Positional Change of Intraocular Pressure and Its Relationship to Ocular Pulse Amplitude

PURPOSE: To investigate the postural change of intraocular pressure (IOP) from sitting to supine position and determine the relationship to other ocular parameters including ocular pulse amplitude (OPA) in glaucoma suspect and open angle glaucoma patients. METHODS: The present study included 46 eyes of 46 patients. First, we measured IOP and OPA using Goldmann applanation tonometer (GAT), Pascal dynamic contour tonometer and TonoPen(R). Using TonoPen(R), the IOP was measured immediately after the subjects were placed in a supine position and 10 minutes and 30 minutes thereafter. We also investigated the correlation between positional change of IOP and axial length (AL), refractive error (RE), and OPA. RESULTS: IOPs of patients in a sitting position measured with GAT and TonoPen(R) were 15.3 +/- 3.3 mm Hg and 16.6 +/- 2.9 mm Hg, respectively, and OPA was 2.57 +/- 0.89 mm Hg. IOPs measured with TonoPen(R) were 17.6 +/- 2.9 mm Hg immediately after position change, 18.2 +/- 3.7 mm Hg after 10 minutes and 17.5 +/- 2.7 mm Hg after 30 minutes. Each IOP change was statistically significant and the largest change was after 10 minutes. Changes of IOP after 10 minutes were positively correlated with OPA (R = 0.340) and RE (R = 0.330) and negatively correlated with AL (R = -0.410). CONCLUSIONS: When placed in a supine position, the IOP of patients increased and then decreased over time. Positional IOP change was influenced by AL and OPA and variable hemodynamic factors and apparently influenced OPA and ocular perfusion pressure.

A Case of Neuromyelitis Optica with Paraneoplastic Syndrome in Hepatocellular Carcinoma

PURPOSE: We report a case of neuromyelitis optica (Devic's syndrome) with hepatocellular carcinoma. CASE SUMMARY: A 70-year-old male with hepatocellular carcinoma presented with bilateral visual loss. A relative afferent pupillary defect was not observed in either eye due to bilateral mydriasis. On brain MRI, there was no specific finding, however, on spine MRI, multiple and severe myelopathies were observed. After high-dose methylprednisolone pulse therapy, the visual acuity was 0.03 in the right eye and counting fingers at 30 cm in the left eye. CONCLUSIONS: We encountered a case of neuromyelitis optica involving bilateral optic neuropathy in hepatocelluar carcinoma. Therefore, in patients with an optic neuropathy of uncertain etiology, clinicians should consider performing a systemic evaluation.

The Efficacy of Vaccinium Uliginosum for Early Age-Related Macula Degeneration

PURPOSE: To evaluate the effect of Bog Bilberry (Vaccinium uliginosum) extract in eyes with early age-related macular degeneration (AMD). METHODS: Forty-four eyes of forty four patients with early AMD were included in this randomized, double-blinded, and placebo-controlled study. All participants were randomly assigned to either the placebo group (n = 24), or the bog bilberry extract group (n = 20). Before drug administration, an ophthalmic examination which included slit lamp microscopy, best corrected visual acuity, and intraocular pressure was performed, and repeated 1and 3 months after treatment. Objective scatter index, glare and tear film break-up time were checked by Optical Quality Analysis System (OQAS, Visiometrics, Spain) and drusen volume, central macular thickness, and RPE and IS/OS junction thickness were investigated with spectral-domain optical coherence tomography (Spectralis, Heidelberg, Germany). RESULTS: In the bog bilberry extract group, RPE and IS/OS junction thickness was significantly increased compared to the placebo group after 3 months of drug administration. CONCLUSIONS: Bog Bilberry extract may play a favorable role in preventing the atrophic change of RPE and IS/OS junction layer and the progression of early macular degeneration.