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Objective: To evaluate medium/long term outcomes and patient satisfaction through relief of symptoms and improved quality of life (QoL) after Jones tube conjunctivodacryocystorhinostomy (JT-CDCR) using the Naso Lacrimal Duct Obstruction symptom-score (NLDO-SS)., Methods: We conducted a retrospective, non-comparative, multicentric study including patients with complete obstruction of the superior and inferior proximal lacrimal drainage system. All patients underwent JT-CDCR, and the patency of the tube was evaluated with saline irrigation and endoscopic examination. We assessed patient satisfaction and quality of life administering the NLDO-SS., Results: We enrolled 16 patients, for a total of 21 eyes operated. The success rate for procedures was 81%. The success rate for single parameters was globally 95.9%; if considered separately, ocular symptoms and nasal symptoms were respectively 94.3% and 100%., Conclusions: JT-CDCR was a reliable procedure, able to solve symptoms in a majority of patients and guaranteed a good quality of life over a long period of time., (Copyright © 2021 Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale, Rome, Italy.)

Introduction: Non-ablative skin rejuvenation is becoming increasingly popular. Ellman RF produces an electric current that generates heat in the dermis producing a contraction of the collagen. LED is a non heating light emission system that induces fibroblast proliferation., Materials and Methods: 30 Caucasian women, prototype I-IV, age from 35 to 65 with peri-orbital photo damage were randomly divided in 3 groups. Group 1 received: 5 RF sessions, 1 every 10 days. Group 2 received 8 LED sessions, 1 every 5 days. Group 3 received RF and LED: 1 RF, 2 LED sessions every 5 days for 3 times (3 RF and 6 LED sessions). A score of satisfaction, considering skin texture, rhytidis reduction and firmness was obtained before the treatment, after each session and 2 months after the last session., Results: Two months after the last treatment in group 1:7 patients were satisfied and 3 were very satisfied; in group 2: 6 patients were satisfied and 4 were very satisfied, in group 3: 4 patients were satisfied and 6 were very satisfied. LED was effective on improvement of skin texture and rhytidis reduction while slightly effective on firmness. RF was effective on skin texture and firmness while slightly effective on rhytidis reduction. LED and RF together were effective on all parameters., Conclusion: LED and RF seem to be safe and effective on skin rejuvenation especially when associated.

Background and Objective: To compare measurements of a new retinal blood flow device with central retinal artery blood velocity., Materials and Methods: One randomly selected eye from each of 13 subjects was examined. Blood flow was measured by laser blood flowmeter and velocity by color Doppler imaging. The correlation between measurements was analyzed using regression analysis where a P value of less than .05 and coefficient of regression values of greater than .5 were considered significant., Results: The laser blood flowmeter produced vessel diameter measurements of 90.1 +/- 18.7 microm (mean +/- standard deviation), velocity of 19.7 +/- 8.06 mm/sec, and flow measurements of 4.24 +/- 2.41 microL/min. Central retinal artery peak systolic velocity, end diastolic velocity, and mean velocity correlated significantly with laser blood flowmeter velocity (P = .01, r = .66; P < .01, r = .77; and P = .003, r = .76, respectively) and flow (P = .01, r = .71; P = .03, r = .6; and P = .01, r = .69, respectively)., Conclusions: The laser blood flowmeter produces retinal artery flow and velocity measurements that correlate with central retinal artery peak systolic velocity end diastolic velocity, and mean velocity measurements. Further validation of the laser blood flowmeter's accuracy in measuring real flow warranted and likely requires more invasive in vivo studies (in animal models). However, this study supports the ability of the laser blood flowmeter to measure retinal blood flow.

Purpose: To compare cerebral blood flow velocities between open-angle glaucoma (OAG) patients and controls, at baseline and during hyperoxia., Design: Observational cohort study., Methods: A prospective study was conducted in a single institution. Sixteen OAG patients and 15 normal subjects, matched for age, were enrolled. Patients and controls were studied at baseline, while breathing room air, and during 100% oxygen breathing. The eye with the more severe visual field defect was chosen in glaucoma patients, while in controls, the study eye was chosen randomly. Subjects with history of diabetes, cardiovascular, or respiratory disease were excluded. Measurements included brachial arterial pressure, heart rate, intraocular pressure and transcranial Doppler (TCD). Mean and peak velocity and pulsatility index of the ipsilateral middle cerebral artery (MCA) were measured by TCD., Results: At baseline, MCA mean and peak systolic blood flow velocities were significantly lower in glaucoma patients compared with controls velocities were significantly lower in glaucoma patients compared with controls (mean velocity: 50.2 vs 65.3 cm/s, P <.05; peak velocity: 74.2 vs 96.8 cm/s, P <.05). Additionally, while hyperoxia significantly decreased both mean and peak systolic velocities in MCA of controls (mean velocity: 65.3 vs 57.7 cm/s, P <.05; peak velocity 96.8 vs 87.9 cm/s, P <.05), it did not cause any significant change in OAG patients., Conclusions: Glaucoma patients were found to have lower MCA blood flow velocities and an absence of vasoreactivity to hyperoxia, compared with controls. The relationship of these cerebral hemodynamic abnormalities to glaucoma pathogenesis and progression remains to be explored.

Purpose: To compare the effects of latanoprost (Xalatan) and dorzolamide (Trusopt) on ocular hemodynamics in normal-tension glaucoma patients., Methods: A randomized, single-masked, parallel design study was conducted. After a 4-week washout period, 20 normal tension glaucoma patients, recruited from a single university-based ophthalmology clinic, received either latanoprost once daily or dorzolamide 3 times daily for 4 weeks. The subjects were examined at baseline and post-treatment. Outcome measures included heart rate (HR), blood pressure (BP), logMar visual acuity (VA), contrast sensitivity (CS), intraocular pressure (IOP), color Doppler imaging (CDI), and fluorescein angiography with the Rodenstock scanning laser ophthalmoscope (SLO). CDI measurements of the retrobulbar vessels included peak systolic velocity, end diastolic velocity, and the calculated resistance index. Arterio-venous passage time (AVP) in the superior and inferior temporal retina was calculated from the SLO angiograms., Results: Neither dorzolamide nor latanoprost had any statistically significantly effect on HR or BP. Both drugs significantly lowered IOP without altering calculated ocular perfusion pressure (p<0.05). There was no statistically significant difference in any CDI measurement. Dorzolamide significantly decreased AVP time in the superior retina (p=0.011), while latanoprost did not (p=0.62)., Conclusions: Dorzolamide, unlike latanoprost, significantly reduced AVP times in the superior temporal retina in normal tension glaucoma (NTG) patients.

Purpose: To study pulsatile ocular blood flow (POBF) throughout pregnancy., Methods: We enrolled twenty-seven healthy women in the first trimester of gestation, only ten of which were followed through the second trimester, and fourteen non pregnant healthy women. In each subject we measured POBF with the POBF pneumotonometer (OBF Ltd. UK), IOP, blood pressure (BP) and heart rate (HR). An unpaired Student t-test was used to compare pregnant women with non-pregnant women, and a two-tailed paired Student t-test was used to compare the same women in the first and second trimester of pregnancy. p <0.05 is considered statistically significant., Results: Results are presented as means +/- SD. In the first trimester of pregnancy the age was 32 +/- 6, POBF 1516.4 +/- 382 ml/min, IOP 13 +/- 3 mmHg, BP 92 +/- 6 mmHg, and HR 86 +/- 14 beats/min. In the second trimester POBF was 1629.11 +/- 352.4 ml/min, intraocular pressure (IOP) 12 +/- 3 mmHg, BP 96 +/- 3 mmHg, and HR 93 +/- 10 beats/min. In the control group the age was 27 +/- 9, POBF 972.23 +/- 329.3 ml/min, BP 88 +/- 4.3 mmHg, and HR 80 +/- 14 beats/min. POBF increases during the first trimester (p = 0.00008). In the second trimester POBF was higher compared to the first trimester (p = 0.0008). Non significant differences were observed for the other parameters., Conclusions: The POBF increases throughout gestation. During pregnancy there is an increase in estrogen which induces endothelial-dependent vasodilatation in several tissues. The estrogen changes may influence POBF.

Purpose: Topically-applied dopamine antagonists reduce intraocular pressure (IOP) and inrease retinal blood flow in animal models. We examined the acute effects of intravenous infusion of a dopamine blocker (droperidol) on these parameters in healthy humans., Methods: Sixteen subjects free from ocular or systemic disease (mean age 33 +/- 10 yrs) received either 5 mg i.v. droperidol over 5 minutes, or i.v. saline placebo in double-masked fashion. IOP was determined 30 and 60 minutes later, while color Doppler imaging was used to determine flow velocities in the ophthalmic, central retinal, and nasal and temporal posterior ciliary arteries 60 minutes after drug infusion., Results: 30 minutes after drug infusion, IOP was reduced 6.0 mmHg as compared with baseline (p<0.001); after 60 minutes, IOP remained reduced by 3.7 mmHg (p<0.001). Placebo had no effect on IOP. While droperidol slightly elevated blood pressure and increased the calculated ocular perfusion pressure, the drug reduced visual acuity and contrast sensitivity (p<0.05). Droperidol elevated peak systolic velocity in the central retinal and nasal posterior ciliary arteries, without changing end-diastolic velocity or the resistance index in either of these vessels. Droperidol had no effect on flow velocities in the ophthalmic artery or the temporal posterior ciliary artery., Conclusions: The rapid and marked ocular hypotension resulting from intravenous droperidol suggests that this agent may prove useful in the management of acute ocular hypertension. The retrobulbar changes consequent to the ocular tension reduction likely represent autoregulatory responses to altered ocular perfusion pressure.