The Effect of High dose Corticosteroid Therapy on the Optic Nerve Head Blood Flow in Experimental Traumatic Optic Neuropathy

The objective of this study was to establish the effect of high dose steroid therapy in traumatic optic neuropathy with Heidelberg Retina Flowmeter(HRF) to detect the changes of optic nerve head bleed flow. HRF permits the noninvasive assessment of the blood velocity, volume and flow(flux) in a sample volume of the nerve head. Such measurements were performed in two groups of experimental traumatic optic neuropathy rabbits. We experimentally damaged the optic nerves of ten white rabbits with a Hartman mosquito. The first group(n=5) was intravenously infected with 0.25mg/kg dexamethasone every six hours for a 48 hour period. The second group(n-5) was used as controls. Both groups were tested before operation, 1 week, 1 month, and 2 months later Experimental optic nerve damage created a significant decrease in optic nerve head blood flow 50.51%(p=0.001), with blood volume decreased by 46.02%(p=0.001) and blood velocity reduced by 43.12%(p=0.002) compared to the baseline value. After 2 months of high dose corticosteroid therapy, optic nerve head blood flow was increased by 76.90% (p=0.012), blood volume 77.53%(p=0.012)and blood velocity 47.21%(p=0.012) as compared to control group. The high dose corticosteroid therapy improved the optic nerve head blood flow as demonstrated in traumatic optic neuropathy. HRF may be used to assess the therapeutic responses in traumatic optic neuropathy under variable conditions.

A Case of Pulmonary and Retroperitoneal Lymphangioleiomyomatosis / 결핵

Lymphangioleiomyomatosis, a rare disease in women of childbearing age, is the result of benign nodular hypertrophy of the smooth muscle of the lypmhatics and other tissues of the abdomen and thorax. We report a 36-years-old woman with pulmonary and retroperitoneal lymphangioleiomyomatosis who responded with hormone treatment. She developed vaginal pruritis and a pelvic ultraound was done given her significant past medical history. Ultrasound examination demonstrated a large mass in the right side of her pelvis. Therefore she was admitted to St. Michael's Hospital in Toronto for laparoscopy. Result of cytology was to be consistent with the diagnosis of retroperitoneal lymphangioleiomyomatosis. High resolution CT sacn of the thorax demonstrated multiple small cystic lesions, without associated nodularity compatible with a diagnosis of pulmonary lymphangioleiomyomatosis. She has been taking Provera tablets l00mg po tid since Dec. 15, 1993. We have given her a prescription for Depo provera 500mg IM monthly since she came back to Korea, and made arrangements for regular follow up monthly. We performed chest X-ray, CT of chest(high resolution), abdomen and pelvis, pulmonary function tests and arterial blood gas analysis. Chest X-ray and CT findings showed no significant change since July. 20, 1993.