Süheyla Köse

Blue-on-yellow perimetry versus achromatic perimetry in type 1 diabetes patients without retinopathy.

In this study, we compared the blue-on-yellow perimetric parameters with conventional automated static threshold perimetric parameters in the detection of psychophysical abnormality in patients with type 1 diabetes mellitus (DM) without diabetic retinopathy. Forty-three patients with type 1 DM without diabetic retinopathy were included this study. Thirty subjects served as age-matched control group. Blue-on yellow perimetry was performed and the results compared to white-on-white perimetry. The values of mean deviation by blue-on-yellow perimetry in the diabetic group were significantly higher than in the control group (P=0.0001). The indices of short fluctuation, pattern standard deviation, corrected pattern standard deviation and foveal sensitivity which all relate to localized depression in sensitivity were similar in both groups. The achromatic perimetric parameters were not different between the groups. We conclude that the short-wavelength-sensitive cones are vulnerable to damage from hyperglycemia and this influence can be detected early by blue-on-yellow perimetry in diabetic patients without retinopathy.

Recession of the Inferior Rectus Muscle Under Topical Anesthesia in Thyroid Ophthalmopathy

PURPOSE To evaluate the results of inferior rectus muscle recession with adjustable loop suture under topical anesthesia for vertical deviations secondary to thyroid ophthalmopathy. PATIENTS AND METHODS Five patients with a vertical deviation greater than 15 PD and severe limitation of upgaze were enrolled in the study. Before proceeding with corrective strabismus surgery, we waited at least 6 months after stabilization of ocular alignment and normalization of thyroid chemistries. All patients underwent inferior rectus muscle recession with adjustable loop suture under topical anesthesia. The postsurgical follow-up was at least 12 months. RESULTS Preoperatively, the mean vertical deviation was 24 PD. At 1 year postoperatively, it had decreased to 2.4 PD. Two patients were orthotropic and 3 patients had residual hypotropia ranging from 2 to 6 PD. The limitation of upgaze was relieved significantly in the postoperative period. Two patients had minimal limitation of downgaze, but none complained of diplopia in the primary or reading positions. Surgery did not trigger a flare-up of orbital inflammation in the early postoperative period. CONCLUSION We advocate that recession of the inferior rectus muscle with adjustable loop suture under topical anesthesia is safe and effective in patients with thyroid ophthalmopathy.

Influences of cyclopentolate hydrochloride on anterior segment parameters with Pentacam in children

Purpose:  To investigate the effects of cyclopentolate hydrochloride 1% on the main numerical parameters of anterior segment with Pentacam rotating Scheimpflug camera in children.

The Nature and Origin of Intraocular Metallic Foreign Bodies Appearing after Phacoemulsification

In order to evaluate the nature and origin of metallic foreign bodies embedded in the iris after uneventful phacoemulsification, we aimed to produce metallic fragments by applying ultrasound power with the same phaco machine and handpiece in an experimental model in vitro. In a glass bottle, we used linear phaco power of 100% continuously for 5 min first with a new phaco tip and then with a used tip. Afterwards, the fluid in the bottle was filtered through a Millipore filter. The remains on the filter were studied by scanning electron microscopy (SEM) and microprobe. Small particles remained on the filter which was used for the new tip. Microprobe microanalysis showed that these particles were mainly titanium, the same as the phaco tip. SEM of both the new and the used tips showed small fragments on the exterior surface and lumen. Intraocular metallic foreign bodies after phacoemulsification are likely to be shaken loose from the phaco tip. Although it is mostly agreed that these fragments are well tolerated, their overall effect remains to be evaluated in the long term.

Clinical evidence for dystrophin dysfunction as a cause of hearing loss in locus DFN4.

Objective: Locus DFN4 is an X‐linked nonsyndromic hearing loss locus originally mapped to Xp21.2. Recently, we have mapped deafness in a second family from Turkey to the same region, refining the location to within the Duchenne muscular dystrophy (DMD) locus. The objective of this study was to characterize the clinical phenotype of the Turkish family with comprehensive audiovestibular testing and high‐resolution temporal bone computerized tomography. Methods: Fourteen members of a three‐generation family were studied in detail including two deaf affected males. Members of the family underwent general physical and otologic examination, vestibular testing, pure‐tone audiometry, otoacoustic emissions, and immitance testing. An affected male underwent high‐resolution computerized tomography of the temporal bone, electroretinogram (ERG), electromyography, electroneurography, and determination of serum creatinine phosphokinase level. Results: Affected males were congenitally deaf with normal vestibular function. Carrier females showed a mild sensorineural hearing loss affecting all frequencies and absent otoacoustic emissions. Otoacoustic emissions in a younger, 3‐year‐old carrier girl were normal. In an affected male, ERG demonstrated subnormal scotopic b‐wave typically seen in DMD. Computerized tomography of the temporal bone was normal. With the exception of the ERG finding, there was no clinical or laboratory evidence of DMD or Becker muscular dystrophy (BMD). Conclusion: The abnormal ERG in the Turkish family in conjunction with mapping of the DFN4 locus to within DMD strongly suggests that a defect in dystrophin is responsible for the hearing loss in this family. Patients with DMD and BMD should be screened systematically for sensorineural hearing loss. This family provides additional evidence for the critical role of cytoskeletal proteins in normal hearing.

The effect of optical correction on refractive development in children with accommodative esotropia

PURPOSE To compare the effects of partial or full hyperopic optical correction on refractive development in children with accommodative esotropia. METHODS Children with accommodative esotropia and hyperopia >3 D were enrolled in this prospective, nonrandomized study. All children underwent an ophthalmologic examination, including refraction, keratometry, and axial length. Subjects were divided into either full- or partial-correction groups according to their tolerance of the full hyperopic correction. Routine follow-up examinations were performed for at least 3 years. The main outcome measure was cycloplegic spherical equivalent at the end of the study period. RESULTS A total of 120 children were enrolled. The mean cycloplegic spherical equivalent, corneal radius, and axial length were significantly (p < 0.05) different between the first and last visits in both groups. However, when all the measurements were adjusted for the age difference between groups, only the difference in axial length between the first and last visits was statistically significant (p < 0.05). Partial or full optical correction in age-adjusted cohorts with accommodative esotropia did not result in a significant change in refraction, keratometry, or axial length between the first and last visits. CONCLUSIONS Partial or full optical correction of hyperopia had similar effects on refractive development of the eye in children with accommodative esotropia. Treatment of accommodative esotropia in children older than age 5 did not appear to impair refractive development.

Retroequatorial recession of horizontal recti with loop suture in the treatment of congenital nystagmus

Purpose The authors wished to evaluate the effectiveness and safety of retroequatorial recession of all four horizontal recti using loop sutures for the treatment of congenital nystagmus. Subjects and methods Twelve patients with congenital nystagmus were enrolled in this prospective study. All patients underwent retroequatorial recession of horizontal recti with loop sutures. All recti were recessed 8mm measuring from the insertion, then the amount of loop suture was determined according to the preoperative ocular alignment of the patients. Electronystagmographic recordings were made in every patient preoperatively and postoperatively as well as an ophthalmological examination. The follow-up period ranged from 6 to 26 months. Results All four horizontal recti were recessed 9 to 12mm including the loop suture (range 1-4mm). Compared to preoperative values, postoperative amplitude and intensity of nystagmus decreased statistically significantly in all patients (p = 0.002). The postoperative decrease in the frequency of nystagmus was not statistically significant (p = 0.173). Improvement of both distance and near visual acuity was achieved in 10 patients. Five of seven patients who had ocular misalignment preoperatively were aligned within 10 PD postoperatively. Improvement in head posture was seen in two of three patients. The authors determined that the improvement in the nystagmus characteristics was most prominent in the immediate postoperative period. Conclusion Retroequatorial recession of all four horizontal recti using loop sutures is a safe and effective procedure for the management of congenital nystagmus.

Accommodative esotropia following surgical treatment of infantile esotropia: frequency and risk factors.

Purpose:  We aimed to examine the frequency of and risk factors for the development of accommodative esotropia following surgical treatment for infantile esotropia.

Binocular visual function in congenital esotropia after bilateral medial rectus recession with loop suture.

PURPOSE Our aim was to evaluate the binocular visual function in congenital esotropia after bimedial rectus recession with loop suture and to address the factors that could take part in the attainment of binocular function. SUBJECTS AND METHODS Forty children with congenital esotropia who were operated on between 12 and 48 months of age were included in the study group. Postoperative follow-up ranged from 2 to 10 years. In order to determine the factors affecting the sensory results in congenital esotropia, we classified our patients into two groups according to their fusion status. We compared the preoperative and postoperative characteristics of patients in these two groups. RESULTS Twenty-one of 40 patients (52.5%) fused the Worth four-dot at near (Group 1), 19 patients (47.5%) did not (Group 2) at the final examination. No patient showed evidence of stereopsis. We found significant differences between these two groups in respect to the final angle of vertical deviation, the age at surgery, the presence of postoperative inferior oblique overaction, dissociated vertical deviation and abnormal head position. Correlation analysis revealed that early alignment of the eyes and the absence of postoperative vertical deviation were associated with increased incidence of achieving some degree of binocular vision. CONCLUSION In congenital esotropia, not all infants may have the potential for normal binocular function owing to yet unknown constitutional factors. We determined that achieving some degree of binocular function may be related to early alignment of the eyes. Additionally, close follow-up and precise treatment of the accompanying vertical deviation, especially inferior oblique overaction and dissociated vertical deviation,in a timely manner may enhance the attainment of binocular sensory function.

Coexistante of intraocular eyelashes and anterior chamber cyst after penetrating eye injury: a case presentation

We herein describe a patient in whom two intraocular eyelashes and an anterior chamber cyst embedded into the anterior surface of the iris was detected following penetrating eye injury. After a one year asymptomatic period, the patient was hospitalized because of uveitic reaction in the anterior chamber which may be due to cyst development. The lashes and cyst were removed surgically, and examined pathologically. There was no complication in one year follow-up period.