Purpose To investigate the relationship between visual acuity and foveal birefringence in patients with neovascular age-related macular degeneration. Methods In total, 40 patients with choroidal neovascularization underwent macular imaging with scanning laser polarimetry. Bowtie patterns, typically seen in birefringence images of the macula, were evaluated and classified into three categories: (1) regular bowtie present; (2) bowtie present, but disrupted; and (3) no bowtie present. The relation of the bowtie appearance to the best-corrected logMAR visual acuities was tested (ANOVA). Results Mean visual acuity was best for the group that had regular bowties (mean logMAR ¼ 0.34) and differed statistically significantly from the disrupted bowtie group and no bowtie group (P ¼ 0.01 and 0.0007). Ages for the three groups did not differ (P ¼ 0.31). Conclusions Appearance of a regular bowtie indicates a substantially intact Henle fibre layer with the potential for good visual function, despite the presence of underlying pathology. Conversely, disruption or absence of a bowtie may indicate severe damage to the photoreceptors, consistent with the finding of poorer visual acuity.
Corneal thickness and osmolarity are significantly correlated to the osmolarity of the rinsing solution. Corneal edema dilutes the agent in the stroma. Therefore, we recommend solutions with low osmolarity (tap water) or high buffer capacity (Previn) for the initial post-trauma irrigation.
In summary, the attenuation of stunning by the ACE inhibitor ramiprilat involves a signal cascade of bradykinin and prostaglandins but not nitric oxide.
The confirmation of microbial cause of keratitis is more effective using microbiopsy than with corneal smears. As a result of the effective treatment after biopsy diagnosis, the majority of cases of keratitis healed. Local therapy seems to have been optimised due to the unroofing of infection during biopsy as well. Therefore microbiopsy in combination with laboratory diagnosis may prove to be a very useful diagnostic and possibly therapeutic method in the clinical routine.
ABSTRACT.Purpose: To evaluate the effects of hypo-osmolar tap water and isotonic saline solution on the intracameral pH, intraocular pressure and histological changes in alkali burned rabbit eyes. Methods: Four groups of four rabbit corneas each were burned with 2 N sodium hydroxide, and then rinsed with 0.5 l or 1.5 l of saline solution or tap water, respectively. Changes in pH were monitored with an intracameral microelectrode. Intraocular pressure (IOP) was monitored by a transducer placed in the vitreous cavity. After enucleation, histology was performed. Results: The pH increased after 1.5 min following alkali application. Irrigation with different solutions affected the maximum pH levels reached. Following the tap water rinse, the maximum rise was significantly lower than after the saline solution rinse. The maximum rise following rinsing with 1.5 l of tap water showed a significant delay. The increase in IOP was 23 ± 10 mmHg without differences between the groups; the original pressure was recovered after 18 ± 9 min. Histology of the eyes revealed a significant oedema in all corneas. Other ocular structures appeared unchanged. Conclusions: The hypo-osmolarity of tap water led to remarkable corneal oedema. Enlargement of the diffusion barrier and intracorneal dilution inhibit elevated intracameral pH levels. The difference in maximum pH levels reached may influence the degree of subsequent intraocular structure injury. Therefore, the use of iso-osmolar saline solution proves to be less efficacious than tap water as an irrigation agent for ocular burns.
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