[Maculopathy with areolar retinal pigment epithelium defects]. / Makulopathie mit areolären RPE-Defekten.

Maculopathy with areolar or annular defects in the retinal pigment epithelium (RPE) can have manifold differential diagnoses. If such alterations occur in adolescence or early adulthood with good visual acuity, precise diagnostics and confirmation of the diagnosis are of special importance with respect to the prognosis of the disease. We report the case of a 36-year-old female patient with bilateral perifoveolar, areolar retinal pigment epithelium defects. The patient suffered from metamorphopsia with good visual acuity. Visual disturbances had initially begun 8 years previously. Perifoveolar RPE defects can be visualized with autofluorescence photography and optical coherence tomography (OCT) and result in functional defects in perimetry, microperimetry and multifocal electroretinography. The symptoms and course are in accordance with fenestrated sheen macular dystrophy. A therapy does not exist. This rare autosomal-dominant inherited macular dystrophy is often asymptomatic and has a good prognosis for visual acuity.

[Papillary hemodynamics in patients with normal pressure glaucoma and hemorrhage of the optic papilla circumference]. / Papilläre Hämodynamik bei Patienten mit Normaldruckglaukom und Papillenrandblutungen.

BACKGROUND: Optic disc hemorrhages in patients with normal-pressure glaucoma (NPG) are usually regarded as a sign of vascular dysfunction and as an indicator for glaucoma damage progression. METHODS: Optic nerve head blood flow was measured in 21 patients suffering from NPG with acute optic disc hemorrhages by scanning laser Doppler flowmetry at various locations of the optic disc. Intraocular pressure and mean deviation of the visual field were also monitored. Two groups served as control: 21 patients with NPG matched for age, sex, and stage of the disease and in addition the contralateral eye without any hemorrhages. RESULTS: Optic nerve head blood flow as a mean of several locations was significantly lower in eyes with optic disc hemorrhages than in controls and differed significantly from the contralateral eye. CONCLUSION: Optic nerve blood flow was lower in NPG eyes with optic disc hemorrhages than in the contralateral eye and in controls.

[Ocular hemodynamics and visual field in glaucoma treated with dorzolamide]. / Okuläre Hämodynamik und Gesichtsfeld beim Glaukom unter Dorzolamid-Therapie.

OBJECTIVE: It has been shown that oral carbonic anhydrase inhibitors improve visual function in glaucoma. Furthermore topical dorzolamide might improve ocular hemodynamics, as was demonstrated previously. This study was undertaken to evaluate whether topical dorzolamide affects visual function and ocular hemodynamics in glaucoma. METHODS: In a retrospective, open clinical trial, dorzolamide eye drops were administered to 28 patients with confirmed primary open angle glaucoma (POAG) in both eyes, 3 times daily for a mean follow up of 9 months. One eye was randomly chosen for evaluation. IOP, blood pressure, heart rate, pulsatile ocular blood flow (POBF) and Humphrey 30-2 visual fields were measured at baseline and after the start of the therapy. POBF was determined by pneumotonography. For statistical analysis the Wilcoxon-matched-paired test and the Bonferoni-Holm adjustment were used. RESULTS: In dorzolamide-treated patients the IOP dropped from 18 mmHg to 15.5 mmHg after 9 months therapy (p < 0.01) and the visual field improved significantly by 18% (p < 0.05). A statistically significant change was found for POBF from 543 microliters/min to 675 microliters/min (p < 0.05). CONCLUSIONS: The results showed the expected drop in intraocular pressure. Visual function and pulsatile ocular blood flow improved significantly which might be explained by an analogous, vasodilatory effect as was observed in orally applied carbonic anhydrase inhibitors.