The Effects of Anti-glaucoma Eyedrops on Corneal Hysteresis in Patients with Open-angle Glaucoma and Glaucoma-suspect

Purpose@#We explored the effects of topical anti-glaucoma medications on the corneal biochemical properties of patients with open-angle glaucoma (OAG) and glaucoma suspect (GS patients). @*Methods@#We retrospectively reviewed data on 115 OAG and 98 GS patients (225 and 128 eyes respectively). Corneal hysteresis (CH) was measured using an ocular response analyzer. Factors influencing CH were determined using a generalized estimation equation. @*Results@#The mean CH was lower in OAG than GS patients (p < 0.001). A lower cornea-compensated intraocular pressure, concomitant use of a beta-adrenergic blocker and an alpha2-adrenergic agonist, a higher visual field mean deviation, and a larger central corneal thickness were associated with a higher CH in the OAG group. @*Conclusions@#Concomitant use of a topical beta-adrenergic blocker and an alpha2-adrenergic agonist was associated with a higher CH.

Orbital Apex Syndrome with Perinuclear Anti-neutrophil Cytoplasmic Antibody-associated Pachymeningitis

Purpose@#To report a rare case of perinuclear anti-neutrophil cytoplasmic antibody-associated pachymeningitis presenting as bilateral orbital apex syndrome.Case summary: A 79-year-old female presented with a visual acuity decrease and ophthalmoplegia in both eyes from 1 week prior to her visit. Orbital magnetic resonance imaging showed diffuse hypertrophy and enhancement of the dura mater near the optic canal and superior orbital fissure causing orbital apex syndrome. The serum titer of perinuclear anti-neutrophil cytoplasmic antibody was elevated. Based on these findings, she was diagnosed with pachymeningitis related to perinuclear anti-neutrophil cytoplasmic antibody-associated vasculitis. The antibody titers decreased and ophthalmoplegia recovered after treatment with high dose intravenous steroid injection, cyclophosphamide, and long-term maintenance therapy with oral azathioprine and prednisolone. However, her visual acuity did not improve in either eye. @*Conclusions@#Perinuclear anti-neutrophil cytoplasmic antibody associated vasculitis can present as orbital apex syndrome and should be considered as a differential diagnosis.