SUMMARYPseudoexfoliation syndrome (PEX) is the most common clinical precursor of openangle glaucoma. Recent studies have shown that pseudoexfoliative material is widely distributed throughout the body, including blood vessels. The aim of our study was to evaluate endothelial function in the brachial artery of patients with pseudoexfoliation syndrome.We prospectively examined 23 patients with PEX (mean age, 70 ± 8 years) and 20 healthy age-and sex-matched individuals (mean age, 68 ± 9 years) as a control group. Brachial artery endothelial function was assessed by vascular response to reactive hyperemia (flow-mediated dilation (FMD) and sublingual nitroglycerin (NTG-mediated dilation) using high-resolution ultrasound. Flow-mediated and NTG-induced dilation were expressed as the percent change in diameter after reactive hyperemia and after NTG administration relative to the baseline value, respectively. Patients with cardiovascular disease and other conditions associated with endothelial dysfunction were excluded.When compared with controls, patients with PEX had significantly lower flow-mediated dilation (4.5 ± 2.8 versus 8.2 ± 3.7, P = 0.01) and NTG-mediated dilation (10.9 ± 3.1 versus 15.8 ± 3.8, P = 0.0001). Flow-mediated dilation and NTG-mediated dilation were similar in PEX patients with glaucoma (n = 11) and without glaucoma (n = 12). Flow-mediated and NTG-mediated dilation did not correlate with any measured parameter in any patient or control subject.The findings indicate that systemic endothelial function is impaired in PEX syndrome patients. (Int Heart J 2006; 47: 77-84)
SUMMARYIn this retrospective study based on 140 esotropic and 51 exotropic patients, the factors influencing successful outcome and response to strabismus surgery were investigated. Thirteen independent variables were chosen. The pre-operative deviation was found to be the only discriminant factor for early and late successful surgical outcomes in esotropic patients. For exotropic patients the visual acuity of the left eye was the discriminant factor for early successful surgical out come. In esotropic patients the response to surgery increased with increasing amounts of pre-operative deviation. It was lower for patients with older age of onset and larger amounts of medial rectus recession.For exotropic patients the response to surgery was higher for larger pre-operative deviations. Eliminating possible sources of error when determining the pre operative deviation will improve the predictability of the response to surgery and surgical outcome.The aim of strabismus surgery is to straighten the eyes in the primary position and to improve versions and the range of binocular single vision. The outcome of strabismus surgery shows great varia bility among patients. The determination of pre operative and intraoperative factors affecting suc cessful surgical outcome would help us to be more confident when planning a surgical intervention. The predictability of the surgical outcome also depends on the assessment of factors affecting the response to strabismus surgery. von Graefe l was the first to mention the dose-response relationship in strabis mus surgery in 1857 and von Pflugk 2 followed him using the degree/mm ratio (squint-angle reduction per millimetre of surgery). Many surgical formulas have been proposed, on the basis of both clinical experience and artificial eye models, to detect factors affecting the response to surgery and to improve the predictability of strabismus surgery ? � 8 Controversy
SUMMARYBotulinum toxin type A (BT A) treatment is an alternative to strabismus surgery. In this retrospective study the data on 45 esotropic and 49 exotropic patients with concomitant strabismus who were treated with BT A were analysed for dose-effect relationship, the effect of repeat doses and amblyopia on success of botulinum treatment. The esotropic patients were treated with a total of 80 and exotropic patients with 91 injections. The deviations were corrected within 5 degrees of straight in 33% of esotropic and 18% of exotropic patients. In esotropic patients the effect was dose dependent. This relation was not shown in exotropic patients. The repeat doses of BTA corrected the deviation to the same extent as the primary ones for both esotropic and exotropic patients. apart from its commonly encountered paralytic effects, is that it produces effects that are not as predictable and stable as traditional surgery. In this study we analysed our data to investigate the dose-effect relationshp and the effect of repeat doses.Correspondence to: Ali Sefik Sanae, MD, Hacettepe University School of Medicine, Department of Ophthalmology, Sihhiye Ankara, 06100 Turkey. MATERIALS AND METHODS In
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