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PURPOSE: We investigated the clinical characteristics of ocular trauma in the military for prevention and treatment application. METHODS: We retrospectively surveyed epidemiologic characteristics by investigating the medical records of 790 patients who were hospitalized in the Armed Forces Capital Hospital from January 1, 2001 to December 31, 2010 and investigated the prognostic factors that influenced visual outcome. RESULTS: Among the 790 patients with ocular trauma, 22.9% of the patients had an open injury and 77.1% had a closed injury. The most common cause of injury was sports-related ocular trauma (39%) and fatigue duty-related trauma (23.4%). The following 8 risk factors were considered poor prognostic factors: open injury, involved posterior segment, operation, initial visual acuity of 0.1 or less, corneal laceration, hyphema, RD, and intraocular foreign body. There was a significant correlation between the probability of poor visual outcome and the number of risk factors (correlation coefficient = -0.468, p < 0.0001). CONCLUSIONS: In the present study, the cause, characteristics and prognostic factor of military personnel's ocular injury were determined. The results can be useful in the prevention and management of ocular injury in the military.
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Humanos , Brazo , Fatiga , Cuerpos Extraños , Hipema , Laceraciones , Registros Médicos , Personal Militar , Estudios Retrospectivos , Factores de Riesgo , Agudeza VisualRESUMEN
PURPOSE: To evaluate the prognostic value of multifocal electroretinography (mfERG) after a decrease of retinal thickness in eyes with diabetic macular edema (DME). METHODS: Sixty patients (60 eyes) underwent intravitreal injection of triamcinolone acetonide or bevacizumab for diabetic macular edema. Eyes were divided into three groups, according to foveal thickness : Group A (==800 micrometer, n=20 eyes). Best-corrected visual acuity (BCVA) and mfERG responses from the most central seven hexagons were analyzed both before and after treatment. RESULTS: The pre-injection P1 amplitudes of mfERG correlated significantly with end-point BCVA in Groups A and B (p0.05) in Group C. CONCLUSIONS: The level of P1 amplitudes of mfERG may be a useful tool to predict visual outcomes after a decrease of retinal thickness in patients with diabetic macular edema.
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Humanos , Anticuerpos Monoclonales Humanizados , Electrorretinografía , Ojo , Inyecciones Intravítreas , Edema Macular , Retinaldehído , Triamcinolona Acetonida , Agudeza Visual , BevacizumabRESUMEN
PURPOSE: To investigate the effect of vertical deviation change, head tilt and diplopia relief, we performed a minimal amount of inferior oblique recession regardless of the vertical deviation angle and the degree of inferior oblique overaction (IOOA) in superior oblique palsy patients. METHODS: We retrospectively analyzed 20 cases of unilateral congenital or acquired superior oblique palsy, which were treated with inferior oblique muscle recession from May 2005, to August 2007. We compared vertical deviation change, head tilt and diplopia relief following surgery. Improvement of head tilt was determined by patient satisfaction measurements. The inferior oblique muscle was attached 4 mm posterior and 2 mm temporal to the lateral border of the inferior rectus muscle insertion in all patients. RESULTS: The average angle of vertical deviation prior to surgery was 12.4 prism diopters (PD), and the total average correction in the angle of vertical deviation after surgery was 9.6PD. After surgery, head tilt improved in 13 of 16 eyes(81%), and of the four remaining eyes, vertical diplopia was absent. CONCLUSIONS: Although vertical deviation remained after surgery, if patients have enough vertical fusional amplitude, they should be able to overcome the diplopia and the head tilt. Judging from the indication of inferior oblique recession in diplopia and cosmetic problem in superior oblique palsy, a minimal amount of inferior oblique recession is thought to be an effective treatment of unilateral superioroblique palsy with no significant IOOA.
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Humanos , Cosméticos , Diplopía , Ojo , Cabeza , Músculos , Parálisis , Satisfacción del Paciente , Estudios RetrospectivosRESUMEN
PURPOSE: We report a case of a 38-year-old man who suffered a blowout fracture of the orbital wall with an intact eyeball entrapped within the maxillary sinus after trauma. CASE SUMMARY: The 38-year-old man was admitted to the emergency room after sustaining a work-related trauma. His chief complaints were loss of vision and bleeding from the left periorbital area. He had no light perception and no eyeball was found in the orbit. Facial CT revealed that the intact eyeball was entrapped within the maxillary sinus. The condition of the optic nerve was difficult to ascertain. Ten hours after post-trauma, reduction surgery was done with a graft from the iliac bone. Ruptured extraocular muscles were not primarily sutured. After four months, vitrectomy was performed on the left eye. The eyeball was repositioned in its place. He had no light perception. Extraocular motility improved at the last follow-up examination. CONCLUSIONS: We report the dislocation of the eyeball globe into the maxillary sinus after a blowout fracture. Visual acuity showed no light perception as a result of central retinal artery occlusion and optic nerve injury. We were able to obtain a good aesthetic and functional result after the operation.
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Adulto , Humanos , Luxaciones Articulares , Urgencias Médicas , Ojo , Estudios de Seguimiento , Hemorragia , Hipogonadismo , Luz , Seno Maxilar , Enfermedades Mitocondriales , Músculos , Oftalmoplejía , Nervio Óptico , Traumatismos del Nervio Óptico , Órbita , Oclusión de la Arteria Retiniana , Trasplantes , Visión Ocular , Agudeza Visual , VitrectomíaRESUMEN
PURPOSE: Paresis of the inferior oblique is the least likely to result in paralysis. We report a patient without a history of trauma successfully treated using contralateral IO recession and SR recession. CASE SUMMARY: A 25-year-old male patient presented to us with an extended history of abnormal head posture, manifested by a marked habitual left head tilt with a face turn to the right. A cover test in the primary position demonstrated 15 prism diopter right hypertropia, which increased to 25 prism diopter right hypertropia in right gaze and 20 prism diopter right hypertropia in right head tilt. The patient was diagnosed with IO palsy, and a right IO recession was performed. RESULTS: Following the IO recession, head tilt was completely resolved and face turn to the right was slightly resolved. Cover test in the primary position demonstrated 12 prism diopter right hypertropia, which increased to 20 prism diopter right hypertropia in right gaze. A head tilt test demonstrated a symmetrical 12 prism diopter right hypertropia. We performed a right SR recession to decrease face turn and hypertropia in the primary position. CONCLUSIONS: We report a patient manifesting abnormal head posture diagnosed with IO palsy, which was successfully treated using contralateral IO recession and SR recession.
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Adulto , Humanos , Masculino , Cabeza , Parálisis , Paresia , Postura , EstrabismoRESUMEN
Perivasculitis and endothelial cell abnormalities are prominent histopathologic features of syphilis. Various cutaneous lesions are the main clinical features of syphilis. We examined whether Treponema pallidum 47 kDa antigen regulates the expression of cell adhesion molecules on human dermal microvascular endothelial cells (HDMEC) and the regulation of T-lymphocytes binding to HDMEC. Using immunofluorescence flow cytometry and enzyme-linked immunosorbent assay (ELISA), we demonstrated that T. pallidum upregulated the expression of adhesion molecules, including intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1) and E-selectin. The 47 kDa antigen of T. pallidum also activated endothelium as measured by the upregulation of the expression of adhesion molecules on HDMEC, and it also promoted an increased adherence of T-lymphocytes to HDMEC. The expressions of ICAM-1 and VCAM-1 on HDMEC and the adherence of T-lymphocytes to HDMEC were inhibited by treatment with anti-TNF-alpha antibody or anti-IL-1alpha antibody. These results show that T. pallidum or T. pallidum-specific 47 kDa antigen are capable of stimulating HDMEC to increase the expression of ICAM-1, VCAM-1 and E-selectin and thereby, promote the adherence of T-lymphocytes. The whole process may play an important role in the immunopathogenesis of syphilis and it is likely that TNF-alpha and IL-1alpha are involved.