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Ocular Anaesthetic Scoring System
Cehajic-Kapetanovic et al report a simple and robust system for assessing and comparing non-topical local anaesthetic techniques (Ocular Anaesthetic Scoring System (OASS)). 100 patients were divided into four groups receiving either sub-Tenon or peribulbar block with 150 or 300 units of hyaluronidase. Patient satisfaction was determined using the Visual Analogue Pain Scale and Iowa Satisfaction with Anaesthesia Scale. The sub-Tenon approach achieved significantly better OASS scores than the peribulbar approach. 300 units of hyaluronidase gave significantly higher OASS scores in both sub-Tenon and peribulbar groups.
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Pain following vitrectomy (20G vs 25 G)
Wickham et al compared post-operative pain following 25-gauge (25G) and 20-gauge (20G) vitrectomy in the first week following surgery. In a randomised controlled trial with 40 patients masked to the treatment allocation, post-operative pain was assessed using both a visual scale and verbal pain scores. In the first 12 h, significant post-operative pain was similar in both groups; however, significant pain was experienced more commonly in the 20G group. There was no statistical difference in the time taken to complete the surgical procedure, although in the 25G group the time from incision to the start of vitrectomy was significantly shorter and in the 20G group the time taken to complete the vitrectomy was less. The authors failed to find significant advantages of using 25G for patients or surgeons.
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New patterns of retinal collateral circulation
Landa and Rosen describe patterns of retinal collateral circulation observed in normal subjects and in a variety of ocular diseases using retinal functional imager. Four patterns of retinal collateral circulation were recognised: (1) looped collateral pattern- an arterovenous anastomotic vessel between the endings of the adjacent artery and vein; (2) vertical collateral pattern- an anastomotic vessel across the horizontal raphe; (3) H shaped collateral pattern- an arterovenous anastomotic vessel between middle parts two vadjacent vessels (artery and vein); (4) cilioretinal–retinal collateral pattern- an anastomotic vessel between the cilioretinal artery and retinal arterial circulation.
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HRT detection of glaucomatous progression
Saarela et al determined the sensitivity and specificity of the stereometric optic nerve head (ONH) parameters of the Heidelberg Retina Tomograph (HRT) to detect progression that was verified in serial stereoscopic ONH photography. In a retrospective study of 342 patients (476 eyes) 51 (11%) eyes showed progression in the stereoscopic ONH photographs evaluated by experienced masked observers. An optimised change in the linear discriminant function value (HRT) was 0.34 with a 65% sensitivity and a 69% specificity for progression. The authors recommend that glaucomatous progression should not be based on the stereometric parameters of the HRT.
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Lenstar LS 900 non-contact biometer
Cruysberg et al evaluated the reproducibility of the Lenstar LS 900 non-contact biometer and comparison it with the Visante anterior-segment Optical Coherence Tomography (AS-OCT) and the IOLMaster in 38 healthy volunteers (76 eyes). The reproducibility of the Lenstar was better than 0.9% for CCT, ACD, LT, K values and AL measurements. The differences in IOL powers, with a mean difference between Lenstar and IOLMaster AL measurements of 0.03 mm, was 0.10 D for an AL of 25 mm. Because of small but significant differences, the measurements of the Lenstar, AS-OCT and IOLMaster are not interchangeable. However, difference in the calculated IOL power was not clinically significant.
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Endophthalmitis following open globe injury
Zhang et al retrospectively studied the clinical characteristics of endophthalmitis following open-globe injury involving 4968 eyes. The endophthalmitis developed in 571 eyes (12%). Despite initial repair, 96 eyes (17%) underwent enucleation or evisceration. Primary repair within 24 h, intraocular tissue prolapse, and selfsealing wounds seemed to impart protective effects against the development of endophthalmitis. Additionally, laceration (including penetration, IOFB and perforation) was also an independent risk factor. Role of intravitreal antibiotics and corticosteroids could not be assessed.
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Ophthalmological findings in children with mitochondrial disease
Grönlund et al describe ophthalmological phenotypes in 59 patients (mean age of 12 yrs) who had mitochondrial disease with known DNA mutations. 81% of the patients had one or more ophthalmological findings such as ptosis, external ophthalmoplegia, strabismus, nystagmus, refractive errors, and partial or total optic atrophy. Retinal dystrophy was recorded in six different genotypes including Kearns–Sayre syndrome.
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Fine-needle aspiration cytopathology and histopathology in orbital mass lesions
Karcioglu et al assessed the diagnostic value of the orbital fine needle aspiration biopsy (FNAB) in a prospective, interventional case series of 66 patients. Immediately after excision of orbital mass lesion, a biopsy was performed with a 23- or 25-gauge needle. The cytopathological and the final histopathological diagnoses were compared. Overall concordance rate was 69%. The concordance rate was highest (100%) among the cases of metastatic/secondary orbital malignancies and inflammatory lesions. Of 11 primary benign tumours, only two cytopathological diagnoses correlated with histopathology. The authors conclude that FNAB diagnoses were least reliable in benign orbital neoplasms and cysts.
See pages 128