Search

To evaluate the efficiency of amniotic membrane in prevention of adhesion formation after strabismus surgery.A prospective, controlled study was conducted on 20 eyes of 10 pigmented rabbits. After disinsertion of the superior rectus muscle, under the muscle insertion area to induce adhesion formation, a partial-thickness 4 x 4 mm sclerectomy was performed in both eyes. In the right eyes, a piece of appropriate size human amniotic membrane was sutured on the sclerectomy site. As the control group, left eyes were operated with a similar procedure but without amniotic membrane transplantation. After 2 months, both eyes were enucleated to perform histopathologic examination.There was no adhesion between the sclera and muscle in the amniotic membrane group; however, there were various degrees of adhesions in the control group (p=0.004). Fibrosis in rectus muscle was present in 40% of the specimens in the amniotic membrane group and 90% in the control group with a higher grade (p=0.023). The mean number of inflammatory cells was significantly higher in the amniotic membrane group (p=0.005).According to our results, amniotic membrane has antifibrotic effect but no anti-inflammatory effect in rabbit eyes due to possible xenograft reaction to human tissues. It is effective in prevention of adhesion formation with possible physical barrier action.

To investigate the process of emmetropization in anisometropic amblyopic subjects during childhood and to determine the effects of spectacle use only and patching.Retrospectively, the records of patients who were diagnosed as anisometropic amblyopes were reviewed and 132 subjects who were between the ages of 5 to 8 at the time of diagnosis, with minimum follow-up of 3 years, were included in the study. Full ophthalmological examination was performed in every subjects and the information from every visit was retrieved for evaluation. Patients were divided into two groups according to the treatment they applied: patching and spectacle alone.The emmetropization process was similar to normal subjects after 3 years of follow-up, with a change of -0.71 D from the baseline spheric retinoscopy measurement in the spectacle group and -0.53 D in patching group (p0.809). Patching and spectacle use did not change the decrease in hypermetropia. Astigmatism and anisometropia scores did not show any difference in two groups in the 3-year follow-up period.The emmetropization process is similar to normal population in anisometropic subjects and spectacle use and patching therapy have no effects on this process. The anisometropia score does not change with patching and stays relatively the same during the follow-up in childhood.

This article is a review of infantile nystagmus syndrome, presenting with an overview of the physiological nystagmus and the etiology, symptoms, clinical evaluation and treatment options

WOS: 000387531800002, PubMed: 27532638, Purpose: Surgery for strabismus associated with neurological impairment is assumed to have unsatisfactory results in comparison with other strabismus cases. The aim of this study is to compare the surgical success rates of infantile esotropia (IE) and strabismus associated with neurological impairment. Methods: The records of 103 patients that received operations for IE and strabismus associated with neurological impairment between January 1994 and May 2014 were reviewed retrospectively. The angles of deviation and surgical success rates were evaluated at preoperative, 1-month postoperative, and 24-month postoperative visits. Results: Forty-five patients received operations for strabismus associated with neurological impairment (25 patients with esotropia and 20 patients with exotropia) and 58 patients for IE. Mean preoperative angles of deviation in cases with neurological impairment were 42 prism diopters (PD) for esotropia, 44.7 PD for exotropia, and 44.4 PD for IE. One patient from each group had consecutive deviation at first visit, and at last visit, 3 patients with neurological impairment and 5 patients with IE had consecutive deviations. Surgical success rates at the end of the second year were 52% for esotropia and 50% for exotropia in patients with neurological impairment and 56.8% for IE cases. Conclusion: This study was unable to find the differences between surgical success rates in IE and strabismus associated with neurological impairment.

A sensitive high performance liquid chromatographic method has been developed and validated for the determination of proparacaine in human aqueous humour. The procedure involved extraction of proparacaine from aqueous humour with cyclohexane. The separation was achieved using a Bondesil C8 (250 × 4.6 mm i.d., particle size 5 μm) analytical column with a mobile phase consisted of acetonitrile and sodium dihydrogen phosphate (pH 3.0, 20 mM) (30:70, v/v). Proparacaine and lidocaine (internal standard, IS) detection was performed by UV–Vis detector at 220 nm. The retention times for proparacaine and IS were 12.01 and 5.58 min, respectively. HPLC–UV–Vis method was linear in the range of 75–4,000 ng mL−1. The limit of detection (LOD) was 25 ng mL−1 and the limit of quantification (LOQ) of proparacaine was found to be 75 ng mL−1 (RSD ≤ 15%, n = 6). In intra- and inter-day precision and accuracy analysis, the relative standard deviation was found to be in the range of 0.96 and 7.98%, the bias values were 0.64 and 3.33%. Recovery of proparacaine from human aqueous humour was 99.98% at 500 ng mL−1. Proparacaine solutions were stable at least 6 months at +4 and −20 °C. Proparacaine levels of aqueous humour in fifteen volunteers’ were in the range of 80.21 and 459.00 ng mL−1. According to system suitability tests and Shewhart’s quality control charts the proparacaine responses were in the acceptance ranges. Developed method was providing a sufficient quality at least over 3 months for determination of proparacaine in human aqueous humour.

In this report, a 17-year-old case with sixth cranial nerve palsy caused by a colloid cyst, localized on the base of the fourth ventricle, is presented. The cyst was excised totally by neuro-surgeons. A remarkable recovery of the sixth cranial nerve palsy was detected after the surgical excision with resolution of diplopia and strabismus.

The Accreditation Council for Graduate Medical Education (ACGME) requires US residency programs to assess ophthalmology residents for competency in 6 core areas. Ophthalmic surgical skills are currently part of the ACGME "Patient Care" competency, although some have advocated for a seventh competency, "Surgical Skills." The Ophthalmology Surgical Competency Assessment Rubric for Strabismus Surgery in Resident Training (OSCAR:Strabismus) tool was designed to aid in the assessment of surgical skills using procedure specific behavioral anchors. The present study evaluated inter-rater agreement of the OSCAR:Strabismus tool in the assessment of resident performance. OSCAR:Strabismus evaluations of resident surgical strabismus cases were performed by a multinational group of faculty strabismus surgeons. Cronbach α statistical analysis of the completed evaluations revealed high inter-rater agreement, indicating the OSCAR:Strabismus is a reliable tool to facilitate assessment of resident strabismus surgical skills.

To report the long-term results of four horizontal rectus muscle recessions that were performed for infantile nystagmus syndrome treatment.In this case series, patients with infantile nystagmus syndrome who had four horizontal muscle recessions previously were recruited and ophthalmological examination and electronystagmography recordings were performed. Objectively, amplitude and frequency of nystagmus were measured from the recordings and the intensity was calculated. Visual acuity, stereopsis, and alignment were evaluated and compared with the preoperative and postoperative values.The records of the 12 patients who had four horizontal rectus muscle recession surgery were evaluated and six patients (5 male, 1 female) who had regular follow-ups were included in this study. Mean follow-up was 14.17 ± 0.41 years (minimum 14 years, maximum 15 years) and mean age of patients at the last visit was 22 years (20-28 years). On subjective evaluation, two-thirds (4/6) of the patients were satisfied with the surgical results and had the impression that after surgery, nystagmus decreased in intensity and head posture improved. On objective evaluation, visual acuity was found to be the same, however, stereopsis improved (preoperatively and postoperatively median stereopsis was 600 sec arc vs 200 sec arc final). The decrease in nystagmus amplitude and frequency was still maintained.Nystagmus surgery on four horizontal rectus muscles has positive effects on binocular function and nystagmus parameters in the long-term follow-up. As we could not treat the primary pathology, the visual acuity was about the same but the decrease in nystagmus amplitude and frequency was still maintained with better stereopsis, and patient satisfaction.

Background: To evaluate a case of atypical optic neuropathy that presented with blurred vision following the use of an antiarrythmic agent. Case: Record of the patient was reviewed to determine the etiology of his optic neuropathy. Observations: Ophthalmological examination revealed unilateral optic disc edema with relatively well-preserved visual acuity. In routine tests, results of complete blood count, erythrocyte sedimentation rate, liver and kidney function tests, chest x-ray, Goldmann visual field examination, and brain computed tomography scan were normal. Orbital ultrasonography revealed optic disc edema with prominent optic nerve head and without orbital pathology. Conclusions: Systemic history and drug intake should be investigated in every patient with optic disc edema. Discontinuation of the medication can prevent further optic nerve damage or involvement of the other eye.

Purpose To evaluate health-related quality of life (HRQOL) in children who had surgery for pediatric cataracts. Methods Twenty-five children were divided into 2 groups according to the age at the time of survey (younger than 6 years in group A and 7 years and older in group B). A questionnaire that had 1 part appraising the child's perception and 3 parts evaluating the functional, social, and surgical apprehensions of parents was given to the participants. The questions in the first part were answered by parents in group A (proxy test) and by children in group B (self test). The correlations between the results and patient characteristics were evaluated statistically. Results Mean (range) score for the first part was 79.5 (58-97) in group A and 70 (56-86) in group B. Functional, social, and surgical scores were 42.5 (0-80), 45 (5-100), and 63 (12.5-100) in group A and 40 (10-90), 70 (40-85), and 75 (25-100) in group B. Functional, social, or surgical scores were not significantly different between groups. Social apprehensions were significantly higher in parents of patients with preoperative strabismus in group B. Functional, social, surgical apprehensions, and children's thoughts were not correlated significantly with age, sex, family history, laterality, associated nystagmus, aphakia or pseudophakia, postoperative optical rehabilitation, or the need for additional surgery in the groups. Conclusions Although pediatric cataracts are known to have a great impact on children's life socially and functionally, there was no significant relationship between patient characteristics and HRQOL. The associated preoperative strabismus causes more social concern in the parents.

We present a case in which Gilbert syndrome was diagnosed following a neuro-ophthalmic complaint. Adverse effects of drugs as well as various systemic, neurological, and local ocular pathologies can cause accommodative insufficiency and loss of accommodation. A 29-year-old man was admitted to an ophthalmology department with blurred vision and diagnosed as suffering from acute accommodation paralysis. He had a history of being given a pheniramine maleate injection for pruritus 20 days previously. Symptoms began immediately following the injection. After systemic evaluation and laboratory tests, he was diagnosed as having Gilbert syndrome. His complaints and symptoms recovered in approximately a further 10 days. Metabolism of pheniramine maleate can be impaired in Gilbert syndrome and anticholinergic effects can cause accommodation paralysis.

The purpose of this study was to determine the value of duplex and color Doppler sonography in the detection of ocular involvement in Behçet's disease.Duplex and color Doppler sonography was done in 21 patients with Behçet's disease and ocular involvement and in 22 patients with Behçet's disease but without ocular involvement. Twenty health volunteers also were examined as a control group. Flow velocities in the central retinal artery, posterior ciliary arteries, and ophthalmic artery were measured in the patients with Behçet's disease.In patients with Behçet's disease and ocular involvement, peak systolic velocities in the central retinal, posterior ciliary, and ophthalmic arteries were 7.3 +/- 2.3, 12.8 +/- 3.1, and 35.8 +/- 7.2 cm/sec, respectively. In patients with Behçet's disease but without ocular involvement, these values were 10.0 +/- 1.9, 17.3 +/- 3.4, and 33.5 +/- 4.0 cm/sec, respectively. In control subjects, the respective calculated values were 12.3 +/- 1.0, 16.5 +/- 1.6, and 35.8 +/- 4.4 cm/sec. For the central retinal and posterior ciliary arteries, peak systolic and diastolic velocities were significantly lower in patients with Behçet's disease and ocular involvement than in control subjects and patients with Behçet's disease but without ocular involvement (p.001). Peak systolic and diastolic velocities in the central retinal artery were significantly lower in patients with Behçet's disease but without ocular involvement than in the control group (p.001); however, no difference was observed for the posterior ciliary artery. Flow velocities in the ophthalmic artery were not significantly different among groups.These findings suggest that duplex and color Doppler sonography may be helpful in the diagnosis of ocular involvement in patients with Behçet's disease.

Aim. To report the optical coherence tomography (OCT) findings in three members of the same family with nanophthalmos associated with elevated papillomacular retinal fold.Methods. Complete ophthalmic examination as well as ultrasonography and OCT was performed in all patients.Results. Axial lengths ranged from 16.75 mm to 17.48 mm and refractive errors ranged from +17.50 D to +20.50 D. Main fundus findings were the hyperopic crowded, cupless optic disc, and retinal fold through papillomacular region. Macular OCT scans revealed retinal fold with normal retinal pigment epithelium and choriocapillaris.Interpretation. It is presumed that the retinal folds in nanophthalmos result from a redundancy of the retinal layer caused by retarded growth of the scleral, choroidal, and retinal pigment epithelial layers. The anatomic information provided by the current study is consistent with this thesis.

Purpose To produce an internationally valid tool to assess skill in performing strabismus surgery. Methods A panel of 7 content experts adapted a previously published tool for assessing phacoemulsification by using a modified Dreyfus scale of skill acquisition and providing behavioral descriptors for each level of skill in each category. The tools were then reviewed by 12 international content experts for their constructive comments. The main outcome measure was a consensus of the experts on the final rubric. Results Experts' comments were incorporated, establishing face and content validity. Conclusions The tool (Ophthalmology Surgical Competency Assessment Rubric for Strabismus Surgery (ICO-OSCAR: strabismus) has face and content validity. It can be used globally to assess strabismus surgical skill. Reliability and predictive validity are yet to be determined.

To investigate the development of dissociated vertical deviation (DVD) in infantile esotropia and its relationship with the infant's age and the surgical intervention technique.The medical records of the patients that were diagnosed with infantile esotropia and followed-up in the Strabismus Department of our clinic (Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey) were reviewed retrospectively. The patients' ages at the time of admission, risk factors, ophthalmological examinations before and after treatment, and treatment mode were recorded and compared.DVD was found to develop in approximately one-half of the cases (47.9%) at an average age of 3.2 years (20 months-5.5 years) regardless of the type of treatment. DVD developed in 80.5% of cases that had no surgery and in 37.5% of cases who were surgically treated. On comparison according to age, DVD was seen in 24.1% of the cases that were treated between ages 6 months and 2 years and in 52% of the cases that were treated after age 2 years. The difference was found to be statistically significant (p0.01). On comparison according to the surgical technique, DVD developed in 34.8% of the cases who had undergone bimedial rectus recession and in 38% of the cases with unilateral recession and resection. This difference was not statistically significant (p0.05).In the treatment of infantile esotropia, early surgical intervention to obtain binocularity and prevent amblyopia is associated with a reduced incidence of the development of DVD. It is concluded that the incidence of the development DVD increases if surgery is not performed, if performed at a later age, or if additional muscle surgery is needed during follow-up due to undercorrection.

We evaluated the efficacy and safety of topical cyclosporine-A in dry eye associated with chronic graft versus host disease (GVHD) in 8 patients. Visual acuity, fluorescein staining of cornea and conjunctiva, tear break-up time, Schirmer test results and subjective complaints were recorded. Topical cyclosporine-A might be an effective and safe treatment option in dry eye related to chronic GVHD.

To determine the changes in retinal nerve fiber layer thickness in subjects with high hyperopia and anisometropic amblyopia.Retinal nerve fiber layer thickness was measured with scanning laser polarimetry and confocal scanning laser tomography in subjects with hyperopia (n=18) with a mean age of 16.6 +/-3.1 years and anisometropic amblyopia (n=14) with a mean age of 17.4 +/-3.8 years. A control group consisted of 25 healthy emmetropic subjects with a mean age of 25.7 +/-11.8 years. In all subjects 3 measurements with 2 different techniques were obtained and the average values for each parameter were analyzed and compared between the groups.Heidelberg Retinal Tomography revealed a smaller disc area and cup/disc ratio (C/D) in the hyperopic and amblyopic subjects in comparison to the control group, however there was no statistically significant difference between the hyperopia and amblyopia groups. Increased nerve fiber layer thickness in these groups had no statistical significance. There was also no statistically significant difference in various parameters in the measurements taken with scanning laser polarimetry.Refractive errors may change the quantitative assessment of optic nerve head topography and retinal nerve fiber layer thickness. There is no associated nerve fiber layer changes in anisometropic amblyopic subjects in comparison to the control group and the subjects with high hyperopia.

Background To evaluate transient pattern electroretinography (PERG) and pattern visual evoked potential (VEP) for the diagnosis, differential diagnosis and follow-up of optic nerve diseases. Methods Twenty-nine consecutive patients (14 female, 15 male) with the diagnosis of ischaemic optic neuropathy (n = 14) and optic neuritis (n = 15) were included in this study. Mean age of the patients with ischaemic optic neuropathy was 63.3 ± 3.3 (60–78) years and the mean age of the patients with optic neuritis was 28.3 ± 8.4 (19–43) years. In each patient ophthalmological examination and systemic evaluation were done and VEP and PERG were recorded. As a control group, VEP recordings of 35 healthy subjects were included. Results In the ischaemic optic neuropathy group (group 1), mean VEP amplitude (±SD) (1.96 ± 0.95 μV) was found to be decreased significantly in the affected eyes in comparison to the control group and the unaffected eyes. The delay in latency (116.3 ± 20.14 msec in the affected eyes compared with 101.31 ± 6.19 msec in unaffected eyes) was statistically significant when compared with the healthy subjects. In the optic neuritis group (group 2), VEP amplitude was decreased (4.13 ± 4.04 μV vs 6.97 ± 3.35 μV and 6.97 ± 4.43 μV) and latency was increased (122.59 ± 20.09 msec vs 101.31 ± 6.19 msec and 108.76 ± 13.57 msec) in affected eyes significantly in comparison to the unaffected eyes and control group, respectively. Even though there were no significant differences for P50 latency and N95/P50 ratios between affected and unaffected eyes in both groups, N95 amplitude decreased significantly in the affected eyes of the ischaemic optic neuropathy patients and N95 latency was found to be decreased in optic neuritis patients. There was no correlation between VEP and PERG findings in both groups. Conclusion VEP amplitude decreased significantly in ischaemic optic neuropathies while latency delay was more significant in patients with optic neuritis. PERG findings showed decreased N95 amplitude in ischemic optic neuropathy without associated latency changes.

Purpose To report optical coherence tomography (OCT) changes in Best's vitelliform macular dystrophy (BVMD) with pseudohypopyon. Design Observational case report. Methods Both eyes of a patient with BVMD showing pseudohypopyon were examined with OCT. Results OCT demonstrated the presence of serous retinal elevation with normal appearing retinal pigment epithelium (RPE) superiorly, and broadening of the outer-retina-choroid-complex signal under retinal elevation, inferiorly. Conclusions OCT findings in our study suggest the accumulation of material under neurosensory retina in BVMD with pseudohypopyon.

A 30-year-old man with Leber hereditary optic neuropathy mutation 11778 displayed no magnetic resonance imaging abnormalities during the acute phase of visual loss in the right eye. Three months later, during the acute phase of visual loss in the left eye, magnetic resonance imaging showed T2 hyperintense signal changes on the right half of the optic chiasm. Six months later, magnetic resonance imaging revealed T2 hyperintense signal changes on both sides of the optic chiasm. This is the first reported case of optic chiasmal involvement on magnetic resonance imaging in the atrophic phase of Leber hereditary optic neuropathy.

Purpose: To investigate the ultrastructural changes in iris and corneal tissue induced by intracameral 1% lidocaine infusion applied during lens extraction in a rabbit model. Methods: The study was conducted using New Zealand rabbits. Eight rabbits received 0.2 mL 1% lidocaine hydrochloride intracamerally and lens extraction was performed, keeping the posterior capsule intact. After lens extraction, cornea and iris tissue samples were obtained for electron microscopy. Eight eyes were included as a control group. Results: Electron microscopy revealed morphological abnor­malities in both cornea and iris of the lidocaine injected eyes, different from the control group. Cytoplasmic vacuolization, phagosomes and residual bodies were observed in epithelial cells. Corneal fibroblasts contained fluid-filled vacuoles, which could be due to the influx of water into the cells as a result of corneal endothelial damage. Mitochondrial swelling and residual bodies were also seen in the cytoplasm of fibroblasts. Blood vessels in the iris contained fluid material composed of fibrin and proteinaceous material and many vacuoles showed vascular endothelial injury. Conclusion: Even a short period of exposure of intra­cameral lidocaine to the ocular tissues can induce histo-logical changes that may result in functional defects.

Absence or deficiency of tear volume (alacrima) is rarely seen in pediatric ophthalmology. It is often a part of the multiple systemic anomalies like Riley-Day syndrome and anhidrotic ectodermal dysplasia, or it may be associated with adrenal gland insufficiency, achalasia, and neurologic disorders like Allgrove's syndrome. We report on a 7-year-old girl presenting alacrima, achalasia, and mental retardation with normal adrenocortical function.

Purpose To describe an active inflammatory cause of pigmented paravenous retinochoroidal atrophy. Methods A 54-year-old female patient presented with complaints of worsening visual acuity and poor night vision was examined. Fundus examination was performed and color fundus photographs were taken. In addition to fluorescein angiography, visual field examinations and electroretinographic tests were performed. Macular evaluation was performed with optical coherence tomography. Results Both fundi showed circumscribed patches of retinochoroidal atrophy and pigmentation along the retinal veins. She had also marked vitreous cells with snow ball opacities and cystoid macular edema in both eyes. Fluorescein angiography confirmed the presence of a hyperfluorescence due to widespread paravenous retinal pigment epithelial defect while ICG angiography disclosed hypofluorescence in all phases. The electroretinogram showed reduced responses especially in the left eye. Visual field tests showed scotomas corresponding with areas of atrophy along the retinal veins. Conclusions This is a report of the findings in pigmented paravenous retinochoroidal atrophy that is a nonspecific degenerative disease and may occur in association with systemic infections or inflammation. Ocular inflammation with cystoid macular edema is an unusual manifestation of the disease.

PURPOSE To determine the efficacy and safety of mitomycin-C as adjunctive treatment and to compare this drug with beta irradiation with strontium-90 after surgical excision of primary and recurrent pterygia. MATERIALS AND METHODS The study group consisted of 193 patients with primary and recurrent pterygia who underwent surgical excision with the bare sclera technique. They were divided into two groups according to the type of adjunctive treatment. In group I, 130 patients (141 eyes, 67.8%) were treated with beta irradiation with Sr-90 doses of 1000-7000 cGy. In group II 63 patients (67 eyes, 32.2%) received topical mitomycin-C at a concentration of 0.02% four times daily for one week postoperatively. Recurrence rates, complications and efficacy of these treatments were compared with the chi-square of Fishers exact test. RESULTS The recurrence rates were 6.4% in group I after a mean postoperative follow-up of 89 months and 17.9% in group II after a mean follow-up of 14.9 months. Recurrence rates and complications were higher in group II and the difference was significant (p

Purpose To evaluate the effect of symmetric recession surgery on all four horizontal rectus muscles in the treatment of patients with congenital motor nystagmus and sensory nystagmus secondary to albinism, dyschromatopsia and degenerative myopia. Methods Prospectively, four patients with a diagnosis of congenital motor nystagmus and eight patients with sensory nystagmus were operated on. The amount of recession was determined according to the ocular alignment of the patients. Electronystagmographic recordings were conducted in every patient pre-operatively and post-operatively, as well as an ophthalmological examination. Results Mean age of the patients at the time of the first visit was 6.7 ± 4.2 years (range 9 months to 14 years) and mean age at the time of operation was 8.3 ± 2.7 years (range 6-14 years). In 8 cases an equal amount of weakening of the four horizontal recti was done, whereas in 2 cases more recession on the lateral recti due to exotropia and in 2 cases more recession on the medial recti due to esotropia was performed. Mean follow-up time was 15.8 months (min. 6 months, max. 28 months). Improvement in visual function was achieved in 7 patients. Amplitude decreased in 9 patients. One patient had a decrease in visual acuity due to progression of her primary macular degeneration. Improvement in head posture was seen in 3 patients and there was no change in the head posture in 2 patients. One patient acquired head posture after surgery. Restriction of motility was seen in none of the patients after surgery in spite of large amounts of recession. Recession of horizontal recti decreased nystagmus amplitude and frequency in 81.8% of patients. Improvement in visual function, measured as an increase in visual acuity in terms of Snellen lines, was achieved in 63.6% of patients. Conclusion Symmetric recession of the horizontal rectus muscles is shown to be a successful procedure to perform in nystagmus patients, resulting in an increase in visual acuity and a decrease in nystagmus amplitude and frequency. It is a reliable alternative to the Kestenbaum operation and is easier to perform surgically.

To evaluate the vascular hemodynamic changes that can be detected with color Doppler imaging (CDI) in diagnosis, differential diagnosis and prognosis of uveitis with different etiologies including Behçet's disease.Four groups consisting of healthy volunteers, uveitis patients with different etiologies and Behçet's disease patients with and without ocular involvement were examined by CDI. Central retinal artery (CRA), posterior ciliary artery (PCA), ophthalmic artery (OA) and central retinal vein (CRV) flow velocities and vascular resistances were measured prospectively by a radiologist blinded to the presence and etiology of uveitis.The peak systolic and end-diastolic velocities in CRA and PCA in Behçet's disease with ocular involvement were significantly lower than all other groups (p0.001). Peak systolic and end-diastolic velocities in CRA were lower than the control group in Behçet's disease patients without ocular involvement (p0.001) but there were no differences in PCA and OA flow velocity (p0.05). In the uveitis group, CRA and CRV flow velocities were significantly lower than in the control group (p0.001).According to our results, uveitis in Behçet's disease is associated with significant reductions of CRA and PCA flow velocities when compared with other types of uveitis and healthy subjects. In cases without ocular involvement, CRA flow velocities were lower than the control group, but there were no real differences in the PCA and OA values. This suggests that vasculitic involvement of PCA is more specific to Behçet's disease and occurs later in the course of the disease. The results also suggest that it may be possible to detect and follow hemodynamic changes in Behçet's disease with CDI before clinical findings of ocular involvement become evident.

Background: To compare binocular functions in amblyopic and non-amblyopic anisometropes and to investigate the possible associated factors for amblyopia development such as type of refractive error and initial age of refractive error correction. Materials and Methods: Prospectively anisometropic subjects with (n=42) and without amblyopia (n=33) were included in the study. Full ophthalmological examination including binocularity and motility was performed. Results: There was no statistically significant difference between the ages at the time of initial refractive error correction ( p0 =0.946). All of the anisometropes (100%) had fusion with Worth 4-dot test and Bagolini glasses. However 81% of amblyopic subjects had fusion with Worth 4 dot test and 88.1% had normal response with Bagolini glasses. Median stereopsis was 60 sec of arc in anisometropic subjects and 400 sec of arc in amblyopes. Conclusion: Our data support that, binocular functions are well developed in anisometropes without amblyopia and initial age at correction of refractive error has no primary effect on development of amblyopia.

A 24 year old patient with acute double vision and headache was admitted to our clinic. A diagnosis of orbital myositis was confirmed after magnetic resonance imaging and orbital echogram. No other clinical manifestations were observed on general examination. Since orbital myositis cases with only neurological symptoms and without typical visual impairment are not frequent, we decided to present this case.

We describe the clinical and radiologic findings and surgical outcome of an orbital dermoid cyst causing a superior oblique muscle palsy in a child. Superior oblique muscle palsy in childhood is most often congenital. Less common causes are trauma, vascular lesions, neoplasms, and infections.(1,2) The most common orbital lesions in children are dermoid and epidermoid cysts.(3-5) A dermoid cyst at the region of trochlea is suspected as the cause of superior oblique muscle palsy in our case. This unusual presentation of a dermoid cyst has not been reported previously.

Bilateral optic neuritis has been reported very rarely as a manifestation of neuro-Behçet’s disease. We present a 50year old woman who had 20-year history of Behçet’s disease presented with acutely blurred vision associated with orbital pain in both eyes. Visual acuity was 0.4 in the right eye and light perception in the left eye; afferent pupillary defect was detected in the left eye. Bilateral swelling of the optic disk was found. The cerebrospinal fluid sample tests were within normal limits. Brain magnetic resonance imaging, magnetic resonance venography and fundus fluorescein angiography were normal. She was diagnosed with bilateral optic neuritis and treated with intravenous methyl prednisolone for 10days. As there was no response to the treatment, therapeutic plasma exchange was started and the patient’s visual acuities improved moderately. We suggest that when high dose steroid is failed to treat ON in BD, treatment with TPE may be considered.

Purpose To evaluate the effect of hormone replacement therapy on ocular hemodynamics in postmenopausal women. Methods Ocular Doppler ultrasonography was performed in 20 postmenopausal women on hormone replacement therapy (HRT) and in 20 women without treatment, as the control group. Central retinal artery (CRA), posterior ciliary artery (PCA) and ophthalmic artery (OA) flow velocities and vascular resistances were measured prospectively by a radiologist blinded to the therapy. There were no associated systemic or ocular diseases or any medication history. Results The mean age of the patients on HRT was 50.05 ± 4.5 yrs (range 44 - 62). The mean age of the control group was 52.8 ± 4.09 yrs (range 46 - 65). The mean duration of HRT was 1.6 ± 1.4 yrs (range 3 months - 5 years). There were no differences between the groups in terms of flow velocities, vascular resistivities or pulsatility indices of OA, CRA and PCA (p>0.05). Conclusions HRT is essential in postmenopausal women for relief of vasomotor symptoms, cardioprotection and prevention of osteoporosis. Even though vaso-occlusive complications of hormone preparations have been reported, we did not observe any changes in ocular hemodynamics detectable with Doppler ultrasonography.