ABSTRACT
PURPOSE: To determine predictors of long-term intraocular pressure (IOP) after cataract surgery. SETTING: Hunter Holmes McGuire Veterans Administration Hospital, Richmond, Virginia, USA. DESIGN: Case series. METHODS: Clinical variables, IOP by applanation tonometry, anatomic features on anterior segment optical coherence tomography (AS-OCT), and gonioscopy were assessed before and after uneventful cataract surgery in eyes with open filtration angles. Multivariate linear regression of preoperative measurements was used to predict the mean IOP from 2 to 18 months postoperatively. RESULTS: The study enrolled 77 eyes (77 patients). Prediction of the mean postoperative IOP improved when up to 4 preoperative IOP values were averaged (r(2) = 0.20) compared with using the final preoperative IOP value only (r(2) = 0.13). The mean iris cross-sectional area decreased after surgery, from 3.84 mm(2) to 3.70 mm(2) (P=.01). The mean convex hull of the iris segments also decreased, from 5.05 mm(2) to 4.19 mm(2) (P<.001). The mean postoperative IOP was independently predicted by the preoperative average IOP, primary open-angle glaucoma, and the convex hull of cross-sectional iris segments (P=.001, model r(2) = 0.38) or iris cross-sectional area (P=.003, model r(2) = 0.36). Phacoemulsification parameters, incision type, and anterior chamber angle and depth did not predict postoperative IOP. CONCLUSIONS: Averaging up to 4 preoperative IOP values improved postoperative IOP predictions. A high iris cross-sectional area or convex hull of the iris segments on AS-OCT was associated with lower postoperative IOP. These findings might help identify patients who are likely to have the largest IOP drop after cataract surgery.
Subject(s)
Intraocular Pressure/physiology , Iris/anatomy & histology , Lens Implantation, Intraocular , Phacoemulsification , Aged , Anatomy, Cross-Sectional , Anterior Eye Segment/pathology , Antihypertensive Agents/administration & dosage , Female , Glaucoma, Open-Angle/drug therapy , Glaucoma, Open-Angle/physiopathology , Gonioscopy , Humans , Male , Postoperative Period , Preoperative Period , Prospective Studies , Refraction, Ocular/physiology , Tomography, Optical Coherence , Tonometry, Ocular , Visual Acuity/physiologyABSTRACT
BACKGROUND: Epinastine is a topical ophthalmic antihistamine and a mast cell stabilizer indicated for treatment of symptoms associated with allergic conjunctivitis. OBJECTIVE: The objective of this review is to provide a comprehensive overview of the pharmacology, clinical efficacy, tolerability and safety of epinastine 0.05% ophthalmic solution. METHODS: Medline literature review from 1950 to 2008. CONCLUSIONS: Epinastine 0.05% ophthalmic solution was found to be a safe and effective medication for the relief of symptoms of allergic conjunctivitis. Epinastine demonstrates very low CNS and cardiac toxicity.
Subject(s)
Conjunctivitis, Allergic/drug therapy , Dibenzazepines/pharmacology , Dibenzazepines/therapeutic use , Imidazoles/pharmacology , Imidazoles/therapeutic use , Clinical Trials as Topic , Dibenzazepines/administration & dosage , Dibenzazepines/adverse effects , Histamine Antagonists/administration & dosage , Histamine Antagonists/adverse effects , Histamine Antagonists/pharmacology , Histamine Antagonists/therapeutic use , Humans , Imidazoles/administration & dosage , Imidazoles/adverse effectsABSTRACT
PURPOSE: To report an unusual case of multiple myeloma presenting with bilateral tearing secondary to lacrimal sac involvement. DESIGN: Observational single case report. METHODS: An 83-year-old woman presented with bilateral tearing secondary to infiltrative lesions of the lacrimal sacs. A biopsy was performed; findings confirmed the diagnosis of multiple myeloma. RESULTS: The lacrimal sac fossa lesions responded to chemotherapy and local radiation. The patient subsequently developed multiple systemic recurrences, ultimately leading to her death. CONCLUSIONS: Multiple myeloma should be included in the differential diagnosis of lacrimal sac lesions.
Subject(s)
Eye Neoplasms/pathology , Lacrimal Apparatus Diseases/pathology , Multiple Myeloma/pathology , Aged, 80 and over , Antineoplastic Agents/therapeutic use , Combined Modality Therapy , Eye Neoplasms/diagnostic imaging , Eye Neoplasms/therapy , Female , Humans , Lacrimal Apparatus Diseases/diagnostic imaging , Lacrimal Apparatus Diseases/therapy , Multiple Myeloma/diagnostic imaging , Multiple Myeloma/therapy , Radiotherapy , Tomography, X-Ray ComputedABSTRACT
PURPOSE: To assess the risk of diabetic retinopathy (DR) in children with type 1 diabetes mellitus (T1DM) diagnosed at a very early age. DESIGN: Observational case series. METHODS: The records of 51 patients were identified through the diabetes database of the Division of Pediatric Endocrinology and Metabolism at Washington University School of Medicine. The patients were diagnosed with T1DM before 2 years of age and were monitored for at least 5 years after diagnosis. The results of ophthalmic screening examinations were reviewed. RESULTS: Fifty-one patients were identified, 33 of whom were monitored for >8 years. None of the patients developed DR. CONCLUSIONS: Children have a negligible risk of developing DR during the first 10 years of life, even if they are diagnosed before age 2. These results indicate that screening for DR is not necessary before age 10.
Subject(s)
Diabetes Mellitus, Type 1/diagnosis , Diabetic Retinopathy/epidemiology , Age Factors , Diabetic Retinopathy/diagnosis , Female , Follow-Up Studies , Humans , Infant , Male , Missouri/epidemiology , Risk FactorsABSTRACT
Ocular migraine, an uncommon cause of transient monocular visual loss, is an entity physicians should be able to recognize in order to provide appropriate treatment and to avoid unnecessary testing. The following text provides an overview of ocular migraine, including discussion of accepted terminology, clinical presentation, and pathophysiology. An ocular and systemic differential diagnosis, appropriate evaluation, therapy, and prognosis are also discussed.
