Infliximab-induced retrobulbar optic neuritis in a patient with ankylosing spondylitis.

Objective: To present a case with infliximab-induced retrobulbar optic neuritis. Case description: A 58-year-old woman presented to our clinic with a two-day history of blurred vision in her right eye. She had numerous uveitis attacks previously, and she was on infliximab treatment for ankylosing spondylitis. Her best-corrected visual acuity was counting fingers and 20/25 in the right and left eye, respectively. Optic discs seemed healthy in fundoscopic examination. The right optic nerve showed high signal intensity on magnetic resonance imaging (MRI). Infliximab treatment was discontinued and systemic steroid therapy was started. After the treatment her best-corrected visual acuity improved to 20/20 in her right eye. Conclusion: Infliximab is a chimeric human-murine monoclonal antibody used in autoimmune diseases. Optic neuritis is a rare but important side effect of infliximab. Thus, infliximab-induced optic neuritis should be kept in mind for patients receiving infliximab treatment.

The Role of Real-Time Elastography in the Differential Diagnosis of Salivary Gland Tumors.

OBJECTIVES: The aim of the study was to scrutinize the value of qualitative elastography in the diagnosis of salivary gland masses. METHODS: Sixty patients were enrolled in this prospective study. Patients aged between 1 and 91 years (mean age, 48.8 ± 20.48) with a salivary gland mass were studied with real-time elastography. All patients were examined by 1 examiner, blinded to all relevant data. On elastography, masses were scored into 4 types according to their stiffness compared to normal tissue. Scores of 3 and 4 were accepted as signs of malignancy. Sensitivity, specificity, and positive and negative predictive value were calculated for elastography in verifying malignancy. RESULTS: Forty-two percent of the masses were located in the parotid, and the rest in submandibular gland. The diameter of the lesions varied between 12 and 60 mm (mean, 24.36 ± 11.98 mm). Forty-four masses were benign (73%), and among them the majority were inflammatory lesions (31 of 60; 51.7%). There were 16 malignant lesions (27%). On elastography, not only all malignant lesions but 15 benign lesions were scored as 3 to 4. All masses scored as 1 to 2 were benign. Sensitivity was 100%; specificity, 66%; positive predictive value, 52%; and negative predictive value, 100%. When only Score 4 lesions were accepted as malignant, these values became 75%, 77%, 55%, and 90%, respectively. CONCLUSIONS: Elastography alone cannot be used to discriminate malignant from benign in the evaluation of salivary gland lesions. However, with its high negative predictive value, it may be used as an adjunct tool to increase the diagnostic value of ultrasonography.

Ophthalmic adverse effects of nasal decongestants on an experimental rat model.

PURPOSE: To investigate the potential effects of chronic exposure to a nasal decongestant and its excipients on ocular tissues using an experimental rat model. METHODS: Sixty adult male Wistar rats were randomized into six groups. The first two groups were control (serum physiologic) and Otrivine® groups. The remaining four groups received the Otrivine excipients xylometazoline, benzalkonium chloride, sorbitol, and ethylene diamine tetra acetic acid. Medications were applied into both nostrils twice a day for 8 weeks. Before the rats were sacrificed, epithelial staining, the Schirmer test, and intraocular pressure measurements were performed under ketamine/xylasine anesthesia (50 and 5 mg/kg, respectively). RESULTS: Epithelial defects and dry eye were common findings in all study groups. Cataracts developed in two cases clinically. Histopathological evaluation revealed many different pathological alterations in all parts of the ocular tissues such as corneal edema, polypoid proliferation and hyalinization of the vessel wall, cystic formation of the lens, retinal nerve fiber layer degeneration, and corpora amylacea formation of the lacrimal gland. CONCLUSIONS: Prolonged usage of the nasal decongestant xylometazoline and its excipients may cause ophthalmic problems such as dry eyes, corneal edema, cataracts, retinal nerve fiber layer, and vascular damage in rats. Although these results were obtained from experimental animals, ophthalmologists should keep in mind the potential ophthalmic adverse effects of this medicine and/or its excipients and exercise caution with drugs containing xylometazoline, ethylene diamine tetra acetic acid, benzalkonium chloride and sorbitol for patients with underlying ocular problems.

Ophthalmic adverse effects of nasal decongestants on an experimental rat model / Efeitos oftálmicos adversos de descongestionantes nasais em modelo experimental com ratos

ABSTRACT Purpose: To investigate the potential effects of chronic exposure to a nasal decongestant and its excipients on ocular tissues using an experimental rat model. Methods: Sixty adult male Wistar rats were randomized into six groups. The first two groups were control (serum physiologic) and Otrivine® groups. The remaining four groups received the Otrivine excipients xylometazoline, benzalkonium chloride, sorbitol, and ethylene diamine tetra acetic acid. Medications were applied into both nostrils twice a day for 8 weeks. Before the rats were sacrificed, epithelial staining, the Schirmer test, and intraocular pressure measurements were performed under ketamine/xylasine anesthesia (50 and 5 mg/kg, respectively). Results: Epithelial defects and dry eye were common findings in all study groups. Cataracts developed in two cases clinically. Histopathological evaluation revealed many different pathological alterations in all parts of the ocular tissues such as corneal edema, polypoid proliferation and hyalinization of the vessel wall, cystic formation of the lens, retinal nerve fiber layer degeneration, and corpora amylacea formation of the lacrimal gland. Conclusions: Prolonged usage of the nasal decongestant xylometazoline and its excipients may cause ophthalmic problems such as dry eyes, corneal edema, cataracts, retinal nerve fiber layer, and vascular damage in rats. Although these results were obtained from experimental animals, ophthalmologists should keep in mind the potential ophthalmic adverse effects of this medicine and/or its excipients and exercise caution with drugs containing xylometazoline, ethylene diamine tetra acetic acid, benzalkonium chloride and sorbitol for patients with underlying ocular problems.

RESUMO Objetivo: Investigar os possíveis efeitos da exposição crônica de descongestionante nasal e seus excipientes em tecidos oculares, utilizando um modelo experimental com ratos. Métodos: Sessenta ratos Wistar adultos machos foram divididos aleatoriamente em seis grupos. Os primeiros dois grupos foram controle (soro fisiológico) e Otrivina®. Os quatro grupos restantes receberam os excipientes de Otrivina, tais como Xilometazolina, Benzalcônio, Sorbitol e Ácido Etilenodiamino Tetracético (EDTA). Os medicamentos foram aplicados em ambas as narinas dos ratos, duas vezes ao dia, durante 8 semanas. Antes que os ratos fossem sacrificados, a coloração epitelial, o teste de Schirmer e a medida da pressão intraocular foram realizados sob anestesia com Ketamina/Xilasina (50 e 5 mg/kg, respectivamente). Resultados: Defeitos epiteliais e olho seco foram achados comuns nos grupos de estudo. A catarata desenvolveu-se clinicamente em dois casos. A avaliação histopatológica revelou a existência de alterações em todas as partes dos tecidos oculares, tais como edema de córnea, proliferação polipoide e hialinização da parede vascular, formação cística da lente, degeneração da camada de fibra nervosa da retina (RNFL) e formação de corpos amiláceos da glândula lacrimal. Conclusões: O uso prolongado do descongestionante nasal Xilometazolina e seus excipientes pode causar vários problemas oftalmológicos, como olho seco, edema de córnea, catarata, RNFL e dano vascular em ratos. Embora esses resultados tenham sido obtidos a partir de animais experimentais, os oftalmologistas devem ter em mente os potenciais efeitos oftalmológicos adversos desse medicamento e/ou de seus excipientes.

Lesion characteristics, histopathologic results, and follow-up of breast lesions after MRI-guided biopsy.

PURPOSE: We aimed to assess the effectiveness of magnetic resonance imaging (MRI)-guided vacuum-assisted breast biopsy (VABB), evaluate and compare the characteristics and histopathologic findings of lesions, and overview the follow-up results of benign lesions. METHODS: MRI findings and histopathologic results of breast lesions biopsied by MRI-guided VABB between 2013 and 2016 were retrospectively analyzed. MRI findings closely related with malignancy were investigated in particular. Follow-up results of benign lesions were evaluated. RESULTS: MRI-guided VABB was applied to 116 lesions of 112 women. Of the lesions, 75 (65%) were benign, while 41 (35%) were malignant. Segmental (94%), clustered (89%), and clustered ring (67%) non-mass-like enhancement patterns were found to be more related with malignancy. False-negative rate of MRI-guided VABB was 12%, underestimation rate was 21%. One of the 54 followed-up benign lesions had a malignant result. CONCLUSION: MRI-guided VABB is a reliable method for the diagnosis of breast lesions that are positive only on MRI. Follow-up results show that cancer detection rate is low for radio-pathologically concordant lesions. Further multicenter studies with larger patient population are needed to elucidate these results.

Review and management of breast lesions detected with breast tomosynthesis but not visible on mammography and ultrasonography.

Background Breast tomosynthesis is more sensitive than mammography and can detect lesions that are not always visible with conventional methods such as digital mammography (MG) and ultrasonography (US). No standardized approach is available for the management of lesions that are detectable with tomosynthesis but are not visible on MG or US. Purpose To review suspicious breast lesions detected with tomosynthesis but not visible on two-dimensional (2D) MG or US and to determine the management options for these lesions. Material and Methods Ethical committee approval was obtained. The radiological records, biopsy or surgery results, and follow-up findings of 107 patients who had a tomosynthesis-positive but MG- or US-negative breast lesion between 2011 and 2016 were retrospectively evaluated. Results Of 107 lesions visible only with tomosynthesis, 74% were architectural distortions and 26% were asymmetrical opacities. All patients underwent magnetic resonance imaging (MRI) for further evaluation. Among the 48 (45%) MRI-negative lesions, none had a suspicious alteration during the follow-up period. Among the MRI-positive lesions, 28% of the 50 architectural distortions and 11% of the nine asymmetrical opacities were malignant. Conclusion Given the inherent high false-positive rate of breast tomosynthesis, breast MRI prior to biopsy may reduce the number of unnecessary biopsies for suspicious breast lesions that are tomosynthesis-positive only.

Screening Fabry's disease in chronic kidney disease patients not on dialysis: a multicenter study.

OBJECTIVES: Fabry's disease is an X-linked inherited, rare, progressive, lysosomal storage disorder, affecting multiple organs due to the deficient activity of α-galactosidase A (α-Gal A) enzyme. The prevalence has been reported to be 0.15-1% in hemodialysis patients; however, the information on the prevalence in chronic kidney disease not on dialysis is lacking. This study aimed to determine the prevalence of Fabry's disease in chronic kidney disease. METHODS: The patients older than 18 years, enclosing KDIGO 2012 chronic kidney disease definitions, not on dialysis, were enrolled. Dried blood spots on Guthrie papers were used to analyze α-Gal A enzyme and genetic analysis was performed in individuals with enzyme activity ≤1.2 µmol/L/h. RESULTS: A total of 1453 chronic kidney disease patients not on dialysis from seven clinics in Turkey were screened. The mean age of the study population was 59.3 ± 15.9 years. 45.6% of patients were female. The creatinine clearance of 77.3% of patients was below 60 mL/min/1.73 m2, 8.4% had proteinuria, and 2.5% had isolated microscopic hematuria. The mean value of patients' α-Gal A enzyme was detected as 2.93 ± 1.92 µmol/L/h. 152 patients had low levels of α-Gal A enzyme activity (≤1.2 µmol/L/h). In mutation analysis, A143T and D313Y variants were disclosed in three male patients. The prevalence of Fabry's disease in chronic kidney disease not on dialysis was found to be 0.2% (0.4% in male, 0.0% in female). CONCLUSION: Fabry's disease should be considered in the differential diagnosis of chronic kidney disease with unknown etiology even in the absence of symptoms and signs suggestive of Fabry's disease.

Acute kidney injury after near drowning: The way from the beach to hemodialysis.

Acute kidney injury (AKI) occurs in many different situations and may have a variable prognosis influenced by clinical setting, underlying cause, and comorbidity. This is important because of the high mortality and morbidity risk affecting many people around the world. Near-drowning related AKI requiring hemodialysis is very seldom reported in literature. Although cardiovascular and respiratory disorders are more frequently seen after this entity, we aimed to emphasize this rare but dangerous complication in near-drowning patients.

Coexistence of Multiple Endocrine Neoplasia Type 2B and Chilaiditi Sign: A Case Report.

We present a 15-year-old female patient with medullary thyroid carcinoma, marfanoid habitus, and mucosal ganglioneuromatosis. Our case had a RET protooncogene mutation ser836 polymorphism in exon 14 and ser904 polymorphism in exon 15. Our patient is thought to be atypical MEN2B due to the absence of M918T or A883F mutations. Chilaiditi sign is an incidental radiographic finding of a usually asymptomatic condition in which a part of intestine is located between the liver and diaphragm; however, the term "Chilaiditi syndrome" is used for symptomatic hepatodiaphragmatic interposition. The patient had no symptoms as abdominal pain, constipation, diarrhea, or emesis. Incidentally, Chilaiditi sign was diagnosed with chest radiograph and thoracoabdominal CT. Our case is the first in the literature indicating the coexistence of Chilaiditi sign and MEN2B.

The impact of pre-procedural waiting period and anxiety level on pain perception in patients undergoing transrectal ultrasound-guided prostate biopsy.

PURPOSE: To investigate the effect of pre-procedural waiting period and anxiety level on pain perception during transrectal ultrasound-guided prostate biopsy. MATERIALS AND METHODS: Sixty patients who had undergone transrectal ultrasound-guided prostate biopsy were enrolled in this prospective study. The subjects were asked to fill out the State-Trait Anxiety Inventory Scale-1 to measure the level of state anxiety at three times: 1) at the time of the procedure request, 2) before the procedure, and 3) before getting the result. Just after biopsy, the patients were asked to fill out a visual analog scale to evaluate pain perception resulting from the biopsy. RESULTS: The mean pre-procedural level of state anxiety score was well correlated with the visual analog scale score (r=0.498; P < 0.001). The mean level of state anxiety scores before biopsy (39.7±9.4) and before getting the result (39.9±8.4) were significantly higher than the mean level of state anxiety score when the procedure was requested (31.4±7.9) (P < 0.001 for both). The patient group was divided into two subgroups according to the waiting time between the request and the procedure itself; the cut-off value between the short and long groups was 10 days. The difference between the mean visual analog scale scores from transrectal ultrasound-guided prostate biopsy patients with the short (n=23, 1.49±0.95) and long (n=37, 2.35±1.12) waiting periods was statistically significant (P = 0.003). CONCLUSION: In conclusion, performing the transrectal ultrasound-guided prostate biopsy procedure as soon as possible and using more effective anesthetic methods, especially for patients with high level of state anxiety scores, may have a positive impact on patient tolerance.

Sclerosing adenosis of the breast: radiologic appearance and efficiency of core needle biopsy.

PURPOSE: To examine the mammography and ultrasonography findings of patients who have a final histopathological diagnosis of sclerosing adenosis after breast biopsy, and to evaluate the follow-up results of patients who underwent core needle biopsies. MATERIALS AND METHODS: Seventy-six of the 723 patients who underwent breast biopsy in our institution were diagnosed with sclerosing adenosis on histopathological examination. Mammography and ultrasonography findings from these 76 lesions were analyzed retrospectively. Thirty-seven of these lesions were sampled by image-guided core needle biopsy; the remaining lesions were excised surgically. Mammograms and ultrasound images of the lesions were re-evaluated, and the post-biopsy medical records of these patients were evaluated. RESULTS: Sclerosing adenosis was the main diagnosis in 41 patients and the complementary diagnosis in 35 patients. Among the first 41 lesions in which sclerosing adenosis was the main diagnosis, there were 18 (44%) mass lesions, 16 (39%) microcalcification clusters, two (5%) lesions with asymmetrical opacity, three (7%) lesions with architectural distortion, and two (5%) lesions with focal acoustical shadowing that was only detected by ultrasonography. No alterations suggesting malignancy were noted during the follow-up examinations of 35 patients who underwent core needle biopsy. CONCLUSION: Sclerosing adenosis is a benign proliferative disease of the breast that can be confused with malignancy on clinical, radiological, and even histopathological examination. There is no typical radiological criterion for diagnosis. Core needle biopsy or excisional biopsy can be used, depending on the lesion's characteristics. Core needle biopsy can be the first step in the diagnosis of sclerosing adenosis.

Fibrotic lesions of the breast: radiological findings and core-neddle biopsy results.

OBJECTIVES: To evaluate the incidence of breast lesions with a histopathological diagnosis of focal fibrosis based on imaging guided core biopsy, to review the radiologic findings and to assess the diagnostic reliability of 14 G core needle biopsy. MATERIALS AND METHODS: 723 patients, who had undergone 14 G core biopsy and/or surgical excisions, were retrospectively analyzed. Overall, 43 lesions were diagnosed as focal fibrosis. Physical examination, mammography, ultrasonography, and follow-up findings were all reviewed. RESULTS: Radiological evaluation revealed that 35 (81%) lesions were solid masses. Of 35 mass lesions, 24 (69%) were well circumscribed, the remaining 11 (31%) lesions were ill defined on mammograms or sonograms. None of the lesions had pathological microcalcifications. Three lesions were surgically excised because of radio-pathological discordance after core needle biopsy. CONCLUSIONS: Focal fibrosis of the breast is a benign condition and reflects the ductal and lobular atrophy secondary to stromal proliferation. The radiological findings of this entity may vary and sometimes mimic those of malignant lesions. The incidence of focal fibrosis among our study population is 6% and a well-defined mass lesion is the most frequent finding. Core needle biopsy is a safe and reliable diagnostic procedure in the management of these cases.

The diagnostic efficiency of ultrasound guided imaging algorithm in evaluation of patients with hematuria.

PURPOSE: To assess the efficiency of the following imaging algorithm, including intravenous urography (IVU) or computed tomography urography (CTU) based on ultrasonographic (US) selection, in the radiological management of hematuria. MATERIALS AND METHODS: One hundred and forty-one patients with hematuria were prospectively evaluated. Group 1 included 106 cases with normal or nearly normal US result and then they were examined with IVU. Group 2 was composed of the remaining 35 cases which had any urinary tract abnormality, and they were directed to CTU. Radiological results were compared with clinical diagnosis. RESULTS: Ultrasonography and IVU results of 97 cases were congruent in group 1. Eight simple cysts were detected with US and 1 non-obstructing ureter stone was detected with IVU in remaining 9 patients. The only discordant case in clinical comparison was found to have urinary bladder cancer on conventional cystoscopy. Ultrasonography and CTU results were congruent in 30 cases. Additional lesions were detected with CTU (3 ureter stones, 1 ureter TCC, 1 advanced RCC) in remaining 5 patients. Ultrasonography+CTU combination results were all concordant with clinical diagnosis. Except 1 case, radio-clinical agreement was achieved. CONCLUSION: Cross-sectional imaging modalities are preferred in evaluation of hematuria. CTU is the method of choice; however the limitations preclude using CTU as first line or screening test. Ultrasonography is now being accepted as a first line imaging modality with the increased sensitivity in mass detection compared to IVU. The US guided imaging algorithm can be used effectively in radiological approach to hematuria.

Adenomatoid ameloblastoma in the mandible and maxilla: report of a case.

Ameloblastoma is an infrequent odontogenic neoplasm located in the mandible and/or infratemporal fossa extending into the maxilla. The authors report a patient who underwent a total of five operative interventions for recurrent lesions involving mandible and infratemporal fossa at other institutions before admission to our hospital. Radiographic imaging in our case demonstrated a solid/multicystic recurrent lesion of the right infratemporal fossa extending into the maxilla. Gross total excision of the tumour was done and the postoperative course was uneventful. In any case with a tumour located in this region, it is important to be aware of this condition because this lesion is unusual but serious pathology as illustrated in this report.

Cutaneous metastatic adenocarcinoma arising from a malignant sacrococcygeal teratoma in an adult.

We present a patient with cutaneous metastasis caused by an adenocarcinoma arising from a malignant teratoma. A 37-year-old woman seen for the complaint of swelling in the genital region also complained of a draining mass in her gluteal region present since birth. Physical examination showed marked edema in the labia majora, multiple hyperkeratotic papules in the left labium majus, and erythema, induration, and swelling in the left femoral and inguinal regions. A soft tumor that exhibited sinus tracts was palpated in the left gluteus. Excision of the gluteal tumor revealed a teratoma. Vulvar skin biopsy confirmed a mucinous adenocarcinoma which had derived from this teratoma. A tumor that arises from pluripotent germ cells, teratoma rarely shows malignant transformation. The patient presented is a rare example of a cutaneous metastasis originating from a congenital sacrococcygeal teratoma in an adult.

[Atypically located pulmonary adenoid cystic carcinoma: case report]. / Atipik yerlesimli pulmoner adenoid kistik karsinom: Olgu sunumu.

Pulmonary adenoid cystic carcinomas typically arise from central extra-pulmonary airways and lung involvement is rare. On the other hand, this entity should be kept in mind because it has a more favorable clinical course compared to the primary lung adenocarcinoma. In this paper; the clinical, radiological and pathological aspects of a 47 years old man with a complaint of chronic cough, who was found to have a mass lesion at upper lobe of right lung and a final diagnosis of primary pulmonary adenoid cystic carcinoma according to transbronchial needle biopsy and pneumonectomy, was presented.

Intraradicular extruded disc herniation as a rare cause of failed back surgery - case report and review of the literature.

We report an unusual case of intradural intraradicular lumbar disc herniation, in which an extruded fragment of disc was found within the sheath of the left S1 nerve root. Previous surgery of our patient in another medical centre was not beneficial. The diagnosis of intraradicular extruded disc herniation was made at the time of surgery during exploration of the L5-S1 disc space. Although magnetic resonance imaging is a useful diagnostic tool in all patients with lumbar disc herniation, preoperative correct diagnosis is usually difficult, as occurred in our patient. A careful observation of the root during surgery is indicated to detect such an anatomical abnormality, especially in cases with recurrent disc herniation.

Ultrasonographic prenatal diagnosis of isolated acephaly.

First trimester obstetric ultrasonography of a 32-year old female patient revealed a 13-week-old (according to the length of the femur and abdominal circumference) intrauterine live pregnancy with the absence of the fetal head. Medical abortus was performed with the diagnosis of acephaly and final diagnosis was confirmed by pathological and radiological examinations. We present and discuss the possible etiopathologic mechanisms of an acephaly case, which is described as acardia-acephaly complex in the literature, and usually appears in cases of twin reversed arterial perfusion sequence, but has not been previously reported as an isolated finding.

[The detectability of posterior portion of superior pericardial recess on routine chest CT]. / Rutin toraks BT incelemesinde süperior perikardiyal bosluk posterior bölümünün görülebilirligi.

The aim of this study was to search for the conspicuity, shape and size of posterior portion of superior pericardial recess (SPR) on routine spiral chest computed tomography (CT). Chest CTs of 180 consecutive patients were reviewed for the presence of the posterior portion of SPR, retrospectively. All images were reevaluated on a workstation by two radiologists in consensus with a constant window setting (window level 50 HU, window width 350 HU). Uniform, sharply outlined structure of near water density, without walls and rims in the posterior aspect of the ascending aorta was defined as posterior portion of the SPR. Identifiable recesses were classified as linear, crescentic, semicircle and amorphous in appearance. The depth of the recess was measured. Pericardial thickness, diameters of ascending and descending aorta, and pulmonary artery and its major branches were noted. Statistical analyses were performed to scrutinize any relationship between the presence of the recess, its shape, depth, gender, pericardial thickness and diameters of thoracic vessels. The recess was identified in 174 (96%) patients. Seventy-nine (45%) recesses were semicircular, 47 (27%) linear, 39 (23%) amorphous and 9 (5%) crescentic. The mean depth was 6 +/- 3.5 mm. The mean diameter of ascending, descending aorta, and pulmonary artery and its main branches were 33.6 +/- 5 mm, 25.7 +/- 3.7 mm, 23.2 +/- 2.6 mm, 19.2 +/- 2.6 mm, and 19.3 +/- 2.6 mm, respectively. The mean pericardial thickness was 2.7 +/- 0.6 mm. The shape and depth of the recess did not correlate with age, gender, vascular diameters and pericardial thickness. The posterior portion of SPR may be encountered in the majority of patients. Conspicuity of the recess may be due to individual variability.

The effect of strabismus surgery on retrobulbar hemodynamics.

PURPOSE: To investigate the potential alterations of ocular hemodynamics after strabismus surgery using color Doppler ultrasonography. MATERIALS AND METHODS: Twenty eyes of 18 patients and the left eyes of 20 healthy age- and sex-matched volunteers were evaluated. Patients were divided into two groups according to the number of operated muscles. Group 1 included seven patients with surgery on one rectus muscle; group 2 included 13 patients with surgery on two rectus muscles. Nine patients underwent adjustable suture eye muscle surgery. The ophthalmic artery, central retinal artery, short posterior ciliary artery, long posterior ciliary artery, and central retinal veins of both groups were examined. With spectral analysis, peak systolic velocity, end-diastolic velocity, resistivity, and pulsatility indices were calculated. RESULTS: There was no difference in the Doppler ultrasonography parameters between the group with surgery on one-horizontal rectus muscle and the group with surgery on two-horizontal rectus muscles. The adjustable suture procedure did not affect retrobulbar hemodynamics. There was no difference between the preoperative and postoperative Doppler examinations. CONCLUSIONS: In contrast with some recent studies, our results suggest that the strabismus surgery involving one- or two-horizontal rectus muscles does not have a measurable effect on retrobulbar blood flow.