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Indian Journal of Ophthalmology Jul 2023Infections of orbit and periorbita are frequent, leading to significant morbidity. Orbital cellulitis is more common in children and young adults. At any age, infection... (Review)
Review
Infections of orbit and periorbita are frequent, leading to significant morbidity. Orbital cellulitis is more common in children and young adults. At any age, infection from the neighboring ethmoid sinuses is a likely cause and is thought to result from anatomical characteristics like thin medial wall, lack of lymphatics, orbital foramina, and septic thrombophlebitis of the valveless veins between the two. Other causes are trauma, orbital foreign bodies, preexisting dental infections, dental procedures, maxillofacial surgeries, Open Reduction and Internal Fixation (ORIF), and retinal buckling procedures. The septum is a natural barrier to the passage of microorganisms. Orbital infections are caused by Gram-positive, Gram-negative organisms and anaerobes in adults and in children, usually by Staphylococcus aureus or Streptococcus species. Individuals older than 15 years of age are more likely to harbor polymicrobial infections. Signs include diffuse lid edema with or without erythema, chemosis, proptosis, and ophthalmoplegia. It is an ocular emergency requiring admission, intravenous antibiotics, and sometimes surgical intervention. Computed tomography (CT) and magnetic resonance imaging (MRI) are the main modalities to identify the extent, route of spread from adjacent structures, and poor response to intravenous antibiotics and to confirm the presence of complications. If orbital cellulitis is secondary to sinus infection, drainage of pus and establishment of ventilation to the sinus are imperative. Loss of vision can occur due to orbital abscess, cavernous sinus thrombosis, optic neuritis, central retinal artery occlusion, and exposure keratopathy, and possible systemic sequelae include meningitis, intracranial abscess, osteomyelitis, and death. The article was written by authors after a thorough literature search in the PubMed-indexed journals.
Topics: Child; Young Adult; Humans; Orbital Cellulitis; Abscess; Orbit; Exophthalmos; Anti-Bacterial Agents
PubMed: 37417106
DOI: 10.4103/IJO.IJO_3283_22 -
Annual Review of Vision Science Sep 2023This review examines the concept of the preferred retinal locus (PRL) in patients with macular diseases. Considering monocular and binocular viewing, we () explain how... (Review)
Review
This review examines the concept of the preferred retinal locus (PRL) in patients with macular diseases. Considering monocular and binocular viewing, we () explain how to identify the PRL and discuss the pitfalls associated with its measurement, () review the current hypotheses for PRL development, () assess whether the PRL is the new reference point of the ocular motor system, and discuss () the functional and () the clinical implications of the PRL. We conclude that the current definition of the PRL is probably incomplete and should incorporate the need to evaluate the PRL in the framework of binocular viewing. We emphasize the need for more research.
Topics: Humans; Retina; Retinal Diseases
PubMed: 36944313
DOI: 10.1146/annurev-vision-111022-123909 -
Annual Review of Vision Science Sep 2023As we navigate and behave in the world, we are constantly deciding, a few times per second, where to look next. The outcomes of these decisions in response to visual... (Review)
Review
As we navigate and behave in the world, we are constantly deciding, a few times per second, where to look next. The outcomes of these decisions in response to visual input are comparatively easy to measure as trajectories of eye movements, offering insight into many unconscious and conscious visual and cognitive processes. In this article, we review recent advances in predicting where we look. We focus on evaluating and comparing models: How can we consistently measure how well models predict eye movements, and how can we judge the contribution of different mechanisms? Probabilistic models facilitate a unified approach to fixation prediction that allows us to use explainable information explained to compare different models across different settings, such as static and video saliency, as well as scanpath prediction. We review how the large variety of saliency maps and scanpath models can be translated into this unifying framework, how much different factors contribute, and how we can select the most informative examples for model comparison. We conclude that the universal scale of information gain offers a powerful tool for the inspection of candidate mechanisms and experimental design that helps us understand the continual decision-making process that determines where we look.
Topics: Fixation, Ocular; Eye Movements
PubMed: 37419107
DOI: 10.1146/annurev-vision-120822-072528 -
BMC Ophthalmology Jun 2023To compare the outcomes of sutured transscleral fixation and sutureless intrascleral fixation for the treatment of a dislocated intraocular lens (IOL). (Comparative Study)
Comparative Study
BACKGROUND
To compare the outcomes of sutured transscleral fixation and sutureless intrascleral fixation for the treatment of a dislocated intraocular lens (IOL).
METHODS
Thirty-five eyes of 35 patients who required IOL repositioning surgery due to IOL dislocation were included in this retrospective study. Sixteen eyes underwent two-point sutured transscleral fixation, eight eyes underwent one-point sutured transscleral fixation, and 11 eyes underwent sutureless intrascleral IOL fixation. The patients were followed for ≥ 12 months after repositioning surgery, and their postoperative outcomes were recorded and analyzed.
RESULTS
The major cause of IOL dislocation was ocular blunt trauma (19/35, 54.3%). The mean corrected distance visual acuity (CDVA) improved significantly after IOL repositioning (P = 0.022). The mean postoperative change in endothelial cell density (ECD) was - 4.5%. There were no significant differences in the changes in CDVA or ECD among the three groups with different repositioning techniques (both P > 0.1). The mean vertical tilt of the IOLs in all enrolled patients was significantly greater than the horizontal value (P = 0.001). The vertical tilt was greater in the two-point scleral fixation group than that in the sutureless intrascleral fixation group (P = 0.048). The mean decentration values in the one-point scleral fixation group in the horizontal and vertical directions were greater than those in the other two groups (all P < 0.01).
CONCLUSION
All three IOL repositioning techniques resulted in favorable ocular prognosis.
Topics: Humans; Eye Injuries; Face; Lenses, Intraocular; Retrospective Studies; Sclera
PubMed: 37312094
DOI: 10.1186/s12886-023-03020-1 -
International Medical Case Reports... 2023To report a case of neurosarcoidosis (NS) who was initially diagnosed as (CI) infection.
PURPOSE
To report a case of neurosarcoidosis (NS) who was initially diagnosed as (CI) infection.
OBSERVATIONS
A 57-year-old diabetic man presented with sudden painless diminution of vision, metamorphopsia, and color vision deficits in the left eye (OS) for one month. His vision was 20/20 in the right eye (OD) and 20/40 OS. Ophthalmic examination revealed left relative afferent pupillary defect, blurred optic nerve margin, creamy chorioretinal infiltration around the optic disc, and mild macular edema. OD examination was non-revealing. Chest CT scan with contrast showed calcified mediastinal lymph nodes, but biopsy of the lymph nodes was normal. Brain and orbit MRI demonstrated soft tissue abnormality with enhancement in left orbital apex with involvement of the extraocular muscles. CSF culture was negative, but complement fixation had positive titer of 1:2 for CI. The patient was diagnosed with CI meningitis, and antifungal therapy was initiated. Slight visual and symptomatic improvement was observed, which was not completely satisfactory. Biopsy of extraocular orbital muscle five months later revealed non-caseating granulomatous inflammation, leading to initiation of prednisone trial therapy. Nine months later, the patient was referred to a tertiary center owing to persistence of optic disc edema OS. PET CT was consistent with a diagnosis of sarcoidosis. Antifungal treatment was discontinued, and oral prednisone with methotrexate was initiated. Subsequently, methotrexate was replaced by infliximab to further manage ocular inflammation and neurologic symptoms which was effective. Vision was 20/20 OD and 20/30 OS at the most recent visit.
CONCLUSION AND IMPORTANCE
Signs and symptoms of neurosarcoidosis and coccidioidomycosis can be similar and deceiving. The index case underscores importance of considering appropriate differential diagnoses in patients with similar symptoms and signs who may respond to preliminary designated treatment but not to the optimal extent. Considering such possibility could assist clinicians in managing the patients timely and efficiently.
PubMed: 38164515
DOI: 10.2147/IMCRJ.S434632