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Purpose@#To evaluate the diagnostic value of retinal nerve fiber layer-to-disc ratio (RDR) compared to established parameters including retinal nerve fiber layer thickness (RNFLT), Bruch membrane opening-minimum rim width (BMO-MRW), and Bruch membrane opening-minimum rim area (BMO-MRA) for differentiating between open angle glaucoma (OAG) and nonarteritic anterior ischemic optic neuropathy (NAION). @*Methods@#This retrospective study included 23 optic disc size-matched normal control eyes and 23 OAG and NAION eyes matched according to global RNFLT. The RDR, RNFLT, BMO-MRW, and BMO-MRA were analyzed; the diagnostic capabilities of these parameters were compared using the area under the receiver operating characteristic curve (AUC). @*Results@#The global BMO-MRW and total BMO-MRA were lower in the OAG group than in the other two groups (all p < 0.001). RDR was greatest in the OAG group, followed by the healthy and NAION groups (p < 0.001). Between the OAG and NAION groups, the AUCs for temporal inferior BMO-MRW, total BMO-MRA, and RDR were 0.987, 0.996, and 1.000, respectively; these were greater than the temporal inferior RNFLT (0.811; p = 0.005, p = 0.006, and p = 0.006, respectively). @*Conclusions@#RDR could be one of the useful parameters for differential diagnosis in OAG and NAION.
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Purpose@#To report a case of orbital apex syndrome and central retinal vein occlusion after blow-out fracture repair.Case summary: A 22-year-old man who underwent emergency re-operation in a department of plastic surgery due to pain, decreased visual acuity, and ophthalmoplegia in all direction after orbital blow-out fracture repair was referred to ophthalmologist on postoperative day 2 and there was no improvement in symptoms. He showed severe complications, including optic neuropathy and ophthalmoplegia in all direction, central retinal vein occlusion, and outer retinal disruption caused by orbital apex hemorrhage. Although we were concerned that it was too late, we started high dose steroid intravenous pulse treatment and the visual acuity, ophthalmoplegia, and retinal findings were improved. However, the optic atrophy and visual field defect did not. @*Conclusions@#After a complicated blow-out fracture repair in other department, if a patient shows severely decreased visual acuity or ocular movement limitation, a thorough and immediate ophthalmologic examination is recommended. During ophthalmologic examination, meticulous examination of the entire eye, including the retina, is required, in addition to general orbital complications. A relatively good prognosis can be expected through accurate cause analysis and appropriate treatment for the confirmed abnormal findings.
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Purpose@#To report a case of transient total occlusive attack of the ophthalmic artery with asymptomatic patent foramen ovale.Case summary: A 31‐year‐old female presented with worsening of intermittent visual loss in her right eye from the previous day. The visual acuity in the right eye was reduced to 0.04 at her first visual examination. In the doctor’s room, her visual acuity in the right eye improved to 1.0 at first; however, after several minutes, it decreased to no light perception. A relative afferent pupillary defect was observed. Following that, fluorescein angiography was performed, and visual acuity improved and worsened repeatedly; corresponding intermittent perfusion and occlusion of the ophthalmic artery were observed during the examination. Further evaluation was performed to determine the cause of intermittent occlusion of the ophthalmic artery; patent foramen ovale was diagnosed. Transient ophthalmic artery occlusion was presumed to have occurred owing to embolism by the patent foramen ovale. Aspirin was used as a prophylaxis. Since then, there have been no recurring symptoms of visual impairment. @*Conclusions@#Patients with ophthalmic diseases such as ophthalmic artery occlusion, retinal artery occlusion, and amaurosis fugax, especially young people, require a thorough assessment to identify potential causes of embolism.
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Background@#Tibial tuberosity transposition (TTT) causes caudalization of the patellar ligament insertion in canine medial patellar luxation, which can lead to increases in patellofemoral contact pressure. @*Objectives@#The purpose of this study is to confirm the effect of patellofemoral contact mechanics after craniolateral and caudolateral transposition of tibial tuberosity in normal canine hindlimbs. @*Methods@#Craniolateral and caudolateral transposition of tibial tuberosity was performed in 5 specimens, respectively. The pressure was measured in the specimen before TTT, and then in the same specimen after TTT. In this process, data was obtained in 10 specimens. The measurement results were output as visualization data through the manufacturer's software and numerical data through spreadsheet. Based on these 2 data and the anatomical structure of the patellofemoral joint (PFJ) surface, whole measurement area was analysed by dividing into medial, lateral and central area. @*Results@#In craniolateralization of tibial tuberosity, total, medial, central contact pressure was decreased and lateral contact pressure was not statistically changed lateral contact pressure than normal PFJ. In caudolateralization of tibial tuberosity, total, lateral contact pressure was increased and medial contact pressure was not statistically changed than normal PFJ. Although not statistically significant changed, central contact pressure in caudolateralization of tibial tuberosity was increased in all 5 specimens. @*Conclusions@#These results imply that traditional TTT, prone to caudal shift of patellar tendon, can increase retropatellar pressure may lead to various complications and diseases of the stifle joint.