Prophylactic Effects of a Fixed Dorsolamide/Timolol Combination on IOP Elevation before Intravitreal Anti-VEGF Injection

PURPOSE: The purpose of the present study was to investigate the prophylactic effects of a fixed combination of dorsolamide/timolol on intraocular pressure (IOP) elevation before intravitreal anti-VEGF injection. METHODS: A prospective, randomized clinical trial was conducted on 91 eyes of 91 patients undergoing intravitreal anti-VEGF injection. The eyes were randomly divided into 2 groups, the eyes which had used the fixed prophylactic dorsolamide/timolol combination (group 1, 58 eyes) and the eyes which had not used the combination (group 2, 15 eyes). The IOP was measured one hour and 5 minutes prior to the procedure, 5 minutes interval up to 30 minutes after the procedure and one hour, 1 day, 7 days, and one month after the procedure. The IOP changes were analyzed. RESULTS: The mean 5 minutes and 30 minutes postoperative IOPs were 14.12 +/- 4.18 mm Hg and 10.87 +/- 1.58 mm Hg in group 1 and 28.21 +/- 3.16 mm Hg and 17.48 +/- 2.34 mm Hg in group 2, respectively. After IVBI, the mean 5 min postoperative IOP was 12.17 +/- 1.13 mm Hg in group 1 and 27.12 +/- 3.35 mm Hg in group 2. After IVRI, the mean 5 minutes postoperative IOP was 15.98 +/- 4.14 mm Hg in group 1 and 25.19 +/- 1.04 mm Hg in group 2. CONCLUSIONS: Prophylactic use of a fixed dorsolamide/timolol combination before intravitreal anti-VEGF injection is an easy and safe method of preventing IOP elevation immediately after intravitreal injection of bevacizumab or ranibizumab.

The Distribution of the Extraocular Pulley Smooth Muscle in the Rabbit

PURPOSE: We evaluated the structure, innervation of the extraocular pulley smooth muscle in the rabbit. METHODS: A rabbit was transcardially perfused with physiological saline followed by 4% formalin. The rabbit orbit was dissected en bloc, paraffin processed, and serially sectioned for Hematoxylin-Eosin and Masson's trichrome stain. The distribution of the extraocular pulley smooth muscle was confirmed by immunohistochemistry with human smooth muscle(SM) alpha-actin. RESULTS: We found that the pulley structure consisted of focal condensations of eleastin and collagenous connective tissue in relationship to the rectus muscle in the equatorial Tenon's fascia. The pulley smooth muscle in relation to medial rectus muscle was immunostained with TH and nNOS. CONCLUSIONS: The data support the presence of the extraocular pulley smooth muscle in the rabbit orbit having both parasympathetic and sympathetic innervation.

Right Superior Oblique Paralysis associated with Idopathic Hypertropic Cranial Pachymeningitis

PURPOSE: Idiopathic hypertrophic cranial pachymeningitis (IHCP) is a rare disase, which causes chronic progressive inflammation and thickening of the basal dura mater. We report a case of IHCP associated with superior oblique paralysis and present a review of the literature. METHODS: An 8-year-old boy presented with binocular diplopia and left side head tilting. Suspecting right superior oblique muscle paralysis, an alternating prism test, head tilt test, fundus examinations, neurologic examination, and brain MRI were performed. RESULTS: The brain MRI revealed abnormal enhancement of the right tentorium in the course of the right fourth cranial nerve, leading to a diagnosis of IHCP with paralytic strabismus and the patient was treated with systemic steroid therapy. CONCLUSIONS: We report a case of IHCP with right superior oblique paralysis. Patients with recent onset paralytic strabismus require appropriate neurolgic and neuroimaging examinations.

A Case of Comamonas Acidovorans Corneal Ulcer

PURPOSE: To report a case of a Comamonas acidovarans corneal ulcer treated with antibiotics in Korea. Comamonas acidovarans corneal ulcer has not been previously reported to our knowledge. METHODS: A 70-year-old woman visited our clinic complaining of left ocular pain and decreased visual acuity for six days. We performed a smear and culture on the corneal lesion and treated it with topical and systemic antibiotics. RESULTS: Comamonas acidovorans was cultured from ulcer lesion. Corneal ulcer improved with the administration of ciprofloxacin and tobramycin.