Purpose:
The purpose of this study was to better understand the role of vascular risk factors in the pathogenesis of primary open-angle glaucoma (POAG), a detailed analysis of retinal arterial wall thickness is needed. The purpose of the present study was to make a morphologic analysis of peripapillary arteriole in POAG using adaptive optics (AO) technology.
Patients and Methods:
We included otherwise healthy subjects with an isolated confirmed diagnosis of bilateral POAG. Patients’ clinical characteristics were noted. AO imaging followed by a complete ophthalmic examination was performed. A single operator masked to clinical data performed 5 measurements at different locations of each analyzed vessel. For each location, lumen diameter and wall thickness were measured. Total diameter, wall-to-lumen ratio (WLR), and whole cross-sectional area were calculated.
Results:
Lumen diameter and total diameter were significantly lower in the glaucoma group (n=31) than in the control group (n=29): [median (interquartile ranges)] 88.3 (82.6-99.2) versus 102.3 (87-113.1) (P=0.03) and 121.1 (109.3-130.5) versus 134.4 (112.7-144.4), respectively (P=0.015). Wall thickness, WLR, and whole cross-sectional area were not significantly different. Apart from a significantly higher WLR in subjects with reported high cholesterol levels, we did not observe any correlation between patients’ clinical characteristics and any of the parameters.
Conclusions:
We observed in POAG a narrowing of the arteriolar lumen without modification of the vessel wall thickness. To date, it is the first time that these data are obtained using AO. This suggests that the vascular risk factor in POAG only reduces the vascular caliber without inducing any patent atherosclerosis of the retinal arterial wall.
We describe a case of immune reconstitution uveitis occurring in an HIV-negative patient with bone-marrow transplant, not directly related to cytomegalovirus retinitis.
Actinic keratosis is considered a precancerous lesion, constituting a precursor to squamous cell carcinoma (SCC) formation. Perineural invasion has been observed in patients with cutaneous carcinoma due to local subcutaneous tissue destruction and primarily involves the trigeminal nerve due to rich innervation provided by the supraorbital nerve in addition to the facial nerve. An unusual case of perineural infiltration and orbital invasion of squamous cell carcinoma associated with actinic keratosis is presented. A 70-year-old Caucasian woman presented with complete left eye ophthalmoplegia, total left upper-eyelid ptosis, and facial pain with paresthesia. Computed tomography revealed a process of the soft tissues in the left cheek infiltrating the infraorbital canal, pterygopalatine fossa, inferior orbital fissure, and left cavernous sinus with periosteal adherence. Magnetic resonance imaging revealed pathological extension via the left infraorbital canal with a considerable area of necrosis. Treatment of facial actinic keratosis may not prevent malignant transformation and can delay diagnosis and treatment of SCC. A deep biopsy appears to be essential for a correct diagnosis. Perineural spread of cutaneous SCC may be characterized by insidious progression in the cranial trigeminal nerve, abnormal ocular motility, diplopia, or external ophthalmoplegia.
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