Summary. In this article the clinical case of ocular pathology with a complete analysis of ophthalmological data were presented, that can be interested to ophthalmologists. Insufficient information about the clinical features and different diagnosis of neurological diseases, their frequent occurrence, similarity of the ophthalmologic signs can cause a large number of misdiagnoses and incorrect choice of approach for the treatment. Examination and analysis of symptoms, data of anamnesis, survey results, differential diagnosis to summarize the final diagnoses is of great importance for the young and experienced ophthalmologists.
Keywords: intraocular pressure, glaucoma, optic neuropathy, visual field loss, normal pressure glaucoma.
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1Fatih University Medical School, Ankara, Turkey 2Inonu University Medical School, Malatya, Turkey
ABSTRACT
Purpose. To compare the 24-h IOP reductions induced by latanoprost, travoprost, and bimatoprost in eyes with exfoliation syndrome (XFS) associated with ocular hypertension (OH).
Methods. This was a prospective, randomized, single masked, and parallel design study with 15 patients in each treatment group. After washout of any previous medications, each patient underwent a baseline 24-h IOP curve testing at 06:00, 09:00, 12:00, 15:00, 18:00, 21:00, and at 24:00 (midnight) hours. Patients were then randomized to receive latanoprost, travoprost, or bimatoprost once a day for 3 months. The 24-h curve testing was repeated at first week, and first and third months.
Results. Maximal and minimal IOP was recorded at 06:00 and 18:00–21:00 hours. There was no significant difference among treatment groups at any time-point except for the first week. At the first week, the travoprost group had significantly lower IOP levels than the latanoprost and bimatoprost groups. All medicines significantly lowered 24-h IOP from baseline (P = 0.001 for each). Although there was no significant difference in IOP reduction among groups at first week and first month, bimatoprost reduced the 24-h IOP (7.9 ± 1.4) more than travoprost (6.6 ± 0.5) at the end of the third month (P = 0.003). The mean 24-h range of IOP was lowest with travoprost in all visits, and between-group differences was significant for travoprost vs latanoprost (P = 0.007) and travoprost vs bimatoprost (P = 0.001) at the third month.
Conclusion. Latanoprost, travoprost, and bimatoprost were effective in reducing the 24-h IOP in patients with XFS and OH, and more research is required with a larger study.
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Department of Ophthalmology, Medical Faculty Mannheim of University of Heidelberg, Germany
The Keynote Lecture – dedicated to Prof. Harvey Lincoff, MD who had passed away November 25, 2017 –, was delivered during the International Conference “Vascular and Endocrine Eye Pathology”, at Kiev, Ukraine, March 1, 2018.
In the subsequent review I will present the various techniques for repair of a primary retinal detachment, which developed over the past 85 years in reattaching the retina.
The 1st conceptual progress in the treatment of a retinal detachment was made by Gonin in 1930 [1]. He postulated that a break is the cause of a retinal detachment. He applied Ignipuncture around the break. The reattachment rate increased from practically 0 % to 57 %.
However, this precise localization of the break was very difficult and therefore, already in 1931, Guist and Lindner [2, 3] circumvented this precise localization of the break by placing many diathermy coagulations – and this as a kind of barricade – posterior to the break to prevent a redetachment. In 1932 Safar [4] placed short perforating pins in a bar or single in a semicircle posterior to the break and touched them with a diathermy electrode to create a barrier or a so-called barricade of coagulations. Drainage occurred when the pins were removed. With this barrier operation retinal reattachment increased to 70 %, but redetachment occurred again. Why? Because the retinal break was not sealed off sufficiently.
The 2nd conceptional progress in the treatment of a retinal detachment evolved with Rosengren in 1938 [5]. He limited again the coagulations to the area of the break, but in addition after drainage of the subretinal fluid, he added an intraocular air bubble to tamponade the break abinterno. Thus, retinal reattachment increased to 77 %, and this was already the case in 1938!