Correlation Between Ischemic Index of Retinal Vein Occlusion and Oxygen Saturation in Retinal Vessels.

PURPOSE: To evaluate the relationship between the ischemic index and the oxygen saturation in retinal vessels in patients with retinal vein occlusion. DESIGN: Prospective, cross-sectional study. METHODS: We performed a prospective study. The cohort consisted of 43 eyes of 43 patients with retinal vein occlusions (RVO), 23 of whom had central retinal vein occlusions (CRVO) and 20 who had branch retinal vein occlusions (BRVO). We evaluated the retinal vessel saturation using an automatic retinal oximetry device. The retinal ischemic index (ISI) was determined using ultra-widefield fluorescein angiography. RESULTS: Mean arterial saturation (±SD) was 100% ± 11%, mean vein saturation was 52% ±13%, and mean A-V difference was 48% ± 16% in eyes with BRVO. The average ISI in the same group was 0.48 (range 0-1). There was no statistically significant correlation between the retinal ischemic index and retinal saturation in the BRVO group. The affected eye in the CRVO group had a mean arterial saturation of 101% ± 6%, vein saturation of 44% ± 11 % and A-V difference of 58% ± 10%. The average ISI in the CRVO group was 0.54 (range 0-1). A statistically significant negative correlation between ISI and vein saturation was found in the CRVO group (r = -0.686; P =.0003). A significant positive correlation between ISI and the A-V difference was found in the CRVO group (r = 0.893; P <.0001). CONCLUSIONS: Oxygen saturation in the retinal vein and the arteriovenous difference correlated with the ischemic index in CRVO patients. No correlation was found for BRVO patients.

Idiopathic intracranial hypertension in pediatric patients.

PURPOSE: To evaluate retrospectively the features, treatment, and outcome of idiopathic intracranial hypertension (IIH) in children. METHODS: Nine patients, 15 years and younger, diagnosed with IIH. Inclusion criteria were papilledema, normal brain computer tomography or magnetic resonance imaging, cerebrospinal fluid pressure greater than 250 mm H(2)O, normal cerebrospinal fluid content, and a nonfocal neurologic examination except for sixth nerve palsy. RESULTS: Of the nine patients, eight were girls. Five girls were overweight and one boy was obese. The most common presenting symptom was headache (5 patients). Diplopia or strabismus did not occur in our group. Visual field abnormalities were present in all eyes, and severe visual loss resulting in light perception vision occurred in both eyes of one patient. Eight patients were treated medically with acetazolamide alone, and one girl needed a combination of acetazolamide and corticosteroids. This girl also required optic nerve sheath decompression surgery. Resolution of papilledema and recovery of visual function occurred in all patients. CONCLUSIONS: Idiopathic intracranial hypertension in prepubertal children is rather uncommon. Prompt diagnosis and management are important to prevent permanent visual loss.