ABSTRACT
PURPOSE: To evaluate the results of overminus lens therapy in the management of children with intermittent exotropia or X(T). METHODS: In this retrospective study, 163 consecutive patients with X(T) who were treated with overminus spectacles with at least 12 months of follow-up were included in the study. The outcome measures were the level of X(T) control evaluated using the Jampolsky's qualitative assessment method and refractive error changes under overminus lens treatment. RESULTS: The mean angle of deviation at the initial visit was 24.7 ± 15.1 prism diopters (PD) that improved to 10.6 ± 4.2 PD with overminus glasses with a median follow-up of 38 months (P = 0.02). One hundred and nine patients (66.8%) achieved good controlled X(T) or orthotropia by overminus lens therapy after 1 year. Three patients progressed to esotropia, which disappeared after discontinuing overminus lens therapy. Overminus lens therapy did not have a statistically significant effect on the mean spherical equivalent of cycloplegic refraction in each eye (right eye: P = 0.13; left eye: P = 0.15). CONCLUSIONS: Overminus lens therapy can be effective for improving the control of X(T) in young children. It can defer the requirement for surgery or decrease the rate of surgical intervention.
ABSTRACT
PURPOSE: To assess the use of temporal artery biopsy (TAB) in diagnosing giant cell arteritis (GCA) and to evaluate patients' clinical and laboratory characteristics. METHODS: We conducted a retrospective chart review of patients with suspected GCA who underwent TAB and had complete workup in a tertiary center in Iran between 2008 and 2017. The 2016 American College of Rheumatology (ACR) revised criteria for early diagnosis of GCA were used for each patient for inclusion in this study. RESULTS: The mean age of the 114 patients in this study was 65.54 ± 10.17 years. The mean overall score according to the 2016 ACR revised criteria was 4.17 ± 1.39, with 5.82 ± 1.28 for positive biopsies and 3.88 ± 1.19 for negative biopsies (p <0.001). Seventeen patients (14.9%) had a positive biopsy. Although the mean post-fixation specimen length in the biopsy-positive group (18.35 ± 6.9 mm) was longer than that in the biopsy-negative group (15.62 ± 8.4 mm), the difference was not statistically significant (P = 0.21). There was no statistically significant difference between the groups in terms of sex, serum hemoglobin, platelet count, and erythrocyte sedimentation rate. There were statistically significant differences between the biopsy-negative and biopsy-positive groups with respect to patients' age and C-reactive protein level (P < 001 and P = 0.012, respectively). CONCLUSION: The majority of TABs were negative. Reducing the number of redundant biopsies is necessary to decrease workload and use of medical services. We suggest that the diagnosis of GCA should be dependent on clinical suspicion.
