Purpose:To study the association of blood pressure(BP)status on the optic disk structure as measured with the Heidelberg Retina Tomograph(HRT)in people without glaucoma.Design:Cross-sectional population-based setting ...Purpose:To study the association of blood pressure(BP)status on the optic disk structure as measured with the Heidelberg Retina Tomograph(HRT)in people without glaucoma.Design:Cross-sectional population-based setting study.Methods:Consecutive participants in the Thessaloniki Eye Study were included in this study.HRT images of the optic disk and BP measurements were taken.Hypertension was defined as a systolic BP(SBP)≥ 140 mmHg,diastolic BP(DBP)≥ 90 mmHg,or both.Subjects were classified in three groups by SBP and DBP.The Kruskal-Wallis test was used to compare the three groups with respect to the HRT parameters.Regression models adjusted for age,gender,height,disk size,intraocular pressure,cardiovascular disease,diabetes,and duration of antihypertensive treatment were used for each HRT parameter to compare values among the different groups.The P value was considered significant at<.05.Results:A total of 232 subjects were included in the analysis.Rim area was signifi cantly different among groups when DBP was considered as the criterion to classify subjects(P=.005).In regression models,cup area,and cup-to-disk(c/d)ratio were increased in subjects with normal DBP that was the result of treatment,as compared with both the high DBP and untreated normal DBP groups.Conclusions:In patients without glaucoma,the DBP< 90 mm Hg that results from antihypertensive treatment is associated with increased cupping and decreased rim area of the optic disk.This information should be considered in research aiming to define the role of the BP status as an independent factor initiating optic disk changes and/or as a contributing factor to glaucoma damage.展开更多
Purpose: To determine the efficacy of echography with new generation contrast agents in visualizing vascularization of choroidal malignant melanomas. Methods: An echographic contrast medium consisting of phospholipidi...Purpose: To determine the efficacy of echography with new generation contrast agents in visualizing vascularization of choroidal malignant melanomas. Methods: An echographic contrast medium consisting of phospholipidic microbubbles filled with sulphur hexafluoride (Sonovue(r)) was used to visualize microcirculation i n 25 cases of choroidal lesions already diagnosed with standardized echography ( 21 choro- idal malignant melanomas, four disciform lesions). Results: In untreated malig nant melanomas contrast agent echography revealed the presence of a dense microc irculation inside the mass. In one case vitreal seeding of the contrast agent wa s detectable before enucleation and histological examination revealed the presen ce of tumoral cells. In 12 cases treated with transpupillary thermotherapy, cont rast agent echographic evaluation showed heavy regression of microcirculation af ter l week, confirmed in one case by histology, and a reduction of 70-80%in di mensions after 6 months (which appeared to have stabilized at subsequent examina tions). In four cases treated with proton beam brachytherapy 2 years prior to ou r examination, contrast agent echography showed the absence of a microvascular n etwork and the presence of large vessels and blood lakes. In four cases of disci form lesion, deep and superficial retina-associated vascularization was observe d, with a weak spread of contrast agent inside the lesion. Conclusion: Live repr esentation with good resolution of choroidal malignant melanoma microcirculation was obtained.展开更多
文摘Purpose:To study the association of blood pressure(BP)status on the optic disk structure as measured with the Heidelberg Retina Tomograph(HRT)in people without glaucoma.Design:Cross-sectional population-based setting study.Methods:Consecutive participants in the Thessaloniki Eye Study were included in this study.HRT images of the optic disk and BP measurements were taken.Hypertension was defined as a systolic BP(SBP)≥ 140 mmHg,diastolic BP(DBP)≥ 90 mmHg,or both.Subjects were classified in three groups by SBP and DBP.The Kruskal-Wallis test was used to compare the three groups with respect to the HRT parameters.Regression models adjusted for age,gender,height,disk size,intraocular pressure,cardiovascular disease,diabetes,and duration of antihypertensive treatment were used for each HRT parameter to compare values among the different groups.The P value was considered significant at<.05.Results:A total of 232 subjects were included in the analysis.Rim area was signifi cantly different among groups when DBP was considered as the criterion to classify subjects(P=.005).In regression models,cup area,and cup-to-disk(c/d)ratio were increased in subjects with normal DBP that was the result of treatment,as compared with both the high DBP and untreated normal DBP groups.Conclusions:In patients without glaucoma,the DBP< 90 mm Hg that results from antihypertensive treatment is associated with increased cupping and decreased rim area of the optic disk.This information should be considered in research aiming to define the role of the BP status as an independent factor initiating optic disk changes and/or as a contributing factor to glaucoma damage.
文摘Purpose: To determine the efficacy of echography with new generation contrast agents in visualizing vascularization of choroidal malignant melanomas. Methods: An echographic contrast medium consisting of phospholipidic microbubbles filled with sulphur hexafluoride (Sonovue(r)) was used to visualize microcirculation i n 25 cases of choroidal lesions already diagnosed with standardized echography ( 21 choro- idal malignant melanomas, four disciform lesions). Results: In untreated malig nant melanomas contrast agent echography revealed the presence of a dense microc irculation inside the mass. In one case vitreal seeding of the contrast agent wa s detectable before enucleation and histological examination revealed the presen ce of tumoral cells. In 12 cases treated with transpupillary thermotherapy, cont rast agent echographic evaluation showed heavy regression of microcirculation af ter l week, confirmed in one case by histology, and a reduction of 70-80%in di mensions after 6 months (which appeared to have stabilized at subsequent examina tions). In four cases treated with proton beam brachytherapy 2 years prior to ou r examination, contrast agent echography showed the absence of a microvascular n etwork and the presence of large vessels and blood lakes. In four cases of disci form lesion, deep and superficial retina-associated vascularization was observe d, with a weak spread of contrast agent inside the lesion. Conclusion: Live repr esentation with good resolution of choroidal malignant melanoma microcirculation was obtained.
