The association between serum homocysteine levels and retinopathy of prematurity.

OBJECTIVE: To evaluate the relationship between serum total homocysteine levels and retinopathy of prematurity (ROP). METHODS: This prospective case-control study involved premature infants diagnosed with ROP 4 weeks after birth (cases); controls were premature infants not developing ROP during follow-up. Fasting serum total homocysteine concentrations were determined in all participants 4 weeks after birth, using high performance liquid chromatography. RESULTS: A total of 45 and 35 infants were included in the case and control groups, respectively. The mean ± SD (range) serum total homocysteine levels were 10.36 ± 1.72 µmol/l (7.45-14.84) in infants with ROP and 8.41 ± 2.12 µmol/l (5.56-13.90) in controls. This difference was statistically significant. Mean ± SD total homocysteine levels were higher in infants with more severe ROP (11.45 ± 1.76 µmol/l) compared with mild ROP (9.92 ± 1.56 µmol/l). CONCLUSIONS: Elevated serum total homocysteine levels are associated with the development of ROP in premature infants. Further studies with larger patient populations are required, to improve understanding of the relationship between homocysteine and ROP development.

Optical coherence tomography and angiography in patients with angioid streaks.

PURPOSE: To investigate the retinal and choroidal features of angioid streak by fluorescein angiography (FA), indocyanine green anigography (ICG-A) and optical coherence tomography (OCT). METHODS: We analysed 46 eyes of 23 patients with angioid streaks examined at our retina section between March 1998 and June 2000. Their mean age was 42.8 years (26-61 years). After a routine ophthalmological examination, OCT and simultaneous fluorescein and indocyanine green angiography (FA/ICG-A) were done. Color fundus photographs were also taken. RESULTS: A peau dorange appearance and angioid streaks were more numerous and apparent with ICG-A than FA. In two eyes (4.3%), some streaks that were well visualized on FA were not visible on ICG-A. Twenty eyes (43.5%) had macular complications and 26 (56.5%) were normal. Occult choroidal neovascularization (CNV) was diagnosed by ICG-A. Nine eyes had occult, and 11 had classic CNV. Ruptures of Bruchs membrane were hypofluorescent in 20 (43.5%) and hyperfluorescent in 26 eyes (56.5%). Optic disc drusen were detected in both eyes of one patient (4.3%). Localized hyperreflectivity was thought to be due to calcium deposits. CONCLUSIONS: Angioid streaks were visualized more clearly and in larger numbers by ICG-A than FA. However, in some cases streaks that were funduscopically and fluorescein angiogrpahically visible could not be seen by ICG-A. Occult CNV was detected by ICG-A. Some mottled areas were seen and more clearly visualized by ICG-A. Calcium deposits were observed as localized areas of hyperreflectivity on OCT. These findings indicate that fluorescein angiography, ICG-A and optical coherence tomography all provide supportive information for each other and can be used for either diagnosis or follow-up of those patients. (Eur J Ophthalmol 2002; 12: 473-81).

Optical coherence tomography (OCT) and angiography in patients with angioid streaks.

PURPOSE: To investigate the retinal and choroidal features of angioid streak by fluorescein angiography (FA), indocyanine green angiography (ICG-A) and optical coherence tomography (OCT). METHODS: We analysed 46 eyes of 23 patients with angioid streaks examined at our retina section between March 1998 and June 2000. Their mean age was 42.8 years (26-61 years). After a routine ophthalmological examination, OCT and simultaneous fluorescein and indocyanine green angiography (FA/ICG-A) were done. Color fundus photographs were also taken. RESULTS: A peau d'orange appearance and angioid streaks were more numerous and apparent with ICG-A than FA. In two eyes (4.3%), some streaks that were well visualized on FA were not visible on ICG-A. Twenty eyes (43.5%) had macular complications and 26 (56.5%) were normal. Occult choroidal neovascularization (CNV) was diagnosed by ICG-A. Nine eyes had occult, and 11 had classic CNV Ruptures of Bruch's membrane were hypofluorescent in 20 (43.5%) and hyperfluorescent in 26 eyes (56.5%). Optic disc drusen were detected in both eyes of one patient (4.3%). Localized hyperreflectivity was thought to be due to calcium deposits. CONCLUSIONS: Angioid streaks were visualized more clearly and in larger numbers by ICG-A than FA. However, in some cases streaks that were funduscopically and fluorescein angiographically visible could not be seen by ICG-A. Occult CNV was detected by ICG-A. Some mottled areas were seen and more clearly visualized by ICG-A. Calcium deposits were observed as localized areas of hyperreflectivity on OCT. These findings indicate that fluorescein angiography, ICG-A and optical coherence tomography all provide supportive information for each other and can be used for either diagnosis or follow-up of those patients.

Vitreoretinal surgery for a subretinal hydatid cyst.

PURPOSE: To report the vitreoretinal surgery for management of a subretinal hydatid cyst. METHODS: Conventional pars plana vitrectomy was performed for the removal of a subretinal hydatid cyst and treatment of retinal detachment in the right eye (RE) of a 34-year-old woman. The cyst content was aspirated by a flute needle after retinotomy and cystotomy. The cyst wall was separated from overlying retina and removed. The retina was attached by liquid perfluorocarbon and silicone oil. Postoperatively, the patient was followed for 15 months. RESULTS: After vitreoretinal surgery, the retina RE was attached and recurrence of hydatid disease was not seen in vitreous cavity or subretinal space during the follow-up period. Visual acuity increased from counting fingers to 20/63 at the end of the follow-up time. CONCLUSION: A subretinal hydatid cyst that causes retinal detachment may be treated effectively with vitreoretinal surgery.

[Value of MRI in the treatment of Grave's disease orbital myopathy]. / L'intérêt de l'IRM dans le traitement de la myopathie de l'orbitopathie dysthyroïdienne.

In order to evaluate the predictability of the results in the treatment of myopathy in cases with the clinical signs of muscle involvement, 177 extraocular muscles of 27 cases whose oedematous status was detected by MRI and who were given antiinflammatory treatment according to the data of this method, were studied. The nature of involvement was detected in respect with the signal intensity and thickness of each rectus muscle prior to the treatment and at the end of the sixth month following a three months' application of combined treatment of steroids and irradiation of 2000 rads. When the initial and final results were compared, the signal intensities of four involved recti showed significant decrease at the end of the treatment, as they were evaluated separately or together. Besides the thicknesses of these groups of involved recti which were evaluated separately showed significant decrease. The evaluation of the signal intensities by MRI is a way that enables noninvasive detection of the edema and prediction of the anti-inflammatory treatment's results of dysthyroid myopathy. Therefore a systematic follow up by MRI is recommended for the treatment choice in dysthyroid myopathy.