Comparison of 180degrees and 360degrees Selective Laser Trabeculoplasty

PURPOSE: To compare the effect and safety of two regimens of Selective Laser Trabeculoplasty (SLT), SLT on 180degrees of trabecular meshwork and SLT with 100 laser spots on 360degrees of trabecular meshwork in patients with primary open-angle glaucoma and ocular hypertension. METHODS: In a retrospective clinical study, the authors compared the pressure-lowering effects of SLT in two groups of patients; group 1 (83 patients) received SLT on 180degrees, group 2 (30 patients) on 360degrees of trabecular meshwork. The clinical outcome indicators included intraocular pressure (IOP) at one day, one week, one month, two months, three months and six months after SLT, and the anterior chamber reaction at post-laser one day. RESULTS: There was no statistically significant difference in the IOP reduction between these two regimens after six months. The anterior chamber reactions in the two groups were significantly different (group 1; 0.61 +/- 0.64, group 2; 1.25 +/- 0.83, p = 0.001). The success rate of group 2 (43.3%) was not different from that of group 1 (31.3%; p = 0.23). CONCLUSIONS: SLT on 180degrees of trabecular meshwork had a similar effect compared to that of SLT on 360degrees of trabecular meshwork in terms of IOP reduction. The authors of the present study suggest that 180degrees SLT is the safest procedure with regard to success rate and complications.

Concentration of Vascular Endothelial Growth Factor After Intracameral Bevacizumab Injection in Eyes With Neovascular Glaucoma

PURPOSE: To study the concentration of vascular endothelial growth factor (VEGF) in the aqueous humor before and after intracameral injection of bevacizumab in eyes with neovascular glaucoma, and to detect the duration of an anti-VEGF effect of bevacizumab in the anterior chamber. METHODS: In this prospective interventional case series, 1.25 mg of bevacizumab was injected into the anterior chamber of five eyes in five neovascular glaucoma patients. Aqueous humor samples were obtained just before intracameral injection of bevacizumab and two weeks after injection. The concentrations of VEGF in the aqueous humor were measured using ELISA. To investigate corneal endothelial damage after intrecameral bevacizumab injection, specular microscopy was performed before injection and two weeks after injection. Slit lamp photo and iris fluorescent angiography was performed to determine the regression of iris neovascularization. RESULTS: After injection, substantial regression of neovascularization or fluorescein leakage was seen in all treated eyes. The VEGF concentrations in the aqueous humor in eyes with NVG were 1181.8+/-1248.3 pg/mL before intracameral injection of bevacizumab. Two weeks after injection, the VEGF concentrations decreased to 33.2+/-12.2 pg/mL (p=0.04, Wilcoxon signed rank test). There were no significant changes in IOP or corneal endothelial cells. CONCLUSIONS: Intracameral bevacizumab injection can remarkably reduce iris neovascularization in neovascular glaucoma patients. VEGF levels were significantly decreased two weeks after injection and corneal toxicity was not observed during short term follow-up.

A Case of Hypopyon Uveitis Associated With Relapsing Polychondritis

PURPOSE: Relapsing polychondritis is an uncommon systemic autoimmune disorder which is characterized by recurrent and often progressive inflammatory episodes involving multiple organ systems, including the ophthalmic, otorhinolaryngeal, respiratory, musculoskeletal, renal, cardiovascular, and dermatologic systems. The most common ocular manifestations are episcleritis and scleritis. Uveitis, especially the nongranulomatous type, has been reported in 3% to 22% of relapsing polychondritis cases. We report uncommon hypopyon uveitis as an ophthalmic finding associated with relapsing polychondritis. CASE SUMMARY: A 56-year-old woman with known relapsing polychondritis presented with ocular pain and redness in the right eye which had developed two months before and was managed for scleritis. However, she developed blurred vision, and hypopyon and vitreous opacity was found. The patient presented to our clinic and we diagnosed her with hypopyon uveitis associated with relapsing polychondritis. The patient was started on systemic steroid therapy consisting of 1% prednisolone acetate, 0.5% moxifloxacin, and 0.5% tobramycin in the right eye. Hypopyon disappeared 8 days following the initiation of treatment, and all symptoms had resolved after 14 days.