The exfoliation syndrome in cognitive impairment of cerebrovascular or Alzheimer's type.

The prevalence of exfoliation syndrome was studied in 39 patients suffering from dementia and cognitive impairment; a positive finding of exfoliation was detected in 11/39 of these patients. A comparison with an age-matched population survey showed that the prevalence of ocular exfoliation and the relative risk were significantly elevated. These results suggested that lesions related to the exfoliative process might be located also in the brain of patients suffering from dementia and cognitive impairment.

A technique for inserting endosseous implants in the atrophic maxilla in a single stage procedure.

A technique is described for inserting autogenous iliac bone into the maxillary sinus of the edentulous patient via a fenestration of the anterolateral maxillary wall, maintaining the mucous membrane lining of the sinus intact, and allowing insertion of titanium screw implants into the atrophic maxilla at the same operation. This method avoids a Le Fort I osteotomy approach with its possible attendant complications.

Morphological aspects of normal optic disc and early signs of glaucomatous alterations.

A group of 110 eyes with untreated ocular hypertension, 94 being non-exfoliative and 16 exfoliative and in addition 10 glaucomatous eyes were selected for this study. The optic nerve head was examined by ophthalmoscopy and a drawing was made of the estimated cupping. The disc pallor was measured from disc photographs in a double masked manner at the same time. The possibility to detect early glaucomatous damage by a single examination will be discussed and the two methods will be compared. This study indicates that an increasing vertical diameter of disc pallor might have a predictive value.

[Aqueous humor outflow pathways following trabeculectomy in patients with glaucoma]. / Kammerwasserabflusswege nach Trabekulektomie bei Glaukom-Patienten.

The distribution pattern of fluorescein sodium after trabeculectomy was studied in 43 patients. There was good correlation between the formation of a visible filtering bleb and fluorescein accumulation at the trabeculectomy site. The mechanism of action of trabeculectomy is discussed with regard to alternative outflow pathways.

Optic disc pallor and visual field defect in exfoliative and non-exfoliative, untreated ocular hypertension.

In a prospective study of untreated ocular hypertension 117 eyes were non-exfoliative and 20 eyes exfoliative. The percentage of optic disc pallor was significantly larger in the exfoliative than in the non-exfoliative group, whereas no significant differences were found in IOP or in the visual field.

Ocular hypertension. A prospective twenty-year follow-up study.

In a prospective study of 41 persons with ocular hypertension followed for 20 years, 14 individuals (34 per cent) developed glaucoma. Of 38 persons who 20 years ago were normotensive, 2 (5 per cent), developed glaucoma. This difference is significant. The mean IOP of the remaining untreated ocular hypertensives was about 7 mmHg higher than the mean tension in the control group.

[Possibility of surface-independent tonography and tonometry]. / Die Möglichkeit der flächenunabhängigen Tonografie und Tonometrie.

A method of simultaneous measurement of intraocular pressure and volume displacement is reported. An electronic pressure sensor (diameter 3 mm) was positioned in the centre of the base of a transparent applanation body (diameter 9 mm). The corneal applanation area could be changed by different applanation forces and was measured photographically. In isolated human and porcine eyes, sensor signal and intraocularly measured pressure were related linearly and independently of the applanation area. In human eyes in situ, the rigidity coefficient decreased with increasing pressure. Adhesive forces and stiffness of the cornea obviously only falsify tonometry at the margin of the applanation area.

Determination of minimum bactericidal concentrations of oxacillin for Staphylococcus aureus: influence and significance of technical factors.

The minimum bactericidal concentration of oxacillin for Staphylococcus aureus was shown to be considerably influenced by technical and definitional factors, particularly by the survival of some organisms on the walls of test tubes and by the growth phase of the inoculum. Attention to technical detail greatly improved reproducibility, and log-phase cultures of all strains showed greater than 99.9% killing in 24 h, at or close to the minimum inhibitory concentration, including eight strains described as tolerant. Some strains showed the paradoxical phenomenon of having more survivors in higher concentrations above the minimum bactericidal concentration. An accepted reference minimum bactericidal concentration procedure is needed for establishing clinical correlates and for a review of endpoint criteria. Routine minimum bactericidal concentration tests on S. aureus should be interpreted with great caution.

The natural course of ocular pressure in ocular hypertension.

The intraocular pressures of ocular hypertensives may undergo diurnal variation and/or slow cyclic variations over years. Studies of both types of variations are reviewed. Pressure tends to decrease cyclically in some ocular hypertensives and to increase in others. It is possible that an increasing pressure trend may be an important symptom indicating a higher risk of development of glaucomatous damage.

The association of ocular hypertension with the exfoliation syndrome, the pigmentary dispersion syndrome and myopia.

The intraocular pressure (IOP) may rise dramatically with the appearance of the exfoliation syndrome. With the pigmentary dispersion syndrome, the IOP may have a tendency toward large spontaneous fluctuations. There is evidence supporting a correlation between elevated IOP and myopia. The author reviews various reports on these entities, noting that perhaps because of the effects of the exfoliation and pigmentary dispersion syndromes on IOP, it is difficult to follow many of these patients over a long period of time without therapy.

Ocular hypertension. II. A carbonic anhydrase inhibitor test for early detection of glaucoma.

The intraocular pressure before and three h after oral administration of a carbonic anhydrase inhibitor was measured in one normotensive, one hypertensive as well as two glaucoma groups. The ratio between the outflow pressure after and before this treatment was estimated. The percentage outflow pressure was found to be about 50% in the normotensive group and in the two glaucoma groups, but in the hypertensive group 68%. This carbonic anhydrase inhibitor test (CAI-test) seems to give additional information which can improve the possibility of differentiating between high normative pressure and early glaucoma prior to glaucomatous lesions.

Ocular hypertension. I. The clinical course during ten years without therapy. Aqueous humour dynamics.

An initial group of 152 subjects with moderate ocular hypertension constituted the basic material of the present study. Antiglaucoma treatment was started in 8 men and in 6 women. A remaining group of 92 subjects were kept under clinical observation for ten years without antiglaucomatous therapy and without any evidence of progressive disc cupping or field defects. The intraocular pressure as well as the outflow facility showed a tendency to decrease with time, which was assumed to indicate a reduction in aqueous flow with increasing age. The tomographic findings support the view that the moderately elevated intraocular pressure is mainly due to an increased rate of aqueous flow.