The purpose of this study was to compare central laminar thickness (LT) among patients with glaucomatous optic neuropathy (GON), patients with non-GON, and normal subjects using enhanced-depth imaging optical coherence tomography (EDI-OCT). Enrolled were 57 patients (n = 64 eyes), including 30 women and 27 men. Three groups were identified: GON (n = 18 eyes), non-GON (n = 16 eyes), and control (n = 30 eyes). The GON group comprised eyes with primary open-angle glaucoma (POAG) (n = 9) and normal-tension glaucoma (NTG) (n = 9). The non-GON group comprised eyes with demyelinating optic neuritis (n = 9), anterior ischemic optic neuropathy (AION) (n = 2), compressive ON (n = 2), Leber hereditary ON (n = 2), and traumatic ON (n = 1). GON and non-GON groups were further divided into mild, moderate, and severe subgroups. Inclusion in the GON group was based on mean deviations (MDs) of visual fields; inclusion in the non-GON group was based on critical flicker frequency (CFF) responses. Intraclass correlation coefficients (ICCs) were used to verify reproducibility of measurements. LTs of GON and non-GON group eyes were thinner than those of control group eyes (p50.01); LTs of GON group eyes were thinner than those of non-GON group eyes (p = 0.01). LTs of severe GON subgroup eyes were thinner than those of moderate and mild GON subgroup eyes (p50.001; p = 0.024, respectively). LTs of severe non-GON subgroup eyes were thinner than those of mild non-GON subgroup eyes (p = 0.002). These results show that EDI-OCT is valuable for documenting structural abnormalities in optic neuropathy (ON).
Background: Pain from intraoperative retraction of extraocular muscles is the main cause of ocular discomfort after strabismus surgery. Injection of the long-acting local anesthetics can reduce ocular pain after strabismus surgery under general anesthesia. Purpose: To evaluate the e cacy of subtenon bupivacaine injection on postoperative pain control Methods: A prospective double-masked randomized trial was conducted in 18 eyes of 9 patients (age range 20-67 years) who underwent binocular strabismus surgery under general anesthesia at Thammasat hospital. Both eyes of each patient were randomized to receive subtenon injection with 0.5% bupivacaine 0.1 ml in one eye and sterile saline injection in the fellow eye at the end of surgery. Primary outcome measures were visual rating pain scores at 30 minutes, 1 hour, 4 hours and 6 hours postoperatively. Secondary outcome measures were adverse e ects of bupivacaine injection. ral acetaminophen was added as per patient pain requirement. The doses of this adjunctive analgesia were recorded. Results: Average pain score between study group vs control group was 1.33 vs 2.66, 1.44 vs 2.77, 1 vs 1.66 and 0.3 vs 1.3 in the rst 30 minutes, 1 hour, 4 hours and 6 hours, respectively. Pain scores at the rst 6 hours postoperatively were signi cantly lower in the study group (P 0.001). Discussion: Adjunctive subtenon bupivacaine injection had e ects at the rst 6 hours postoperatively in adults undergoing strabismus surgery with general anesthesia technique. Conclusion: Subtenon injection of bupivacaine may reduce postoperative pain score in adult strabismus surgery.
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