Müslime Yalaz

Haemodynamic changes in ocular Behçet's disease

Editor,—Behcet’s disease (BD) is an immune system related obstructive vasculitis characterised by recurrent inflammation that affects multiple systems. Posterior uveitis and retinal vasculitis are the common features of ocular involvement.1-3 Colour Doppler imaging (CDI) is a non-invasive ultrasonographic method which permits simultaneous grey scale imaging of structure and colour coded imaging of blood velocity. CDI has successfully demonstrated changes in orbital haemodynamics associated with a variety of pathological conditions.4-7In the present study the haemodynamic changes in ophthalmic (OA), central retinal (CRA), and posterior ciliary arteries (PCA) of the patients with BD were investigated by using CDI. ### CASE REPORT The study group consisted of 26 patients with BD (five females, 21 males), aged between 22 and 58 (mean 32.19 (SD 8.27)). Diagnosis was made according to the criteria recommended by International Study Group for Behcet’s disease.8 Control group consisted of 20 males, six females, aged between 21 and 58 (31.49 (8.60)), who had no ocular or systemic pathology other than presbyopia. After performing full ophthalmological evaluation, transocular CDI was performed in all the patients and controls with a colour Doppler sonographic unit (General Electric Sonochrome …

Preoperative brush and impression cytology in ocular surface squamous neoplasms.

OBJECTIVE Preoperative cytologic diagnoses of ocular surface squamous neoplasms were evaluated and compared with histologic diagnoses. STUDY DESIGN Impression cytology (Millipore filter paper) and brush cytology were applied to 32 patients who had conjunctival neoplasms. Papanicolaou-stained cytologic preparations and hematoxylin and eosin-stained histologic sections were examined by light microscopy. RESULTS The brush technique was used on 27 patients; impression cytology was applied in 5 cases. Cytologic and histologic diagnoses were concordant in 26 cases. Squamous cell carcinoma or carcinoma in situ was diagnosed in 18 and dysplasia in 4 cases. Squamous metaplasia and normal-appearing conjunctival epithelial cells were diagnosed cytologically in four cases; of those histologic diagnoses, one was pterygium and three, conjunctival nevus. Four cases revealed discrepancies between the cytologic and histologic preparations. There was one false positive result, and one case was subconjunctival invasion of basal cell carcinoma of the eyelid. CONCLUSION Impression and brush cytology are fast, cost-effective, reliable and noninvasive diagnostic tools for ocular surface squamous neoplasms. However, the brush technique has several advantages over impression cytology.

Mersilene mesh: long-term results in oculoplastic surgery

We evaluated the long-term results of Mersilene mesh application in 72 patients with various ophthalmic disorders. Mersilene mesh was used as a cover material for primary and secondary orbital implantation, as a sling material for the upper and lower lids, and as a spacer material for lid retraction. The postoperative follow-up period ranged from 15 to 62 months (average 43.21±12.8). Orbital implant exposure developed in 10 of 35 cases who had undergone enucleation and primary orbital implantation. Sphere exposure developed in one of 18 cases who had undergone secondary orbital implantation. We used Mersilene mesh as a frontalis sling material in 19 ptotic lids of 15 cases. Suture granuloma developed in 3 cases, and in 2 cases we observed Mersilene mesh extrusion associated with chronic discharge near the free edge of the lid. When used as a spacer material in lid retraction surgery, Mersilene mesh extruded through the conjunctiva of both lower lids in one of three cases. These long-term results indicate ...

Lacrimal Intubation with the Ritleng System in Recurrent Congenital Nasolacrimal Duct Obstruction in Children

Purpose: To evaluate the efficacy of the Ritleng lacrimal intubation system in the treatment of congenital nasolacrimal duct obstruction. Methods: Twenty-six patients (29 eyes) with congenital nasolacrimal duct obstruction, who ranged in age from 2 to 12 years (mean, 4.85 ± 2.9 years), underwent silicone intubation with the Ritleng lacrimal intubation system. The Ritleng lacrimal intubation system is composed of a Ritleng probe, a monofilament guide thread and a silicone tube. The prolene tip was removed from the inferior meatus with nasal endoscopy in 26 eyes, whereas this was done by using a Ritleng hook in 3. Clinical success was defined by the relief from symptoms and signs of obstruction. The tubes were left in place for an average of 6 months. The patients were followed up between 6 and 25 months (mean, 8.3 months). Results: All cases were successfully intubated with the Ritleng system. Two cases underwent reintubation because of tube dislocation during the first week. Granuloma developed at the edge of the inferior punctum in 1 case. We observed relief from symptoms in all cases. Conclusion: The Ritleng lacrimal intubation system is an easy, effective and nontraumatizing procedure for the treatment of congenital nasolacrimal duct obstruction.

Inferior ophthalmic vein varix and thrombosis

Orbital varices are congenital venous malformations of the orbit, affected by changes in venous pressure. Sudden thrombosis is an occasional feature of orbital varices. A case is presented of a patient with an inferior ophthalmic vein varix, in whom thrombosis developed five months after the initial examination, which regressed spontaneously during a follow-up period of six months. The literature is reviewed.

Management of scleral defect with phacocele

Subconjunctival dislocation of the crystalline lens is known as phacocele. Most cases of phacocele are associated with blunt trauma, existence of scleral rigidity, hard crystalline lens, and a history of scleral surgery. We report a case of traumatic phacocele with a scleral defect in a patient whom had been operated for trabeculectomy 5 years ago.

Book Reviews / Erratum

The updated fourth edition of the Color Atlas of ENT Diagnosis is an illustrated first introduction examination, diagnosis and therapy of the most frequent ear, nose and throat diseases. The more than 500 good-to-excellent color pictures are of great help to the beginner to become familiar with the conditions typically seen in the ENT field. The text is divided into five main sections: examination; ear; nose and face; pharynx and larynx; head and neck. As the stated purpose of this small pocket book is not to be a textbook but a pictorial survey, the majority of the book is reserved for the excellent pictures. Although most of the color photographs are self-explanatory every illustration is accompanied by a short descriptive text. Moreover, small paragraphs introduce special issues like laryngectomy or audiologic examination. I suggest a reference list for additional reading. All in all this small pocket atlas will be of great help to medical students, ENT trainees and general practitioners seeking a quick reference during daily practice. Elmar Oestreicher, Munich Maria Sanna, Hiroshi Sunose, Fernando Mancini, Alessandra Russo, Abdelkader Taibeh