Evaluation of macular choroidal and microvascular network changes by activity scores and serum antibodies in thyroid eye patients and healthy subjects.

AIM: To investigate the choroidal thickness and the microvascular network changes around the macula in thyroid eye disease (TED) patients at different stages and the relationship of those changes with risk factors, serum antibodies and the severity of TED. METHODS: A total of 85 participants were enrolled. All participants underwent ophthalmology and endocrinology examinations. Subfoveal choroidal thickness (SFCT), superficial (s) and deep (d) foveal avascular zone (FAZ) area, mean (m) and central (c) superficial vascular density (SVD), deep vascular density (DVD) measurements of the enrolled cases were performed with Topcon swept source optical coherence tomography (OCT)/OCT angiography (OCTA) DRI OCT Triton. Multiple linear regression analysis was used to explore the associations between SFCT, FAZ area, SVD, DVD and the relevant factors of TED. RESULTS: Those with active TED patients had higher c-DVD and m-DVD levels (P<0.05), however there is no statistically significant difference in SFCT between active and stable TED patients. Among the serum antibodies, it was observed that s-FAZ and d-FAZ increased, c-SVD and m-SVD decreased in patients with high thyroid stimulating hormone-receptor autoantibodies (TRAB) level, whereas SFCT thickened in patients with high levels of both TRAB and human thyroglobulin (hTG). There was no significant difference in SFCT, FAZ, SVD and DVD measurement at gender, between hyperthyroid and euthyroid patients and among those with or without thyroid papillary carcinoma. CONCLUSION: The results show that both disease activation and serum antibodies differentially affect both superficial and deep retinal vascular density. It has also been shown that high serum antibody levels affect choroidal thickness independent of clinical activity.

Imaging of the lower punctum with anterior segment OCT in patients with dacryocystorhinostomy who underwent bicanalicular silicone tube implantation.

Spectral domain OCT imaging of the lower punctum in cases with silicone tube implantation OBJECTIVE: To record the structural changes in the lower punctum by performing spectral domain anterior segment OCT imaging of dacryocystorhinostomy cases who underwent bicanalicular silicone tube implantation. METHODS: Thirty eyes of 30 patients who underwent bicanalicular Crawford silicone tube implantation with dacryocystorhinostomy were included in the study. The mean age of the cases was 53 ± 13.96 (24-72). Of the cases, 19 were female and 11 were male, 18 of them were operated on the right eye and 12 on the left eye. The lower punctum images of the cases were recorded with spectral domain anterior segment OCT preoperatively and at the 1st day, 1st month and 6th month after explantation of the silicone tube. In the lower punctum, external punctal width(EPW) and canaliculi depth (CD) were measured. RESULTS: The mean EPW and CD measurements of the cases in the preoperative period, respectively; 544.90±144.11 µm and 451.70±197.45 µm. First day after silicone tube explantation, EPW was 818.00±186.83 µm and CD was 735.35±337.15 µm, at 1st month EPW was 665.95±142.12 µm and CD was 619.30±212.11 µm and at 6th months EPW was 530±150.29 µm and CD was 558.45±254.37 µm, respectively. Mean EPW values were found to be higher on the first day after extubation than before surgery (p = 0.001). There was no significant difference in the mean EPW values at the first and sixth months after extubation compared to pre-implantation (p>0.05). The mean CD values were higher at the 1st day, 1st month and 6th month after tube explantation than preoperative CD values, they were not statistically significant. CONCLUSIONS: According to the lower punctum OCT imaging data, silicone tube implantations applied to the canalicular system do not create a structurally significant difference in the lower punctum. The punctal opening gradually decreases after extubation. The decrease in EPW values is more pronounced than the decrease in CD values. Silicone tube implantation was more effective in maintaining canaliculi depth compared to external punctal diameter.

Factors affecting the need for silicon tube implantation in cases of congenital dacriostenosis: time of delivery, type of delivery and age of operation.

PURPOSE: To evaluate the delivery time, type of delivery, age at the time of operation, and surgical methods applied in cases of congenital nasolacrimal duct obstruction (CNLDO). METHODS: This study retrospectively included a total of 207 eyes of 160 cases who underwent surgery for CNLDO between February 2012 and April 2021. According to their age at the time of operation, the cases were divided into 0-12, 12-24, 24-36, 36-48 and > 48 months groups. The cases were evaluated as term/preterm according to the delivery time and cesarean section/vaginal delivery according to the type of delivery. The surgical methods applied were examined as probing alone and probing plus silicone tube implantation. RESULTS: Of the cases, 146 (91.2%) were born at term and 14 (8.7%) were born preterm, and there was no statistically significant difference in the silicone tube implantation rates according to the time of delivery. The rate of silicone tube implantation was statistically significantly higher in the vaginal delivery group than in the cesarean section group (p = 0.001; p < 0.01). The rate of silicone tube implantation was higher in those who were older than the age of the operation. CONCLUSIONS: Although the rate of those who were born by cesarean section was higher in probing cases, those who required silicone intubation were more common in those who were born vaginally. This suggests that dacryostenosis in the vaginally born cases resulted from a persistent structural and anatomical obstruction despite the presence of a high intrauterine pressure increase and enzymatic lysis.

Intraosseous malignant peripheral nerve sheath tumor at the frontal bone in a child: a rare cause of proptosis.

We report a nine-year-old male having malignant peripheral nerve sheath tumor (MPNST) of the frontal bone, represented with a twelve-month history of ptosis and proptosis in his right eye and enlarged rapidly in the last three months. Except for slight numbness at his one-third of the right forehead, he had no neurological deficit. The patient's both eyes were having normal eye movements, and he had no visual acuity or field loss. After surgery, we observed the patient with no recurrence for 4 years.

Quality analysis of YouTube videos about thyroid orbitopathy.

PURPOSE: To evaluate the quality and reliability of YouTube videos about Thyroid Orbitopathy. METHODS: A YouTube search was performed using the keyword 'Graves eye disease', 'thyroid eye disease', 'thyroid orbitopathy', 'thyroid ophtalmopathy' in the search bar of YouTube. The first 50 videos were analyzed for each keywords, and the first 100 videos that came out were included in the study. The numbers of views, likes, dislikes, comments, daily viewing rate (number of views per day), uploaded source, country of origin, video type (patient experience, scholarly information), and described treatment technique were evaluated for all videos. They were also evaluated regarding their DISCERN, Journal of the American Medical Association (JAMA), global quality score (GQS) and usefulness score by two independent ophthalmologists. RESULTS: Of the top 100 videos, 94 videos met the criteria. The mean DISCERN, JAMA, GQS and usefulness score were 55.27 ± 16.57, 3.04 ± 0.64, 3.44 ± 0.93 and 3.23 ± 1.1. If we look at the upload source 53 (56.4%) videos were uploaded by physicians, 30 (31.9%) videos by institutions/private health institutions, 7 (7.4%) videos by health channels, 4 (4.3%) videos by patients. All scoring systems showed a statistically significant and strong positive correlation with each other (p < 0.001). A statistically significant positive correlation between viewing rate, likes and comments was observed. As the duration of the video increased, a significant increase in the scores in other scores was observed. CONCLUSION: We observed that the tests we used in the scoring were correlated with each other. Most of the thyroid orbitopathy videos on YouTube were of good quality. Ophthalmologists should guide their patients who want to get information on YouTube to watch videos uploaded by health care professionals.

Changes in TRPV1 Expression as Well as Substance P and Vasoactive Intestinal Peptide Levels Are Associated with Recurrence of Pterygium.

Pterygium, a disease of the ocular surface, is characterized by the proliferation and invasion of fibrovascular tissue. Chronic inflammation contributes to pterygium occurrence. Sensory neuropeptides of TRPV1-positive nerve fibers are involved in inflammation and corneal wound healing. The possible association between TRPV1 in nerve fibers and neuropeptides such as Substance P (SP) and Vasoactive Intestinal Peptide (VIP) in the recurrence of pterygium has not been examined before. The pterygia from 64 patients were used to determine changes in SP and VIP levels using 10 min acetic-acid extraction that yielded mainly neuronal peptides. There was a sufficient amount of pterygium tissues from the 35 patients for further immunohistochemical analysis of TRPV1 and S100, which is a glial marker to visualize nerve fibers. SP and VIP levels increased markedly in cases with primary and secondary recurrences, and there was a close correlation between SP and VIP levels. TRPV1 expression increased in the epithelium, while stromal expression decreased in recurrences. Nerve fibers were demonstrated mainly in the stroma, and serial sections confirmed the localization of TRPV1 with the nerve fibers. These results together with previous findings demonstrated that the increased epithelial expression of TRPV1 in recurrent pterygia might be involved in the pathogenesis, and the inhibition of epithelial TRPV1 activity may prevent recurrence.

Genotype and phenotype characteristics of X-linked retinoschisis: the first report of a Turkish population.

BACKGROUND: X-linked retinoschisis is an inherited retinal disease caused by mutations in the RS1 gene; however, a genotype-phenotype correlation regarding the mutation type or location within the RS1 gene and clinical characteristics of the patients has not been established yet. This is the first report documenting the genotypes and ophthalmological findings in a Turkish population with confirmed RS1 mutations. MATERIALS AND METHODS: Fifty eyes of 25 male patients were included in the study. RS1 mutation analysis was performed by DNA sequencing. Retrospective analysis of ocular examinations and SD-OCT scans were applied. RESULTS: The major mutation was c.422 G > A (p.Arg141His, exon 5) affecting 14 patients (56%) and c.531 T > G was the only non-sense mutation out of 7 pathogenic variants. At presentation; the mean age was 24.6 ± 16.2 (4-72) years, mean visual acuity (VA) was 0.61 ± 0.32 (logMAR, 0.10-1.30). Forty-six (92%) eyes had macular, 16 eyes (32%) had peripheral retinoschisis. None of the eyes had macular scar, whereas 7 eyes (14%) had macular atrophy. The most frequent location of schisis was inner nuclear layer (37.5%). The eyes with disruption of ellipsoid zone (EZ) or external limiting membrane (ELM) had worse VA (for EZ, 0.65 ± 0.25 versus 0.45 ± 0.34, logMAR, 31 versus 17 eyes, p = .013; for ELM, 0.66 ± 0.27 versus 0.45 ± 0.31, logMAR, 30 versus 18 eyes, p = .008). CONCLUSIONS: Seven different pathogenic variants in the RS1 gene were identified; with c.422 G > A (p.Arg141His) as the most frequent variant and c.531 T > G as only non-sense mutation. Having EZ or ELM disruption were the significant factors affecting VA.

Evaluation of ocular blood flow by Doppler ultrasound in patients with essential blepharospasm.

PURPOSE: Benign essential blepharospasm (EB) is a focal facial dyskinesia that occurs with the involuntary contraction of muscles around the eyes. In the literature, studies on blepharospasm focus on elucidating the pathophysiology of this condition in the brain. To the best of our knowledge, there is no research evaluating the orbital imaging findings of patients with EB. Therefore, the current study aimed to determine whether there was any change in the blood supply of muscles around the eye or ocular blood flow in patients with blepharospasm and investigate flow changes that may be caused by spasm. METHODS: Thirty patients with EB and 30 controls were included in the study. Orbital Doppler ultrasound was performed in all cases to measure ophthalmic and temporal artery peak systolic velocity and end diastolic velocity and calculate resistive index values. Superior ophthalmic vein blood flow velocity (SOVBFV) was also measured. RESULTS: There was no significant difference between the groups in terms of age and gender distribution (P = 0.345 and 0.870, respectively). SOVBFV was found to be significantly higher in the EB group (P = 0.001). No significant difference was observed in the remaining investigated parameters. CONCLUSIONS: In conclusion, our study suggested that ocular spasm in patients with EB had no effect on blood flow other than SOVBFV. When SOVBFV was compared between the EB and control groups, it was found to be increased in the EB group. We consider that this statistical difference may be clinically and pathophysiologically significant.

A small incision technique for repairing involutional lower eyelid entropion.

PURPOSE: The objective of this paper is to describe and review our experience with Goldberg's small incision technique for use with involutional entropion. METHODS: Retrospective consecutive interventional case series with validated late surgical outcomes were reported. All involutional entropion cases with horizontal laxity of less than 8 mm were repaired with a small incision technique. Retractors were separated from the tarsus by blunt dissection made from three 4 mm horizontal incisions. Three 6-0 double-armed polyglactin sutures were used to tighten retractors and the orbicularis oculi muscle. The sutures were removed 3 weeks postoperatively or earlier if overcorrection continued during the first week of the postoperative period. Data were obtained for a postoperative follow-up period of at least 24 months. RESULTS: A total of thirty-seven lower eyelids from thirty-one patients with involutional entropion were included in the study. Primary operations were performed on 31 eyelids and reoperations on six eyelids. The mean follow-up time was 40 ± 11 months. Thirty-six (97.3%) of the eyelids had no recurrence. As overcorrection was seen postoperatively in ten eyelids (27%), a number of sutures had to be removed earlier than planned. The ectropion eventually resolved, and no recurrence was seen during follow-up in these patients. CONCLUSIONS: In our practice, the small incision technique has been highly effective in involutional entropion repair, with minimal complications. Although this approach does not directly address lateral canthal tendon laxity, the procedure has the advantages of being easy to learn and also that it can be combined with other procedures for tendon laxity.

A unique case of isolated sebaceous adenoma of the bulbar conjunctiva.

Our patient was a 34 year-old male who presented with a painless conjunctival mass that had developed 3 months before his first visit. On performing slit-lamp biomicroscopy, a lobulated pink-yellowish solid mobile mass was observed on the nasal bulbar conjunctival surface of his left eye. The tumor was excised, and histopathologic examination of the tumor revealed a sebaceous adenoma. Systemic examination was normal. No recurrence was observed during the 24-month follow-up period. Sebaceous adenoma of the bulbar conjunctiva is an extremely rare benign tumor, which may be observed to be isolated in the absence of malignancy.

A unique case of isolated sebaceous adenoma of the bulbar conjunctiva / Um caso único de adenoma sebáceo isolado de conjuntiva bulbar

ABSTRACT Our patient was a 34 year-old male who presented with a painless conjunctival mass that had developed 3 months before his first visit. On performing slit-lamp biomicroscopy, a lobulated pink-yellowish solid mobile mass was observed on the nasal bulbar conjunctival surface of his left eye. The tumor was excised, and histopathologic examination of the tumor revealed a sebaceous adenoma. Systemic examination was normal. No recurrence was observed during the 24-month follow-up period. Sebaceous adenoma of the bulbar conjunctiva is an extremely rare benign tumor, which may be observed to be isolated in the absence of malignancy.

RESUMO Nosso paciente era um homem de 34 anos que apresentou uma massa conjuntival indolor desde há 3 meses antes da primeira consulta. Na biomicroscopia por lâmpada de fenda, observa-se uma massa rosa-amarelada, sólida, móvel e lobulada na superfície conjuntival bulbar nasal, em seu olho esquerdo. O tumor foi retirado e o exame histopatológico demonstrou um adenoma sebáceo. O exame sistêmico era normal. Nenhuma recidiva foi observada durante os 24 meses de acompanhamento. Adenoma sebáceo da conjuntiva bulbar é um tumor benigno extremamente raro e pode ser visto isolado, sem quaisquer doenças malignas associadas.

The Expression of GDF-15 in the Human Vitreous in the Presence of Retinal Pathologies with an Inflammatory Component.

PURPOSE: The presence of growth differentiation factor-15 (GDF-15), a protein implicated in the regulation of the inflammatory response, was investigated in the vitreous of patients with vitreoretinal disorders. METHODS: Vitreous and plasma samples were collected from patients with idiopathic epiretinal membrane (IERM), macular hole (MH), rhegmatogenous retinal detachment (RRD), nucleus drop (ND), or proliferative diabetic retinopathy (PDR). GDF-15 concentrations were measured using ELISA. RESULTS: The vitreous levels of GDF-15 were higher in ND (5) and PDR (14) patients (1494 ± 243 and 904 ± 138 pg/mL, respectively) than RRD (3), MH (3), and IERM (8) patients (302 ± 160, 288 ± 24, and 254 ± 91 pg/mL, respectively). The vitreous levels of GDF-15 were significantly higher in patients with inflammatory vitreoretinal disorders (p < 0.0001). CONCLUSIONS: This is the first report showing that GDF-15 appears to be expressed in the vitreous, and that its expression is significantly higher in the presence of a vitreoretinal disorder in which there is an inflammatory component.

An uncommon ocular manifestation of Sweet syndrome: peripheral ulcerative keratitis and nodular scleritis.

Sweet syndrome (acute febrile neutrophilic dermatosis) is characterized by fever, neutrophilic leukocytosis, and abrupt appearance of painful erythematous nodules and plaques, particularly on the face, neck, and limbs. In this study, we report a very rare case of Sweet syndrome in which the patient presented nodular scleritis and peripheral ulcerative keratitis during the dermatologically inactive period of the disease.

Iatrogenic retinal breaks caused by infusion fluid during pars plana vitrectomy.

OBJECTIVE: To describe a series of cases of iatrogenic retinal breaks (IRBs) caused by the infusion fluid flow of a 25-gauge pars plana vitrectomy (PPV) system. DESIGN: Retrospective case series. METHODS: During 25-gauge PPV, 4 cases had IRBs caused by infusion fluid flow. The IRBs rapidly progressed to localized retinal detachment. RESULTS: The first 3 cases had IRBs on the nasal quadrant midperiphery of the retina. The IRBs were treated with laser retinopexy and tamponade during surgery. Case 4 had a macular hole and macular detachment during scleral indentation. The IRBs seemed to be caused by intraocular pressure (IOP) control mechanisms of the vitrectomy device. CONCLUSIONS: To prevent IRBs caused by infusion fluid flow, we recommend using an IOP control limit of 4 mL/min for 25-gauge vitrectomy, with valved cannulas. In addition, the surgeon must be cautious during scleral indentation and air-fluid exchange not to cause a rebound hypotonia.

An uncommon ocular manifestation of Sweet syndrome: peripheral ulcerative keratitis and nodular scleritis / Uma manifestação ocular rara de síndrome de Sweet: ceratite ulcerativa periférica e esclerite nodular

Sweet syndrome (acute febrile neutrophilic dermatosis) is characterized by fever, neutrophilic leukocytosis, and abrupt appearance of painful erythematous nodules and plaques, particularly on the face, neck, and limbs. In this study, we report a very rare case of Sweet syndrome in which the patient presented nodular scleritis and peripheral ulcerative keratitis during the dermatologically inactive period of the disease.

A síndrome de Sweet (dermatose neutrofílica febril aguda) é caracterizada por febre, leucocitose neutrofílica, aparecimento abrupto de nódulos eritematosos dolorosos e placas, principalmente na face, pescoço e membros. Neste artigo, relatamos um caso muito raro de síndrome de Sweet, que tinha esclerite nodular e ceratite ulcerativa periférica no período dermatologicamente inativo da doença.

Is Smoking a Risk Factor in Ocular Behçet Disease?

PURPOSE: To investigate the association between smoking and prognosis of ocular Behçet disease. MATERIAL/METHODS: Medical records of 202 patients with Behçet uveitis were collected retrospectively. Patients were assigned to two groups according to smoking habits. In group I, 72 patients were current smokers. In group II, 130 were nonsmokers. The localization of uveitis, time to resolution of uveitis, time to recurrences, visual acuities, and presence of cystoid macular edema were compared between groups. RESULTS: The demographic characteristics were similar in both groups. Smoking was not associated with types of uveitis with OR of 1.01 (95% CI, 0.99-1.04; p = 0.21) for anterior uveitis, 0.96 (95%CI, 0.90-1.02; p = 0.18) for posterior uveitis, and 1.80 (95% CI, 0.75-2.77; p = 0.24) for panuveitis. The average times to inflammation resolution were 48 ± 10.1 days in group I and 51 ± 14 days in group II (p = 0.82). The average times to recurrence were 8.6 ± 5 months for smokers and 9.1 ± 7 months for nonsmokers (p = 0.43). Patients with CME in groups were 18 (25%) and 42 (32.3%), respectively (p = 0.08). CONCLUSIONS: Our findings suggest that smoking does not have a negative effect on the clinical findings and prognosis of uveitis in Behçet disease.

Surgical results of the slipped medial rectus muscle after hang back recession surgery.

AIM: To analyze the surgical results of a slipped medial rectus muscle (MRM) after hang back recession surgery for esotropia. METHODS: Twenty-one patients who underwent re-exploration for diagnosed slipped muscle after hang back recession surgery were included in this retrospective study. Dynamic magnetic resonance imaging was performed to identify the location of the slipped muscle. Ocular motility was evaluated with assessment with prism and cover test in gaze at cardinal positions. The operations were performed by the same consultant. Intraoperative forced duction test was performed under general anesthesia. The empty sheath of the slipped MRM was resected and the muscle was advanced to the original insertion site in all patients. RESULTS: The average age of 21 patients who had consecutive exotropia with a slipped MRM at the time of presentation was 17.4±5.4y (5-50y). The average duration between the first operation and the diagnosis of the slipped muscle was 25mo (12 to 36mo). The mean follow up after the corrective surgery was 28mo. The mean preoperative adduction limitation in the field of action of the slipped muscle was -2.26 (ranging from -1 to -4). All patients had full adduction postoperatively. CONCLUSION: The diagnosis of the slipped muscle should be confirmed during the strabismus surgery. The slipped muscle may be caused due to insufficient suture and excessive rubbing of the eye. When divergent strabismus is observed after the recession of the MRM, a slipped muscle should be considered in the differential diagnosis.

A case report of bilateral choroidal metastases of epithelial carcinoma of pancreas.

A 49-year-old woman with acute loss of vision in her left eye was examined in our clinic. Two months before arriving at out clinic, she was diagnosed with pancreatic endothelial carcinoma. Her visual acuities were 20/20 for the right and 20/200 for the left eye. Fundus examination and fundus fluorescein angiography showed bilateral subretinal solitary mass. Multiple metastases to lung, pleura, liver, spleen, and abdominal lymph nodes were detected during the initial diagnosis. The patient underwent chemotherapy during the period when the visual symptoms were observed. No additional treatment was offered because of the extent of the disease and poor general health. Although pancreatic endothelial carcinoma usually spreads to the abdominal visceral organs and lungs, choroidal metastases are rarely observed.

A case report of bilateral choroidal metastases of epithelial carcinoma of pancreas / Um relato de caso de metástases de coroide bilaterais de carcinoma epitelial de pâncreas

A 49-year-old woman with acute loss of vision in her left eye was examined in our clinic. Two months before arriving at out clinic, she was diagnosed with pancreatic endothelial carcinoma. Her visual acuities were 20/20 for the right and 20/200 for the left eye. Fundus examination and fundus fluorescein angiography showed bilateral subretinal solitary mass. Multiple metastases to lung, pleura, liver, spleen, and abdominal lymph nodes were detected during the initial diagnosis. The patient underwent chemotherapy during the period when the visual symptoms were observed. No additional treatment was offered because of the extent of the disease and poor general health. Although pancreatic endothelial carcinoma usually spreads to the abdominal visceral organs and lungs, choroidal metastases are rarely observed.

Uma mulher de 49 anos de idade, com perda visual aguda de seu olho esquerdo, que teve diagnóstico de carcinoma endotelial de pâncreas há dois meses, foi examinada em nossa clínica. Suas acuidades visuais eram 20/20 no olho direito e 20/200 no olho esquerdo. O exame de fundo de olho e a angiofluoresceinografia mostraram massa solitária sub-retiniana bilateral. Múltiplas metástases do pulmão, pleura, fígado, baço e nódulos linfáticos abdominais foram detectados no diagnóstico inicial. A paciente foi submetida a quimioterapia durante o tempo que os sintomas visuais foram observados. Nenhum tratamento adicional foi oferecido por causa da extensão da doença e problemas de saúde em geral. Embora o carcinoma endotelial de pâncreas normalmente se espalhe para órgãos abdominais e pulmões, este pode ser uma causa rara de metástases de coroide.

Bilateral congenital cataracts in an infant with Klinefelter syndrome.

Congenital cataract is one of the most treatable causes of visual impairment and blindness during infancy, with an estimated prevalence of approximately 2.5:10,000 infants under the age of 1 year. Congenital cataract can be observed with certain chromosomal abnormalities, such as trisomies, deletions, translocations and Turner syndrome. In Klinefelter syndrome, however, ocular complications and cataract are not commonly encountered, so reports in the literature are very rare. In this manuscript, we present a 3-month-old male infant who had congenital cataracts. Chromosomal analysis revealed that his karyotype was 47,XXY. He did not show any of the main clinical signs of Klinefelter syndrome because of his very young age. To the best of our knowledge, our patient is only the second-ever case reported in the literature in which congenital cataracts have been found in an infant with a nonmosaic 47,XXY karyotype. The aim of the present report is to both describe the ocular abnormalities that can sometimes be found in Klinefelter syndrome and to emphasize the importance of performing a karyotype analysis in order to rule out chromosome abnormalities in patients with congenital cataracts.