[Combination surgery for wet age-related macular degeneration and chronic peripheral uveitis].

AIM: To develop a combination surgery for wet age-related macular degeneration and concurrent chronic peripheral uveitis that would include intravitreal injection of Lucentis and cryocerclage of the peripheral retina. MATERIAL AND METHODS: A total of 75 patients were examined and divided into 2 groups: the main group (37 patients) and the controls (38 patients). Patients from the main group underwent the new combination surgery, while the controls received intravitreal Lucentis alone (peripheral uveitis was managed therapeutically). RESULTS: It has been found that the new combination method provides a significant and stable improvement in visual acuity (by a factor of 10) and a decrease in the area of central scotoma (by a factor of 2.95) in the postoperative period. The period needed for recovery in the central retinal thickness is also 1.6 times shorter. CONCLUSION: The new combination surgery for wet age-related macular degeneration and concurrent chronic peripheral uveitis provides rapid reduction of inflammation in the extreme periphery of the fundus and a 1.5 times faster (as compared to traditional methods) primary restoration of topographic anatomy of the retina in the macular region.

Expansion of Severely Constricted Visual Field Using Google Glass.

Google Glass (Google, Mountain View, CA) is a wearable technology with a computer and camera mounted on an eyeglass frame. The camera captures wide-angle video and projects it onto a prism located in the right superior temporal quadrant of the wearer's visual field. The authors present a case of an individual who used Google Glass' video projection feature to expand his severely constricted right visual field. This patient reported improved ambulatory navigation. Using Google Glass, the patient's peripheral vision, measured using Goldmann kinetic perimetry, expanded impressively. Based on these preliminary results, the authors propose further characterization on the potential utility of such head-mount display technology as a tool to improve the lives of patients with severely constricted visual fields. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:486-489.].

A congruous superior quadrantanopsia following a junctional scotoma induced by asperogillosis.

A 69-year old man presented to us with decreased vision in his right eye and a relative afferent pupillary defect. Under the presumption that he was suffering from retrobulbar optic neuritis or ischemic optic neuropathy, visual field tests were performed, revealing the presence of a junctional scotoma. Imaging studies revealed tumorous lesions extending from the sphenoid sinus at the right superior orbital fissure, with erosion of the right medial orbital wall and optic canal. Right optic nerve decompression was performed via an endoscopic sphenoidectomy, and histopathologic examination confirmed the presence of aspergillosis. The patient did not receive any postoperative antifungal treatment; however, his vision improved to 20 / 40, and his visual field developed a left congruous superior quadrantanopsia 18 months postoperatively. A junctional scotoma can be caused by aspergillosis, demonstrating the importance of examining the asymptomatic eye when a patient is experiencing a loss of vision in one eye. Furthermore, damage to the distal optic nerve adjacent to the proximal optic chiasm can induce unusual congruous superior quadrantanopsia.

[Central scotoma and blurred vision in a patient with Crohn's disease]. / Zentralskotom und Verschwommensehen bei bekanntem Morbus Crohn.

A 42-year-old male patient was transferred as an emergency with suspected retrobulbar neuritis due to a central scotoma. He had suffered from reduced vision in the right eye in the past. The diagnosis was chronic recurrent retinopathy centralis serosa due to many years of corticosteroid intake for bronchial asthma and Crohn's disease. Photodynamic therapy was carried out on the right eye and the corticosteroids were discontinued.

Age-related macular degeneration: an update on treatment.

Age-related macular degeneration is a chronic disease leading to progressive central vision loss. It is the leading cause of irreversible blindness in the United States, most commonly affecting white Caucasians aged more than 55 years. Typical symptoms include decreased central vision, central scotoma, and metamorphopsia. Patients with acute loss of vision should be promptly referred to an ophthalmologist. New antiangiogenic therapies have significantly improved visual prognosis in these patients.

Campimetria computarizada con el analizador de campos visuales humphrey: estudio de 350 casos / Computarized perimetry with the of humphrey visual field: study of 350 cases

Se reportan 350 historias médicas de pacientes referidos a una consulta privada en el Centro Médico de Cracas, para evaluación del campo visual mediante campimetria computarizada, entre 1992 y 1995. Un total de 700 ojos fueron evaluados. Se utilizo el analizador computarizado de campos visuales humphrey. Del total de pacientes, 63 por ciento correspondieron al sexo femenino y 37 por ciento masculino. La edad promedio fue de 47,3 años. El motivo de consulta más frecuente fue el control de glucoma (50 por ciento), seguido de pacientes a los cuales no se les preciso el motivo de consulta (24 por ciento) y sospecha de glaucoma (21 por ciento). En cuanto a los hallazgos, 59 por ciento correspondieron a campos visuales normales, seguido de escotomas paracentrales con 13 por ciento, escotoma arcuato en área de Bjerrum con 12 por ciento, aumento de la mancha ciega con un 6 por ciento. 174 pacientes fueron evaluados para control de glaucoma (348 ojos), 59 por ciento con hallazgos positivos (40 por ciento de escotomas arcuatos en áreas de Bjerrum, 32 por ciento de escotomas o defectos paracentrales, 15 por ciento aumento de la mancha ciega). 74 pacientes (148 ojos) fueron evaluados por sospecha de glaucoma, 27 por ciento con hallazgos positivos en la campimetria (39 por ciento de escotomas o defectos paracentrales, 19 por ciento de aumento de la mancha ciega, 13 por ciento escotomas arcuatos en área de Bjerrum, 8 por ciento escalón nasal, 8 por ciento campos visuales tubulares y 8 por ciento de cambios en la sensibilidad retiniana)

A double-blind, placebo-controlled trial of fish oil concentrate (MaxEpa) in stroke patients.

The feeding of large amounts of fish or fish oils to healthy volunteers has been shown to reduce plasma triglycerides and platelet aggregation, and prolong the skin bleeding time. To determine whether a commercially available marine oil (MaxEpa) would have similar effect in stroke patients, we performed a double-blind, placebo-controlled study in 11 patients (7 men, 4 women) with completed stroke (7) or transient ischemic attacks (TIA's) (4). Ten 1 ml opaque capsules containing either MaxEpa or olive oil were given daily for 6 weeks, and then the patients were crossed-over. Aspirin was avoided during the trial. The data were analyzed by paired-sample t-tests. A significant reduction was found in serum triglycerides, but total serum cholesterol and HDL cholesterol were unaffected. The bleeding time was modestly prolonged after 3 weeks of treatment, but the differences between MaxEpa and olive oil treatments were not significant at 6 weeks. Aside from an increase in collagen-stimulated malondialdehyde formation no other statistically significant changes in hemostatic factors were observed. We conclude that the ingestion of up to 10 MaxEpa capsules daily for 6 weeks has little influence on such established risk factors as cholesterol concentration and platelet function in patients with stroke or TIA's.

Restitution of visual field in patients with damage to the geniculostriate visual pathway.

Previous experiments have investigated the effect of specific practice on partially blinded monkeys after striate cortex lesions. Similar procedures were adapted for patients suffering homonymous field defects due to geniculostriate damage. Both methods, light detection and saccadic localization, led to an enlargement of the visual field. The amount of this enlargement depended on the eccentricity of the field border as well as on the level of light sensitivity in the region between the intact field and the scotoma. Recovery of visual field included the reappearance of various visual functions (e.g. visual acuity, color identification). In periods without training visual field did not recover. It is hypothesized that recovery can take place at the level of the striate cortex, and is mediated by structures interacting with the striate cortex, e.g. the superior colliculus.

Spectacle correction of alphakia: how aspheric do they have to be?

A comparison of spheric and aspheric cataract lenses was carried out on 28 patients with uncomplicated surgery. Lenses were evaluated with respect to eccentric acuity, visual field, ring scotoma, magnification, distortion, and subjective preferences. The results suggest that design differences can be applied to specific visual tasks, thus improving clinical lens prescribing.