Pseudoexfoliatio capsulae and endothelin-1 plasma levels.

The authors found an increase of endothelin-1 (ET-1) plasma levels in patients with pseudoexfoliatio syndrome (PXS): 2.730 +/- 0.224 pg/ml vs 1.420 +/- 0.30S pg/ml. With Color Doppler Imaging (CDI) they found in PXS patients a decrease of peak systolic velocity values in the posterior ciliary arteries that were 12.725 +/- 2.536 cm/sec vs 15.450 +/- 3.173 cm/sec (p < 0.049) while the resistance values were increased 0.640 +/- 0.051 vs 0.548 +/- 0.058 (p < 0.001). The increase of ET-1 plasma levels may assess the vasospasm and uveal tissue hypoxia.

Fatty acid use in glaucomatous optic neuropathy treatment.

The authors have studied the efficacy of an association of DHA, vitamin E and vitamin B complex (TROFINERV) in glaucomatous patients. The parameters evaluated were computerized visual field (CVF) and retinal contrast sensitivity (RCS). Thirty chronic simple glaucoma patients in good tensional compensation with local therapy were given TROFINERV oral therapy. The results show significant differences after 90 days of treatment both in the perimetric indices (MD, SF, CPSD; p < 0.05) and in the RCS frequency values (p < 0.05). In the light of the results obtained, the authors consider the use of such association to be a useful support in glaucomatous patient therapy for preventing or delaying the progress of damage.

Color Doppler imaging and plasma levels of endothelin-1 in low-tension glaucoma.

Endothelin-1 (ET-1) is a potent vasoconstrictor peptide produced by vascular endothelin cells There are reports in the literature that ET-1 plasma levels are raised in low tension glaucoma (LTG). ET-1 plasma concentration and Color Doppler Imaging (CDI) evaluation in ophthalmic and posterior ciliary arteries were measured in 15 LTG patients and in 15 healthy subjects. The blood flow index recorded for the ophthalmic artery in normal subjects was a PSV of 36.646 +/- 6.611 cm/sec with RI of 0.717 +/- 0.019 while in the LTG patients it was 32.961 +/- 3.045 cm/sec (p < 0.003) with RI of 0.789 +/- 0.018 (p < 0.001). For the posterior ciliary arteries in the same two groups, we obtained a PSV of 13.878 +/- 4.149 cm/sec vs 8.720 +/- 1.645 cm/sec (p < 0.001) and an RI of 0.679 +/- 0.039 vs 0.722 +/- 0.024 (p < 0.001). The plasma ET-1 level in normal subjects was 1.720 +/- 0.174 pg while in LTG patients it was 2.947 +/- 0.217 pg (p < 0.001). On the basis of our experience, we think that GON and the visual field damage found in LTG can be attributed to an alteration in the endothelial self-regulating sections and consequent vascular insufficiency, particularly pronounced in the posterior ciliary arteries which, since it is these that provide the blood supply to the optic nerve head, leads to irreversible functional damage.

The use of flunarizine in the management of low-tension glaucoma: a color Doppler study.

The authors assess the efficacy of flunarizine in improving blood flow and perimetric indices in low-tension glaucoma (LTG). A group of 20 patients with LTG well-compensated by medical treatment underwent Color Doppler Imaging (CDI) of the ophthalmic artery and posterior ciliary arteries with peak systolic velocity (PSV) and Purcelot's index (PI) evaluation. Computerized perimetry was also performed to assess MD, SF and CPSD. The parameters were measured before and after three months' therapy with flunarizine. Data before and after flunarizine treatment were: Ophthalmic artery- PSV 33.261 +/- 1.628 cm/sec vs 35.746 +/- 0.800 cm/sec (p < 0.001); PI 0.697 +/- 0.017 vs 0.627 +/- 0.031 (p < 0.001); Posterior ciliary arteries- PSV 9.385 +/- 0.751 cm/sec vs 10.738 +/- 1.566 cm/sec (p < 0.005); PI 0.673 +/- 0.056 vs 0.589 +/- 0.023 (p < 0.001). The perimetric indices were modified as follows: MD -11.002 +/- 6.574 vs -6.604 +/- 6.426 (p < 0.006); SF 5.05 +/- 5.717 vs 2.937 +/- 1.780 (p < 0.193); CPSD 10.198 +/- 13.392 vs 3.445 +/- 2.709 (p < 0.093). Oral administration of flunarizine, a calcium channel-blocker which acts at a vascular and neuronal level, improves the blood flow indices for the optic nerve, improving thereby the perimetric indices in LTG.

[Color Doppler ultrasonography in retinitis pigmentosa. Preliminary study]. / Echo-Doppler couleur dans la rétinopathie pigmentaire. Etude préliminaire.

PURPOSE: Retinitis pigmentosa is a bilateral retinal degeneration. The primary disorder is still debated. METHODS: We performed a prospective investigation of the ocular circulation directly by color Doppler imaging (CDI). A total of 28 eyes of 14 patients (8 men and 6 women, affected with retinitis pigmentosa) were recruited for this study. For each case were evaluated protosystolic velocity and the resistive index of the ophthalmic artery, central retinal artery, posterior ciliary arteries and choroid. These values, furthermore, have been compared with a control group. RESULTS: The results of the CDI in the group of RP and in the CG were: in the OA: PSV 31.177 +/- 5.119 cm/sec vs 36.700 +/- 3.152 cm/sec (p < 0.007); RI 0.713 +/- 0.058 vs 0.717 +/- 0.019 (p < 0.0839); in the CRA PSV 7.075 +/- 1.611 cm/sec vs 12.710 +/- 2.795 cm/sec (p < 0.001); RI 0.560 +/- 0.062 vs 0.550 +/- 0.051 (p < 0.234); in the PCA: PSV 8.569 +/- 3.408 cm/sec vs 14.100 +/- 2.571 cm/sec (p < 0.001) with RI 0.634 +/- 0.090 vs 0.681 +/- 0.045 (p < 0.145). In the CHO: PSV 12.312 +/- 2.327 cm/sec vs 16.170 +/- 1.846 cm/sec (p < 0.001) with RI 0.581 +/- 0.072 vs 0.638 +/- 0.050 (p < 0.065). CONCLUSION: Our results suggest that in the affected eyes there is a statistically significant reduction in blood flow in ophthalmic and ciliary arteries. These data offer new views on the retinitis cause of pigmentosa and possible therapeutics to be studied.

Interferon alpha in the therapy of conjunctival lymphoma in an HIV+ patient.

The authors evaluated the efficacy of interferon-alpha used intralesionally in the therapy of low-grade conjunctival non-Hodgkin lymphoma in an HIV-positive patient. The patient received one intralesional injection of 1,000,000 U of interferon-alpha three times a week for a total of twelve doses. The remission of conjunctival involvement was seen three months from the end of therapy. The intralesional use of interferon-alpha can be considered an efficacious therapy for low-grade conjunctival non-Hodgkin lymphoma.

Colour Doppler analysis of the choroidal circulation in chronic open-angle glaucoma.

PURPOSE: To assess any alteration of the blood flow in the ophthalmic artery, in the posterior ciliary arteries and in the choroid of the glaucomatous eye. METHODS: We studied 15 patients, 11 males and 4 females (mean age 62.4 years), with chronic open-angle glaucoma in good tonometric control by medical therapy. All patients underwent colour Doppler examination of the ophthalmic artery, posterior ciliary artery and choroid. The data for peak systolic velocity (Pv) and resistance index (RI) were compared with those of healthy control subjects. RESULTS: The Pv in the ophthalmic artery of glaucomatous patients was 32.961 +/- 3.045 cm/s (p < 0.033) and RI 0.789 +/- 0.018 (p < 0.001). The Pv of posterior ciliary arteries was 8.720 +/- 1.645 cm/s (p < 0.001) and RI 0.722 +/- 0.024 (p < 0.005). In the choroid the Pv was 10.637 +/- 1.401 cm/s (p < 0.001) and RI 0.643 +/- 0.051 (p < 0.022). CONCLUSIONS: Our data indicate that in a chronic open-angle glaucoma there is an alteration in the eye blood flow especially in the posterior ciliary arteries and the choroid.

Correlation between visual field and color Doppler parameters in chronic open angle glaucoma.

The authors evaluated, by means of colour Doppler imaging, the blood flow in ophthalmic artery and posterior ciliary arteries in subjects with chronic open angle glaucoma. On the basis of the visual field indices (MD, SF, CPSD) the patients' eyes were divided in two groups: group A with better indices and group B with great damage. At the posterior ciliary arteries they found these values: PSV 10.264 +/- 2.363 cm/s (group A) vs. 7.882 +/- 1.251 cm/s (group B) (p < 0.008); RI 0.615 +/- 0.065 (group A) vs. 0.695 +/- 0.064 (group B) (p < 0.009). These data highlight a correlation between the visual field damage and the reduced supply of optic nerve head.

Topical treatment of postvitrectomy fibrin formation with tissue plasminogen activator.

Tissue plasminogen activator (tPA) is able to dissolve any fibrin material that forms in the anterior chamber or vitreous humor. This property has been reported by various experimental studies performed in rabbits. The authors demonstrate the tPA eye drops administered to patients with postoperative hyphema, which did not respond to traditional therapy, gave rapid clearance of the clot. Following its topical administration for the first time in patients, the harmless nature of the drug is emphasized as well as its efficacy. This study indicates the promising features of this drug which deserve further investigation.