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.

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.

In this study population, pOBF was increased with travoprost and latanoprost in the short term, but this effect was kept constant only with travoprost. IOP was reduced with both drugs after short-term therapy, and this reduction was maintained in both groups. Travoprost may represent another option for the medical treatment of POAG.

Phacoemulsification and foldable IOL implantation do not influence RNFL parameters, as measured by GDx Access.