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Effect of orthoptic procedures on stereoscopic acuities.

Ten stereophotogrammetry students and three graduate photogrammetrists were given 7 weeks of nonspecific orthoptic exercises. The visual systems of these 13 experimental subjects were matched to those of 13 control subjects chosen from the students and staff of the Ferris State College of Optometry. Stereoscopic acuities were determined before and after the training period on both groups using a Wild Stereoplotter, a Howard-Dolman apparatus, and the Keystone Multi-Stereo Test. Stereoscopic acuities as determined on the stereoplotter and the Howard-Dolman apparatus were improved at better than a 0.05 significance level as computed on the Wilcoxon signed rank test and Student's t-test for the difference between two dependent means.

Adult↗

Interaction between nelfinavir and tacrolimus after orthoptic liver transplantation in a patient coinfected with HIV and hepatitis C virus (HCV).

A 49-year old male patient with severe hemophilia A, coinfected with HIV and HCV, who underwent orthoptic liver transplantation because of hepatitis C cirrhosis is presented. We describe a strong interaction between nelfinavir and tacrolimus postoperatively, that caused a reduction of the dose of tacrolimus by a factor 70 compared with normal, to achieve therapeutic blood concentrations and to avoid toxic side effects. We suggest that nelfinavir inhibits the metabolism of tacrolimus because both compounds are well-known substrates for the cytochrome P450 isoenzyme CYP 3A4. The nelfinavir serum concentrations were not affected by the institution of tacrolimus. Although the interaction dramatically changed the tacrolimus dose-concentration relationship, the situation was manageable by frequent monitoring of blood concentrations of tacrolimus.

Drug Interactions↗

Orthoptic status before and immediately after heroin detoxification.

AIM: To determine whether changes in orthoptic status take place during withdrawal from heroin and/or methadone. METHOD: A prospective study of patients, using a repeated measures design, attending a 5 day naltrexone compressed opiate detoxification programme. RESULTS: 83 patients were seen before detoxification (mean age 27.1 (SD 4.6) years) and 69 after detoxification. The horizontal angle of deviation became less exo/more eso at distance (p<0.001) but no significant change was found at near (p = 0.069). Stereoacuity, visual acuity, and convergence were found to be reduced in the immediate post-detoxification period. Prism fusion range, refractive error, subjective accommodation, and objective accommodation at 33 cm did not reduce but a small decrease was found in objective accommodation at 20 cm. CONCLUSIONS: The eso trend found in these patients may be responsible for the development of acute concomitant esotropia in some patients undergoing heroin detoxification. However, the mechanism for this trend does not appear to be caused by divergence insufficiency or sixth nerve palsy.

Accommodation, Ocular↗

Orthoptics.

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Orthoptics↗