ABSTRACT
We report a case of bilateral loss of pupillary light reflex and accommodation following 360° peripheral retinal laser therapy. A 24 years old male underwent prophylactic laser barrage for peripheral retinal lattice degenerations. Soon after the procedure, he developed bilateral loss of pupillary light reflex and accommodation. The patient faced difficulty while doing near work. On instillation of 0.125% pilocarpine, both pupils demonstrated the phenomenon of denervation supersensitivity. Damage to the short ciliary nerves was the most likely mechanism responsible for this adverse outcome.
Subject(s)
Ciliary Body/innervation , Light Coagulation/adverse effects , Parasympathetic Nervous System/radiation effects , Retinal Degeneration/surgery , Accommodation, Ocular/drug effects , Adult , Ciliary Body/radiation effects , Humans , Male , Miotics/administration & dosage , Muscle Denervation , Parasympathetic Nervous System/drug effects , Pilocarpine/administration & dosage , Reflex, Pupillary/drug effects , Retinal Degeneration/diagnosis , Treatment OutcomeABSTRACT
OBJECTIVE: To calculate the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of measurements of the retinal nerve fiber layer using the Stratus optical coherence tomography in glaucoma subjects with visual field defects on achromatic perimetry as the gold standard. STUDY DESIGN: Comparative cross-sectional. PLACE AND DURATION OF STUDY: Outdoor clinic of Layton Rehmatulla Benevolent Trust Hospital (LRBT), Lahore, from August 2007 to January 2008. METHODOLOGY: Fifty normal subjects and 50 glaucoma patients were selected from outdoor clinic of LRBT. Retinal nerve fiber layer thickness (RNFL) of all the subjects were measured by Stratus optical coherence tomography (OCT). Visual field defects on achromatic perimetry was used as the gold standard. RESULTS: The sensitivity and specificity of retinal nerve fiber layer measurement for perimetric glaucoma using the OCT were 82% and 96% respectively. The positive predictive value, negative predictive value and diagnostic accuracy were 95%, 84% and 89% respectively. CONCLUSION: There is a high sensitivity and specificity of RNFL measurements using the new Stratus OCT for the diagnosis of perimetric glaucoma.
