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Aim: To evaluate if functionally relevant deficits in reading performance exist in children with essential microstrabismic amblyopia by comparing the monocular and binocular reading performance with the reading performance of normal sighted children with full visual acuity in both eyes. Methods: The reading performance of 40 children (mean age 11.6 (SD 1.4) years) was evaluated monocularly and binocularly in randomised order, using standardised reading charts for the simultaneous determination of reading acuity and speed. 20 of the tested children were under treatment for unilateral microstrabismic amblyopia (visual acuity in the amblyopic eyes: logMAR 0.19 (0.15); fellow eyes −0.1 (0.07)); the others were normal sighted controls (visual acuity in the right eyes −0.04 (0.15); left eyes −0.08 (0.07)). Results: In respect of the binocular maximum reading speed (MRS), significant differences were found between the children with microstrabismic amblyopia and the normal controls (p = 0.03): whereas the controls achieved a binocular MRS of 200.4 (11) wpm (words per minute), the children with unilateral amblyopia achieved only a binocular MRS of 172.9 (43.9) wpm. No significant differences between the two groups were found in respect of the binocular logMAR visual acuity and reading acuity (p>0.05). For the monocular reading performance, significant impairment was found in the amblyopic eyes, whereas no significant differences were found between the sound fellow eyes of the amblyopic children and the control group. Conclusion: In binocular MRS, significant differences could be found between children with microstrabismic amblyopia and normal controls. This result indicates the presence of a functionally relevant reading impairment, even though the binocular visual acuity and reading acuity were both comparable with the control group.

The high level expression of somatostatin receptors (SSTR) on various tumor cells has provided the molecular basis for successful use of radiolabeled octreotide / lanreotide analogs as tumor tracers in nuclear medicine. Other (nontumoral) potential indications for SSTR scintigraphy are based on an increased lymphocyte binding at sites of inflammatory or immunologic diseases such as thyroidassociated ophtalmology. The vast majority of human tumors seem to over-express the one or the other of five distinct hSSTR subtype receptors. Whereas neuroendocrine tumors frequently overexpress hSSTR2, intestinal adenocarcinomas seem to overexpress more often hSSTR3 or hSSTR4, or both of these hSSTR. In contrast to 111In-DTPA-DPhe1-octreotide (OctreoScan) which binds to hSSTR2 and 5 with high affinity (Kd 0.1-5 nM), to hSSTR3 with moderate affinity (Kd 10-100 nM) and does not bind to hSSTR1 and hSSTR4, 111In / 90Y-DOTA-lanreotide was found to bind to hSSTR2, 3, 4, and 5 with high affinity, and to hSSTR1 with lower affinity (Kd 200 nM). Based on its unique hSSTR binding profile, 111In-DOTA-lanreotide was suggested to be a potential radioligand for tumor diagnosis, and 90 Y-DOTA-lanreotide suitable for receptor-mediated radionuclide therapy. As opposed to 111In-DTPADPhe1- octreotide and 111In-DOTA-DPhe1-Tyr3-octreotide, discrepancies in the scintigraphic results were seen in about one third of (neuroendocrine) tumor patients concerning both the tumor uptake as well as detection of tumor lesions. On a molecular level, these discrepancies seem to be based on a \"higher\" high-affinity binding of 111In-DOTA-DPhe1-Tyr3-octreotide to hSSTR2 (Kd 0.1-1 nM). Other somatostatin analogs with divergent affinity to the five known hSSTR subtype receptors have also found their way into the clinics, such as 99mTc-depreotide (NeoSpect, NeoTect). Most of the imaging results are reported for neuroendocrine tumors (octreotide analogs) or nonsmall cell lung cancer (99mTc-depreotide), indicating high diagnostic cabability of this type of receptor tracers. Consequently to their use as receptor imaging agents, hSSTR recognizing radioligands have also been implemented for experimental receptor-targeted radionuclide therapy. Beneficial results were reported for highdose treatment with 111In-DTPA-DPhe1-octreotide, based on the emission of Auger electrons. The Phase IIa study \"MAURITIUS\" (Multicenter Analysis of a Universal Receptor Imaging and Treatment Initiative, a eUropean Study) showed in progressive cancer patients (therapy entry criteria) with a calculated tumor dose > 10 Gy / GBq 90 Y-DOTA-lanreotide, the proof-of-principle for treating tumor patients with peptide receptor imaging agents. In the \"MAURITIUS\" study, cummulative treatment doses up to 200 mCi 90 Y-DOTA-lanreotide were given as short-term infusion. Overall treatment results in 70 patients indicated stable tumor disease in 35% of patients and regressive tumor disease in 10% of tumor patients with different tumor entities expressing hSSTR. No acute or chronic severe hematological toxicity, change in renal or liver function parameters due to 90 Y-DOTA-lanreotide treatment, were reported. 90Y-DOTA-DPhe1-Tyr3-octreotide may show a higher tumor uptake in neuroendocrine tumor lesions and may therefore be superior for treatment in patients with neuroendocrine tumors. However, there is only limited excess to long-term and survival data at present. Potential indications for 90 Y-DOTA-lanreotide are radioiodine-negative thyroid cancer, hepatocellular cancer and lung cancer. Besides newer approaches and recent developments of 188Re-labeled radioligands, no clinical results on the treatment response are yet available. In conclusion, several radioligands have been implemented on the basis of peptide receptor recognition throughout the last decade. A plentitude of preclinical data and clinical studies confirm their potential use in diagnosis as well as \"proof-ofprinciple\" for therapy of cancer patients. However, an optimal radiopeptide formulation does not yet exist for receptor-targeted radionuclide therapy. Ongoing developments may result in peptides more suitable for this kind of receptor-targeted radionuclide therapy.

To examine if standardized reading charts with highly comparable test items can be used for evaluating impairments in the monocular reading performance of children with microstrabismic amblyopia characterized by a small angle of squint with less than 5 degrees. The reading performance of 22 children (mean age: 11.7+/-1.6 years) with unilateral microstrabismic amblyopia was evaluated monocularly in both eyes, using standardized reading charts for the simultaneous determination of reading acuity and speed. The print sizes of the highly comparable sentence optotypes were logarithmically graded, providing constant geometric proportions for all testing distances in order to control contour interaction. All children were under continuous amblyopia therapy. In the amblyopic eyes, reading acuity and maximum reading speed were significantly impaired when compared to the sound fellow eyes (P<0.001). In respect of the maximum reading speed, a mean inter-ocular difference of 33+/-19 words per minute was found, revealing functionally relevant deficits in monocular reading performance. The amblyopic eyes achieved only a significantly reduced reading acuity (mean inter-ocular difference: LogRAD 0.5+/-0.24; P<0.001). In eight children, the amblyopic eyes achieved a best-corrected visual acuity of LogMAR 0.0 or better: in respect of the visual acuity, there was no significant inter-ocular difference, but reading acuity and maximum reading speed were significantly impaired when compared to the fellow eyes. Microstrabismic amblyopia was associated with significant impairment of reading acuity and speed in treated amblyopes, even in those with no persistent acuity deficit. To improve treatment addressing these functional deficits, reading performance should be monitored over time using standardized reading tests, which provide essential information about functionally relevant reading impairments.

Ziel dieser retrospektiven Untersuchung war die quantitative Flächen- und Volumenberechnung von isolierten Orbitabodenfrakturen aus der Computertomographie (CT) und die Korrelation dieser Daten mit posttraumatisch erhobenen ophthalmologischen Befunden. Insgesamt 76 Patienten mit isolierten Orbitabodenfrakturen wurden radiologisch und klinisch ausgewertet. Die CT erfolgte in koronarer Schichtführung (1,5-3,0 mm Schichtdicke) bei kontinuierlichem Tischvorschub. Aus dem CT-Datensatz wurden die Orbitaboden- und Frakturfläche sowie das Herniationsvolumen mithilfe eines Computerprogramms vermessen und berechnet. Der Zusammenhang der quantitativen CT-Daten mit den ophthalmologischen Befunden (Motilität, Diplopie und Bulbusposition) wurde statistisch erfasst. Die Berechnung der CT-Datensätze ergab eine mittlere Orbitabodenfläche von 6,33±1,05 cm^sup 2^, eine mittlere Frakturfläche von 2,60±1,14 cm^sup 2^ und ein mittleres Herniationsvolumen von 1,16±0,80 cm^sup 3^. Das Herniationsvolumen korrelierte signifikant mit den ophthalmologischen Befunden (p≤0,01). Die Frakturfläche korrelierte signifikant mit dem Bulbusstand (p≤0,01) und war mit Diplopie und Motilitätsstörungen trendmäßig schwächer assoziiert (p<0,10). Mit der effizienten Auswertung von zweidimensionalen CT-Datensätzen können Orbitabodenfrakturen quantitativ beurteilt werden. Die Lage und die Funktion des Bulbus werden vor allem durch das Volumen des verlagerten periorbitalen Gewebes beeinflusst. The goal of this retrospective study was quantitative calculation of area and volume of isolated orbital floor fractures from computed tomography (CT) and correlation of these data with post-traumatic ophthalmologic findings. A total of 76 patients with isolated orbital floor fractures were evaluated radiologically and clinically. CT scanning was performed in coronal sections (1.5-mm to 3.0-mm slice thickness) with contiguous table feed. Orbital floor and fracture area as well as volume of displaced tissue were measured and calculated from the CT dataset. The relation of quantitative CT data to ophthalmologic findings (motility, diplopia, and globe position) was assessed statistically. Calculation of the CT dataset revealed a mean orbital floor area of 6.33±1.05 cm^sup 2^, a mean fracture area of 2.60±1.14 cm^sup 2^, and a mean volume of displaced tissue of 1.16±0.80 cm^sup 3^. Volume of displaced tissue correlated significantly with ophthalmologic findings (p≤0.01). Fracture area correlated significantly with globe position (p≤0.01) and was less associated with diplopia and motility disturbances (p<0.10). Efficient evaluation of two-dimensional CT data enables quantitative assessment of orbital floor fractures. Position and function of the globe are mainly affected by the volume of displaced periorbital tissue.[PUBLICATION ABSTRACT]

Receptors for somatostatin (SST) (SSTR) are expressed on various tumor cells as well as on activated lymphocytes. Previous data have shown that (99m)Tc-P829 binds with high affinity to many different types of tumor cells as well as to leukocytes via the human hSSTR2, hSSTR3, and hSSTR5 target receptors. Consequently, (99m)Tc-P829 was successfully introduced as a peptide tracer for tumor imaging. In this study, we evaluated the orbital uptake of (99m)Tc-P829 in patients with active and inactive thyroid-associated orbitopathy (TAO), accompanied by lymphocyte infiltration in the acute stage and by muscle fibrosis in the chronic stage of the disease. To evaluate its clinical usefulness in Graves' disease, (99m)Tc-P829 scintigraphy (approximately equal to 740 MBq) was performed in 44 patients with TAO (median duration, 19 mo; range, 1-360 mo). The clinical activity of the orbital disease was graded by the NOSPECS (no signs or symptoms; only signs, no symptoms; signs only; proptosis; eye muscle involvement; corneal involvement; sight visual acuity reduction) classification of the American Thyroid Association, the clinical activity score (CAS), and the superonasal index (SNI). SPECT (360 degrees ) and planar studies were completed within 3 h after injection. Orbital (O) regions of interest (ROIs) were compared with temporoparietal and occipital (OCC) ROIs. Orbital uptake ratios in Graves' disease were compared with data obtained from lung cancer patients with no eye disease (n = 22). Overall, (99m)Tc-P829 biokinetics were the same in Graves' disease patients as in lung cancer patients, showing a rapid blood clearance and visualization of the facial bones within minutes of injection. In all control patients, the orbit appeared as a \"cold area,\" whereas visual orbital accumulation of (99m)Tc-P829 was found in patients with active TAO (O/OCC ratios: 1.26 +/- 0.04 vs. 1.69 +/- 0.04; P < 0.01, respectively). Patients with active eye disease (n = 25) presented with an increased orbital uptake of (99m)Tc-P829 compared with patients with inactive disease (n = 19; O/OCC ratio: 1.12 +/- 0.05; P < 0.01). A statistically significant correlation was found between CAS and the orbital uptake (O/OCC ratio) values (r = 0.90), whereas no correlation could be documented regarding the NOSPECS classification as well as the SNI. In TAO, (99m)Tc-P829 yields high orbital binding with good clinical correlation. The better image quality due to the high energy of technetium, the lower radiation dose for patients and personnel, and the short acquisition protocol favor SSTR scintigraphy with (99m)Tc-P829 over (111)In-labeled compounds. The in-house availability of the radiotracer and cost-effectiveness are further advantages.

The goal of this retrospective study was quantitative calculation of area and volume of isolated orbital floor fractures from computed tomography (CT) and correlation of these data with post-traumatic ophthalmologic findings. A total of 76 patients with isolated orbital floor fractures were evaluated radiologically and clinically. CT scanning was performed in coronal sections (1.5-mm to 3.0-mm slice thickness) with contiguous table feed. Orbital floor and fracture area as well as volume of displaced tissue were measured and calculated from the CT dataset. The relation of quantitative CT data to ophthalmologic findings (motility, diplopia, and globe position) was assessed statistically. Calculation of the CT dataset revealed a mean orbital floor area of 6.33+/-1.05 cm(2), a mean fracture area of 2.60+/-1.14 cm(2), and a mean volume of displaced tissue of 1.16+/-0.80 cm(3). Volume of displaced tissue correlated significantly with ophthalmologic findings (p< or =0.01). Fracture area correlated significantly with globe position (p< or =0.01) and was less associated with diplopia and motility disturbances (p<0.10). Efficient evaluation of two-dimensional CT data enables quantitative assessment of orbital floor fractures. Position and function of the globe are mainly affected by the volume of displaced periorbital tissue.