Lovro Bojić

Epidemiological Study of Nontraumatic Phakic Rhegmatogenous Retinal Detachment

We studied the epidemiological characteristics of nontraumatic phakic rhegmatogenous retinal detachment (RRD) in a defined population of Split-Dalmatia County, Croatia. A total of 278 eyes of 272 patients developed RRD during an 11-year period, 1988–1998, with a population of 465,947. The annual incidence was 5.4 per 100,000 population. The mean age of patients was 58.3 years, and the sex distribution corresponded with that in the general population. There was insignificant preponderance of right eye involvement. Bilaterality was observed in 2.2%. The presence of myopia was diagnosed in 46.9% eyes.

Influence of betaxolol and timolol on the venous tone in glaucoma patients

The aim of this study was the assessment of physiological venous reflexes in 40 glaucoma patients treated with topically applied timolol maleate 0.50% and betaxolol HCL 0.50%. They were divided into two groups of twenty each; one group being given timolol and the other betaxolol. The assessment of the venous tone was performed by testing venous reflexes. We found no statistically significant difference between timolol and betaxolol; however, when the influence of circulating catecholamines and the other vasoactive substances was excluded by suprasphygmatic insufflation of a pediatric cuff, a significant difference was found in the Valsalvas maneuver (125.5 ± 8.1 vs 85.0 ± 34.3 venoconstrictive units VCUs, p = 0.03).The IOP was significantly decreased in both treatment group, although the pressure reduction effect was more pronounced in the timolol group.Our study suggests that timolol and betaxolol have a slightly different mode of action on the venous side of circulation under topical medications. It is possible that the use of betaxolol topically may reducea systemic venoconstriction.

Venous Tone in Glaucoma and Hypertension

The aim of this study was the assessment of physiological venous reflexes in systemically hypertensive and normotensive subjects with primary open-angle glaucoma. The experimental group consisted of 20 normotensive and 20 untreated systemically hypertensive patients with open-angle glaucoma. The control group consisted of 31 volunteers divided into two subgroups: 16 control normotensives and 15 untreated hypertensives. The assessment of venous tone changes was performed by testing venous reflexes. Venoconstriction responses to physiological stimuli were significantly decreased in normotensive glaucoma patients, compared to normotensive controls [for the Valsalva manoeuvre 93.4 +/- 80.2 vs. 413.3 +/- 335.4 venoconstrictive units (VCUs), p = 0.02, and for a deep breath 89.1 +/- 100.1 vs. 316.8 +/- 343.2 VCUs, p = 0.03]. The intensity of venous reflexes in hypertensive glaucoma patients did not differ significantly from that seen in hypertensive controls, due to a significantly weaker flex venoconstriction in hypertensive controls when compared to normotensive controls subjects. This study confirmed the presence of venous dysregulation in subjects with primary open-angle glaucoma and visual field loss as a part of an autonomic dysfunction. Systemic hypertension does not make this condition worse.

Should we screen for asymptomatic left ventricular dysfunction in glaucoma patients

BACKGROUNDnThe aim of the study was to assess the frequency of asymptomatic left ventricular dysfunction in primary open-angle glaucoma patients.nnnPATIENTS AND METHODSnTwo-dimensional and pulsed Doppler echocardiography of transmitral flow was performed on 31 glaucoma patients and 27 controls.nnnRESULTSnNo significant difference was found in early (E) and late (A) transmitral filling velocity, velocity time integral E wave (VTIE) and A wave (VTIA), left ventricular end-diastolic pressure, pulmonary capillary wedge pressure, left ventricular ejection fraction (EF) and fractional shortening (FS). A significant difference was found in ratio E/A (P=0.04) and ratio VTIA/VTIE (P=0.05), although all obtained values were within the 95% confidence limit for the corresponding age.nnnCONCLUSIONnOur study tends to indicate the possibility of dysfunction of myocardial relaxation in glaucoma patients, which might be partially attributed to systemic vascular dysregulation.