Ingimundur Gíslason

Retinal vasoconstriction after laser treatment for diabetic macular edema.

The diameter of retinal arterioles, venules, and their macular branches was measured before and after macular laser photocoagulation in one eye each of six men and eight women with diabetic macular edema. The macular arteriolar branches constricted 20.2% (P < .001) and the venular branches constricted 13.8% (P < .001). This autoregulatory vasoconstriction results from the improved retinal oxygenation caused by the laser treatment. By extrapolating the principles of tissue edema formation in general, we hypothesized how macular laser treatment affects diabetic macular edema. Starlings law predicts that (laser-induced) vasoconstriction and reduced intravascular hydrostatic pressure should reduce edema formation in any tissue, including the retina.

Screening for eye disease in type 2 diabetes mellitus

Abstract. A screening program for diabetic eye disease was established in Iceland in 1980. Approximately 90% of the insulin dependent patients in Iceland undergo annual eye examination and fundus photography and about a fifth of the type 2 diabetic patients. We report on 245 diabetic patients with type 2 diabetes. Any diabetic retinopathy was present in 100 patients (41%), proliferative retinopathy had been present in 17 (7%) and 24 (10%) had clinically significant diabetic macular edema. Twohundred and twenty‐four patients (91%) had visual acuity equal or better than 6/12 in their better eye, 17 patients (7%) with 6/18–6/36 in their better eye, and 4 patients (1.6%) equal or worse than 6/60 in their better eye.

SYSTEMATIC SCREENING FOR DIABETIC EYE DISEASE IN INSULIN DEPENDENT DIABETES

Abstract. Under a national program established in 1980, the eyes of approximately 90% of the insulin dependent diabetic patients in Iceland have undergone annual eye examination and fundus photography. Laser treatment was given for proliferative retinopathy or diabetic macu‐lar edema according to Diabetic Retinopathy Study and Early Treatment Diabetic Retinopathy Study criteria. We report on 205 insulin‐taking patients whose age at diagnosis was less than 30 years of age. Retinopathy was present in 106 (52%) patients and proliferative retinopathy in 26 (13%). 196 patients (96%) had visual acuity equal or better than 6/12 in their better eye, 6 patients (3%) with 6/18–6/48 in their better eye, and 2 patients (1%) equal or worse than 6/60 in their better eye.

Effects of retrobulbar bupivacaine on post‐operative pain and nausea in retinal detachment surgery

Abstract. A prospective double‐masked clinical trial was conducted to determine whether retrobulbar bupivacaine block had an effect on post‐operative pain, nausea and intra‐ and post‐operative use af analgesics in retinal detachment surgery performed under general anaesthesia. Thirty‐two patients were randomized to have general anaesthesia with or without retrobulbar bupivacaine. Pain score was documented as 0–10 (0 = no pain. 10 = worst pain ever felt). Post‐operative pain score was significantly lower in the retrobulbar block group during the first post‐operative hours than in the control group. Men complained more about post‐operative pain than did women. The patients in the retrobulbar group complained less about nausea. Significantly fewer patients in the retrobulbar group required parenteral pain relief during operation and the first 48 h after.

Exudative retinal detachment in familial pulmonary hypertension

Abstract In a family with pulmonary hypertension, one woman developed bilateral exudative retinal detachments and her daughter developed a unilateral exudative retinal detachment during pregnancy. Treatment with Acetazolamide provided quick recovery in the bilateral case, whereas the unilateral exudative detachment recovered without treatment after delivery. Exudative retinal detachments have not previously been associated with pulmonary hypertension.