Background: In young patients with the clinical symptoms of a neuritis neuroradiological imaging is not always necessary. This case report describes a young patient who suffered from a recurrence after 5 years. Since ...Background: In young patients with the clinical symptoms of a neuritis neuroradiological imaging is not always necessary. This case report describes a young patient who suffered from a recurrence after 5 years. Since all findings, particularly visual evoked potentials, were classic for neuritis, the patient was treated for neuritis although periocular pain was not present. Case Report: Five years after a neuritis of the left eye (OS), the patient was again referred with a visual loss (VA 0.3 OS). In addition to an afferent pupillary defect OS and a constricted visual field OS, an inter- eye latency difference was demonstrated in the visually evoked potentials. The patient was treated with megadose steroid therapy. Although periocular pain as a classic symptom was absent, no neuroradiological imaging was performed. Six weeks later visual acuity and visual fields further worsened, such that a nuclear magnetic resonance imaging was indicated revealing a meningioma frontobasally compressing the optic nerve. After neurosurgical intervention visual acuity and field stabilized. Conclusions: In rare cases, meningioma may mimick the symptoms of neuritis. Therefore, neuroradiological imaging is indicated in recurrences or complicated disease courses, particularly if classic symptoms such as periocular pain are missing.展开更多
PURPOSE: To investigate the effect of retrobulbar anaesthesia on retrobulbar haemodynamics, colour Doppler imaging was performed. Furthermore, the additive effect of epinephrine was examined. Method: Forty-one patient...PURPOSE: To investigate the effect of retrobulbar anaesthesia on retrobulbar haemodynamics, colour Doppler imaging was performed. Furthermore, the additive effect of epinephrine was examined. Method: Forty-one patients (age 72.7±8.9; 22 f, 19 m) undergoing planned cataract surgery were included in a prospective study. Colour Doppler imaging was performed before and directly after retrobulbar anaesthesia and after cataract surgery to measure the peak systolic velocity (PSV) and end diastolic velocity (EDV) in the ophthalmic artery, central retinal artery and central retinal vein. In 18 patients lidocaine 2%with-out additives (2 ml, retrobulbar transconjunctival injection) and in 23 patients lidocaine 2%with epinephrine 1:200,000 was used. Results: After retrobulbar anaesthesia both groups had a significant reduction of the PSV and of the EDV. After surgery flow velocities increased again. The addition of epinephrine resulted in a significantly greater reduction and slower recovery of flow velocities. Conclusion: Retrobulbar anaesthesia induces a marked reduction of velocity in the retrobulbar vessels. The supplement epinephrine increases this effect, and recovery is much slower. Thus, particularly in patients with already disturbed ocular haemodynamics epinephrine should not be used in order to avoid irreversible functional damage.展开更多
Background: Excessively draining fistulas may lead to enucleation when primary suture closure is not effective. In these cases preserved cadaver tissues such as sclera, fascia lata, dura mater and peritoneum have been...Background: Excessively draining fistulas may lead to enucleation when primary suture closure is not effective. In these cases preserved cadaver tissues such as sclera, fascia lata, dura mater and peritoneum have been used for patch graft repair with variable results. In this study, the clinical outcomes after transplantation of scleral patch grafts have been investigated. Method: Twenty- eight eyes of twenty- seven patients underwent surgery with homologous scleral patch grafts for repair of excessively draining scleral fistulas after cataract surgery (n =2), leaking filtering blebs following full- thickness filtration surgery (n=7), large scleral perforations due to trauma (n=7), corneo- scleral ulcerations due to severe eye burns (n=9) or after radiotherapy of malignant melanoma (n=3). The mean size of the rectangular grafts was 8.6 × 6.7 mm (± 2.8/3.1 mm). Clinical follow- up was up to 73 months (median 30 months). Results: Twenty- three of 28 eyes (82.1% ) showed functional closure after initial surgery without any wound complication such as patch retraction or leakage and without evidence of inflammation. In five eyes surgical revision was necessary. Two of these eyes had to be enucleated due to uncontrollable dehiscence after the second operation. Two eyes were enucleated at the patient’ s demand due to pain. The fifth eye showed effective closure after the second operation. Conclusion: In our study scleral patch grafts were useful in adequately closing large corneo- scleral defects in 24 of 28 eyes (85.7% ). The antigen load and, therefore, the rejection of the scleral grafts is minimized due to the denaturation of proteins during the alcohol treatment before storage.展开更多
Purpose: To correlate retinal circulatory measurements using scanning laser fl uorescein angiography and flow velocities of retrobulbar vessels measured by mea ns of colour Doppler imaging. Methods: Fifteen patients w...Purpose: To correlate retinal circulatory measurements using scanning laser fl uorescein angiography and flow velocities of retrobulbar vessels measured by mea ns of colour Doppler imaging. Methods: Fifteen patients with normal pressure gla ucoma (NPG) and 15 healthy volunteers underwent colour Doppler imaging and fluor escein angiographic studies. Peak systolic velocities (PSVs), end-diastolic velocities (EDVs) and resistive indices (RIs) of the ophthalmic artery (OA) an d central retinal artery were obtained. In the fluorescein angiograms arterioven ous passage time (AVP) was quantified by means of digital dye dilution curve ana lysis. Results: Arteriovenous passage time was significantly prolonged in NPG pa tients compared to healthy subjects (P=0.0026). In the central retinal artery PS V (P=0.023) and EDV (P < 0.0001) were significantly decreased and RI was increas ed (P < 0.0001) in patients with NPG. The EDV of the central retinal artery show ed a significant correlation with AVP (EDV: r=-0.53, P=0.0023). The RI of the c entral retinal artery correlated significantly to AVP (RI: r= 0.63, P< 0.0001). The AVP did not correlate to EDV or PSV, nor to the RI measured in the ophthalmi c artery. Conclusion: Arteriovenous passage time, which represents blood flow in a vascular segment of artery, capillary bed and corresponding vein, was found t o be correlated to the EDV and the RI of the central retinal artery. The combina tion of different techniques allows further interpretation of ocular circulatory responses.展开更多
Aim:Ocular hemodynamics is of great interest in glaucoma,especially since vascular disturbances may play a pathogenetic role in disease development.To investigate the hemodynamic differences between normal pressure gl...Aim:Ocular hemodynamics is of great interest in glaucoma,especially since vascular disturbances may play a pathogenetic role in disease development.To investigate the hemodynamic differences between normal pressure glaucoma patients and normal volunteers,flow velocities of the retrobulbar vessels were measured by colour Doppler imaging.Method:15 patients with normal pressure glaucoma(NPG)and 15 healthy volunteers underwent colour Doppler imaging(CDI)of the retrobulbar vessels.The patients and the volunteers were especially gender and age-matched.Peak systolic velocities(PSV),end-diastolic velocities(EDV),and resistive indices(RI)of the ophthalmic artery and central retinal artery were obtained.Results:In NPG patients,PSV and EDV in the central retinal artery were significantly decreased,whereas RI was increased in central retinal artery and the ophthalmic artery.Conclusion:Colour Doppler imaging is a non-invasive technique that allows further estimation of the ocular circulatory status.Particularly in the group of patients with disturbed hemodynamics,like NPG patients,it was able to show a reduction of the retrobulbar hemodynamics.展开更多
文摘Background: In young patients with the clinical symptoms of a neuritis neuroradiological imaging is not always necessary. This case report describes a young patient who suffered from a recurrence after 5 years. Since all findings, particularly visual evoked potentials, were classic for neuritis, the patient was treated for neuritis although periocular pain was not present. Case Report: Five years after a neuritis of the left eye (OS), the patient was again referred with a visual loss (VA 0.3 OS). In addition to an afferent pupillary defect OS and a constricted visual field OS, an inter- eye latency difference was demonstrated in the visually evoked potentials. The patient was treated with megadose steroid therapy. Although periocular pain as a classic symptom was absent, no neuroradiological imaging was performed. Six weeks later visual acuity and visual fields further worsened, such that a nuclear magnetic resonance imaging was indicated revealing a meningioma frontobasally compressing the optic nerve. After neurosurgical intervention visual acuity and field stabilized. Conclusions: In rare cases, meningioma may mimick the symptoms of neuritis. Therefore, neuroradiological imaging is indicated in recurrences or complicated disease courses, particularly if classic symptoms such as periocular pain are missing.
文摘PURPOSE: To investigate the effect of retrobulbar anaesthesia on retrobulbar haemodynamics, colour Doppler imaging was performed. Furthermore, the additive effect of epinephrine was examined. Method: Forty-one patients (age 72.7±8.9; 22 f, 19 m) undergoing planned cataract surgery were included in a prospective study. Colour Doppler imaging was performed before and directly after retrobulbar anaesthesia and after cataract surgery to measure the peak systolic velocity (PSV) and end diastolic velocity (EDV) in the ophthalmic artery, central retinal artery and central retinal vein. In 18 patients lidocaine 2%with-out additives (2 ml, retrobulbar transconjunctival injection) and in 23 patients lidocaine 2%with epinephrine 1:200,000 was used. Results: After retrobulbar anaesthesia both groups had a significant reduction of the PSV and of the EDV. After surgery flow velocities increased again. The addition of epinephrine resulted in a significantly greater reduction and slower recovery of flow velocities. Conclusion: Retrobulbar anaesthesia induces a marked reduction of velocity in the retrobulbar vessels. The supplement epinephrine increases this effect, and recovery is much slower. Thus, particularly in patients with already disturbed ocular haemodynamics epinephrine should not be used in order to avoid irreversible functional damage.
文摘Background: Excessively draining fistulas may lead to enucleation when primary suture closure is not effective. In these cases preserved cadaver tissues such as sclera, fascia lata, dura mater and peritoneum have been used for patch graft repair with variable results. In this study, the clinical outcomes after transplantation of scleral patch grafts have been investigated. Method: Twenty- eight eyes of twenty- seven patients underwent surgery with homologous scleral patch grafts for repair of excessively draining scleral fistulas after cataract surgery (n =2), leaking filtering blebs following full- thickness filtration surgery (n=7), large scleral perforations due to trauma (n=7), corneo- scleral ulcerations due to severe eye burns (n=9) or after radiotherapy of malignant melanoma (n=3). The mean size of the rectangular grafts was 8.6 × 6.7 mm (± 2.8/3.1 mm). Clinical follow- up was up to 73 months (median 30 months). Results: Twenty- three of 28 eyes (82.1% ) showed functional closure after initial surgery without any wound complication such as patch retraction or leakage and without evidence of inflammation. In five eyes surgical revision was necessary. Two of these eyes had to be enucleated due to uncontrollable dehiscence after the second operation. Two eyes were enucleated at the patient’ s demand due to pain. The fifth eye showed effective closure after the second operation. Conclusion: In our study scleral patch grafts were useful in adequately closing large corneo- scleral defects in 24 of 28 eyes (85.7% ). The antigen load and, therefore, the rejection of the scleral grafts is minimized due to the denaturation of proteins during the alcohol treatment before storage.
文摘Purpose: To correlate retinal circulatory measurements using scanning laser fl uorescein angiography and flow velocities of retrobulbar vessels measured by mea ns of colour Doppler imaging. Methods: Fifteen patients with normal pressure gla ucoma (NPG) and 15 healthy volunteers underwent colour Doppler imaging and fluor escein angiographic studies. Peak systolic velocities (PSVs), end-diastolic velocities (EDVs) and resistive indices (RIs) of the ophthalmic artery (OA) an d central retinal artery were obtained. In the fluorescein angiograms arterioven ous passage time (AVP) was quantified by means of digital dye dilution curve ana lysis. Results: Arteriovenous passage time was significantly prolonged in NPG pa tients compared to healthy subjects (P=0.0026). In the central retinal artery PS V (P=0.023) and EDV (P < 0.0001) were significantly decreased and RI was increas ed (P < 0.0001) in patients with NPG. The EDV of the central retinal artery show ed a significant correlation with AVP (EDV: r=-0.53, P=0.0023). The RI of the c entral retinal artery correlated significantly to AVP (RI: r= 0.63, P< 0.0001). The AVP did not correlate to EDV or PSV, nor to the RI measured in the ophthalmi c artery. Conclusion: Arteriovenous passage time, which represents blood flow in a vascular segment of artery, capillary bed and corresponding vein, was found t o be correlated to the EDV and the RI of the central retinal artery. The combina tion of different techniques allows further interpretation of ocular circulatory responses.
文摘Aim:Ocular hemodynamics is of great interest in glaucoma,especially since vascular disturbances may play a pathogenetic role in disease development.To investigate the hemodynamic differences between normal pressure glaucoma patients and normal volunteers,flow velocities of the retrobulbar vessels were measured by colour Doppler imaging.Method:15 patients with normal pressure glaucoma(NPG)and 15 healthy volunteers underwent colour Doppler imaging(CDI)of the retrobulbar vessels.The patients and the volunteers were especially gender and age-matched.Peak systolic velocities(PSV),end-diastolic velocities(EDV),and resistive indices(RI)of the ophthalmic artery and central retinal artery were obtained.Results:In NPG patients,PSV and EDV in the central retinal artery were significantly decreased,whereas RI was increased in central retinal artery and the ophthalmic artery.Conclusion:Colour Doppler imaging is a non-invasive technique that allows further estimation of the ocular circulatory status.Particularly in the group of patients with disturbed hemodynamics,like NPG patients,it was able to show a reduction of the retrobulbar hemodynamics.
