The selective vulnerability of retinal ganglion cells in rat chronic ocular hypertension model at early phase.

Glutamate neurotoxicity has been postulated to play a prominent role in glaucoma. In this study the possible roles of two subunits of glutamate receptors during the early phase of retinal ganglion cell (RGC) loss in a rat chronic ocular hypertension (COH) model were investigated. COH was induced by applying argon laser to the episcleral and limbal veins of the right eye of rats, the observation times were at 4, 14 and 28 days after the first laser. RGCs were retrogradely labeled by putting Fluoro-Gold (FG) on the surface of both side superior colliculus. Immunohistochemical staining using specific antibodies against N-methyl-D-aspartate receptor 1 (NR1) or glutamate receptor 2/3 (GluR2/3) was performed on the retinal sections of normal and COH eyes. Fluorescent images were captured using confocal laser scanning microscope and the number of NR1 and GluR2/3 labeled cells were counted and cell size was measured using Stereo Investigator. During the observation period, the numbers of NR1 and GluR2/3 positive RGCs in the RGC layer were reduced parallel to the loss of RGC. The dramatic loss of GluR2/3 immunoreactive neurons occurred starting immediately after the first laser to 4 days while the dramatic loss of NR1 immunoreactive neurons occurred from 14 to 28 days after the first laser. Size difference was detected in NR1 immunoreactive RGCs, large ones were more sensitive to the high ocular pressure. These results suggest that both NR1 and GluR2/3 are involved in the mediation of RGC death in the early stage of COH.

An unusual complication after strabismus surgery.

Orbital cellulitis is rarely reported after strabismus surgery; fewer than 10 cases have been reported. Nonetheless, orbital cellulitis is a potentially sight- and life-threatening condition. A high index of suspicion, use of a multidisciplinary approach, early diagnosis, aggressive treatment, and close monitoring are all important means of avoiding potentially irreversible visual loss and systemic complications. We report a case where early use of aggressive treatment to manage a post-strabismus surgery infection led to a good outcome.

Serous retinal detachment in Joubert syndrome.

This report describes a 3-year-old Chinese-Italian boy with Joubert syndrome. Fundus examination showed bilateral optic disc coloboma. Left serous retinal detachment was also found. This ocular finding was not reported in the previous literature. Although Joubert syndrome has many variable phenotypes and the molecular basis is still unknown, the newly reported ocular features suggest that a different genetic form may be present.

Spontaneous carotid cavernous fistula in a pediatric patient: case report and review of literature.

A 14-year-old boy presented with spontaneous, painless proptosis of the right eye. Computed tomography and digital subtraction angiography revealed an indirect carotid cavernous fistula. Because there were no sight-threatening complications, we adopted a conservative approach. The condition resolved 1 month after initial presentation, with angiographically confirmed spontaneous obliteration of the fistula.

Topical autologous serum promotes enucleation wound healing in retinoblastoma patients.

Two retinoblastoma patients underwent uneventful enucleations while undergoing perioperative chemotherapy. In both cases the postoperative course was complicated by poor conjunctival wound healing. Administration of topical autologous serum was associated with wound healing and conjunctivalization of these wounds.

SR and LR Union Suture for the Treatment of Myopic Strabismus Fixus: Is Scleral Fixation Necessary?

PURPOSE: To evaluate and compare the effectiveness of scleral fixation SR and LR union suture and nonscleral fixation union suture for the treatment of myopic strabismus fixus. METHODS: Retrospective review of 32 eyes of 22 patients with myopic strabismus fixus who had undergone union suture of superior rectus (SR) and lateral rectus (LR) with or without scleral fixation, and follow-up longer than 6 months at Hong Kong Eye Hospital from 2006 to 2013. Surgical techniques and outcomes in terms of ocular alignment are analyzed. RESULTS: There is significant overall improvement both in postoperative angle of esodeviation (P < 0.01) and postoperative range of movement (P = 0.042). Comparing between the sclera fixation group (11 eyes) versus nonscleral fixation group (21 eyes), the postoperative horizontal deviation, the postoperative vertical deviation, successful outcome, and the change in horizontal deviation were not significantly different (P > 0.05). CONCLUSIONS: Union suture of SR and LR is an effective procedure in correcting myopic strabismus fixus. Fixation of the union suture to the sclera does not improve surgical outcome.

Photographic essay. Anterior segment optical coherence tomography findings of early capsular block syndrome.

Capsular block syndrome (CBS) or capsular bag distension syndrome is characterized by distension of the capsular bag after uneventful phacoemulsification and endocapsular intraocular lens implantation. The syndrome has also been reported after extracapsular cataract extraction and intraocular lens placed in the sulcus. We report the anterior segment optical coherence tomographic findings in a case of early postoperative CBS. Anterior segment optical coherence tomographic aids in the diagnosis and management of CBS.