scholarly journals Medical and Surgical Treatment in Pediatric Orbital Myositis Associated with Coxsackie Virus

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Pedro Gil ◽  
João Gil ◽  
Catarina Paiva ◽  
Guilherme Castela ◽  
Rui Castela
Keyword(s):  
Acute Infection ◽  
Analytical Investigation ◽  
Strabismus Surgery ◽  
Coxsackie Virus ◽  
Medial Rectus ◽  
Ocular Motility ◽  
Ophthalmological Examination ◽  
Orbital Myositis ◽  
Prism Dioptre ◽  
Serologic Screening

Purpose.To report a case of orbital myositis associated with Coxsackie virus and its medical and surgical approach.Methods.Complete ophthalmological examination and imaging and analytical investigation were performed.Results. A 6-year-old male presented with subacute painless binocular horizontal diplopia. Examination revealed bilateral best-corrected visual acuity (BCVA) of 20/20 and right eye 45-prism-dioptre (PD) esotropia in near and distance fixations, with no motility restrictions. Serologic screening was positive for Coxsackie virus acute infection and computerized tomography (CT) suggested right eye medial rectus orbital myositis. An oral corticosteroid 1.0 mg/kg/day regimen was started. A new CT after two months showed symmetrical lesions in both medial rectus muscles. Corticosteroids were increased to 1.5 mg/kg/day. After imagiological resolution on the 4th month, alternating 45 PD esotropia persisted. Bilateral 7 mm medial rectus recession was performed after 1 year without spontaneous recovery. At 1-year follow-up, the patient is orthophoric with 200′′ stereopsis and bilateral 20/20 BCVA.Conclusions. To our knowledge, this is the first reported case of orbital myositis associated with Coxsackie virus. This is also the first reported case of isolated strabismus surgery after orbital myositis in pediatric age, highlighting the favourable aesthetic and functional outcomes even in cases of late ocular motility disorders.

scholarly journals OCT-Angiography Findings in Patients with Amblyopia: Comparison between Healthy Controls, Treatment-Responsive, and Treatment-Unresponsive Amblyopic Patients

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1751
Author(s):  
Annabella Salerni ◽  
Gloria Gambini ◽  
Chiara Fedeli ◽  
Ludovica Paris ◽  
Emanuele Crincoli ◽  
...  
Keyword(s):  
Linear Regression Analysis ◽  
Vascular Density ◽  
Ocular Motility ◽  
Ophthalmological Examination ◽  
Light Stimulation ◽  
Cross Sectional ◽  
Vascular Plexus ◽  
The Mean ◽  
Normal Controls ◽  
Expert Physician

There is no consensus on whether amblyopia affects the retinal vascular plexus and morphology. Previous studies focused on the differences between amblyopic patients and normal controls without evaluating amblyopic eyes after patching. To evaluate differences in the superficial vascular density of amblyopic eyes, normal eyes, and amblyopic eyes reaching normal BCVA after patch therapy, OCTA was used. All patients underwent a comprehensive ophthalmological examination, including visual acuity, refraction, ocular motility tests, and anterior and posterior segment examination. OCTA was performed by an expert physician using the Zeiss Cirrus 5000-HD-OCT Angioplex (Carl Zeiss, Meditec, Inc., Dublin, OH, USA). OCTA scans were performed using a 3 × 3 mm2 and 6 × 6 mm2 fovea-centered image setting. The mean outer macular vessel density in the previously amblyopic group was 19.15 ± 0.51%. This was statistically significantly higher than in both the amblyopic group (18.70 ± 1.14%) and the normal controls (18.18 ± 1.40%) (p = 0.014). The previously amblyopic group also significantly differed from both normal controls and amblyopic eyes with regards to the inner (p = 0.011), outer (p = 0.006), and full (p = 0.003) macular perfusion. Finally, linear regression analysis revealed that BCVA was linearly correlated to outer perfusion in amblyopic (p = 0.003) and ex amblyopic eyes (p < 0.001). Considering the cross-sectional nature of our study, from our results, we can only hypothesize a possible correlation between light stimulation and retinal vasculature development. However, further longitudinal studies are needed to support this hypothesis.

scholarly journals Clinical Analysis of restrictive strabismus secondary to ophthalmic surgery

2021 ◽  
Author(s):  
Lili Guo ◽  
Zhihua Zhao ◽  
Zequn Miao ◽  
Qianru Ouyang ◽  
Xin Xu ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Case Series ◽  
Strabismus Surgery ◽  
Ocular Motility ◽  
Ophthalmic Surgery ◽  
Retrospective Case ◽  
Eye Muscle ◽  
Lateral Ligaments ◽  
Surgical Methods ◽  
Restrictive Strabismus

Abstract Background: This study aimed to report the clinical characteristics and surgical methods of restrictive strabismus secondary to ophthalmic surgery. Methods: This retrospective case series covered 14 restrictive strabismus cases secondary to ophthalmic surgery. After evaluation of the clinical history and the basic ophthalmological findings, the following parameters were examined: squint angles (prism with alternative cover test, Krimsky’s test or Maddox cross), ocular motility, duction test and the forced duction test. All paitients underwent surgery, the strabismus surgery included the excision of adhesions and scar tissue, adhesiolysis, medial and lateral ligaments separated, repositioning of extraocular muscles (according to the degree of deviations). We described the clinical characteristics and evaluated the surgical results in strabismus eyes. Results: All patients were satisfied with the results of surgery, obtained anatomical reduction and partial functional recovery. In nine cases with preoperative diplopia, eight cases had no diplopia after surgery and one patient’s diplopia disappeared after the secondary surgery. The other five cases without preoperative diplopia, but had restricted ocular motility, which improved significantly than before surgery. Conclusions: Orbital surgery, trauma, conjunctival surgery, strabismus surgery and so on, can lead to secondary restrictive strabismus surgery. Strabismus surgical treatments including the full removal of the muscles around the scar, adhesiolysis, medial and lateral ligaments separated, eye muscle surgery, can provide excellent results and patient’s satisfaction.

Strabismus and oculomotility

2012 ◽  
Author(s):  
Rebecca Ford ◽  
Moneesh Patel
Keyword(s):  
Clinical Skills ◽  
Strabismus Surgery ◽  
Ocular Motility ◽  
Clinical Knowledge ◽  
Ocular Movements ◽  
Single Vision ◽  
Visual Acuity Testing ◽  
Concomitant Strabismus ◽  
Binocular Single Vision ◽  
Retinal Correspondence

The chapter begins by discussing the anatomy and actions of the extraocular muscles and central control of ocular motility, before covering the key clinical skills, namely patient assessment, assessment of ocular movements, visual acuity testing, tests of stereopsis and binocular single vision, tests of retinal correspondence and suppression, and Hess charts. It then covers the key areas of clinical knowledge, including amblyopia, binocular vision and stereopsis, concomitant strabismus, incomitant strabismus, restrictive ocular motility disorders, complex ocular motility syndromes, vertical deviations , and alphabet patterns, and the key practical skills, namely the principles of strabismus surgery and other procedures in strabismus. The chapter concludes with five case-based discussions, on myopic anisometropia, esotropia, infantile esotropia, orbital floor fracture, and consecutive exotropia.

scholarly journals The changes of refractive status and anterior segment parameters after strabismus surgery

2019 ◽  
Author(s):  
Wenke Zhou ◽  
Hanyun Wu ◽  
Yumeng Zheng ◽  
Li Zhang
Keyword(s):  
Anterior Segment ◽  
Strabismus Surgery ◽  
Lateral Rectus ◽  
Medial Rectus ◽  
Group Iii ◽  
Group I ◽  
Surgical Methods ◽  
Refractive Status ◽  
Anterior Segment Parameters ◽  
Operation Results

Abstract Purpose To investigate the effects of strabismus surgery on the refractive status and anterior segment parameters, meanwhile to conduct a research on the causes of these changes. Methods This was a retrospective study about 65 patients (104 eyes) who underwent strabismus surgery by a single surgeon from February 2017 to May 2018. The patients were divided into 4 groups. Group I: unilateral lateral rectus recession (40 eyes), Group II: unilateral medial rectus recession (16 eyes), Group III: monocular lateral rectus recession and medial rectus resection (30 eyes), Group IV: disinsertion of the inferior oblique (18 eyes). Refractive status and anterior segment parameters were measured at 1 day before operation, 1 week, 1 month and at least 3 month after operation. Results Spherical equivalent significantly showed a myopic shift during postoperative 1 week in horizontal rectus surgery, and it still showed a statistical changes during postoperative at least 3 month unilateral medial rectus recession. J0 displayed a shift in the with-the-rule direction in unilateral medial / lateral rectus recession lasted to the at least 3 month after surgery. J45 had no significant change in all groups as time passed by. Patients manifested statistically significant changes in steepest keratometry at 1 week after operation in horizontal rectus surgery.Flattest keratometry changed significantly only in unilateral medial rectus recession lasted to the at least 3 month after surgery .There was no change in disinsertion of the inferior oblique . Conclusions Refractive changes are a significant side effect of strabismus surgery, therefore, patients should be informed about it prior to surgery and the appropriate time for optometry should be chosen according to the different surgical methods after surgery.

scholarly journals Expression of schizophrenia biomarkers in extraocular muscles from patients with strabismus: an explanation for the link between exotropia and schizophrenia?

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e4214 ◽  
Author(s):  
Andrea B. Agarwal ◽  
Austin J. Christensen ◽  
Cheng-Yuan Feng ◽  
Dan Wen ◽  
L. Alan Johnson ◽  
...  
Keyword(s):  
Gene Expression ◽  
Causative Factor ◽  
Strabismus Surgery ◽  
Extraocular Muscles ◽  
Lateral Rectus ◽  
Medial Rectus ◽  
Specific Gene ◽  
Altered Gene Expression ◽  
Altered Gene ◽  
Specific Association

Recent studies have implicated exotropia as a risk factor for schizophrenia. We determined whether schizophrenia biomarkers have abnormal levels of expression in extraocular muscles from patients with strabismus and explored whether differences in gene expression between medial and lateral rectus muscles may explain the specific association of schizophrenia with exotropia but not esotropia. Samples from horizontal extraocular muscles were obtained during strabismus surgery and compared with age- and muscle type-matched normal muscles from organ donors. We used PCR arrays to identify differences in gene expression among 417 signaling molecules. We then focused on established schizophrenia-related growth factors, cytokines, and regulators of the extracellular matrix. Among 36 genes with significantly altered gene expression in dysfunctional horizontal rectus muscles, over one third were schizophrenia-related: CTGF, CXCR4, IL1B, IL10RA, MIF, MMP2, NPY1R, NRG1, NTRK2, SERPINA3, TIMP1, TIMP2, and TNF (adjusted p value ≤ 0.016667). By PCR array, expression of three of these genes was significantly different in medial rectus muscles, while eleven were significantly altered in lateral rectus muscles. Comparing baseline levels between muscle types, three schizophrenia-related genes (NPY1R, NTRK2, TIMP2) had lower levels of expression in medial rectus muscles. Despite the surprisingly large number of schizophrenia-related genes with altered gene expression levels in dysfunctional muscles, the lack of specificity for medial rectus muscles undermines a model of shared, region-specific gene expression abnormalities between exotropia and schizophrenia, but rather suggests consideration of the alternative model: that exotropia-induced aberrant early visual experiences may enable and/or contribute as a causative factor to the development of schizophrenia.

Evaluation of ocular motility deviation changes in exotropic patients after cycloplegic eye drops versus prism adaptation test

2018 ◽  
Vol 29 (5) ◽  
pp. 482-485 ◽  
Author(s):  
Alon Zahavi ◽  
Ronit Friling ◽  
Yonina Ron ◽  
Miriam Ehrenberg ◽  
Yoav Nahum ◽  
...  
Keyword(s):  
Medical History ◽  
Statistical Significance ◽  
Strabismus Surgery ◽  
Prism Adaptation ◽  
Eye Drops ◽  
Ocular Motility ◽  
End Points ◽  
End Point ◽  
Significant Difference ◽  
Adaptation Test

Purpose:To evaluate changes in ocular motility deviation with cycloplegic eye drop examination compared to the prism adaptation test in patients with strabismus.Methods:The medical charts were reviewed of all patients who underwent primary strabismus surgery in our center from December 2013 to July 2015. Data collected included demographics, medical history, and findings on pre-operative ophthalmic/orthoptic examination. Ocular motility deviation was measured before instillation of cycloplegic eye drops, immediately after maximal dilation (end point), and 10 and 20 min later. Prism adaptation test readings were taken at baseline, immediately after prism removal (end point), and 10 and 20 min later.Results:A total of 43 patients had complete pre- and post-operative evaluations. Our analysis focused only on the exotropic patients (n = 33). On cycloplegics, there was no significant difference in ocular motility deviation between baseline and end point for distance and near (p = 0.584, p = 0.468, respectively). On prism adaptation test, comparison of ocular motility deviation between baseline and end point was statistically significant for distance and near (p = 0.002, p = 0.001, respectively). Changes remained significant 10 min after the end point for near (p = 0.011). Comparison at the end points between the tests revealed statistical significance for distance and near, favoring the prism adaptation test (p = 0.001 and p < 0.001, respectively). This significance was maintained even after 10 min for near (p = 0.036).Conclusion:The prism adaptation test is preferred over cycloplegic eye drops for the evaluation of maximal reserve of distance/near motility before surgical correction of exotropia.

scholarly journals Surgical outcomes of strabismus after iatrogenic ophthalmic artery occlusion caused by cosmetic filler injections

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Hee Kyung Yang ◽  
Se Joon Woo ◽  
Seong-Joon Kim ◽  
Jeong-Min Hwang
Keyword(s):  
Surgical Outcomes ◽  
Ophthalmic Artery ◽  
Artery Occlusion ◽  
Strabismus Surgery ◽  
Successful Outcome ◽  
Ocular Motility ◽  
Hand Motion ◽  
Filler Injection ◽  
Facial Filler ◽  
Filler Injections

Abstract Background To investigate the surgical outcomes of strabismus related to iatrogenic occlusion of the ophthalmic artery and its branches from cosmetic facial filler injection. Methods A retrospective study was performed on 6 patients who underwent strabismus surgery among 23 patients who had suffered occlusion of the ophthalmic artery and its branches after cosmetic facial filler injection. Initial, preoperative and final ocular motility examinations, the type of surgery and surgical outcomes were evaluated. Results At initial presentation, visual acuity was no light perception in 5 patients and hand motion in one patient. Five out of 6 patients showed initial ophthalmoplegia. Among these 5 patients, eye motility fully recovered in 3 patients although sensory strabismus developed during follow-up, while the remaining 2 patients had persistent ocular motility limitations. Strabismus surgery was performed at 2.2 ± 1.5 years after iatrogenic ophthalmic artery occlusion. Preoperatively, 5 of the 6 patients showed exotropia, and one patient had esotropia. Vertical deviation was found in 3 out of 6 patients in addition to the horizontal deviation. Successful outcome was achieved only in the 4 patients without persistent ophthalmoplegia after 1.4 ± 1.0 years from surgery. The other two patients with persistent ocular motility limitations failed to achieve successful alignment after surgery, and one patient eventually underwent evisceration due to phthisis bulbi. Conclusions In our study, surgical outcomes of strabismus caused by cosmetic facial filler injection were successful only in patients without persistent ophthalmoplegia at the time of surgery.

scholarly journals Bifoveal Fusion Recovery by Liquid Crystal Glasses in Children

2021 ◽  
Vol 20 (3) ◽  
pp. 118-124
Author(s):  
Igor E. Aznauryan ◽  
Alexander A. Shpak ◽  
Victoriya O Balasanyan ◽  
Erik I. Aznauryan ◽  
Satenik G. Agagulyan
Keyword(s):  
Binocular Vision ◽  
Visual Fields ◽  
Strabismus Surgery ◽  
Main Group ◽  
Control Group ◽  
Ophthalmological Examination ◽  
Ophthalmic Pathology ◽  
Rehabilitation Measures ◽  
Observation Period

Introduction. Rehabilitation of visual functions in childhood is an urgent problem for pediatric ophthalmology. Researchers are constantlylooking for new rehabilitation measures for diseases such as myopia and retinopathy of prematurity. But timely and effectiveimplementation of rehabilitation measures to restore binocular functions in case of strabismus is not least important. Aim. This study aims to analyze bifoveal fusion recovery using method of LCD glasses with alternating occlusion of visual fields andcompare its efficacy with orthoptic treatment using synoptophore. Material and methods. Ninety-nine patients with prior esotropia, post-operative absence of bifoveal fusion and residual angle ofdeviation <10° were treated. All patients were hyperopic, the spherical refraction was not more than 4.75 diopters, the cylindricalrefraction not more than 1.5 diopters. At the same time, presence of mild amblyopia was allowed. Patients with vertical strabismusand cyclotropia identified during synoptophore examination and cyclotropy examination using Maddox rods, as well as patients withconcomitant ophthalmic pathology were excluded. All patients underwent a standard ophthalmological examination, as well as determinationof binocular vision by a 4-point test, a study on a synoptophore with the determination of the objective and subjectiveangles of strabismus. The main group included 46 patients who underwent treatment by alternating occlusion of visual fields with LCD glasses continuously for 4 hours/day, the control group included 53 patients who underwent synoptophore treatment for 12 months (3-4 courses). The observation period was 12 months. Results. Bifoveal fusion and binocular vision were significantly more often recovered by LCD glasses treatment as compared to thesinoptophore treatment. Stable bifoveal fusion was formed in 32 (69.5%) and 11 (21%) children, unstable in nine (19.6%) and two (4%); treatment was ineffective in five (10.9%) and 40 (75%) patients, respectively. Binocular vision was obtained in 18 (39.1%) and 11 (21%) patients, and taking into account the subsequent diploptic treatment in cases with unstable bifoveal fusion in 12 more patients (66.7%) in the main group. Conclusion. Alternating occlusion of visual fields with LCD glasses is a more effective mean of bifoveal fusion and binocular visionrecovery than orthoptic treatment with a synoptophore in patients after successful strabismus surgery.

A Study of Horizontal Strabismus Surgery: Is Medial Rectus Surgery More Effective on Near Deviation?

1990 ◽  
pp. 487-492
Author(s):  
Michiko Deguchi ◽  
Tsuranu Yokoyama ◽  
Koji Kamihata ◽  
Yuki Matsuzaka ◽  
Kayo Kawanami ◽  
...  
Keyword(s):  
Strabismus Surgery ◽  
Medial Rectus
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