Giuseppe Ciurlo

Fluctuations of Intraocular Pressure during the Day in Open-Angle Glaucoma, Normal-Tension Glaucoma and Normal Subjects

Purpose: The aim of the present paper is to describe the variations in intraocular pressure (IOP) during the day in normals, in patients with primary open-angle glaucoma (POAG) and in patients with normal-tension glaucoma (NTG). IOP represents one of the most important risk factors for glaucoma. However the IOP value is not constant during the day and IOP fluctuation could influence the diagnostic and prognostic evaluation of the glaucomatous disease. Methods: For this purpose IOP was evaluated every 2 h from 8 a.m. to 8 p.m. in one randomized eye of 33 normal subjects, 95 POAG and 50 NTG patients. Results: The results show that the highest IOP values were detectable in the morning in all three groups. The lowest values were found in the early afternoon hours. These variations were most evident in POAG patients. The daily IOP fluctuations were directly proportional to IOP level. Conclusion: The study evidents that a single tonometric evaluation, especially if done in the first hours of the afternoon, is not sufficient to correctly evaluate the IOP-related risk in glaucoma patients. If the pressure peaks are important in determining the extent of glaucomatous damage in NTG patients IOP should not have an important role in optic nerve head damage. The use of diurnal curves seems to be mandatory for the assessment of IOP-related risk and of efficiency of the therapeutic approach.

Non-steroidal treatment of pollen-induced conjunctivitis: comparison of different pharmacological protocols.

Pharmacological treatment of allergic conjunctivitis may be based on the therapeutic use of topical steroids; however, because of the side effects, steroids are not clinically suitable in either prolonged treatment, or pollinosis. Because non‐steroidal topical drugs are suitable in prolonged treatment, this single‐blind study evaluated the following topical drugs: cromoglycate plus chlorphenamine, cromoglycate plus tetryzolin and imidazolin plus nafazolin, compared with placebo. The results confirm significant clinical efficacy of these drugs on signs and symptoms compared with placebo. Thus, “non‐steroidal” topical drugs should be the preferred choice in prolonged forms of pollen‐induced (e.g. Parietaria and/or grasses) conjunctivitis.

Congenital Glaucoma Associated with An Arginase Deficit: A Case Report

Purpose. Argininemia is a rare congenital disease caused by deficiency. We present here a case in which argininemia and buphthalmos are associated. Case report. This female patient, who died at eighteen, had intraocular pressure correlated with her blood levels of arginine. Hyperammoniemia causes a change in pH that could explain an increase in aqueous humor (from the ciliary body). Ammonium ions could also damage the matrix of the trabecular meshwork. Conclusions. The association of argininemia and buphthalmos have never been described. This might be because of the different expressions of the disease, or because nobody has ever looked for ocular hypertension in these patients unless they had subjective symptoms.

A new therapeutical approach to central serous retinopathy, a hypothesis

SummaryThe authors report two cases of patients affected by Central Serous Retinopathy (C.S.R.) lasting few days; they were immediately started with an antiviral therapy (Acycloguanosine) for few days and in both cases the regression of symptoms and a flat retina were observed after a very shorter time then the spontaneous course. A fluorescein angiography confirmed a healing of the leaking points very few days after the therapy was discontinued.The authors discuss their finding in relation to the latest hypothesis on C.S.R. pathogenesis.

Intraimage reproducibility of measurements in the macular area using a computerized system

An accurate analysis of the morphological changes which take place during pathological processes of the posterior pole is important for a correct diagnosis and therapeutic approach. The purpose of the study was to determine the intraobserver and interobserver reproducibility of the Image-net system 100 (Topcon, Japan) to take measurements on the retina.The program ’Linear/Areal Measurement functions‘ of Image-net system 100 which is an image digitalization technique, was tested. Twelve patients were consecutively selected from the patients of the Retina Center of the Department of Ophthalmology, University of Genoa. Three images of each eye were taken from each subject and only the best image was used in this study. The intraobserver and interobserver reproducibility of both the distance between two pre-set points (linear measurement), and the perimeter and area of preselected retinal zones were calculated.The repeatability (or intraobserver reproducibility) of the linear sizes was measured by the coefficient of variation and ranged from 0.32% to 7.38%, while the interobserver reproducibility ranged from 0.46% to5.22%. The repeatability and reproducibility of the perimeters ranged from 0.72% to 9.63% and from0.6%to 5.7%, respectively, while the repeatability and reproducibility of the areas ranged from 0.72% to 9.63%and from 0.6% to 5.7%, respectively.Although the results were quite good, the quality of the image of the fundus and the number of observers influenced the coefficient of variation; furthermore, the anatomy of the areas to be measured and the computer’mouse‘ could increase the value of the coefficient of variation.

Flicker Fusion in Pericoecal Area

The pericoecal area is known to be the site of some early defects of the visual field. Flicker fusion frequencies, on turn, have been reported to be often altered when more classical Perimetric examination results are still unchanged. This work is intended to report ‘normal’ values for flicker fusion frequencies in this area based on the examination of four normal subjects.

Light Threshold and Temporal Resolution in the Central Visual Field

A target flickering at a constant speed presented at different points of the central visual field is fused at luminancies that are directly related to the light threshold of the tested point.