Increased pressure of dilated episcleral veins with open-angle glaucoma without exophthalmos.

Six unilateral cases and one bilateral case of dilated episcleral veins with elevated intraocular pressure without exophthalmos are described. Episcleral venous pressure measured on six unilateral cases showed increased pressure in the affected eye compared to the other eye and to normal controls. Two eyes had typical glaucomatous disc and visual field changes.

6-hydroxydopamine in the treatment of open-angle glaucoma.

We evaluated the effectiveness of subconjunctival injections of 6-hydroxydopamine in conjunction with epinephrine in lowering ocular tension in 63 eyes of 61 patients with open-angle glaucoma. A single injection caused a peak median reduction in ocular tension of 6 mm Hg four weeks after the injection. Ten eyes (16%) showed no significant decrease in ocular tension.

Fluorescein angiography. Demonstration of flow pattern of anterior ciliary arteries.

With fluorescein angiography of the episcleral region at two frames per second, the wide, tortuous vessels perforating the sclera near the limbus were shown to first fill with fluorescein at an average of 19 s after intravenous injection of fluorescein. These perforating vessels should be called the anterior ciliary arteries because they are the first vessels to fill with fluorescein, fill at the same time the iris fills, give out branches, have higher pressure compared with veins, and show pulsations when the pressure is applied to them. In addition in most cases, distinctly different veins that fill laminarly or fully were seen.

Episcleral venous pressure. Differences between normal, ocular hypertensive, and primary open angle glaucomas.

The pressures of the episcleral veins of 20 normal patients, 29 patients with ocular hypertension, and 22 patients with treated primary open angle glaucoma were measured by an air pressure chamber device mounted on a slitlamp. The episcleral venous pressures (EVPs) of the patients with ocular hypertension were found to be significantly lower than those of the patients with glaucoma and the normal patients. The EVP was also found to be significantly negatively correlated with the ocular pressure (OP), so that the EVP decreases as the OP increases.

Fluorescein angiography of the optic disc. A longitudinal follow-up study.

A comparison of two or more disc fluorescein angiograms performed on separate occasions was done on 60 eyes of normal subjects and patients with ocular hypertension, primary open-angle glaucoma, and low-tension glaucoma. Clinically stable patients did not show any change in their disc angiographic filling patterns. Eyes that developed new visual-field defects with increased disc cupping and pallor correspondingly showed new absolute filling defects or areas of hypofluorescence.