Ewy Meyer

Retinal function in high refractive error assessed electroretinographically.

The retinal function of patients with high refractive error was studied electroretinographically. Thirty-one hypermetropic patients, 7 myopic patients, and 7 patients with either unilateral or bilateral aphakia participated in the study. The ERG responses were measured in the light- and dark-adapted states. It was found that myopic eyes were characterised by subnormal amplitude but normal pattern, expressed by normal relationship between the b-wave amplitude and the a-wave amplitude. In aphakia the ERG responses were of normal amplitude and pattern. However, the hypermetropic patients could be divided into 3 groups. One group included subjects with a subnormal b-wave to a-wave relationship. The second group was characterised by a normal b- to a-wave relationship, while patients belonging to the third group exhibited supernormal b-wave to a-wave relationship. This classification of hypermetropic subjects did not correlate with the axial length of the eye or the refraction of the ocular media.

Pseudoexfoliation: Epidemiology, Clinical and Scanning Electron Microscopic Study

The prevalence of pseudoexfoliation among patients of Sephardic origin was more than twice the expected when compared with the ethnic distribution of the population consulting the Rambam Medical Center eye clinic. A strong association between brown irises and pseudoexfoliation was noted. No uniform scanning electron microscope pattern was seen of the pseudoexfoliation.

Clinical characteristics and long-term postoperative results of infantile esotropia and myopia

PURPOSE To determine the short-term (6 month) and long-term (4 year) surgical results of infantile esotropia in a control group of 100 patients, as compared to a myopia (-2.0 to -5.0 diopters [D]) group of 13 patients and to a high-myopia (greater than -8.0 D) group of 14 patients. METHOD A retrospective chart review with selection according to inclusion criteria. RESULTS All 14 high-myopic patients (100%) achieved short-term unacceptable result of large-angle (greater than 20 prism diopters) deviation as compared to 29 (29%) and four (31%) of the patients in the control and myopia groups, respectively (P < 0.0001). Eighty (80%) of the patients in the control group and 10 (77%) in the myopia group achieved long-term favorable postoperative results of subnormal binocular vision, microtropia, or small-angle (less than 20 prism diopters) deviation, with no statistical differences between the two groups. In contrast, 10 (71%) of the patients in the high-myopia group achieved a final unacceptable result of large-angle deviation, as compared to 20 (20%) and three (23%) in the control and myopia groups, respectively (P < 0.0001). Persistent preoperative amblyopia was associated with a higher percentage of unfavorable surgical results and was more frequent in the high-myopia group (50%) as compared to the control group (14%) (P = 0.0004). CONCLUSIONS Careful attention must be directed preoperatively toward reversing amblyopia and correcting refractive errors because persistent amblyopia at the time of surgery was associated with a higher percentage of unacceptable postoperative large-angle deviation. The conventional amount of recession or resection of muscles should be increased in high-myopic cases with infantile esotropia, because less effect is produced per millimeter of recession/resection initially and, in the long-term, the constant stimulus to accommodative convergence apparently causes recurrent esotropia.

Light and Electron Microscopical Study of the Conjunctiva in Sicca Syndrome

Conjunctival biopsies of 11 patients with sicca syndrome were studied under light and transmission electron microscopy. The notable findings were vasculitis of the conjunctival vessels. There were severe changes in the microvilli, namely a loss of microvilli and decrease in their height, measuring approximately 1,000-2,000 A, in comparison with microvilli of the control conjunctiva, measuring 4,000 A in height. There was no branching yet or fusion of microvilli.

Microphthalmos with orbital cyst: a clinicopathological report.

The clinical and histopathological findings in a case of microphthalmos with orbital cyst is described. The clinical interesting feature of this case was the bilateral coloboma which represented interference in the development of the eye at different stages of embryonic life.

Myotonic Dystrophy: Pathological Study of the Eyes

A 56-year-old patient with histopathologically established myotonic dystrophy is described. Gross pathological examination of the eyes revealed cataracts and peripheral retinal dystrophy as described previously. Lacy vacuolization of the pigment epithelium of the iris and vacuolization of the nonpigmentary ciliary epithelium were also found. These latter findings have, to our knowledge, not been hereto described in the literature.

Massive Fibrosis of Extraocular Muscles Related to Intraocular Tumor

A resin histological and ultrastructural study of 9 fibrotic extraocular muscles from 2 patients who underwent enucleation because of advanced intraocular malignant melanoma is reported. Total fibrosis of the extraocular muscles was evident in one case and extensive fibrosis in the other case. The patients did not suffer from congenital fibrosis syndrome. Ultrastructurally, the muscle tissue was replaced by collagen fibrils showing great variability of caliber.

End-stage fibrosis of the lateral rectus muscle in myopia with esotropia. An ultrastructural study.

The fibrotic lateral rectus muscle and the medial rectus muscle of 4 patients with esotropia and myopia who underwent surgical correction were studied ultrastructurally. All patients revealed underactivity of the lateral rectus muscle. In 3 patients the underactive lateral rectus was completely fibrotic; in 1 patient there was 80% fibrosis, and the rest of the muscle showed different stages of degeneration. The fibrotic lateral recti were composed of collagen fibrils and remnants of degenerated organelles. The collagen fibrils of the lateral recti were of different sizes, and the mean diameter varied from 65 to 92 nm. On the other hand, the interstitial collagen fibrils of nonfibrotic medial rectus muscles of these patients and also of control muscles showed less variation in size, and the mean diameter was smaller as compared with the fibrotic lateral rectus. It is suggested that the collagen fibrils that compose the fibrotic lateral rectus muscle probably develop under conditions which differ from the normal development of collagen fibrils.

Primary and secondary overacting inferior oblique muscles: an ultrastructural study.

Biopsy material from primary and secondary overacting inferior oblique muscles were examined by light and electron microscopy. Most muscle fibres were in different stages of atrophy. A high variation of alterations was encountered in all muscles. The most striking abnormalities were huge accumulations of mitochondria and muscle vacuolisation related mainly to the enlargement of the tubules of sarcoplasmic reticulum. The mitochondrial aggregates and vacuolisation occupied more muscle surface in the inferior muscles of primary overaction than those of secondary overaction.

Connective tissue of the orbital cavity in retinal detachment : an ultrastructural study

The connective tissue from Tenons capsule of 7 patients who underwent surgery for retinal detachment was studied ultrastructurally. Five patients were 58-70 years old, and 2 were young adults. The Tenon capsules of 6 children and of 2 aged patients without retinal problems were used as controls. In young controls the Tenon capsule was composed mainly of round, smooth collagen fibrils and a few elastic fibers. The collagen fibrils varied in size from 70 to 110 nm. In the aged patients with retinal detachment, the collagen fibrils showed marked variation of size and also abnormalities of shape in 4 out of 5 cases. The diameter of collagen fibrils varied from 32 to 160 nm, and the elastic fibers were fewer as compared with controls. The possibility arises that age-related structural changes of the orbital connective tissue could predispose to retinal detachment.