Search

Background: the antiglaucomatous treatments interact with the ocular surface and can induce its alteration which may affect the therapeutic results Aim : to describe the interactions between the ocular surface and anti-glaucoma medications and to propose practical attitudes to prevent and manage this issue., Methods: a retrospective study about 100 patients with a primary opened angle glaucoma treated with anti-glaucomatous drops containing preservatives. We performed an exhaustive examination of the ocular surface with fluorescein instillation to search superficial punctuate keratitis and to evaluate the break up time. All patients had a Schirmer test I., Results: our patients were under monotherapy in 46% ,two medications in 36%, three medications in 11% and four medications in 7% .Beta-blockers were statistically related to the conjunctival hyperaemia (p = 0.014), BUT alteration (p = 0.001) and Schirmer test ≤ 5 mm (p = 0.0001). Prostaglandin analogues were statistically related to a Schirmer test ≤ 5 mm (p = 0.02). The use of more than two anti-glaucomatous medications was linked to the severity of the clinical signs., Conclusions: anti glaucoma drops affect the ocular surface through several mechanisms: allergic reaction, direct and indirect toxicity of the active agents as well as their preservatives. The risk is increased by the prior ocular surface abnormalities in these patients. This disease influences the quality of life and leads to poor adherence to treatment.

Purpose: To study the morphologic alterations around the optic disc by spectral optical coherence tomography (SD OCT) in eyes with high myopia., Patients and Methods: Two hundred eyes (113 patients) with high myopia were included. The participants had complete ophthalmologic examinations and OCT examinations. OCT scans were obtained around the optic in each patient., Results: We detected by OCT, a peripapillary detachment in 14 eyes (11.0%), a retinischisis peripapillary in 10 eyes (5%) and paravascular abnormalities as microfolds and paravascular cysts in 80 eyes (40%). A statistically significant difference was found between patients with microfolds paravascular and the rest of the patients concerning age (P=0.0034) and axial length (P=0.001). The patients with paravascular cysts were older (P=0.0022), had a greater axial length (P=0.0044) and a high rate of posterior staphyloma compared to other patients., Conclusion: Perpapillary changes detected by SD OCT in eyes in high myopia are relatively frequent and don't always present a clinical or ophthalmoscopic changes., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Purpose: To measure macular choroidal thickness (CT) using spectral-domain optical coherence tomography (SD-OCT) in highly myopic eyes with dome-shaped macula (DSM), and to investigate whether the choroid is thicker in these eyes compared to highly myopic eyes without MB., Patients and Methods: A cross-sectional study of 200 eyes was performed between January 2010 and June 2012. Twenty-four highly myopic eyes (12%) had a dome-shaped macula. All patients underwent a complete ophthalmological examination, SD-OCT (TOPCON 2000), and B-scan ultrasonography. OCT scans were analyzed in 7 sections, and subfoveal CT was measured manually between the Bruch's membrane and the internal aspect of the sclera. The 20 eyes with isolated dome-shaped macular were paired by age and axial length (AL) with 20 eyes without macular involvement., Results: In the subgroup with isolated MB, the mean subfoveal CT was 101.86 μm (± 21.35 μm). A statistically significant negative correlation was found between CT and AL (r=-0.623, P=0.0001). The regression equation demonstrated a decrease of 8.3 μm per mm of AL. In the subgroup without MB, matched with the subgroup with MB by age (P=0.591), and AL (P=0.815), the mean subfoveal CT was 89.54 μm (± 20.12 μm). The comparison between the two subgroups found a statistically significant difference in subfoveal CT (P<10-4)., Conclusions: In our study, choroidal thickness is increased in highly myopic eyes with dome-shaped macula compared to highly myopic eyes without dome-shaped macula. These findings suggest that abnormalities of the choroid may play a role in the pathogenesis of dome-shaped macula., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Purpose: To investigate the factors linked to foveoschisis in high myopia., Methods: Retrospective study of 113 patients (200 eyes) with high myopia was conducted between January 2010 and June 2012. Subjects underwent a complete ophthalmic examination, spectral domain optical coherence tomography (OCT TOPCON 2000) and ocular echography., Results: Of the 200 eyes, 22 (11%) had foveoschisis on OCT examination. On the basis of univariate analysis, five variables were associated with the pathologic changes, including spherical equivalent over 10 diopters (P=0.044), axial length over 30 mm (P=0.0028), macular chorioretinal atrophy (P=0.0009), posterior staphyloma (P=0.0007) and vitreoretinal interface factors (P=0.0002). In the multivariate analysis, three factors were independently associated with foveoschisis in high myopia: axial length (adjusted OR, 16.7; IC 95% 1.4-219.7, P=0.036), macular chorioretinal atrophy (adjusted OR, 13.2; IC 95%, 1.3-133.1, P=0.044), and vitreoretinal interface factors (adjusted OR, 36.1; IC 95%, 3.5-376.9, P=0.002)., Conclusions: In our study, axial length, macular chorioretinal atrophy, and vitreoretinal interface factors were independently associated foveoschisis in highly myopic eyes., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)