INTERESTING EYE NEWS & CLINICAL PEARLS

Inheritance is autosomal dominant Presentation is in the 20's to 30's with gradual impairment of central vision. Signs in chronological order: 1) Non-specific foveal granularity. 2) Circumscribed RPE atrophy and loss of the choriocapillaris at the macula. 3) Slowly expanding geographic atrophy with prominence of large choroidal vessels . Prognosis is poor with severe visual loss occurring by the 50's to 60's. So if you see a younger patient with macular pigment changes orgeographic atrophy, consider this diagnosis.

Cornea - Abstract: Volume 26(8) September 2007 p 930-934 Effect of Prophylactic Oral Acyclovir After Penetrating Keratoplasty for Herpes Simplex Keratitis. This paper concludes: Prophylactic oral acyclovir use after PK for HSV keratitis is associated with decreased episodes of rejection and improved graft survival.

Journal of Glaucoma - Abstract: Volume 16(5) August 2007 p 437-439 Intravitreal Bevacizumab (Avastin) Injection for Neovascular Glaucoma. This paper investigated the use of Avastin in 2 patients with nonvascular glaucoma. It concludes: Both patients demonstrated dramatic short-term response in terms of intraocular pressure reduction and regression of neovascularization.

The amount of intraocular pressure rise during pharmacological pupillary dilatation is an indicator of the likelihood of future progression of glaucoma -- Siam et al. 91 (9): 1170 -- British Journal of Ophthalmology This study concludes: In patients with open-angle glaucoma, the amount of increase in IOP caused by pharmacological pupillary dilatation is related to the likelihood of future progression of glaucoma.

http://revoptom.com/index.asp?page=2_12883.htm The most common and first ocular sign of Fabry’s disease: bilateral corneal diffuse yellow epithelial haziness that gradually becomes concentrated into dense rays that radiate from the center of the cornea into dense bronze to cream-colored streaks arranged in a vortex or star-shaped pattern (whorl-like or verticillata).8,9 These opacities appear to be in the subepithelial or Bowman’s layer of the cornea.8 Corneal involvement occurs in over 90% of these patients,

Review of Ophthalmology From this article, canalsplasty appears to be a safe & effective alternative to trabeculectomy. Results if one study shows lowering of IOP from around 24mm Hg to around 16 mm Hg. This article concludes: Dr. Tetz says he believes canaloplasty is a good choice as a replacement for trabeculectomy. “Overall, the pressure results of viscocanalostomy are comparable to those of trabeculectomy without mitomycin,” says Dr. Tetz, “but with a much lower risk of postoperative complications and much less intense care required immediately postop. So far, the results of canaloplasty are even better.” J Cataract Refract Surg 2007;33:7:1217-1226.

ScienceDirect - Ophthalmology : Intravitreal Bevacizumab for Treatment of Uveitic Macular Edema This study concludes: These results suggest that a single intravitreal injection of bevacizumab is well tolerated and is associated with short-term improvement in VA and decreased OCT retinal thickness in a considerable proportion of patients with uveitic CME resistant to conventional therapy. Further evaluation of intravitreal bevacizumab for uveitic CME in controlled randomized studies is warranted.