The Clinical Usefulness of the Teller Acuity Cards Test in Preverbal Children

PURPOSE: To determine the clinical usefulness of the Teller Acuity Cards(TAC) test in infants and preverbal children less than 48 months old. METHODS: We retrospectively analyzed 55 consecutive patients. We had measured visual acuity with the TAC test for the preverbal period, and optotype acuity was measured with Hahn's letter chart for the follow-up period. Test-retest long-term repeatability was evaluated by comparing the last two TAC acuities. We compared the last TAC acuity with the first optotype acuity to estimate the predictive validity of the TAC test. Finally, we also tested the reliability of the TAC test compared with the optotype acuity test for the assessment of interocular visual acuity differences in patients with unilateral amblyopia. RESULTS: The mean age of patients at the initial TAC test was 21.6 months. The first optotype acuity was obtained at the age of 37 months. Earlier TAC acuity correlated significantly with later TAC acuity (r=0.77, p<0.001). Although the TAC test underestimated the visual acuity more than the optotype test, there was minimal correlation between the two tests (r=0.28, p<0.05). In the presence of the interocular difference of visual acuity with the TAC test, unilateral amblyopia as assessed by optotype test could be anticipated (r=0.44, p<0.05). CONCLUSIONS: The TAC test can be used as a reliable method to estimate visual acuity in infants and preverbal children. Earlier The TAC acuities are valid predictors of optotype acuities later in childhood. The TAC test is an especially useful method in detecting unilateral amblyopia.

Scanning Electron Microscopic Observations of Sequential Alterations of Type 1 HSV Keratitis in Rabbits

PURPOSE: This study aimed to investigate the microscopic findings of characteristic epithelial herpes simplex keratitis (HSK) and the changes of those findings over time. METHODS: Sixteen rabbits were inoculated with the Kos-stain of herpes simplex virus (HSV) type 1 in both eyes. Two rabbits each were enucleated on the 2nd, 3rd, 4th, 5th, 6th, 7th, and 9th day after viral inoculation and were observed with a scanning electron microscope (S-2380n, Hitachi, Japan). RESULTS: Corneas showed dendritic epithelial desquamation, changes in epithelial microvilli, and changes in intercellular adhesion. With progression, the basement membrane and basal cells were exposed, intercellular spaces were broadened, and the adhesion of basal cells to basement membrane and the intercellular adhesion were loosened. Later, infiltrations of some inflammatory cells were found. Until the last day there was no destruction of basement membrane or an exposure of stroma. CONCLUSIONS: Though it was impossible to follow up a lesion throughout the experiment because of the necessity of enucleation, and in addition, the findings could not be generalized to all the strains, this study provides a better understanding of HSK. Further studies on various manifestations of HSK from other strains of HSV are needed in the future.

Treatment of Retinal Arterial Macroaneurysm

PURPOSE: To evaluate the visual prognosis of retinal arterial macroaneurysm with various treatment. METHODS: We did retrospective study in 16 patients(16 eyes) of retinal arterial macroaneurysm diagnosed at our hospital from March 1996 to January 2003. RESULTS: The range of patient's age was from 26 to 92 year-old, and 10 patients were female and 6 patients were male. In 6 eyes without treatment, spontaneous absorption of hemorrhage or edema occurred in 4 eyes. In 2 eyes with preretinal hemorrhage involving the macular area, vision was improved 2 lines or more as hemorrhage was subsided. Two eyes with Nd: YAG laser photodisruption obtained visual improvement of 4 lines or more. In 2 eyes misdiagnosed as CNV, argon laser photocoagulation was performed. In 6 eyes treated surgically with tPA injection or pars plana vitrectomy, 5 eyes showed visual improvement of 4 lines or more. CONCLUSIONS: Laser therapy or vitrectomy seems to be an effective method for the treatment of retinal arterial macroaneurysm involving the macular area.

A Case of Retinoblastoma Presenting With Dislocated lens

PURPOSE: It has been known that retinoblastoma very rarely produces a dislocated lens. We report herein a case of retinoblastoma with a dislocated lens. METHODS: A 2-year-old boy developed left conjunctival injection and discharge for 3 days. Anterior segment examination, B-scan ultrasonography, orbital computed tomography were performed. RESULTS: Anterior segment examination revealed whitish floating materials in anterior chamber. B-scan ultrasonography demonstrated a vitreous opacity and intraocular mass. Orbital computed tomography revealed the lens dislocated in vitreous cavity and nasally calcified intraocular mass in the left globe. Enucleation was performed under the impression of retinoblastoma and histopathologic examination demonstrated endophytic retinoblastoma with lens dislocation. CONCLUSIONS: We report a case of retinoblastoma with dislocated lens which has been very rarely reported.