In patients affected by clinically definite MS without history of optic neuritis and no visual symptoms, there is a large prevalence of visual pathway involvement that can be diagnosed only by performing multiple tests. The comparison of the tests is also useful to detect the presence of multiple lesions in the same patient.
Coenzyme Q10 associated with vitamin E administration in OAG shows a beneficial effect on the inner retinal function (PERG improvement) with consequent enhancement of the visual cortical responses (VEP improvement).
ABSTRACT.Purpose: To compare the intermediate-term efficacy of 5-fluorouracil (5-FU) and Mitomycin C (MMC) as adjunctive antimetabolites in neovascular glaucoma (NVG) filtration surgery. Methods: Forty consecutive eyes of 40 patients with NVG refractory to medical therapy were randomized to receive antimetabolite-augmented trabeculectomy. Eighteen eyes received postoperative 5-FU (5-FU group) and 22 eyes received intraoperative, low-dose (0.2 mg ⁄ ml) MMC for 2 mins (MMC group). The main outcome measure was intraocular pressure (IOP). Surgical success was defined as IOP < 21 mmHg with topical treatment (qualified success) or without topical treatment (complete success). Surgical failure was defined as IOP ‡ 21 mmHg, despite postoperative topical treatment, and by postoperative blindness. Results: The mean follow-up period was 35.8 ± 22.6 months in the 5-FU group and 18.6 ± 17.2 months in the MMC group. This difference was not significant. Mean IOP decreased from 40.4 ± 10.3 mmHg to 14.7 ± 3.4 mmHg (p < 0.0001) in the 5-FU group and from 42 ± 11.3 mmHg to 22.9 ± 13.3 mmHg (p ¼ 0.0006) in the MMC group; however, the difference between the 5-FU and MMC groups was not significant at any point. The success rate in the 5-FU group was 55.5% (44.4% complete, 11.1% qualified), compared with 54.5% (9.1% complete, 45.4% qualified) in the MMC group. This difference was not significant. Conclusions: The percentage of patients who achieved postoperative IOP < 21 mmHg was similar in both groups, although a larger proportion of patients treated with MMC-augmented trabeculectomy required topical treatment in comparison with the 5-FU group.
This study suggests that topical medications that enhance outflow (e.g., bimatoprost, latanoprost, travoprost, and brimonidine) may provide, under stressful conditions such as the WDT, better IOP stabilization than medications that decrease aqueous humor inflow, such as timolol and topical carbonic anhydrase inhibitors.
Aim-To evaluate the accuracy and reliability of the optical versus ultrasonic measurement of anterior chamber depth (ACD) in a group of patients aVected by high myopia or hyperopia, before phakic IOL implant. Methods-18 consecutive patients (34 eyes) were enrolled in this study, and asked to undergo phakic IOL implant to correct high myopia or hyperopia. The mean age was 29.5 (SD 3.4) years, the male/female ratio was 10/8. 13 patients (24 eyes) were myopic (mean myopia −16.17 (4.39) D, range −9 to −24 D), whereas five patients (10 eyes) were hyperopic (mean hyperopia 7.4 (2.01) D, range 5.5-11 D). For each patient, ACD was evaluated comparing an optical system (Orbscan topograph system) with a standard A-scan ultrasound system. To evaluate the reliability of the two methods, the average of three optical and 10 ultrasonic consecutive measurements were considered. Statistical analysis was performed by means linear regression. Results-The average diVerence between optical and ultrasound values was 0.17 (0.1) mm (4.68% (2.52%)). There was a constant underestimation of the ACD with the optical system compared with the ultrasound measurement, more evident in the hyperopic eyes (5.20% (1.95%)) than in myopic ones (4.46% (2.72%)). The reliability of measurements, as showed by the standard deviation values, was higher in the optical system (0.03 (0.02)) than in the ultrasound (0.1 (0.05)), with a statistical diVerence (p<0.001). The linear regression analysis between optical and ultrasound measurements was 0.8992 (p<0.0001). Conclusions-The optical measurement of ACD is an accurate and reliable technique in high myopic and hyperopic eyes. It gives a small underestimation of the ACD values, but it could be preferable to the ultrasound technique, because it demonstrates more repeatability and has the advantages of a non-contact technique.
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