Autofluorescence imaging of pingueculae.

AIMS: To analyse the autofluoresence (AF) properties of pingueculae and compare the size of AF with the extent of the visible lesion. METHODS: Forty eyes of 23 patients with pingueculae were included in the study. AF images were obtained using an HRA2 confocal scanning laser ophthalmoscope; anterior segment photographies were obtained using TRC-50IX, IMAGEnet 2000 Digital Imaging System. The AF characteristics of pingueculae were analysed. The extent of visible lesion in anterior segment photography and AF image was compared. RESULTS: AF images revealed well-defined hyper-autofluorescence in the area of pinguecula, which was greater than the extent of visible pinguecula in the slit-lamp examination, in 40 of 56 lesions (71.4%). In none of the eyes was the hyperautofluorescent area smaller than the extent of visible lesion. CONCLUSION: Pingueculae display hyperautofluorescence in AF imaging. The real size of pingueculae may be estimated by its AF characteristics, which is mostly larger than the visible lesion.

Optical coherence tomography evaluation of macular edema after intravitreal triamcinolone acetonide in patients with parafoveal telangiectasis.

PURPOSE: Parafoveal telangiectasis (PT) is a developmental or acquired microvascular abnormality of the macula. Leakage of the abnormal parafoveal capillaries leads to macular edema with subsequent decrease in visual acuity. Intravitreal triamcinolone acetonide is recently widely used in the management of intraocular proliferative, edematous, and neovascular diseases. METHODS: This report presents the evaluation of three cases with PT in whom intravitreal triamcinolone acetonide (IVTA) injection was performed. Fundus fluorescein angiography (FA) and optical coherence tomography (OCT) were used in follow-up of the patients. RESULTS: Following pars plana intravitreal injection of 4 mg of triamcinolone acetonide, the patients had angiographic improvement of the macular edema and minimal decrease in retinal thickness on OCT, accompanied by improvement in visual acuity and subjective visual assessment. CONCLUSIONS: The results of the present study on parafoveal capillary telangiectasis suggest that the intravitreal injection of triamcinolone acetonide may be a therapeutic option to increase visual acuity and decrease vascular leakage on FA. Following IVTA procedure, follow-up of these patients with both OCT and FA is important for correct clinical evaluation. Future studies on this method seem to be warranted.

Radial keratotomy for the optical rehabilitation of mild to moderate keratoconus: more than 5 years' experience.

PURPOSE: To present the authors' long-term experience of radial keratotomy (RK) for the optical rehabilitation of patients with mild to moderate keratoconus--central corneal thickness of greater than 400 microm and without apical scarring. METHODS: In this observational, noncomparative series of cases, all consecutive patients with mild or moderate keratoconus, treated by RK between 1990 and 2002, with at least 1 year follow-up were included. A total of 170 eyes of 96 patients were investigated. Mean follow-up was 42.08 +/- 28.14 months. Visual acuity, refraction, corneal curvature, central corneal thickness, and complications were evaluated. RESULTS: In all of the control visits, mean uncorrected and best spectacle corrected visual acuities were better than preoperative values (p<0.0001). Preoperative myopic spherical refraction decreased significantly (p<0.0001), and remained relatively unchanged throughout the follow-up (p=0.43). A small but statistically significant decrease from baseline was ob-served in astigmatism (p=0.038), which almost disappeared 1 year after the surgery (p=0.47). The surgery produced a statistically significant flattening of the corneal curvature (p<0.0001). Central corneal thickness did not change significantly (p>0.05) in either control visit. In 33 eyes (19.4%), re-deepening of the incisions was required. In 3 eyes (1.8%) penetrating keratoplasty was performed, due to disease progression in 2 eyes (1.2%) and acute traumatic hydrops in 1 eye (0.6%). In 4 eyes (2.2%) microperforation, in 2 eyes (1.2%) macroperforation, in 1 eye (0.6%) infectious keratitis, and in 1 eye (0.6%) hyperopic shift occurred. CONCLUSIONS: RK surgery was found to be a reasonable option for the rehabilitation of a selected group of keratoconus patients in the early or moderate stages.

Radial keratotomy for the optical rehabilitation of mild to moderate keratoconus: More than 5 years experience.

PURPOSE: To present the authors long-term experience of radial keratotomy (RK) for the optical rehabilitation of patients with mild to moderate keratoconus central corneal thickness of greater than 400 m and without apical scarring. METHODS: In this observational, noncomparative series of cases, all consecutive patients with mild or moderate keratoconus, treated by RK between 1990 and 2002, with at least 1 year follow-up were included. A total of 170 eyes of 96 patients were investigated. Mean follow-up was 42.08 28.14 months. Visual acuity, refraction, corneal curvature, central corneal thickness, and complications were evaluated. RESULTS: In all of the control visits, mean uncorrected and best spectacle corrected visual acuities were better than preoperative values (p<0.0001). Preoperative myopic spherical refraction decreased significantly (p<0.0001), and remained relatively unchanged throughout the follow-up (p=0.43). A small but statistically significant decrease from baseline was ob-served in astigmatism (p=0.038), which almost disappeared 1 year after the surgery (p=0.47). The surgery produced a statistically significant flattening of the corneal curvature (p<0.0001). Central corneal thickness did not change significantly (p>0.05) in either control visit. In 33 eyes (19.4%), re-deepening of the incisions was required. In 3 eyes (1.8%) penetrating keratoplasty was performed, due to disease progression in 2 eyes (1.2%) and acute traumatic hydrops in 1 eye (0.6%). In 4 eyes (2.2%) microperforation, in 2 eyes (1.2%) macroperforation, in 1 eye (0.6%) infectious keratitis, and in 1 eye (0.6%) hyperopic shift occurred. CONCLUSIONS: RK surgery was found to be a reasonable option for the rehabilitation of a selected group of keratoconus patients in the early or moderate stages.