The Effect of Alcohol on Eye Movement

This is a study to determine if there is a significant relationship between eye movement and alcohol intake at and below the legal limit of 0.05% blood alcohol concentration(BAC), and to identify the minimal BAC that causes significant change in eye movement. Twenty healthy males were orally given 0.57g/㎏ alcohol. After the alcohol intake, the BAC was measured at 10 minute intervals along with measurements of saccadic velocity, latency, and gain of pursuit movement of the eye. Linear regression analysis between BAC≤0.05% and saccadic velocity and latency resulted in correlation coefficients of 0.258 and 0.306 respectively(p ＜0.005), while gain of pursuit movement had no relation to BAC. The latency at 0.05~0.06% BAC interval increased compared with the values before alcohol intake, with statistical significance(p＜0 . 0 5 ) . Although there existed variations among subjects, a significant functional change of eye movement developed at 0.05% BAC, the legal limit of alcohol. Eye movement is thought to be a valuable indicator of CNS depression by alcohol and prolonged latency of saccadic eye movement by alcohol may be the explanation for increased risk of traffic accidents after alcohol intake(J Korean Ophthalmol Soc 41:215~224, 2000).ope

The Efect of Strabismus Surgery on Refractive Error Measured with Corneal tophography

This study was prospectively performed to assess the corneal refractive changes after strabismus surgery. Seventy patients who were average 12.56 years old were enrolled and the corneal refractive power was measured with corneal topography system(Videokeratoscope, Eye Sys TM laboratories). The postoperative corneal refractive changes were not observed at apex, 3 ㎜ zone and 5㎜ zone in all the patients, but the corneal refractive power increased at 5㎜ zone for one week only in resection and recession surgery group. The corneal refractive changes according to the amount of surgery were not observed, but the significant correlation was noted at apex and 3㎜ zone for one week, while at 5㎜ zone for 8weeks in horizontal muscle recession surgery group The corneal refractive changes after strabismus surgery were noted at the peripheral cornea and especially in resection and recession surgery group. Further studies of this subject including more patients of various operation methods are expected(J Korean Ophthalmol Soc 41:500~505, 2000).ope

Parent-reported symptoms of attention deficit hyperactivity disorder in children with intermittent exotropia before and after strabismus surgery

PURPOSE: To investigate the symptoms of attention deficit hyperactivity disorder (ADHD) as reported by parents in children with intermittent exotropia [X(T)] and to determine whether strabismus surgery for X(T) affects ADHD symptoms. MATERIALS AND METHODS: Fifty-one consecutive children undergoing muscle surgery for X(T) were prospectively recruited. One parent of each child completed the ADHD rating scale IV (ADHD RS-IV) assessment consecutively before and one year after surgery. Patients whose preoperative scores were above the cut-off point, the 90th percentile based on a Korean sample, were regarded as demonstrating the ADHD trait. The impact of muscle surgery on ADHD symptoms was assessed by comparing the preoperative scores with the post-operative scores. RESULTS: Eight (15.7%) of the 51 patients demonstrated the ADHD trait. ADHD RS-IV scores following strabismus surgery significantly decreased in patients with the ADHD trait (p=0.014), while they did not differ in patients without the ADHD trait. Seven (87.5%) of the 8 patients with the ADHD trait showed improvement in their ADHD RS-IV scores after surgery. There was no difference in surgical success rates between X(T) patients with and without the ADHD trait. CONCLUSION: The ADHD trait was relatively common in children with X(T), and the parent-reported symptoms of the children with the ADHD trait improved after strabismus surgery. These results suggest that childhood X(T) may be one contributing factor to ADHD- related symptoms.ope

Impact of laser refractive surgery on ocular alignment in myopic patients.

PURPOSE: To evaluate the impact of myopic keratorefractive surgery on ocular alignment. METHODS: This prospective study included 194 eyes of 97 myopic patients undergoing laser refractive surgery. All patients received a complete ophthalmic examination with particular attention to ocular alignment before and 3 months after surgery. RESULTS: Patients with a mean age of 26.6 years and a mean refractive error of -4.83 diopters (D) myopia were treated. Asymptomatic ocular misalignment was present preoperatively in 46 (47%) patients: a small-angle heterophoria (1-8 prism diopters, PD) in 36%; and a large-angle heterophoria (>8 PD)/heterotropia in 11%. Postoperatively, the change in angles of 10 PD or greater occurred in 3% for distance and 6% for near fixation: in 7% of the patients with orthophoria, in 3% of those with a small-angle heterophoria, and in 18% of those with a large-angle heterophoria/heterotropia. No patient developed diplopia. The preoperative magnitude of myopia or postoperative refractive status was not related to the change in ocular alignment. The higher anisometropia was associated with a decrease in deviation (P=0.041 for distance and P=0.002 for near fixation), whereas the further near point of convergence tended to be related with an increase in near deviation (P=0.055). CONCLUSIONS: Myopic refractive surgery may cause a change in ocular alignment, especially in cases with a large-angle heterophoria/heterotropia. There is also a chance of improvement of misalignment in patients with anisometropia.ope

Two cases of mirror-image eye anomalies in monozygotic twins

We report two cases of mirror image anomalies in two different pairs of monozygotic twins. In case 1, the twins exhibited mirroring of strabismus and refractive errors. Twin 1 had 35 prism diopters (PD) right intermittent exotropia at distant fixation and myopic anisometropia that was spherical 2.00 diopters more myopic in the right eye. Twin 2 had 35 PD left intermittent exotropia at distant fixation and her left eye was more myopic by - spherical 1.00 diopters. In case 2, the twins were diagnosed with infantile nystagmus with upbeat jerk. Twin 1 exhibited a habitual head turn of 30° to the left with dampening of her nystagmus in dextroversion. Twin 2 also exhibited abnormal head position, but in his case the habitual turn was 30° to the right. We believe that this is the first report describing mirror imaged intermittent exotropia with anisometropia and infantile nystagmus with opposite abnormal head positions in pairs of monozygotic twins.ope

urgical Management of Concurrent Strabismus and Face Turn in Patients with Infantile Nystagmus

Purpose: To investigate the effect of adjusted Kestenbaum surgery in patients with idiopathic infantile nystagmus who were affected by both strabismus and face turn. Methods: This retrospective consecutive case series included 12 patients with infantile nystagmus who had face turn and strabismus. All patients underwent adjusted Kestenbaum surgery between 1996 and 2014, and primary outcome measures were the postoperative degree of face turn and strabismus. Results: All patients had jerky nystagmus with compensatory face turn and strabismus. Of the 12 patients, eight patients were exotropes and four patients were esotropes. The mean age at surgery was 12.5 ± 10.7 years (range, 2-36 years). The mean postoperative follow-up was 17.8 ± 12.0 months (range, 7-43 months). Surgery was successful in eight (66.7%) out of 12 patients. Improvement of anomalous head posture was satisfactory in all patients, but an angle of deviation within 10 prism diopters was not achieved in four patients. Conclusions: Adjusted Kestenbaum surgery simultaneously improved both ocular misalignment and face turn with one-stage surgery. Two or three rectus muscles surgery can be considered in these patients because it is not only simpler than four muscles surgery but also can preserve one or two rectus muscles.ope

Sporadic Congenital Oculomotor Apraxia Associated with Ataxia

Purpose: To evaluate the natural clinical course of sporadic congenital oculomotor apraxia associated with ataxia. Methods: In a retrospective study from June 1994 to March 2004, 3 patients with sporadic congenital oculomotor apraxia associated with ataxia were evaluated. Oculomotor apraxia and ataxia were checked. Results: The three patients with sporadic congenital oculomotor apraxia associated with ataxia showed a decrease in head thrust which can be found specifically in oculomotor apraxia, and an improvement of oculomotor apraxia and ataxia over the 10-year observation period. Conclusions: A favorable natural clinical course can be expected in a case of sporadic congenital oculomotor apraxia associated with ataxia in the absence of any clinical evidence of inheritance or genetic abnormality.ope

Recession-resection surgery augmented with botulinum toxin a chemodenervation for paralytic horizontal strabismus.

In this case series study, we assessed the effects of recession-resection surgery augmented with botulinum toxin A chemodenervation for patients with chronic paralytic horizontal strabismus. In addition, we compared these effects with those of full tendon transposition (FTT) augmented with posterior intermuscular suture (PIMS). Ten patients who underwent strabismus surgery due to paralytic horizontal strabismus were retrospectively reviewed. They received a recession-resection surgery augmented with botulinum toxin A chemodenervation (type I surgery) or a FTT augmented with PIMS (type II surgery). The preoperative angle of deviation (AOD) and postoperative improvement in AOD were compared according to the type of procedure. The preoperative AOD was 60.00 ± 28.50 prism diopters (PD) for type I surgery and 68.00 ± 27.06 PD for type II (p = 0.421). Improvement in AOD was 53.20 ± 25.01 PD for type I surgery and 44.20 ± 18.74 PD for type II (p = 0.548). Recession-resection surgery augmented with botulinum toxin A chemodenervation is a concise and effective procedure for treating paralytic horizontal strabismus.ope

Enhanced expression of transglutaminase 2 in anterior polar cataracts and its induction by TGF-B in vitro

Background/aims: Transglutaminase activity has long been implicated in the cataract formation. However, the precise mechanism of how it is produced and involved in this process remains unclear. Here the authors sought to examine whether transglutaminase 2 (TGase 2) is expressed in lens epithelial cells from patients with anterior polar cataracts, to determine whether TGase 2 expression is induced by transforming growth factor (TGF-β) in cultured lens epithelial cells, and to determine whether TGase 2 participates in the crosslinking of fibronectin in lens epithelial cells in vitro. Methods: Lens epithelial cells from anterior polar cataracts, nuclear cataracts, and non-cataractous clear lenses were examined for the expression of TGase 2 using reverse transcription-polymerase chain reaction, western blot analysis, and immunohistochemical analysis. The modulation of extracellular TGase 2 activity by TGF-β was measured by the formation of fibronectin polymers and the incorporation of fluorescein cadaverine into extracellular matrix proteins. The effect of TGase 2 overexpression was analysed by immunofluorescence staining and western blot analysis of human lens epithelial (HLE) B-3 cells transiently transfected with TGase 2 gene. Results: The expression of TGase 2 mRNA and its protein was markedly enhanced in lens epithelial cells from patients with anterior polar cataracts. Treatment of HLE B-3 cells with TGF-β caused an increase in TGase 2 protein, its extracellular activity, and the crosslinking of fibronectin. Transient transfection of HLE B-3 cells with the TGase 2 gene led to the increased production of fibronectin monomers and polymers. Conclusions: This study shows that TGase 2 is overexpressed in lens epithelial cells from anterior polar cataracts and that TGF-β may be a causative factor in the induction of TGase 2. The enhanced expression of TGase 2 might cause the accumulation and crosslinking of the extracellular matrix proteins and might play a part in anterior polar cataract development.ope

Effect of tanshinone IIA in an in vitro model of Graves’ orbitopathy

PURPOSE: We investigated the therapeutic effect of nontoxic concentrations of tanshinone IIA (TanIIA) from Salvia miltiorrhiza in primary cultures of orbital fibroblasts from Graves' orbitopathy (GO). METHODS: The effect of TanIIA on IL-1β-induced proinflammatory cytokine (IL-6, IL-8, MCP-1) expression was determined by real-time PCR. Antioxidant activity was investigated by measuring intracellular reactive oxygen species (ROS) generation stimulated by cigarette smoke extract (CSE) and heme oxygenase-1 (HO-1) expression. To evaluate antiadipogenic activity, fibroblasts were subjected to a differentiation protocol, including peroxisome proliferator activator gamma (PPARγ) agonist, for 10 days, and exposed to TanIIA during adipocyte differentiation. Differentiated cells were stained with Oil Red O, and the expression of adipogenesis-related factors, PPARγ, and CCAAT-enhancer-binding proteins (C/EBP) α and β were determined by Western blot. RESULTS: Expression of IL-6, IL-8, and MCP-1 mRNA was inhibited by TanIIA pretreatment in a dose-dependent manner in GO orbital fibroblasts (P < 0.05). Tanshinone IIA decreased CSE- or H2O2-induced ROS levels in a dose-dependent manner and upregulated HO-1 protein expression in a time- and dose-dependent manner (P < 0.001). Treatment of orbital fibroblasts with TanIIA increased phosphorylated extracellular signal-regulated kinase (pERK), and an ERK inhibitor significantly blocked TanIIA-induced HO-1 upregulation. Adipogenesis was inhibited by TanIIA in a dose-dependent manner (P < 0.001), as evidenced by Oil Red O stain and decreased PPARγ and C/EBPα expression in Western blot analysis. CONCLUSIONS: Our study results suggest that TanIIA possesses significant anti-inflammatory, antioxidant, and antiadipogenic effects in primary orbital fibroblasts. These results provide the basis for further study of the potential use of TanIIA to treat GO. Tanshinone IIA showed significant anti-inflammatory, antioxidant, and antiadipogenic effects in primary orbital fibroblasts from Graves' orbitopathy patients. These results provide the basis for further study of the potential use of tanshinone IIA to treat Graves' orbitopathy.ope