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Lacrimal gland (LG) involvement in patients with Graves ophthalmopathy (GO) has been considered as a potential cause of the associated GO symptoms and different studies demonstrated the LG involvement in patients with GO than healthy controls. The aim of this study was to evaluate LG involvement, through measurement of its herniation, using a magnetic resonance imaging (MRI) index, in patients with different GO activities. Thirty-two consecutive Caucasian patients affected by GO were enrolled and grouped in group A (16 with inactive GO, CAS < 3) and B (16 with active GO, CAS ≥ 3) according to their GO activity. All patients underwent clinical-endocrinological assessment, a complete ocular evaluation, and orbital MRI examination. No difference was found between the hormonal parameters, thyroid ultrasound-derived parameters, and thyroid-stimulating hormone (TSH) receptor (TSH-R) antibodies (TRAb) levels in group B and those in group A. The LG herniation (LGH) measurement evaluated by MRI was significantly higher in group B for both right (10.1 (7.3–17) vs. 7 (0–3.4) mm; p = 0.004) and left (8.5 (6.6–13) vs. 5.8 (0–12) mm; p = 0.026) eye than group A. A positive correlation was found between TRAb and LGH herniation (Rho 0.462, p = 0.009). Measurement of LGH seems to be a good marker of the disease and GO activity. • Lacrimal gland herniation is a simple index related to disease activity • Lacrimal gland herniation is correlated to TRAb levels • Lacrimal gland evaluation could be useful to differentiate active from inactive Graves ophthalmopathy in an early stage of disease

This clinical case report describes the clinical findings and diagnosis of lacrimal gland adenocarcinoma that developed 20 years after external beam radiotherapy in the treatment of bilateral retinoblastoma. Visual acuity, slit lamp biomicroscopy, fundus color photography, nuclear magnetic resonance, lateral orbitotomy and histological analysis are described.

Purpose: To compare new-generation multifocal intraocular lenses (IOLs) with monofocal IOLs. Design: Randomized prospective clinical trial. Participants: Sixty-two consecutive patients with cataract, seen between January of 2005 and January of 2006 at the Department of Ophthalmology of Palermo University Hospital in Italy, were bilaterally implanted with monofocal (AR 40, Advanced Medical Optics [AMO], Santa Ana, CA; 15 patients), multifocal refractive (Array SA40N, AMO; 16 patients), multifocal refractive (ReZoom, AMO; 15 patients), or multifocal diffractive pupil-independent (Tecnis ZM900, AMO; 16 patients) IOLs. Intervention: Bimanual phacoemulsification. Main Outcome Measures: Primary outcomes were far, near, and intermediate visual acuity of the 4 IOL-implanted groups. Secondary outcomes were defocusing curves, contrast sensitivity, patients' quality of life (7-item visual function questionnaire [VF-7], halos and glare presence, overall satisfaction), and spectacle independence. Snellen visual acuity was measured as uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), uncorrected near visual acuity (UCNVA), best distance corrected near visual acuity (BDCNVA), best corrected near visual acuity (BCNVA), uncorrected intermediate visual acuity (UCIVA), and best distance corrected intermediate visual acuity (BDCIVA). Results: UCNVA was 20/50 in the monofocal IOL group, compared with 20/32 or better in the multifocal IOL groups (P

Aim : To evaluate the presence of type A behavior in patients affected by open-angle glaucoma (OAG) and the possible role of psychophysiological stress as a risk factor for OAG. Materials and methods Fifty patients, 30 women and 20 men, affected by OAG, underwent ophthalmological examination consisting of complete biomicroscopy, tonometry and daily tonometric curve, examination of the visual field by means of computerized perimeter "Octopus 1-2-3," and its assessment with the Glaucoma Staging System 2, morphologic monitoring of the retinal nerve fiber layer with GDx VCC and psychological assessment (Hamilton Anxiety Rating Scale) to evaluate the presence of anxiety and its level; type A/B personality questionnaire (Jenkin Modified Activity Survey; Ercta-B test for the further evaluation of type A personality; STAY test; Brief-cope test; Life event. Results Sixty-four percent of the subjects, 17 women and 13 men, showed type A behavior, and in these patients both trait and state anxiety were much more evident (P=0.001). In the type A subjects, there was a much more significant visual field involvement (P=0.001); this involvement showed a negative correlation (P=0.024) with the Brief-cope scale. Conclusions The personality study is an extremely important part of the diagnostic work-up and treatment of OAG.

OBJECTIVE: The eye represents a target site for GH action, although few data are available in patients with GH deficiency (GHD). Our aim was to evaluate central corneal thickness (CCT) and intraocular pressure (IOP) values in GHD children to assess the role played by GHD or GH treatment on these parameters. DESIGN: In 74 prepubertal GHD children (51M, 23F, aged 10.4±2.4years) we measured CCT and IOP before and after 12months of treatment. A baseline evaluation was also made in 50 healthy children matched for age, gender and body mass index. The study outcome considered CCT and IOP during treatment and their correlations with biochemical and auxological data. RESULTS: No difference in CCT and IOP between GHD children at baseline and controls was found (all p>0.005). GHD children after 12months of therapy showed greater CCT (564.7±13.1μm) than both baseline values (535.7±17μm; p

Obiettivo. Obiettivo del presente studio è stato quello di rilevare qualsiasi possibile variazione nella pressione intraoculare (PIO) in soggetti non glaucomatosi sottoposti a esami endoscopici come la gastroscopia o la colonscopia, al fine di valutare il ruolo della tensione mentale in tali cambiamenti. Metodi. La frequenza cardiaca e il tono oculare sono stati misurati prima e subito dopo le procedure endoscopiche e 30’ dopo la somministrazione di un antagonista delle benzodiazepine in 100 soggetti, 52 uomini e 48 donne, sottoposti a gastroscopia, colonscopia o entrambi gli esami nella stessa occasione. Risultati. La frequenza cardiaca è diminuita da 82,10±14,41 a 76,11±10,96 30’ dopo la somministrazione di flumazenil con una riduzione significativa (P>0,001). Anche la PIO è diminuita in maniera considerevole, da 15,25±2,88 mmHg prima dell’esame a 12,98±2,16 mmHg 30’ dopo la somministrazione dell’antagonista delle benzodiazepine (P=0,001). Conclusioni. Sulla base dei risultati del nostro studio, siamo in grado di affermare che la tensione mentale generata dalle procedure diagnostiche invasive comporta un aumento della PIO che, in alcuni soggetti, può raggiungere livelli patologici.

Optical coherence tomography (OCT) has been proven useful in measuring retinal thickness (RT) in patients with diabetes, although with discordant results in different studies. We examined RT in patients with type 1 diabetes (T1D) with or without minimal diabetic retinopathy (MDR) to test whether OCT is able to identify early retinal changes and potential correlations with metabolic parameters. RT of 102 patients with T1D (53 females, 49 males, aged 27.03 +/- 7.4 years) and of 42 healthy controls was examined, with analysis of nine different sectors (fovea, four pericentral and four peripheral sectors). According to the results of basal fundus photography, patients were divided into two groups, without MDR (48 cases) and with MDR (54 cases). Patients with proliferative DR or macular edema were excluded. No difference was found between patients with or without MDR and the control group for all OCT parameters investigated. Mean HbA1c of the last 5 years (P < 0.001), microalbuminuria (P = 0.002), total (P = 0.046) and LDL cholesterol (P = 0.007) and triglyceride (P < 0.001) levels were higher in patients with MDR, along with higher prevalence of hypertension (P = 0.013), younger age at diagnosis (P = 0.018) and longer diabetes duration (P < 0.001) with regard to the patients without MDR and controls, although no significant correlation between these parameters and RT was found. Our study suggests that MDR without macular edema in patients with T1D cannot be detected with OCT. Therefore, the conventional diagnostic methods are mandatory to detect early DR.

Our aime was to investigate the correlation between GO ocular parameters obtained by MRI with contrast administration and the well-know clinical indicators of GO and to examine the relationship between the clinical course of hyperthyroidism and GO severity