Comparison of the Retinomax hand-held autorefractor versus table-top autorefractor and retinoscopy

AIM:To compare noncycloplegic and cycloplegic results of Retinomax measurements with findings achieved after cycloplegia using table-top autorefractor and retinoscopy.METHODS:The study included 127 patients(mean age96.7mo,range 21 to 221).Retinomax(Rmax)(Nikon Inc.,Japan)was used to obtain noncycloplegic refraction.Under cycloplegia,refraction was measured with Rmax,table-top autorefractor(TTR)(Nikon NRK 8000,Inc.,Japan)and retinoscopy.The values of sphere,spherical equivalent,cylinder and axis of cylinder were recorded for Rmax,TTR and retinoscopy in each eye.All results were analyzed statistically.RESULTS:The mean spheric values(SV),spherical equivalent values(SEV)and cylindrical values(CV)of the noncycloplegic Rmax(SV:0.64 D,SEV:0.65 D and CV:0.03 D,respectively)were found to be significantly lower than cycloplegic TTR(1.43 D,1.38 D and 0.3 D;P=0.012,P=0.011 and P=0.04,respectively)and retinoscopy(1.34 D,1.45 D and 0.23 D;P=0.04,P=0.002 and P=0.045,respectively).Mean cycloplegic SV,SEV,CV were not significantly different between Rmax and TTR,Rmax and retinoscopy,TTR and retinoscopy.Cycloplegic or noncycloplegic axis values were not different between any method.CONCLUSION:Rmax may be used successfully as a screening tool but may not be accurate enough for actual spectacle prescription.Cycloplegic Rmax measurements may be able to identify refractive error in children because of approximate results to retinoscopy.

Retinal nerve fiber layer thickness changes in obstructive sleep apnea syndrome: one year follow-up results

·AIM: To investigate the retinal nerve fiber layer(RNFL)thickness changes in patients with obstructive sleep apnea syndrome(OSAS) for one year follow-up. To discuss the possibility of detecting tendency of glaucoma in this population by using spectral domain optical coherence tomography(3D-OCT-2000 Spectral domain).·METHODS: After polysomnographic study, all subjects(64 OSAS patients and 40 controls) underwent detailed ophthalmological examination. After these examinations,patients with glaucoma and patients who had ophthalmological and/or systemic disease were excluded from the study.Totally, 20 patients in OSAS group and five patients in controls were excluded from the study in the first examination and follow-up period. The RNFL thickness was assessed with OCT. Forty-four OSAS patients and 35 control subjects were followed up for12 mo. RNFL thickness change and OSAS patients were evaluated for severity of disease by Apnea-Hypopnea Index(AHI).·RESULTS: Forty-four OSAS patients and 35 controls were enrolled in the study. Statistically significance was found between OSAS patients and controls at the 12 thmo.Average RNFL thickness was found to be significantly lower in last measurements in OSAS patients when compared with first measurements and control subjects(P 【0.001, 0.002, respectively). There was a statistically significant correlation among AHI, and RNFL thickness(P 【0.05).·CONCLUSION: The results suggest that the patients with OSAS were related with a proportional decrease in the RNFL thickness. These patients should be followed up regularly for glaucomatous changes. Detecting more RNFL thinning in severe OSAS was important.

Traumatic central cord syndrome in a 2-year-old child: minor trauma but major complication

BACKGROUND: Traumatic central cord syndrome(TCCS) is the most frequently encountered incomplete spinal cord injury, and it is a relatively rare situation in children younger than 15 years, but may have serious consequences.METHODS: We report the case of a 2-year-old female child with upper extremity weakness following a simple fall. All vitals and systemic examination findings were normal, except for 2/5 muscular strength in the upper extremities. While radiographic imaging showed no pathologic fi ndings, MRI exposed spinal injury. The patient was treated conservatively with medication only. The medical treatment of the patient consisted of anti-edema treatment with methylprednisolone in the first 24 hours; 330 mg of methylprednisolone infused in the first hour, followed by 59 mg per hour during the next 23 hours. Along with pharmacological treatment, she received physiotherapy sessions during her 11-day hospitalization period.RESULTS: The child had full recovery within 6 months after conservative treatment.CONCLUSION: Neurological deficit without plain radiographic evidence in pediatric spinal trauma patients is a rare but signifi cant incident.