Home About us Contact
|
Home About us Contact | ||
|
|
||
Mean Visual Acuity (mean + visual_acuity)
Selected AbstractsPreterm and at term children: morphological and functional analysis of optic nerve and visual pathway with OCT, HRT and pVEPACTA OPHTHALMOLOGICA, Issue 2009R ANGELI Purpose To compare optic nerve morphology and visual function in 14 preterm children(mean gestational age:33,38) with normal cerebral ultrasound at birth and 15 at term children (mean gestational age:39,67). Methods Mean preterm age was 7,6 years, mean at term was 9,1 years. Children underwent to complete functional and morphological evaluation of Optic Nerve Head (ONH) with Heidelberg Retinal Tomography and Optical Coherence Tomography. The same children were evaluated at birth and at the time of morphological examinations by mean of transient and steady state pVEP. Results Mean visual acuity was 9,85 in the preterm, 10 in the at term children. HRT in preterm and at term children at term(n=28) preterm(n=25) P value mean sd mean sd Disc Area 2,5 0,7 2,34 0,68 0,38 Cup Area 0,50 0,44 0,58 0,47 0,51 Rim Area 2 0,45 1,76 0,37 0,047 C/D Area Ratio 0,18 0,12 0,22 0,14 0,23 C/D Linear Ratio 0,4 0,15 0,45 0,16 0,30 Mean RNFL Thick 0,2 0,07 0,24 0,2 0,26 Tab.1 A statistically significant reduction was found in preterm children as regard rim area (p=0,047,tab 1) at HRT and superior RNFL thickness (p=0,01), temporal and inferior inner macular thickness (p=0,03) at OCT. Differences in the pVep latencies were found at 3 and 8 months after birth, but not at the time of morphological examination. Steady State pVEP amplitudes differences were not statistically significant. Conclusion Morphologic optic disk and macula differences between term and preterm children seems not functionally affect the visual pathway. [source] Rapid reduction of hard exudates in eyes with diabetic retinopathy after intravitreal triamcinolone: data from a randomized, placebo-controlled, clinical trialACTA OPHTHALMOLOGICA, Issue 3 2009Jörgen Larsson Abstract. Purpose:, To assess the effect of triamcinolone acetonide over 3 months on hard exudates in patients with diabetic macular oedema (DMO). Methods:, Thirty-two eyes of 16 patients with DMO and hard exudates were included in a randomized, placebo-controlled trial. Treated eyes received a single-dose (4 mg) intravitreal injection of triamcinolone acetonide. Control eyes received an injection of subconjunctival saline. Results:, The overall area of hard exudates decreased significantly between the baseline and 3-month visits in treated eyes, but not in control eyes. The mean change in level of hard exudates between the two visits was , 0.75 arbitrary units (AU) (95% confidence interval [CI] , 1.32 to , 0.18) in the central plus inner circle (1500 ,m) and , 0.81 AU (95% CI , 1.49 to , 0.13) over the whole grid (3000 ,m) in treated eyes, compared with 0.31 AU (95% CI , 0.19 to 0.82) and 0.31 AU (95% CI , 0.11 to 0.74), respectively, in control eyes (p < 0.001). Mean visual acuity improved by five letters in treated but not in control eyes (p = 0.01). Conclusions:, Intravitreal triamcinolone reduces hard exudates in the short-term in eyes with DMO. [source] Early intravitreal bevacizumab for non-ischaemic central retinal vein occlusionACTA OPHTHALMOLOGICA, Issue 1 2009Florian Rensch Abstract. Purpose:, To evaluate the effect of early intravitreal bevacizumab injections for the treatment of macular oedema caused by non-ischaemic central retinal vein occlusion (CRVO). Methods:, The study included 25 patients (25 eyes) with macular oedema caused by non-ischaemic central retinal vein occlusion, who received three intravitreal injections of 1.5 mg bevacizumab with an interval of 6 weeks between the injections. Mean duration of central retinal vein occlusion prior to the first injection was 4.2 ± 3.6 days. All patients were re-examined 1, 3 and 6 months after the first injection. The main outcome parameters were visual acuity and macular thickness, as measured by optical coherence tomography. Results:, Mean visual acuity improved significantly from 0.97 ± 0.40 logMAR at baseline to 0.70 ± 0.42 logMAR (P = 0.007) at 1 month, 0.69 ± 0.46 (P = 0.006) 3 months and 0.69 ± 0.52 (P = 0.015) 6 months after the first injection. Mean central retinal thickness decreased significantly from 530 ± 152 ,m at baseline to 347 ± 127 ,m (P < 0.001) at 1 month, 370 ± 165 ,m (P < 0.001) 3 months and 346 ± 129 ,m (P < 0.001) 6 months (P < 0.001) after the first injection. The increase in visual acuity correlated significantly (P < 0.01) with the decrease in macular thickness. Mean intraocular pressure was 14.2 ± 3.2 mmHg at baseline and did not differ significantly from the measurement obtained at 1 month (P = 0.59), 3 months (P = 0.88) and 6 months after the first injection (P = 0.65). Conclusion:, Intravitreal bevacizumab injections given shortly after onset of non-ischaemic central retinal vein occlusion may result in a significant increase in vision and a corresponding decrease in macular oedema. [source] Dynamics of visual improvement following chiasmal decompression.ACTA OPHTHALMOLOGICA, Issue 5 2002Quantitative pre-, postoperative observations ABSTRACT. Purpose:, To study early visual restoration following surgical removal of pituitary adenomas compressing the optic chiasm. Methods:, Eleven patients were examined with high-pass resolution perimetry (HRP) before and after trans-sphenoidal adenomectomy. Visual fields were examined on the second postoperative day. The result was interpreted in terms of the estimated fraction of functioning retino-cortical connections. Results:, In the upper and lower temporal visual field quadrants, the mean increases in the fraction of functioning neural channels were 19% (p <,0.001) and 17% (p =,0.001), respectively, on day 2 after surgery. These increased to 35% on day 12. The nasal hemifield showed no change on day 2, but functioning neural channels had increased by 15% on day 5 (p =,0.017). Mean visual acuity improved from 0.6 preoperatively to 1.0 on day 2 (p =,0.030) but did not change significantly thereafter. Conclusion:, All visual field sectors and visual acuity improved after surgery. Improvement starting in the temporal hemifield was already evident on the second postoperative day. [source] Triamcinolone-induced cataract in eyes with diabetic macular oedema: 3-year prospective data from a randomized clinical trialCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 6 2010Mark C Gillies FRANZCO PhD Abstract Purpose:, To describe the 3-year risk of cataract after intravitreal triamcinolone (IVTA) injections for diabetic macular oedema and the outcomes of cataract surgery. Methods:, Prospective data from a randomized clinical trial were analysed. At baseline, 27 phakic eyes with diabetic macular oedema were randomized to receive IVTA and 25 to receive sham injection. After 2 years, initial sham-treated eyes were eligible to receive IVTA as the study became open label for the third year. The cumulative incidence of cataract surgery was the primary outcome of the study. Other outcomes assessed included progression of cataract, best-corrected logarithm of the minimal angle of resolution visual acuity before and after surgery and central macular thickness. Results:, Over the 3 years of the study, 15/27 (56%) phakic eyes in the IVTA treated group underwent cataract surgery as compared with 2/25 (8%) initial sham-treated eyes (P < 0.001). Mean visual acuity 6 months after cataract surgery was better than at entry into the trial. Two (15%) of the eyes in the IVTA-treated group undergoing cataract surgery had a loss of >15 letters. In the IVTA-treated group, 10/15 (67%) eyes that had three or more injections had progression of posterior subcapsular cataract by ,2 grades as compared with only 2/12 (17%) eyes that had fewer than three injections (P = 0.009). Conclusions:, Over half of the eyes receiving IVTA injections for diabetic macular oedema required cataract surgery within 3 years. In eyes with three or more IVTA injections, two-thirds had progression of posterior subcapsular cataract. Visual outcomes after cataract surgery were generally good, although a small proportion of eyes lost greater than 15 letters over the course of the study. [source] Endophthalmitis in the western Sydney region: a case-control studyCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 6 2001Somsak Lertsumitkul FRACO ABSTRACT Background: A retrospective case-control study was conducted to investigate risk factors for endophthalmitis following routine intraocular surgery. Methods: A review was performed of consecutive cases of endophthalmitis from three teaching hospitals in the western Sydney region and matched controls from the same institutions between 1996 and 1998. Results: There were 31 cases and 66 controls. Eighty procedures were phacoemulsification, 15 conventional extracapsular cataract extraction, and two were penetrating keratoplasties. Of the 80 patients who had phacoemulsification surgery, 50 had a clear corneal incision, and 26 had a scleral incision (four were unknown). Logistic regression showed an increased risk of endophthalmitis with surgical complications (P = 0.002) and clear cornea temporal incisions (P = 0.007). Risk of endophthalmitis was reduced with use of subconjunctival injections (P = 0.008). The yield for the Gram stain was 47% and for culture was 67%. Anterior chamber tap in addition to vitreous biopsy alone did not increase the yield for microorganism (P = 0.78). Mean visual acuity on presentation was hand movement with 13 patients (50%) showing visual improvement following intravitreal injections of antibiotics (P = 0.003). Visual prognosis did not correlate with presenting visual acuity but appeared to be better in those who grew Staphylococcus epidermidis or were culture negative. Conclusions: Although this study is unable to draw definite conclusions regarding risk of endophthalmitis in clear corneal temporal cataract surgery, sufficient data suggest the importance of incision type and location. Surgical complication is an important risk factor for endophthalmitis. Use of subconjunctival antibiotic injections at the conclusion of the procedure is recommended. [source] Value of internal limiting membrane peeling in surgery for idiopathic macular hole and the correlation between function and retinal morphologyACTA OPHTHALMOLOGICA, Issue thesis2 2009Ulrik Correll Christensen MD Abstract. Idiopathic macular hole is characterized by a full thickness anatomic defect in the foveal retina leading to loss of central vision, metamorphopsia and a central scotoma. Classic macular hole surgery consists of vitrectomy, posterior vitreous cortex separation and intraocular gas tamponade, but during the past decade focus has especially been on internal limiting membrane (ILM) peeling as adjuvant therapy for increasing closure rates. With increasing use of ILM peeling and indocyanine green (ICG) staining, which is used for specific visualization of the ILM, concerns about the safety of the procedure have arisen. At present, it is not known whether ICG-assisted ILM peeling potentially reduces the functional outcome after macular hole surgery. The purpose of the present PhD thesis was to examine whether ICG-assisted ILM peeling offers surgical and functional benefit in macular hole surgery. We conducted a randomized clinical trial including 78 pseudophakic patients with idiopathic macular hole stages 2 and 3. Patients were randomly assigned to macular hole surgery consisting of (i) vitrectomy alone without instrumental retinal surface contact (non-peeling), (ii) vitrectomy plus 0.05% isotonic ICG-assisted ILM peeling or (iii) vitrectomy plus 0.15% trypan blue (TB)-assisted ILM peeling. Morphologic and functional outcomes were assessed 3, 6 and 12 months after surgery. The results show that surgery with ILM peeling, for both stages 2 and 3 macular holes, is associated with a significantly higher closure rate than surgery without ILM peeling (95% versus 45%). The overall functional results confirm that surgery for macular hole generally leads to favourable visual results, with two-thirds of eyes regaining reading vision (,20/40). Macular hole surgery can be considered a safe procedure with a low incidence of sight-threatening adverse events; the retinal detachment rate was 2.2%. Visual outcomes in eyes with primary hole closure were not significantly different between the intervention groups; however, for the stage 2 subgroup with primary macular hole closure, there was a trend towards a better mean visual acuity in the non-peeling group (78.2 letters) compared to the ICG-peeling group (70.9 letters), p = 0.06. Performing repeated macular hole surgery was associated with a significant reduction in functional outcome indicating that primary focus should be on closing the macular hole in one procedure. Morphological studies of closed macular holes with contrast-enhanced optical coherence tomography (OCT) found thinning and discontinuity of the central photoreceptor layer matrix that were highly specific for predicting the likelihood of an eye having regained reading vision 12 months after macular hole surgery. Additionally, healing after macular hole surgery appeared to begin with the contraction of the inner aspect of the retina, forming a roof over a subfoveal fluid-filled cavity, and to end with a gradual restoration of the anatomy in the outer layers of the retina at the junction of the photoreceptor inner and outer segments. We found the more intact this structure was on contrast-enhanced OCT 3 months after macular hole surgery, the better the visual acuity after 12 months, whereas late rather than early resolution of subfoveal fluid had no impact on final visual outcome. The use ILM peeling and intraoperative dyes did not have any functionally important effects on postoperative macular structure. Based on the above findings, we conclude that ILM peeling should be performed in all cases of full thickness macular hole surgery. The use of 0.05% intraoperative isotonic ICG with short exposure time appears to be a safe alternative in stage 3 macular hole surgery, whereas a slight reduction in functional potential not can be excluded when performing 0.05% isotonic ICG-assisted ILM peeling in stage 2 macular hole surgery. [source] Aniridia among children and teenagers in Sweden and NorwayACTA OPHTHALMOLOGICA, Issue 2 2009Ulla Edén In the November 2008 issue (AOS 86:7), the article by Ulla Edén et al. was not published correctly in the printed issue. Unfortunately, part of the section ,Visual acuity' in the Results was repeated on page 732, and the start of the Discussion was omitted on page 732. The full and correct version of this article is printed hereunder. The Publisher apologises for this error. Reference EdénU, BeijarC, RiiseR & TornqvistK (2008): Aniridia among children and teenagers in Sweden and Norway. Acta Ophthalmol86: 730,734. Abstract. Purpose:, To investigate patients under the age of 20 with aniridia in Sweden and Norway in order to estimate the prevalence of aniridia, to describe clinical signs and identify complications in the young, which will help improve diagnostic tools and treatment. Methods:, A thorough search for patients with aniridia (of all ages) was performed. Sixty-two of the 181 patients were under the age of 20. Fifty-two of them were examined and they constituted the study population. Patient history was obtained and all participants underwent clinical ophthalmologic examination, including photography. Blood samples were taken for mutation analysis. Results:, Epidemiological data are only based on the results in Sweden. The age-specific prevalence in Sweden was 1:47 000, male/female ratio was 0.57, mean age 12 years and median age 14 years. The proportion of sporadic cases including WAGR (Wilms tumour, Aniridia, Genitourinary abnormalities, Mental Retardation) and Gillespie syndrome (aniridia, cerebellar ataxia and mental retardation) was 48%. In the entire study population (Sweden and Norway), the mean visual acuity (VA) was 0.2 (range 0.04,0.9). We found VA < 0.3 in 80% and <0.1 in 18% of the patients. Twenty-two patients (42%) had one or more of the sight threatening complications such as cataract/lens luxation, corneal clouding or glaucoma. Conclusion:, Descriptions of aniridia in the younger are rare. This study shows that aniridia seems to be more common than previously estimated and that some complications appear early in life. Watchfulness as regards these complications and regular examinations are essential even in the youngest. [source] | ||||||||||