Selective Laser Trabeculoplasty as Primary Treatment for Open-Angle Glaucoma.

Open-angle glaucoma is a silent, chronic disorder which results in progressive and permanent vision loss. Designing the optimal treatment regimen can be particularly challenging in the management of high-risk patients with frequent loss to follow-up or a longstanding history of medication noncompliance. In this article we aim to review fundamental techniques in glaucoma diagnosis and treatment with emphasis on the strengths and weaknesses of selective laser trabeculoplasty, a technique in modern therapy which may mold the future of primary treatment in open angle glaucoma management.

Retinal pigment epithelial detachment with disgorgement in age-related macular degeneration observed with OCT.

This report describes a rare appearance of retinal pigment epithelial changes in a 71-year-old woman with known long-standing, non-exudative age-related macular degeneration. She presented with visual distortion in her right eye and was found to have a retinal pigment epithelial detachment (RPED) on optical coherence tomography (OCT). Over the following 8 years, sequential OCT imaging revealed an appearance and progression of a break in the existing RPED, disgorgement of material from within the RPED, and appearance of hyper-reflective spots within the inner retinal layers, suggesting pigment epithelial cell migration.

Wall shear stress association with rupture status in volume matched sidewall aneurysms.

Objective: Flow induced tangential wall shear stress (WSS) is thought to be involved in aneurysm formation, growth, and rupture. Low WSS was previously associated with rupture, but definitive quantitative analyses remain scant as larger aneurysms are associated with lower WSS regardless of rupture status, and ruptured aneurysms are larger than unruptured aneurysms. Here, the intra-dome WSS was evaluated on 18 internal carotid artery aneurysms, volume matched as ruptured/unruptured pairs in order to remove the confounding effect of size dependence.

Colocalization of thin-walled dome regions with low hemodynamic wall shear stress in unruptured cerebral aneurysms.

Object: Wall shear stress (WSS) plays a role in regulating endothelial function and has been suspected in cerebral aneurysm rupture. The aim of this study was to evaluate the spatial relationship between localized thinning of the aneurysm dome and estimated hemodynamic factors, hypothesizing that a low WSS would correlate with aneurysm wall degeneration.

Methods: Steady-state computational fluid dynamics analysis was performed on 16 aneurysms in 14 patients based on rotational angiographic volumes to derive maps of WSS, its spatial gradient (WSSG), and pressure.

Cerebral aneurysm wall thickness analysis using intraoperative microscopy: effect of size and gender on thin translucent regions.

Objective: Wall thickness is a poorly documented characteristic of cerebral aneurysms which may provide insight into adaptive aneurysmal growth, aneurysm rupture risk and response to endovascular treatment. The distribution of aneurysm wall thickness, as observed by intraoperative video microscopy, is described.

Methods: 54 unruptured saccular cerebral aneurysms were selected based on the availability of intraoperative video obtained from patients undergoing microsurgical clipping.

High-frequency stimulation in the ventral posterolateral thalamus reverses electrophysiologic changes and hyperalgesia in a rat model of peripheral neuropathic pain.

Chronic neuropathic pain is associated with long-term changes at multiple levels of the neuroaxis, including in the brain, where electrical stimulation has been used to manage severe pain conditions. However, the clinical outcome of deep brain stimulation is often mixed, and the mechanisms are poorly understood. By means of electrophysiologic methods, we sought to characterize the changes in neuronal activity in the ventral posterolateral nucleus of the thalamus (VPL) in a rat model of peripheral neuropathic pain, and to reverse these changes with low-voltage, high-frequency stimulation (HFS) in the VPL.

Minocycline injection in the ventral posterolateral thalamus reverses microglial reactivity and thermal hyperalgesia secondary to sciatic neuropathy.

We hypothesized that microglia in the ventral posterolateral (VPL) nucleus of the thalamus are reactive following peripheral nerve injury, and that inhibition of microglia by minocycline injection in the VPL attenuates thermal hyperalgesia. Our results show increased expression of OX-42 co-localized with phosphorylated p38MAPK (P-p38) in the VPL seven days after chronic constriction injury (CCI) of the sciatic nerve. However, astrocytic GFAP expression in the VPL is unchanged 7 and 14 days after CCI.