Spontaneous orbital subcutaneous emphysema after sneezing.

Orbital subcutaneous emphysema develops when air enters the surrounding soft tissue. This occurs as a result facial bone trauma, iatrogenic dental and otolaryngeal procedures, and gas-producing infectious microorganisms. Case reports regarding this phenomenon after sneezing are very uncommon. Although orbital subcutaneous emphysema is not a true emergency, it can be distressful to patients. This case serves to bring awareness to emergency department physicians regarding the possibility of a nontraumatic orbital subcutaneous emphysema and its related complications.

Managing epibulbar choristoma with microphthalmos.

A 3-year-old boy had a large epibulbar choristoma with microphthalmos of his left eye. He received simple partial tumor excision due to significant local mechanical erosion and disfiguring appearance. The cosmetic outcome was satisfactory.

Protective Effect of Melatonin against Oxidative Stress-Induced Apoptosis and Enhanced Autophagy in Human Retinal Pigment Epithelium Cells.

Age-related macular degeneration (AMD) affects the retinal macula and results in loss of vision, and AMD is the primary cause of blindness and severe visual impairment among elderly people worldwide. AMD is characterized by the accumulation of drusen in the Bruch's membrane and dysfunction of retinal pigment epithelial (RPE) cells and photoreceptors. The pathogenesis of AMD remains unclear, and no effective treatment exists. Accumulating evidence indicates that oxidative stress plays a critical role in RPE cell degeneration and AMD. Melatonin is an antioxidant that scavenges free radicals, and it has anti-inflammatory, antitumor, and antiangiogenic effects. This study investigated the antioxidative, antiapoptotic, and autophagic effects of melatonin on oxidative damage to RPE cells. We used hydrogen peroxide (H2O2) to stimulate reactive oxygen species production to cause cell apoptosis in ARPE-19 cell lines. Our findings revealed that treatment with melatonin significantly inhibited H2O2-induced RPE cell damage, decreased the apoptotic rate, increased the mitochondrial membrane potential, and increased the autophagy effect. Furthermore, melatonin reduced the Bax/Bcl-2 ratio and the expression levels of the apoptosis-associated proteins cytochrome c and caspase 7. Additionally, melatonin upregulated the expression of the autophagy-related proteins LC3-II and Beclin-1 and downregulated the expression of p62. Thus, melatonin's effects on autophagy and apoptosis can protect against H2O2-induced oxidative damage in human RPE cells. Melatonin may have multiple protective effects on human RPE cells against H2O2-induced oxidative damage.

Correlation between myopic ametropia and stereoacuity in school-aged children in Taiwan.

PURPOSE: To investigate the correlation between stereoacuity, as analyzed by the Titmus stereotest, and the severity of myopia, astigmatism and anisometropia in a school-aged population in Taiwan. METHODS: Cycloplegic autorefraction, best corrected monocular visual acuity and stereoacuity were measured in 6- to 18-year-old school children. Children with amblyopia (best corrected visual acuity of <20/25) or strabismus were excluded from this study. The correlation between stereoacuity and the severity of myopia, astigmatism and anisometropia was analyzed by the Titmus stereotest. RESULTS: A total of 166 children (95 boys, 71 girls; mean age 10.75 years, range 6-18 years) with myopia or astigmatism were enrolled in the study. The mean spherical error was -2.22 ± 1.70 diopters (D) (range -0.25 to -9.50 D), and the mean astigmatism was -0.72 ± 0.89 (range 0 to -4.50) D. An anisometropia of >1.00 D and spherical anisometropia of >1.00 D were strongly associated with decreased stereoacuity on the Titmus stereotest (P < 0.001). Astigmatism was also correlated with the performance of stereopsis (P = 0.013). CONCLUSION: Anisometropia (>1.00 D), spherical anisometropia (>1.00 D), and astigmatism were associated with reduced stereoacuity in school-aged children.