Demographic and Clinical Profile of Pediatric Uveitis in Delta Region, Egypt.

PURPOSE: Pediatric uveitis poses unique challenges, characterized by difficulties in performing comprehensive examinations, potential delays in diagnosis, and a heightened risk of ocular complications. This study evaluate the etiologic and clinical characteristics of uveitis in children presenting to the Mansoura Ophthalmic Center, Mansoura, Egypt. METHODS: A cross-sectional observational study was undertaken involving children diagnosed with uveitis attending the uveitis outpatient clinic at Mansoura University Ophthalmic Center. Comprehensive clinical evaluations were carried out, including detailed history taking and exhaustive ophthalmological examinations. Whenever deemed necessary, Spectral Domain Optical Coherence Tomography (OCT) and Fluorescein Fundus Angiography (FFA) were utilized to secure retinal images. An extensive systemic evaluation was also conducted to discern the diverse causes of uveitis among the participants. RESULTS: The cohort comprised 63 children, impacting 97 eyes. Bilateral involvement was seen in 54% of cases, with a male predominance of 58.7%. The predominant etiologies of uveitis were presumed trematode-induced (36.7%), Juvenile Idiopathic Arthritis (JIA) accounting for 28.6%, and in 12.7% of cases, the cause remained undetermined. Anterior uveitis emerged as the primary presentation in 79.4% of cases. Regarding visual loss, cataract was the leading cause at 56.4%, followed by vitritis at 38.4%, and macular edema at 20.5%. CONCLUSION: Anterior uveitis was the most frequent presentation in our pediatric cohort. Despite the challenges, the majority of children with uveitis exhibited no significant visual impairment, with most causes of visual loss being reversible.

Characteristics of Childhood Presumed Trematode-Induced Granulomatous Anterior Uveitis Using Ultrasound Biomicroscopy.

PURPOSE: To investigate the UBM characteristics of presumed trematode-induced granulomatous uveitis. DESIGN: Prospective case series. METHODS: Thirty patients who presented with anterior chamber (AC) granuloma were included. UBM Imaging included Cornea, iris, AC angle, posterior chamber, ciliary body, and vitreous base. RESULTS: Thirty eyes were included with a mean age of 12.4 ± 2.5 years. UBM findings were retrocrneal membrane (33%), sub conjunctival nodule (10%), AC granuloma (100%); peripheral anterior synechia, granuloma-like lesion in posterior chamber; ciliary body edema with localized granuloma at specific site (100%), cataract in 30% either localized or generalized, and dot or thread-like high reflection on vitreous base in (20%). CONCLUSION: Presumed trematode-induced AC granuloma is common among children living in the rural areas of Egypt. UBM examinations can demonstrate various pathologic changes of anterior segment of the eye and provide objective evidence for the exact origin of those granulomas.

Assessment of Corneal Densitometry in Big-Bubble Dissection Versus Manual Dissection Deep Anterior Lamellar Keratoplasty.

PURPOSE: The aim of this study was to assess corneal densitometry and visual outcomes after big-bubble deep anterior lamellar keratoplasty (BB-DALK) and manual dissection deep anterior lamellar keratoplasty in patients with keratoconus. METHODS: This retrospective comparative observational study included 40 keratoconic patients who underwent DALK surgery: 22 eyes had BB-DALK (group I) and 18 eyes had failed BB technique and DALK was completed by manual dissection (group II). Best -corrected visual acuity (BCVA), corneal topographic parameters, residual stromal tissue thickness, and endothelial cell count were recorded at 1, 3, 6, and 12 months postoperatively. Densitometric analysis of different corneal layers and zones was performed using Scheimpflug tomography at each visit; values were recorded and compared between the 2 groups. RESULTS: At 1 and 6 months postoperatively, BCVA was better in group I than in group II, but with no statistically significant difference. At 12 months, the visual acuities became nearly similar in both groups (0.30 ± 0.13 vs. 0.30 ± 0.14 logarithm of the minimum angle of resolution, P = 0.888). Regarding corneal densitometric analysis, the recorded values for the posterior corneal layer were significantly higher in group II compared with group I at 3, 6, 9, and 12 months postoperatively in the 0- to 2-mm zone (P < 0.001) and the 2- to 6-mm zone (P = 0.029, 0.028, 0.001, and <0.001). CONCLUSIONS: Manual dissection DALK after failed BB technique may affect the interface stromal reflectivity up to 12 months postoperatively. However, this does not significantly affect the visual acuity in comparison with successful BB-DALK.

A new protocetid whale offers clues to biogeography and feeding ecology in early cetacean evolution.

Over about 10 million years, the ancestors of whales transformed from herbivorous, deer-like, terrestrial mammals into carnivorous and fully aquatic cetaceans. Protocetids are Eocene whales that represent a unique semiaquatic stage in that dramatic evolutionary transformation. Here, we report on a new medium-sized protocetid, Phiomicetus anubis gen. et sp. nov., consisting of a partial skeleton from the middle Eocene (Lutetian) of the Fayum Depression in Egypt. The new species differs from other protocetids in having large, elongated temporal fossae, anteriorly placed pterygoids, elongated parietals, an unfused mandibular symphysis that terminates at the level of P3, and a relatively enlarged I3. Unique features of the skull and mandible suggest a capacity for more efficient oral mechanical processing than the typical protocetid condition, thereby allowing for a strong raptorial feeding style. Phylogenetic analysis nests Phiomicetus within the paraphyletic Protocetidae, as the most basal protocetid known from Africa. Recovery of Phiomicetus from the same bed that yielded the remingtonocetid Rayanistes afer provides the first clear evidence for the co-occurrence of the basal cetacean families Remingtonocetidae and Protocetidae in Africa. The discovery of Phiomicetus further augments our understanding of the biogeography and feeding ecology of early whales.

Sites of highest predictability for neurodegeneration in patients with type 2 diabetes mellitus without diabetic retinopathy.

PURPOSE: Identifying earlier retinal thickness affection and predictability for diabetic retinal neurodegeneration (DRN) in patients with type 2 diabetes mellitus (DM2) without diabetic retinopathy (DR). PATIENTS AND METHODS: This is a comparative cross-sectional study. Thirty-eight eyes of 19 patients with DM2 without any signs of DR and 38 eyes of 19 controls underwent retinal evaluation using optical coherence tomography. Macular ganglion cell layer (GCL), macular retinal nerve fiber layer (mRNFL), inner plexiform layer (IPL), total macular thickness, peripapillary retinal nerve fiber layer (pRNFL) and Bruch's membrane opening-minimum rim width (BMO-MRW) were evaluated. RESULTS: GCL showed significant thickness reduction in the total, superior and inferior halves as well as the 9 ETDRS regions (except the nasal and lower outer regions). The mRNFL showed a significant reduction in the total, superior and inferior halves as well as the lower and nasal outer regions. The IPL showed significant reduction in the 4 inner regions only. The pRNFL showed significant reduction in the total, superotemporal and inferotemporal sectors values. The BMO-MRW did not show any significant thickness change. CONCLUSION: The total, superior and inferior GCL and mRNFL, in addition to the global pRNFL were the most affected and predictive layers for DRN in patients with DM type 2 without DR. It appears that the GCL is the primary site of DRN and the rest of the changes represented a degeneration of the axonal path between the optic disk and the macular GCL.

Horizontal Extraocular Muscle Insertion Site in Relation to Axial Length Using Swept-Source Anterior Segment OCT.

PURPOSE: The purpose of this study was to correlate between the axial length of the globe and the insertion site of horizontal extraocular muscles using swept-source anterior segment optical coherence tomography (SS-ASOCT), with posing an equation to calculate the muscle insertion site from the axial length. METHODS: The study design was observational and cross-sectional. It was performed on 157 eyes of 157 healthy subjects. The distance of the medial rectus (MR) and the lateral rectus (LR) insertion sites from the limbus were measured using SS-ASOCT. The insertion sites' distances were correlated to the axial length (hypermetropes < 22.5 mm, myopes > 24.5). Correlation between numerical variables was done by Pearson's correlation coefficient and confirmed by linear regression analysis and scatter diagrams. RESULTS: The mean MR insertion site was 5.47 ± 0.19 mm in hypermetropes versus 5.68 ± 0.23 mm in myopes, whereas the mean LR insertion site was 6.81± 0.23 mm in hyperopes versus 7.08 ± 0.16 mm in myopes. The axial length showed a moderate positive, but significant, correlation to the insertional position for the medial and lateral rectus muscles (MR: r=0.417, p<0.001; LR: r=0.410, p<0.001). CONCLUSION: Comparing the horizontal extraocular muscle insertion site to axial length using SS-ASOCT showed a significant positive correlation. The model equation for MR insertion: MR (mm) = 4.522 + 0.045 (AXL in mm) with an R = 0.437, R2= 0.191, F=12.071, P<0.001. The model equation for LR insertion: LR (mm) = 5.72 + 0.048 (AXL in mm) with an R = 0.438, R2= 0.192, F=12.116, P<0.001.

Retinal thickness as a potential biomarker of neurodegeneration and a predictor of early cognitive impairment in patients with multiple sclerosis.

OBJECTIVES: The purpose of this research is to predict the cognitive impairment and to determine its correlation with retinal thickness, mainly (RFNL and GCIPL) in cases of multiple sclerosis. METHODS: 60 multiple sclerosis patients and 30 age and sex-matched healthy controls were included in this study. Cognitive functions were evaluated in all study participants by the Montreal Cognitive Assessment (MoCA). OCT imaging was done to determine the thickness. The correlation between the cognitive domains of MoCA and the thickness of the retinal nerve fiber layers was analyzed by Spearman correlation. ROC curve was constructed to determine the cut-off points for retinal thickness, and a binary logistic regression was performed to determine the independent predictive capacity of established cut-off points. RESULTS: Impaired cognition was found in 26 MS patients (43.3%). Cognitively impaired patients were significantly older (P < 0.05), had significantly longer disease duration (P < 0.05), had higher average EDSS scores (4.3 ± 1.22 vs 3.1 ± 1.45, P < 0.001), and occurred more in progressive types of MS (P < 0.001). A significant positive correlation was found between cognitive function and RNFL thickness and GCIPL (P < 0.001). The retinal thickness (RNFL and GCIPL) cut-off points established for the prediction of cognitive impairment in MS patients were 79 µm and 76 µm, respectively. CONCLUSION: The clear correlation between cognitive impairment and atrophy of inner retinal layers (RNFL and GCIPL) proposes that OCT is valuable in evaluating the neurodegeneration and prediction of early cognitive impairment in MS. ABBREVIATIONS: EDSS: Expanded Disability Status Scale; HCs: Healthy controls; GCIPL: Ganglion cell-inner plexiform layer; ILM: Internal limiting membrane; INL:  Inner nuclear layer; MoCA: Montreal Cognitive Assessment; MS: Multiple sclerosis; PPMS: Primary progressive multiple sclerosis; RNFL:  Retinal nerve fiber layer; RRMS: Relapsing-remitting multiple sclerosis; SD: Standard deviations; SPMS: Secondary progressive multiple sclerosis; SPSS: Statistical Package for the Social Sciences.

Serum and aqueous humor concentrations of interleukin-27 in diabetic retinopathy patients.

PURPOSE: Interleukin (IL)-27 has been reported to possess anti- and proinflammatory properties in several immune related-disorders, but its role in diabetic retinopathy is still elusive. Here, we aimed to (i) evaluate IL-27 concentrations in serum and aqueous humor of diabetic patients with or without retinopathy and (ii) test whether IL-27 is correlated with some risk factors of diabetic retinopathy. METHODS: The study comprised 60 diabetic patients with and without retinopathy along with 20 healthy controls. Serum and aqueous humor concentrations of IL-27 were assessed by ELISA. RESULTS: The mean of IL-27 concentration in aqueous humor in patients with diabetic retinopathy (6.7 ± 2.7 ng/L) was significantly elevated in comparison with either diabetic patients without retinopathy (4.6 ± 0.5 ng/L) or healthy control group (4.1 ± 0.8 ng/L). Besides, IL-27 concentration in aqueous humor was positively correlated with serum glucose, lipid profile and glycated hemoglobin (HbA1c). CONCLUSIONS: Based on this study, IL-27 is implicated in the pathogenesis of diabetic retinopathy and positively correlates with the disorder progression.

Perforated punctal plugs with adjuvant use of mitomycin-C in management of acquired external punctal stenosis grades 0 and 1.

OBJECTIVE: To evaluate the use of perforated punctal plugs with adjuvant application of mitomycin-C in the management of acquired external punctal stenosis grades 0 and 1. METHODS: This is a prospective interventional case series including 30 eyes of 30 patients with acquired external punctal stenosis of the lower punctum of grades 0 and 1 presenting with epiphora. They were examined to exclude other causes of lacrimation and epiphora: Slit-lamp assessment of the stenosed punctum and grading was done, probing was done to exclude associated canalicular stenosis, and syringing was done to exclude nasolacrimal duct obstruction. For all cases, dilatation was done, followed by application of mitomycin-C, and perforated punctal plugs were then inserted. Plugs were removed after 6 months, and anatomical and functional success were assessed and followed during and for 6 months after removal of the plugs. RESULTS: The study included 30 patients with acquired external punctal stenosis: 9 males (30%) and 21 females (70%) with a mean age of 62.83 ± 8.3 years. Punctal stenosis grade 0 (no punctum) occurred in 9 cases (30%), and grade 1 (the punctum is covered by a membrane) occurred in 21 cases (70%). Six months after removal of the plugs, epiphora improved in 93.3% of patients, and fluorescein dye disappearance test results improved in 90% of patients; 6.7% of cases had early extrusion of the plug, and 3.3% had granuloma formation. CONCLUSIONS: Application of perforated punctal plugs combined with mitomycin-C is a simple and efficient technique in the management of tight acquired external punctal stenosis.

Macular choroidal thickness in normal Egyptians measured by swept source optical coherence tomography.

BACKGROUND: To provide a normal database of choroidal thickness (CT) in nine Early Treatment Diabetes Retinopathy Study (ETDRS) subfields in Egypt using deep-range imaging swept source optical coherence tomography (DRI SS OCT). METHODS: This study included a total of 129 eyes of 71 normal Egyptian subjects, comprising 63 males and 66 females. The mean age was 36.85 ± 14.22 years (range, 16-67 years). The mean axial length was 23.84 ± 0.78 mm. CT was measured in nine subfields as defined by the ETDRS-style grid using a DRI SS OCT, and line measurements of subfoveal choroidal thicknesses (SFCT) were also performed. RESULTS: Mean SFCT was 300.87 ± 72.256 µm for ring measurements and 319.72 ± 76.45 µm for line measurements (P = 0.04). CT was higher in the superior and temporal quadrants than the inferior and nasal quadrants. A negative correlation between subfoveal choroidal thickness and age was detected in all regions (P < 0.001) except the nasal quadrant. A negative correlation between the SFCT and axial length was also detected (P < 0.001). Males tended to have a thicker choroid than females; however, the difference was not significant. CONCLUSIONS: DRI SS OCT provides a topographic map of choroidal thickness with an ETDRS layout. This study establishes, for the first time, a normal database for CT in the Egyptian population. Age and axial length were associated with choroidal parameters in healthy subjects. Line measurements of the SFCT differed significantly from SFCT ring measurements, so it is recommended that each method be compared independently.

Correlation Between En Face Optical Coherence Tomography Defects of the Inner Retinal Layers and Ganglion Cell Inner Plexiform Layer Analysis After Internal Limiting Membrane Peeling for Idiopathic Full-Thickness Macular Hole.

PURPOSE: The purpose of this study was to report en face optical coherence tomography (OCT) inner retinal changes after internal limiting membrane (ILM) peeling for idiopathic full-thickness macular hole (IFTMH) and to correlate these findings with macular ganglion cell inner plexiform layer (GC-IPL) analysis. METHODS: This prospective study included 20 patients with IFTMH treated using pars plana vitrectomy with ILM peeling. All patients were analyzed using en face OCT at 6 months after surgery to determinate the effect of ILM peeling on the inner retinal layers. Correlation between the GC-IPL en face OCT findings and that obtained by three-dimensional volumetric OCT scanning also was performed. RESULTS: Seven patients (35%) showed defects in the retinal nerve fiber layer (RNFL) that appeared as multiple dark dots with no visible defects at the GC-IPL, either with en face OCT or 3D volumetric OCT scanning. Thirteen patients (65%) showed a similar combination of RNFL defects and well-circumscribed defects in the underlying GC-IPL. These defects could be visualized on en face OCT display, and they correlated with areas of GC-IPL thinning detected in the 3D volumetric OCT scanning. CONCLUSIONS: With ILM peeling, en face OCT scanning showed two forms of inner retinal layers changes. The first form was the concentric macular dark spots (CMDS) with intact GC-IPL. The second form appeared in the CMDS with evident localized defects in the underlying GC-IPL. These defects correlate with the areas of GC-IPL thinning detected using 3D volumetric OCT scanning.

Functional anatomical, histological and ultrastructural studies of three chameleon species: Chamaeleo chamaeleon, Chamaeleo africanus, and Chamaeleon vulgaris / Estudios anatómicos, histológicos y ultraestructurales funcionales de tres especies de camaleón: Chamaeleo chamaeleon, Chamaeleo africanus, y Chamaeleon vulgaris

Three chamaeleon species including Chameleon Chamaeleo chamaeleon, Chameleon Chamaeleo africanus, and Chamaeleon vulgaris were collected and their tongue were dissected and examined morphologically and investigated using light and scanning electron microscopy. Both species showed similar histological manifestation of lingual papillae and tubular glands with dense mucous secretion especially in Chamaeleon vulgaris. There is no keratinization of lingual surfaces. Ultrastructurally, filliform represent the only pattern of lingual pappillae and take either cylindrical, conical and leaflet structure.Although the examined chalmaeleon species collected from different habitat, it shows almost similarities in their histological and ultrastructural structures.

Fueron recolectadas tres especies de Camaleón incluyendo Camaleón Chamaeleo chamaeleon, Camaleón Chamaeleo africanus y Chamaeleon vulgaris. Se disecó su lengua y examinó morfológicamente mediante el uso de microscopía de luz y electrónica de barrido. Ambas especies mostraron características histológicas similares en relación a las papilas linguales y glándulas tubulares con secreción mucosa densa, especialmente el Chamaeleon vulgaris. No hubo queratinización de las superficies linguales. Ultraes-tructuralmente, el único patrón de papilas linguales fue el filiforme, tomando una estructura ya sea cilíndrica, cónica y de hoja. Aunque las especies de Camaleón examinadas se recogieron de diferentes hábitat, ellas mostraron similitudes en su estructura histológica y ultraestructural.

Neurotoxicological effects of nicotine on the embryonic development of cerebellar cortex of chick embryo during various stages of incubation.

Long-acting nicotine is known to exert pathological effects on almost all tissues including the cerebellar cortex. The present work was designed to elucidate the effect of nicotine on the development of cerebellar cortex of chick embryo during incubation period. The fertilized eggs of hen (Gallus gallus domesticus) were injected into the air space by a single dose of long acting nicotine (1.6 mg/kg/egg) at the 4th day of incubation. The embryos were taken out of the eggs on days 8, 12 and 16 of incubation. The cerebellum of the control and treated embryos at above ages were processed for histopathological examination. The TEM were examined at 16th day of incubation. The results of the present study revealed that, exposure to long-acting nicotine markedly influence the histogenesis of cerebellar cortex of chick embryo during the incubation period. At 8th day of incubation, nicotine delayed the differentiation of the cerebellar analge; especially the external granular layer (EGL) and inner cortical layer (ICL). Furthermore, at 12th day of incubation, the cerebellar foliation was irregular and the Purkinje cells not recognized. By 16th day of incubation, the cerebellar foliations were irregular with interrupted cerebellar cortex and irregular arrangement of Purkinje cells. Immunohistochemical analysis for antibody P53 protein revealed that the cerebellar cortex in all stages of nicotine treated groups possessed a moderate to weak reaction for P53 protein however; this reaction was markedly stronger in the cerebellar cortex of control groups. Moreover, the flow cytometric analysis confirmed that the percentage of apoptosis in control group was significantly higher compared with that of nicotine treated group. At the TEM level, the cerebellar Purkinje cells of 16th day of treated groups showed multiple subcellular alterations in compared with those of the corresponding control group. Such changes represented by appearing of vacuolated mitochondria, cisternal fragmentation of RER, irregular grooves of Golgi tubules. Also, multiple cytoplasmic vacuoles and aggregation of Nissl granules were recorded around pyknotic nucleus.

Multifocal electroretinography and optical coherence tomography changes after repeated intravitreal bevacizumab (Avastin) in myopic choroidal neovascularization.

PURPOSE: The purpose of this study was to evaluate the short-term efficacy and safety of repeated intravitreal bevacizumab for myopic choroidal neovascularization. METHODS: We performed a prospective, nonrandomized, interventional case series study. Sixteen eyes from 16 patients with myopic choroidal neovascularization secondary to pathologic myopia had a monthly injection of intravitreal bevacizumab 1.25 mg for 3 consecutive months. Best-corrected visual acuity assessment, optical coherence tomography, fluorescein angiography and multifocal electroretinogram were performed before treatment and at 1, 2, 3, and 6 months. RESULTS: The mean logarithm of minimum angle of resolution best-corrected visual acuity was 1.43 before treatment. At 6 months after treatment, the mean best-corrected visual acuity improved significantly (P = 0.02) to 0.7. Fluorescein angiography demonstrated absence of leakage in 14 eyes (87.5%) and persistent but decreased leakage in the remaining 2 eyes (12.5%). Optical coherence tomography showed a highly significant reduction in the foveal central thickness (P < 0.001) at all follow-up visits. The foveal and parafoveal rings showed a significant improvement in the multifocal electroretinogram responses. At the sixth month follow-up, the P1 amplitudes and implicit time P values in the foveal and parafoveal rings were <0.01 and <0.001, respectively. None of the remaining three rings showed any significant change throughout the study period. CONCLUSION: In 6-month follow-up, repeated injections of intravitreal bevacizumab were effective in treating myopic choroidal neovascularization. No adverse effect was detected on retinal function evaluated by multifocal electroretinogram.

Studies on tongue of reptilian species Psammophis sibilans, Tarentola annularis and Crocodylus niloticus / Estudios sobre la lengua de las especies de reptiles Psammophis sibilans, Tarentola annularis y Crocodylus niloticus

Three different reptilian species Psammophis sibilans (Order Ophidia), Tarentola annularis (Order Squamata and Crocodylus niloticus (Order Crocodylia) are used in the present study. Their tongue is removed and examined morphologically. Their lingual mucosa examined under scanning electron microscopy (SEM) as well as processed for histological investigation. Gross morphological studies revealed variations of tongue gross structure being elongated with bifurcated end in P. sibilans or triangular flattened structure with broad base and conical free border in T. annularis or rough triangular fill almost the floor cavity in C. niloticus. At SEM, the lingual mucosa showed fine striated grooves radially arranged in oblique extension with missing of lingual papillae. Numerous microridges are detected above the cell surfaces in P. sibilans. T. annularis exhibited arrangement of conical flattened filiform papillae and abundant of microridges. However in C. niloticus, the lingual mucosa possessed different kinds of filiform papillae besides gustatory papillae and widespread arrangement of taste buds. Histologically, confirmed SEM of illustrating the lingual mucosa protrusion of stratified squamous epithelium in P. sibilans and presence of apical taste buds in conical filiform papillae of T. annularis. The lingual mucosa of C. niloticus revealed different forms of both filiform and gustatory papillae.

En el presente estudio fueron utilizados tres diferentes especies de reptiles Psammophis sibilans (Orden Ophidia), Tarentola annularis (Orden Squamata y Crocodylus niloticus (Orden Crocodylia). Sus lenguas fueron removidas y examinadas morfológicamente. Las mucosas linguales se examinaron bajo microscopio electrónico de barrido (SEM) y también procesadas para la investigación histológica. El estudio morfológico macroscópico reveló variaciones de la estructura de la lengua, siendo éstas alargadas con el extremo bifurcado en P. sibilans o de estructura triangular aplanada con una base amplia y el borde libre cónico en T. annularis o triangular rugosa llenando casi todo el suelo de la cavidad en C. niloticus. En el SEM, la mucosa lingual mostró finas ranuras estriadas dispuestas radialmente en la extensión oblicua con pérdida de las papilas linguales. Numerosas microcrestas fueron detectadas por encima de la superficie de las células en P. sibilans. T. annularis exhibiendo una disposición de papilas filiformes cónicas aplanadas y abundante de microcrestas. Sin embargo, en C. niloticus, la mucosa lingual posee diferentes tipos de papilas filiformes además de papilas gustativas con una extensa disposición de corpúsculos gustativas. Histológicamente, mediante confirmación de SEM se ilustra la protrusión del epitelio escamoso estratificado de la mucosa lingual en P. sibilans y la presencia de corpúsculos gustativos apicales en las papilas filiformes cónicas de T. annularis. La mucosa lingual de C. niloticus reveló diferentes formas de ambas papilas, filiformes y gustativas.

Detection of macular changes by optical coherence tomography after inferior oblique muscle surgery.

PURPOSE: To detect macular changes after inferior oblique muscle myectomy and anterior transposition by the use of 3-dimensional optical coherence tomography (OCT). METHODS: Patients who received surgery for correction of horizontal strabismus and weakening of inferior oblique muscle overaction were included. OCT was performed shortly before surgery and again 1 day, 1 week, and 1 month postoperatively. RESULTS: A total of 23 eyes of 16 patients were included. OCT showed no significant macular changes after inferior oblique myectomy or anterior transposition. CONCLUSIONS: We documented no harmful effects on the macula after manipulation of the inferior oblique muscle during standard weakening procedures.