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

Comparison of the effect of adjuvant 5-fluorouracil, low molecular weight heparin and daunomycin in combination with triamcinolone during vitrectomy in advanced retinal detachment

To compare the success rate of adjunctive 5-fluorouracil [5-FU] and low molecular weight heparin [LMWH], and daunomycin in combination with triamcinolone during vitrectomy in eyes with retinal detachment [RD] and proliferative vitreoretinopathy [PVR]. In this prospective randomized clinical trial, 69 eyes from 69 patients with RD and PVR [grade B or C] randomized to 3 groups. Group 1: received 5-FU and LMWH [200 microgram/ml 5-FU and 5 IU/ml LMWH, Fragmin]; group 2: received daunomycin [0.5 mg] in 500 cc infusion fluid; and group 3: control group. In all patients, 0.1 cc intravitreal triamcinolone was used during vitrectomy. The patients visited on day 1, week 1, month 1, 3 and 6. Best corrected visual acuity [BCVA] and retinal status compared in the 3 groups. Complete data were available for 60 out of 69 patients. Thirty five patients [58.3%] were male and 25 patients [41.7%] were female. The patient age range was 19-84 years and the mean age was 49. The groups did not have significant difference in age, sex, duration of detachment, severity of PVR, preoperative visual acuity [V/A], lens status, type of tamponade and encircling band and buckle. Postoperative V/A and retina status also was the same in the 3 groups. Perioperative infusion of 5-FU, LMWH and daunomycin does not significantly increase the success rate of patients with RD and PVR comparing to control group. Although visual acuity improvement and retina reattachment rate in group 1 and 2 were better than control group, but statistical analysis failed to show significant difference between the 3 groups

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

case series study of leber's congenital amaurosis: Clinical description and ERG findings

To evaluate the incidence of Leber's Congenital Amaurosis [LCA] in low vision children referred to electrophysiology ward of Farabi Eye Hospital, and review the clinical features of disease and Electroretiongraphy [ERG] test values to confirm the diagnosis and severity of the disease in Iran. Prospective observational case series. Two-hundred and fifteen cases of low vision infants and young children were referred to electrophysiology ward of Farabi Eye Hospital during 18 months. Clinical LCA diagnosis was made and ERG tests were done and LCA diagnosis was confirmed. The symptoms, signs and the results of eye examination and ERG findings were recorded. The mean age of the patients was 27.43 [range, 1-120 months]. Among low vision patients fourteen percent of patients had LCA. Fifty-four percent of the patients were female. Nystagmus and low vision were the two most common clinical manifestations of these patients. Hyperopia was the main refractive error [54.80%] and mild abnormalities in fundus examinations were found in 67.70% of cases. In nearly 90% of cases consanguinity was found. ERG was flat or unrecordable in more than 90% of cases, but in less than 10% of cases with recordable curves, severe decrease in amplitude of waves was encountered. ERG confirmed LCA diagnosis in 31 out of 37 patients [positive predictive value of 83.7%]. The incidence of LCA in low vision children is similar to other studies. ERG helped in confirmation of presence or absence of overall retinal dysfunction in the majority 31/37 [83.7%] of LCA patients. It can differentiate these cases from other cases with poor vision in infantile age but genetic testing is recommended