Dorairaj, Syril

Abstract Purpose: To compare vascular parameters, assessed by endothelin-1 (ET-1) blood levels, Laser Doppler Imaging (LDI) of distal phalanx, and nailfold capillaroscopy (NC), between open-angle glaucoma (OAG) patients with low (LTDH) and high-tension optic disc hemorrhages (HTDH). Methods: In this prospective study, patients were classified as LTDH if presenting an IOP<16 mmHg and HTDH if an IOP³16 mmHg at the time of DH detection. Demographic and ophthalmological data, ET-1 concentration, LDI (before and after 1, 10 and 20 minutes after cold stimulation) and NC findings were evaluated. Results: Thirty-tree patients were included (mean age, 62.3±13 years). Regarding ET-1 blood level, it was 65% higher in the LTDH group (2.27±1.46 pg/ml) compared to the HTDH (1.37±0.57 pg/ml; p=0.03). In addition, there was a significant negative correlation between ET-1 blood concentration and IOP at the time of DH detection (r=-0.45; p=0.02). Blood flow measurement in LTDH patients were lower than those observed in patients with HTDH 10 and 20 minutes after cold stimulus (p<0.01). Conclusion: Patients developing DH with lower IOPs have higher ET-1 blood levels and more peripheral vascular dysfunction (than those with higher IOPs), as estimated by LDI. These findings suggest that distinct underling mechanisms maybe involved in patients developing DH with different IOP ranges.

SUMMARY OBJECTIVES To bring summarized information about what has been published so far regarding Covid-19, facilitating the access to information and a better understanding of this pandemic, and to contribute to the medical community in the decision-making against this virus. METHODS This review article brings collected information from different articles published since the beginning of the pandemic of the 2019 novel coronavirus. KEY RESULTS This paper aggregates and consolidates some epidemiological parameters and clinical knowledge about the novel coronavirus and brings what is new in the search for pandemic control. MAJOR CONCLUSIONS Governments and health authorities are under increased pressure to control the COVID-19 spreading. In this scenario, the scientific community is working hard to produce relevant papers which will help in the next steps against coronavirus. Our review summarized the latest news about SARS-CoV2, evidencing what we know about COVID-19 until now.

Purpose: To compare provocative test-based and long-term intraocular pressure variation parameters in patients with stable open-angle glaucoma. Methods: A prospective observational study was carried out in which stable open-angle glaucoma patients (⩾3 years of follow-up without any changes on current medical regimen) were consecutively enrolled. All patients were submitted to a water-drinking test. Long-term intraocular pressure parameters were obtained from isolated intraocular pressure measurements from each visit (⩾5 visits). We investigated the correlation and agreement between the following water-drinking test and long-term intraocular pressure parameters: mean, peak, and fluctuation. In addition, the percentage of eyes with significant intraocular pressure peaks during the water-drinking test (defined as a difference ⩾25% between water-drinking test intraocular pressure peak and mean long-term intraocular pressure) was assessed. Results: Sixty-three eyes from 63 open-angle glaucoma patients (mean age, 60.7 ± 11.8 years) were included. Mean and water-drinking test intraocular pressure peak correlated significantly with mean ( r = 0.67) and maximum long-term intraocular pressure ( r = 0.52), respectively ( p < 0.01). The correlation between water-drinking test intraocular pressure fluctuation and long-term intraocular pressure fluctuation was not significant ( p = 0.45). Limits of agreement from Bland–Altman plots exceeded the maximum allowed difference between methods (3 mm Hg) for all the intraocular pressure parameters analyzed, suggesting poor agreement between water-drinking test–derived and long-term intraocular pressure values. Overall, significant water-drinking test intraocular pressure peaks were observed in 39.7% of these eyes with stable open-angle glaucoma. Conclusion: Although some water-drinking test–based and long-term intraocular pressure parameters correlate significantly, water-drinking test results may not reflect the long-term intraocular pressure profile of stable open-angle glaucoma patients, as their agreement is poor. Many of these patients may experience significant water-drinking test intraocular pressure peaks, despite long-standing stable disease and unchanged medical regimen.

AbstractBackgroundTo investigate anatomical configuration of ciliary body and iris using ultrasound biomicroscopy as a predictor of malignant glaucoma development.DesignRetrospective study in a tertiary care hospital.ParticipantsCohort of 31 consecutive patients diagnosed with post‐surgical malignant glaucoma.MethodsAnterior chamber angle, iris and ciliary body configuration of involved eyes that had ultrasound biomicroscopy evaluation prior to the malignant glaucoma onset were evaluated. In cases with no presurgical ultrasound biomicroscopy exam of the involved eye, images from the fellow eye (imaged within 6 months) were analysed.Main Outcome MeasuresQualitative parameters.ResultsThirty‐one eyes (31 patients) had confirmed malignant glaucoma between 1996 and 2008. Most patients were women (65%) and had an anatomical narrow angle or angle‐closure glaucoma (77%). Mean intraocular pressure at diagnosis was 30.4 ± 13.5 mmHg. The most common operation was trabeculectomy with mitomycin C (55%, 17/31 eyes), combined (3/17) or not (14/17) with cataract extraction and intraocular lens implantation. Among these 31 cases, we were able to evaluate the ultrasound biomicroscopy images of 13 patients (13 eyes) including involved eyes imaged prior to the malignant glaucoma onset or eligible fellow eyes. A narrow angle with or without iridotrabecular contact was found in all eyes. A large and/or anteriorly positioned ciliary body associated with an iris root angulating forward and centrally, revealing a plateau iris configuration, was noticed in 85% (11/13) of these eyes.ConclusionIdentification of plateau iris configuration by ultrasound biomicroscopy should be considered as a possible predictor of post‐operative malignant glaucoma development.