Evaluation of mean retinal sensitivity using MP-1 microperimeter in patients with diabetic macular edema before and after laser photocoagulation treatment.

INTRODUCTION: Diabetic macular edema (DME) is a common cause of visual acuity deterioration among patients with diabetes. Laser photocoagulation still remains the most common treatment of DME and diabetic retinopathy. OBJECTIVES: The aim of the study was to assess mean central retinal sensitivity among patients with DME before and after laser photocoagulation treatment. Additionally, we estimated the best-corrected visual acuity (BCVA) and retinal macular thickness before and after treatment. PATIENTS AND METHODS: The study included 30 patients (35 eyes with DME). The mean age was 61.9 ±4.8 years. Insulin was administered in 22 patients and oral antidiabetics in 8. Laser photocoagulation in the macular area was performed in all patients using the Pascal laser. We measured the BCVA, mean central retinal sensitivity, and retinal thickness in the macula (divided into 9 segments). The measurements were performed before and at 1, 3, and 6 months after laser treatment. Central retinal sensitivity was assessed with the MP-1 microperimeter and macular thickness with optical coherence tomography (Stratus OCT). RESULTS: The statistical analysis did not reveal significant differences between BCVA and central retinal sensitivity in the study group before and after laser treatment. The analysis of the mean central retinal thickness showed a significant decrease in macular edema in the individual segments at 1, 3, and 6 months after photocoagulation. CONCLUSIONS: Photocoagulation of DME with the Pascal laser did not cause significant changes either in the BCVA or central retinal sensitivity. Laser treatment in patients with DME significantly reduced central retinal edema in most segments.

Anterior ischemic optic neuropathy after conventional coronary artery bypass graft surgery.

BACKGROUND: Perioperative optic neuropathy is a disease which can lead to serious, irreversible damage of vision. This complication could be the result of non-ocular surgery, for example, cardiac or spinal procedures. We present a case of anterior ischemic neuropathy (AION) which occurred following a conventional coronary artery bypass graft procedure. CASE REPORT: A 57-year-old man, 4 days after Conventional Coronary Artery Bypass Graft surgery as result of multi-vessel stabile coronary artery disease and history of anterolateral wall myocardial infarction, was admitted to the Eye Clinic due to significant loss of vision in his right eye. The patient had hypertension and was a heavy smoker. On admission, the slit lamp examination revealed a relative afferent pupillary defect in the right eye. The fundus examination showed optic disc edema with the presence of flame hemorrhages. Best corrected visual acuity (BCVA) was 0.02. The results of eye examination and fluorescein angiography confirmed the diagnosis of AION. Anti-aggregation and antithrombotic treatment was continued with steroids and vasodilators. After 7 days of this treatment we noticed the improvement of BCVA to 0.2. At 6-month follow-up, the vision was stable, and fundus examination revealed optic disc atrophy. CONCLUSIONS: After cardiac surgical operations, such as coronary artery bypass graft procedures, anterior ischemic optic neuropathy may occur. In those cases, close cooperation between the various specialists is necessary.

Needle aspiration with surgical excision of an epithelial posttraumatic iris cyst--a case report.

BACKGROUND: The aim of this study was to report on epithelial posttraumatic iris cyst that was successfully treated with needle aspiration and surgical excision with surrounding iris tissue. CASE REPORT: A 30-year-old women was treated for a large fluid-filled cyst in the anterior chamber of the left eye; 25 years before, she had an open globe injury. She observed deterioration of her visual acuity 1 year before her visit to our clinic. During ophthalmological examination, an iris cyst was diagnosed. As a result, she had Nd: YAG laser puncture of the cyst in the left eye, performed 5 months before she came to our clinic. After a short time of decompression, the cyst rapidly grew in size (2/3 of the anterior chamber), and her visual acuity was getting worse due to an aggressive growth of the iris cyst. Visual acuity was 0.06. Needle aspiration with surgical excision of the cyst with surrounding iris tissue was performed. Histopathologic examination confirmed an epithelial cyst. At the 1-year follow-up, there was no evidence of recurrence of the iris cyst, and BCVA was 0.2. CONCLUSIONS: This case report provides evidence that needle aspiration with surgical excision of iris cyst seems to be an effective treatment method of this complication.