Oscillatory potentials in diabetic retina without retinopath

To study recordings of oscillatory potentials [OPs] of the electroretinogram [ERG] in diabetic eyes that have no visible fundus alterations to ascertain whether changes in sensitivity are evident when compared with recordings from age-matched controls. OPs of the ERG were measured from 68 eyes of 34 patients with diabetes without retinopathy and from 30 eyes of 15 normal subjects. A reduction in the amplitude of each oscillatory potential, as well as delayed implicit time of each oscillatory potential peak could be found in diabetic patients without retinopathy although not all significant. Decrease in the amplitude of OP1 and summed OP [OP-sum] and also delayed the implicit time of OP1 were seen between diabetic patients with no observable diabetic retinopathy. Patients with diabetes without retinopathy show prolonged latencies in OPs recordings and decreased in amplitudes of OP-1 and OP-sum. This indicates an alteration in inner retinal sensitivity or ischemic change of overall retinal layer that can be explained by an impaired rod-cone interaction

Primary open-angle glaucoma risk factors

The objective of this study was to identify possible risk factors associated with primary open-angle glaucoma [POAG]. A case-control study included patients seen at Rasoul-Akram Hospital ophthalmology clinic. Cases were consecutive patients with confirmed unilateral or bilateral POAG presented during the study period. Controls were a random sample of all other patients aged 30 or more, seen in the same department in the same period who were randomly selected if they fulfilled the inclusion criteria and then matched with the cases by age and sex. Data on demographic, anthropometric as well as medical characteristics were collected from 191 subjects, by interview and medical examination. Sixty consecutive patients with POAG and 131 controls were chosen. Odds ratios [OR] are calculated for the relation between POAG and family history of glaucoma, body mass index, hypertension, diabetes mellitus. cigarette smoking, migraine, and refractive error Chi-square and student t tests were used. Results indicated the following: family history of glauccma: OR: 35, 95% Cl: 4.57-282.43, P<0.0001, hyperopia: OR: 0.432, 95% Cl: 0.209-0.893, P=0.021, hypertension: OR: 1.46, 95% Cl: 0.78-2.73, P=0.223, body mass index: P=0.378 [student t test], migraine: OR: 0.46, 95% Cl: 0.098-2.23, P=0.507, and cigarette smoking: OR: 1.81; 95% Cl, 0.747-4.41; P= 0.184. This study replicated the finding that family history is a major risk factor for POAG [when adjusting for age and sex], while it failed to show that hypertension, diabetes mellitus, myopia, cigarette smoking, migraine, and body mass index to be associated with POAG. It also suggested a protective role for hyperopia in POAG

Iris-supported artisan phakic intraocular lenses for treatment of moderate to high myopia

To evaluate the efficacy and safety of the Artisan Phakic Intraocular Lens [PIOL] for the correction of high myopia. In this prospective study of 22 eyes of 14 patients with high myopia, Artisan PIOLs [Ophtec BV] were implanted. Uncorrected visual acuity [UCVA], best corrected visual acuity [BCVA], refraction, astigmatism, safety, and predictability were analyzed. The mean of preoperative spherical equivalent was -11.1 +/- 3.3 D. An Artisan myopia lens was implanted in 28 eyes of 14 patients with preoperative myopia ranging from -6.0 to -20.0 D. The mean of patient age was 22.7 +/- 4.3 years. At three months follow-up, all eyes had a postoperative refraction within +/- 1 D emmetropia. Mean uncorrected visual acuity improved from less than 20/200 to 20/50, and mean best corrected visual acuity improved from 20/39 to 20/30. The mean endothelial cell loss was 4.45% at three months, which was not significant. Postoperative complications included anterior chamber reaction in 10 [45%] patients that resolved with medical treatment in all of them. No other serious complications developed in any of the treated eyes during follow-up period. Artisan PIOLs can correct moderate to high myopia with good refractive results. There were no serious complications in this study

Concomitant carotid-cavernous fistula, chorioretinitis sclopetaria, and optic nerve transection

A 15- year-old boy with history of BB gun injury to his left eye was referred to our center. His visual acuity was no light perception in the left eye. Ocular findings were severe proptosis, conjunctival injection, and conjunctival vascular tortuosity. Fundus examination revealed an extensive inferior chorioretinal scar compatible with chorioretinitis sclopetaria. A distinct bruit was detected by left orbital auscultation. Orbital and brain CT- scan showed transected optic nerve by the BB gun pellet which lodged at the left parasellar area. Cerebral angiography showed a high flow direct carotid-cavernous fistula that was successfully treated by endovascular embolization. This patient is the first reported case of concomitant carotid-cavernous fistula, optic nerve transection, and chorioretintis sclopetaria due to BB gun injury

Delayed onset bacterial keratitis after implantation of intrastromal corneal ring segments

The incidence of microbial keratitis after Intacs implantation is extremely low and channel infection has been infrequently reported. We present a 23-year-old woman with keratoconus of both eyes who underwent implantation of two intrastromal corneal ring segments [Intacs, KeraVision, Inc., Fremont, CA, USA] in the right eye. After 2.5 months, the patient presented with decreased vision, inflammation, and stromal infiltration at the lower channel site of Intacs. Culture was positive for Escherichia coli. The patient was treated with removing of lower segment of Intacs, and subconjunctival and topical antibiotics. The keratitis resolved, leaving opacity and thinning and mild neovascularization in the lower channel site. Our case report illustrates the risk of microbial keratitis even months after Intacs implantation. It shows need for long-term postoperative attention by both patient and physician