scholarly journals Results of asymmetric bilateral medial rectus retroposition in unilateral Duane retraction syndrome’s type I

2012 ◽  
Vol 59 (3) ◽  
pp. 77-80
Author(s):  
Milorad Ljutica ◽  
Miroslav Stamenkovic ◽  
Dusica Risovic ◽  
Nebojsa Nikitovic ◽  
Branko Stankov
Keyword(s):  
Anterior Segment ◽  
Medial Rectus ◽  
Type I ◽  
Refractive Errors ◽  
Pathological Changes ◽  
Retraction Syndrome ◽  
Before And After ◽  
Duane Retraction Syndrome ◽  
The Right

Objective: To describe the results of asymmetric bilateral medial rectus retroposition in unilateral Duane retraction syndrome-this type I. Method: This is a retrospective study involving 18 patients, mean age 11.2 years (3-37 years) with unilateral Duane retraction syndrome?s type who were operated in 2009 up to 2011 year. The aim was to investigate the existence of ocular torticollis, size deviation before and after surgery and presence of amblyopia, anisometropia, type of refractive errors and lateralization. Results: All 18 patients were surgically treated by asymmetric retroposition of internal rectus (for 1-2mm more on the healthy eye). All patients preoperatively de-monstrated ocular torticollis. Size of mean preoperative deviation was +22.2 pD of primary angle PD and +46 pD of secondary angle. Postoperative finding: deviation of> +10 PD is noted to the presence of mild torticollis in one patient. Intermediate follow-up period was 9.8 months. Unilateral Duane?s syndrome is common among members of women (67%) compared to males (33%). Lateralization of Duane?s syndrome is more common in the left eye compared to the right (83% vs. 17%). Amblyopia was present in two patients and anisometropia (11.1%). As for refractive errors: hyperopia was found in 9 patients (50%), hypermetric astigmatism in 7 cases (39%), myopia and 1 (5.5%) and emmetropia (5.5%). None of the patients had no pathological changes in the fundus and anterior segment. Conclusion: Asymmetric bilateral medial rectus retroposition is extremely effective in the treatment of ocular torticollis and esotropia in patients with unilateral Duane retraction syndrome-this type I.

Reoperation in esotropic Duane retraction syndrome: Long-term motor outcome of superior rectus transposition

2019 ◽  
pp. 112067211989788
Author(s):  
Adriano Magli ◽  
Luca Rombetto ◽  
Paolo Esposito Veneruso
Keyword(s):  
Head Position ◽  
Medial Rectus ◽  
Head Turn ◽  
Superior Rectus ◽  
Vertical Deviation ◽  
Retraction Syndrome ◽  
Motor Outcome ◽  
Duane Retraction Syndrome

Aim: The aim was to evaluate the long-term motor outcome of superior rectus transposition procedure in patients affected by unilateral esotropic Duane retraction syndrome with residual esotropia and anomalous head position. Methods: A retrospective analysis of medical records of patients affected by esotropic Duane retraction syndrome who underwent superior rectus transposition procedure as reoperation for residual esotropia and/or residual anomalous head position. Amount of deviation, anomalous head position, duction limitation, globe retraction, presence of upshoot/downshoot, and vertical deviation were analyzed before and after superior rectus transposition procedure. Results: Twenty patients were selected. All patients underwent unilateral medial rectus recession or bilateral medial rectus recession, for unilateral esotropic Duane retraction syndrome at least 2 years before superior rectus transposition reoperation. Mean age at surgery (superior rectus transposition) was 12 ± 6.8 years, and the follow-up period was 2.7 ± 0.6. Mean deviations at distance and near before surgery were 19.5 ± 5.7 and 15.2 ± 6.8, respectively. Two patients showed upshoot. Head turn was 11.4 ± 5.1°; abduction limitation was −2.6 ± 0.9. After superior rectus transposition, all patients showed an improvement of esotropia at distance and near (8.1 ± 5.7 and 5.1 ± 5.6, respectively; p < 0.05), anomalous head position (5.6 ± 3.9°; p < 0.05), and abduction limitation (−2.3 ± 0.8; p < 0.05). No statistically significant changes occurred in globe retraction. No adduction limitation, vertical deviation, and upshoot/downshoot were present after superior rectus transposition procedure. Results were stable during follow-up. Conclusion: Superior rectus transposition procedure is an effective procedure in esotropic Duane retraction syndrome patients who previously undergone unilateral/bilateral medial rectus recession, with residual esotropia and anomalous head position. It allows improvement of esotropia, head turn, and partial recovery of abduction in a significant percentage of patients (30%) with no vertical complications.

scholarly journals Evaluation of Recovery of Activities of Daily Living in Patients with Sequelae from Cerebral Vascular Disease

2013 ◽  
Vol 6 (2) ◽  
pp. 125-130
Author(s):  
Danelina E. Vacheva ◽  
Verjinia K. Simeonova ◽  
Boyko St. Stamenov
Keyword(s):  
Activities Of Daily Living ◽  
Cerebrovascular Disease ◽  
Daily Living ◽  
Personal Hygiene ◽  
Rank Test ◽  
Self Assessment ◽  
Cerebral Vascular Disease ◽  
Before And After ◽  
The Right

Summary Bulgaria ranks first in the world in incidence, morbidity and death associated with cerebrovascular disease. The aim of the study was to investigate, follow-up and register recovery of activities of daily living (using the toilet and maintaining personal hygiene) in patients with sequelae from cerebrovascular disease in a subacute stage, who underwent physiotherapy and rehabilitation. Sixty-one patients were included and followed up. They were given tailored physiotherapy and rehabilitation. This included kinesitherapy, occupational therapy and electrotherapy. All the patients filled in self-assessment questionnaires before and after the rehabilitation course. Major parameters were assessed, irrespective of the limb affected -dominant or non-dominant. Results were analyzed using the Wilcoxon rank test. At the end of the rehabilitation course, the Wilcoxon curves were driven to the right, confirming improvement concerning independence, irrespective of involvement of dominant or non-dominant limb.

scholarly journals Accelerated corneal endothelial cell loss in two patients with granulomatosis with polyangiitis following phacoemulsification

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Fang-Chi Hsiao ◽  
Hung-Ta Chen ◽  
Kuan-Jen Chen ◽  
Yi-Jen Hsueh ◽  
Yaa-Jyuhn James Meir ◽  
...  
Keyword(s):  
Endothelial Cells ◽  
Cataract Surgery ◽  
Granulomatosis With Polyangiitis ◽  
Corneal Edema ◽  
Cell Loss ◽  
Multiple Organs ◽  
First Case ◽  
Before And After ◽  
The Right

Abstract Background Generally, the loss rate of human endothelial cells (HCEC) in routine cataract surgery is 8.5%. When the corneal endothelial cells density (ECD) drops, the HCEC may decompensate to keep cornea dehydration which leads to corneal edema. Granulomatosis with polyangiitis (GPA) is an uncommon autoimmune disease involving multiple organs including eyes such as conjunctivitis, scleritis, uveitis, and corneal ulcer. In this study, we report two cases of GPA whose corneal ECD decreased significantly after phacoemulsification cataract surgery. Case presentation In the first case of 69-year-old male with GPA, the ECD dropped 39.6% (OD) four months after phacoemulsification and 38.1% (OS) six months postoperatively respectively. At the final follow-up, the residual ECD was only 55% in the right eye in the 49th month, and 56% remained in the left eye in the 39th month. In the second case of 54-year old female, left ECD dropped 63.9% at the 4th month after surgery and 69.6% ECD remained at the 15th month postoperatively while similar ECD of right eye before and after left eye surgery. Conclusion Extensive preoperative ophthalmic evaluation and meticulous postoperative inflammation control should be applied to prevent severe loss of HCEC in GPA patients.

scholarly journals Right Ventricular Free Wall Strain for Detection of Anthracycline Induced Cardiac Toxicity

2021 ◽  
Author(s):  
Armin Attar ◽  
Fatemeh Azizi ◽  
Firoozeh Abtahi ◽  
Mojtaba Karimi
Keyword(s):  
Cardiac Toxicity ◽  
Speckle Tracking Echocardiography ◽  
Global Longitudinal Strain ◽  
Lv Function ◽  
Free Wall ◽  
Right Ventricular Free Wall ◽  
Before And After ◽  
The Right ◽  
Rv Function

Abstract Background Anthracycline agents are routinely used for treatment of many types of malignancy, while imposing the risk for cardiotoxicity (AT-CMP). Although the right ventricle (RV) is more susceptible to cardiotoxicity, most of the studies have focused on left ventricle (LV) function for monitoring AT-CMP. In this study, we have focused on RV function before and after chemotherapy using two-dimensional speckle tracking Echocardiography (2D-STE). Material and Methods In this prospective study, newly diagnosed and untreated cancerous patients without previous cardiovascular diseases were enrolled. For all patients, baseline echocardiography was performed before the initiation of the anthracycline regimen and after 6 months of follow up when the chemotherapy was stopped. Several parameters of LV and RV function were measured using 3D echocardiography and STE techniques. Results 60 patients were enrolled in the study. There was a significant decrease (P = 0.001) in RV fractional area change (53.57 %±4.36 vs. 45.66% ±6.19), RV Global longitudinal strain (GLS) (− 22.93%±1.95 vs. −18.53 ± 2.75), and RV free wall strain (FWLS) (− 25.75%±3.01 VS. −20.30 ± 3.78). There was a significant decline in LVEF (59.42 ± 6.36% vs. 51.1 ± 6.31%) and LV-GLS (-21.1 ± 1.8% vs -18.6 ± 2.6%) (both P = 0.001) as well. Among the parameters changed following chemotherapy, RV-FWLS was dropped to a pathological level in 25% of patients showing the highest potential for detection of anthracyclines effect on the myocardium. Conclusion Anthracycline therapy can induce subclinical RV dysfunction. RV-FWLS may be proposed as the most sensitive echocardiographic marker for monitoring AT-CMP. This finding needs to be confirmed in future and larger studies.

scholarly journals A Case Study on Retinoblastoma Associated Orbital Cellulitis

2021 ◽  
pp. 91-97
Author(s):  
Sagili Chandrasekhara Reddy ◽  
Bina Sharine Menon
Keyword(s):  
Anterior Segment ◽  
Oral Prednisolone ◽  
Detailed Examination ◽  
Orbital Cellulitis ◽  
Eye Drops ◽  
Upper Eyelid ◽  
Bilateral Retinoblastoma ◽  
Pediatric Oncologist ◽  
The Right

A 20-months-old male child was brought to the Eye clinic with swelling of right upper eyelid, discharge sticking the eyelids in the right eye and redness in both eyes of three days duration. On detailed examination of anterior segment and fundus, the diagnosis of bilateral retinoblastoma with conjunctivitis was made. The conjunctivitis was cured with ciprofloxacin eye drops and eye ointment. CT scan of orbits and brain confirmed the diagnosis of retinoblastoma with calcification in both eyes. Optic nerve on both sides was normal and there was no metastasis in the brain. Since it was a bilateral case of retinoblastoma, chemoreduction followed by enucleation in the right eye, and salvaging the left eye with chemotherapy in order to save the vision was planned. Intravenous triple drug chemotherapy with carboplatin, etoposide and vincristine (six cycles) was started by pediatric oncologist in pediatric ward. After two weeks of completing the first cycle of treatment, enucleation of right eye was done. Postoperative period was uneventful. The chemotherapy was continued. The child developed marked swelling of left upper eyelid few days before the sixth cycle of chemotherapy. Examination of left eye showed signs of aseptic orbital cellulitis which was treated with oral prednisolone and topical eye drops of combination of gentamycin and dexamethasone. The inflammatory signs subsided completely in ten days time. The sixth cycle of chemotherapy was completed. On the follow up visit two weeks after discharge, the left eye ball was normal. In the first follow up, the child could pick up the toys thrown in front of him. Unfortunately the child defaulted follow up. Retinoblastoma should be excluded in all young children with orbital cellulitis because misdiagnosis is life threatening.

scholarly journals A Rare Case of Unilateral Progressive Cataract in a Young Patient Receiving Topiramate

2020 ◽  
Vol 11 (2) ◽  
pp. 276-281 ◽  
Author(s):  
Tanuja Kate ◽  
Rajiv Choudhary ◽  
Jyoti Singhai ◽  
Navita Pathak
Keyword(s):  
Young Patient ◽  
Past History ◽  
Anterior Segment ◽  
Acute Angle ◽  
Angle Closure ◽  
Rapid Progression ◽  
Topical Steroids ◽  
Acute Angle Closure ◽  
The Right

This case report presents an instance of unilateral cataract formation and its rapid progression following topiramate-induced bilateral acute angle closure. An 18-year-old female diagnosed with acute angle closure in both eyes had started treatment on the previous day at another healthcare facility. The patient presented with complaints of pain, sudden diminution of vision, excessive watering, and photophobia (both eyes) and reported the use of topiramate for headache for 10 days. There was no past history of decreased vision, trauma, uveitis, or use of steroids. Topiramate-induced bilateral secondary angle closure attack was the presumptive diagnosis. Topiramate use was stopped, and antiglaucoma drugs, topical cycloplegic, and topical steroids were started. On 1-day follow-up, clearer cornea and peripheral anterior capsular lenticular opacity of the right eye were observed. Gonioscopy showed closed angles. Anterior segment optical coherence tomography showed forward movement of the iris-lens diaphragm and closed angles. B-scan showed ciliochoroidal effusion in the right eye and normal left eye. At 2-month follow-up, formed anterior chamber and posterior subcapsular cataract in the right eye were seen. There were no lenticular changes in the left eye. Definite progression of cataract from day-1 to 2-month follow-up was seen in the right eye. To our knowledge, this is the first report of the rapid progression of cataract following topiramate-induced secondary angle closure in a young patient warranting surgical intervention.

scholarly journals Traumatic scleral wound dehiscence with filtering bleb formation after surgical repair of penetrating globe injury

2013 ◽  
Vol 5 (1) ◽  
pp. 136-137 ◽  
Author(s):  
A Ozkaya ◽  
Z Alkin ◽  
Y Acet ◽  
U Yigit
Keyword(s):  
Surgical Repair ◽  
Ocular Trauma ◽  
Anterior Segment ◽  
Wound Dehiscence ◽  
Rare Occurrence ◽  
Filtering Bleb ◽  
Bleb Formation ◽  
The Right ◽  
Blunt Ocular Trauma

Backgropund: Filtering bleb formation after surgical repair of penetrating globe injury is a rare occurrence. Case: A 45-year-old male who had undergone surgical repair of a corneoscleral laceration 16 months earlier presented to emergency room after blunt trauma to the left eye. His best-corrected visual acuities were 20/20 in the right eye and 20/25 in the left. An anterior segment examination found a conjunctival filtering bleb formation on scarred sclera at superotemporal location near the limbus. Anterior chamber was slightly shallow and the Seidel test was negative. Intraocular pressures were 17 mm Hg in the right eye, 7 mm Hg in the left. The fundus examination revealed no abnormal findings. The patient was treated with topical aplication of a steroid and a cycloplegic drop during three weeks. After 16 months follow-up, the visual acuity remained unchanged with the persistence of filtering bleb. IOP was 8 mm Hg in the left eye. Follow-up examinations showed no complications related to trauma. Conclusion: Blunt ocular trauma can cause dehiscence in old scleral scars and subsequent filtering bleb formation. Nepal J Ophthalmol 2013; 5(9):136-137 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7843

Heterozygous 5p13.3-13.2 deletion in a patient with type I Chiari malformation and bilateral Duane retraction syndrome

2010 ◽  
Vol 77 (5) ◽  
pp. 499-502 ◽  
Author(s):  
F Bayrakli ◽  
K Bilguvar ◽  
D Ceyhan ◽  
AG Ercan-Sencicek ◽  
T Cankaya ◽  
...  
Keyword(s):  
Chiari Malformation ◽  
Type I ◽  
Retraction Syndrome ◽  
Duane Retraction Syndrome
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