Binocular vision & strabismus quarterly最新文献

Purpose: The aim of this study was to evaluate movement disorder patterns and extraocular muscle involvement in Iranian Graves' Ophthalmopathy (GO) patients.

Methods: We examined 75 patients (37 women and 38 men) with GO. Female to male ratio was 0.97 among all patients and 0.72 among restrictive myopathic cases (male 18(58.1%), female 13 (41.9%), P=0.2). Their age ranged from 16 to 66 years; mean age was 35.42+/-11.63 and 33.55+/-10,.31 among patients affected by restrictive enlargement and who did not, respectively.

Results: Orbital CT assessment showed EOM enlargement in 124 out of 150 orbits (82.6%). clinical restriction was evident in 31 (41.3%) out of 75 patients. Bilateral restriction was observed in 14 out of 31 (45.1%). The most frequent type of movement limitation was supraduction limitation followed by abduction, inferaduction, and adduction limitations (59%, 40%, 31.1% and 13.3% respectively). This was compatible with Hess screen results and orbital CT reports in regard of IR, MR, SR and LR involvement. Sixteen out of 75 patients reported diplopia. Mean Hertel exophthalmometry readings were higher in eyes with restrictive myopathy.

Conclusion: This study showed more restrictive myopathy in cases with more extraocular enlargement and positive correlation between severity of inferior rectus enlargement and Hertel reading. A higher rate of male patients in our study may be due to ethnic differences in GO in Iranian patients or due to severity of involvement in this group.

Purpose: To report a systematic approach to, and the visual and electrophysiological effect of, eye muscle surgery in 100 patients with infantile nyustagmus syndrome (INS).

Methods: Prospective, interventional case cohort analysis of clinical and eye movement data in 100 patients with INS who had virgin extraocular eye muscles operated on for nystagmus with or without combinations of strabismus and an anomalous head posture. All patients were followed at least 9 months after surgery. Outcome measures, part of an IRB approved study, included binocular visual acuity, head position, strabismic deviation, and eye movement recordings, from which waveform types and an Automated Nystagmus Acuityn Function (ANAF) was calculated. Computerized parametric and non-parametric statistical analysis of data were performed using standard software on both individual and group data.

Results: There were 9 consistent surgical procedures used with the most common being that for a horizontal head posture alone (22%). Age at surgery averaged 14 years with 11 months followup. Sixty-eight percent had associated eye disease (optic nerve, retinal, amblyopia, cataracts). Group means in binocular acuity, strabismic deviation, head posture, abd ANAF measures from eye improved for all procedures. There were 12 (12%) reoperations without any serious surgical complications. Individual analysis revealed only age and head posture differences in outcome measures between the 9 procedures.

Conclusions: Using this approach, surgery on the extraocular muscles in patients with INS results in improvements in multiple aspects of ocular motor and visual function.

A number of surgical and non-surgical options are available for patients with intermittent exotropia. This paper provides a review of this strabismus condition, particularly divergence excess type, with a particular emphasis on treatment. We highlight that there is a lack of evidence for best practice and a need for not only high-quality clinical studies but also a better understanding of current practice patterns among clinicians so as to inform future research.

Unlabelled: PRUPOSE: To report a patient who developed an isolated inferior rectus paresis due to a pineal gland tumor, and to our knowledge never reported before. Our purpose is also to demonstrate that, even in partial and mild inferior rectus muscle paresis, the findings of the inhibitional palsy described by Chavasse and the downshoot of the fellow eye in adduction help determine the diagnosis.

Case report: A patient with pineal gland tumor demonstrated findings characteristic of unilateral isolated inferior rectus paresis.

Conclusion: Although bilateral sixth nerve paresis and Parinaud's syndrome are commonly reported in pineal gland tumors; in the the presence of an isolated inferior rectus palsy, one should also consider the pineal gland as the causative factor.

Background and purpose: The loss of an extraocular muscle is an infrequent but serious complication of strabismus surgery. The purpose is to show that a tailored tongue of Tenon's capsule, 7.0 mm to 9.0 mm wide and 12.0 mm to 14.0 mm long, fashioned in the direction of a lost medial rectus muscle and attached at the site of its original insertion can restore full ocular movement in the direction of action of the muscle.

Case report: Thisis a report of a patient who underwent re-shaping and attachment of Tenon's capsule to the original insertion of the medial rectus muscle that ruptured during attempted medial rectus recession for longstanding esotropia with medial rectus restriction. The procedure was done immediately following the loss and failure to retrieve the lost muscle.

Results: Residual large angle esotropia and good adduction were obtained postoperatively despite a severed and consecutively lost medial rectus muscle.

Conclusion: A tongue of Tenon's capsule, attached at the original site of a lost extraocular rectus muscle in a young adult, works as a pseudo-tendon successfully restoring function in the direction of action of that muscle.