A nearby transiting rocky exoplanet that is suitable for atmospheric investigation

Spectroscopy of transiting exoplanets can be used to investigate their atmospheric properties and habitability. Combining radial velocity (RV) and transit data provides additional information on exoplanet physical properties. We detect a transiting rocky planet with an orbital period of 1.467 days around the nearby red dwarf star Gliese 486. The planet Gliese 486 b is 2.81 Earth masses and 1.31 Earth radii, with uncertainties of 5%, as determined from RV data and photometric light curves. The host star is at a distance of ~8.1 parsecs, has a J-band magnitude of ~7.2, and is observable from both hemispheres of Earth. On the basis of these properties and the planet's short orbital period and high equilibrium temperature, we show that this terrestrial planet is suitable for emission and transit spectroscopy.

A giant exoplanet orbiting a very-low-mass star challenges planet formation models

Surveys have shown that super-Earth and Neptune-mass exoplanets are more frequent than gas giants around low-mass stars, as predicted by the core accretion theory of planet formation. We report the discovery of a giant planet around the very-low-mass star GJ 3512, as determined by optical and near-infrared radial-velocity observations. The planet has a minimum mass of 0.46 Jupiter masses, very high for such a small host star, and an eccentric 204-day orbit. Dynamical models show that the high eccentricity is most likely due to planet-planet interactions. We use simulations to demonstrate that the GJ 3512 planetary system challenges generally accepted formation theories, and that it puts constraints on the planet accretion and migration rates. Disk instabilities may be more efficient in forming planets than previously thought.

Three Cases of Spontaneous Hyphaema

Background Spontaneous anterior chamber bleeding is a rare event. We present three photodocumented cases treated in our clinic. History and Findings Three patients sought medical assistance in our clinic because of bleeding inside the eye and/or visual impairment. None of them had a history of trauma or intraocular surgery. Treatment and Outcome Two patients had oral anticoagulation, which was discontinued. These cases were treated with topical steroids. The third patient had no anticoagulation and no topical steroids were used in treatment. Topical intraocular pressure-lowering drugs were administered as needed. In all three cases, the anterior chamber bleeding stopped spontaneously. No intervention was required. Even after resolution of the bleeding, there were no signs of iris abnormalities. Conclusions In cases of spontaneous anterior chamber bleeding without a history of trauma, oral anticoagulation, hypertension and iris abnormalities such as microaneurysm, pseudoexfoliation, iridocyclitis or neovascularisation have to be considered.

Sweet but dangerous - the role of immunoglobulin G glycosylation in autoimmunity and inflammation

Glycosylation is well-known to modulate the functional capabilities of immunoglobulin G (IgG)-mediated cellular and humoral responses. Indeed, highly sialylated and desialylated IgG is endowed with anti- and pro-inflammatory activities, respectively, whereas fully deglycosylated IgG is a rather lame duck, with no effector function besides toxin neutralization. Recently, several studies revealed the impact of different glycosylation patterns on the Fc part and Fab fragment of IgG in several autoimmune diseases, including systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). Here, we provide a synoptic update summarizing the most important aspects of antibody glycosylation, and the current progress in this field. We also discuss the therapeutic options generated by the modification of the glycosylation of IgG in a potential treatment for chronic inflammatory diseases.

[One Year Experience with Quality Control of Cataract Surgery Using an Internet-Based EUREQUO Database]

Purpose Quality control is particularly important in invasive medicine. As cataract surgery is the most frequently performed and most successful ophthalmic surgery, quality control should become mandatory. Patients and Methods Retrospective analysis of all cataract procedures performed in a 12 months period (01. 07. 2014 - 30. 06. 2015) at our hospital, using an internet-based EUREQOU database. This database is easy to use and allows local results to be compared with all participants in Switzerland and elsewhere in Europe. Results During one year, 904 cataract procedures were performed at our hospital. Of these, 892 with complete data were compared to 2918 operations performed in Switzerland and 274,644 in other European countries. Our sample contained more patients with markedly reduced visual acuity (< 0.1; 8.4/4.8/3.5 %; KSW/Switzerland/Europe), more patients with glaucoma (28.1/13.9/7.1 %) and more patients with pseudoexfoliation (22.8/11.5/0.56 %). Despite our training of young ophthalmic surgeons, the rate of capsular complications was as low (0.67/0.34/0.67 %) as in other series. Four to 6 weeks after surgery, the majority of patients achieved a best corrected visual acuity of ≥ 0.8 (79.2 vs. 87.4 % in Europe, not enough data from Switzerland). Biometric prediction error (79.2 % within ± 0.75 D) was within the target range, but in the lower quartile. Conclusions Despite the relatively high number of complex patients in our hospital, quality control reveals that we performed cataract surgery with low complication rates and good results. Although quality control is rapid and easy, only three centres in Switzerland are participating.

[Lens exchange for subluxation of posterior chamber lenses implanted in the capsular bag or in the ciliary sulcus]

PURPOSE

There are an increasing number of patients with decreased vision due to dislocated posterior chamber lenses, with pseudoexfoliation being the main risk factor. Various techniques for refixation of the subluxated posterior chamber IOL have been described. Experience with our technique of IOL-explantation, anterior vitrectomy and implantation of an Artisan anterior chamber lens are presented.

PATIENTS AND METHODS

In a retrospective study design all lens exchanges with implantation of an Artisan anterior chamber lens performed between 2003 and 2012 are analyzed. The study included 65 eyes of 61 patients (age 79.6 ± 9.2 years: 43-98). The majority of eyes (46/65; 70.8%) had Sundown Syndrome (late in-the-bag intraocular lens dislocation), in 19 eyes the posterior chamber lens was implanted primary or secondary into the ciliary sulcus. In the 46 eyes with Sundown Syndrome cataract surgery with implantation of a posterior chamber lens in the capsular bag was performed 7.4 ± 3.7 (1-22) years before subluxation within the bag. Pseudoexfoliation was the main risk factor in 42/46 (91.2%) of these eyes. A capsular tension ring (CTR) was implanted during cataract surgery in 34/46 (73.9%) eyes. The 34 IOLs with a CTR luxated significantly earlier (p < 0.02 Mann-Whitney U) than the 12 IOLs without a CTR (6.6 ± 3.6 years; median 5.8 vs. 9.4 ± 3.1 years; median 9.2).

RESULTS

The average visual gain was 0.2 logMAR in the group of luxated capsular bag lenses and 0.12 logMAR in the group of luxated sulcus lenses. Postoperative IOP decompensation was seen in 17/65 (26.2%) eyes (requiring IOP-lowering surgery in 8 eyes), 7 eyes developed corneal decompensation, 5 eyes had central retinal vein occlusion and one eye developed postoperative endophthalmitis.

CONCLUSIONS

Lens exchange with implantation of an Artisan anterior chamber lens has become a routine procedure to improve vision in patients with subluxated IOLs. Postoperative IOP decompensation and vascular problems are the major complications.

[Arguments against pressure-lowering treatment of ocular hypertension. Prophylactic treatment is unnecessary]

The main argument against a pressure-lowering treatment for patients with ocular hypertension (OHT) is the principle of "first do no harm". The imprecision of intraocular pressure (IOP) measurements and the fact that increased IOP is only a risk factor for glaucoma raise major doubts on a clinical definition of OHT. The use of IOP-lowering treatment in the absence of functional or morphological glaucomatous changes should only be initiated if the IOP is very high (>32 mmHg). If the IOP is between 21 and 32 mmHg the glaucoma conversion risk of the individual patient should be estimated. The risk factors as proven in major prospective trials (OHTS/EGPS) should be assessed using the risk calculator. Only patients with a high risk (>13%) of conversion profit from prophylactic IOP-lowering treatment. For all patients with intermediate or low risk of conversion the potential side-effects (local and systemic) of the treatment outweigh the possible benefit, so that the principle of "watchful waiting" is the best for patients with OHT. If morphological or functional progression is observed IOP-lowering treatment should be started immediately.

Comparison of histopathological findings with duplex sonography of the temporal arteries in suspected giant cell arteritis

INTRODUCTION

In clinical practice the temporal artery biopsy (TAB) in suspected giant cell arteritis (GCA) is still believed to be the "gold standard". The purpose of this study was to compare the histopathological findings of the TAB with duplex sonography of the temporal artery.

PATIENTS AND METHODS

In our retrospective study we analysed 85 consecutive patients (52 female, mean age 71.5, range 55 - 91 years; 33 male, mean age 71.6, range 44 - 91 years) with suspected GCA who underwent TAB in our clinic between January 1999 - February 2011. All patients received a preoperative duplex sonography, 57 patients including description of the temporal arteries.

RESULTS

38 of 85 (44.7 %) of the artery biopsies were proven positive for GCA by histopathology. Interpretation of the duplex sonography was congruent of histopathological interpretation of the biopsy in 39 patients (68.4 %) and incongruent in 18 patients (31.6 %). Sensitivity of duplex-sonography was 44.4 %, specificity 90 %, positive predictive value 80 %.

DISCUSSION

Duplex sonography is a non-invasive and very helpful diagnostic tool to guide the clinician in cases of suspected GCA but needs considerable skills. It shows a good specificity and relatively high positive predictive value as there are only few false positive results. A negative report however does not rule out GCA, so that in our opinion the TAB - at least in those cases - should still be performed.

[First experience with the Heidelberg Edge Perimeter® on patients with ocular hypertension and preperimetric glaucoma]

BACKGROUND

The white-on-white computerised static perimetry is not very sensitive to detect a beginning visual field loss. A newer technique to test the central visual field with a flicker defined form technology (FDF) is the Heidelberg Edge Perimeter® (HEP).

PATIENTS AND METHODS

A study with 90 eyes from 50 patients (mean age 59 ± 14 years) with ocular hypertension and/or optic nerve suspicious for glaucoma without detectable visual field loss in the Octopus® perimetry (Program dG-2) with the Heidelberg Edge Perimeter® was performed. The "mean defect" (MD), the "pattern standard deviation" and the glaucoma hemifield test (GHT) were calculated and compared with the indices of the Octopus®.

RESULTS

Despite normal visual field findings in the Octopus® perimetry (MD < 2.0 dB) we detected in 48 out of 90 eyes (53 %) pathological visual fields in the HEP examination.

CONCLUSIONS

As a new research method the Heidelberg Edge perimetry® seems to be more sensitive than conventional static perimetry in early detection of visual field alterations in patients between ocular hypertension and incipient glaucoma.

[Mechanical dilatation of the pupil in phacoemulsification surgery: first experiences with the 6.25 mm Malyugin-ring]

PURPOSE

Inadequate mydriasis may cause major problems in phacoemulsification surgery. Usually 4 iris retractors are used to allow adequate pupillary dilatation. Implantation of a Malyugin ring to maintain a 6.25 mm pupil is a new alternative.

PATIENTS AND METHODS

A Malyugin ring was used in 46 eyes of 39 patients (aged 80.1 ± 6.2 years). The ring is im- and explanted with a disposable shooter through the main incision. Indications for the use of the ring were inadequate mydriasis due to pseudoexfoliation (n = 27), intraoperative floppy iris syndrome (n = 5), the combination of PEX and IFIS (n = 11), extensive posterior synechiae (n = 2) or inadquate mydriasis after long-term pilocarpine treatment (n = 1).

RESULTS

In 44/46 eyes phacoemulsification with implantation of foldable posterior chamber lens was performed without complications. In 2 eyes with massive phakodonesis an Artisan anterior chamber lens had to be implanted after anterior vitrectomy because of total zonulolysis. There where no complications associated to the use of the device and with increasing experience duration of implantation as well as explantation was reduced to 2 - 4.5 min (median 2:51 min).

CONCLUSIONS

In cases of phacoemulsification surgery with inadequate mydriasis implantation of a Malyugin ring is a simple, safe and fast alternative to iris-retractors; it allows better pupil-size without additional stab incisions.

[Sinusitis and ocular motility disorders]

BACKGROUND

Secondary inflammatory orbital involvement due to acute or chronic sinusitis is common. The pneumatized system of the paranasal sinuses is abut to the bones of the orbit in up to 80 percent, therefore the association is a seductive theory due to their anatomic closeness. Typically, sinusitis can influence ocular motility by affecting single muscles or a combination of muscles/cranial nerves due to a local inflammatory tissue reaction. The expected picture would be a more or less complex restriction of eye movements.

PATIENTS AND METHODS

In this case study nine consecutive patients were prospectively included between January 2006 and August 2007.

RESULTS

Five of the patients did not experience any motility disorder, the other four had a restricted motility. Case reports of the four patients are presented to demonstrate the range of ocular motility disorders related to sinusitis.

CONCLUSIONS

Orbital complications due to sinusitis include motility disorders among others. They can even cause orbital sepsis and cavernous sinus thrombosis. On the one hand sinusitis can affect almost the whole spectrum of ocular motility disorders, on the other hand it may mask a dangerous cerebral aneurysm. The "close-lying" connections, as seductive they are, should not divert from the rule: infrequent causes are infrequent and frequent causes are frequent!

[Surgery for intraocular hypotony due to avascular filtering blebs]

BACKGROUND

The incidence of ocular hypotony after filtering procedures has increased due to the widespread use of antimetabolites. In cases of persistent hypotony with leaking filtering bleb and/or hypotony-maculopathy surgical repair should be discussed.

PATIENTS AND METHODS

Between 2001 and 2007 twelve patients (age between 35 and 88 years) underwent surgical repair of an avascular bleb with autologous scleral patch and conjunctival advancement. Indication for surgery was in 9 / 12 patients ocular hypotony, in 2 patients inadvertent filtering blebs after cataract extraction and in one patient a leaking bleb with blebitis.

RESULTS

Intraocular pressure was normalized in all cases by the end of the follow-up period (4 - 66 months) (preop: 5.7 +/- 4.1 mmHg; postop 14.8 +/- 3.1 mmHg). Eight out of twelve patients required IOP-lowering medications (1 - 3) to maintain the target IOP. Best-corrected visual acuity increased from 0.4 +/- 0.1 to 0.67 +/- 0.2 (Snellen), 3 / 8 phakic patients required cataract surgery.

CONCLUSIONS

Revision of avascular filtering blebs with autologous scleral patch and conjunctival advancement is a successful surgical approach to eliminate ocular hypotony. However, the majority of patients need IOP-lowering drugs after surgery.

Wie sehen Glaukomgesichtsfelder wirklich aus?

Analysis of the visual fields of 20 glaucoma patients using 229 F2 programmes consisting of 30 degrees long profiles with 1 degree resolution and double measurements of the light sensitivity threshold, revealed that there is a positive correlation between mean loss and mean short-term fluctuations; short-term fluctuations tend to be larger with increasing loss of sensitivity. However, small short-term fluctuations were also seen in areas of greatly reduced sensitivity. Analysis of the F2 programmes showed 12 different abnormal patterns. The pattern most frequently found, "increased scatter with normal sensitivity", appears to be the earliest perimetric sign of glaucoma. Progression of the glaucomatous damage produces a "gray area of increased scatter", usually accompanied by reduced sensitivity with a poorly defined lower and upper threshold.

[Ocular pulse amplitude: a new biometrical parameter for the diagnose of glaucoma?]

BACKGROUND

Dynamic contour tonometry (DCT) enables accurate transcorneal measurements of the intraocular pressure and ocular pulse amplitude (OPA). In this study, we investigated whether this new biometrical parameter can characterize different glaucoma types and serve as a helpful tool in the diagnosis and therapy of the disease.

PATIENTS AND METHODS

A total of 441 eyes of 222 patients were included. Pressure measurements were performed with contour and applanation tonometry.

RESULTS

Mean OPA was 3.1+/-1.4 mmHg. Eyes with ocular hypertension showed significantly higher OPA values (3.6+/-1.3 mmHg) than healthy eyes (3.1+/-1.4 mmHg) and eyes with low-tension glaucoma (2.9+/-1.4 mmHg). After trabeculectomy, the values were significantly lower (2.4+/-1.3 mmHg) than in healthy eyes.

CONCLUSION

The size of the OPA seems to be characteristic for different types of glaucoma and directly dependent on intraocular pressure levels. Further investigation is indicated to clarify its diagnostic usefulness.

[Quality assurance in biometry before cataract surgery: which patients have an increased risk of aberrance from target refraction?]

BACKGROUND

An important factor for patient satisfaction after cataract surgery is the achievement of the planned target refraction. The formulae which are used to calculate the necessary refractive power of the intraocular lens (IOL) to be implanted have been improved over time in order to deliver exact predictions even in those cases in which the measurements of an eye deviate greatly from the norm. We examined which of the routinely measured biometric values have an influence on reaching target refraction.

PATIENTS AND METHODS

This retrospective investigation reports on a case series of 153 eyes of 146 patients within 6 months in which a cataract operation was performed. The average age at the time of operation was 73.5 years. Four measurements were taken preoperatively: refraction (Ref), axial length (AL), corneal refractive power (CR) and anterior chamber depth (ACD). Each of these measurements was examined regarding its influence on the refractive outcome. One of three end points was possible for each eye: achievement of target refraction within +/- 0.5 dpt, aberrance from target refraction by more than + 0.5 dpt and aberrance from target refraction by more than - 0.5 dpt. A multivariate regression analysis was performed in which aberrance from target refraction was defined as the dependent variable and the four mentioned measurements were set as independent variables.

RESULTS

Of the 153 eyes, in 91 eyes the target refraction was achieved within 0.5 dpt (group 1). In 37 eyes the aberrance from target refraction was more than - 0.5 dpt (group 2) and in 25 eyes it was more than + 0.5 dpt (group 3). The mean measurement values in groups 1, 2 and 3 were as follows: for preoperative refraction 0.0 dpt/0.5 dpt/0.625 dpt, for corneal refractive power 42.84 dpt/42.29 dpt/42.67 dpt, for axial length 23.41 mm/23.36 mm/23.73 mm and for anterior chamber depth 3.07 mm/3.00 mm/3.20 mm. No statistically significant relation between the respective measured values or a combination thereof and the refractive result could be demonstrated.

CONCLUSIONS

The formulae for calculating IOL power available today are highly developed and integrate preoperative biometries in a non-linear way, so that there is little difference between measurements within the norm and outlying ones concerning their influence on the refractive result. When conducting quality assurance efforts, we recommend to direct attention to factors influencing anterior chamber depth.

Positiver Ibopamin Provokationstest bei Verdacht auf Niederdruckglaukom

BACKGROUND

Ibopamine is an alpha-adrenergic agent and causes an elevation of intraocular pressure in eyes with increased outflow resistance. It has been proposed as a test substance for the detection of early ocular hydrodynamic disorders.

PATIENTS AND METHODS

A total of 64 normal-tension glaucoma suspect eyes without anti-hypertensive treatment were enrolled. A daily pressure curve was registered with measurements at 7:00 am, 8:00 am, 12:00 am, 17:00 pm using an applanation tonometer and a contour tonometer followed by instillation of ibopamine 2% in both eyes. Tonometry was performed every 15 minutes during the following hour. An IOP increase of > 2.0 mmHg was considered positive.

RESULTS

The positive test group showed a significant pressure increase from 18.04 to 22.06 mmHg. Ocular pulse amplitude increased from 2.96 to 3.97 mmHg and was positively correlated with the pressure. Intraocular pressure was unchanged in the negative test group. Central corneal thickness was not significantly different in the two groups (p = 0.32).

CONCLUSIONS

Ibopamine 2% eye drops have a positive pressure effect in 50% of suspected normal-tension glaucoma eyes and may differentiate between eyes with normal trabecular outflow capacity and eyes with increased resistance in the trabecular meshwork that are prone to pressure peaks and deterioration to glaucoma.

Kataraktoperation und kombinierte Katarakt-/Glaukomoperation als augeninnendrucksenkende Maßnahme in Augen mit relativem anterioren Mikrophthalmus

PURPOSE

Eyes with relative anterior microphthalmos (RAM) (normal [> 20.0 mm] axial length but disproportionally small anterior segment [horizontal corneal diameter < 11 mm]) often present with increased intraocular pressure. Under these difficult conditions cataract surgery alone or in combination with a glaucoma filtering procedure is often required.

PATIENTS AND METHODS

We retrospectively reviewed the records of 71 patients (108 eyes) with RAM in whom cataract only (n = 72) or combined cataract/glaucoma surgery (n = 36) was performed. Preoperative clinical and biometric findings, intraoperative complications and postoperative results (visual acuity and intraocular pressure) were analysed.

RESULTS

Median preoperative values were 7.46 mm for corneal curvature, 2.53 mm for anterior chamber depth and 22.44 mm for axial length. The implanted lens had a median 25.0 dioptric power. The IOP was reduced from 15.6 +/- 3.9 mm Hg to 13.5 +/- 3.1 mm Hg with cataract surgery alone and from 22.4 +/- 5.5 mm Hg to 15.4 +/- 4.0 mm Hg with combined surgery. Mean best corrected visual acuity improved from 0.4 +/- 0.2 to 0.79 +/- 0.25 with cataract surgery and from 0.5 +/- 0.3 to 0.81 +/- 0.24 with combined surgery. Intraoperatively only 3 eyes had a rupture of the posterior capsule and postoperatively 2 eyes developed malignant glaucoma in the combined group.

CONCLUSIONS

The results show that, in eyes with RAM, cataract surgery alone or in combination with glaucoma surgery can be performed with excellent results and low complication rate if adequate precautions are taken (especially the use of hyperosmotic agents).

Pfeffersprayverletzungen des vorderen Augensegmentes

BACKGROUND

A wide variety of pepper sprays is currently available and gaining increasing popularity among both professional guardians and amateurs. Adverse side effects to the anterior segment of the eye are known but underestimated.

HISTORY AND SIGNS

We present two cases with severe corneal and conjunctival damage after accidental self injury by a pepper spray (Jet Protector Guardian Angel), benzyl alcohol 90.1 %, capsaicinoids 2.6 %).

THERAPY AND OUTCOME

Despite immediate and intensive irrigation, a complete epithelial defect, extensive ischemia to the limbus and the conjunctiva and a circular conjunctival chemosis were diagnosed. After slow re-epithelialization in both cases, a neurotrophic superficial keratitis, a reduced corneal sensibility and in one case deep stromal scarring were noted.

CONCLUSIONS

Pepper spray application to the eye might result in severe and permanent damage to the corneo-conjunctival tissue which is not adequately addressed in the current literature. From the present case reports arise the discussion whether the irritative and lipophilic capsacin/benzyl alcohol mixture or the pyrotechnical additives nitrocellulose und sinoxide are responsible for the anterior segment injuries.

[Filtering glaucoma surgery as outpatient procedure]

BACKGROUND

While cataract surgery is nowadays performed routinely as an outpatient procedure, performing filtering glaucoma surgery under these conditions remains questionable due to the more demanding perioperative management.

PATIENTS AND METHODS

Outpatient filtering glaucoma surgery (trabeculectomy and combined phakoemulsification and trabeculectomy (phakotrab)) is performed at the Ophthalmology Department of Kantonsspital Winterthur when requested by the patient. This paper provides a retrospective review of all outpatient filtering glaucoma procedures performed in the last three and a half years.

RESULTS

Forty-six filtering procedures (21 trabeculectomies and 25 phakotrabs) were performed in 45 eyes of 40 patients (50 - 84 years) as outpatient procedures. Mitomycin C was administered in 16/21 trabeculectomies and in 7/25 combined procedures. In the trabeculectomy group, intraocular pressure (IOP) was surgically lowered from 23.3 +/- 7.2 mm Hg (under 2.4 +/- 0.8 IOP-lowering medications) to 12.7 +/- 3.5 mm Hg (20/21 patients without medication). In the combined group, IOP was lowered from 20.8 +/- 6.3 (under 2.0 +/- 0.7 medications) to 13.7 +/- 2.7 mm Hg (only 5/25 patients still requiring IOP-lowering medications). In the latter group, the best corrected visual acuity was below 20/40 only in 2 eyes due to advanced glaucomatous optic atrophy. One patient developed relative intraocular hypotony (IOP 6 mm Hg), one patient required needling + 5-fluorouracil injection and one patient required surgical revision of the trabeculectomy after 14 months.

DISCUSSION

Adequate patient selection and refined surgical technique (tight wound closure and releasable sutures or argon laser suturolysis) allow performing filtering glaucoma surgery as an outpatient procedure. Extended post-operative care during the first 2 months is the key for IOP-lowering success.

Axonal loss from acute optic neuropathy documented by scanning laser polarimetry

BACKGROUND/AIMS

Retinal nerve fibre layer analysis by scanning laser polarimetry has been shown to facilitate diagnosis of glaucoma while its role in glaucoma follow up is still unclear. A major difficulty is the slow reduction of retinal nerve fibre layer thickness in glaucomatous optic neuropathy. Eyes of patients were studied after acute retrobulbar optic nerve lesion in order to evaluate the usefulness of scanning laser polarimetry in documenting retinal nerve fibre layer loss over time.

METHODS

Five patients who suffered severe retrobulbar optic neuropathy have had repeated measurements of the retinal nerve fibre layer using scanning laser polarimetry at various intervals, the first examination being within 1 week of injury.

RESULTS

All eyes showed a marked decrease in peripapillary retinal nerve fibre layer thickness, which followed an exponential curve and occurred predominantly within 8 weeks of injury. Compared to a previous study using red-free photographs, scanning laser polarimetry showed retinal nerve fibre layer loss earlier in the course of descending atrophy.

CONCLUSION

Scanning laser polarimetry is useful for early detection and documentation of retinal nerve fibre layer loss following acute injury to the retrobulbar optic nerve. It seems to be a promising tool for follow up of individual glaucoma patients.