Search

Purpose: To report a case of strabismus in a five-week-old infant, likely secondary to a rare occurrence of congenitally acquired ocular toxocariasis., Methods: Retrospective case report., Results: A five-week-old male infant with left exotropia was referred to pediatric ophthalmology and to a vitreoretinal specialist. Fundoscopic examination revealed a granuloma with associated retinal folds and tractional retinal detachment typical for ocular toxocariasis. Serology revealed positivity for Toxocara antibodies, consistent with the clinical diagnosis of ocular toxocariasis., Conclusion: Ocular toxocariasis is typically thought to be secondary to acquired Toxocara infection secondary to fecal-oral transmission. In this case of early-onset strabismus secondary to ocular toxocariasis, it is hypothesized that this is a presentation of congenitally acquired toxocariasis.

Objective: To compare the anatomic and visual outcomes in primary rhegmatogenous retinal detachment repair involving combined pars plana vitrectomy (PPV)/scleral buckle (SB) using a sutureless belt loops technique versus a conventional sutured buckle technique., Methods: This is a retrospective, consecutive, interventional, comparative case series study using patients treated for primary retinal detachment who underwent the SB procedure in combination with PPV. Details regarding anatomic and visual outcome were analyzed., Results: Thirty-five eyes were included in this study: 18 eyes (18 patients) treated with combined PPV and SB performed using a sutureless belt loops technique (group A) and 17 eyes (17 patients) treated with combined PPV and SB sutured to the sclera (group B). Successful anatomic attachment and appropriate buckle height were achieved in all 35 cases. There was 1 case of redetachment in each group during the follow-up: 1/17 (5.9%) in group A and 1/18 (5.6%) in group B (p = 0.97). No cases of buckle infection, extrusion, or intrusion were noted during the follow-up period., Conclusion: SBs installed using a belt loops sutureless technique appear to be as safe and effective as those applied using conventional suturing for repair of retinal detachment, with similar anatomic and functional outcomes., (© 2018 S. Karger AG, Basel.)

Background and Objective: Sutureless scleral fixation is an effective technique for placement of a secondary intraocular lens. The authors propose a modification that may simplify intraoperative technical challenges., Study Design: Description of surgical technique., Results: Successful placement of stable secondary intraocular lens., Conclusion: This modified technique has the potential to reduce intraoperative complications. Studies including more patients with longer follow-up are needed to test the viability., (Copyright 2015, SLACK Incorporated.)

Purpose: To determine whether the use of mupirocin ointment for preoperative eradication of nasal bacterial carriage was effective in reducing conjunctival bacterial flora., Methods: Prospective, double-arm, blinded clinical trial of 37 eyes of 37 patients undergoing intraocular surgery (cataract extraction or pars plana vitrectomy) randomized to either control or mupirocin treatment groups. Treated patients received mupirocin nasal ointment twice daily for 5 days prior to surgery. Nasal cultures were obtained in all patients. All patients received a standard 5% povidone-iodine preparation before the surgical procedure, and conjunctival cultures were obtained in all patients before and after the povidone-iodine preparation., Results: All 37 patient nasal swabs were positive for bacterial growth (cultures were obtained prior to the use of mupirocin ointment in the treatment group). One of 15 eyes (6.7%) in the treatment group had positive conjunctival cultures prior to povidone-iodine preparation, compared with nine of 22 eyes (41%) in the control group (P < .05). Even after povidone-iodine preparation, eight of 22 eyes (36%) in the control group demonstrated persistent positive cultures, whereas one (6.7%) of the treatment eyes exhibited growth (P < .05)., Conclusions: Prophylactic use of mupirocin nasal ointment resulted in significant reduction of conjunctival flora with or without preoperative topical 5% povidone-iodine preparation. The use of mupirocin nasal ointment prior to intraocular surgery or intravitreal injections is a novel method for reducing conjunctival contamination rates, which theoretically should reduce the incidence of endophthalmitis.

Objective: Our objective was to determine the effectiveness of alpha1-blockers on upper tract stasis in men with spinal cord injury (SCI) who use reflex voiding for bladder management., Methods: A retrospective chart review of men with SCI at or above T6, who used reflex voiding for bladder management and had upper tract stasis diagnosed by renal scan. Inclusion was based on the availability of the following tests both before and after alpha1-receptor blockade: renal scan, urodynamic studies, and arterial pressures. Part I evaluated the impact of alpha1-blockers on upper tract stasis. Part II evaluated the impact of alpha1-blockers on urodynamic parameters in those with and without resolution of stasis., Statistical Methods: Chi-square test was used to determine the statistical significance of resolution of upper tract stasis. Student's t test for 2-paired samples was used to evaluate whether urodynamic parameters differed significantly before and after treatment with alpha1-blockers., Main Outcome Measures: Urodynamic parameters evaluated included mean changes in opening pressure, maximum detrusor voiding pressure, and duration of uninhibited contraction., Results: Ten men with upper tract stasis were identified (15 renal units). After >6 months on alpha1-receptor antagonist therapy, upper tract stasis resolved in 8 of the 10 men (11 renal units) and persisted in 2 men (4 renal units). (P = .00026). The only urodynamic parameter that significantly changed in those with resolution of upper tract stasis was the duration of the uninhibited contraction (resolution of stasis: -57 seconds; P < .001), persistence of stasis: +12 seconds (P < .05). No significant change in opening pressures occurred in either those with resolution of stasis or persistent stasis (P < .78). Maximum arterial pressures during voiding statistically decreased with the use of alpha1-blockers (152 mmHg vs 135 mmHg; P < .01)., Conclusions: alpha1-Receptor-antagonist therapy improved upper tract stasis in men with SCI. The urodynamic parameter that changed in those with resolution of upper tract stasis was the duration of uninhibited contractions, which decreased significantly.

To test whether heat-sensitive receptors participate in the cutaneous vascular responses to direct heating, we monitored skin blood flow (SkBF; laser Doppler flowmetry) where the sensation of heat was induced either by local warming (T(Loc); Peltier cooling/heating unit) or by both direct warming and chemical stimulation of heat-sensitive nociceptors (capsaicin). In part I, topical capsaicin (0.075 or 0.025%) was applied to 12 cm(2) of skin 1 h before stepwise local warming of untreated and capsaicin-treated forearm skin. Pretreatment with 0.075% capsaicin cream shifted the SkBF/T(Loc) relationship to lower temperatures by an average of 6 +/- 0.8 degrees C (P < 0.05). In part II, we used a combination of topical capsaicin (0.025%) and local warming to evoke thermal sensation at one site and only local warming to evoke thermal sensation at a separate site. Cutaneous vasomotor responses were compared when the temperatures at these two sites were perceived to be the same. SkBF differed significantly between capsaicin and control sites when compared on the basis of actual temperatures, but that difference became insignificant when compared on the basis of the perceived temperatures. These data suggest heat-sensitive nociceptors are important in the cutaneous vasodilator response to local skin warming.

A method is described for performing localized in vivo spin-lattice relaxation time (T1) measurements in which data is taken along a strip or line. This method, which is used in conjunction with standard imaging practice, provides smaller T1 measurement times if only a limited number of measurements are required. Studies of the reproducibility and the homogeneity of these T1 determinations have been carried out using human subjects and phantoms. T1 measurements made of several regions of normal brain, abdominal, and pelvic organs are described.