Ophthalmologic profile among Hansen’s disease patients in a tertiary hospital

Background@#Ophthalmologic evaluation is often neglected in routine screening of Hansen’s disease patients. In line with the global aim of reducing grade 2 disability, eye examination should be an essential part of routine examination of Hansen’s disease patients.@*Objective@#To describe the ophthalmologic profile of patients with Hansen’s disease seen in a tertiary hospital.@*Methods@#A point-prevalence survey was conducted. Sixty-six Hansen’s disease patients, aged 18 and above, underwent complete ophthalmologic examination including visual acuity, refraction, external eye examination, intraocular pressure determination, dilated pupil examination, palpebral aperture measurement, corneal sensation testing, and tear breakup time determination. Statistical analysis was done.@*Results@#All patients had ocular findings with lepromatous leprosy (62%) being the highest. Fifty-three percent had Type 2 lepra reaction. Most were males, disease duration in majority was < 5 years and bacillary morphologic index was 4.0 – 4.99. Patients with Grade 1 and Grade 2 disability of the eyes were 62% and 17% respectively. The most common ocular complications were: abnormal tear breakup time (79%), cataracts (53%),blepharitis (47%), madarosis (39%) and corneal opacities (24%).@*Conclusion@#There is a significant number of ocular findings among leprosy patients in this study. The highest number of ocular complications is among patients in the lepromatous pole. There is a preference of M. leprae for cooler areas; hence, the anterior chamber was greatly affected.

Applicationofopticalcoherence tomography in maculopathy of high myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the value of optical coherence tomography (OCT) in maculopathy of high myopia. METHODS: Totally 50 patients (50 affected eyes) with high myopia who were admitted to our hospital during the period from June 2016 to May 2017 were prospectively enrolled in the observation group, and 50 normal healthy people(50 eyes) were selected as the control group at the same time. All subjects completed the conventional ophthalmic examination and OCT after admission. The visual acuity, intraocular pressure, diopter, eye axis, macular thickness and morphological changes were recorded, and detection of maculopathy of high myopia by different examination methods was statistically analyzed. RESULTS: Conventional ophthalmic examination showed that the macular region was normal in 37 eyes and abnormal in 13 eyes (26%) while OCT showed that it was normal in 12 eyes and abnormal in 38 eyes (76%) in the observation group. The rate of maculopathy detected by OCT was higher than that by conventional ophthalmologic examination, with a significant difference (P < 0. 05). The rates of subretinal or choroidal neovascularization and macular epiretinal membrane detected by OCT were higher than those by conventional ophthalmologic examination, with significant differences (P<0. 05). There was no significant difference in the proportion of normal results between conventional ophthalmologic examination and OCT in the control group (P>0. 05). The intraocular pressure, diopter and axial length of patients with high myopia and maculopathy were higher/longer than those of the control group, the BVCA was worse than that of the control group, the thickness of retinal macular region, thickness of nerves above and below the optic disc, thickness of optic nerves on the bitamporal and nasal sides of the optic disc were lower than those of the control group, with significant differences (P<0.05). CONCLUSION: OCT can quantitatively determine the thickness of nerve fiber layer around the retina in patients with high myopia, and clearly display the characteristics of maculopathy, which can provide reliable quantitative data for the diagnosis of maculopathy of high myopia.

Clinical Characteristics of Children Diagnosed with Migraine

PURPOSE: To analyze the clinical characteristics of visual symptoms, aspects of headache, and ophthalmologic features in children diagnosed with migraine. METHODS: The medical records of 31 Korean children who had been diagnosed with migraine by pediatric neurologists were retrospectively reviewed and visual symptoms and ophthalmologic examinations were evaluated. RESULTS: The mean age of the 31 patients was 10.8 years (range, 5-17 years). The mean age of onset of headache was 9 years (range, 4-15 years). Nineteen patients (61.3%) had the associated visual aura. Visual symptoms of the 19 patients included blurred vision, unilateral vision loss, flickering lights, scotoma, and visual hallucination in descending order. However, there was no specific abnormality observed on thorough ophthalmologic examinations. CONCLUSIONS: Most of the children diagnosed with migraine did not show any ophthalmologic problems. Careful ophthalmologic examination with an understanding of migraine should be performed and reassurance to patients may be beneficial.

Ocular manifestations in Leigh syndrome / 소아과

PURPOSE: Leigh syndrome is a typical type of mitochondrial disease. This study was conducted to analyze the types of ophthalmologic symptoms and results of funduscopy conducted in the ophthalmologic examination of patients with Leigh syndrome. METHODS: Funduscopy was conducted on 24 subjects, who were chosen among those diagnosed as having mitochondrial respiratory chain complex defect and who were clinically suitable for the criteria of Leigh syndrome. Their clinical features, ophthalmologic symptoms, and ophthalmologic examination results were retrospectively analyzed. RESULTS: Of the 24 patients with Leigh syndrome, 11 developed ophthalmologic symptoms and no abnormal finding was observed in 13. The most frequent abnormal finding was visual disturbance in 5 patients. Funduscopy revealed abnormal findings in 17 patients; retinal pigmentation was the most frequent abnormality and was seen in 9 patients. CONCLUSION: Funduscopy can be an important screening test to find ophthalmologic abnormalities among patients with mitochondrial disease (MD), including those patients whose ophthalmologic symptoms are inconspicuous. It is predicted that an improved screening test can be made in the future that will identify risk factors related to ophthalmologic symptoms.

Voluntary Nystagmus

PURPOSE: We evaluated the clinical manifestations of voluntary nystagmus in three patients and verified the efficacy of video-oculography as a diagnostic tool to differentiate voluntary nystagmus from congenital or latent nystagmus. METHODS: Meticulous history taking and neuro-ophthalmologic examination were performed for three patients with voluntary nystagmus. Video-oculography was also performed in one patient. RESULTS: All of the three patients were young men in military service. Neuro-ophthalmologic examination was normal in all three patients, except for shaking of the eyes. Video-oculography in one patient showed 5~6 Hz pendular oscillation with an amplitude of 7~15 degrees and a peak velocity of 345.4 deg/sec, verifying that the oscillatory eye movement was composed of saccades and was not a nystagmus. CONCLUSIONS: In differentiating between voluntary and congenital nystagmus, video-oculography as well as history taking and neuro-ophthalmologic examination were very helpful.