The features of diagnosis and treatmentof unilateral concomitant strabismus with visual fixation defect in preschool children

BACKGROUND:Particular difficulties in treatment of children with monolateral strabismus are associated with the presence of severe amblyopia in the squinting eye in combination with a visual fixation defect (acentral or intermittent). AIM:To assess the anatomical and functional status of children with visual fixation defects, to find out the causes of failures in treatment of this group of patients, to determine the tactics of their management. MATERIALS AND METHODS:The study included 92 children of preschool age (from 3 to 7 years) with monolateral concomitant strabismus. The follow-up period for the children ranged from 12 to 72 months. The average age of the examined children was 4.6 1.1 years. Three variants of visual fixation were identified in the squinting eye: central visual fixation (CVF) 68 eyes; intermittent visual fixation (IVF ) 7 eyes; and acentral visual fixation (AVF) 17 eyes. All patients underwent a comprehensive examination: visometry; strabometry; autorefractometry; determination of the critical frequency of light flashes; assessment of visual fixation; optical coherence tomography of the retina. All children underwent passive and active pleoptics. RESULTS:The visual acuity of children with CVF significantly increased due to pleoptics. At the same time in cases of IVF and even more in those of AVF, visual acuity remained significantly lower than that of the fixating eye, pleoptics were ineffective in this group of patients. In patients with CVF, the critical frequency of light flashes of the squinting eye increased in statistically significant figures, while in IVF and AVF, the difference between squinting and fixing eye remained. According to OCT data, changes in the macular area were detected in 18 (75%) eyes in patients with IVF and AVF, which allows us to distinguish organic pathology from amblyopia. CONCLUSIONS:In children with monolateral strabismus, it is necessary to determine visual fixation of the squinting eye. At IVF and AVF, it is mandatory to conduct optical coherence tomography of the macular area to exclude organic pathology. In patients with monolateral concomitant strabismus with IVF and AVF, surgery on oculomotor muscles is indicated.

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THE DAMAGE OF THE OPTIC NERVE AS THE OUTCOME OF UNINTENTIONAL POISONING BY CLOSANTEL

MNJ (Malang Neurology Journal) ◽

10.21776/ub.mnj.2021.007.01.14 ◽

2021 ◽

Vol 7 (1) ◽

pp. 70-73

Author(s):

Evgenia Sergeevna Kurakina ◽

Elena Eduardovna Ioyleva ◽

Mutlaq Ali Saif Saif ◽

Natalia Alexandrovna Gavrilova

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Optic Nerve ◽

Optic Neuropathy ◽

Ganglion Cells ◽

Small Scale ◽

Optical Coherence ◽

Macular Area ◽

Internal Layers ◽

Toxic Damage

Background: In recent decades, the problem of toxic damage of the visual system due to poisoning by various medicines has become particularly relevant. The clinical case of a bilateral acute optic neuropathy of toxic genesis in a patient by the unintentional application of closantel used in veterinary practice is presented in the report. Closantel is a structural derivative of the salicylanilides, which is used exclusively in veterinary medicine for the prevention and treatment of large and small-scale cattle. Neurological and ophthalmic symptoms are often associated with the intoxication of closantel. Objective: To describe the toxic damage of the optic nerve due to unintentional poisoning by closantel. Methods: A patient aged 55 years is examined. A standard survey of ophthalmology was carried out. Photoregistration of the ocular fundus was used by a funduscamera Visucam 500 (Carl Zeiss Meditec AG, Germany), from special methods of research - the spectral optical coherence tomography (OCT) with a study of the macular area of the retina and the disc of the optic nerve on the device Zeiss Cirrus 5000 (Carl Zeiss Meditec, USA) and the optical coherence tomography with the function of angiography (OCT-A) of the macular area of the retina using RTVue XR Avanti (Optovue, USA) Results: The patient complained of a severe, yet painless, reduction in vision of both eyes after an accidental intramuscular injection of the medicine called "Closantrem" in dose 4.0 ml. The visual acuity OU - an accounting of fingers on the face at a distance of 10 cm. By ophthalmoscopy OU: the disc of the optic nerve is discolourated, its boundaries are indistinct, the arteries and the veins are narrowed, in the macular area of the retina without a visible physical pathology. The perimetry is in the correct projection of the light. A reduction in the thickness of the external and internal layers of the retina was observed as a result of the OCT of the macular zone OU. According to OCT of the disc of the optic nerve: the thickness of the layer of nerve fibres is in the upper and lower nasal segments. OS – the prominence of the disc of the optic nerve in vitreous. The fascinated changes of the cerebral cortex have not been found during the MRT. The diagnosis was made OU: Acute optic neuropathy of toxic genesis. A course of integrated conservative treatment has been introduced: the anti-inflammatory, metabolic, nootropic, vitamin therapy, magnetotherapy, electrostimulation and electrophoresis. Conclusion: Potentially, any medicines are toxic, which may cause a number of side effects from the visual and central nervous system. The toxic damage of the ganglion cells of the retina was initially occurring due to unintentional application of closantel, resulting in a reduction of the central visual acuity, followed by the development of the optic nerve atrophy.

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Cystoid Macular Edema Secondary to Paclitaxel Therapy

Latin American Journal of Ophthalmology ◽

10.25259/lajo-2-2018 ◽

2019 ◽

Vol 2 ◽

pp. 1 ◽

Cited By ~ 3

Author(s):

Anibal Martin Folgar ◽

Jorge Oscar Zarate

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Fluorescein Angiography ◽

Macular Edema ◽

Cystoid Macular Edema ◽

Metastatic Breast ◽

Breast Adenocarcinoma ◽

Optical Coherence ◽

Ophthalmoscopic Examination

We present a 57-year-old referred reduced visual acuity who was in treatment with paclitaxel for developing metastatic breast adenocarcinoma. Ophthalmoscopic examination, optical coherence tomography, and autofluorescence show the cystoid macular edema, but fluorescein angiography is normal, without leakage of dye in the late times. The patient responds well 8 weeks after stopping antineoplastic. Paclitaxel can cause cystoid macular edema and lifting a recovery both anatomical and functional of the macula.

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Status of macular area of the retina after cataract phacoemulsification in two eyes according to the optical coherence tomography

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2019-1-71-73 ◽

2019 ◽

pp. 71-73

Author(s):

I.E. Ioshin ◽

◽

A.I. Tolchinskaya ◽

A.M. Bagirov ◽

◽

...

Keyword(s):

Optical Coherence Tomography ◽

Optical Coherence ◽

Macular Area

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Macular Features on Spectral-Domain Optical Coherence Tomography Imaging Associated With Visual Acuity in Coats' Disease

Investigative Opthalmology & Visual Science ◽

10.1167/iovs.18-24109 ◽

2018 ◽

Vol 59 (7) ◽

pp. 3161 ◽

Cited By ~ 6

Author(s):

Sally S. Ong ◽

Prithvi Mruthyunjaya ◽

Sandra Stinnett ◽

Lejla Vajzovic ◽

Cynthia A. Toth

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Spectral Domain ◽

Optical Coherence ◽

Tomography Imaging ◽

Coats Disease ◽

Optical Coherence Tomography Imaging

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Foveal Exudative Macroaneurysm Treated with Intravitreal Ranibizumab

Case Reports in Ophthalmology ◽

10.1159/000431353 ◽

2015 ◽

Vol 6 (2) ◽

pp. 170-175 ◽

Cited By ~ 6

Author(s):

Carlos Menezes ◽

Rui Carvalho ◽

Carla Teixeira ◽

José Alberto Lemos ◽

Rita Gonçalves ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Macular Edema ◽

Morphological Data ◽

Foveal Avascular Zone ◽

Optical Coherence ◽

Intravitreal Ranibizumab ◽

Corrected Visual Acuity ◽

Retinal Macroaneurysm ◽

Best Corrected Visual Acuity

Purpose: We report a case of a foveal macroaneurysm with long-standing macular edema in a rare location, successfully treated with intravitreal ranibizumab. Methods: We report the case of a 52-year-old man with left eye long-term visual loss due to macular edema caused by a retinal macroaneurysm, localized about 400 μm from the center of the fovea, and its response to 6 monthly ranibizumab intravitreal injections. His best-corrected visual acuity and morphological data evaluated by optical coherence tomography and fluorescein angiography are presented. Results: His best-corrected visual acuity improved from 1/10 to 3/10 after the 3rd injection, and from 1/10 to 4/10 after the 6th one. The central retinal thickness was evaluated by optical coherence tomography and improved from 310 to 233 μm, with the resolution of both the associated serous detachments and the cystoid macular edema; an almost complete reabsorption of the hard exudates at the end of the treatment was also observed. The macroaneurysm lumen almost obliterated after the 3rd injection and completely collapsed at the end of treatment. Conclusions: Intravitreal ranibizumab may be effective in the treatment of long-standing macular edema associated with foveal macroaneurysms. To the best of our knowledge, this is the first report of a retinal macroaneurysm located so close to the foveal avascular zone.

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Natural History of Idiopathic Epiretinal Membrane in Eyes with Good Vision Assessed by Spectral-Domain Optical Coherence Tomography

Ophthalmologica ◽

10.1159/000437058 ◽

2015 ◽

Vol 234 (2) ◽

pp. 91-100 ◽

Cited By ~ 12

Author(s):

Ik Soo Byon ◽

Gang Yun Pak ◽

Han Jo Kwon ◽

Kyong Ho Kim ◽

Sung Who Park ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Natural History ◽

Visual Function ◽

Epiretinal Membrane ◽

Membrane Separation ◽

Early Stage ◽

Optical Coherence ◽

Idiopathic Epiretinal Membrane ◽

History Of

Purpose: To investigate the natural history of idiopathic epiretinal membrane (ERM) in eyes with good visual function using optical coherence tomography (OCT). Methods: Sixty-two eyes of 58 patients with idiopathic ERM, visual acuity of 20/40 or better, and no significant metamorphopsia were included. The best corrected visual acuity (BCVA), central macular thickness (CMT), membrane configuration, and ellipsoid zone signal data over 24 months were retrospectively analyzed. Based on OCT findings, ERM configurations were categorized as global attachment (GA), partial attachment (PA), pseudohole, and vitreomacular traction (VMT). Results: The mean BCVA and CMT did not change significantly between baseline and 24 months. GA, PA, pseudohole, and VMT types were observed in 33, 19, 9, and 1 eye at baseline, and in 20, 22, 10, and 1 eye at 24 months, respectively. A membrane configuration change was noted in 24 eyes (38.7%) during follow-up, and the distribution shifted from GA to the other types (p < 0.001). Six eyes had visual loss due to membrane progression, and 4 eyes had spontaneous membrane separation. Of the 10 eyes with progression or separation, 6 were of the PA type. Conclusions: Although the BCVA remains stable over 2 years in most idiopathic ERM eyes with good visual function at baseline, the membrane configuration may change, affecting visual acuity. The GA type would be an early stage, and the PA type is prone to changes in visual acuity.

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ASSOCIATION OF THE EXTENT OF DIABETIC MACULAR EDEMA AS ASSESSED BY OPTICAL COHERENCE TOMOGRAPHY WITH VISUAL ACUITY AND RETINAL OUTCOME VARIABLES

Retina ◽

10.1097/iae.0b013e318194995d ◽

2009 ◽

Vol 29 (3) ◽

pp. 300-305 ◽

Cited By ~ 20

Author(s):

DAVID J. BROWNING ◽

RAJENDRA S. APTE ◽

SUSAN B. BRESSLER ◽

KAKARLA V. CHALAM ◽

RONALD P. DANIS ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Optical Coherence

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Objective quantification of lens nuclear opacities using swept-source anterior segment optical coherence tomography

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-318334 ◽

2021 ◽

pp. bjophthalmol-2020-318334

Author(s):

Wei Wang ◽

Jiaqing Zhang ◽

Xiaoxun Gu ◽

Xiaoting Ruan ◽

Xiaoyun Chen ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Anterior Segment ◽

Training Dataset ◽

Dissipated Energy ◽

Nuclear Density ◽

Optical Coherence ◽

Nuclear Cataract ◽

Swept Source ◽

Ultrasonic Time

Background/aimsThe primary objective is to quantify the lens nuclear opacity using swept-source anterior segment optical coherence tomography (SS-ASOCT) and to evaluate its correlations with Lens Opacities Classification System III (LOCS-III) system and surgical parameters. The secondary objective is to assess the diagnostic performance for hard nuclear cataract.MethodsThis cross-sectional study included 1222 patients eligible for cataract surgery (1222 eyes). The latest SS-ASOCT (CASIA-2) was used to obtain high-resolution lens images, and the average nuclear density (AND) and maximum nuclear density (MND) were measured by a custom ImageJ software. Spearman’s correlations analysis was used to assess associations of AND/MND with LOCS-III nuclear scores, visual acuity and surgical parameters. The subjects were then split randomly (9:1) into the training dataset and validating dataset. Receiver operating characteristic curves and calibration curves were constructed for the classification on hard nuclear cataract.ResultsThe AND and MND from SS-ASOCT images were significantly correlated with nuclear colour scores (AND: r=0.716; MND: r=0.660; p<0.001) and nuclear opalescence scores (AND: r=0.712; MND: r=0.655; p<0.001). The AND by SS-ASOCT images had the highest values of Spearman’s r for preoperative corrected distance visual acuity (r=0.3131), total ultrasonic time (r=0.3481) and cumulative dissipated energy (r=0.4265). The nuclear density had good performance in classifying hard nuclear cataract, with area under the curves of 0.859 (0.831–0.886) for AND and 0.796 (0.768–0.823) for MND.ConclusionObjective and quantitative evaluation of the lens nuclear density using SS-ASOCT images enable accurate diagnosis of hard nuclear cataract.

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