PURPOSE: To study pulsatile ocular blood flow (POBF) throughout pregnancy. METHODS: We enrolled twenty-seven healthy women in the first trimester of gestation, only ten of which were followed through the second trimester, and fourteen non pregnant healthy women. In each subject we measured POBF with the POBF pneumotonometer (OBF Ltd. UK), IOP, blood pressure (BP) and heart rate (HR). An unpaired Student t-test was used to compare pregnant women with non-pregnant women, and a two-tailed paired Student t-test was used to compare the same women in the first and second trimester of pregnancy. p <0.05 is considered statistically significant. RESULTS: Results are presented as means +/- SD. In the first trimester of pregnancy the age was 32 +/- 6, POBF 1516.4 +/- 382 ml/min, IOP 13 +/- 3 mmHg, BP 92 +/- 6 mmHg, and HR 86 +/- 14 beats/min. In the second trimester POBF was 1629.11 +/- 352.4 ml/min, intraocular pressure (IOP) 12 +/- 3 mmHg, BP 96 +/- 3 mmHg, and HR 93 +/- 10 beats/min. In the control group the age was 27 +/- 9, POBF 972.23 +/- 329.3 ml/min, BP 88 +/- 4.3 mmHg, and HR 80 +/- 14 beats/min. POBF increases during the first trimester (p = 0.00008). In the second trimester POBF was higher compared to the first trimester (p = 0.0008). Non significant differences were observed for the other parameters. CONCLUSIONS: The POBF increases throughout gestation. During pregnancy there is an increase in estrogen which induces endothelial-dependent vasodilatation in several tissues. The estrogen changes may influence POBF.

Adolescent↗

PubMedDate not supplied

Impaired neural conduction in crossed visual pathways in patients with ocular hypertension.

PURPOSE: To evaluate the neural conduction along crossed and uncrossed visual pathways in patients with ocular hypertension (OHT). METHODS: Fifteen patients (mean age 59.1+/-6.8 years) with OHT (IOP>22 mmHg, Humphrey 24-2 with mean deviation [MD]>-2 dB) were enrolled. They were compared to 15 age-matched controls. In OHT patients and control subjects, visual evoked potentials (VEPs) were recorded using full-field checkerboard patterns (the check subtended 15' of visual arc; contrast 80%) reversed at 2 Hz. VEP responses were simultaneously recorded in the homolateral visual cortex (HC) and in the contralateral visual cortex (CC), with respect to the stimulated eye. RESULTS: In OHT patients, VEP P100 implicit times observed in HC and CC were both significantly delayed (analysis of variance, p<0.01) when compared to those of controls, and, in particular, longer in CC than in HC. The interhemispheric differences (ID: P100 implicit time in HC - P100 implicit time in CC) were significantly higher in OHT patients than controls (-3.16+/-1.80 msec and 1.16+/-1.04 msec, respectively, p=0.001). In OHT patients we observed an MD hemifield difference (difference between nasal and temporal MD values) higher than in controls (-0.82+/-0.80 dB and 0.04+/-1.03 dB, respectively, p<0.01) and significantly correlated with the ID (r: 0.836, p<0.001). CONCLUSIONS: The observed asymmetry in the bioelectrical cortical responses and in the visual hemifield parameters suggests that crossed visual pathways could be impaired earlier than uncrossed visual pathways in OHT patients.

Aged↗

PubMedDate not supplied

Pilot study to evaluate the efficacy and safety of pneumatic trabeculoplasty in glaucoma and ocular hypertension.

PURPOSE: Following laser-assisted in situ keratomileusis (LASIK), intraocular pressure (IOP) is measurably lower in a significant number of cases. It has been proposed that the decrease in IOP may be a real event. Prior trials have evaluated pneumatic trabeculoplasty (PNT) in combination with concomitant glaucoma medications. The aim of this study was to determine the efficacy and the safety of PNT alone to lower IOP in patients with primary open angle glaucoma (POAG) or ocular hypertension (OH). METHODS AND RESULTS: A total of 37 subjects with POAG or OH were enrolled in a prospective, open-label, fellow-eye, multicenter trial to determine the IOP lowering effects of PNT. All subjects underwent ophthalmologic examinations and IOP measurements and were washed out from all glaucoma medications prior to the start of the study. The trial was intrapatient controlled for the first 30 days, with one eye receiving PNT at days 0 and 7 and the fellow eye serving as the control. The second eye was treated with PNT at day 30. The patients were followed for 120 days, with the first eye receiving an additional PNT treatment at days 90 and 97. Two analyses-an intent to treat analysis in which the last IOP measurement for patients dropped from the study was carried forward and an analysis including only those patients who completed the trial-were performed. Of the 37 patients enrolled, 27 (73%) completed the study. For the intent to treat analysis the baseline mean IOP was 24.7+/-1.9 mmHg for eye 1 and 23.6+/-2.3 mmHg for eye 2 and the difference was statistically significant (p<0.05). Using this analysis the differences between eye 1 mean IOP at days 1, 7, 14, and 60 and the baseline mean IOP were statistically significant (p<0.05). The differences between eye 2 mean IOP and the baseline mean IOP were statistically significant (p<0.05) at all time points except day 14 and day 30. The greater mean IOP reductions from the baseline mean IOP for eye 1 were at study day 1 (-16,1%), day 14 (-9%), and day 60 (-8.9%). For eye 2 they were at day 60 (-8.7%) and at day 120 (-9.1%). For the analysis that included only those subjects who completed the trial the decrease in eye 1 mean IOP from baseline was statistically significant (p<0.05) at all time points. The decrease in eye 2 mean IOP from baseline was statistically significant at all time points except day 30. Using this analysis the greater mean IOP reductions from the baseline mean IOP for eye 1 were at study day 1 (-19%), day 14 (-15.7%), day 37 (-16.3%), day 60 (-20.0%), day 90 (-18.1%), day 97 (-16.8%), and day 120 (-15.8%). For eye 2 greater mean IOP reductions from baseline mean IOP were seen on day 37 (-13.0%), day 60 (-16.7%), day 90 (-15.5%), day 97 (-14.5%), and day 120 (-7.2%). No statistically significant differences were found in mean IOP reduction between the two eyes treated. A total of 34 patients (92%) showed adverse effects: conjunctival hyperemia in 26 (70.3%) and conjunctival hemorrhage in 14 (37.8%). CONCLUSIONS: This pilot study of PNT showed a potentially good IOP lowering effect on glaucoma and hypertensive patients. Additional studies would help to better define the types of patients who respond to PNT and to identify risk factors that may lead to treatment failure.

Adult↗

PubMedDate not supplied

Electrophysiological assessment of visual pathways in glaucoma.

PURPOSE: To assess nerve conduction in visual pathways in patients with open-angle glaucoma. METHODS: Pattern-electroretinograms (PERG) and visual-evoked potentials (VEP) were simultaneously recorded in 16 patients with open-angle glaucoma (POAG) and 15 age-matched controls. The visual stimuli were checker-board patterns (the check edges subtend 15'; the contrast was 70% and reversed at the rate of 2 reversals/s). RESULTS: POAG patients showed significantly higher PERG and VEP latencies (ANOVA: P < 0.01) and significantly lower amplitudes than controls; the retinocortical time (RCT: difference between VEP P100 latency and PERG P50 latency) was longer (P < 0.01) in POAG than controls and the longer RCT was correlated with the reduced PERG amplitude (r:0.798, P < 0.01). CONCLUSIONS: This suggests that POAG patients have an involvement of the innermost retinal layers and impaired nerve conduction in their visual pathways.

Aged↗

PubMedDate not supplied

[Ocular tonography as a diagnostic test in myasthenia (preliminary note)].

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Adolescent↗