Thyroid associated ophthalmopathy is an autoimmune disorder affecting the orbital and periorbital tissues. Hyperthyroidism is commonly associated with thyroid associated ophthalmopathy, however in 5% to 10% of cases it is euthyroid. Genetic, environmental and endogenous factors play a role in the initiation of the thyroid ophthalmopathy. Smoking has been identified as the strongest risk factor for the development of the disorder. The pathogenesis involves activation of both humoral and cell mediated immunity with subsequent production of gycoaminoglycans, hyaluronic acid resulting in oedema formation, increase extraocular mass and adipogenesis in the orbit. The natural history of the disease progresses from active to inactive fibrotic stage over a period of years. Diagnosis is mainly clinical and almost all patients with ophthalmopathy exhibit some form of thyroid abnormality on further testing. Treatment is based on the clinical severity of the disease. Non-severe cases are managed by supportive measures to reduce the symptomatology and severe cases are treated by either medical or surgical decompression. Rehabilitative surgery is done for quiescent disease to reduce diplopia and improve cosmesis.
To develop a simple prediction model for the pre-screening of Retinopathy of Prematurity (ROP) among preterm babies.This was a prospective study. The test dataset (January 2007 until December 2010) was used to construct risk prediction models, and the validation dataset (January 2011 until March 2012) was used to validate the models developed from the test dataset. Two prediction models were produced using the test dataset based on logistic regression equations in which the development of ROP was used as the outcome.The sensitivity and specificity for model 1 [gestational age (GA), birth weight (BW), intraventricular haemorrhage (IVH) and respiratory distress syndrome (RDS)] was 82 % and 81.7%, respectively; for model 2, (GA and BW) the sensitivity and specificity were 80.5% and 80.3%, respectively.Model 2 was preferable, as it only required two predictors (GA and BW). Our prediction model can be used for early detection of ROP to avoid poor outcomes.
Pregnancy is associated with increased risk of development and progression of diabetic retinopathy (DR). Although pregnancy does not have any long term effect on DR, progression of retinopathy changes occur in 50%-70% of cases. The greatest risk of worsening occurs during the second trimester and persists as long as 12 months postpartum. The other factors found to be associated with its progression include duration of the diabetes, severity of retinopathy at conception, hyperglycaemic control, anaemia and progression of coexisting hypertension. Because of the increased risk of progression of the disease in pregnancy, conception should be delayed till the ocular disease is treated and stabilized and laser photocoagulation should be promptly instituted in all cases of severe non-proliferative retinopathy and should not be delayed till the patient develops early proliferative changes. Good diabetic control before and during pregnancy can help prevent this increase in the progression and serious vision loss.
We report a case of jerk seesaw nystagmus that developed after posterior cranial fossa decompression with cerebellar tonsillectomy for Chiari I malformation. A 40-year-old female was diagnosed to be suffering from a Chiari I malformation associated with syringomyelia. Posterior cranial fossa decompression with cerebellar tonsillectomy was performed. Three months later, she developed oscillopsia and jerk seesaw nystagmus. The oscillopsia improved substantially with oral gabapentin. We conclude that oscillopsia and acquired nystagmus are rare but potentially disabling complications following posterior cranial fossa decompression. Oral gabapentin may be effective in the management of oscillopsia secondary to acquired jerk seesaw nystagmus.
Signal detection theory holds that performance can be modeled under conditions of physical specification of signals and systems, with no attention given to signal informational content. By contrast, Shannon [Bell Syst. Tech. J. 30, 50–64 (1951)] proposed that performance is open to coding influences and, therefore, may vary with signal content. This study examined performance of subjects for three-element sequences wherein the content varied systematically from words, to nonword, vocal system outputs, to speech-patterned noises. Signals formed a twenty sequences closed set, randomly selected and delivered with equal probabilities. Subjects were trained prior to experimental runs to a 90% criterion but probably not to asymptotic performance, using trial-by-trial feedback. All signal elements were represented by multiple tokens and all signals were of equal power and duration. Training was accomplished in the ‘‘clear,’’ signal/noise ratio was an experimental variable and both training and experimental conditions were self-paced. Subjects were paid for performance throughout. Results are discussed from several theoretical perspectives.
Abstract Background To report a case of branch retinal vein occlusion in a young adult with bipolar mood disorder treated with quetiapine fumarate. Case Presentation A 29 years old gentleman who was taking quetiapine fumarate for 3 years for bipolar mood disorder, presented with sudden vision loss. He was found to have a superior temporal branch retinal vein occlusion associated with hypercholesterolemia. Conclusion Atypical antipsychotic drugs have metabolic side effects which require regular monitoring and prompt treatment.
Abstract Background To screen for visual impairment in Malaysian preschool children. Methods Visual screening was conducted in 400 preschool children aged 4 to 6 years. The screening involved two basic procedures; the distant visual acuity test using the Sheridan Gardiner chart and the depth perception test using the Langs stereoacuity test. Criteria for referral were a visual acuity of 6/12 or less in the better eye or a fail in the depth perception test. Results The prevalence of visual impairment was 5% (95% confidence interval [CI] = 3.3, 7.6). Of the 400 preschool children screened, 20 of them failed the distant visual acuity test or the stereopsis test. Refractive errors were the most common cause of visual impairment (95%, 95% CI = 76.2, 98.8); myopic astigmatism was the commonest type of refractive error (63.2%, 95% CI = 40.8, 80.9). Conclusion The study is a small but important step in the effort to understand the problem of visual impairment among our preschool children. Our study showed that it is feasible to measure distant visual acuity and stereopsis in this age group.
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