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1.
Am J Case Rep ; 25: e943299, 2024 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-38508873

RESUMO

BACKGROUND Pseudo-Brown syndrome is characterized by dysfunction of the superior oblique tendon-trochlear complex. Canine tooth syndrome, which involves superior oblique palsy with pseudo-Brown syndrome, results from damage to the trochlear and superior oblique tendon from dog bites around the eye. This report describes a variant of canine tooth syndrome without pseudo-Brown syndrome following a dog bite around the left upper eyelid. In this case, magnetic resonance imaging (MRI) facilitated early diagnosis and therapeutic intervention. CASE REPORT A 19-year-old man presented with torsional diplopia following a dog bite around the left upper eyelid and forehead. Five days after the injury, an alternate prism cover test revealed 6 prism diopters (Δ) exotropia and 5Δ left hypertropia. Ocular motility showed no significant limitation in elevation or depression during adduction. MRI performed on the same day showed a high-signal area extending from the superior oblique tendon to the trochlear region and the superior oblique muscle belly of the left eye. A diagnosis of canine tooth syndrome without pseudo-Brown syndrome was made and oral steroids were administered. Ocular alignment did not improve, so left inferior oblique myotomy was performed 7 months after the injury. The patient's cyclovertical diplopia resolved postoperatively. CONCLUSIONS Dog bites around the eye can result in abnormalities of the extraocular muscles. Early MRI may be useful for diagnosis and determining treatment strategies. This report has highlighted the importance of rapid assessment and management of patients with dog bites involving the eye.


Assuntos
Transtornos da Motilidade Ocular , Estrabismo , Masculino , Animais , Humanos , Cães , Adulto Jovem , Adulto , Transtornos da Motilidade Ocular/patologia , Transtornos da Motilidade Ocular/cirurgia , Diplopia/etiologia , Estrabismo/etiologia , Estrabismo/cirurgia , Movimentos Oculares , Músculos Oculomotores/patologia , Músculos Oculomotores/cirurgia , Síndrome , Paralisia
3.
Am J Ophthalmol ; 246: 51-57, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36270333

RESUMO

PURPOSE: To compare the facial features of patients with sagging eye syndrome (SES) and other ophthalmic diseases, and to evaluate the diagnostic usefulness of facial features for SES. DESIGN: Retrospective cross-section study. METHODS: We evaluated frontal facial photographs of patients >60 years of age with SES and intermittent exotropia (IXT), and control patients who visited the ophthalmology outpatient clinics of 2 institutions between June 2020 and December 2021. Three ophthalmologists evaluated each eye for sunken upper eyelid, blepharoptosis, and baggy lower eyelid, using a scoring scale. The average scores for each parameter among the 3 groups were analyzed. Patients with glaucoma, visual acuity <16/20, SES with a vertical strabismus angle of ≥6 Δ, IXT that could not be maintained in the phoria position during photography, a history of previous oculoplastic or ophthalmic surgery, and use prostaglandin analogs for cosmetic purposes were excluded. RESULTS: A total of 86 patients were included: 23 with SES, 28 with IXT, and 35 in the control group. All were Japanese. In all, 45 patients were male and 41 were female. The mean age was 72.7 ± 7.4 years. The sunken upper eyelid scores were significantly higher in the SES group than in the control and IXT groups (P < .001), whereas the baggy lower eyelid scores were significantly higher in the IXT group than in the control group (P < .05). CONCLUSIONS: Age-related orbital connective tissue degeneration may manifest as SES in the upper eyelid and as IXT in the lower eyelid.


Assuntos
Blefaroptose , Exotropia , Estrabismo , Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Exotropia/diagnóstico , Exotropia/cirurgia , Estudos Retrospectivos , Acuidade Visual , Doença Crônica , Síndrome
4.
J Eye Mov Res ; 15(1)2022.
Artigo em Inglês | MEDLINE | ID: mdl-35444735

RESUMO

This study compared the time required to produce nine-directional ocular photographs using the conventional method to that using the newly devised 9Gaze application. In total, 20 healthy adults, 10 adult patients with strabismus, and 10 pediatric patients with amblyopia or strabismus had their ocular photographs taken using a digital camera with PowerPoint 2010, and with an iPad, and iPod touch with 9Gaze. Photographs of 10 healthy patients were taken by orthoptists with <1 year of experience, and the other participants had theirs taken by those with >1 year of experience. The required time was compared between the three devices in all patients and the two orthoptist groups in 20 healthy adults (>1 year and <1 year of experience). The required times were significantly different between the devices: 515.5 ± 187.0 sec with the digital camera, 117.4 ± 17.8 sec with the iPad, and 76.3 ± 14.1 sec with the iPod touch. The required time with the digital camera was significantly different between the two orthoptist groups (404.7 ± 150.8 vs. 626.3 ± 154.2 sec, P=0.007). The use of the 9Gaze application shortened the recording time required. Furthermore, 9Gaze can be used without considering the years of experience of the examiner.

5.
Ocul Immunol Inflamm ; 30(1): 223-230, 2022 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-32815752

RESUMO

PURPOSE: The efficacy of infliximab (IFX) and adalimumab (ADA) for treating Behçet's syndrome (BS) and sarcoidosis has not been compared adequately. METHODS: We reviewed the medical records of patients with uveitis diagnosed at Tokyo Medical University Hospital and compared the efficacy of IFX and ADA for BS and the efficacy of ADA for sarcoidosis and BS. RESULTS: 68 patients in IFX group and 63 patients in ADA group were analyzed. In BS patients, IFX and ADA were both effective in improving uveitic macular edema (UME). ADA improved UME in BS but not in sarcoidosis patients. The efficacy of ADA in reducing doses of corticosteroids and glaucoma medications was better in sarcoidosis than in the BS group. CONCLUSION: Both IFX and ADA are efficacious in improving UME in BS patients. The reason that ADA improves UME better in BS than in sarcoidosis may be due to the difference in pathogenesis between these diseases.


Assuntos
Síndrome de Behçet , Sarcoidose , Uveíte , Adalimumab/uso terapêutico , Síndrome de Behçet/complicações , Síndrome de Behçet/diagnóstico , Síndrome de Behçet/tratamento farmacológico , Humanos , Infliximab/uso terapêutico , Sarcoidose/complicações , Sarcoidose/diagnóstico , Sarcoidose/tratamento farmacológico , Resultado do Tratamento , Inibidores do Fator de Necrose Tumoral , Fator de Necrose Tumoral alfa/uso terapêutico , Uveíte/diagnóstico , Uveíte/tratamento farmacológico , Uveíte/etiologia
6.
Jpn J Ophthalmol ; 65(6): 836-842, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34491475

RESUMO

PURPOSE: We assessed the efficacy and safety of performing intraocular surgery for refractory uveitis under adalimumab (ADA) therapy. STUDY DESIGN: Single-center cohort study between 2016 and 2019. METHODS: In uveitis patients undergoing intraocular surgery under ADA treatment, we collected clinical data before surgery, and at the first visit, 6 months and last visit after surgery (follow-up 19.3 ± 8.1 months). Primary outcomes were visual acuity (VA) improvement in patients after cataract surgery, intraocular pressure (IOP) in patients after trabeculectomy and intraocular inflammation in all patients. Secondary outcomes were activated inflammation, vitreous opacity (OCV), uveitic macula edema (UME) and infection. RESULTS: Of 81 patients (161 eyes) initiated ADA therapy for uveitis, 19 patients (23 eyes) underwent intraocular surgery and were analyzed. Twelve of 18 eyes (66.6%) that underwent cataract surgery or vitrectomy with/without cataract surgery had improved VA at the last visit compared to before surgery. All 5 eyes that underwent trabeculectomy showed controlled IOP 6 months after surgery. Intraocular inflammation was resolved in 22 of 23 eyes at the first postoperative visit. Postoperative intraocular inflammation recurred in 3 eyes; 2 with UME, 1 with OCV. No eyes developed infection postoperatively. Preoperative ADA therapy duration was unrelated to relapse of intraocular inflammation. CONCLUSION: Surgery for refractory uveitis under ADA treatment is safe and achieves good visual outcome and uveitis control if inflammation exists before surgery. ADA does not increase the risk of infections. Intraoperative findings of UME at surgery requires attention for postoperative relapse.


Assuntos
Extração de Catarata , Catarata , Uveíte , Adalimumab/uso terapêutico , Estudos de Coortes , Humanos , Pressão Intraocular , Complicações Pós-Operatórias , Estudos Retrospectivos , Resultado do Tratamento , Uveíte/diagnóstico , Uveíte/tratamento farmacológico
7.
Ocul Immunol Inflamm ; 29(5): 976-981, 2021 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-32068467

RESUMO

Purpose: We investigated the changes in etiology of uveitis at the Uveitis Clinic of Tokyo Medical University Hospital in recent years.Methods: Medical records of patients with uveitis diagnosed between 2011 and 2017 (Group A) and between 2001 and 2007 (Group B) were reviewed.Results: 1,587 patients in group A and 1,507 patients in group B were analyzed. For noninfectious uveitis, frequencies of Vogt-Koyanagi-Harada disease, intraocular lymphoma (IOL) and iridocyclitis in young girls increased, while those of sarcoidosis and Behçet's disease decreased in the recent era. For infectious uveitis, herpetic iridocyclitis, ocular toxoplasmosis, ocular syphilis, and bacterial endophthalmitis increased, while acute retinal necrosis and ocular toxocariasis decreased. Unclassified uveitis decreased, whereas infectious uveitis and IOL increased due to the availability of new diagnostic tests.Conclusion: Etiologies of uveitis have changed over the years. Further development of novel tests and diagnostic criteria would increase definitive diagnosis for unclassified uveitis. (147/150 words).


Assuntos
Uveíte/epidemiologia , Uveíte/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Síndrome de Behçet/complicações , Síndrome de Behçet/epidemiologia , Criança , Pré-Escolar , Endoftalmite/complicações , Endoftalmite/epidemiologia , Estudos Epidemiológicos , Feminino , Humanos , Lactente , Recém-Nascido , Linfoma Intraocular/complicações , Linfoma Intraocular/epidemiologia , Iridociclite/complicações , Iridociclite/epidemiologia , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sarcoidose/complicações , Sarcoidose/epidemiologia , Sífilis/complicações , Sífilis/epidemiologia , Toxoplasmose Ocular/complicações , Toxoplasmose Ocular/epidemiologia , Uveíte/diagnóstico , Síndrome Uveomeningoencefálica/complicações , Síndrome Uveomeningoencefálica/epidemiologia
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