Asteroid hyalosis.

PURPOSE: This study evaluated ocular and systemic diseases in patients with asteroid hyalosis and compared axial lengths of asteroid hyalosis patients with the normal population. METHODS: The examination of 26 patients with asteroid hyalosis consisted of complete history, complete ocular examination, blood pressure and laboratory studies in order to detect systemic diseases, A and B scan ultrasonography to measure axial lengths and to detect posterior vitreous detachment. RESULTS: All patients had unilateral asteroid hyalosis; 10 (38.5%) were symptomatic. Eight patients (20.5%) had type II diabetes mellitus, 13 (33.3%) patients had systemic arterial hypertension and 7 (18%) had atherosclerotic heart disease; 5 (12.8%) had hyperlipidemia and 6 (15.4%) had hypercholesterolemia. Posterior vitreous detachment was found in 3 (11.5%) patients with asteroid hyalosis, and 6 patients in the control group (23.1%) had posterior vitreous detachment (p<0.01). In patients with asteroid hyalosis, the mean axial length difference between two eyes was 0.32 +/- 0.06, against 0. 10 +/- 0.02 in the control group (p<0.01). CONCLUSION: Asteroid hyalosis may be found together with systemic diseases and such patients must be evaluated systematically for diabetes mellitus, hypertension and hyperlipidemia. Asteroid hyalosis can also cause artefactual lowering of axial length measurement, leading to significant error in calculations of intraocular lens power. This must be kept in mind before cataract surgery.

Effects of scleral buckling on the retrobulbar haemodynamic changes.

PURPOSE: This study was planned to investigate blood flow changes due to scleral buckling surgery. In addition the effects on these changes of factors related to patient characteristics and operative technique were studied. METHODS: Central retinal artery (CRA) and ophthalmic artery (OA) blood flow velocities were studied with colour Doppler ultrasonography after scleral buckling surgery in 25 patients with unilateral rhegmatogenous retinal detachment. The effects of the patient's age, referral time, aetiological factors, operative technique, cryotherapy width and buckling distance on the haemodynamic changes were noted. RESULTS: Buckling surgery reduces the blood flow velocities in the CRA, but affects OA blood flow less. Encircling is found to be responsible and it is greater in patients with anatomical success. Other factors do not have any significant effect on these changes. CONCLUSIONS: Good anatomical and functional results can be achieved despite these haemodynamic changes. It must be kept in mind that these changes may cause complications in some patients and the surgery must be minimized.

Idiopathic orbital inflammatory disease.

The purpose of this study was to review our clinical experience with 132 idiopathic orbital inflammation cases seen between 1971 and 1994. Clinical charts of the patients were evaluated retrospectively. Patient age ranged from 5 to 80 (mean 46.5) years. The follow-up period was between 6 to 172 (mean 42.8) months. Proptosis (82%), motility restriction (54%), visual acuity loss (38%) were the three more common presenting signs. The diagnosis was made by open biopsy in 96 cases and clinically in 36 cases. Radiologic patterns of involvement were available for 84 cases. Diffuse inflammatory disease (40 cases) was the most frequent radiologic pattern followed by myositis (21 cases) and dacryoadenitis (14 cases). Focal encapsulated mass (5 cases), Tolosa-Hunt syndrome (2 cases) perineuritis (1 case) and periscleritis (1 case) were the other types of orbital pseudotumors. The response to treatment was known for 60 of the 84 radiologically classified cases. High-dose oral corticosteroid treatment was successful in 35 out of 60 (58.3%) cases and radiotherapy in 9 out of 14 (64.3%) cases resistant to corticosteroids. One resistant case responded to cyclophosphamide and 2 cases with focal mass lesions were treated with orbitotomy. Four additional cases had spontaneous remission. Overall, 51 out of 64 patients (79.7%) had an eventual good outcome. In conclusion, we found open biopsy to be a safe and reliable procedure in orbital pseudotumors with the exclusion of acute phase cases. The success rate of treatment for this group of orbital disorders is high with the exception of certain disease patterns.

Macular subretinal neovascular membrane associated with pseudotumor cerebri.

We report on the development of juxtapapillary subretinal neovascular membrane and permanent severe visual loss in a patient with pseudotumor cerebri. The patient was managed by a lumboperitoneal shunt. After surgery, despite resolving papilledema and intracranial pressure control, the membrane had enlarged rapidly to involve the foveal avascular zone, and resulted in rapid visual loss. The membrane slowly regressed, and was replaced by fibrous tissue at the ninth month, causing permanent severe visual loss.