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Ultrasonographic abnormalities in the eyes of dogs with cataracts: 147 cases (1986-1992).

Records of 147 dogs with cataracts and that had an ultrasonographic examination of their eyes were reviewed. Ultrasonography was performed, using a real-time mechanical sector scanner (7.5 or 10.0 MHz transducer), after topical anesthesia of the cornea. Vitreous degeneration was diagnosed in 23% of the eyes examined. Retinal detachment was detected in 11% of all eyes, but was detected in 4% of eyes with immature cataracts, 6.5% of eyes with mature cataracts, and 19% of eyes with hypermature cataracts. In 66% of the eyes, the cataract was the only ultrasonographic abnormality found. Vitreous degeneration and retinal detachment were most often observed in eyes with a hypermature cataract, and were uncommon in eyes with an immature cataract. We concluded that ultrasonographic examination can detect abnormalities of the posterior segment when opacity of the anterior segment precludes complete ophthalmoscopic examination and that it is a quick and easy procedure for screening dogs for retinal detachment prior to cataract surgery.

Age Factors↗

Equarin, a novel soluble molecule expressed with polarity at chick embryonic lens equator, is involved in eye formation.

The lens plays an important role in eye development. To investigate the molecular mechanisms involved, we used signal sequence trap screens with a chicken lens cDNA library and identified a novel secreted molecule, equarin. Equarin encodes consensus repeat domains conserved in human SRPX and mouse Urb. In the embryonic eye, equarin transcript is detected exclusively in the lens, and persists in the lens equatorial region in a high-dorsal-to-low-ventral gradient. In vitro analysis of equarin protein indicated that after translation, it is modified, cleaved, and secreted to extracellular locations. Microinjection of equarin mRNA into Xenopus embryos induced abnormal eye development. These data suggest that equarin is involved in eye formation.

Alternative Splicing↗

The chromosome 2 distal short arm trisomy syndrome.

A trisomy for the distal short arm of chromosome 2 (2p23 leads to 2pter) resulted in similar phenotypic and developmental abnormalities in three related males. The cytogenetic defect was traced to a familial balanced 2;3 translocation [t(2;3) (p23;27)]. Comparison of these patients with the seven previously published cases of 2p partial trisomy reveals a pattern of common features including severe mental and growth retardation, a characteristics facial dysmorphism particularly affecting the eyes, abnormalities of the sternum, spine, and digits, a heart defect, and, in males, cryptorchidism and a striking genital anomaly consisting of a very small penis buried in dorsally fused scrotal skin.

Adult↗

Tubulointerstitial nephritis and uveitis (TINU) syndrome in a 52-year-old female: a case report and review of the literature.

Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare entity first described in 1975, affecting mainly young women and adolescents. We present a case of a 52-year-old female patient (one of the oldest in the literature) who complained of fever, anorexia, nausea, and vomiting. After she was admitted to our hospital, laboratory tests revealed tubular proteinuria, elevated erythrocyte sedimentation rate (ESR), anemia, and renal insufficiency (serum creatinine 4.2 mg/dL) with metabolic acidosis. Ophthalmologic examination revealed anterior uveitis (iritis) and renal biopsy showed acute tubulointerstitial nephritis. The diagnosis of TINU syndrome was established and the patient was treated with oral corticosteroids. All symptoms and ophthalmologic abnormalities disappeared after 6 weeks of treatment. Renal function also recovered completely and remained stable at follow-up. TINU syndrome should be considered in the differential diagnosis of unexplained tubulointerstitial nephritis, especially in the presence of ocular findings. Corticosteroid therapy is still controversial, but it helps in the quick resolution of renal and mainly eye abnormalities.

Anti-Inflammatory Agents↗

[Thyroid ophthalmopathy ad a unique clinical manifestation of thyrotoxicosis].

Thyroid ophthalmopathy (TO) or Graves ophthalmopathy embraces a broad range of eye abnormalities which up to 90% of patients with hyperthyroidism (HT) are affected with. In some 10% of TO patients, this may begin oligosymptomatically, often with double vision and with neither clinical nor biochemical signs of thyroid disease. It is imperative to carry out a differential diagnosis with countless other causes for double vision and other eye socket processes. Ophthalmopathy may also occur in patients with hypothyroidism and for this reason some authors prefer to refer to it as dysthyroid orbitopathy. We present four cases of TO in which double vision was the first clinical sign of TO which in one case became severe, in two cases preceded hyperthyroid symptomatology and in the remaining case happened after hyperthyroidism had been corrected. The most valuable diagnostic test was orbit computerised tomography (CT) scan, which proved positive in all cases, and that, along with clinical tests and thyroid function data, confirmed a diagnosis of TO. All initially improved with corticosteroids although none completely regained eye movement during the time they were under supervision. The same happens in about 50% of patients who do not respond to treatment either with corticosteroids or with radiotherapy, and response is usually incomplete in those who do so respond.

Adrenal Cortex Hormones↗

A new syndrome with cerebro-oculo-skeletal-renal involvement.

We report on an infant male who presented with microcephaly of prenatal onset, schizencephaly, decorticated disturbance of the neurological function, congenital optic atrophy, abnormal eye movements and nystagmus. In addition, he had a skeletal dysplasia with predominant acromelic involvement and a renal disease characterized by both nephritic and nephrotic changes. The natural history of his condition included severe postnatal failure to thrive, lack of development of psychomotor milestones, intractable seizures, terminal renal insufficiency with early death. Such spectrum of phenotypic abnormalities has never been reported before and we suggest that it may represent a new syndromic entity. The differential diagnosis with the oculo-skeletal-renal syndromes, with the osteodysplastic primordial dwarfism of the Taybi-Linder type and with the Hutterite cerebro-osteo-nephrodysplasia, is discussed.

Abnormalities, Multiple↗

MR imaging of Joubert's syndrome.

Joubert's syndrome is a rare developmental defect of the cerebellar vermis associated with episodic hyperpnea and apnea, abnormal eye movements, and mental retardation. The condition is usually diagnosed clinically during the neonatal period. This article reports nine patients with the syndrome (six males, three females; ages ranging from 2.5 to 9 yrs), and describes MR imaging findings in seven of these. Besides the previously described characteristic and relatively common changes of the syndrome, the MR imaging findings in these patients revealed thinned optic tracts, enlarged temporal horns in the absence of hydrocephalus, high-signal of the cerebral periventricular white matter, abnormal signal in the decussation of the superior cerebellar peduncles, and abnormal embryonic vessels associated with the dysplastic folia of the cerebellar hemispheres.

Agenesis of Corpus Callosum↗

Dyslexic and normal readers' eye movements.

Dyslexic and normal readers' eye movements were compared while tracking a moving fixation point and in reading. Contrary to previous reports, the dyslexic and normal readers did not differ in their number of saccades, percentage of regressions, or stability of fixations in the tracking task. Thus, defective oculomotor control was not associated with or a causal factor in dyslexia, and the dyslexics' abnormal eye movements in reading must be related to differences in higher cognitive processes. However, individual differences in oculmotor efficiency, independent of reading ability, were found within both the dyslexic and normal groups, and these differences were correlated in reading and tracking tasks.

Adolescent↗

Embryotoxicity and teratogenicity of formocresol on developing chick embryos.

White Leghorn chick embryos were used to investigate the embryotoxicity and teratogenicity of 25 and 50% Buckley's formocresol. Embryos were injected at 48 h and sacrificed on the ninth day of incubation. The percentage of mortality of sham and vehicle controls was 4.8 and 17.7%, respectively, whereas eggs injected with 25 and 50% formocresol displayed a 40 and 100% mortality rate. Gross morphological abnormalities, weights, and crown-rump lengths were determined, demonstrating that Buckley's formocresol is embryotoxic and teratogenic in chick embryos. Gross morphological changes were noted to include cranial hematomas, facial abnormalities, eye and beak deformities as well as alterations in feather germ appearance. Histological changes included alterations in the organization of the eyes, and formation of the beak, palate, vasculature, musculature, cartilage, and bone. Moreover, experimental embryos displayed a retardation of development in that they lagged behind their controls by approximately 24 to 36 h.

Abnormalities, Drug-Induced↗

Postmortem ophthalmologic examination by endoscopy.

Abnormal intraocular findings detected during forensic autopsies have generally been ignored. In this study, we assessed the usefulness of postmortem ophthalmologic examination in 46 cases using an endoscope system with a tip diameter of 0.9 mm. This procedure was performed using a portable system, and only 1 assistant was needed. Furthermore, the procedure required only about 5 minutes for both eyes. Abnormal intraocular findings were seen in 22 (47.8%) of 46 cases. Fundus hemorrhages were observed in 4, and papilledema was observed in 3 of 5 cases of death due to head trauma; besides, it was possible to estimate the interval between head trauma and death based on intraocular findings. Seven of 16 cases of death from asphyxia presented abnormal intraocular findings, including retinal splinter hemorrhages. Fundus hemorrhages were observed in 2 of 3 cases of death by drowning, which, to our knowledge, had never been reported to date.Thus, this procedure proved easy to perform, and it may be useful to detect significant abnormal intraocular findings related to the presumed cause of death during autopsies.

Adolescent↗

Saccadic intrusions contributing to reading disability: a case report.

Horizontal eye movements were recorded during tracking and reading in a patient with probable neurological involvement who complained of periods of oscillopsia and severe asthenopia, especially during reading. Saccadic intrusions occurred during all tracking tasks. Single and multiple saccadic intrusions found while reading, frequently accompanied periods of visual disturbance, and we attribute part of the reading disability to the presence of such abnormal eye movements. Various therapeutic measures were attempted and achieved some degree of success.

Adult↗

Properties of the feedback loops controlling eye growth and refractive state in the chicken.

Recent experiments in chickens provide evidence that axial eye growth and refractive state are guided by mechanisms sensitive to refractive error. To determine whether or not the sign of refractive error is derived from longitudinal chromatic aberration we raised chicks with spectacle lenses in monochromatic light. The eyes showed an appropriate growth response to correct for the defocus imposed by the lenses no different than in previous experiments in white light. Thus, in normally accommodating chicks chromatic cues are not necessary for emmetropization to occur. We examined the linearity of feedback loops controlling axial eye growth: positive spectacle lenses were found to inhibit axial growth very efficiently making the eyes shorter than normal whereas negative lenses had little effect on axial elongation: feedback loops for regulation of axial growth are highly nonlinear and act most efficiently on the myopic side. We found that, subsequent to a period of binocular deprivation of form vision, the refractive errors acquired are highly correlated in both eyes. Since both eyes grew without visual feedback we conclude that the gains in the feedback loops that control axial growth must be similar in both eyes. We suggest that the gains are genetically determined and are typical for each individual. Chicks made near-sighted in both eyes by "deprivation of form vision" were corrected by appropriate negative lenses. Three out of five chicks recovered from myopia despite the correction. Also two chicks that were made near-sighted in one eye recovered with no regard to the correcting lens. Three chicks remained more myopic than the correcting lens required and finally started to recover while the lens was still in place. Two out of three chicks that were made far-sighted showed recovery despite appropriate correction by positive lenses. We conclude that there must be a nonvisual mechanism highly sensitive to abnormal eye shape. During expt (4) we found unexpectedly that the development of form deprivation myopia is inhibited if no part of the retina in an animal is exposed to normal visual experience. The result indicates that some communication between both eyes exists, although form deprivation myopia itself has been shown to develop independently in both eyes.

Animals↗

Optic disc parameters and onset of glaucomatous field loss. I. Methods and progressive changes in disc morphology.

Serial stereoscopic fundus photographs taken in known relationship to the onset of glaucomatous visual field loss on 12 eyes were intermixed with those from 206 age- and race-matched controls and analyzed in randomized masked fashion. Progressive changes in the size, shape, or contour of the disc, and a newly described parameter, thickness of the nerve fiber layer as it crosses the disc rim, were readily apparent by the time of onset of glaucomatous field loss in all but two abnormal eyes (one case). In the latter instance, direct comparison of stereophotos indicated progressive pallor of the remaining disc tissue. Serial stereophotographs appear superior to fundus drawings for anticipating glaucomatous field loss.

Glaucoma↗

Ocular manifestations of ataxia-telangiectasia.

PURPOSE: To report the manifestations of ataxia-telangiectasia (A-T) on the ocular sensory and motor systems. DESIGN: A prospective observational case series. METHODS: In a single tertiary care institition, a comprehensive ophthalmologic evaluation was made of patients with A-T as part of a systemic/neurologic evaluation. Sixty-three A-T patients between the ages of 2 and 28 years were examined. RESULTS: In 58 A-T patients whose visual acuity could be measured, best-corrected visual acuity in the better eye was 20/20 to 20/30 in 39 (67%), 20/40 to 20/50 in 17 (29%), and 20/60 to 20/80 in 2 (4%). The mean geometric visual acuity of the better eye was 20/31. Telangiectatic vessels were seen in the bulbar conjunctiva in 57 of 63 patients (91%) and on the skin of the face of 21 patients (33%). Twenty-four of 63 patients (38%) had strabismus. Esodeviations were the most common, seen in 15 individuals. Apraxia of horizontal gaze was observed in 19 of 63 patients (30%). Hypometric saccades were evident in 48 (76%), pursuit abnormalities in 43 (63%), and nystagmus in 18 (29%). Accommodation was deficient in the 54 patients in whom it was measured. No posterior segment vascular anomalies were detected. CONCLUSIONS: Visual acuity of 20/50 was present in 96% of the patients we examined. Telangiectatic vessels on the bulbar conjunctiva were seen in nearly every patient, though these are of no functional significance. Ocular motor abnormalities, especially strabismus, are a common finding in A-T. Poor accommodation and abnormal eye movements may lead to reading difficulty reported by patients with A-T.

Adolescent↗

Automated detection of ocular alignment with binocular retinal birefringence scanning.

We previously developed a retinal birefingence scanning (RBS) device to detect eye fixation. The purpose of this study was to determine whether a new binocular RBS (BRBS) instrument can detect simultaneous fixation of both eyes. Control (nonmyopic and myopic) and strabismic subjects were studied by use of BRBS at a fixation distance of 45 cm. Binocularity (the percentage of measurements with bilateral fixation) was determined from the BRBS output. All nonstrabismic subjects with good quality signals had binocularity >75%. Binocularity averaged 5% in four subjects with strabismus (range of 0-20%). BRBS may potentially be used to screen individuals for abnormal eye alignment.

Automation↗

The predictability of infant visual-evoked response testing on future visual acuity.

We reviewed the records of 27 infants with abnormal eye examinations and visual-evoked response (VER) testing (mean age, 10.5 months) who subsequently underwent a long-term follow-up ophthalmology examination (mean duration, 41 months). The infants were initially diagnosed with various ocular disorders including cortical blindness (eight), optic nerve hypoplasia (six), congenital cataract (two), and retinopathy of prematurity (one). Standard optotype visual-acuity determinations were available in the follow-up records of 11 children (21 eyes), and fixation behavior was obtained in the remaining 16 children (32 eyes). Results revealed that pattern-reversal VER P1 latency was predictive (87%) of whether visual acuity was equal to (or better than) or worse than 20/100 and whether a patient would have good fixation behavior (fix and follow, FF) or poor fixation (no FF) (86%) (P less than .001). Although flash VER P1 latency was also predictive of later visual acuity or good fixation (73%), it was not statistically significant. Pattern VER P1 amplitude and flash VER P1 amplitude were not predictive of later visual function. The predictive power of pattern VER P1 latency for later visual function probably relates to its reflection of macular function and low variability. An analysis of the variability of each of the four VER factors in normal infants (n = 50) indicated that pattern VER P1 latency was the least variable, and consequently most sensitive, VER factor for detecting and quantifying pathology. Overall, the results of this retrospective study suggest that pattern VER P1 latency may have important predictive power for later visual function in infants with an initially abnormal ophthalmologic examination.

Evoked Potentials, Visual↗

Children of methadone-maintained mothers: follow-up to 18 months of age.

Limited information is available on the long-term effects of in utero methadone exposure. This report describes the somatic and neurobehavioral findings of children in the first 18 months of life born to methadone-maintained mothers and to a matched drug-free comparison group of mothers. Findings during the neonatal period were (1) a 75% incidence of moderate-to-severe narcotic abstinence syndrome, (2) a significant incidence of head circumferences below the third percentile, and (3) elevated systolic blood pressure. In follow-up, the methadone children had (1) a significantly higher incidence of otitis media; (2) a significant incidence of head circumferences below the third percentile; (3) neurologic findings of tone discrepancies, developmental delays, and poor fine motor coordination; (4) a high incidence of abnormal eye findings; and (5) significantly lower scores on the Bayley mental and motor developmental indices. These neurobehavioral findings in children of methadone-treated mothers at 18 months of age may be predictors of later learning and behavioral problems.

Abnormalities, Drug-Induced↗