Ocular and eyelid involvement in collagen vascular diseases. Part I. Sjögren syndrome and systemic lupus erythematosus.

Collagen vascular disease is a heterogeneous group of autoimmune diseases that affect multiple organ systems. Sjögren syndrome, dermatomyositis, scleroderma, systemic lupus erythematosus, and sarcoidosis are collagen vascular diseases that often present with characteristic cutaneous manifestations. Although less known, various ocular manifestations that affect both external and internal structures of the eye can be seen in these conditions. Multidisciplinary management between dermatologists and ophthalmologists is essential in the early diagnosis and management of collagen vascular diseases affecting both the skin and eye. Part I of our series will discuss the ocular manifestations, their diagnosis, and therapeutic options in Sjögren syndrome and systemic lupus erythematosus.

Ocular and eyelid involvement in collagen vascular diseases. Part II. Dermatomyositis, scleroderma, and sarcoidosis.

Collagen vascular disease is a heterogeneous group of autoimmune diseases that affect multiple organ systems. Sjögren syndrome, dermatomyositis, scleroderma, systemic lupus erythematosus, and sarcoidosis are collagen vascular diseases that often present with characteristic cutaneous manifestations. Although less known, various ocular manifestations that affect both external and internal structures of the eye can also be seen in these conditions. Multidisciplinary management between dermatologists and ophthalmologists is essential in the early diagnosis and management of collagen vascular diseases affecting both the skin and eye. In part II of our series, we discuss the ocular manifestations, diagnosis, and therapeutic options of dermatomyositis, scleroderma, and sarcoidosis.

Effect of intraoperative factors on IOP reduction after phacoemulsification.

The purpose of the study was to determine the independent predictors of long-term intraocular pressure (IOP) reduction after cataract surgery with phacoemulsification. This is a retrospective review of uncomplicated cataract surgeries from 2006 to 2008 at the Baltimore VA Medical Center with longitudinal follow-up. Demographic, clinical, biometric, and intraoperative variables including phacoemulsification parameters were recorded. Univariate and multivariate linear regression were used to analyze the relationship between these variables and postoperative IOP, which was the outcome variable. Analysis was performed in 115 eyes of 115 patients who underwent uncomplicated phacoemulsification during the study period. There was an average postoperative IOP reduction through 12, 24, and 36 months of -1.7 ± 3.1, -1.5 ± 3.8, and -1.3 ± 2.6 mmHg, respectively. Higher preoperative IOP (P < 0.001), a more anterior relative lens position (P < 0.05), and longer phaco time (P < 0.05) were significantly associated with greater postoperative decrease in IOP using univariate analysis. Using multivariate analysis, preoperative IOP (P < 0.001), and phaco time (P = 0.038) were associated with greater postoperative IOP reduction through 24 months. Phaco time is independently associated with IOP reduction after adjusting for age and preoperative IOP. Higher preoperative IOP is associated with a greater IOP-lowering effect after phacoemulsification.

Venous sinus stenting in idiopathic intracranial hypertension: a safer surgical approach?

PURPOSE OF REVIEW: The purpose is to summarize treatment strategies in idiopathic intracranial hypertension (IIH), a potentially sight-threatening disease, with a focus on the most current outcome data for venous sinus stenting. RECENT FINDINGS: Historically, the primary treatment options for medically refractory IIH consisted of either optic nerve sheath fenestration or cerebrospinal fluid diversion procedures. The visual outcomes of these procedures are favorable, though they tend to be associated with a high rate of complication and failure. Recent trials suggest that venous sinus stenting offers both comparable rates of efficacy - with improved papilledema in 97% of patients, resolved headache in 83%, and improved visual acuity in 78% - and improved safety and reliability relative to older surgical techniques. SUMMARY: Patients whose sight is threatened by medically refractory IIH must often consider invasive procedures to control their disease. Venous sinus stenting may offer equal efficacy and lower failure and complication rates than traditional surgical approaches such as optic nerve sheath fenestration and cerebrospinal fluid diversion.