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Long-term Visual Outcome (long-term + visual_outcome)
Selected AbstractsLong-term outcome of children with cortical visual impairmentDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 6 2006Carey A Matsuba MDCM MHSc FRCP(C) Cortical visual impairment (CVI) is now the most common cause of visual impairment in children. Little is known about the long-term visual outcome. This study evaluates the outcome of children with congenital CVI. Using medical records, 423 children (225 males, 198 females) were identified with congenital CVI. Of these children, 259 had follow-up visual acuity assessments. The children's gestational age varied with 32 weeks or less representing 15.9%; 33 to 36 weeks representing 10.7%; 37 to 42 weeks representing 61.2%; and 43 weeks or greater representing 0.9% (11.3% of patients'gestational age was unrecorded). Clinical data were extracted and information regarding outcome was gathered. The majority of children showed improvement in their visual acuity levels after 2 or more years of follow-up. For the 194 children initially assessed before 3 years of age, 97 had improved, 75 were unchanged, 18 had deteriorated, and 4 had sub-optimal assessments. For the 74 children initially assessed at 3 or more years of age, 23 had improved, 44 remained unchanged, 3 had deteriorated, and 4 had sub-optimal testing. Children with better visual acuity levels at follow-up were more likely to have favourable cognitive outcomes (non-mental retardation)* in 12.2% versus 2.8% (p<0.01). Similarly, favourable motor outcomes (independent ambulation) were present in 20.1% for those with better visual acuities versus 7.9% for those with poorer visual acuities (p<0.01). Our study demonstrates that the majority of children with CVI underwent improvement in visual acuity. Additional disabilities were common, but those children with better visual acuity outcomes faired better. Given the frequency of comorbid conditions, appropriate diagnostic assessment services are needed. [source] Long-term study of vascular perfusion effects following arteriovenous sheathotomy for branch retinal vein occlusionACTA OPHTHALMOLOGICA, Issue 3 2010Mahiul M. K. Muqit Abstract. Purpose:, To evaluate the perfusion effects and long-term visual outcome of pars plana vitrectomy (PPV) combined with arteriovenous sheathotomy (AVS) with or without triamcinolone for nonischaemic branch retinal vein occlusion (NI-BRVO). Methods:, Prospective, interventional case series of eight patients with NI-BRVO and haemorrhagic macular oedema. Patients underwent PPV and AVS (n = 5), or PPV, AVS and intravitreal triamcinolone (IVT, n = 3). A masked grading technique assessed fundus photographs and fluorescein angiography (FFA) following surgery. Scanning laser ophthalmoscopy/optical coherence tomography (SLO/OCT) evaluated macular oedema and outer retinal architecture. Main outcomes examined included visual acuity (VA), retinal reperfusion, collateral vessel regression, vascular dilatation, cystoid macular oedema (CMO), and ocular neovascularization. Results:, Seven of eight patients underwent uncomplicated surgery, with increased intraretinal perfusion and reduced engorgement of distal retinal veins. The mean pre-logMAR VA was 0.8 (SD 0.17) and did not improve significantly after surgery (post-logMAR 0.6, SD 0.38; p = 0.11, paired t -test). SLO/OCT showed persistent CMO in four patients, and subfoveal thinning of the photoreceptor layer. Collateral vessels disappeared at the blockage site post-AVS in 7/8 eyes, and this was associated with improved retinal perfusion. Six of eight patients developed epiretinal membrane. No patients developed ocular neovascularization. The average follow-up was 34.5 months. Conclusions:, PPV with AVS is a safe procedure, and adjunctive IVT had no additional effects on vascular perfusion. Successful decompressive surgery was followed by disappearance of collateral vessels at the BRVO blockage site and was a clinical marker for intravascular reperfusion. Long-term epiretinal gliosis and subfoveal photoreceptor atrophy limited functional and visual recovery. [source] Foveal serous detachment in juvenile idiopathic arthritis(JIA)-associated uveitisACTA OPHTHALMOLOGICA, Issue 2009F LIANG Purpose To characterize the foveal serous detachment(FSD) in JIA-associated uveitis. To investigate the correlation with visual acuity (VA) and ocular inflammation. Methods 9 children having FSD with JIA-associated uveitis were identified between 2005-2007. All were treated with periocular steroid injection and systemic anti-TNF , antibody.Outcome measures included VA,ocular inflammation quantified by laser flare photometry and the macular profile analyzed by OCT. Results All patients(8 female,1 male) had bilateral uveitis and 6 had bilateral SRD. All patients had risk factors to develop severe anterior uveitis. The mean age at the onset of uveitis and at the onset of FSD was 4.1±1.1years and 7.6±2.2years. At the onset of FSD 6 children were refractory to methotrexate and systemic corticosteroids. It had a high frequency of ocular complications:87% posterior synechiae, 80% cataract, 60% band keratopathy and 20% glaucoma.FSD appeared isolated in 21% of eyes,it was associated with diffuse macular edema in 46% and with cystoid macular edema in 12% of cases. Before therapeutic intensification,the mean VA was 0.46logMAR,the mean foveal thickness(FT) was 261,m. At 6 months follow-up:VA increased to 0.22logMAR(p=0.017),the reduction of flare was 41%(p=0.003),the mean FT was 229,m(p=0.59). At 12 months follow-up,the mean VA was 0.19logMAR(p=0.0029),the mean FT was 196,m(p=0.009),only 1 eye showed persistant SRD. Conclusion FSD is a late-stage complication of sustained and insufficiently treated anterior uveitis in JIA-associated uveitis and must be considered for the long-term visual outcome. An agressive immunomodulatory strategy is mandatory in order to achieve strict control of ocular inflammation and improve the visual function. [source] Craniopharyngioma: a review of long-term visual outcomeCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 3 2003Celia Chen MB BS MPHS Abstract Purpose: To assess the clinical presentation and long-term visual outcome in a series of patients with craniopharyn-gioma. Methods: Retrospective case review. Results: Thirty-six patients were reviewed, comprising 19 female patients and 17 male patients. The age range was 2,77 years with a bimodal distribution of 17 children (mean age 10 years) and 19 adults (mean age 47 years). Blurred vision was the most common visual complaint (23 cases, 64%) and headache the most frequent systemic complaint (19 cases, 53%). The average duration of systemic symptoms was 45 weeks compared to 10 weeks for visual symptoms. Deficits in visual acuity occurred in 13 patients (36%) and showed no significant change from initial presentation to final review. Sixteen patients (44%) had bitemporal hemianopia on presentation and pleomorphism (change from one type of visual field defect to another) occurred in 11 patients. Recurrence of tumour occurred in 15 patients (42%) and was more likely in children (59%) than adults (26%). The mean time period to recurrence was 7 years. The average follow-up period for all cases was 10 years. Conclusion: Patients with craniopharyngioma generally present late, and the visual symptoms are often preceded by a long history of systemic symptoms. Children are more likely to present with systemic symptoms than adults. Visual field pleomorphism is a feature of craniopharyngioma and occurred in one-third of the patients. Local recurrence is common. Although magnetic resonance imaging is the recommended means of follow up, regular neuro-ophthalmic review is useful in the early detection of anterior visual pathway compression by recurrent tumour. [source] | ||||||||||