ABSTRACT
PURPOSE: To assess the clinical efficacy of ibopamine eye drops in severe hypotony secondary to chronic progressive uveitis. METHODS: Case report. A 47-year-old man with a 37-year history of diffuse uveitis and severe refractory hypotony was treated with topical 2% ibopamine (Trazyl) six times a day. Intraocular pressure, visual acuity, visual field and side effects were recorded during 15 months of follow-up. RESULTS: IOP, visual acuity and visual field increased after four days of therapy and lasted for two months when the drug was suspended because of the onset of filamentous keratopathy. A new course of treatment with 2% ibopamine eye drops in a different solvent (BSS) resulted in a stable increase in IOP, VA and visual field, with no side effects in a follow-up of 13 months. CONCLUSIONS: Ibopamine 2% eye drops in BSS solvent seem effective in the treatment of uveitis-related hypotony.
Subject(s)
Deoxyepinephrine/analogs & derivatives , Deoxyepinephrine/therapeutic use , Dopamine Agonists/therapeutic use , Intraocular Pressure/drug effects , Ocular Hypotension/drug therapy , Uveitis/complications , Chronic Disease , Humans , Male , Middle Aged , Ocular Hypotension/etiology , Ophthalmic Solutions , Visual Acuity/drug effects , Visual Fields/drug effectsABSTRACT
PURPOSE: To assess the sensitivity and specificity of the lactoferrin tear test (LTT) in the diagnosis of keratoconjunctivitis sicca due to Sjögren's syndrome (SS), comparing it with the other lacrimal tests and with immunological tests. METHODS: 25 patients suffering from SS (24 women and 1 man, median age 51.5 years, s.d. 16.3); control group: 20 patients with various kinds of conjunctivitis without dry eye. Tests in both groups: Schirmer I (ST), BUT, ferning test, lactoferrin immunoassay, fluorescein and Rose Bengal staining. Immunological tests: serum titers of anti-nuclear (ANA), anti-DNA, anti-ENA (SS-A, SS-B, RNP, FR) antibodies. In the patients with SS, labial salivary gland biopsy was also performed. RESULTS: LTT had a specificity of 95% and a sensitivity of 72%, compared to 85% and 64% for the Schirmer I test. The ferning test has the highest sensitivity (92%), and none of the cases positive to BUT was negative to the ferning test. The combination of LTT and ferning test gave a value of 78% compared to 70% with ST. The correlations between positive LTT and positive ANA, SS-A and labial biopsy were respectively 83%, 67% and 80%, as against 67%, 50% and 65% for the Schirmer I test. CONCLUSIONS: In our study, LTT showed very high specificity, good sensitivity particularly when combined with qualitative tear tests, and a good correlation with the immunological and bioptic tests for SS. Since it is easy to perform, in our opinion LTT can be included in the diagnostic routine for keratoconjunctivitis sicca in SS.
Subject(s)
Lactoferrin/analysis , RNA, Small Cytoplasmic , Sjogren's Syndrome/diagnosis , Tears/chemistry , Antibodies, Antinuclear/analysis , Autoantigens/analysis , DNA/immunology , Female , Humans , Keratoconjunctivitis Sicca/diagnosis , Keratoconjunctivitis Sicca/etiology , Male , Middle Aged , Ribonucleoproteins/analysis , Sensitivity and Specificity , Sjogren's Syndrome/complications , snRNP Core Proteins , SS-B AntigenABSTRACT
The authors report the utility of the Echo-doppler and Doppler CW exams before and after the surgical therapy of the chorioretinal and optic nerve's hypoperfusion conditions. They have studied 112 patients affected by these pathologies and evaluated the blood flow's modifications. This exam is even usefull for the patient's selection before surgery without any serious complications.
