ABSTRACT
To evaluate the effect of early drainage of delayed suprachoroidal hemorrhage [SCH] after glaucoma surgery. These study reports seven cases of delayed supra-choroidal hemorrhage following glaucoma surgery managed with early drainage. In this series instead of waiting for 7 to 14 days for clot lysis, the SCH was drained from the suprachoroidal space immediately after diagnosis. Seven eyes of 7 patients with delayed SCH including 4 men and 3 women were enrolled in the study. Median age was 42.57 +/- 29.61 years and mean follow up duration was 21.43 +/- 13.35 months. Immediately after diagnosis, choroidal tap and anterior chamber reformation were performed for all the patients. Intraocular pressure [IOP] decreased significantly after intervention. At final follow up, mean visual acuity was 1.08 +/- 0.31 LogMAR. Immediate surgical drainage of suprachoroidal hemorrhage seems to be an effective and safe method for treatment of delayed SCH; and it may decrease the inflammation from the entrapped blood in suprachoroidal space and reduce complications and additional procedures. Larger trials are recommended for further evaluation
ABSTRACT
To determine whether angiotensin II levels in aqueous humor is related to diabetes mellitus and to evaluate the effect of captopril. In a case-control study, aqueous humor samples were obtained during cataract surgery from 58 eyes of 58 patients, of which 37 were diabetic. From these latter subjects, 16 had taken captopril [captopril group] and 21 had not taken nay angiotensin converting enzyme [ACE] inhibitor [non-captopril group]. Angiotensin level was assessed by radimmunoassay. Severity of macular edema was evaluated by clinical examination after surgery. Mann Whitey U test was used to assess the statistical difference of mean angiotensin II and Hb AIIC levels between the groups and Spearman's rank-order correlation coefficient was used to evaluate correlation between aqueous levels of angiotensin II and of macular edema. The aqueous levels of angiotensin II was significantly higher in diabetic patients [31.0 +/- 7.3 pg/ml] compared to non-diabetics [6.28 +/- 2.8 pg/ml]. [P<0.0001] Aqueous concentration of angiotensin II in the captopril group [16.3 +/- 6.5 ug/ml] was significantly lower than in the non-captopril group [75.73 +/- 9.36]. [P<0.0003] Severity of macular edema was significantly lower in the captopril group as compared to the non-captopril group such that 68.75% of the captopril groups vs 33.3% of the non-captopril group had macular edema [P<0.005]. These finding suggest that the aqueous level of angiotensin II is significantly correlated with the severity of macular edema and may have a role in pathogenesis of macular edema in diabetic patients. It seems that modulation of the rennin-angiotensin system may become a very important target for medical treatment in patients with diabetic macular edema