Spectral domain optical coherence tomography for early detection of retinal alterations in patients using hydroxychloroquine

Objective: To determine whether early toxic effects from hydroxychloroquine (HCQ) could be detected by spectral-domain optical coherence tomography (SD-OCT) before symtomatic visual loss occured. Materials and Methods: Fifteen subjects with a history of the chronic use of hydroxychloroquine monotherapy for less than five years without fundus changes (group 1) and 15 visually normal healthy subjects (group 2) were enrolled in this study. All participants underwent systemic and ocular examination, visual field testing, and macular scan imaging using SD-OCT. Results: There were no significant differences in sex and ages between the groups (P > 0.05). Mean duration of HCQ usage in group 1 was 2.5 ± 1.34 (range:1-5) years. Visual field testing with central 10-2 threshold program was normal in all subjects. Inner retinal thickness in parafoveal and perifoveal area were found to be significantly lower in group 1 compared to group 2 (P < 0.01 for perifoveal, P < 0.05 for parafoveal retinal measurements). However, significant thinning was demonstrated only in full retinal thickness of perifoveal area in group 1 compared to group 2 (P: 0.013). Parafoveal and perifoveal inner retinal thickness measurements of inferior quadrants were significantly reduced in group 1 compared to group 2 (P < 0.01). Conclusion: Significant thinning of inner retinal layer especially in parafoveal and perifoveal areas in the absence of clinical fundus changes was observed in our study. We consider that SD-OCT may determine when inner retinal thinning starts in these patients and may contribute a quantitative approach to the early diagnosis and progression of retinal changes

Amniotic membrane in the management of strabismus reoperations

WOS: 000316146900015PubMed ID: 23233195To reduce postoperative scar formation and to improve duction using amniotic membrane (AM) in strabismus reoperations. A prospective study of interventional case series comprised of 14 patients with restrictive strabismus. Objective clinical findings (visual acuity, angle of deviations and degree of duction deficits) were recorded in both the pre- and post-operative periods. Strabismus surgery included the excision of adhesions and scar tissue, repositioning of extraocular muscles (according to the degree of deviations) and placement of two sheets, one between muscle and tenon and the other between muscle and sclera. Conjunctival recession with covering of the bare sclera using AM was also performed. The mean preoperative deviation of the patients was 34.3 prism diopters (PD) and mean post-operative deviation was 4.6 PD. The mean pre-operative duction deficit of the patients was 1.7; mean post-operative duction deficit was 0.2. Postoperatively all patients improved in relation to deviation and duction. Less than 8 PD deviations with no duction deficits were achieved in 12 (86 %) of the patients. Amniotic membrane placement around the extraocular muscle improves the duction and decreases the residual angle of deviations by inhibiting postoperative scar formation

CONCOMITANT CUTANEOUS METASTATIC TUBERCULOUS ABSCESSES AND MULTIFOCAL SKELETAL TUBERCULOSIS

Tuberculosis, one of the oldest diseases known to affect humans is caused by the bacteria mycobacterium tuberculosis. The disease usually affects the lungs, although, in up to one third of cases, other organs are involved. Metastatic tuberculosis abscess is a rare form of skin tuberculosis. It is characterized by nodule and abscess formation throughout the body after hematogenous spread of mycobacterium tuberculosis from a primary focus during a period of impaired immunity. Tuberculosis osteomyelitis is also a rare form of extrapulmonary tuberculosis in pediatric age group. Skeletal tuberculosis pathogenesis is related to reactivation of hematogenous foci or spread from adjacent paravertebral lymph nodes. Weight-bearing joints are affected most commonly. Bilateral hand and foot bone involvement is rarely reported. We present a five-year-old girl with two very rare presentations of the disease such as osteomyelitis and metastatic skin abscess

The Morpho-functional Evaluation of Retina in Amblyopia

Purpose: To investigate the morphological or functional differences of retina in amblyopia

Structural and functional comparison of the persistent and resolved amblyopia

To assess structural or functional differences of the retina among subjects with persistent and resolved amblyopia

Tear Nitric Oxide Levels in Behcet's Disease

The aim of this study was to evaluate the tear nitric oxide (NO) level in patients with Behcet's disease and to compare it with that in healthy subjects