Introduction: The etiology of primary open-angle glaucoma remains unclear. Various risk factors, including vascular abnormalities, have been associated with this disease. Sleep-associated diseases, like sleep apnea syndrome, might also represent a risk factor. Sleep apnea syndrome is characterized by repetitive upper airway obstructions during sleep, inducing hypoxia and sleep disruption with the risk of cardiovascular and neurological sequelae. In this study, we determined the prevalence of sleep apnea syndrome in primary open-angle glaucoma patients. Methods: Overnight transcutaneous finger oximetry was performed in 30 consecutive patients having primary open-angle glaucoma. We assessed the oximetry disturbance index during night sleep, a parameter used to diagnose sleep apnea syndrome and to grade its severity. Results: Sleep apnea syndrome was more prevalent among primary open-angle glaucoma patients compared to normal historic controls of the same age and sex distribution (χ² = 9.35, d.f. = 3, p < 0.025). The oximetry disturbance index grade was significantly larger in the primary open-angle glaucoma group compared to normal controls (U = 3,352, p = 0.01). According to the oximetry disturbance index, 20% (6/30) of primary open-angle glaucoma patients had sleep apnea syndrome. Conclusion: Primary open-angle glaucoma is associated with sleep apnea syndrome. Early recognition and treatment of sleep apnea syndrome are important to avoid cardiovascular and neurological complications.

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Summary Sertoli cells in testicular biopsies from 7 patients with Sertoli‐cell‐only syndrome, 8 patients who had been treated with cyclophosphamide for testicular neoplasia, 8 patients with oligozoospermia, 7 patients with cryptorchidism, and 8 patients with seminoma were examined under the electron microscope and compared with Sertoli cells of normal tissues. The investigations reveal that each of these conditions of impaired fertility is characterized by the occurrence of a special type of Sertoli cell. The cell pattern is either restricted to one or two of the normally occurring cell types, or modified cells predominate that might be typical of the underlying disturbance of spermatogenesis. It is suggested that the cell type which prevails in the Sertoli‐cell‐only syndrome is capable of maintaining a basic production of a substance that inhibits FSH secretion. Zusammenfassung Sertolizellen aus Hodenbiopsien von 7 Patienten mit Sertolizellsyndrom, 8 Patienten, die wegen eines Hodenkarzinoms mit Zyklophosphamid behandelt wurden, 8 Patienten mit Oligozoospermie, 7 Patienten mit Kryptorchismus und 8 Patienten mit Seminom wurden elektronenmikroskopisch untersucht und mit Sertolizellen aus normalem Gewebe verglichen. Dabei zeigte sich, daß jedes dieser Krankheitsbilder durch das Vorkommen eines bestimmten Sertolizelltyps charakterisiert werden kann. Entweder herrschen ein oder zwei der schon normalerweise vorkommenden Zelltypen vor, oder es treten neue abgewandelte Zelltypen auf, die für die zugrunde liegende Stöning der Spermatogenese typisch sein könnten. Es wird vermutet, daß derjenige Sertolizelltyp, der im Sertolizellsyndrom überwiegt, die Basisproduktion eines die FSH Sekretion hemmenden Faktors aufrechzuerhalten vermag. Resumen Se examinan al microscopico electrónico células de Sertoli de 7 pacientes con síndrome de célula única de Sertoli, 8 pacientes que habían sido tratados con ciclofosfamida debido a neoplasia testicular, 8 pacientes con oligozoospermia, 7 pacientes con criptorquidia, y 8 pacientes con seminoma. Se comparan estas células con células de Sertoli de tejidos normales. Las investigaciones revelan que cada una de estas condiciones de fertilidad disminuída se caracteriza por la presencia de un tipo determinado de células de Sertoli. El modelo de célula se restringe a uno o dos de los tipos que se encuentran normalmente, o bien predominan células modificadas que podrian ser típicas de la anomalía subyaciente de la espermatogénesis. Se sugiere que el tipo de célula que prevalece en el síndrome de célula única de Sertoli, es capaz de mantener una producción básica de substancia que inhiba la secretión de FSH.

A vitrectomy was performed in 18 eyes (15 patients) with vitreous hemorrhages due to Terson's syndrome. The average age of the patients was 46.5 +/- 14.4 years. The mean interval between the acute event of an intracranial hemorrhage and the vitrectomy was 6.8 +/- 4.9 months. The vitreous hemorrhage was associated with epiretinal membranes in 3, PVR in 2, and retinal breaks and/or rhegmatogenous retinal detachment in 3 eyes. The vitrectomy had to be combined with membrane peeling in 2, encircling procedures or exoplants in 4, cryotherapy in 5, endolaser in 1, and air/SF6 gas filling in 3 eyes. A missing or incomplete posterior vitreous detachment in 8 eyes was associated with a higher risk of PVR and retinal detachment. Two eyes with this condition needed 3 secondary operations. The mean follow-up duration was 32 (1 to 126) months. Two patients died 4 and 11 months after the operation. The visual acuity improved significantly following vitrectomy in all 18 eyes. The final visual acuity was better than 20/40 in 73% and 20/25 to 20/20 in 56%. The initial postoperative visual acuity decreased later on due to nuclear cataract in 7 of 10 eyes of patients over 45 years of age. A complicated cataract developed in only 1 of 8 eyes of younger patients who maintained a mean visual acuity of 20/25. Vitrectomy for Terson's syndrome is recommended in bilateral cases without spontaneous clearing of the vitreous within 3 months, as well as in cases with PVR and imminent retinal detachment.(ABSTRACT TRUNCATED AT 250 WORDS)

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