RESUMO
The lamina cribrosa thickness (LCT) could be affected by dynamic changes in its structure. Using Spectral-domain-optical coherence tomography (SD-OCT), we have studied the behaviour of the laminar region in 14 young subjects over 24h. Significant changes in LCT were observed, depending on the time at which the measurement was taken, with the maximum thickness being observed at 7.30 p.m., and the minimum at 7.30 a.m. This finding could suggests a circadian pattern in the LCT thickness in healthy subjects, which could have implications for the classification, diagnosis and prognosis of both normal and glaucomatous subjects.
RESUMO
CLINICAL CASES: Four cases of patients simulating eye problems are reported. The patients included: an adopted 9 year-old girl complaining of bilateral visual loss, a 10 year-old girl with school and family problems complaining of decreased visual acuity, a 22 year-old female mentioning unilateral visual loss after a car accident, and a 30 year-old female complaining of decreased visual acuity after refractive surgery. Structural and functional tests were performed on all 4 patients and none of the tests revealed any pathological findings. The 4 cases were diagnosed as patients simulating ophthalmological symptoms. DISCUSSION: A non-organic cause of visual loss is a common problem in Ophthalmology. Simulation is the diagnosis used when an adult consciously tries to obtain some kind of benefit without proven pathology. In the case of children, obtaining benefit is not their intention, but psycho-social and psychiatric problems are frequently associated in these cases.