Predictive analysis of maxillary canine impaction through sella turcica bridging, ponticulus posticus calcification, and lateral incisor anomalies: a retrospective observational study

Maxillary canine impaction is an increasing dental anomaly and is often related to other dento-skeletal anomalies. The aim of this work is to support the clinician in evaluating the relationship between a displaced maxillary canine and clinical (the features of lateral incisors)/skeletal (ponticulus posticus and sella turcica bridging) anomalies through orthopanoramic radiographs, lateral cephalograms, and plaster casts to identify the parameters that best predict maxillary canine impaction. A retrospective observational study was carried out on the analysis of the medical records, radiographic findings (panoramic radiographs and lateral cephalograms), and plaster casts of 203 orthodontic patients divided into a case group, with at least one impacted maxillary canine, and a control group, without an impaction. A chi-square test and logistic regression analysis were used to analyze the data. A statistically significant association was found between the impaction of the maxillary canine and the female sex, the bridging of the sella turcica, the ponticulus posticus calcification, and the anomaly of the lateral incisor; a logistic regression revealed that these significant variables were found to be positive predictors of impacted maxillary canines, particularly in reference to the impaction in the palatal area. Finding one of these clinical and radiographic elements can represent a predictive sign of the possible impaction of the maxillary canine

Visual acuity and contrast sensitivity: AcrySof ReSTOR apodized diffractive versus AcrySof SA60AT monofocal intraocular lenses

PURPOSE: To compare the visual acuity and contrast sensitivity in eyes with the AcrySof ReSTOR multifocal intraocular lens (IOL) (Alcon) and eyes with the monofocal AcrySof SA60AT IOL. SETTING: Policlinico Umberto I, Department of Ophthalmology, Rome, and private clinical practice, Rome, Italy. METHODS: One hundred eyes had phacoemulsification cataract extraction and implantation of a ReSTOR multifocal OIL in the capsular bag. Inclusion criteria were corneal astigmatism less than 1.5 diopters (D), myopia less than 4.0 D, and no associated ocular disease. A complete ophthalmic examination, including uncorrected visual acuity, best spectacle-corrected visual acuity, and contrast sensitivity, was performed 6 months postoperatively. Results were compared with those in 40 eyes with the AcrySof monofocal IOL single-piece IOL. RESULTS: In the multifocal group, 90 eyes (90%) had an uncorrected distance visual acuity of 20/25 or better (logMAR <0.10) and an uncorrected near visual acuity at 35 cm of J3 or better (logMAR 0.14). The multifocal group and monofocal group had similar distance uncorrected and best corrected visual acuities; however, the multifocal group had significantly better near uncorrected acuity. The mean contrast sensitivity values were 18.28 dB (static program) and 17.95 dB (dynamic program) in the multifocal group and 19.18 dB (static program) and 21.2 dB (dynamic program) in the monofocal group. CONCLUSIONS: The ReSTOR multifocal IOL provided a satisfactory full range of vision; 92% of the patients achieved total spectacle independence. Contrast sensitivity was lower than with the SA60AT monofocal IOL

Considerazioni su di un caso di aracnoidite ottico-chiasmatica.

Gli A.A. studiano l' evoluzione di un caso di aracnoidite ottico-chiasmatica. Vengono presi in considerazione le possibilità e i limite della terapia medica e chirurgica. Particolare attenzione viene rivolta alla difficoltà di una diagnosi precoce, cardine essenziale per una prognosi favorevole

Early detection of macular changes with multifocal ERG in patients on antimalarial drug therapy

Purpose: To compare and to evaluate the use of the multifocal electroretinography (mfERG) to conventional systems in assessing early changes of the retinal electric signals in patients with ocular dysfunction due to antimalarial drug therapy. Methods: This article represents an up-to-date review of the current thoughts regarding the mfERG technique and its use in providing a topographic measure of the retinal electrophysiological activity. Results: Various investigations have been suggested to be useful in the assessment of toxic retinopathy, but, since they involve subjective responses by the patients and lack of sensibility, the mfERG may be particularly useful for documenting early toxic retinopathy. Conclusions: A small percentage of patients face retinal functional alterations and ocular lesions and that is possible thanks to the use of lower dosages of hydroxychloroquine (Hy) and chloroquine (CQ), but the problem still remains because of the cumulative dose of the drugs in therapy that many of these patients go through. The mfERG can be considered a good method of early detection and tracking of the progression of macular changes of retinopathy and could occupy a key position in assessing macular changes in patients on antimalarial drug therapy

Hess area ratio and diplopia: Evaluation of 30 patients undergoing surgical repair for orbital blow-out fracture

PURPOSE: To determine if the Hess area ratio is effective in predicting postoperative diplopia in patients undergoing surgery for orbital blow-out fracture. METHODS: Our retrospective, interventional case series study involved 30 consecutive cases affected by orbital fractures and diplopia undergoing surgical correction within 7 days after injury. To evaluate ocular motility disturbance, we measured the involved ocular motility range by use of a manual Hess screen test before and 4 months after surgery. The percentage of Hess area ratio % was used to express the range of ocular motility in a numerical value. RESULTS: All patients with preoperative Hess area ratio >85% had no postoperative diplopia, and most patients (57%) having a preoperative Hess area ratio <65% had postoperative diplopia. When the Hess area ratio was between 65% and 85%, surgical outcomes were variable and most patients (55%) described no problematic diplopia in the peripheral visual field. CONCLUSIONS: The Hess area ratio is a useful procedure to convert Hess graphic representation in a numerical value so that Hess chart data can be compared among clinicians and used to predict surgical outcomes in patients undergoing surgery for orbital blow-out fractures. © 2009 The American Society of Opthalmic Plastic and Reconstructive Surgery, Inc

Problemi di chirurgia oculare nella sindrome di Lowe.

Si descrive un caso di Sindrome di Lowe con presenza di cataratta e dermoide corneale associato. Si mettono in evidenza le problematiche di chirurgia oculare