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ABSTRACT: To report new cases of bilateral acute depigmentation of the iris (BADI), a recently described clinical entity, and to report the 4-year follow-up of 2 patients that was published previously.
A retrospective case series.
Twenty-six Turkish patients who were diagnosed with BADI between 2006 and 2008 and 2 patients who were reported previously.
We reviewed the patients' charts and clinical photographs. Observation procedures included clinical examination, anterior segment color photography, laser flare photometry, and pupillometry. We performed an anterior chamber tap in 2 patients for polymerase chain reaction (PCR) to demonstrate the DNA of herpes simplex virus (HSV), varicella zoster virus (VZV), and cytomegalovirus (CMV) in the aqueous samples.
Demographic features, presenting symptoms, laboratory findings, changes in iris stromal pigment and architecture, and time to resolution of pigment dispersion in the anterior chamber.
Nineteen patients were female, and 7 patients were male. Mean age was 32.3+/-8.6 years. All had bilateral involvement. Twenty patients (76.9%) presented with photophobia and red eyes, and 4 patients (15.4%) presented with a recent change in eye color. Ten patients (38.5%) had flu-like symptoms preceding the onset of ocular symptoms. Diagnostic laboratory workup, viral serology, and PCR analysis of the aqueous humor were unrewarding. Diffuse depigmentation of the iris stroma from the collarette to the iris root was seen in 16 patients, and geographic areas of depigmentation were seen in 10 patients. There was heavy pigment deposition in the trabecular meshwork in all patients. Anterior chamber flare was elevated in eyes with circulating pigment. The pupil was not affected. Twenty patients received topical corticosteroids. Pigment dispersion resolved in 1 to 16 weeks (median, 9 weeks). The intraocular pressure was elevated in 8 steroid-treated eyes but was controlled with antiglaucomatous medications. In 2 patients reported previously, the depigmented iris stroma became repigmented after 4 years.
Patients with BADI present with bilateral, symmetrical, nontransilluminating depigmentation of the iris stroma and pigment discharge into the anterior chamber. Young female persons are more commonly affected. The cause remains unknown. After 4 years, the ocular findings in 2 patients normalized.
Ophthalmology 07/2009; 116(8):1552-7, 1557.e1. · 5.45 Impact Factor
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Journal of American Association for Pediatric Ophthalmology and Strabismus 05/2005; 9(2):195-7. · 1.03 Impact Factor
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ABSTRACT: To determine the factors associated with favorable and less favorable outcomes in strabismus surgery for treatment of exotropia and to show the factors influencing the efficacy of the surgical procedure.
Case files of 225 patients with a diagnosis of primary exotropia were evaluated. Information about patient age at onset of deviation, patient age at surgery, interval between onset and surgery, preoperative deviation, refractive errors, degree of anisometropia, visual acuity, presence of amblyopia, presence of an A- or a V-pattern, amount of surgery performed, type of exotropia (intermittent or constant), and existence of binocular single vision before surgery were obtained and evaluated using multiple regression analysis.
Preoperative deviation and refractive errors were proved to be significant factors influencing a favorable outcome in patients with surgically treated exotropia (r(2) = 0.12, P <.001, and r(2) = 0.07, P <.001 respectively). Preoperative deviation, amount of surgery performed, and refractive errors shifting toward myopia significantly influenced the efficacy of the surgery performed (r(2) = 0.31, 0.06, and 0.025, respectively).
Special care should be paid to refractive errors in patients with exotropia before determining the amount of surgical intervention.
Journal of American Association for Pediatric Ophthalmology and Strabismus 02/2004; 8(1):56-60. · 1.03 Impact Factor
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ABSTRACT: The Esterman binocular visual field test was performed on 24 amblyopic subjects and 10 normal subjects. No correlation was found between the evaluated clinical parameters and Esterman scores in the patients with amblyopia. The Esterman score may not properly reflect the actual binocular disability in amblyopia.
Journal of Pediatric Ophthalmology & Strabismus 41(2):112-3. · 0.63 Impact Factor
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ABSTRACT: To assess the efficacy and safety of holmium laser thermal keratoplasty (Ho:LTK) for hyperopia in eyes overcorrected after laser in situ keratomileusis (LASIK) for myopia.
We performed a prospective evaluation of Ho:LTK in eyes with secondary hyperopia from +1.00 to +5.50 D after LASIK. Thirty-seven eyes of 23 patients received one concentric 8-spot application at the 6-mm-diameter zone. Mean patient age was 41.3 +/- 13.0 years (range 20 to 68 yr). Mean corneal thickness was 455.86 +/- 31.20 microm (range 373 to 506 microm).
Mean spherical equivalent refraction changed from +2.30 +/- 1.08 D to +0.45 +/- 1.00 D at 12 months after Ho:LTK. Thirty-one eyes (84%) were within +/- 1.00 D of emmetropia and 25 eyes (68%) were within +/- 0.50 D at 1 year. Mean change in refraction was 1.84 +/- 0.92 D. No eye lost 2 lines of best spectacle-corrected visual acuity.
Ho:LTK is a suitable alternative for correcting secondary hyperopia resulting from LASIK for myopia. Parameter adjustments may be necessary for improving the results.
Journal of refractive surgery (Thorofare, N.J.: 1995) 20(3):253-7. · 2.54 Impact Factor
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ABSTRACT: To evaluate the functions of the magnocellular and parvocellular pathways in strabismic amblyopia.
Visual evoked potentials produced by achromatic and chromatic stimuli in 14 children with strabismic amblyopia were compared with those in 14 age-matched control subjects. The achromatic sine-wave grating with low spatial frequency was used to stimulate the magnocellular pathway, whereas the parvocellular pathway was stimulated by the chromatic sine-wave grating (isoluminant red-green) with low and high spatial frequencies.
When the achromatic stimuli with low spatial frequency were used, the latencies of the N1 and P1 components and the amplitude of the N1-P1 complex were similar in the children with strabismic amblyopia and the control subjects. There also were no differences between the amblyopic and non-amblyopic eyes of the children with strabismic amblyopia. When chromatic stimuli with low and high spatial frequencies were used, the latencies of the N1 and P1 components were significantly longer and the amplitude of the N1-P1 complex was significantly smaller in the children with strabismic amblyopia than in the control group. When the amblyopic and non-amblyopic eyes of the children with strabismic amblyopia were compared, the latencies of the N1 and P1 components were longer and the amplitude of the N1-P1 complex was smaller in the amblyopic eyes.
In strabismic amblyopia, the cells in the parvocellular pathway may be more involved, whereas the magnocellular pathway may be relatively spared.
Journal of Pediatric Ophthalmology & Strabismus 39(4):215-21. · 0.63 Impact Factor
