Ipsilateral Eye Research Articles

Conjunctival malignancies

Conjunctival malignancies are rare. However, some of these tumors are among the most aggressive malignancies in ophthalmology and require radical forms of therapy that may lead to blindness or loss of the ipsilateral eye and tumor-associated death. The most relevant primary conjunctival malignancies for oncologists are squamous cell carcinoma, malignant melanoma and malignant lymphoma. Surgical therapy is the primary treatment for squamous cell carcinoma and malignant melanoma. An adjuvant therapy in the form of topical chemotherapy or radiation is necessary in most cases. The isolated malignant lymphoma of the conjunctiva is biopsied excisionally if possible. However, if an incisional biopsy was unavoidable, additional irradiation should be performed; malignant lymphoma generally responds very well to relatively low irradiation doses with agood prognosis quad vitam. More aggressive forms, such as diffuse large cell B‑cell lymphoma or mantle cell lymphoma, must also be treated systemically at an early stage.

A CASE REPORT ON STERNOCLEIDOMASTOID SYNDROME - A TRUE PAIN IN THE NECK

The Sternocleidomastoid (SCM) muscle may develop myofascial trigger points and the physical manifestation of pain and signs and symptoms due to these trigger points is commonly referred to as SCM syndrome. The diagnosis of SCM syndrome can be onerous as non-specific signs and symptoms associated with SCM syndrome may vary in presentation. The subject in this case report had post-acceleration-deceleration induced injury to SCM with hypertrophy of sternocleidomastoid muscle on the left side. The patient reported pain over the left SCM muscle, forehead, around the ipsilateral eye, over the cheek, the tip of the chin, sternoclavicular joint and deep in the throat upon. The patient was ascribed various diagnosis before a definitive diagnosis was made. The patient underwent three trigger point injections under ultrasound guidance, last one with BOTOX, and reported long-lasting pain relief. Overall with intensive physical therapy and trigger point injections the acute symptoms resolved. Key words: Sternocleidomastoid syndrome, myofascial pain syndromes, trigger points, ultrasound, Botox

Ipsilateral eye contributions to online visuomotor control of right upper-limb movements

A limb’s initial position is often biased to the right of the midline during activities of daily living. Given this specific initial limb position, visual cues of the limb become first available to the ipsilateral eye relative to the contralateral eye. The current study investigated online control of the dominant limb as a function of having visual cues available to the ipsilateral or contralateral eye, in relation to the initial start position of the limb. Participants began each trial with their right limb on a home position to the left or right of the midline. After movement onset, a brief visual sample was provided to the ipsilateral or contralateral eye. On one third of the trials, an imperceptible 3 cm target jump was introduced. If visual information from the eye ipsilateral to the limb is preferentially used to control ongoing movements of the dominant limb, corrections for the target jump should be observed when movements began from the right of the body’s midline and vision was available to the ipsilateral eye. As expected, limb trajectory corrections for the target jump were only observed when participants started from the right home position and visual information was provided to the ipsilateral eye. We purport that such visuomotor asymmetry specialization emerges via neurophysiological developments, which may arise from naturalistic and probabilistic limb trajectory asymmetries.

Subarachnoid Hemorrhage due to a Ruptured Arteriovenous Malformation

Brain arteriovenous malformations (bAVMs) have an estimated prevalence of 10-18 per 100,000 persons. They consist of a nidus which connects arteries and veins in the absence of an intervening capillary bed. The absence of a capillary network allows for high-flow AV shunting that can be sufficient in some cases to increase cardiac output and cause a systolic-diastolic bruit heard over the ipsilateral cranium, eye, and/or forehead. Resulting shear stresses on the vessel walls can dilate and cause subendothelial thickening and abnormal or absent media and elastic lamina in the feeding arteries, predisposing to the development of arterial aneurysms and to bAVM rupture which is estimated to account for 1.4% to 2% of hemorrhagic strokes. AVMs can occur at any site in the central nervous system, including the cerebral cortex, brainstem and spinal cord. Approximately half of cortical AVMs are situated in the border zone watershed area between the distal anterior, middle, and posterior cerebral arteries.

Benign abducens nerve palsy: diagnosis by exclusion

Of all the cranial nerves, the abducens nerve has the longest intracranial course hence is most common cranial nerve to be affected secondary to any potentially devastating intracranial cause. It can indicate significant underlying pathology. Abducens or sixth cranial nerve innervates lateral rectus muscle and pathology of this nerve results in abduction deficiency of ipsilateral eye. Most of the time it will be unilateral but bilateral involvement is also well known. It can recurrent without any underlying identifiable pathology. The 6th nerve palsy is considered as benign after ruling out all possible causes. Benign causes account for just 9 to 14% of all 6th nerve palsies in children. Most of the time benign 6th nerve palsy occurs after viral infection or vaccination as an immunological reaction. In our case patient had history of pentavalent vaccination 1 month back. After thorough investigation and ruling out all possible causes it was attributed to post vaccination immunological reaction. which resolved spontaneously over 4months.

The Macaque Cerebellar Flocculus Outputs a Forward Model of Eye Movement.

The central nervous system (CNS) achieves fine motor control by generating predictions of the consequences of the motor command, often called forward models of the movement. These predictions are used centrally to detect not-self generated sensations, to modify ongoing movements, and to induce motor learning. However, finding a neuronal correlate of forward models has proven difficult. In the oculomotor system, we can identify neuronal correlates of forward models vs. neuronal correlates of motor commands by examining neuronal responses during smooth pursuit at eccentric eye positions. During pursuit, torsional eye movement information is not present in the motor command, but it is generated by the mechanic of the orbit. Importantly, the directionality and approximate magnitude of torsional eye movement follow the half angle rule. We use this rule to investigate the role of the cerebellar flocculus complex (FL, flocculus and ventral paraflocculus) in the generation of forward models of the eye. We found that mossy fibers (input elements to the FL) did not change their response to pursuit with eccentricity. Thus, they do not carry torsional eye movement information. However, vertical Purkinje cells (PCs; output elements of the FL) showed a preference for counter-clockwise (CCW) eye velocity [corresponding to extorsion (outward rotation) of the ipsilateral eye]. We hypothesize that FL computes an estimate of torsional eye movement since torsion is present in PCs but not in mossy fibers. Overall, our results add to those of other laboratories in supporting the existence in the CNS of a predictive signal constructed from motor command information.

High rate of recurrence of herpes zoster–related ocular disease after phacoemulsification cataract surgery

To examine the outcomes of phacoemulsification cataract surgery in eyes with herpes zoster-related keratitis and/or uveitis and evaluate the risks for recurrent disease. Public ophthalmology service, Auckland, New Zealand. Retrospective case series. Patients with herpes zoster-related keratitis and/or uveitis who had cataract surgery in the ipsilateral eye were reviewed. Outcome measures were intraoperative and postoperative complications, postoperative visual acuity, and recurrent disease. Fifty-seven eyes of 57 patients were included. Thirty-eight patients (66.7%) had recurrent disease before cataract surgery. Intraoperative complications occurred in 8 patients (14.0%) and included posterior capsule tear in 2 patients (3.5%). Postoperative complications included intraocular pressure of 30mm Hg or higher in 2 patients (3.5%) and central corneal edema in 8 patients (14.0%); all resolved by 1month. Cystoid macular edema occurred in 2 patients (3.5%). The median corrected distance visual acuity at 12months was 20/40 (interquartile range, 20/30-20/50). Corneal scarring was associated with poorer vision (P=.003). Herpes zoster recurred in 23 patients (40.4%) after surgery. An increased risk for recurrence was associated with shorter periods of quiescence (P=.029) and greater number of recurrences before surgery (P=.039). One eye was eviscerated because of the severity of the disease. Phacoemulsification in eyes with previous herpes zoster-related keratitis or uveitis posed a mildly increased risk for intraoperative and postoperative complications; however, herpes zoster disease recurrence after surgery was common and was severe in some cases. Consideration should be given to maximizing the period of quiescence before surgery and the potential role of antiviral prophylaxis.

Visual deprivation independent shift of ocular dominance induced by cross-modal plasticity.

There is convincing evidence that the deprivation of one sense can lead to adaptive neuronal changes in spared primary sensory cortices. However, the repercussions of late-onset sensory deprivations on functionality of the remaining sensory cortices are poorly understood. Using repeated intrinsic signal imaging we investigated the effects of whisker or auditory deprivation (WD or AD, respectively) on responsiveness of the binocular primary visual cortex (V1) in fully adult mice. The binocular zone of mice is innervated by both eyes, with the contralateral eye always dominating V1 input over ipsilateral eye input, the normal ocular dominance (OD) ratio. Strikingly, we found that 3 days of WD or AD induced a transient shift of OD, which was mediated by a potentiation of V1 input through the ipsilateral eye. This cross-modal effect was accompanied by strengthening of layer 4 synapses in V1, required visual experience through the ipsilateral eye and was mediated by an increase of the excitation/inhibition ratio in V1. Finally, we demonstrate that both WD and AD induced a long-lasting improvement of visual performance. Our data provide evidence that the deprivation of a non-visual sensory modality cross-modally induces experience dependent V1 plasticity and improves visual behavior, even in adult mice.

Contributions of binocular and monocular cues to motion-in-depth perception.

Intercepting and avoiding moving objects requires accurate motion-in-depth (MID) perception. Such motion can be estimated based on both binocular and monocular cues. Because previous studies largely characterized sensitivity to these cues individually, their relative contributions to MID perception remain unclear. Here we measured sensitivity to binocular, monocular, and combined cue MID stimuli using a motion coherence paradigm. We first confirmed prior reports of substantial variability in binocular MID cue sensitivity across the visual field. The stimuli were matched for eccentricity and speed, suggesting that this variability has a neural basis. Second, we determined that monocular MID cue sensitivity also varied considerably across the visual field. A major component of this variability was geometric: An MID stimulus produces the largest motion signals in the eye contralateral to its visual field location. This resulted in better monocular discrimination performance when the contralateral rather than ipsilateral eye was stimulated. Third, we found that monocular cue sensitivity generally exceeded, and was independent of, binocular cue sensitivity. Finally, contralateral monocular cue sensitivity was found to be a strong predictor of combined cue sensitivity. These results reveal distinct factors constraining the contributions of binocular and monocular cues to three-dimensional motion perception.

Neuromodulatory control of localized dendritic spiking in critical period cortex.

Sensory experience in early postnatal life, during so-called critical periods, restructures neural circuitry to enhance information processing. It is unclear why the cortex is susceptible to sensory instruction in early life and why this susceptibility wanes with age. Here, we define a developmentally-restricted engagement of inhibitory circuitry that shapes localized dendritic activity and is needed for vision to drive the emergence of binocular visual responses in mouse primary visual cortex. We find that at the peak of the critical period for binocular plasticity, acetylcholine released from the basal forebrain during periods of heightened arousal directly excites somatostatin-expressing (SST) interneurons. Their inhibition of pyramidal cell dendrites and of fast-spiking, parvalbumin-expressing (PV) interneurons enhances branch-specific dendritic responses and somatic spike rates within pyramidal cells. By adulthood, this cholinergic sensitivity is lost, and compartmentalized dendritic responses are absent but can be re-instated by optogenetic activation of SST cells. Conversely, suppressing SST cell activity during the critical period prevents the normal development of binocular receptive fields by impairing the maturation of ipsilateral eye inputs. This transient cholinergic modulation of SST cells, therefore, appears to orchestrate two features of neural plasticity – somatic disinhibition and compartmentalized dendritic spiking. Loss of this modulation may contribute to critical period closure.

Plasticity in Adult Mouse Visual Cortex Following Optic Nerve Injury.

Optic nerve (ON) injury is an established model of axonal injury which results in retrograde degeneration and death of retinal ganglion cells as well anterograde loss of transmission and Wallerian degeneration of the injured axons. While the local impact of ON crush has been extensively documented we know comparatively little about the functional changes that occur in higher visual structures such as primary visual cortex (V1). We explored the extent of adult cortical plasticity using ON crush in aged mice. V1 function of the contralateral hemisphere was assessed longitudinally by intrinsic signal imaging and 2-photon calcium imaging before and after ON crush. Functional imaging demonstrated an immediate shift in V1 ocular dominance towards the ipsilateral, intact eye, due to the expected almost complete loss of responses to contralateral eye stimulation. Surprisingly, within 2 weeks we observed a delayed increase in ipsilateral eye responses. Additionally, spontaneous activity in V1 was reduced, similar to the lesion projection zone after retinal lesions. The observed changes in V1 activity indicate that severe ON injury in adulthood evokes cortical plasticity not only cross-modally but also within the visual cortex; this plasticity may be best compared with that seen after retinal lesions.

Development and Validation of the Cluster Headache Screening Questionnaire.

Background and PurposeCluster headache (CH) is frequently either not diagnosed or the diagnosis is delayed. We addressed this issue by developing the self-administered Cluster Headache Screening Questionnaire (CHSQ).MethodsExperts selected items from the diagnostic criteria of CH and the characteristics of migraine. The questionnaire was administered to first-visit headache patients at nine headache clinics. The finally developed CHSQ included items based on the differences in responses between CH and non-CH patients, and the accuracy and reliability of the scoring model were assessed.ResultsForty-two patients with CH, 207 migraineurs, 73 with tension-type headache, and 18 with primary stabbing headache were enrolled. The CHSQ item were scored as follows: 3 points for ipsilateral eye symptoms, agitation, and duration; 2 points for clustering patterns; and 1 point for the male sex, unilateral pain, disability, ipsilateral nasal symptoms, and frequency. The total score of the CHSQ ranged from 0 to 16. The mean score was higher in patients with CH than in non-CH patients (12.9 vs. 3.4, p<0.001). At a cutoff score of >8 points, the CHSQ had a sensitivity, specificity, positive predictive value, and negative predictive value of 95.2%, 96%, 76.9%, and 99.3%, respectively.ConclusionsThe CHSQ is a reliable screening tool for the rapid identification of CH.

Transarterial embolization of carvernous sinus dural arteriovenous fistulas of slender feeding artery with rapid injection of Onyx

Objective To observe the efficacy of transarterial embolization of carvernous sinus dural arteriovenous fistulas (CSDAVFs) with slender feeding artery by rapid injection of Onyx. Methods From December 2010 to December 2016, a total of 20 patients with CSDAVFs with slender feeding artery were admitted to the Neurosurgery Department of the First Affiliated Hospital of Soochow University (12 cases), Changhai Hospital of the Second Military Medical University (4 cases) and the Second Affiliated Hospital of Medical College, Zhejiang University (4 cases). Those clinical data were analyzed retrospectively in this study. All underwent transarterial embolization with rapid injection of Onyx. Results Twenty-two interventional therapeutic procedures and embolization of feeding arteries were performed in all 20 patients, which involved ascending pharyngeal arteries in 11, middle meningeal arteries in 7, accessory meningeal arteries in 2 and internal maxillary arteries in 2. The mean time of Onyx injection was 5 sec-4 min and the volume of Onyx injected was 0.4-1.5 ml. Postoperative immediate complete embolization was achieved in 8, near-complete embolization in 11 and partial embolization in 1 (with 3 repeats of procedures). Postoperatively, there were 2 cases of ipsilateral facial numbness and 1 case of ipsilateral eyelid ptosis and eye movement disorder occurring after 3 times of arterial embolization. The follow-up period was 2-32 months, with an average of 9.5±2.7 months. In 19 patients with complete embolization and secondary embolization, the clinical symptoms disappeared completely. Among them, 18 cases of conjunctival hyperemia and ocular protrusion disappeared within 2 weeks after operation, and 1 case of heavier conjunctival edema disappeared within 3 weeks after operation. The symptoms of diplopia and vision loss improved within 1 to 3 months after surgery, and there was no recurrence. Twelve patients were followed up by DSA, and 7 patients with complete embolization showed complete occlusion of the fistula and no recurrence. Conclusion Transarterial embolization with rapid injection of Onyx may effectively treat CSDAVFs with slender feeding artery with relatively little complications and satisfactory follow-up results. Key words: Arteriovenous fistula; Dura mater; Carvernous sinus; Treatment outcome

Lacrimal Gland Denervation Alters Tear Protein Composition and Impairs Ipsilateral Eye Closures and Corneal Nociception

PurposeTo evaluate spontaneous and evoked ocular sensory responses in rats after denervation of the lacrimal gland, as well as protein changes in tears that may mediate functional changes.MethodsSprague-Dawley rats served as subjects. The left lacrimal gland was partially denervated with saporin toxin conjugated to p75. Unilateral and bilateral eye closures (winks and blinks) and grooming behaviors were measured weekly. Nociceptive responses were evoked by ocular application of menthol; tear production was assessed using the phenol thread test. Relative changes in tear protein abundances were measured using a Tandem Mass Tagging approach.ResultsDenervation of the lacrimal gland reduced eye closure behavior, particularly in the ipsilateral eye, and eye wipe responses to noxious menthol were also reduced. Tear volume did not change, but tear protein composition was altered. Proteins implicated in the structural integrity of epithelial cells and in protective functions were reduced by lacrimal denervation, including keratins, serotransferrin, and beta-defensin. Other proteins that may modulate TRPM8 channels and alter sensory neuronal function were reduced, including arachidonate 15-lipoxygenase B. A low-abundance protein that responds to oxidative stress and injury, proteasome subunit beta type 10, was upregulated in denervated rats.ConclusionsDenervation of the lacrimal gland causes long-lasting hypoalgesia, impairs the blink response, and alters tear proteins. Tear proteins were altered without changing tear volume. We speculate that impaired TRPM8 function in corneal sensory nerves may contribute to ocular hypoalgesia, supporting growing evidence that this transduction molecule is important for both nociceptive and spontaneous blinking behaviors.

Cross-modal Restoration of Juvenile-like Ocular Dominance Plasticity after Increasing GABAergic Inhibition

In juvenile and young adult mice monocular deprivation (MD) shifts the ocular dominance (OD) of binocular neurons in the primary visual cortex (V1) away from the deprived eye. However, OD plasticity is completely absent in mice older than 110 days, but can be reactivated by treatments which decrease GABA levels in V1. Typically, these OD shifts can be prevented by increasing GABAergic transmission with diazepam. We could recently demonstrate that both bilateral whisker and auditory deprivation (WD, AD), can also restore OD plasticity in mice older than 110 days, since MD for 7 days in WD mice caused a potentiation of V1 input through the ipsilateral (open) eye, the characteristic feature of OD plasticity of “young adult” mice. Here we examined whether WD for 7 days also decreases GABA levels. For this, we performed post mortem HPLC analysis of V1 tissue. Indeed, we found that WD significantly decreased GABA levels in V1. Surprisingly, enhancing GABAergic inhibition by diazepam did not abolish OD shifts in WD mice, as revealed by repeated intrinsic signal imaging. On the contrary, this treatment led to a depression of V1 input through the previously closed contralateral eye, the characteristic signature of OD plasticity in juvenile mice during the critical period. Interestingly, the same result was obtained after AD. Taken together, these results suggest that cross-modally restored OD plasticity does not only depend on reduction of GABA levels in V1, but also requires other, so far unknown mechanisms.

Endoscopic Assisted Retrosigmoid Approach for Cerebellopontine Angle Epidermoid Tumor.

This case is a 20-year-old male, who presented with 1 month of right facial weakness (HB4) and complaints of ipsilateral eye dryness. He was initially treated for Bell's palsy with steroids and antiviral agents, but subsequently developed diplopia with right lateral gaze and underwent an MRI (magnetic resonance imaging). MRI demonstrated a 4.5 cm irregular lesion in the right cerebellopontine angle consistent with an epidermoid cyst. Because the tumor had grown with the development of the central nervous system, it has extended into different compartments, including the tentorial incisura and pineal region. A predefined surgical corridor created by the tumor facilitated access to the majority of the tumor through a retrosigmoid approach. Angled endoscopes (30-degree up and down) provided further visualization of tumor away from the line of sight of the microscope, thus allowing for gross total resection of the lesion. This video also demonstrates a sharp dissection technique necessary for safe removal of adherent tumor from critical neurovascular structures, including the basilar artery and several cranial nerves. The ipsilateral auditory evoked responses (ABRs) showed slight improvement from baseline toward the end of the case. A gross total resection was achieved, as shown by the MRI. The patient remained at his baseline cranial nerve (CN) V, VII, and VIII deficits during the immediate postoperative period. The link to the video can be found at: https://youtu.be/vCq5juJh8hk .

Comparison of Multiple Treatment Planning Techniques for High-Grade Glioma Tumors Near to Critical Organs

Aim: The purpose of this study was to compare 6 treatment planning methods (5-beam coplanar intensity-modulated radiotherapy (IMRT), 7-beam coplanar IMRT, 7-beam noncoplanar IMRT, 2 full arc coplanar volumetric modulated arc therapy (VMAT), 2 half partial arc coplanar VMAT, and 2 half partial arc noncoplanar VMAT) for high-grade gliomas with planning target volumes (PTVs) overlapping the optic pathway and/or brainstem. Patients and Methods: 27 previously-treated patients with high-grade gliomas were replanned for treatment with IMRT₅, IMRT₇, IMRT_7-non, VMAT_2f, VMAT_2h, and VMAT_2h-non. In order to perform a comparative study of the treatment outcomes, 3 tumor localizations (right-sided, left-sided, and central tumors) were selected. Patients were administered a PTV dose of 60 Gy in 30 fractions with a maximum permitted dose of 110%. Results: Comparison of the 3 IMRT plans and 3 VMAT plans was performed for all 27 patients. The median conformity index was significantly higher (p < 0.05) in all IMRT plans compared to all VMAT plans in the case of right sided tumors. Significant differences were also observed between coplanar and noncoplanar plans in IMRT and VMAT in right-sided tumors (p < 0.05). Differences in brainstem mean doses were only found to be significant between coplanar and noncoplanar plans in centrally-located tumors. In right- and left-sided tumors, the VMAT_2f plans demonstrated higher values than all IMRT plans in their mean values for radiation doses to the ipsilateral optic nerves, contralateral optic nerves, ipsilateral lens, ipsilateral eye, contralateral lens, contralateral eye, and contralateral optic nerves, as well in the maximums for the optic chiasm and contralateral optic nerves. Significantly faster treatment times were achieved with all VMAT plans compared to IMRT plans. Conclusion: IMRT techniques provided better target coverage than VMAT plans. However, VMAT techniques reduced treatment delivery time more than IMRT techniques. Technique selection for tumors located in 3 different localizations should be individualized in accordance with patients' specific parameters.

Long-Term Functional and Structural Consequences of Primary Blast Overpressure to the Eye.

Acoustic blast overpressure (ABO) injury in military personnel and civilians is often accompanied by delayed visual deficits. However, most animal model studies dealing with blast-induced visual defects have focused on short-term (≤1 month) changes. Here, we evaluated long-term (≤8 months) retinal structure and function deficits in rats with ABO injury. Adult male Long-Evans rats were subjected to ABO from a single blast (approximately 190 dB SPL, ∼63 kPa, @80 psi), generated by a shock tube device. Retinal function (electroretinography; ERG), visual function (optomotor response), retinal thickness (spectral domain-optical coherence tomography; SD-OCT), and spatial cognition/exploratory motor behavior (Y-maze) were measured at 2, 4, 6, and 8 months post-blast. Immunohistochemical analysis of glial fibrillary acidic protein (GFAP) in retinal sections was performed at 8 months post-blast. Electroretinogram a- and b-waves, oscillatory potentials, and flicker responses showed greater amplitudes with delayed implicit times in both eyes of blast-exposed animals, relative to controls. Contrast sensitivity (CS) was reduced in both eyes of blast-exposed animals, whereas spatial frequency (SF) was decreased only in ipsilateral eyes, relative to controls. Total retinal thickness was greater in both eyes of blast-exposed animals, relative to controls, due to increased thickness of several retinal layers. Age, but not blast exposure, altered Y-maze outcomes. GFAP was greatly increased in blast-exposed retinas. ABO exposure resulted in visual and retinal changes that persisted up to 8 months post-blast, mimicking some of the visual deficits observed in human blast-exposed patients, thereby making this a useful model to study mechanisms of injury and potential treatments.

Retinal ganglion cell complex and peripapillary retinal nerve fiber layer thicknesses following carotid endarterectomy.

To examine changes in retinal ganglion cell complex (GCC) and peripapillary retinal nerve fiber layer (RNFL) thicknesses by optical coherence tomography (OCT) in contralateral and ipsilatateral eyes of carotid artery stenosis (CAS) patients before and after carotid endarterectomy (CEA). Forty-two consecutive patients diagnosed with CAS (70-99% stenosis rate) who underwent CEA were included in this prospective cross-sectional study. The indication for CEA was based on the Asymptomatic Carotid Atherosclerosis Study. Doppler ultrasonography and computed tomography angiography were performed to calculate CAS. All the subjects underwent an ophthalmological examination, including best corrected visual acuity (BCVA), intraocular pressure (IOP) measurements, biomicroscopy, fundoscopy, and OCT before and after the surgery. The mean preoperative intraocular pressure was 15.2 ± 2.1mmHg in the ipsilateral eye and 15.8 ± 2.7 in the contralateral eye. The mean postoperative intraocular pressure in the ipsilateral and contralateral eye was 18.6 ± 3.0 and 19.3 ± 3.8, respectively. The intraocular pressure was significantly higher in postoperative eyes (p = 0.0001). There was a statistically significant decrease in peripapillary RNFL thickness in superior quadrants postoperatively in ipsilateral eyes. The retinal GCC layer thickness was not significantly different before and after CEA in ipsilateral and contralateral eyes. Carotid endarterectomy results in thinning of the superior peripapillary RNFL thickness. To the best of our knowledge, this is the first study to examine peripapillary RNFL and GCC thicknesses before and after CEA.

Retinal changes in Parkinson's disease and glaucoma

BackgroundThe topic of retinal neurodegeneration in PD is controversial, therefore the objective was to compare macular ganglion cell complex (mGCC) and peripapillary retinal nerve fiber layer (pRNFL) thickness in PD using 2 Spectral-Domain (SD) Optical Coherence Tomography (OCT) devices. MethodsIn total, 146 eyes of 130 age-similar patients were included, of these 46 eyes of 30 PD patients, 60 eyes of 60 glaucoma patients and 40 eyes of 40 healthy controls. Peripapillary RNFL and mGCC were measured. Correlation analyses were performed for evaluation of association between pRNFL or mGCC and PD severity using the Movement Disorder Society (MDS)-Unified Parkinson Disease Rating Scale (UPDRS). Scatterplots were used to evaluate relationships between disease duration, dopamine dose, olfactory assessment and retinal thickness. ResultsNo significant difference was found for both eyes of PD patients compared to healthy subjects neither for overall mGCC nor each sector. However, the ipsilateral eye to the most-affected body side with bradykinesia in PD patients had a statistically significant thinner superior pRNFL compared to healthy controls (P = 0.03). There was no significant correlation between pRNFL or mGCC and disease severity; also, the scatterplots did not indicate a correlation between disease duration, dopamine dose, olfactory testing and OCT results. ConclusionsImaging of the retina revealed thinning of some retinal layers of the ipsilateral eye to the most-affected body side in PD patients compared to healthy controls. Peripapillary RNFL and mGCC did not correlate to disease severity; however, this was a fairly small and heterogeneous group of PD patients.