Spectral-domain optical coherence tomography versus ultrasound biomicroscopy for imaging of nonpigmented iris tumors.

PURPOSE: To evaluate the use of spectral-domain optical coherence tomography (SDOCT) for imaging of nonpigmented iris tumors, through its comparison with ultrasound biomicroscopy (UBM). DESIGN: Retrospective observational case series. METHODS: Consecutive patients with non-pigmented iris tumors, not extending to the ciliary body, who were concurrently evaluated with SD-OCT and UBM were included. Demographics, anterior segment clinical photographs, images obtained with SD-OCT (Cirrus HD-OCT, Zeiss Meditec, Dublin, California, USA) with 5.1.1 anterior segment software upgrade, and UBM (Humphrey Instruments, San Leandro, California, USA) were reviewed. The images produced were compared regarding the degree of anterior and posterior tumor surface resolution, internal structures, tumor thickness measurement, image artefacts, and overall tumor visualization. RESULTS: Thirty-seven patients with nonpigmented iris tumors were included. Comparing SDOCT to UBM, the image definitions of anterior tumor surface and internal tumor heterogeneity were equivalent. Posterior tumor surface was well defined in 54% of SDOCT vs 100% in UBM images. Full tumor thickness measurement was possible in 86% of SDOCT vs 100% with UBM. The maximum measurable tumor thickness with SDOCT was 1.34 mm. SDOCT images showed optical aberrations such as shadowing and ghost images in 22 tumors (59%), which encroached on the tumor image in 8 patients (22%). The overall tumor visualization with SDOCT was possible in 65% of the iris tumors. CONCLUSIONS: UBM generally provides superior imaging quality and reproducible measurements of nonpigmented iris tumors. Nevertheless, SDOCT, being a noncontact technique, can be a reliable alternative in imaging and following some selected nonpigmented iris tumors.

Ultrasound biomicroscopy diagnosis of an axenfeld loop.

A 67-year-old man was referred for evaluation of a small mass on the sclera of the right eye. Ultrasound biomicroscopy of the mass suggested the diagnosis of Axenfeld loop.

Epinephrine in irrigating solutions and its effect on blood pressure and pulse rates

A study was done to determine if epinephrine 1:600,000 concentration mixed with BSS will have any effect on a patients cardiovascular status during and after cataract surgery. A retrospective study was done on 50 cataract patients from January to June 1999. 0.3ml of epinephrine added to 500cc of BSS were used as the irrigating solution for phacoemulsification. Phacoemulsification using the pre-slice technique under topical anesthesia was performed on all patients. Irrigation and aspiration was done and small amounts of solution to reform the chamber. Patients blood pressure and pulse rates were taken preoperatively, intra-operatively, post-operatively and 24 hrs. post-operatively. Results showed no statistically significant rise in systolic blood pressure and pulse rates. We conclude that epinephrine 1:600,000 mixture in BSS is a safe way of maintaining pupillary dilatation during phacoemulsification. (Author)