This study was conducted to assess optic nerve and peripapillary retinal nerve fibre layer (RNFL) changes in patients with idiopathic Parkinson's disease (PD) and its correlation with disease duration and severity. Optic nerve parameters and RNFL thickness were measured in 24 PD patients and 25 age-gender-matched controls by Heidelberg Retinal Tomography II (Heidelberg Engineering, Dossenheim, Germany). Patients with visual acuity below 20/25 were excluded. The mean RNFL in the temporal sector was significantly thinner in the study group than the control group (p ¼ 0.020). Additionally, disease severity and duration negatively correlated with optic disc parameters in some sectors.

No abstract

This study was conducted to assess ocular pulse amplitude and retinal nerve fibre layer in patients with multiple sclerosis and their correlation with disease duration and with severity. Retinal nerve fibre layer thickness was measured by Heidelberg Retinal Tomography II (HRT-II; Heidelberg Engineering, Dossenheim, Germany) and ocular pulse amplitude was measured by dynamic contour tonometry (Ziemer Ophthalmic Systems, Port, Switzerland) in 37 multiple sclerosis patients and 72 age-and gender-matched controls. Ocular pulse amplitude was significantly reduced and retinal nerve fibre layer was significantly thinner in temporal, superotemporal, and nasal sectors in patients with multiple sclerosis regardless of having an optic neuritis attack. The retinal nerve fibre layer was thinner in eyes with a previous optic neuritis attack compared with the eyes without an attack, but the difference was not significant. Ocular pulse amplitude showed a positive correlation with visual evoked potential amplitude and a negative correlation with visual evoked potential latency. Retinal nerve fibre layer thickness showed a significant negative correlation with the disease duration but not with visually evoked potential, disease severity, nor previous optic neuritis. These findings indicate that the process of degeneration starts in the early period of the disease, as our study group is composed of earlymiddle-stage multiple sclerosis patients, and is independent of relapses.

ÖzetElli iki yafl›nda erkek hasta, 3 hafta önce inguinal herni cerrahisi için spinal anestezi ald›ktan sonra bafllayan sol gözde kayma ve çift görme yak›nmalar›yla baflvurdu. Sol gözde ezotropya ve abdüksüyonda -4 k›s›tl›l›k mevcut olan hastada, spinal anestezi sonras›nda beyin-omurilik s›v›s› (BOS) kaça¤›na ba¤l› 6. kranial sinir felci tan›s› düflünülerek s›v› replasman tedavisi ve epidural kan yamas› uyguland›. Hastan›n takibinde 1. ayda diplopinin azald›¤›, 6. ayda ise göz hareketlerinin serbestleflti¤i görüldü. Spinal anestezi sonras› görülen nadir ve geçici bir durum olan 6. kranial sinir felcinin, BOS kaça¤› sonucu oluflan intrakranial hipotansiyona sekonder 6. kranial sinirin traksiyona u¤ramas› ile ortaya ç›kt›¤› düflünülmektedir. ( SummaryA 52-year-old male patient presented with diplopia and strabismus, which developed 3 weeks ago following spinal anesthesia for inguinal hernia repair. He had left esotropia and abduction was limited (-4) in the left eye. The patient was diagnosed as having 6 th cranial nerve palsy secondary to cerebrospinal fluid leakage following dural puncture and had intravenous hydration and epidural blood patch treatment. Diplopia decreased by the first month and his eye movements returned to normal by the 6 th month after treatment. 6 th cranial nerve palsy secondary to spinal anesthesia is a rare and temporary condition, which is thought to be secondary to the traction of 6th nerve due to intracranial hypotension following cerebrospinal fluid leakage. ( GiriflLomber ponksiyon (LP), gerek tan›, gerekse anestezi amac›yla s›kl›kla kullan›lan bir yöntemdir. LP'la iliflkili kraniyal sinir (KS) felci, nadir görülen bir komplikasyondur. ‹nsidans› 1/5800 olarak belirtilmifltir.1 Tüm kraniyal sinirler etkilenebilmekle birlikte en s›k tutulan, uzun intrakraniyal seyri nedeniyle 6. KS'dir.2 Burada spinal anestezi sonras› 6. kraniyal sinir felci geliflen bir olgunun sunumu hedeflenmifltir. Olgu SunumuElli iki yafl›nda erkek hasta sol gözde ani bafllayan içe kayma ve çift görme yak›nmalar›yla baflvurdu. Hastan›n yak›nmalar›n›n 3 hafta önce inguinal herni cerrahisi için spinal anestezi ald›ktan sonra bafllad›¤›, çift görme flikayetlerine ek olarak bulant› ve bafl a¤r›s›n›n da bulundu¤u ö¤renildi. Görme keskinli¤i bilateral tam olan hastan›n ön ve arka segment muayenesinde patoloji sap-

A 45-year-old male presented with lid edema and blurred vision in his left eye. He had a history of operation for a sellar and parasellar mass 1 month ago. Best-corrected visual acuity was 7/10 in his left eye. He had marked lid edema, prominent chemosis, episcleral vascular injection, proptosis and mildly congested and tortuous retinal vessels in the left eye. Intraocular pressure was 35mmHg and eye movements were severely restricted in all directions in his left eye. Orbital magnetic resonance (MR) imaging showed left proptosis and cranial venous MR angiography demonstrated multiple tortuous and enlarged vessels near the left carotid artery and the left cavernous sinus resembling carotid-cavernous fistula, and enlarged superior ophthalmic vein. The patient underwent successful endovascular stent-graft implantation for the left iatrogenic carotid-cavernous fistula. At postoperative 3 weeks, visual acuity was 10/10 with complete regression of proptosis and restriction in his left eye.