Ultrasound biomicroscopy in acetazolamide-induced myopic shift with appositional angle closure / Biomicroscopia ultrassônica em mudança miópica induzida por acetazolamida no fechamento de ângulo

ABSTRACT We report a case of a 49-year-old female who presented to the emergency department with blurred vision and vomiting, hours after taking two tablets of 250 mg of acetazolamide. The anterior chamber was bilaterally flat, with normal intraocular pressure in both eyes. An ultrasound biomicroscopic (UBM) examination showed bilateral ciliary effusion and complete appositional angle closure in all quadrants. Acetazolamide-induced bilateral angle closure was diagnosed. Steroid and cycloplegic therapy were initiated, and acetazolamide was discontinued. The following day, the anterior chamber had regained its volume without substantial change in the effusion size. Three weeks later, complete resolution of the ciliary effusion was verified by means of a third UBM scan.

RESUMO Relatamos um caso de uma mulher de 49 anos que se apresentou ao departamento de emergência informando visão borrada e vômitos, horas após ter tomado dois comprimidos de 250 mg de acetazolamida. A câmara anterior era bilateralmente plana com pressão intraocular normal em ambos os olhos. Um exame de biomicroscopia ultrassônica (UBM) mostrou efusão ciliar bilateral e fechamento completo do ângulo aposicional em todos os quadrantes. O bloqueio angular bilateral induzido por acetazolamida foi diagnosticado. O tratamento com esteróides e cicloplégicos foi iniciado e a acetazolamida foi descontinuada. No dia seguinte, a câmara anterior recuperou seu volume sem alterações substanciais no tamanho da efusão. Três semanas depois, a resolução completa da efusão ciliar foi verificada por meio de uma terceira biomicroscopia ultrassônica.

Relations between Age, Weight, Refractive Error and Eye Shape by Computerized Tomography in Children

PURPOSE: To investigate relationships between age, weight, refractive error, and morphologic changes in children's eyes by computerized tomography (CT). METHODS: Of the 772 eyes of 386 patients under the age of 20 years, who visited our Department of Ophthalmology between January 2005 to August 2006 and underwent CT of the orbit, 406 eyes of 354 patients with clear CT images and normal eyeball contour were enrolled in the present retrospective study. The axial lengths, widths, horizontal and vertical lengths, refractive errors, and body weight of eyes were measured, and relationship between these parameters were investigated. RESULTS: Axial length was found to correlate significantly with eye width (r=0.914), and in emmetropic eyes and myopic eyes, axial lengths and widths were found to increase as age and body weight increased. Axial lengths increased rapidly until age 10, and then increased slowly. In emmetropic eyes, widths / axial lengths increased with age, but in myopic eyes these decreased as age or severity of myopia increased. Moreover, as age increased, the myopic population and severity also increased. CONCLUSIONS: The axial length was longer in case of myopia compared to emmetropia in all age groups and there was almost no difference in the increase rate of axial length by the age of myopia and emmetropia. However, the width was wider in case of myopia compared to emmetropia in all age groups and the increase rate of width in myopia by age was smaller than that of emmetropia. Myopia showed decreasing rate of width/axial length with increase of age, from 1.004 in 5 years to 0.971 in 20 years. However, emmetropia showed increasing rate of width/axial length with increase of age, from 0.990 in 5 years to 1.006 in 20 years.

Clinical study of myopic eyes [pachymentry, corneal tobography and ultrasonography]

One hundred and thirty-four eyes of sixty-eight patients of both sexes with age ranged from 18 to 45 years and degree of myopia from 1.5 to 18.0 D were examined before refractive surgery with ultrasonic pachymeter, computed corneal topography and A-Scan ultrasonography. From pachymetric, ultrasonographic and corneal topographic results highly significant relationship between degree of myopia and axial length of the eye was found. Also, insignificant relationship between degree of myopia and both anterior chamber depth and lens thickness was detected. A weak negative relationship between central and paracentral corneal thickness and maximum corneal curvature and insignificant relationship between age and corneal thickness were found. Corneal thickness is less in females than males, but of insignificant value. The study revealed that there was a weak relationship between degree of myopia and central corneal thickness. An insignificant statistical difference between right and left eyes in pachymetric, ultrasonic and corneal curvatures values was found

Ultrasound biometric measurements in myopia: a case-control study

Thirty emmetropic subjects [50 eyes] and one hundred thirty myopic patients [260 eyes] were selected and examined ophthalmologically and by ultrasonic biometer. These myopic patients were classified into three groups [mild, moderate and high] according to the degree of myopia. Among the biometric measurement it was found that the mean axial length showed gradual persistent significant increase from 23.34 +/- 0.58 in emmetropes to 24.2 +/- 1.02 in mild myopia to 25.06 +/- 0.77 in moderate myopia then to 25.51 +/- 0.77 in high myopia as the variance ratio [V.R.]=35.226 and P<0.001. The axial length and refraction had a significant negative correlation [r=-0.316 and P<0.05] in mild myopia. More stronger in moderate myopia [r=-0.428 and P<0.001] and strongest in high myopia [r=-0.667 and P<0.001]. The anterior chamber depth and lens thickness showed non-significant correlation with the different degrees of myopia. It was concluded that the axial length was the most influencing factor on refraction as by multiple regression the predicted refraction can be computed by the following equation: predicted refraction = -1.34672 [axial length] + 29.35439