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Tomoko Terai,1,2 Shohei Eda,1,2 Jun Sugasawa,2 Masahiro Tonari,2 Junko Matsuo,2 Hidehiro Oku,2 Tsunehiko Ikeda2 1Department of Ophthalmology, Shiga Medical Center for Children, Moriyama-City, Shiga, Japan; 2Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, Japan Purpose: To investigate the age-related development of refractive errors and changes of visual acuity (VA), and the systemic and ocular anomalies in Japanese children and young adults with Down syndrome (DS).Design: Retrospective cohort study.Subjects and methods: This study involved 222 Japanese children and young adults with DS (age range: 3 months to 19 years) seen at the Department of Ophthalmology, Shiga Medical Center for Children, Shiga, Japan. The subjects were divided into the following six age groups: 1) infant (age 0 to

Yuko Nishikawa, Hidehiro Oku, Masahiro Tonari, Junko Matsuo, Jun Sugasawa, Tsunehiko Ikeda Department of Ophthalmology, Osaka Medical College, Takatsuki, Osaka, Japan Purpose: Idiopathic orbital inflammation (IOI) and orbital cellulitis can present similar clinical features, and the diagnoses of these two disorders are sometimes confused. The purpose of the present study was to determine whether or not inflammatory markers in the blood can be useful to differentiate between IOI and orbital cellulitis in cases with acute eyelid erythema and edema.Subjects and methods: In this retrospective single-institute study, we reviewed the medical records spanning the past 10 years at the Department of Ophthalmology, Osaka Medical College Hospital, Takatsuki, Osaka, Japan, and found 45 cases, with patients >15 years of age, with presumed IOI. Their blood samples were obtained within 5 days after the onset of IOI. Of those cases, 15 patients (10 males, 5 females, mean age of 56.9 years; range 38–76 years) presented acute eyelid erythema and edema, and were initially misdiagnosed as orbital cellulitis. Thus, inflammatory markers in the blood (ie, white blood cells [WBCs] and C-reactive protein [CRP]) of those 15 patients were analyzed with 17 patients (10 males, 7 females) having orbital cellulitis. The receiver operating characteristic curve analysis was performed to determine the optimal cut-off values. Results: The mean ± standard error (SE) levels of the WBC were 6.80±0.70×10³/µL in the IOI patients, and 8.54±0.91×10³/µL in the orbital cellulitis patients, and no significant differences were observed (P=0.15, Student’s t-test). However, the mean ± SE levels of CRP were 1.04±0.43 mg/dL in the IOI patients, yet were significantly increased to 4.65±1.21 mg/dL in the orbital cellulitis patients (P=0.01, Student’s t-test). The area under the curve value was 0.80 and the optimal cut-off value was 0.43 for orbital cellulitis, with sensitivity and specificity being 82% and 73%, respectively. Conclusion: The findings of this study indicate that CRP may be useful in distinguishing patients with idiopathic orbital inflammation from those with orbital cellulitis. Keywords: idiopathic orbital inflammation, orbital cellulitis, CRP, WBC, cut-off value

Takuji Kurimoto, Masahiro Tonari, Norihiko Ishizaki, Junko Matsuo, Hidehiro Oku, Jun Sugasawa, Tsunehiko IkedaDepartment of Ophthalmology, Osaka Medical College, Osaka, JapanAbstract: We report a case of eosinophilic chronic rhinosinusitis (ECRS) associated with optic neuropathy. The visual acuity in the right eye was suddenly reduced to no light perception on awakening in the morning. Fundus examination of both eyes on the same day showed no remarkable changes. Emergency computed tomography showed pan-sinusitis bilaterally and a partial defect of the sphenoid bone on the right side. From the clinical findings, the case was diagnosed as optic neuropathy associated with chronic sinusitis. Endoscopic sinus surgery (ESS) was performed on the same day, and all of the major sinuses were found to be filled with highly viscous fluid. Part of the optic canal had a defect probably due to inflammatory invasion from the adjacent sphenoid bone. Steroid therapy was started immediately postoperatively. Histopathological examination of excised polyps showed that numerous eosinophils had invaded the polyps but no hyphae were present. The patient reported that he had bronchial asthma and had had nasal polypectomy. Six months after the ESS and steroid therapy, the patient had a recurrence of the sinusitis. At that time, laboratory examination showed an elevation of total IgE and eosinophil numbers. From the clinical findings and course, this case was diagnosed as ECRS accompanied by optic neuropathy. Although ECRS rarely has ocular complications, the inflammation can spread and the optic nerve can be affected.Keywords: optic neuropathy, eosinophilic chronic rhinosinusitis, chronic sinusitis, allergic fungal rhinosinusitis

Cluster ion beams have revolutionized the analysis of organic surfaces in time-of-flight secondary ion mass spectrometry and opened up new capabilities for organic depth profiling. Much effort has been devoted to understanding the capabilities and improving the performance of [SF.sub.5.sup.+] and [C.sub.60.sup.n+], which are successful for many, but not all, organic materials. Here, we explore the potential of organic depth profiling using novel argon cluster ions, [Ar.sub.500.sup.+] to [Ar.sub.1000.sup.+]. We present results for an organic delta layer reference sample, consisting of ultrathin 'delta' layers of lrganox 3114 (~2.4 nm) embedded between thick layers of Irganox 1010 (~46 or 91 nm). This indicates that, for the reference material, major benefits can be obtained with Ar cluster ions, including a constant high sputtering yield throughout a depth of ~390 nm, and an extremely low sputter-induced roughness of 10.1021/ac901045q