Purpose Ibopamine is a prodrug of N-methyldopamine that has a non-cycloplegic mydriatic action due to its α-adrenergic properties and is able to induce, when topically given, a transient increase of intraocular pressure (IOP) in eyes with hydrodynamic disorders. Methods This is a randomized, crossover, open-labeled, two- center study. Forty patients (20 open-angle glaucoma patients and 20 healthy subjects) were treated with ibopamine 2% eye drops and phenylephrine 10% eye drops. Results Ibopamine induced a significant increase in IOP only in glaucomatous eyes (p<0.001) without a significant hypertensive effect in normal eyes. Ibopamine and phenylephrine showed a similar mydriatic activity but ibopamine was able to induce an hypertensive effect only in glaucomatous eyes. Conclusions The results confirm the use of ibopamine as provocative test in detection of hydrodynamic disorders.

In 2001, for the first time in its life, the AISG is holding its Annual Meeting far away from its traditional venue, i.e. Rapallo.The explanation for this decision on the part of its Directive Council, approved, moreover, enthusiastically, by the great majority of its members, lies, in my opinion, in two good reasons: 1 the concomitant IGS with the weight of its programme and the number of participants, as well as the outstanding names present; 2 the attractive beauty of this famous city of Prague, so full of history and charming spots.Our idea has been very much appreciated by our Greek colleagues, who have decided to join us in this initiative, which, on the other hand, has been supported right from the beginning as well by the organizers of IGS, Prof Melamed and Prof Schumann. To both of them go our sincere thanks for their welcome and collaboration.Let us think of it this way, however, that a third good reason for joining our forces may lie in the desire not only to exchange ideas and knowledge, but to meet friends who, for many reasons of life, we see all too rarely and with whom it is so nice to spend some time in a pleasant atmosphere speaking of many topics not necessarily only of ophthalmology.Also for this reason, let us succeed in respecting the times of the programme so as to have more time for enjoying ourselves. 7Prague opening remarks Partly as a result of my participation as moderator in the 1999 American Academy of Ophthalmology Glaucoma Subspecialty Day Symposium on Normal Tension Glaucoma, I have been requested to present an overview on this topic. Having made liberal use of materials provided by each of the speakers in the symposium, I wish to thank Drs Brian Lee, David Greenfield and Roger Hitchings and acknowledge their contributions. This presentation will be divided into the following four sections:I. The misnomer of normal tension glaucoma (NTG). II. Potentially contributing factors in the pathogenesis of glaucoma and their relevance to normal tension glaucoma. III. Potentially differentiating characteristics between glaucoma with normal IOP and glaucoma with elevated intraocular pressure (IOP). IV. Lessons learned from the Normal Tension Glaucoma Study. I. The misnomer of normal tension glaucoma (NTG)There is considerable controversy on whether normal tension glaucoma represents a distinct entity or is simply primary openangle glaucoma (POAG) with IOP within the normal range. Because IOP is a continuous variable with no definite dividing line between normal and abnormal, many authorities are questioning whether the term normal tension glaucoma should be abandoned. Normal tension glaucoma is typically defined as a glaucomatous optic neuropathy despite IOP consistently below 21 mmHg. The question must therefore be asked, 'What's so special about 21 mmHg?' Answering that question requires a review of Leydhecker's landmark investigation of 1958 wherein the IOPs of 20 000 eyes were obtained with Schiotz tonometry (Leydhecker et al. 1959). The mean IOP was found to be 15.5 mmHg with a standar...

Pattern-reversal electroretinograms (PERG) and visual evoked potentials (P-VEP) were measured for 10 eyes from 10 rigorously selected patients with bilateral advanced primary open angle glaucoma (POAG), before and after surgical trabeculectomy. The aim was to establish whether electrofunctional examinations improved after major IOP reduction. Only one eye at random was operated, and the fellow eye was used as control. The aim of this study, using electrofunctional examinations, was to clarify whether ganglion cell damage was reversible after marked reduction of IOP by surgery. The results indicate that glaucomatous damage seems to be irreversible.

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These data stress that, even in presence of a moderate and transient IOP increase, inner retinal function of patients with OHT may be transiently affected.