A young woman with ulcerative colitis developed pneumonia, which responded to corticosteroids. Histological examination showed this to be bronchiolitis obliterans organising pneumonia. We are grateful to Professor B Corrin, Brompton Hospital, London, for reviewing the lung biopsy specimen.
We evaluated the differences in the optic nerve head in patients with chronic open-angle glaucoma (HTG) and those with low-tension glaucoma with either relatively high (between 16 and 21 mmHg [LTGH]) or low (< or = 15 mmHg [LTGL]) intraocular pressures. We included 36 patients in this study. We found that LTGL patients had a significantly greater mean area of peripapillary atrophy inferior to the optic disc (0.65 +/- 0.38 mm2) than LTGH (0.40 +/- 0.38 mm2) or HTG (0.34 +/- 0.25 mm2) patients (p < 0.005). No significant difference was found between groups for the area of the neural rim, optic disc, cup/pallor discrepancy, or peripapillary halo, or in the diameter of the largest artery or vein in the inferior and superior peripapillary area. This study raises the question of whether a separate mechanism of damage could exist at the optic disc in patients whose intraocular pressure is < or = 15 mmHg because of a greater extent of peripapillary atrophy than in patients with higher intraocular pressures.
We evaluated the intra- and inter-observer variability of depth measurements of the optic disc in cadaver eyes using the Glaucoma-scope. Intra-observer variation of 10 separately captured images became significantly greater with increasing depth of the optic cup (p < 0.001). The standard deviation of depth measurements were 9.06 mu over the neural rim, 25.00 mu along the cup wall, and 40.94 mu at the bottom of the optic cup. However, intra-observer variation of a single captured image did not increase with greater optic cup depth. Intra-observer variation, but not inter-observer variation, generally was greater when measuring the superior than inferior optic disc (p < 0.05). This study suggests that when capturing separate optic disc images with the Glaucoma-scope, increased variation in depth measurements can be expected with greater optic cup depth and in the superior portion of the optic disc.
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