The effect of hyperbaric oxygen on intraocular pressure.

The effects of hyperoxia on intraocular pressure (IOP) have been studied in experiments on human beings and animals. The changes occurring in IOP in patients during routine HBO2 therapy are unknown. In this study we investigated IOP changes arising during the HBO2 therapy at 2.5 ATA. Fifty-six patients receiving HBO2 therapy for various reasons were included in the study. Bilateral IOPs of patients measured with the Tono-pen XL (Medtronic, Solan, USA) tonometer before, during and after HBO2 therapy. Average IOPs were 14.85 +/- 3.17 mmHg (range, 10-24), 13.00 +/- 2.97 mmHg (range, 9-21) and 14.74 +/- 3.12 mmHg (range, 10-22), respectively. IOP was reduced significantly during HBO2 therapy and returned its pre- HBO2 levels after therapy. Our data indicated a statistically significant decrease in IOPs during therapy at 2.5 ATA. This decrease was of minor physiological significance in these patients whose baseline IOP values were within the normal range.

The influence of the learning effect on automated perimetry in a Turkish population.

PURPOSE: To evaluate the influence of learning effect on the outcome of automated perimetry and to assess the factors associated with the learning effect in a Turkish population. METHODS: The Swedish Interactive Threshold Algorithm (SITA) standard 30-2 test was performed on a Humphrey Visual Field Analyzer in 102 normal Turkish subjects who had not previously undertaken any form of perimetry. Each subject completed three testing sessions, each separated by at least one day. The SITA standard 30-2 testing sessions included both eyes. The right eye was always tested before left eye. The reliability parameters, test duration and visual field (VF) global indices (mean deviation [MD] and pattern standard deviation [PSD]) obtained from right eyes in the first and third sessions were compared to assess the learning effect. Change in these parameters between the first and third sessions was calculated, and the effect of gender, age and educational level on this change was evaluated. RESULTS: The reliability parameters, test duration and VF global indices each improved between the first and third sessions (P ≤ 0.001). The change in the parameters was greater in subjects over 50 years of age and with an educational level less than high school (P ≤ 0.01). No correlation was found between learning effect and gender. CONCLUSION: In normal Turkish subjects, a significant learning effect was observed during VF testing with the SITA standard 30-2. The learning effect was correlated with age and educational level.

Central serous retinal detachment following glaucoma filtration surgery.

We report the occurrence of central serous retinal detachment in association with hypotony in a patient that had undergone glaucoma filtration surgery. A 35-year-old man, who had a recent closed-globe injury, underwent trabeculectomy with mitomycin C for intractable traumatic glaucoma. On the second day after surgery, the eye became hypotonous and the patient's visual acuity decreased abruptly to counting fingers. Fundoscopy and optical coherence tomography revealed a central serous retinal detachment. Fundus florescein angiography showed choroidal leakage from traumatic perifoveal retinal pigment epithelial defects. Although the hypotony resolved within the first postoperative week, it took 2 months for the central serous retinal detachment to clear. To our knowledge, this is the first reported case of isolated central serous retinal detachment following glaucoma filtration surgery.

[Orbital varix presenting with enophthalmos. A case report]. / Varice orbitaire survenant avec énophtalmie. A propos d'un cas.

We report a 23-year-old patient, presenting with enophthalmos in the left eye. The ophthalmologic examination was normal, except a 3-mm enophthalmos measured using the Hertel's exophthalmometer and an intermittent proptosis observed through the Valsalva maneuver. Orbital imaging tests disclosed a retroocular vascular lesion. A carotis arteriography was performed, and it revealed a tumor with vascular elements presumed to be orbital varix. Ultrasound Doppler examination showed a nonechogenic lesion with an increasing volume during Valsalva. Based on these findings, the tumor was diagnosed as orbital varix. We decided to manage the patient conservatively, in the absence of complications such as proptosis with corneal exposure, optic nerve compression, or esthetically unacceptable appearance. Orbital varix is a vascular anomaly, accounting for 2 % of orbital tumors. It generally presents with an intermittent exophthalmos or orbital hemorrhages. The development of enophthalmos associated with varices, such as reported in our case, is rare.

[Poland-Möbius syndrome associated with lacrimal punctal and canalicular agenesis]. / Syndrome de Poland-Möbius associé à une agénésie des points et des canalicules lacrymaux.

We report the case of a 21-year-old patient who presented with epiphora in the left eye and a bilateral ocular motility problem. The clinical examination revealed bilateral moderate abduction limitation (impairment of the VIth cranial nerve), facial diplegia with amimic face (impairment of the VIIth cranial nerve), punctal agenesis of the left eye, absence of the left pectoralis major muscle, left breast aplasia, and hypoplasia of the left upper limb and hand. Neither the lacrimal puncta nor the canaliculi could be found during surgical exploration of left lacrimal system using operating microscope. Based on these findings, the patient was diagnosed with Poland-Möbius syndrome associated with punctal and canalicular agenesis. Poland-Möbius syndrome is a rare entity characterized by the association of two different syndromes: Poland syndrome and Möbius syndrome. Several abnormalities in association with this syndrome have been published. However, punctal and canalicular agenesis is not among these reported abnormalities.

Near-infrared and short-wavelength autofluorescence imaging in central serous chorioretinopathy.

AIMS: The aim of the study was to compare the results of short-wavelength (SW) and near-infrared (NIR) autofluorescence (AF) in acute central serous chorioretinopathy (CSC). METHODS: Twenty-six eyes of the 26 patients diagnosed with CSC (mean age 37.4 years) were included in this retrospective study. AF images were evaluated and compared with angiographic and ophthalmoscopic findings. Fluorescein angiography and AF imaging were performed using a confocal scanning laser ophthalmoscope. RESULTS: Focally decreased AF at the leakage site was seen in most of the cases with acute CSC (20 of 26 eyes in SW-AF; 20 of 20 eyes in NIR-AF). Twenty-four of the 26 cases had decreased SW-AF corresponding to the area of the serous retinal detachment, while 19 of the available 20 cases had decreased NIR-AF corresponding to the area of the serous retinal detachment. Increased granular AF corresponding to the extent of the former retinal detachment was seen earlier with SW-AF imaging, but disappeared later in the course of disease with NIR-AF imaging. CONCLUSIONS: AF imaging in CSC demonstrates different patterns according to the course of the disease, reflecting RPE and outer retinal changes. Combining two different methods of AF imaging could predict recent or former CSC episodes and may be a non-invasive technique for monitoring CSC and performing differential diagnosis.

Excitation-time-dependent increment in the luminescence of fundus autofluorescence.

AIM: To investigate the excitation-time-dependent increment in luminescence of fundus autofluorescence. METHODS: Fundus autofluorescence (FAF) images were obtained with a confocal scanning laser ophthalmoscope. Consecutive 60 images of each eye were taken at 1 s time intervals immediately after the beginning of argon laser excitation. Twenty-one eyes of 21 normal subjects were enrolled in the study. To analyse the luminescence of fundus autofluorescence, an 80 x 80 pixel square selection was placed in a relatively avascular fundus area of each consecutive image. Individual grey-scale values of the selected areas were recorded, and the time slope was plotted. RESULTS: The time-dependent increment of the autofluorescence was observed in all subjects. The average luminosity value of subjects at the beginning was calculated as 32.5 mean grey value (MGV), and luminosity reached its maximum (45.4 MGV) between 25 and 30 s. CONCLUSION: The excitation-time-dependent increment in FAF luminosity should be taken into account while acquiring FAF images for quantitative, comparative and longitudinal studies.

Relationship between serum soluble E-selectin levels and development of diabetic retinopathy in patients with type 2 diabetes.

OBJECTIVE: To investigate whether diabetic retinopathy is associated with serum soluble E-selectin (ssE-selectin) level in type 2 diabetic patients. MATERIAL AND METHODS: Fifty-six patients with type 2 diabetes classified as Groups A, B, C and D according to grade of retinopathy were enrolled in the study. Sixteen age- and gender-matched healthy control subjects were also enrolled. Levels of ssE-selectin were measured using enzyme-linked immunosorbent assays (ELISAs) in all patients and control subjects. Clinical characteristics and ssE-selectin levels were compared between the groups. RESULTS: There was no statistically significant difference in ssE-selectin levels between diabetic patients and non-diabetic control subjects (p>0.05). There was also no statistically significant difference in levels of ss E-selectin between diabetic subgroups (Groups A, B, C, D) (p>0.05). No correlation was found between ssE-selectin level and HbA1c, or duration of diabetes in the whole group of diabetic patients (r = 0.10, p>0.05 and r = -0.12, p>0.05, respectively). CONCLUSIONS: The study shows that no significant elevation of ssE-selectin occurs in patients with type 2 diabetes in comparison with control subjects. Our results also indicate that there is no statistically significant correlation between ssE-selectin level and the development or grade of diabetic retinopathy.