The Effect of Sympathectomy on Circardian Rhythm of Intraocular Pressure in Rat

PURPOSE: The present study was undertaken to determine the 24 - hour pattern of intraocular pressure (IOP), and to reveal the effect of unilateral decentralization on circardian rhythm of IOP in eyes of rats. METHODS: Nine male Sprague - Dawley rats were exposed to a 12 - hour light / dark cycle for 3 weeks. 24-hours IOP pattern was measured at six time points (8, 12, 16, 20, 24, and 4 circardian time) by Tonopen XL tonometer in awake state. After unilateral sympathectomy (cervical ganglionectomy), IOP measurements were performed at the same time points on post-operation 1, 2, 3, and 4 weeks. RESULTS: 24 - hour IOP pattern of rats showed a rhythmic pattern that appeared to be sinusoidal with 12 - hour light / dark cycle. IOPs were low during the light phase and high during dark phase. After unilateral sympathectomy, the circardian rhythm of IOP was maintained in control eyes. But in sympathecotmized eyes, the circardian thythm of IOP was loss. CONCLUSIONS: These results show that sympathetic nervous systems contribute to the circardian rhythm of IOP in rats.

Coil Embolization Via a Superior Ophthalmic Vein Approach of Carotid Cavernous Sinus Fistula

PURPOSE: The result of embolization via an external superior ophthalmic vein approach of carotid cavernous sinus fistula was first described around 1970s. We report a case of coil embolization of carotid cavernous sinus fistula using a superior ophthalmic vein approach. METHODS: A 70-year-old female had a 3-month history of headache, periocular pain, and diplopia. Diagnostic orbital contrast-enhanced CT, brain MRI and contrast-angiography and cerebral angiography revealed a carotid cavernous sinus fistula. Fistula occlusion via transfemoral endovascular embolization failed, so we then tried coil embolization using an external superior ophthalmic vein approach of carotid cavernous sinus fistula. RESULTS: The coil embolization via an external superior ophthalmic vein approach was difficult because of venous tortuosity and poor exposure of part of orbital roof area. But, X-ray-guided direct puncture of the superior ophthalmic vein was successful. We thus had good results with coil embolization of carotid cavernous fistula. CONCLUSIONS: The coil embolization via superior ophthalmic vein approach is an effective and challengeable treatment when surgical cauterization or conventional endovascular embolization fails. We suggest that there is need to training ophthalmologists to be experienced in external orbital surgery.