Changes of saccadic eye movements in thyroid-associated ophthalmopathy.

Purpose: To establish whether or not the dynamics of saccadic eye movements are significantly changed in patients with different stages of thyroid-associated ophthalmopathy (TAO) and, subsequently, if analysis of saccades could serve as an additional diagnostic tool for early detection of inflammatory activity in TAO.

Methods: Thirty-seven patients with TAO and 10 age- and gender-matched control subjects were investigated. The patients were divided into four groups according to the stage of the disease: (i) early mild disease (n = 10), (ii) early severe disease (n = 11), (iii) long-standing restrictive disease (n = 10) and (iv) proven auto-immune hyperthyroidism without any signs of TAO (n = 6).

Saccadic eye movement velocity measured with the infrared reflection and search coil eye-tracking systems in patients with thyroid-associated ophthalmopathy.

Background: Assessment of changes in saccade velocity may be useful in the early detection of thyroid-associated ophthalmopathy (TAO). Two eye-tracking systems were used to measure the velocity of saccadic eye movements in patients with TAO.

Method: Fourteen patients with active TAO and 14 healthy controls were enrolled for recordings with two eye-tracking systems: the magnetic scleral search coil (MSC; Skalar Medical) and the infrared reflection systems (IR; Orbit XY-1000).

Magnetic resonance imaging and ultrasound measurements of extraocular muscles in thyroid-associated ophthalmopathy at different stages of the disease.

Purpose: To assess extraocular muscle (EOM) involvement in thyroid-associated orbitopathy (TAO) of different stages with magnetic resonance imaging (MRI) and ultrasound techniques.

Methods: A total of 32 patients with TAO were divided into three groups according to whether they had mild active, pronounced active or longstanding inactive disease. Six patients with Graves' disease but no clinical signs of TAO and 10 healthy control subjects were also studied.

Drift in ocular torsion during sustained head tilt.

Purpose: A head tilt towards the shoulder (roll) induces an ocular counter-roll (OCR), i.e. torsion in the opposite direction to the head.

Drift in ocular counterrolling during static head tilt.

A decreasing drift of the counter-rolled eye position (OCR) during head tilt was recently described. The underlying mechanism is not known. OCR in eleven healthy subjects was recorded (Search coil, Skalar) during a head tilt paradigm in two test conditions.

Wave-front analysis as screening technique for amblyogenic ametropia with and without cycloplegia.

Introduction: For many years, attempts have been made to find an easy, efficient and inexpensive method to screen children for amblyogenic ametropia. Wave-front analysis is a new way to determine the refractive state of the eye from a distance. This technique could be a useful tool for infant screening.

Torsional and vertical eye movements during head tilt dynamic characteristics.

Purpose: As the first response to a Bielschowsky head tilt test (BHTT), a fast transient torsional eye movement in the same direction as the head tilt has been shown with the three-dimensional (3D)-video oculography (3D-VOG) technique, and this movement is paralleled by a transient vertical vergence shift inducing a physiological skew deviation. The purpose of the present study was to investigate these dynamic eye movements further in response to a BHTT paradigm with the magnetic search coil technique.

Methods: Ten healthy subjects performed a BHTT (15 degrees, 30 degrees, and 45 degrees) toward each shoulder while (search coil) the monocular eye and head positions were recorded.

Conjugacy of torsional eye movements in response to a head tilt paradigm.

Purpose: Vertically skewed eye movements are induced by head tilt toward the shoulder (roll). Because vertical and torsional eye movements are tightly coupled both mechanically and neuronally, the purpose of the present study was to investigate the conjugacy of torsional eye movements during the Bielschowsky head tilt test (BHTT). Furthermore, the purpose was to investigate the influence of different visual and viewing condition on torsional conjugacy.

Assessment of ocular counterroll during head tilt using binocular video oculography.

Purpose: According to recent literature, the presence and the amount of true compensatory ocular counterroll is still debatable. The purpose of the current study was to assess compensatory counterroll in response to lateral head tilt using a new noninvasive recording technique, and, furthermore, to find out whether the amount of counterroll is influenced by the presence or absence of spatial orientation.

Methods: Eye movement recordings were performed using the infrared three-dimensional video oculography (3D-VOG) technique.

X-linked ocular albinism (Nettleship-Falls): a novel 29-bp deletion in exon 1. Carrier detection by ophthalmic examination and DNA analysis.

Background: Mutations in the OA1 gene on the short arm of the X chromosome are known to cause X-linked ocular albinism (x1OA) in males. A four-generation family with this disorder, including asymptomatic carrier females, was investigated by molecular analysis of the OA1 gene.

Methods: DNA samples were available from 22 individuals of this family, including 6 affected males and 6 obligate carriers.

Comitant strabismus.

A review of the literature on comitant strabismus of the period from April 1999 until April 2000 is presented. A rather new and increasingly important issue is the psychosocial aspect of strabismus. Two studies have demonstrated that strabismus creates a significant negative social prejudice on the patients and that it can significantly reduce an applicant's ability to obtain employment.

Preliminary report: saccade analysis in acute Graves' ophthalmopathy.

A prospective study on the saccadic properties of 10 patients with acute Graves' ophthalmopathy (GO) compared to 10 healthy individuals was performed using the induction scleral search coil. No significant changes were observed among six patients with moderate disease. In four patients suffering from optic nerve compression, however, a substantial decrease of saccadic velocity and related parameters was detected.

[Transnasal anchor suture for facilitating silicone tube intubation in deep congenital nasolacrimal duct stenosis].

Background: In silicone intubation of the nasolacrimal duct for congenital obstruction, retrieval of the guide thread behind the inferior turbinate can be difficult and time consuming. To facilitate this maneuver a modification of the conventional technique has been developed.

Patients And Method: In the conventional technique, a hollow probe was inserted into both lacrimal puncti and pushed downward into the nasal cavity.

Clinical significance of saccade analysis in early active Graves' ophthalmopathy.

Purpose: To assess whether saccadic eye movements show distinct changes in patients with early active Graves' ophthalmopathy (GO), which could serve as a diagnostic tool for early detection and treatment.

Methods: Each of two prospective studies included 10 patients with early acute GO and 10 age- and sex-matched control subjects. In the explorative study (ES) 15 dynamic parameters of saccades were analyzed.

Interleukin-1 receptor antagonist ribonucleic acid and protein expression by cultured Graves' and normal orbital fibroblasts is differentially modulated by dexamethasone and irradiation.

Recent data have indicated that orbital fibroblasts (OF) can be stimulated to produce marked quantities of interleukin-1 receptor antagonist (IL-1RA), a powerful inhibitor of the proinflammatory activities of interleukin-1 in the orbital tissues in Graves' ophthalmopathy (GO). We examined whether the beneficial effects of dexamethasone or irradiation, the two main therapeutic modalities applied in patients with active GO, may be related to their capacity to alter IL-1RA ribonucleic acid (RNA) and protein expression in OF. Early passages of cultured OF were obtained from orbital connective tissue and extraocular muscle of patients with severe active GO and five control subjects.

[Exophthalmos--what now?].

Exophthalmos is most commonly due to Graves' ophthalmopathy (GO), the most frequent extrathyroidal manifestation of Graves' disease. The clinical signs and symptoms of GO are the consequences of increased orbital connective and adipose tissue volume, and of interstitial enlargement of extraocular muscles, within the confines of the bony orbits. Diagnosis of GO is usually readily established by obtaining a careful history, detailed clinical examination of the thyroid gland, eyes and orbits, few laboratory tests and ultrasonography of the thyroid gland and the orbital contents.

[Changes in subjective cyclodeviation and objective cycloposition after modified Harada-Ito operation in acquired trochlear paralysis].

Background: After recently published own investigations on subjective and objective cyclorotatory changes following inferior oblique recession for inferior oblique overaction, it was our aim to determine and to compare subjective and objective cyclorotatory changes following a modified Harada-Ito procedure for acquired trochlear palsy.

Patients And Methods: Eight patients suffering from acquired uni-(n = 3) or bilateral (n = 5) trochlear palsy were investigated before surgery and 1 day, 3 days and 4 months after surgery. Subjective cyclodeviation was assessed by Harms' tangent scale.

[North Carolina macular dystrophy. Hereditary macular disease with good functional prognosis].

Background: North Carolina macular dystrophy (NCMD) is a rare autosomal dominant maculopathy with highly variable expressivity. Genetic analysis of an American family consisting of 247 members out of which 96 were affected with NCMD allowed chromosomal assignment of the NCMD locus to 6q14-q16.2.

An ancestral core haplotype defines the critical region harbouring the North Carolina macular dystrophy gene (MCDR1).

Autosomal dominant North Carolina macular dystrophy (NCMD) or central areolar pigment epithelial dystrophy (CAPED) is an allelic disorder that maps to an approximately 7.2 cM interval between DNA markers at D6S424 and D6S1671 on 6q14-q16.2.

[Endocrinologic and metabolic complications of Alagille syndrome].

Background: Patients with gastrointestinal and hepatobiliary disorders, either congenital or acquired early in childhood, are at high risk for various endocrine and metabolic abnormalities.

Case Report: A 27-year-old woman with Alagille's syndrome presented with progressive jaundice and gait disturbances following surgery and ingestion of oral contraceptives. On physical examination, short stature, facial dysmorphism and neuromuscular symptoms such as polyneuropathy and spinocerebellar ataxia were noted.

Soluble interleukin-1 receptor antagonist serum levels in smokers and nonsmokers with Graves' ophthalmopathy undergoing orbital radiotherapy.

Interleukin-1 (IL-1) plays an important role in the pathogenesis of Graves' ophthalmopathy (GO). Impaired antagonism of the proinflammatory cytokine IL-1 by the naturally occurring IL-1 receptor antagonist (IL-1RA) has been implicated in the initiation and perpetuation of various autoimmune diseases and may play a role in the evolution of GO. Cigarette smoking appears to adversely affect the course of GO.

[Dural carotid-cavernous sinus fistulas: clinical aspects, diagnosis and therapeutic intervention].

Background: Carotid cavernous fistulas are cerebral artenovenous shunts which may present with ocular or orbital signs. Direct fistulas are distinguished from dural shunts with respect to the anatomical situation.

Patients: We report on two patients with spontaneous dural carotid cavernous fistulas with multiple feeding vessels.