Evaluation of Agreement between HRT III and iVue OCT in Glaucoma and Ocular Hypertension Patients.

Purpose. To determine the agreement between Moorfields Regression Analysis (MRA), Glaucoma Probability Score (GPS) of Heidelberg retinal tomograph (HRT III), and peripapillary nerve fibers thickness by iVue Optical Coherence Tomography (OCT). Methods. 72 eyes with ocular hypertension or primary open angle glaucoma (POAG) were included in the study: 54 eyes had normal visual fields (VF) and 18 had VF damage. All subjects performed achromatic 30° VF by Octopus Program G1X dynamic strategy and were imaged with HRT III and iVue OCT. Sectorial and global MRA, GPS, and OCT parameters were used for the analysis. Kappa statistic was used to assess the agreement between methods. Results. A significant agreement between iVue OCT and GPS for the inferotemporal quadrant (κ: 0.555) was found in patients with abnormal VF. A good overall agreement between GPS and MRA was found in all the eyes tested (κ: 0.511). A good agreement between iVue OCT and MRA was shown in the superonasal (κ: 0.656) and nasal (κ: 0.627) quadrants followed by the superotemporal (κ: 0.602) and inferotemporal (κ: 0.586) sectors in all the studied eyes. Conclusion. The highest percentages of agreement were found per quadrant of the MRA and the iVue OCT confirming that in glaucoma damage starts from the temporal hemiretina.

A comparison of antibiotic release between a cement scaffold, a perforated cement scaffold and a cement scaffold mixed to calcium sulphate: in vitro study.

One of the most dangerous possible complications in joint replacement is infection due to bacteria adhere to prosthesis surface making biofilm difficult to erase. The gold standard treatment consists in prosthesis removal, placement of antibiotic-impregnated cement spacer and systemic antibiotics therapy. When the infection heals a new prosthesis is implanted. The antibiotic-impregnated spacer is important to maintain the prosthesis space and to guarantee a local high concentration of antibiotics. The release of the antibiotic by the cement happens at its surface so that, increasing this, the concentration of antibiotic should be increased as well. The aim of the present study is to verify the different release of antibiotic in plasma by different groups of scaffolds to identify the best solution to make the antibiotic spacer in septic prosthesis revision. Six groups of three antibiotic impregnated cement cube-shaped have been done. The first, made by only antibiotic and cement, the second by a double concentration of the antibiotic and cement, the third made by the antibiotic cement and perforated in every surface with a needle before hardening, the fourth similar to the previous but with a double concentration of antibiotic, the fifth by antibiotic-impregnated cement mixed with calcium sulphate pellets, the sixth similar to the previous with a double concentration of antibiotic. The cubes were immersed in plasma and the concentration of antibiotic released valued at specific times. The perforated cement scaffold demonstrated the best result during the first four weeks.

A new method of biofeedback in the management of low vision.

Twenty-eight patients with low vision were enrolled into the study. A preliminary study was carried out on 18 eyes of 13 patients with low vision who underwent visual rehabilitation with a new instrument for biofeedback (BF) applied to vision; improved biofeedback integrated system (Ibis). Successively, eight patients (16 eyes) with bilateral low vision were subjected to biofeedback in one eye. The experimental and control eye were evaluated separately. Then a placebo training was developed on seven patients (12 eyes). Visual acuity, colour vision, automated perimetry, contrast sensitivity and flash VEP were evaluated. A brief review of the literature and the possible mechanisms behind the results are discussed.

Fox's modified technique using the Mersilene mesh sling in the management of blepharoptosis.

BACKGROUND AND OBJECTIVE: Frontalis suspension is the best surgical procedure for severe ptosis with poor or absent levator muscle function. In addition to autologous fascia lata, a variety of materials are available for suspension. The authors describe the use of Mersilene mesh slings developed to overcome the problems of failure, slippage, and extrusion commonly associated with various suspensory materials. PATIENTS AND METHODS: Brow suspension was performed in 20 ptotic eyelids of 14 patients. All patients had severe ptosis with levator function of 4 mm or less. The surgical technique used was a modified version of the method originally described by Fox using the Mersilene mesh sling. RESULTS: The improvement in lid height was evaluated by preoperative and postoperative vertical aperture measurements and ranged from 2 to 5 mm (average 3.5 mm). The results were maintained in all cases during a follow-up period of 18 months. CONCLUSION: The good functional and cosmetic results suggest that Fox's modified technique using the Mersilene mesh sling has a definite place in ptosis management.

The influence of age on the flash visual evoked potentials.

The effect of age on flash visual evoked potentials was investigate in 148 normal subjects aged 6 yo 84 years. The occurrence of the P1 wave progressively increased with age, while the P2 wave was recordable in all the subjects. There were significant effects of age on the P2 latency (p < or = 0.01). The latency of the N1 and N2 waves significantly changed with age. In particular, the N2 wave that occurred in the absence of the P1 wave had a latency similar to that of the N1 wave was present. We suggest that the cases apparently without the P1 wave could be explained with a merging of this was with the P2 wave in a major single deflection.

Ferning of aqueous humor in the pseudoexfoliation syndrome.

The authors report on the results obtained in the crystallization of the aqueous humor in 6 patients suffering from cataract with pseudoexfoliation syndrome. The principle characteristics of the aqueous in these cases are described and are compared with the features of aqueous humor in 20 cases of uncomplicated cataract. Tetragonal shaped masses of material with a distinct tendency to localization in the intersections of fern patterns were demonstrated in the crystallized aqueous from patients with pseudoexfoliation syndrome. These aggregates most probably correspond to exfoliation material.

Atypical retinitis pigmentosa: a report of three cases.

We report three cases of patients with atypical retinitis pigmentosa (RP): sector bilateral, sector unilateral, and inverse. Clinical and functional features of perimetry, color vision testing, adaptometry, electroretinography, fluorangiography, and audiometry are described. One patient had isolated RP; the others had syndromic RP, combined with defective hearing and celiac disease. Two of these patients were followed for three years and one for 13 years. Their disease courses during the period of observation are discussed.

Flash visual-evoked potentials and flash electroretinography in the preoperative visual prognosis of eyes with cataracts.

This study evaluated the reliability of flash visual-evoked potentials and flash electroretinography in the prognosis of postoperative visual acuity after cataract extraction. We tested 94 patients with cataract in whom the preoperative visual acuity ranged from light perception to 3/10. On the basis of the electrophysiologic tests, we formulated three types of preoperative visual prognosis: high, intermediate, and poor. To assess the postoperative visual acuity, all subjects were followed for at least three months after cataract extraction. Visual acuity was subdivided in three arbitrary classes: less than or equal to 1/10, between 2/10 and 5/10, and between 6/10 and 10/10. Finally, we evaluated the reliability of our preoperative prognosis. Statistical analysis of our results (using the chi-square test) showed our predictions were highly significant for the total sample, revealing a strict correlation between our prognosis and the final visual acuity.

A technical variation of posterior chamber IOL implantation.

In posterior chamber intraocular lens (IOL) implantation, one of the most delicate phases is placing the loops in the capsular bag or in the ciliary sulcus. We describe a technique to simplify the phase of IOL insertion by tying the superior loop with a nylon suture. No changes to the lens and no special instruments are required.

Macrodacryocystography and echography in diagnosis of disorders of the lacrimal pathways.

The comparative advantages and limitations of macrodacryocystography and echography for evaluating disorders of the lacrimal system are discussed and illustrated. In our opinion, macrodacryocystography is superior to ultrasonography in identifying the site and the nature of anatomical and functional abnormalities and in evaluating the effectiveness of treatment after surgery. Echography, however, is particularly useful in the study of the lacrimal sac, especially if an occlusion of the common canaliculus prevents filling of the lacrimal sac, thus ruling out macrodacryocystography.