Szemészet, 2007 (144. évfolyam, 1-4. szám)

2007-12-01 / 4. szám

144. évfolyam (2007) Supplementum 1.

63

Influence of selective laser trabeculoplasty (SLT) on diurnal IOP fluctuation in POAG

Péter Kóthy, Márta Tóth, Gábor Holló

Department of Ophthalmology, Semmelweis University, Budapest

Purpose: To investigate the influence of SLT on mean diurnal IOP (mean-IOP) and diurnal IOP fluctuation. Methods: Twenty-six eyes of 13 POAG patients underwent a 4-week washout before baseline diurnal IOP curve. Standard 360-degree SLT was performed. IOP was controlled at week 1 and month 1. The IOP curve was repeated after 3 and 6 months. IOP lowering medication was started (failure) if mean-IOP was higher than 22 mmHg or any single IOP value exceeded 26 mmHg at any visit.

Results: Post-treatment IOP elevation >5 mm Hg was found in 16 eyes (62%). An at least 20% decrease of the mean-IOP was not reached.. Baseline mean-IOP and diurnal IOP fluctuation (mean±SD) were higher for the 11 eyes requiring medication before the month 3 visit than for the other eyes (mean IOP: 28.8±5.2 mmHg vs. 20.8±3.1 mmHg, unpaired t-test, p<0.0001; IOP fluctuation: 9.5±3.7 mmHg vs. 6.8±1.9 mmHg, p=0.0423). For the eyes with no medication mean-IOP changed from 19.3±1.4 mmHg (baseline) to 18.6±1.4 mmHg (month 3, Duncan test, p=0.090) and to 18.2±2.0 mmHg (month 6, p=0.017). No difference was seen between month 3 and 6 (p=0.351). Diurnal IOP fluctuation decreased from 7.2±2.3 mmHg (baseline) to 4.3±1.7 mmHg (month 3, p = 0.0004) and to 5.1 ±1.7 mmHg (month 6, p=0.004). No difference was found between the month 3 and the month 6 values (p=0.225).

Conclusion: SLT resulted in a decrease of the mean diurnal IOP and the diurnal IOP fluctuation.

AMD: past and current therapeutic approaches

George Kranias

Department of Ophthalmology, University of Cincinnati College of Medicine, Ohio USA

The management of neovascular age-related macular degeneration (AMD) is undergoing an unprecedented evolution. Over the past 10 years, most of the retina specialists have abandoned laser photocoagulation to treat choroidal neovascularization (CNV) with new technologies, including photodynamic therapy and the use of anti-angiogenesis agents. There has been exponential growth of interest by pharmaceutical companies in AMD over the past few years because of the large unmet medical need and the growing AMD market. The goal of this talk is to review the past and current therapeutic approaches of neovascular AMD.

Flashing lights and floaters

George Kranias

Department of Ophthalmology, University of Cincinnati College of Medicine, Ohio, USA

Purpose: A review of the various etiologies of flashing lights, floaters or both as visual phenomena perceived by the patient. Illustrative cases are presented so that the ophthalmologist can determine whether the situation is vision or life threatening in nature.

Introduction: The subjective visual perception of light without a light stimulus is termed photopsia. This is related to an abnormality that occurs anywhere within the visual system extending from the retina to the cerebral cortex. Helpful in the anatomic localization of the problem is a thorough history and description of the perceived “lights” from the patient. A review of systemic health and present medicines is also taken. The duration, frequency, and pattern of the lights, as well as, associated systemic symptomatology, (such as headache, paresthesias, and palpitations) is ascertained. The lights are characterized as “swirling”, small round light bulbs, lightning streaks, colored