Efficacy of the fixed combinations of bimatoprost or latanoprost plus timolol in patients uncontrolled with prostaglandin monotherapy: a multicenter, randomized, investigator-masked, clinical study.

PURPOSE: To compare the efficacy and tolerability of a once-daily evening dose of bimatoprost/timolol fixed combination (BTFC) with that of a once-daily evening dose of latanoprost/timolol fixed combination (LTFC) in patients not controlled with prostaglandins analogues monotherapy. METHODS: A total of 82 patients on prostaglandin analogues monotherapy were enrolled in this prospective, multicenter, investigator masked, clinical study and were randomized to either BTFC (n=47) or LTFC (n=35) topical therapy once at night for 12 weeks. The primary endpoint of the study was to compare the mean daily intraocular pressure (IOP) reduction from baseline between the two treatment arms. Secondary endpoints included the mean daily IOP at 1 and 3 months compared to baseline and the percentage of patients showing a mean IOP reduction from baseline greater than or equal to 15% or 20%. RESULTS: Mean IOP at baseline was 22.7+/-2.0 and 22.1+/-2.6 mmHg in the BTFC and LTFC groups, respectively (p=0.23). Both treatments were effective in reducing the IOP from baseline. The mean IOP reduction was significantly greater in the BTFC group than in the LTFC group (-21.4% vs -13.7%, p<0.001). A higher percentage of patients in the BTFC group showed a mean IOP reduction from baseline >or=15% (72.3% vs 40.0%) and >or=20% (61.7% vs 17.1%) compared to patients in the LTFC group. CONCLUSIONS: Both BTFC and LTFC were more effective versus the monotherapy with prostaglandin analogues. BTFC demonstrated higher performance than LTFC in terms of relative IOP reduction.

The role of Humphrey Matrix testing in the early diagnosis of retinopathy in type 1 diabetes.

AIM: The aim of the study was to investigate the role of Humphrey Matrix threshold testing in the detection of early functional retinal impairment in subjects with type 1 diabetes mellitus (DM1) without any signs of retinal vasculopathy, and to investigate the relationship between both functional and structural retinal parameters and metabolic control. METHODS: Thirty eyes of 30 subjects with DM1, with no sign of retinal vasculopathy, and 30 eyes of 30 age- and sex-matched healthy subjects were enrolled in this cross-sectional clinical study. Functional testing included Humphrey Matrix perimetry and white-on-white Humphrey visual field perimetry (HFA), while retinal nerve fibre layer (RNFL) thickness was measured by scanning laser polarimetry with variable corneal birefringence compensator (GDx VCC). RESULTS: Matrix mean deviation (MD) was found to be significantly reduced in subjects with DM1 compared with controls (-1.10 (SD 2.98; 95% CI -2.21 to 0.01) vs 1.37 (SD 2.11; 95% CI 0.58 to 2.16), p = 0.0005). HFA MD and pattern standard deviation (PSD) were significantly worse in subjects with DM1 compared with controls (p = 0.010 and p = 0.013 respectively). Among structural parameters, average peripapillary RNFL thickness was reduced in DM1 subjects (p = 0.006). Matrix MD and HFA MD and PSD, and average peripapillary and superior RNFL, were significantly reduced in subjects with DM1 with HbA(1c) > or = 7% compared with controls. CONCLUSIONS: Functional and structural retinal testing by Humphrey Matrix and GDx VCC could be useful for the identification of early retinal impairment in people with DM1 with no sign of retinal vasculopathy.

[Diagnostic value of abdominal echography in cirrhosis of the African black. A study of 99 cases]. / Valeur diagnostique de l'échographie abdominale dans la cirrhose du noir africain. Une étude de 99 cas.

We reviewed sonographic findings and evaluated the impact of conventional ultrasound (US) in the management of 99 consecutive black africans with liver cirrhosis. Patients were studied in the University teaching Hospital of Yaoundé (Cameroon). There were 73 males and 26 females, with a mean age of 49 years (range 15 to 71 years). 90 p. cent patients presented with symptoms suggestive of liver disease. The commonest sonographic liver abnormalities were: echo coarseness with poor depiction of intrahepatic vessels, irregularity of the liver surface, hypertrophy of caudate lobe, hepatomegaly, and decreased beam penetration through the liver. Ascitis and other signs of portal hypertension were present respectively in 44 p. cent and 33 p. cent of subjects. 15 p. cent of subjects had hepatocellular carcinoma. Choletithiasis was seen in 6 subjects (6%), and chronic pancreatitis in 3 patients (3 p. cent). For 21 patients (21 p. cent), US depicted significant abdominal disease which was not clinically suspected, and for 10 patients (10 p. cent), it discovered silent liver cirrhosis. Our findings suggest that conventional US may be a useful tool in the management of some black african subjects with liver cirrhosis.

Hepatocellular carcinoma in Cameroon : sonographic findings and clinical outcome : a study of 72 cases in the University Teaching Hospital; Yaounde; Cameroon

Sonographic findings and clinical outcome of 72 consecutive patients with hepatocellular carcinoma (HCC) in the Yaounde University Teaching during a period of 20 months are reviewed. The purpose of the study was to assess the sonographic pattern and natural history of HCC in Cameroon. The diagnosis was established by fine needle biopsy; or by a combination of clinical features; elevated serum alphafoetoprotein and sonographic findings. There were 55 males and 17 females. Fifty-five (76 per cent) patients presented with hepatomegaly. Three types of HCC were found : nodular; diffuse and mixed. Twenty-two patients had significant ascites. A thrombus in a major portal vein was present in 19 patients. Ten had secondary lesions on presentation. Only one patient was operated on; but the tumour was not resectable