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L eber hereditary optic neuropathy (LHON) is a form of blindness due to retinal ganglion cell dysfunction (1), caused by mutations in mitochondrial DNA (mtDNA), which affect complex I (NADH-ubiquinone oxidoreductase) of the mitochondrial respiratory chain (2,3). Although rare (estimated prevalence of 1 in 27,000-45,000), it affects all ages and gender, causing rapid and severe, bilateral (usually sequential), painless loss of central vision (4-7). Spon

Although refractive astigmatism decreased in both groups, toric IOL implantation was more effective and predictable, resulting in greater spectacle independence.

Cyclodialysis is the result of the separation of the longitudinal ciliary muscle fibers from the scleral spur, which creates an abnormal pathway for aqueous humor drainage that may lead to ocular hypotony. For many years cyclodialysis was considered a treatment option for glaucoma. However, today it usually occurs as a complication of blunt trauma or more rarely as a complication of anterior segment ocular surgery. Ocular hypotony can lead to cataract development, optic disk swelling, refractive changes, and several retinal complications, making accurate identification and timely intervention of the cleft mandatory. Traditionally gonioscopy was the only available technique to diagnose and localize the cleft. However, other tests such as optical coherence tomography, magnetic resonance imaging, transillumination, and specially ultrasound biomicroscopy are now available for the diagnosis of cyclodialysis. Multiple treatment options are also available for this condition. Although medical treatment can be effective to close small clefts, surgery is needed in most patients to restore ocular pressure.

ABSTRACT.Purpose: To evaluate the usefulness of optical coherence tomography (OCT) for follow-up of optic neuritis (ON) compared with subjective visual function tests. Methods: Twelve patients with ON underwent a complete ophthalmological evaluation at initial diagnosis, including best corrected visual acuity (VA), visual fields testing and OCT examination. These examinations were repeated periodically over 6 months. Retinal nerve fibre layer (RNFL) thickness evolution was analysed and correlated with VA and visual field mean deviation. Results: Six months after ON, mean RNFL in the affected eye decreased significantly compared with that in the fellow eye (24.54%). A significant correlation was found between RNFL thinning and final VA (r ¼ 0.807, p ¼ 0.005), with a 1-line drop in VA for every 5.4-lm decrease. All patients with an altered visual field had an abnormal RNFL value; of the seven patients with normal visual fields, 57% had an abnormal RNFL value (p < 5%). Conclusions: Optical coherence tomography can detect axonal damage as early as the third month after an isolated initial episode of ON, even in the presence of normal visual fields. Mean RNFL thinning is correlated with final VA.

Peripapillary RNFL thickness abnormalities assessed by OCT in patients with mild papilledema were quantitatively correlated with visual field sensitivity losses. The data support the possible use of OCT as a noninvasive quantitative method of monitoring the amount and evolution of papilledema.