Utility of Heidelberg retinal tomography as a screening tool for analyzing retinal nerve fiber layer defects.

CONTEXT: Although Heidelberg retinal tomography (HRT)-generated topographic images have been studied extensively for the detection of retinal nerve fiber layer (RNFL) defects, little is known about the role of HRT-generated surface reflectivity images in the detection of RNFL defects in either patients with glaucoma or glaucoma suspects. AIMS: To evaluate the effectiveness of HRT version II (HRT II) optic nerve reflectivity images in uncovering RNFL defects in an outpatient population evaluated for glaucoma. STUDY DESIGN/MATERIALS AND METHODS: In 102 consecutive eyes from 60 patients evaluated for glaucoma in an academic-based practice, HRT II optic nerve images were prospectively imaged and compared with clinical optic nerve exam techniques to see if HRT II was able to detect RNFL defects overlooked in clinical practice. RESULTS: Nine eyes (8.8%) were found to have RNFL defects recognized by screening with HRT II. Of these nine eyes, eight (88.9%) were recognized to demonstrate RNFL defects by conventional examination techniques. One additional eye had an RNFL defect seen on physical exam that was not detected by HRT. CONCLUSION: In academic practice, HRT II may be helpful in complementing conventional exam techniques in the recognition and documentation of acquired RNFL loss.

Bilateral retrobulbar optic neuritis as first signs of Lyme disease.

Bilateral retrobulbar optic neuritis in young adults are most often caused by demyelinate disease (MS). In all cases where MS was eliminated, we have used selected tests regarding to history, clinical findings and differential diagnosis. Diagnosis of Lyme disease is approved by diagnostic criteria proposed by Center for Control and Prevention of disease. In our case diagnosis of Lyme disease was established by history of illness, clinical findings and positive serlological tests.

[Retrobulbar optic neuritis as first sign of HIV infection]. / Retrobulbarni opticki neuritis kao prvi znak HIV infekcije.

This case is about a unilateral retrobulbar optic neuritis, as rare and first sing of HIV infection. A young woman had came at Eye Clinic because suddenly she lost her sight on the right eye completely. At the visual field, we found anopsia, but at the stereoscopic fundus examination the situation was almost normal. After complete clinical examination we conclude that she is immunodeficiency person, HIV-positive, with clinical manifestation retrobulbar neuritis and with skin manifestation varicella zoster infection in region of the left arm.

[Congenital optic disc excavatio]. / Kongenitalna eskavacja papile nervi optici.

We presented a case of congenital optic disk pit, rare congenital abnormality in the patient 23 years old male. Stereoscopic fundus examination revealed oval, gray defect of nerve tissue located in the temporal quadrant of optic nerve. We noticed and exophthalmus. Laboratory test showed slightly elevated thiroid tests. In the follow-up period of two years visual acuity was stabile while visual field showed deep parapapilar scotoma.