<i>Objective:</i> The purpose of the study was to investigate if absolute values and reproducibility of thickness maps obtained from 2 optical coherence tomography (OCT) scanning protocols, regular high-resolution and fast low-density mode, differ in patients with diabetic macular edema. <i>Methods:</i> A total of 26 consecutive patients undergoing fluorescein angiography and Stratus OCT scanning for the evaluation of diabetic macular edema at the Departments of Ophthalmology in Munich and Vienna were included. <i>Results:</i> Retinal thickness of the central field of the thickness map measured by fast retinal thickness protocol was 287 ± 97 and 290 ± 113 µm by the regular protocol. This difference as well as that for all other fields was not statistically significant. Three times repeated measurements applying both OCT scanning modes in 10 patients yielded very good intrasession correlation coefficients between 0.70 and 0.99, with corresponding intrasession standard deviations ranging between 6 and 16 µm. The fast mode yielded slightly less reproducible values than the regular mode. Visual acuity did not influence the results. <i>Conclusion:</i> In practice both scanning modes can be interchanged and absolute values can be compared directly. Best reproducibility is obtained with higher sampling density even in patients with reduced visual acuity due to diabetic macular edema.
Purpose: To present the 10- to 12-year functional and morphological results of in-the-bag implantation of a foldable, plate-haptic, silicone posterior chamber intraocular lens (IOL). Setting: Department of Ophthalmology, University of Vienna Medical School, Vienna, Austria. Methods: Between September 1987 and December 1989, 160 silicone posterior chamber IOLs (Staar AA-4203C) were implanted in the capsular bag through a 3.5 mm corneoscleral incision after a continuous curvilinear capsulorhexis was created. In spring 1999, 36 patients (38 eyes) could be included in a follow-up examination. Results: The median follow-up was 10.5 years ± 2 (SD). The mean visual acuity was 0.82 ± 0.34. The mean refraction (spherical equivalent) was +0.57 diopter (D), an insignificant change from the mean at the first postoperative follow-up at 1 month (+0.40 D). Slitlamp examination showed mildly dispersed pigment on the IOL surface in 81.58% of cases. All IOLs had a Tyndall effect (clouding). In 84.21%, the effect was minimal, in 10.53% it was moderate, and in 5.26% it was more intense. Ninety-two percent of the IOLs were centered within 0.5 mm. Of the 22 cases of decentration (57.89%), 86.36% were toward the 12 o'clock position in the bag. The neodymium:YAG capsulotomy rate was 10.52%. There were no cases of IOL-related inflammation or a clinically significant cystoid macular edema. Conclusion: The 10- to 12-year results suggest favorable clinical results of implantation of Staar AA-4203C plate-haptic, silicone posterior chamber IOLs.
During their acute phase, premacular hemorrhages under the internal limiting membrane induce an absolute scotoma. It is generally suspected that extravasal blood has a toxic effect on the neuroretina. The objective of this study is to investigate whether one can indeed detect sensoric defects after resorbed hemorrhages under the internal limiting membrane.Our patient group consisted of 10 patients with resorbed premacular hemorrhages, which had been caused by either Vasalva-Manouver or arterial macroaneurysms. In order to avoid visual field defects due to other causes, patients with diabetes, retinal vein occlusion and glaucoma were excluded from this study. The investigation was carried out with the Scotometry Programme Vers. 2.01 of the Rodenstock Scanning Laser Ophthalmoscope. Furthermore, fundus photographs were taken.Under condition of no pre-existing retinal pathologies, no scotomas could be revealed at the site of the preretinal hemorrhage after full resorption. Relative or absolute scotomas could only be found in cases of pre-existing epiretinal gliosis, pigmentepitheliumdefect, persistent subretinal hemorrhages or scars.Since no sensoric defects of the retinal receptors could be detected, the hypothesis of the extravasal blood having a direct toxic effect on the neuroretina, could not be confirmed in this patient group.
The widespread use of highly active antiretroviral therapy (HAART) has changed the clinical picture of HIV-associated eye disease. We evaluated the incidence of ocular manifestations of HIV infection since the introduction of HAART.Between January 1996 and December 2002, we examined 539 HIV-infected patients in our hospital. Follow-up of the patients was performed in case of ophthalmologic symptoms, regardless of current immunologic status, or for screening.A total of 217 patients (40.3%) had HIV-associated eye disease. Of these patients, 42.0% had no eye symptoms. Fifty-eight (10.8%) of the 539 patients had cytomegalovirus (CMV) retinitis, most of whom had CMV retinitis before receiving HAART. Four patients developed immune-recovery uveitis. A total of 145 patients (26.9%) had HIV-related microangiopathy and 96 (17.8%) had dry-eye syndrome.The introduction of HAART had a major impact on the medical history of patients with HIV-related eye disease with improved survival time and decreased morbidity.
To investigate the response of retinal vessel diameters to photocoagulation treatment and their role for the success of laser treatment in patients with retinal vein occlusion.The study included 14 patients with branch vein occlusion or macular vein occlusion. The ophthalmologic examination included best-corrected visual acuity, biomicroscopy, fundus photography, and fluorescein angiography. Retinal vessel diameters were quantified before and after laser photocoagulation using a retinal vessel analyzer.Retinal vessel diameters.In cases manifesting macular vein occlusions, no significant change of the vessel diameter in any vessel was observed during the follow-up period. In the group with branch vein occlusion, all vessels tended to constrict after the laser photocoagulation. The effect of laser treatment on retinal vessel diameters was significant for superotemporal (P =.045, analysis of variance [ANOVA]) and inferotemporal branch veins (P =.03, ANOVA). Vasoconstriction was more pronounced in the occluded branch veins (P =.009, ANOVA) compared with the nonaffected veins (P =.12; ANOVA). The change of visual acuity after 3 months was correlated with the change of vessel diameter 3 months after laser treatment for occluded venular branches (r = 0.78, P =.02, linear regression). There was no correlation between the number of laser burns and the change of vessel diameters in the affected veins in this period (r = 0.12, P =.75, linear regression).Our results show that retinal photocoagulation in patients with branch vein occlusion has a vasoconstrictive effect on occluded veins. The correlation between the change in visual acuity and the change in vessel diameter indicates that branch vein constriction after photocoagulation may be an early indicator of the success of laser treatment.
Abstract Purpose: Scattering of blood flow data as assessed with laser Doppler flowmetry (LDF) in humans is a problem in many studies using this technique. We set out to reduce variability in LDF data by partializing out the effect of the total returning light level (DC) on LDF parameters in the choroid. Methods: In 20 healthy subjects choroidal blood flow was measured at different DC values using a portable confocal LDF device. To reduce scattering of data partializing out the effect of yield, defined as DC/gain, firstly a previously described method based on a third order polynomia fit using all obtained data was applied. Secondly a new method based on a linear fit obtained for each subject individually was used. In addition, these correction procedures were applied retrospectively to the data of a recent study investigating the effect of a nitric oxide (NO) synthase inhibitor on choroidal and optic nerve head blood flow parameters. Results: Both methods were successful in reducing scattering of LDF parameters in the choroid with varying baseline DC values. In addition, both methods minimized scattering of the effect of the NO synthase inhibitor on ocular blood flow parameters as analyzed retrospectively. Whereas, however, the previous approach altered the magnitude of the mean change induced by the NO synthase inhibitor to higher values, the new method preserved the originally reported effect. Conclusions: When systematic changes in DC occur after an intervention one needs to be careful in interpreting the obtained data. The approach presented here may represent an effective, easily applicable and valid way to reduce scattering of data from using LDF to assess blood flow in the posterior pole of the human eye.
