A Romani

Intraocular pressure changes in secondary positions of gaze in normal subjects and in restrictive ocular motility disorders

One hundred normal Caucasian eyes and 29 eyes with restrictive disorders of ocular motility were studied in order to delineate intraocular pressure changes in secondary positions of gaze. Applanation tonometry was performed in the primary position and at an angle of 22°. In patients with restrictive syndromes the changes of intraocular pressure in the secondary positions of gaze were significantly higher (p < 0.0001) than in normal subjects.The range of variation in normal subjects was 0, +3 mmHg for supraduction and −3, +1 mmHg for abduction. Patients with restrictive syndromes showed changes between +1 and +15 mmHg for supraduction and between +3 and +10 mmHg for abduction. Results obtained in the two groups showed the existence of false negatives. This test is thus a practical and useful diagnostic tool, but its results must be evaluated cautiously.

Blood coagulation parameters in retinal arterial occlusion

Abstract · Background: Thromboembolism is considered a crucial event in the pathogenesis of retinal occlusion, resulting in a severe damage of central or peripheral visual function. · Methods: We evaluated hemostatic system parameters in the plasma of 14 patients (11 males and 3 females aged 59–73 years) affected by acute retinal ischemia (central retinal arterial occlusion or arterial branch occlusion). The diagnosis of retinal arterial occlusion was established according to clinical symptoms, ophthalmoscopic findings and fluorescein angiography. In addition to routine coagulation tests, antithrombin III, prothrombin fragment 1+2 (F1+2), thrombin-antithrombin III complex (TAT), and D-dimer were measured in the plasma both at the moment of diagnosis (before therapy initiation) and 3–6 months later (at least 1 months after antithrombotic therapy discontinuation). · Results: We found a marked increase in the plasma levels of F1+2, TAT, and D-dimer during the acute event, compared with healthy control values. F1+2 and TAT significantly decreased during follow-up, whereas D-dimer was unchanged. · Conclusion: Our data indicate accelerated conversion of prothrombin to thrombin (high F1+2) and an increase in circulating thrombin (high TAT) during retinal arterial occlusion, providing evidence that increased thrombin generation may play a role in acute retinal ischemia.

Divergence pseudoparalysis: a case report.

Divergence paralysis is a clinical syndrome that is characterized by esotropia and diplopia at distance fixation and fusion at near fixation. This syndrome is thought to result from a lesion in the brain stem, probably in the midbrain or in the pontine region. This paper reports a case in which ocular motility disturbances, simulating divergence paralysis, were caused by a bilateral and symmetrical restrictive syndrome involving the medial rectus muscles.