Inflammation assessment after selective laser trabeculoplasty (SLT) treatment.

PURPOSE: Selective laser trabeculoplasty (SLT) appears to be a safe and effective method to lower intraocular pressure (IOP). The exact mechanism of action for reducing IOP and inflammation levels is not known. The aim of this study was to assess inflammation after SLT treatment. METHODS: Forty patients (80 eyes) were included in the study. INCLUSION CRITERIA: Glaucoma (pigmentary and pseudoexfoliative glaucoma)/ocular hypertension patients that will be treated with SLT in just one eye, both with and without eye-drops. EXCLUSION CRITERIA: patients suffering from ocular or systemic inflammatory diseases are treated with cortisone or immunosuppressive drugs. Inflammation was measured in two different ways: (i) clinically with a slit lamp and classified 0-4; (ii) objectively with a 'Laser flare meter (Kowa FM 500)'. Measurements were taken before SLT, 2 hr, 1 week and 1 month after SLT treatment, both eyes were evaluated. IOP was also checked in the same way. SLT treatment was performed in 90°. RESULTS: Inflammation before and after SLT showed no significant difference measured clinically with slit lamp and objectively with the laser flare meter among the groups. No inflammation or IOP reduction was found in the untreated eyes. No IOP spikes after SLT treatment were found. CONCLUSION: Selective laser trabeculoplasty treatment seems not to induce inflammation in the anterior chamber when 90° was treated. SLT effectively and safely lowers IOP and might be considered as primary therapy.

Magnetic resonance imaging and ultrasound measurements of extraocular muscles in thyroid-associated ophthalmopathy at different stages of the disease.

PURPOSE: To assess extraocular muscle (EOM) involvement in thyroid-associated orbitopathy (TAO) of different stages with magnetic resonance imaging (MRI) and ultrasound techniques. METHODS: A total of 32 patients with TAO were divided into three groups according to whether they had mild active, pronounced active or longstanding inactive disease. Six patients with Graves' disease but no clinical signs of TAO and 10 healthy control subjects were also studied. Muscle volume and cross-sectional area were measured with MRI. A-scan ultrasound was used to measure muscle thickness. RESULTS: The average MRI volume and maximal cross-sectional area of the EOM were significantly larger in patients with pronounced active and longstanding inactive TAO than in control subjects. Increased average muscle thickness measured by ultrasound was found mainly in patients with longstanding disease. Muscle enlargement was seen with MRI and ultrasound in individual patients in all patient groups, including those with Graves' disease but no TAO. Bilateral muscle enlargement was revealed by MRI in about two-thirds of patients with mild active TAO and in all patients with pronounced active and longstanding inactive TAO. Bilateral involvement estimated with ultrasound was less common in all patient groups. The MRI and ultrasound findings were not well correlated in any patient group. CONCLUSIONS: Extraocular muscle enlargement was seen in all patient groups with TAO of differing levels of severity. Measurements with MRI of muscle volume or maximal cross-sectional area are considered good indicators of muscle enlargement in TAO.