Purpose: To evaluate the relationship between age and retinal nerve fiber layer (RNFL) thickness in normal subjects, as measured by optical coherence tomography (OCT). Methods: One hundred and forty-four normal subjects (144 eyes), ranging from 16 to 84 years of age, were enrolled in this cross-sectional study. The RNFL thickness was determined using OCT with three circle scans 3.4 mm in diameter. Results: The average RNFL thickness was inversely correlated with age (r = –0.348, p < 0.001). Analyzing the quadrants as a parameter, RNFL thickness in the superior, temporal and inferior quadrants also decreased with age. Using 30-degree segments, there were significant correlations between age and the RNFL thickness of temporal segments (7–11 o’clock). The average RNFL thickness had the highest correlation among all parameters (r = –0.348, p < 0.001). Regarding nasal quadrant thickness, RNFL ratios (average, superior, temporal and inferior RNFL thickness relative to the nasal quadrant thickness) were not significantly correlated with age. The refractive error did not affect RNFL thickness (r = 0.091, p = 0.276). Conclusion: Our study revealed that RNFL thickness, in particular in the temporal quadrant, measured by OCT significantly decreased with age. Age has to be taken into consideration when we compare RNFL thickness between normal and glaucomatous eyes.

The ideal option was a treatment that was readily available and could be delivered safely and effectively in the recumbent position. Argon laser photocoagulation via the indirect ophthalmoscope was therefore our procedure of choice. We found the procedure quick, effective and inexpensive. It is also easily performed by ophthalmologists experienced in the use of argon laser photocoagulation via the binocular indirect ophthalmoscope. We propose that similar patients can be treated by this method before referral to a vitreoretinal surgeon for vitrectomy.Dellaporta 5 described a similar procedure in which evacuation of subretinal haemorrhage was achieved by perforation of the retina using direct argon laser photocoagulation delivery with good results. Sahu and co-workers 6 described a stretch burn technique which apparently reduces the size and energy level requirement of the penetrating burn. We did not find this procedure necessary; however, we suspect that more than one penetrating burn is required to enable the blood to flow into the vitreous cavity.The relative ease and apparent efficacy of this technique are encouraging; however, in bilateral macular haemorrhages the patient may find it difficult to fixate and thus require a local anaesthetic to reduce ocular movement and hence inadvertent retinal burns. Bleb leaks may occur as an early or late complication of glaucoma filtering surgery, and are often recalcitrant to therapy. Spontaneous late bleb leaks occur more frequently in glaucoma filtering surgery following adjunctive use of the antimetabolites mitomycin C 1 or 5-fluorouracil, and with full-thickness procedures. We describe a new 'repair technique' in a patient with a late onset leaking bleb. Case reportA 48-year-old woman with primary open angle glaucoma in the right eye had undergone trabeculectomy with an antiproliferative agent 31/z years previously. Trabeculectomy was performed with a limbal-based flap. A cellulose sponge containing mitomycin C 0.2 mg! dl was applied to the eye between the sclera and conjunctiva for 3 min. After the application of a second sponge, the conjunctiva was irrigated with at least 250 ml balanced salt solution. A 4 mm lamellar scleral flap was prepared at a uniform depth of approximately one-half of scleral thickness. After entering the anterior chamber, a Kelly-Descemet punch (Stortz Instruments, St Louis, MO) was used to excise the trabeculum, cornea and scleral tissue. A peripheral iridectomy at the same site was performed. Five 10-0 nylon sutures were used to close the scleral flap. The conjunctival incision was closed with running locked 10-0 nylon sutures. The post operative intraocular pressure was well controlled at approximately 15 mmHg in the operated eye for 2 years after the operation. The post-operative best corrected visual acuity was 20/20 with a refractive error of -9.0 D.

No abstract

No abstract