Relationship between optical coherence tomography findings and clinical variables in patients with opiate use disorder / Relação entre os achados da tomografia de coerência óptica e as variáveis clínicas em pacientes com transtorno por uso de opiáceos

ABSTRACT Purpose: This study aimed to examine optical coherence tomography findings in patients with opiate use disorder by comparing them with healthy controls. Methods: The study included 30 opiate use disorder patients and 30 controls. The participants' detailed biomicroscopic examinations, visual acuity, intraocular pressure, and both eye examinations were evaluated. A total of 120 eyes were evaluated using optical coherence tomography, measuring the central macular thickness, mean macular thickness, mean macular volume and retinal nerve fiber layer thickness. Moreover, all participants filled in the demographic data form and Barratt Impulsiveness Scale. Results: Upon examination of the optical coherence tomography findings, central macular thickness, mean macular thickness, and mean macular volume were thinner in both eyes in patients with opiate use disorder (p<0.01 in all measurements in both eyes). Similarly, the total values of the superior quadrant and retinal nerve fiber layer thickness were statistically significant in both eyes compared to that in the control group (p=0.007, p=0.002; p=0.049, p=0.007, in the right and left eyes, respectively). Only the left eye was positively correlated with retinal nerve fiber layer superior quadrant measurement and hospitalization (r=0.380, p=0.039). Conclusion: Our results revealed that the patients' central macular thickness, mean macular thickness, and mean macular volume values were thinner. Increase in the retinal nerve fiber layer thickness superior quadrant thickness and total value was also observed. Further studies with larger sampling groups that evaluate neuroimaging findings should be conducted.

RESUMO Objetivo: O objetivo foi investigar foi, os achados da tomografia de coerência óptica em pacientes com transtorno do uso de opiáceos, comparando-os com controles saudáveis. Métodos: O estudo incluiu 30 pacientes com transtorno do uso de opiáceos e 30 controles. Os exames biomicroscópicos detalhados de todos os participantes, acuidade visual, pressão intraocular e ambos os exames oculares foram avaliados com tomografia de coerência óptica. Um total de 120 olhos foram avaliados usando tomografia de coerência óptica, e a espessura macular central, espessura macular média, volume macular médio e a espessura da camada de fibra nervosa da retina dos participantes foram medidos. Além disso, todos os participantes preencheram o Formulário de Dados Demográficos e a Escala de Impulsividade Barratt (BIS-11). Resultados: Quando os achados de tomografia de coerência óptica foram examinados, espessura macular central, espessura macular média e volume macular médio eram mais finos de acordo com controles saudáveis em ambos os olhos em pacientes com transtorno do uso de opiáceos (p<0,01 em todas as medições em ambos os olhos). Da mesma forma, os valores totais do quadrante superior e espessura da camada de fibra nervosa da retina estavam mais em níveis estatisticamente significativos em ambos os olhos em comparação com o grupo controle (p=0,007, p=0,002; p=0,049, p=0,007, no olho direito e esquerdo, respectivamente). Estar internado em hospital e apenas a medida do quadrante superior da espessura da camada de fibra nervosa da retina do olho esquerdo associou-se positivamente (r=0,380, p=0,039). Conclusão: Em nossos resultados, descobrimos que os valores de espessura macular central, espessura macular média e volume macular médio dos pacientes eram mais finos. Verificamos também espessamento no quadrante superior e valor total da espessura da camada de fibra nervosa da retina. Nosso estudo deve ser apoiado por novos estudos com grupos de amostragem maiores, nos quais os achados de neuroimagem são avaliados.

Macroscopic morphological aspects, ecometry and rebound tonometry of the eye bulb in sloth (Bradypus variegatus) / Aspectos morfológicos macroscópicos, ecometria e tonometria de rebote do bulbo ocular em bicho-preguiça (Bradypus variegatus)

The field related to the visual system of wild animals is deeply scarce. Settling anatomical and physiological parameters for these animals is still a descriptive vision for Bradypus variegatus (Schinz, 1825). Thus, our research aimed to determine patterns of normal eye for this species. For this purpose, eight eye bulbs were dissected from the carcasses obtained by natural death, and then performed an overview of ocular anatomical. Rebound tonometry (RBT) and ocular B-mode ultrasonography were also applied for eight eyes in four animals from "Parque Estadual Dois Irmãos", situated in the city of Recife, state of Pernambuco (PE), to estimate the intraocular pressure and ocular ecobiometry. The ocular morphology of sloth is similar as described for other species, however, with some peculiarities. They present a third eyelid emerging in the nasal region of the inferior conjunctival sac and retina and also contain little differentiated blood vessels. Medium the intraocular pressure (IOP) was 4.25mmHg with no difference for both eyes. Ultrasonography of ocular anatomy is also similar regarding other species. Ecobiometric patterns were evaluated to determine the anterior chamber depth, lens width, vitreous chamber depth, and axial length (AL) of ocular globe and the averaged as shown 0.63±1.11mm, 3.73±0.24mm, 6.15±0.41mm, 3.70±0.27mm, and 8.48±0.22mm, respectively. There was no difference between the right and left eyes. The RBT and ocular B-mode ultrasonography are fast exams and easy for animal testing. This study contributed to the characterization of ocular anatomy as well as settling medium values of IOP and intraocular measures; however, further research on physiology and histology is necessary to better understand the visual function of the species.(AU)

O campo de estudo relacionado ao sistema visual de animais silvestres é muito escasso. Estabelecer parâmetros anatômicos e fisiológicos para estes animais ainda está restrito a uma visão descritiva, assim ocorre em Bradypus variegatus (Schinz, 1825). Diante deste fato, objetivou-se com este estudo determinar padrões de normalidade oftálmica nesta espécie. Para isto foram dissecados oito bulbos oculares de cadáveres obtidos por morte natural e realizada a descrição anatômica ocular. Além disso, foram realizadas tonometria de rebote (TonoVet®) e ultrassonografia em modo B em oito olhos de quatro animais provenientes do Parque Estadual Dois Irmãos, Recife/PE, para avaliação da pressão intraocular e realização da ecobiometria ocular. A anatomia ocular do bicho-preguiça é semelhante à descrita para outras espécies com algumas particularidades. Apresentam uma terceira pálpebra emergindo na região nasal do saco conjuntival inferior e retina com vasos sanguíneos pouco diferenciados. A pressão intraocular média foi de 4,25mmHg não havendo diferença entre os olhos direito e esquerdo. A anatomia ocular ultrassonográfica é semelhante à encontrada para outras espécies. Os padrões ecobiométricos obtidos foram: profundidade da câmara anterior, espessura do cristalino, diâmetro do cristalino, profundidade da câmara vítrea e comprimento axial do bubo ocular com tamanhos médios de 0,63±1,11mm, 3,73±0,24mm, 6,15±0,41mm, 3,70±0,27mm e 8,48±0,22mm, respectivamente. Não houve diferença entre os olhos direito e esquerdo. A tonometria de rebote e a ultrassonografia ocular em modo B são exames de rápida e fácil execução, sendo bem tolerados pelos animais. Este estudo contribuiu para a caracterização anatômica ocular e para o estabelecimento de valores médios da pressão intraocular e das medidas intraoculares, no entanto são necessárias outras pesquisas na área da fisiologia e histologia para melhor compreensão da função visual da espécie.(AU)

Comparison of Preoperative and Postoperative Ocular Biometry in Eyes with Phakic Intraocular Lens Implantations

PURPOSE: To compare preoperative and postoperative ocular biometry in patients with iris-fixated phakic intraocular lens (pIOLs): Artisan and Artiflex. MATERIALS AND METHODS: This study included 40 eyes with Artisan and 36 eyes with Artiflex pIOL implants. Anterior chamber depth (ACD) and axial length (AL) were measured by applanation ultrasonography (A-scan) and partial coherence interferometry (IOLMaster) preoperatively and 3 months after pIOL implantation. RESULTS: ACD measurements after Artisan or Artiflex pIOL implantation were smaller than preoperative measurements. Specifically, the difference after Artisan pIOL implantation was -1.07+/-0.17 mm by A-scan and -0.08+/-0.08 mm by IOLMaster. The difference after Artiflex pIOL implantation was -1.31+/-0.15 mm by A-scan and -0.05+/-0.07 mm by IOLMaster. After Artisan pIOL implantation, differences in AL measurements by A-scan were insignificant (difference: -0.03+/-0.15 mm), whereas postoperative AL measurements by IOLMaster were significantly longer than preoperative measurements (difference: 0.12+/-0.07 mm). After Artiflex pIOL implantation, AL measurements by both A-scan and IOLMaster were significantly longer than preoperative measurements (difference: 0.09+/-0.16 mm by A-scan and 0.07+/-0.10 mm by IOLMaster). In the Artiflex group, differences in AL measurements by A-scan correlated with the central thickness of the Artiflex pIOL. CONCLUSION: ACD and AL measurements were influenced by iris-fixated phakic IOL implantation.

Aspergillus endophthalmitis in orthotopic liver transplantation.

In this report, we describe a patient with drug-induced liver failure who developed endogenous endophthalmitis after liver transplantation. Our patient's clinical course was so fulminant that the eye was lost in less than 1 month, without any response to therapy. Recognition of this infection is important because many patients die of disseminated Aspergillus infection, which may be detected early with bedside funduscopic examination by an ophthalmologist. Probably if the patient had referred to us earlier, it may have been possible to save the eye.

Ocular volume determination in Nigerians

To determine the ocular volume in healthy Nigerian eyes. This was a cross-sectional descriptive study of volunteers, staff and students of University of Benin Teaching Hospital [UBTH] and University of Benin, Nigeria. Measurements of the eyeball were taken on the B-mode image using a Medison's Sonoace 1500 ultrasound machine using a 6.5 MHz curvi-linear transducer placed over the closed eyelid. The vertical, horizontal and axial diameters of the eyes of healthy subjects were measured and used to compute the ocular volumes. The age and sex of the subjects were also recorded. Two hundred subjects comprising 125 females [62%] and 75 males [38%] were included in the study. The age range was 3-92 years and overall mean age was 41.48 +/- 23.26 years for both sexes. The mean eyeball volume was slightly larger for males than for females. [Males: Right eye=10.64ccm3, Left eye=10.37ccm3; Females: Right eye=10.59 ccm[3], Left eye=10.19 ccm[3]]. The difference was not statistically significant [P= 0.229]. The right eyeball volume was higher on the right for both males and females but the difference was not statistically significant [P= 0.198]. There was a gradual increase in eyeball volume with age. This study was able to generate normal eyeball volumes in a sample of Nigerians which hopefully will serve as reference for normal values in Black Africans

Síndrome do seio silencioso: relato de caso e revisão da literatura / Silent sinus syndrome: case report and literature review

O objetivo deste trabalho é relatar um caso de síndrome do seio silencioso e revisar os aspectos mais importantes para o diagnóstico e tratamento. A síndrome do seio silencioso é uma entidade clínica rara caracterizada por enoftalmia espontânea e por hipoglobus associados a atelectasia do seio maxilar, que requer tratamento cirúrgico. O diagnóstico é usualmente acidental durante a investigação radiológica de pacientes com enoftalmia. A endoscopia nasal pode apresentar um padrão característico com colapso lateral da concha média e apófise unciforme. Usualmente observa-se uma retração importante da fontanela posterior do seio maxilar comprometido. O tratamento é cirúrgico, objetivando a aeração do seio maxilar comprometido para o meato médio por meio de antrostomia. O óstio natural de drenagem do seio comprometido deve ser incluído na antrostomia, para evitar o fenômeno de recirculação de muco. O mesmo apresentou evolução favorável pós-cirúrgica com follow-up de 1 ano sem progressão da enoftalmia. Conclui-se que a síndrome do seio silencioso é uma patologia rara, que deve ser incluída no diagnóstico diferencial de enoftalmia. Os achados de imagem com envolvimento da órbita e do seio maxilar confirmam o diagnóstico, e o tratamento exige a aeração cirúrgica do seio comprometido

This paper aims to report a case of silent sinus syndrome and to review importantaspects related to the diagnosis and the treatment of this condition. The silent sinus syndrome is a rare disorder characterized by spontaneous enopthtalmos and hypoglobus associated to maxillary sinus atelectasis that requires surgical treatment. The diagnosis might be suspected during the investigation of enophtalmos. Nasal endoscopy might present a classical pattern with lateral collapse of the middle turbinate and the uncinate process. A severe retraction of the posterior fontanelle might also be noted. Treatment is surgical and aims to ventilate the maxillary sinus through the middle meatus antrostomy. The antrostomy must include the natural ostium in order to prevent mucus re-circulation phenomenon. The patient reported in this study showed 1 year post-surgery a excellent result with no progression of the enophtalmos. We conclude that the silent sinus syndromeis a rare entity that must be included in the differential diagnosis of nophtalmos. Image findings with orbital and maxillary sinus involvement confirms the diagnosis and that the treatment requires surgical ventilation of the compromised sinus

Relations between Age, Weight, Refractive Error and Eye Shape by Computerized Tomography in Children

PURPOSE: To investigate relationships between age, weight, refractive error, and morphologic changes in children's eyes by computerized tomography (CT). METHODS: Of the 772 eyes of 386 patients under the age of 20 years, who visited our Department of Ophthalmology between January 2005 to August 2006 and underwent CT of the orbit, 406 eyes of 354 patients with clear CT images and normal eyeball contour were enrolled in the present retrospective study. The axial lengths, widths, horizontal and vertical lengths, refractive errors, and body weight of eyes were measured, and relationship between these parameters were investigated. RESULTS: Axial length was found to correlate significantly with eye width (r=0.914), and in emmetropic eyes and myopic eyes, axial lengths and widths were found to increase as age and body weight increased. Axial lengths increased rapidly until age 10, and then increased slowly. In emmetropic eyes, widths / axial lengths increased with age, but in myopic eyes these decreased as age or severity of myopia increased. Moreover, as age increased, the myopic population and severity also increased. CONCLUSIONS: The axial length was longer in case of myopia compared to emmetropia in all age groups and there was almost no difference in the increase rate of axial length by the age of myopia and emmetropia. However, the width was wider in case of myopia compared to emmetropia in all age groups and the increase rate of width in myopia by age was smaller than that of emmetropia. Myopia showed decreasing rate of width/axial length with increase of age, from 1.004 in 5 years to 0.971 in 20 years. However, emmetropia showed increasing rate of width/axial length with increase of age, from 0.990 in 5 years to 1.006 in 20 years.

Combined chemoreduction and adjuvant therapy for management of intraocular retinoblastoma

The aim of the current study is to investigate the effectiveness of combined chemoreduction and local ophthalmic therapy for treatment of intraocular retinoblastoma with the goal of avoiding enucleation and/or external beam radiotherapy [EBRT]. This is a prospective non - randomized study. Fifty-seven eyes were followed in 43 children with intraocular retinoblastoma who attended to the pediatric unit of Kasr El-Aini Center of Radiation Oncology and Nuclear Medicine [NEMROCK] during the period from March 2002 till March 2004. Eiligible patients were treated with a six-cycle protocol of vincristine, etoposide, and carboplatin [VEC]. When maximum retinal tumors regression was achieved, adjuvant treatment [thermotherapy or cryotherapy] was delivered without randomization to the smallest possible tumor volume in an effort, if possible, to avoid enucleation and/or EBRT. The mean age of the patients at presentation was 27.69 months [range 1-96 months]. The Reese-Ellsworth classification included, group I non, group II in 6 eyes [10.5%], group III in 13 eyes [22.8%], group IV in 21 eyes [36.9%], and group IV in 17 eyes [29.8%]. In 35 eyes combined chemoreduction and local ophthalmic therapy were successful in terms of avoidance of enucleation and/or EBRT, with a success [globe salvage] rate of 61.4%. All Reese-Ellsworth group II and III eyes responded to the conservative approach, whereas only 12/21 [57.1%] and 4/17[23.5%] of group IV and V eyes respectively, responded. Seven eyes [12.3%] required EBRT, 5 eyes [8.8%] required enucleation and 10 eyes [17.5%] required a combination of EBRT and enucleation. Event-free survival [i.e, free of EBRT or enucleation] for the study population at one year was 50.8%. In retinoblastoma patients with Reese-Ellsworth eye groups 1, 2, or 3, systemic chemotherapy used with local ophthalmic therapies can eliminate the need for enucleation or EBRT without significant systemic toxicity. More effective therapy is required for Reese-Ellsworth eye groups 4 and 5

Interpretation of computed tomography imaging of the eye and orbit. A systematic approach.

Computed tomography (CT) has revolutionised the diagnosis and management of ocular and orbital diseases. The use of thin sections with multiplanar scanning (axial, coronal and sagittal planes) and the possibility of three-dimensional reconstruction permits thorough evaluation. To make the most of this technique, users must familiarize themselves with the pertinent CT principles and terminology. The diagnostic yield is optimal when the ophthalmologist and radiologist collaborate in the radiodiagnostic workup. In this article we describe a systematic approach to the interpretation of ocular and orbital CT scans.

Localization of intraocular and intraorbital foreign bodies using computed tomography

Accurate localization of foreign bodies in the region of the orbit is vital for correct management. Computed tomography is recommended as the investigation of choice following a plain radiograph in cases of suspected ocular injury by a metallic foreign body

Fishhook injury of the eye: a case report

Eye injuries caused by fishhooks are rare but there have been reports in the past with the hook either abrading the cornea or piercing the lid, orbital tissues or the eyeball. This is a case report of an Omani boy admitted with a penetrating injury of the left eyeball caused by a fishhook. The hook was successfully removed after surgically extending the wound. The wound was anterior and damage to the choroid and retina was minimal which helped in the restoration of normal vision, the child was followed up for a period of more than two years without any complications

spectroscopic study on the importance of NADH in eye lenses

The present work illustrated the importance of NADH in case of one of the oxidative stresses, cataracta nuclearis. The results showed that, the average amount of NADH existed in healthy [control] lens is about 70.18 mug/100 mg of lens. This value decreased as the cataract progresses. The amount of NADH reaches to about 1.32 mug/100 mg of lens in case of advanced stage of cataract. It is also found that, the average amount of NAD increases from about 8.98 mug in healthy lens to 13.32 mug/100 mg of lens in case of matura cataractous lens. The work also elucidated the importance of the spectroscopic studies in detection and progression of any biological abnormality

Ocular biometry in fullterm newborns

This study was designed to evaluate parameters of eye size in fullterm newborns in our region of the world, and to compare these values for the two sexes. Two hundred fullterm infants [110 male, 90 female], born by uncomplicated vaginal delivery were subjected to an ophthalmological examination including ocular ultrasound biometry on both eyes within 24 hours after birth. The following data were elicited, expressed as mean +/- standard deviation: duration of gestation 40.1 +/- 1.3 weeks, birth weight 3.29 +/- 0.407 kg; body length 51.1 +/- 2.08 cm; and head circumference 34.59 +/- 1.56 cm. Regarding the eye: axial length 16.94 +/- 0.488 mm; depth of the anterior chamber 2.49 mm +/- 0.201 mm; and lens thickness 3.45 mm +/- 0.297 mm. There was a statistically significant difference in the measured parameters of eye size between male female innnfants in our sample. Our results did not significantly from those of surveys performed on other populations in the world

Ultrasonographic findings in eyes with complicated and traumatic cataract

Inability to examine the posterior segment ophthalmoscopically in eyes with cataractous lens makes sonography a helpful tool in hands of ophthalmologists to get an idea about the structures behind the lens. In this work 71 eyes with complicated cataract and 27 eyes with traumatic were examined clinically and both A, B scan were performed to all of them. We found 27 cataractous eyes complicated to iridocyclities, 15 due to degenerative myopia, one of them showed retinal detachment, 14 eyes due to neglected retinal detachment, 10 eyes due to glaucoma, and 5 eyes due to diabetes mellitus. In traumatic cataract 14 eyes had penetrating injury, 9 had blunt and 5 bad retained intraocular foreign bodies

Pars plicata lensectomy in soft cataract

Pars plicata lensectomy is a suitable operation for cataracts occurring in infants and young ages, rather than planned extracapsular technique which result in capsular clouding, or limbal approach which may result in corneal damage and difficulties in complete removal of lens material