PubMed · 23601
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E G Gamm. [Aqueous humor].. https://pubmed.ncbi.nlm.nih.gov/23601/
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A 32-year-old asymptomatic woman was found to have unilateral papilledema on routine ophthalmological examination. Subsequent visual field, neuroimaging, and cerebrospinal fluid examinations were consistent with the diagnosis of pseudotumor cerebri. This case demonstrates that pseudotumor cerebri may present as unilateral papilledema in any asymptomatic patient and illustrates the need for thorough neuro-ophthalmological evaluations to allow early detection of cases with atypical presentations to increase the efficacy of therapeutic intervention and prevent progressive visual loss.
The effect of acetazolamide in the treatment of chronic macular edema has been well established. The pharmacologic action of this product suggested possible efficacy in the treatment of serous retinal detachment. We studied 38 patients presenting with serous retinal detachments of various etiologies divided into four groups: age related macular degeneration, central serous chorioretinopathy or diffuse epithelial retinopathy, epiretinal membranes, and other causes. Treatment with acetazolamide, at a dosage of 0.375 g/day, in three divided doses was proposed for five weeks. We observed a reduction of metamorphopsia in all cases, a stability or even an improvement of visual acuity, and a resorption of serous retinal detachment confirmed by decreased pooling of fluorescein on the angiographic examination. Considering each etiology, clinical and angiographic findings demonstrated the value of this treatment, although this study was not prospective. The encouraging results observed in many cases, raise hopes concerning the treatment for these diseases, usually not amenable to treatment.
New clinical methods are proposed to assess (1) neuronal activities of the retinal inner layers including amacrine cells by means of the oscillatory potential, (2) photopic function through the rapid decay in the off-response and (3) activities of the retinal pigment epithelium through susceptibility of the standing potential of the eye to osmotic stress and to Diamox. These new methods are able to reveal otherwise undetectable retinal disorders.