapsing retinitis, re-induction therapy was initiated, and if unsuccessful, the patient was switched to foscarnet. Patients developing resistant retinitis despite foscarnet therapy were offered a GCV-foscarnet combination therapy. Under primary GCV therapy, the median first stable interval of the whole group was 202 days (mean 238 days). Twenty-five out of 33 CMV retinitis patients (76%) responded to initial GCV therapy. Eleven of these patients showed relapsing retinitis that could be stabilised in 3 patients solely with combination therapy. Eight patients did not respond to primary GCV therapy. Three of them improved with foscarnet, but 3 patients did not respond to either treatment. In 18 (56%) out of 32 patients, CMV cultures yielded positive results. Considering our series, we may conclude that in the majority of patients primary or secondary viral resistance can be overcome by dose increase, switching to the alternative drug or a combination therapy.