Faculty Bibliography

Glaucoma, a leading cause of blindness worldwide, is a chronic neurodegenerative disorder. Patients with glaucoma may require long-term administration of intraocular pressure (IOP)-lowering medications. These medications belong to several classes of molecules including beta-adrenergic blockers, cholinergic agents, alpha-adrenergic agonists, carbonic anhydrase inhibitors and ocular hypotensive lipids. Most adverse effects associated with IOP-lowering medications are mild and ocular in nature; however, several of them are associated with systemic risks as well as serious ocular effects, especially following chronic use. The following review discusses the acute and long-term effects of commonly used IOP-lowering medications.

PURPOSE: To report a case of herpes simplex virus reactivation after starting bimatoprost treatment for glaucoma. DESIGN: Interventional case report. METHODS: A 66-year-old woman had a herpes simplex keratouveitis reactivation that occurred within 1 month after starting bimatoprost. The herpes simplex had been inactive for more than 10 years. RESULTS: Bimatoprost and prednisolone acetate 0.12% were discontinued; oral acyclovir, ofloxacin, and betaxolol 0.25% were initiated. Two weeks later, prednisolone acetate 1% was added. The reactivation resolved, and 1 month later, the best corrected visual acuity improved to 20/40. CONCLUSION: Caution should be used in prescribing bimatoprost for patients with a history of herpes simplex virus keratitis.

This case describes a patient who developed a systemic anaphylactic reaction to a subconjunctival injection of cephalosporin. The patient did well, but required intensive therapy, including airway intubation. She had a history of penicillin allergy. Even 50 mg of cephalosporin antibiotic injected locally can produce a life threatening anaphylactic reaction.

Objetivos: Apresentar uma nova tecnologia, Tomografia de Coerencia Optica (Optical Coherence Tomography - OCT), a qual pode ser um instrumento clínico útil para a deteccao precoce do glaucoma e de sua progressao. Local: New England Eye Center/ Tufts University School of Medicine, Hospital das Clinicas da Universidade de Sao Paulo e Instituto Benjamin Constant. Metodos: Discussao sobre a tecnologia do OCT e interpretacao de imagens de pacientes glaucomatosos e normais. Resultados: Demonstrar o uso do OCT, um metodo qualitativo e quantitativo de estudo da camada de fibras nervosas, no diagnostico de glaucoma. Conclusao: OCT e uma tecnologia com potencial para auxiliar no diagnostico e tratamento do glaucoma.(AU)