ABSTRACT
PURPOSE: We report a case of a patient who underwent uneventful facotrabeculectomy. Right after surgery patient she complained of very poor vision, showing hemorrhage spots scattered throughout the retina. Differential diagnosis is studied. CONCLUSION: An ocular decompression retinopathy should be the first diagnosis; however clinical details and diagnosis tests suggest the ocular ischemic syndrome as the reason of the problem.
Subject(s)
Retinal Hemorrhage/etiology , Trabeculectomy/adverse effects , Aged , Diagnosis, Differential , Female , Humans , Retinal Hemorrhage/diagnosisABSTRACT
Presentamos el caso de una paciente que tras la realización de una facotrabeculectomía sin complicaciones presentó en el postoperatorio inmediato un cuadro caracterizado por la presencia de hemorragias retinianas múltiples con muy baja agudeza visual. Planteamos el diagnóstico diferencial. Discusión: Aunque en un principio el cuadro podría ser sugerente de una retinopatía por descompresión ocular, datos clínicos y pruebas diagnósticas sugieren la existencia de hipoperfusión como causa del cuadro clínico (AU)
Subject(s)
Aged , Female , Humans , Trabeculectomy , Retinal Hemorrhage , Diagnosis, DifferentialABSTRACT
OBJECTIVE: To analyze the relationship between intraocular pressure (IOP) and visual field loss in patients with primary open-angle glaucoma (POAG) and in those with pseudoexfoliative glaucoma (PEXG). DESIGN: A cross-sectional, observational study. PARTICIPANTS: Thirty-one patients with PEXG and 31 patients with POAG that was newly diagnosed were included in this study. MAIN OUTCOME MEASURES: The authors recorded the untreated IOP and the amount of the visual field loss, at presentation, in both study groups. RESULTS: The authors found a significant relationship between IOP and visual field mean deviation (MD) index (P = 0.0001, r = 0.68) in PEXG but not in POAG eyes (P = 0.7). CONCLUSION: The authors found that untreated IOP levels can explain the amount of visual field loss, as measured by the MD index, much better in patients with PEXG than in comparable patients with POAG. Thus, vulnerability of the optic nerve head to increased IOP appears to be different in these two diagnostic categories.
Subject(s)
Exfoliation Syndrome/complications , Glaucoma, Open-Angle/complications , Intraocular Pressure , Vision Disorders/etiology , Visual Fields , Aged , Aged, 80 and over , Cross-Sectional Studies , Exfoliation Syndrome/physiopathology , Female , Glaucoma, Open-Angle/physiopathology , Humans , Male , Middle Aged , Optic Disk/physiopathology , Risk Factors , Vision Disorders/physiopathologyABSTRACT
PURPOSE: The purpose of this study was to compare the hypotensive response of human glaucomatous eyes to 1% pilocarpine solution before and after argon laser trabeculoplasty. METHODS: We designed a prospective, 'repeated measures' study comparing the ocular hypotensive effect of acutely administered 1% pilocarpine solution in 30 medically uncontrolled glaucomatous eyes, before and after argon laser trabeculoplasty. RESULTS: The pilocarpine-induced IOP decrease was 3.6 +/- 0.59 mmHg before argon laser trabeculoplasty, and 1.8 +/- 0.53 mmHg after laser therapy. In both instances, the pilocarpine hypotensive effect was significantly correlated with pretreatment IOP (p = 0.02, r = 0.41 before argon laser trabeculoplasty, and p = 0.003, r = 0.52 after argon laser trabeculoplasty). We built a 'repeated measurements ANCOVA' model, and found no statistically significant difference between the pilocarpine IOP lowering effect before and after argon laser trabeculoplasty (p = 0.4). CONCLUSION: Argon laser trabeculoplasty does not modify the IOP lowering effect of 1% pilocarpine solution.
