Graefe's Archive for Clinical and Experimental Ophthalmology - To investigate clinical findings of the pseudo inferior oblique overaction (IOOA) syndrome and the outcomes of strabismus surgery... 相似文献
Purpose: To present clinical findings of a 28-year-old woman with multifocal surgically induced necrotizing scleritis following uncomplicated strabismus surgery.
Method: A 28-year-old woman underwent uncomplicated strabismus surgery of her right eye for sensory exotropia under general anesthesia (6 mm right medial rectus muscle resection and 8 mm right lateral rectus muscle recession).
Design: Retrospective, observational case report and literature review.
Results: One month after strabismus surgery, the patient presented with surgically induced necrotizing scleritis in the nasal aspect of sclera. Bacterial culture of the bed of the scleral melt showed no growth and all laboratory evaluation was normal. The scleritis completely resolved after initiation of systemic corticosteroids and oral azathioprine. Three weeks later (after tapering dose of systemic medication), the patient returned with large area of necrotizing scleritis in the same eye, but this time in the temporal aspect of sclera.
Conclusion: To our knowledge, this is the first documented case of multifocal surgically induced necrotizing scleritis occurring after strabismus surgery. This study also highlights the fact that scleritis may recur even in an area distant from the site of surgery, despite initial control. It seems that maybe with a longer course of treatment it is less likely to recur, and tapering medications should be carefully managed. 相似文献
ABSTRACTObjectives: To report the clinical outcomes of a new modification to muscle belly union surgery in heavy eye syndrome.Methods: Muscle belly union was performed in patients with large-angle esotropia and characteristic findings of heavy eye syndrome on orbital imaging. After isolation of superior and lateral rectus muscle and passing a single armed suture in each muscle belly, approximation was achieved via tying of both arms of separate sutures together. Medial rectus (MR) was also recessed considering the results of the intraoperative force duction test.Results: Surgery was conducted in 24 eyes of 16 patients. The mean preoperative esotropia was 93.71 ± 23.1 prism diopters (PD), which improved significantly after the operation (final esotropia: 11.53 ± 15.59 PD, P value = 0.001). Six patients also exhibited mild hypotropia preoperatively (9.33 ± 6.88 PD), which resolved completely after surgery in all cases. Evaluation of preoperative abduction limitation (minus 3.1 ± 1.83) showed a significant improvement postoperatively (minus 0.95 ± 0.68, P value = 0.000). Additionally, mild limitation of adduction (minus 1) was seen in nine patients due to large MR recession. However, none of the patients reported postoperative diplopia.Conclusion: Our new approach in muscle belly union surgery resulted in favorable outcomes compared with previous studies. It seems that the two-suture technique presented in this study yields more convenient approximation of muscle bellies and acts as a safety suture upon spontaneous loosening of the first applied suture. 相似文献
Purpose: To report 3 cases of cherubism, one of whom underwent surgery for orbital manifestations, and to provide a literature review.
Case reports: Our patients were normal at birth and developed painless enlarging of the cheeks and jaws when they were 4–5 years old. Ophthalmologic examinations showed mild proptosis, superior globe displacement and inferior scleral show in all cases. Cases 2 and 3 had lower lid skin discoloration. Computed tomography (CT) scans demonstrated bilateral multicystic lesions in the maxilla and mandible with cortical thinning in all cases. In Case 3, left eye hyperglobus and anisometropic amblyopia was seen. In this case, the CT scan showed a round, well-defined and homogeneous mass, involving the anterior and superior walls of the maxillary sinus on the left side, extending into inferior orbit. Debulking of the mass was performed at the surgery. The pathologic findings were compatible with the diagnosis of giant cell reparative granuloma. He returned 1 year after surgery with recurrence of the mass.
Discussion: A few cases were reported in the literature with histopathologically proven orbital cherubism. To our knowledge, lower lid skin discoloration in Cases 2 and 3 and anisometropic amblyopia in case 3 were not described elsewhere in cherubism cases. We recommend that all cases with cherubism must be examined by an ophthalmologist to diagnose and treat possible orbital manifestations. 相似文献
Graefe's Archive for Clinical and Experimental Ophthalmology - Superior rectus transposition (SRT) with medial rectus recession has been used for the treatment of sixth nerve palsy and... 相似文献
The aim of this study was to evaluate possible interactions among
Angiotensin-I converting enzyme genotype, insertion/deletion polymorphism
and atherosclerosis of vein grafts in Iranian patients, and characterize
their clinical and demographic profile.
METHODS
In this cross-sectional study, patients who underwent coronary artery bypass
graft surgery more than five years ago, were included for angiographic
analysis. Atherosclerosis was determined by quantitative angiography and
adjusted Gensini score. The gene angiotensin converting enzyme I/D
polymorphism was detected by polymerase chain reaction.
RESULTS
A total of 102 patients participated in this study. Eighty-four patients
were male. The frequency distribution of DD, ID and II polymorphism were
23.6%, 62.7% and 13.7% respectively. There were no differences among
genotypic groups in age, sex, number of risk factors, number of vein grafts
and months since bypass surgery. According to adjusted Gensini score
[0.18±0.12 (II) vs. 0.11±0.09 (ID) and
0.1±0.09 (DD) P=0.021] the II genotype was
associated with severity of vein graft atherosclerosis.
CONCLUSION
Although there are conflicting results about gene angiotensin converting
enzyme I/D polymorphism and the degree of venous bypass graft degeneration,
this study suggests an association between ACE genotype II and
atherosclerosis of saphenous vein grafts, however, large samples considering
clinical, demographic and ethnic profile are necessary to confirm these
results. 相似文献
Background: Neonatal lupus erythematosus (NLE) is a transient autoimmune disease of developing fetus and neonate in mothers with systemic lupus erythematosus (SLE). In this report we introduce an infant with NLE whose mother had rheumatoid arthritis.
Case Presentation: Our case was a 40 day old male infant with discoid-like and annular skin lesions over forehead and neck, irritability and low grade fever. There was a history of prematurity due to preeclampsia. There was no cytopenia or cardiac involvement but liver enzymes were more than 5-fold increased. FANA, Anti Ro and La were negative. The mother had a history of un-controlled rheumatoid arthritis for 12 years with deformity in metacarpal and PIP and ulnar deviation in hands. FANA=1/640 and anti-SSB/La was positive in the mother but there was no other clinical and paraclinical sign of SLE. Without any treatment and during months, the skin and mucosal lesions gradually disappeared without any scar and liver enzymes reached the normal level. After 6 months follow up, he was symptom free with normal growth and development.
Conclusion: We recommend to check anti SSA/Ro and anti SSB/La antibodies in all pregnant women with connective tissue diseases to prevent life-threatening involvement of the infant.Key Words: Neonatal Lupus, Rheumatoid Arthritis, Anti SSA/Ro, Anti SSB/La相似文献
