Graves' ophthalmopathy, eye muscle antibodies and HLA antigens.
Explore the source record for details and available documents.
SEARCH · PubMed Health
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Four subjects suffering from a unilateral peripheral paralysis of the 3rd or the 6th nerves have been studied in spatial localization tasks, with their normal eye occluded. When peripheral targets were presented in the hemifield corresponding to the paralysis, the saccadic eye movements (recorded from the normal occluded eye) were of an exaggerated amplitude. 'Staircase' oculomotor patterns, closely similar to those occurring in 'open-loop' visual stimulation, could also be observed. Our patients also presented the classical hypermetric misreaching when attempting to point by hand at visual targets in an otherwise dark room. This effect (past-pointing) was likely to be due to a monitoring of the exaggerated oculomotor signal: in one subject past-pointing disappeared when reaching at the targets on the basis of the sole retinal cues. Finally, the classically described illusory visual effects of ocular paralysis were limited to a feeling of instability during self-motion.
Explore the source record for details and available documents.
PURPOSE: To present a new surgical procedure for convergent strabismus fixus. DESIGN: Interventional case report. METHODS: A 69-year-old woman was referred to us because of esotropia of both eyes. Both eyes were fixed in a position of extreme adduction, and ocular motility was severely restricted in all directions. Magnetic resonance imaging demonstrated that the superior rectus (SR) was deviated nasally and the lateral rectus (LR) was deviated inferiorly. We performed operations for both eyes consisting of hemitranspositions of the SR and LR combined with a large recession of the medial rectus. RESULTS: Postoperatively, the patient became able to fixate in primary gaze and ocular motility markedly improved in all directions. Magnetic resonance imaging confirmed that the paths of the SR and LR were corrected. CONCLUSIONS: This surgical procedure appears to be a useful option for treating convergent strabismus fixus.
A fluorescent antiserum against myosin from chicken anterior latissimus dorsi muscle, which stains specifically the multiply innervated slow fibers of birds and amphibians, was applied to frozen sections of human extraocular muscles. A proportion of fibers in oculorotatory muscles were labeled by the antiserum. In contrast, no labeled extrafusal fiber was present in the levator palpebrae or in other body muscles. Serial study of sections stained for acetylcholinesterase and myosin ATPase showed that the labeled fibers in human oculorotatory muscles are multiply innervated and display acid-stable myosin ATPase activity.
In many wild species there is a correlation between the capacity for directional hearing and directional seeing, which is associated with the mobility of the eye balls. Among the breeds of domestic rabbits, there are some with pendulous, floppy external ears (e.g., Englische Widder, EW) that might limit directional hearing. The size of the brain stem nuclei in EWs has been determined and compared to rabbits with upright ears. In EW, the oculomotor nuclei are relatively larger than in the other breeds. Possibly, this indicates a compensation of a loss in directional hearing ability achieved through greater mobility of the eyes. At the same time, a variability of brain composition between the breeds, which is an intraspecific variability, is obvious.
Explore the source record for details and available documents.
An experimental animal study was conducted to determine whether fibrin glue could be used in strabismus surgery (recession, resection, and muscular neurotization). Fibrin glue was used in place of some or all of the commonly used 7-0 Vicryl sutures. In order to evaluate the adhesion of the fibrin glue the rabbits' eyes were enucleated 10-67 days after surgery, fixed in 8% formalin solution and then histologically examined. In the recession and resection specimens a solid joint between muscles and sclera was found, without any significant scar formation or atrophy of the muscles. The muscular neurotization specimens also exhibited a firm connection between the two muscles, with no abnormal loss of muscle fibers by cicatrization or atrophy. In none of the cases did the conjunctiva show any tendency to conglutination. In view of the simplicity of the fibrin gluing technique and the uniform bonding effect, application in human patients is recommended.
PURPOSE: To elucidate the etiology of an acquired, restrictive motility disorder in patients with high myopia. METHODS: Thirty-three orbits were imaged using a Siemens Magnetom or Siemens Vision (both 1.5 Tesla) MRI (magnetic resonance imaging) scanner, applying a head coil. Coronal T1-weighted, spin-echo images were obtained. Orbits of three different patient groups were analyzed. Group 1 (n = 14): patients with high axial myopia and restricted eye motility (average axial length = 31.4 mm; refractive error more than -15 D). Group 2 (n = 8): subjects with high axial myopia and normal eye motility (average axial length = 29.2 mm). Controls (n = 11): emmetropic subjects with normal eye motility. RESULTS: Highly myopic patients showed significant displacements of recti EOMs in comparison to the controls. Mean displacements as measured in the plane 3 mm anterior to the globe-optic nerve junction in primary gaze were, in group 1: lateral rectus (LR) 2.9 mm (2.5 downward, 1.4 medial), medial rectus (MR) 1.3 mm downward. In group 2: LR 1.4 mm (1.3 downward, 0.6 medial) and MR 1.2 mm downward. In both groups 1 and 2, the inferior rectus (IR) was displaced 1.3 mm medially and upwards. In both groups of myopic patients the superior rectus (SR) was displaced 1.5 mm medially and downwards. CONCLUSIONS: In patients with high axial myopia, displacements of all recti EOMs can be detected by MRI. However, displacement of the LR into the lateral and inferior quadrant of the orbit is significantly greatest. We therefore assume LR displacement to be a major pathophysiological factor for the restrictive motility disorder in high myopia. EOM dislocations can be explained by myopia-associated alterations in the orbital connective tissues confining EOM positions in relation to the orbital wall.
The purpose of this paper is to outline the clinical benefits and electrophysiological changes after extraocular muscle surgery for acquired nystagmus and strabismus in an adult patient. a 41-year-old Caucasian female suffered from oscillopsia, bilateral cranial nerve IV palsies, and vertical nystagmus. Medical therapy was ineffective. She underwent bilateral, eight muscle surgical procedure which included: tenectomies of the superior oblique OU, myectomies of the inferior oblique OU, recessions of the medial rectus muscles OU (with OD on a post-operatively adjustable suture), and differential recessions of the superior rectus muscles OU. This provided marked improvement in her symptoms. These results suggest that surgery for acquired nystagmus can affect an improvement in the characteristics of the nystagmus that result in visual complaints. Combining "nystagmus surgery" plus strabismus surgery may be a viable option in some adult patients with acquired nystagmus who are unresponsive to medical therapy.
In free space a random-dot-stereogramme for the determination of the extent of cyclofusion is used with the help of a haploscope. In the normal person orthophoria with regard to rolling to within +/- 1 degrees is found not only in the primary position but also in the secondary and tertiary positions and with head tilt. From the fact that with circular rotation of both eye images against each other pseudostereoscopic effects occur, it is deduced that the cyclofusion seen here occurred sensorially. The testing of the area of cyclofusion gives a very good basis for determining the indication for operation on the superior oblique muscle. It is shown with examples that simply tucking this muscle when old trochlear nerve paresis is present without provable excyclotropia is not favorable. Instead one must tuck the muscle asymmetrically in such cases--the fold should be markedly smaller at the anterior border of the muscle which acts more as a rotator, than at the posterior border.
Surgical counter-rotation after macular translocation is indicated when a non-fusionable cyclodeviation exists by lack of suppression. Different surgical options exist to counter-rotate the globe after macular translocation. Primary angles of retinal rotation up to 40 degrees can be compensated for.
UNLABELLED: We wanted to study the effect of squint surgery on the blood-aqueous barrier in children. Our interest was to ascertain whether or not there is a breakdown of the blood-aqueous barrier after routine squint surgery, and whether this would need antiinflammatory treatment with steroids. PATIENTS AND METHODS: Forty-seven eyes of 18 girls and 7 boys (age range 4-14 years) were examined. The children were generally healthy and had not undergone any previous eye surgery. The mean age of patients (n = 25) was 7.8 +/- 3.1 years. Using the laser flare meter Kowa FM-500, the flare (photocounts/ms) in the anterior chamber was measured before and on the 2nd day after squint surgery (n = 32). Fifteen eyes served as controls and were not operated on. Following surgery, the operated eyes were treated with aminoglycoside eye drops (three times daily). No steroids or non-steroidal antiinflammatory drugs were applied before or after surgery. RESULTS: The flare values were 4.10 +/- 1.29 photocounts/ms before and 3.89 +/- 1.27 photocounts/ms after squint surgery. There was no significant increase (P = 0.58) of flare on the 2nd postoperative day. CONCLUSION: Our data confirm that there is no clinically significant disruption of the blood-aqueous barrier following squint surgery. We therefore conclude that there is no need for postoperative therapy with steroids.
We inserted a silicone rubber elastic band along the course of a paralyzed lateral rectus and of a paralyzed superior oblique to restore alignment and to provide a spring against which the antagonist could pull. The lateral rectus band has been in place for 7 years. It provides alignment and a field of single binocular vision of 20 degrees. The superior oblique band has been in place for 17 months. It provides alignment and single vision over 30 degrees from the primary position except for a restriction in upgaze-adduction to 25 degrees (Brown syndrome) and in downgaze-adduction to 20 degrees. Such engineered elastic bands are a useful addition to current surgical techniques for management of cases of paralysis and restriction.
An analysis of 59 cases with excentric fixation shows the special efficacy of treatment methods, which are related to variations of the innervation stimulus with prisme, operative methods and especially with the "Fadenoperation" developed by Cüppers.
Here we demonstrate previously unreported ocular defects in mice homozygous for a new allele of the Large gene, veils, and for Large(myd) mice. Clinically, vitreal fibroplasia and retinal vessel tortuosity and fluorescein leakage are observed. These vascular defects may be due to the extreme disorganization of the astrocytic template on which endothelial cells migrate in the retina. Abnormal electroretinograms recorded from Large(vls) or Large(myd) mice are accompanied by disorganization of the outer plexiform layer (OPL) with a dramatic reduction in the number of synaptic complexes. In both mutants, the internal limiting membrane (ILM) is disrupted with ectopic cells in the vitreous. Interestingly, while all components of the dystrophin glycoprotein complex are present at reduced levels in the OPL, they were absent in the ILM of affected mice. Finally, hypoglycosylation of alpha-dystroglycan previously implicated in muscle and brain defects is also observed in the retina and may contribute to the ocular abnormalities.
BACKGROUND: Rarely, an additional Brown's syndrome develops spontaneously in cases of posttraumatic bilateral superior oblique palsy. Surgical measures are controversial and problematic. CASE REPORT: We here report on a 40-year-old patient who, 2 years after blunt head trauma, presented with residual bilateral VIth nerve palsy with 12 degrees excyclotropia in downgaze, abnormal head postures of 20 degrees chin down position in binocular viewing and reduced elevation in adduction. His binocular field of gaze ranged from 10 degrees upgaze to 25 degrees upgaze. After thorough discussion of the situation we suggested bilateral superior oblique tucking, depending on interoperative findings. In a forced duction test under general anesthesia both eyes showed restricted elevation in adduction. Both superior oblique tendons seemed stiff. A 2.5-mm tuck (right) and a 3.0-mm tuck (left) of the anterior part of the tendon were performed. After operation the patient showed a central field of binocular fusion ranging from 10 degrees upgaze to 25 degrees downgaze, in right gaze up to 30 degrees and in left gaze unrestricted. Excyclotropia was present only in downgaze and not more than 6 degrees. CONCLUSION: A low-dosage anterior tuck of the superior oblique tendon was successful in eliminating excyclotropia sufficiently and enlarging the binocular field of fusion.