Comparison of anterior chamber depth measurements using Orbscan II and IOLMaster.

PURPOSE: To evaluate and compare anterior chamber depth (ACD) measurements using Orbscan II (Bausch & Lomb, Rochester, NY) and IOLMaster (Carl Zeiss Meditec AG, Jena, Germany). METHODS: In this prospective clinical study, the authors measured ACD of 145 phakic eyes of 30 healthy volunteers and 115 patients using Orbscan II and IOLMaster. Average patient age was 52.9+/-19.4 (range 16 to 87) years. ACD was evaluated from corneal epithelium to anterior lens surface. Additionally, axial length (AL) was measured using the Zeiss IOLMaster to calculate the regression coefficient between AL and ACD. RESULTS: Mean ACD was 3.35+/-0.43 mm (range 2.01 mm to 4.37 mm) using Orbscan II and 3.36+/-0.41 mm (range 2.09 mm to 4.24 mm) using IOLMaster. Mean total axial length was 24.04 mm +/- 2.1 mm (range 20.7 mm to 31.41 mm). The linear regression coefficient of ACD between both methods was R=0.95. ACD and AL correlated only slightly (R=0.57). The Spearman coefficients of rank correlation were 0.94 and 0.61, respectively. A p value less than 0.01 (paired Wilcoxon test) was considered statistically significant. However, a significant difference was not calculated comparing ACD measurements using both systems and the Bland-Altman-Plot showed 95% of the differences ranging between 0.25 and -0.27 mm. CONCLUSIONS: Regarding clinical application, both systems seem to be equally good and interchangeable in clinical practice in terms of ACD evaluation.

[Severe course and contingent risk factors in optic neuropathy and myelopathy after tuberculostatics]. / Schwerwiegender Verlauf und belastende Faktoren bei Optikusneuropathie und Myelopathie durch Tuberkulostatika.

A male patient with tuberculous lymphadenopathy was treated with a four-fold therapy of ethambutol, isoniacide, rifampicin and pyracinamide. After 10 weeks the patient suffered from photophobia. Although ethambutol was discontinued vision decreased and visual field defects occurred as well as signs of myelopathy. Isoniacide was then discontinued and in the subsequent phase the vision was slowly restored over a period of 36 months. The combined toxicity of ethambutol and isoniacide seems to have been the main cause of the severe and protracted optic neuropathy.

[Progressive peripunctal nevus in an adult]. / Progredienter Nävuszellnävus des Punctum lacrimale im Erwachsenenalter.

Nevi arise from migration of melanocytes into the epithelium. Over the years they experience a typical maturation, with the possibility of an increased thickness due to accompanying inflammation or fibrosis but actual growth of nevi is rare in adults. A 70-year-old patient presented with a growing tumour around the punctum lacrimale. The histological examination revealed a conjunctival nevus without any transformation. Peripunctal nevi are rare. The localisation of a nevus in the area of the punctum lacrimale was first published in 1931 and only 10 other patients with such a nevus have been reported. If at all, an enlargement of a peripunctal nevus has been described in younger patients. The patient presented here showed significant growth of the nevus at an atypically high age without any histological signs of malignancy or proliferation. The reason for this uncommon nevus enlargement remains unclear.