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  1. Creig Hoyt, Editor

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    ULTRASOUND BIOMICROSCOPY FOR ANTERIOR SEGMENT TUMOURS

    Ultrasound biomicroscopy has dramatically improved resolution of anterior segment tumours. In a retrospective analysis of 132 eyes evaluated in an ocular oncology unit Conway and co-workers demonstrated the superiority of ultrasound biomicroscopy versus conventional B-scan for the precise localisation of uveal melanoma, especially involving the ciliary body and peripheral iris. See p 950

    SYSTEMIC HYPERTENSION AND GLAUCOMA

    Hypertension is an important risk factor for cardiovascular disease. Recent data suggest common mechanisms related to altered epithelial sodium transport in the distal nephron and ciliated epithelium. This may explain the coincidence of glaucoma and systemic hypertension. Langman and co-workers report that hypertension is significantly more common in patients with glaucoma than in controls. They recommend that the choice of cardiovascular treatment could substantially influence glaucoma incidence, with β blockage protecting and angiotensin converting enzyme inhibitors or calcium channel blockers not affecting underlying risk. See p 960

    OBESITY AND AGE RELATED MACULAR DEGENERATION

    Age related macular degeneration (ARMD) is a degenerative disease of the macula and the leading cause of blindness and visual impairment among people aged 50 years or over in developed countries. Obesity may be one of the risk factors for ARMD as has been suggested in several previous studies. However, Moeini and co-workers report a case-control study including 50 patients with ARMD and 80 control subjects. In this study obesity appears to be a risk factor for progression of ARMD but there is no significant relation with the presence of ARMD. See p 964

    EVIDENCE OF RETINAL TOXICITY AFTER ETHAMBUTOL USE

    Ethambutol is commonly used for the treatment of tuberculosis and Mycobacterium avium complex infections. It has been known for some time that optic neuropathy may complicate its use. Behbehani and co-workers studied four patients with ethambutol associated visual loss with multifocal electroretinography (ERG). This study suggests that abnormalities in multifocal ERGs can be detected in some patients with ethambutol use. Ethambutol may be toxic to the retina as well as the optic nerve. See p 976

    LATERAL RECTUS MUSCLE ATTACHMENT TO THE ORBITAL WALL

    Surgical treatment of third cranial nerve paralysis is a challenging problem. Weakening of the left lateral rectus muscle with standard surgical procedures usually does not realign the eyes appropriately. Morad and co-workers describe a surgical approach to this problem that involves disinsertion of the lateral rectus muscle and reattachment to the lateral orbital wall. In their studies this simple and safe surgical procedure re-established reasonable ocular alignment in primary gaze. See p 983

    DOSAGE OF INTRAVITREAL TRIAMCINOLONE IN DIABETIC MACULAR OEDEMA

    Macular oedema is one of the most important reasons for reduced vision in patients with diabetic retinopathy. Recent reports suggest that intravitreal triamcinolone acetonide may be an alternative treatment to reduce macular oedema. Spandau and co-workers report a prospective randomised double masked clinical interventional study of 27 eyes with diffuse diabetic macular oedema. They randomly divided the patients into three study groups receiving an intravitreal injection of filtered triamcinolone acetonide of 2 mg, 5 mg, or 13 mg. In this study patients with diffuse macular oedema who received 13 mg of intravitreal triamcinolone exhibited a longer lasting treatment response than those who received either 5 mg or 2 mg. This study did not demonstrate that the increased dosage used was associated with an increase in intraocular pressure elevations. See p 999

    RADIOTHERAPY FOR AGE RELATED MACULAR DEGENERATION

    The SubFoveal Radiotherapy Study Group reports the result of visual functioning and quality of life studies in a multicentre single mask randomised control of 12 Gy of external beam therapy for the treatment of choroidal neovascularisation and age related macular degeneration. In this study, both control and treated subjects had significant losses in visual functioning as seen by a progressive decline in mean scores in the four dimensions of daily living tasks dependent on vision scores. The small benefits noted in clinical measures of vision in treated eyes did not translate into better self reported visual functioning in patients who received treatment when compared with the control arm. See p 1045

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