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An intensive 72 hour study of the cardiovascular effects of severe diffuse brain injury was made in seven patients. No other major injury was present. Patients received optimal care very rapidly after injury and intracranial pressure, which was continuously monitored, was maintained at or just above normal by elective positive pressure ventilation techniques. Three patients showed evidence of progressive myocardial ischaemia on continuous electrocardiographic monitoring. Two of these patients died. Ventricular arrhythmias were uncommon but one of the patients with ischaemia developed ventricular tachycardia. Heart rate patterns were very abnormal but did not predict complications. Blood pressure did not vary greatly and cardiac outputs were usually normal. Pronounced excesses of urinary catecholamines and serum creatine kinase 2 isoenzyme (CK MB) as well as total creatine kinase were found. Histological evidence of myocardial damage could be shown at necropsy in the one case whose heart was available for study. This study shows that the cardiac effects of isolated diffuse cerebral injury may be harmful and even fatal despite correction of secondary factors such as anoxia and raised intracranial pressure. The findings suggest that evaluation of the potential benefits of sympathetic blockade is warranted. Cardiac complications of cerebral damage deserve wider recognition by intensive care personnel, neurologists, and neurosurgeons. [ABSTRACT FROM PUBLISHER]

In eleven patients with Parkinsonism there was a strong inverse relationship between the frequency of spontaneous activity of the arms and the degree of fatiguing of repetitive finger movements made upon command. The prevalence of spontaneous arm movement was related inversely (but more weakly) to the time taken to complete a pegboard test or to move clothespegs by hand; it had little association with the speed of linear movement or with simple motor reaction time involving the arm. [ABSTRACT FROM AUTHOR]

The article focuses on the different treatment approaches for vascular age related macular degeneration. Transpupillary thermotherapy is a subthreshold photocoagulation delivering moderate heat to the choroid and retinal pigment epithelium using a diode laser. Photodynamic therapy using a sensitizing agent such as verteporfin, in conjunction with low power diode laser, achieves a selective photothrombosis of the choroidal neovascularization.

Background: The causes of recurrent choroidal neovascularisation (CNV) after photodynamic therapy (PDT) remain controversial. Subretinal surgery was carried out after unsuccessful PDT. Aims: To determine intraoperatively the status of the posterior vitreous interface. Design: Interventional case series. Methods: Conventional three-port vitrectomy was carried out in 10 eyes with CNV that had undergone 1-4 PDT sessions. The vitreous cutter was held close to the edge of the optic nerve to evaluate the status of the posterior vitreous. Results: Lesion size showed an increase from 1 .5 (standard deviation (SD) 0.53) to 2.3 (SD 0.83) macular photocoagulation study disc diameters, between the first and the last PDT. lntraoperative findings during vitrectomy showed little liquefaction of the vitreous gel and an incomplete posterior-vitreous detachment, with remarkably firm attachments at the macula in all cases (10/10). Conclusion: We determined an abnormally high incidence of vitreous attachments in eyes with recurrent CNV. Vitreomacular attachments may trigger the progression or recurrence of CNV. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Acute Retinal Pigment Epithelial Tear Following Intravitreal Bevacizumab (Avastin) Injection for Occult Choroidal Neovascularisation Secondary to Age Related Macular Degeneration," published in the previous issue.

Presents a letter to the editor about optical coherence tomography in photodynamic therapy.