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Visual Acuity (visual + acuity)
Kinds of Visual Acuity Terms modified by Visual Acuity Selected AbstractsHow should we quantify the performance of KPro's?ACTA OPHTHALMOLOGICA, Issue 2009Purpose To report a method of standardized data collection and reporting and statistical assessment that can be used for all KPro´s available on the market. The database (will be presented) should be , Usable for different types of KPro´s , Easily adaptable to changes in technique , Allow for complete entry of relevant data Methods Visual Acuity data should be reported in different international surgical centres in a standardized manner: Best spectacle corrected VA, unless BCVA only possible with CL (> useful time of wear). A complete entry of all relevant data is possible in this database. The statistical analysis should be agreed upon by all centres. For Survival Time = Retention of KPro > the Kaplan-Meier method For Visual Acuity over the Course of Time > the Monte-Carlo method Results A database will be demonstrated that can be used free of charge by all KPro centres interested. The VISUAL ACUITY BY TIME- INDEX (VAT- Index) will also be presented, whose theoretical basis published in: Journal of Theoretical Medicine, 2002 / 4, 183-190, W. Hitzl and G. Grabner [bdquo]Application of the Monte Carlo Method for the Assessment of Long-term Success in Keratoprosthesis Surgery". Example of its use will be give, based in data, courtesy Barraquer Eye Clinic, Barcelona. Conclusion With the Kaplan-Meier method: + analysis is done quickly, uses all data available, hypotheses tests are available for comparisons and mean and median survival time can be computed - no information about relation between time and best corrected visual acuity and the definition of terminal event is arbitrary to a certain extent. Monte-Carlo method (VAT-index): + Method is based on a so-called non-parametric longitudinal model + Reliabel estimation of relation between time and best corrected visual acuity at any given time point (patient as well as surgeon is basically interested in this relation). + statistically valid analysis and better comparison of different KPro techniques + easy comparison of defined postoperative periods + comparison of different initial clinical findings and diseases possible + long-time follow-up of BCVA - shorter follow-up time as compared with Kaplan-Meier method (e.g. with strict [bdquo]80%data complete" criteria) [source] MOOKP clinical results and IndicationsACTA OPHTHALMOLOGICA, Issue 2009G FALCINELLI Purpose To demonstrate which are the reasons that permit by the modified osteo-odonto-keratoprosthesis (Mookp) technique to obtain in 275 blind eyes,with a basic pathology where 42% of eyes were dry,and 32% had severe physical/chemical burns,excellent anatomical and functional results. Methods Tables are shown which put into evidence the best visual acuity obtained in the 275 eyes affected by corneal blindness,operated by the Mookp technique from 1973 to 2008, with a 36 years causistry,with a very long follow-up. Results 275 blind eyes. Best Visual Acuity recovered, between 10/10 and 5/10 in 80.25% of operated eyes, excellent for any working activity,( best visual acuity recovered), between 10/10 and 2/10 in 91,20%, useful for any activity. Final V.A., between 10/10 and 5/10 in 67,68%, and between 10/10 and 2/10 in 78,11%- Conclusion The reasons for these excellent results are due to the biological properties of this Kpro invented by Strampelli and to the modifications made by Falcinelli. The indications for this technique are all those types of corneal blindness not treatable by penetrating keratoplasty. [source] Differential effects of ageing on foveal and peripheral colour visionACTA OPHTHALMOLOGICA, Issue 2009F RAUSCHER Purpose Colour sensitivity was assessed to establish aging effects both at the fovea and 6 deg away from fixation, in each of the four quadrants. Methods 65 normal healthy subjects (from 20 to 80 years of age) took part in the study. All subjects had Visual Acuity (VA) of 6/6 or better. Fixation accuracy was monitored using infrared imaging of the pupil and the tests were carried out on the P_SCAN system. Target size was adjusted for parafoveal locations to account for retinal and cortical magnification. Yellow-blue (YB) and red-green (RG) colour discrimination was assessed using the CAD (colour assessment and diagnosis) test (http://www.caa.co.uk/docs/33/200904.pdf). Results RG and YB colour thresholds were analysed separately for all five locations tested and showed no significant effect with ageing below the age of 60 years. Two age bands were formed based on statistical analysis (20-59.9 and 60-79.9). The decline in performance with age was more rapid at the fovea and exhibited a steeper gradient when compared with results in the periphery for both RG and YB discrimination. Foveal YB discrimination showed the largest ageing effect. No significant difference was found between the four parafoveal locations. YB discrimination at the fovea also exhibited the largest inter-subject variability. Conclusion These findings may have clinical significance in the very early detection of disease processes that remain subclinical in many subjects. Differences between foveal and peripheral locations help to differentiate between the normal effects of ageing and disease. For example, higher foveal and normal peripheral YB thresholds in normal subjects from high peripheral thresholds in early glaucomatous subjects. [source] Evaluation of Melbourne Edge Test contrast sensitivity measures in the visually impairedOPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 4 2005James S. Wolffsohn Abstract Aim:, Contrast sensitivity (CS) provides important information on visual function. This study aimed to assess differences in clinical expediency of the CS increment-matched new back-lit and original paper versions of the Melbourne Edge Test (MET) to determine the CS of the visually impaired. Methods:, The back-lit and paper MET were administered to 75 visually impaired subjects (28,97 years). Two versions of the back-lit MET acetates were used to match the CS increments with the paper-based MET. Measures of CS were repeated after 30 min and again in the presence of a focal light source directed onto the MET. Visual acuity was measured with a Bailey,Lovie chart and subjects rated how much difficulty they had with face and vehicle recognition. Results:, The back-lit MET gave a significantly higher CS than the paper-based version (14.2 ± 4.1 dB vs 11.3 ± 4.3 dB, p < 0.001). A significantly higher reading resulted with repetition of the paper-based MET (by 1.0 ± 1.7 dB, p < 0.001), but this was not evident with the back-lit MET (by 0.1 ± 1.4 dB, p = 0.53). The MET readings were increased by a focal light source, in both the back-lit (by 0.3 ± 0.81, p < 0.01) and paper-based (1.2 ± 1.7, p < 0.001) versions. CS as measured by the back-lit and paper-based versions of the MET was significantly correlated to patients' perceived ability to recognise faces (r = 0.71, r = 0.85 respectively; p < 0.001) and vehicles (r = 0.67, r = 0.82 respectively; p < 0.001), and with distance visual acuity (both r = ,0.64; p < 0.001). Conclusions:, The CS increment-matched back-lit MET gives higher CS values than the old paper-based test by approximately 3 dB and is more repeatable and less affected by external light sources. Clinically, the MET score provides information on patient difficulties with visual tasks, such as recognising faces. [source] Visual function of police officers who have undergone refractive surgeryAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 11 2006Jeffery K. Hovis OD Abstract Introduction The visual acuity and contrast sensitivity of police recruits and officers was evaluated in both normal and dim illumination conditions to determine whether officers who have had refractive surgery have compromised night vision. Methods The control group consisted of 76 officers and recruits who have not had refractive surgery and the refractive surgery group consisted of 22 officers and recruits who had refractive surgery. Visual acuity and contrast sensitivity were measured under both room illumination and dim illumination. The room illumination test series included high contrast acuity, low contrast acuity and Pelli-Robson contrast sensitivity. The dim illumination test series included high contrast acuity, low contrast acuity, Pelli-Robson contrast sensitivity, license plate number acuity (with and without glare) and the Mesotest. Results The general findings were that the refractive surgery group had lower acuity scores on low contrast targets in both room and dim light levels along with a reduction in the Mesotest scores with a glare source compared to the control group. Conclusions Although refractive surgery police recruits and officers had reduced performance on some vision tests, these reductions were small and it is unlikely that their performance on vision related tasks would be compromised, on average. The major concern is the small number of refractive surgery candidates whose results were well outside the range of the non-surgical candidates. Their vision may be unacceptable for policing. Am. J. Ind. Med. 49:885,894, 2006. © 2006 Wiley-Liss, Inc. [source] Visual acuity in the cathemeral strepsirrhine Eulemur macaco flavifronsAMERICAN JOURNAL OF PRIMATOLOGY, Issue 4 2009Carrie C. Veilleux Abstract Studies of visual acuity in primates have shown that diurnal haplorhines have higher acuity (30,75 cycles per degree (c/deg)) than most other mammals. However, relatively little is known about visual acuity in non-haplorhine primates, and published estimates are only available for four strepsirrhine genera (Microcebus, Otolemur, Galago, and Lemur). We present here the first measurements of visual acuity in a cathemeral strepsirrhine species, the blue-eyed black lemur (Eulemur macaco flavifrons). Acuity in two subjects, a 3-year-old male and a 16-year-old female, was assessed behaviorally using a two-alternative forced choice discrimination task. Visual stimuli consisted of high contrast square wave gratings of seven spatial frequencies. Acuity threshold was determined using a 70% correct response criterion. Results indicate a maximum visual acuity of 5.1,c/deg for the female (1718 trials) and 3.8,c/deg for the male (846 trials). These values for E. macaco are slightly lower than those reported for diurnal Lemur catta, and are generally comparable to those reported for nocturnal Microcebus murinus and Otolemur crassicaudatus. To examine ecological sources of variation in primate visual acuity, we also calculated maximum theoretical acuity for Cheirogaleus medius (2.8,c/deg) and Tarsius syrichta (8.9,c/deg) using published data on retinal ganglion cell density and eye morphology. These data suggest that visual acuity in primates may be influenced by activity pattern, diet, and phylogenetic history. In particular, the relatively high acuity of T. syrichta and Galago senegalensis suggests that visual predation may be an important selective factor favoring high visual acuity in primates. Am. J. Primatol. 71:343,352, 2009. © 2009 Wiley-Liss, Inc. [source] A new instrument for pain assessment in the immediate postoperative period,ANAESTHESIA, Issue 4 2009A. M. Machata Summary Perceptual-cognitive impairment after general anaesthesia may affect the ability to reliably report pain severity with the standard visual analog scale (VAS). To minimise these limitations, we developed ,PAULA the PAIN-METER®' (PAULA): it has five coloured emoticon faces on the forefront, it is twice as long as a standard VAS scale, and patients use a slider to mark their pain experience. Forty-eight postoperative patients rated descriptive pain terms on PAULA and on a standard VAS immediately after admission and before discharge from the postanaesthesia care unit. Visual acuity was determined before both assessments. The values obtained with PAULA showed less variance than those obtained with the standard VAS, even at the first assessment, where only 23% of the patients had regained their visual acuity. Furthermore, the deviations of the absolute VAS values in individual patients for each descriptive pain term were significantly smaller with PAULA than with the standard VAS. [source] Long-term remission after cessation of interferon-, treatment in patients with severe uveitis due to Behçet's diseaseARTHRITIS & RHEUMATISM, Issue 9 2010Christoph M. E. Deuter Objective To retrospectively assess the development of visual acuity and the frequency and duration of relapse-free periods in patients who were treated with interferon-, (IFN,) for severe uveitis due to Behçet's disease (BD) and who completed a followup period of ,2 years. Methods IFN alfa-2a was administered at an initial dosage of 6 million IU per day, then tapered to a maintenance dosage of 3 million IU twice per week, and finally discontinued, if possible. In case of a relapse, IFN treatment was repeated. Visual acuity at the end of followup was compared with visual acuity when ocular disease was in remission. Results Of 53 patients (96 eyes), 52 (98.1%) responded to IFN. In 47 patients (88.7%), IFN could be discontinued when the disease was in remission. Twenty of these 47 (42.6%) needed a second treatment course during a median followup of 6.0 years (range 2.0,12.6 years). Visual acuity improved or remained unchanged in 91 eyes (94.8%). Ocular disease was still in remission in 50% of the patients 45.9 months after cessation of the first IFN course. The relapse rate tended to be lower in women than in men. The BD activity score decreased significantly during followup, but long-term remission of nonocular BD manifestations was not achieved. However, since local treatments were sufficient, no systemic treatment was administered. Conclusion Our findings indicate that IFN, induces long-lasting remission in patients with severe ocular BD, resulting in a notable improvement in visual prognosis. [source] Combined intravitreal bevacizumab and triamcinolone in exudative age-related macular degenerationACTA OPHTHALMOLOGICA, Issue 6 2010Jost B. Jonas Acta Ophthalmol. 2010: 88: 630,634 Abstract. Purpose:, We report on the combined application of intravitreal bevacizumab and triamcinolone acetonide for treatment of exudative age-related macular degeneration (AMD). Methods:, The clinical interventional case-series study included 16 patients (16 eyes) with exudative AMD who had previously received 3.5 ± 1.8 mono-injections of bevacizumab (1.5 mg) without significant improvement in visual acuity (VA) or reduction in macular exudation. All patients underwent a combined intravitreal injection of bevacizumab (1.5 mg) and triamcinolone acetonide (about 20 mg). Main outcome measures were VA and macular thickness as determined by optical coherence tomography. All patients were re-examined at 2,3 months after the intervention. Results:, Visual acuity improved significantly (p = 0.03) from 0.80 ± 0.40 logMAR prior to the combined injection to 0.65 ± 0.42 logMAR at 3 months after the injection. An improvement of , 1 Snellen line was found in eight subjects, an increase of , 2 lines in five subjects, and an improvement of , 3 lines in two subjects. One patient lost 1 line and one patient lost 3 lines. Central retinal thickness decreased significantly from 272 ± 62 ,m to 220 ± 47 ,m (p = 0.03). At the 6-month follow-up examination, central retinal thickness had increased again to 319 ± 142 ,m, which was not significantly (p = 0.30) different from baseline measurements. Conclusions:, The combined intravitreal application of bevacizumab and triamcinolone may temporarily be helpful in the treatment of exudative AMD if previous intravitreal bevacizumab mono-injections have failed to improve vision and reduce macular oedema. [source] Bifocals in children with Down syndrome (BiDS) , visual acuity, accommodation and early literacy skillsACTA OPHTHALMOLOGICA, Issue 6 2010Krithika Nandakumar Acta Ophthalmol. 2010: 88: e196,e204 Abstract. Purpose:, Reduced accommodation is seen in children and young adults with Down syndrome (DS), yet providing bifocals has not become a routine clinical management. This study investigates the impact of bifocals on visual function, visual perceptual and early literacy skills in a group of school children with DS. Methods:, In this longitudinal study, each child was followed for 5 months with single-vision (SV) lenses after which bifocals were prescribed if required, based on their accommodative response. Visual acuity (VA), accommodation, perceptual and literacy skills were measured after adaptation to bifocals and 5 months later. Educational progress and compliance with spectacle wear were assessed through school and parental reports. Results:, Fourteen children and young adults with DS participated in the study. Eighty-five percent required bifocals with additions ranging from +1.00 D to +3.50 D. The mean near logMAR VA improved with bifocals (p = 0.007) compared to SV lenses. Repeated measures anova showed that there was more accurate focus (less accommodative lag) through the bifocals (p = 0.002), but no change in the accommodation exerted through the distance portion compared to SV lenses (p = 0.423). There was a main effect of time on sight words (p = 0.013), Word Identification (p = 0.047), Visual Closure (p = 0.006) and Visual Form Constancy (p = 0.001). Conclusion:, Bifocals provide clearer near vision in DS children with reduced accommodation. This is shown by improved VA and decreased lag of accommodation. The results indicate that the improvement in VA results in improved scores in early literacy skills. Better compliance with bifocals over SV lenses was seen. [source] 4233: Outcomes of the Boston Keratoprosthesis Type IIACTA OPHTHALMOLOGICA, Issue 2010J CHODOSH Purpose To report the long term outcomes of Boston keratoprosthesis type II implantation in the management of severe ocular surface disease and corneal blindness. Methods A retrospective review of medical records of patients after Boston keratoprosthesis type II implantation at the Massachusetts Eye and Ear Infirmary from January, 1, 2000 through December 31, 2009. Main outcome measures included visual acuity, device retention, and postoperative complications. Results A total of 29 eyes of 26 patients received a Boston keratoprosthesis type II during the study period. Operated patients had corneal blindness due to mucous membrane pemphigoid (51.7%), Stevens Johnson syndrome/toxic epidermal necrolysis (41.4%), or other ocular surface disease (6.9%). Visual acuity after surgery improved to at least 20/200 in 23 eyes (79.3%), and to 20/30 or better in 10 eyes (34.5%). In patients with at least 1 year of follow-up (n=21), visual acuity of 20/200 or better was maintained in 14 eyes (66.7%). Of these 14 eyes, 6 eyes (42.9%) retained visual acuity of 20/200 or better for more than 5 years. Overall, visual acuity of 20/200 or better was maintained for at least 5 years in 6 of 23 eyes (26.0%). Eyes that failed to improve to 20/200 or lost vision during follow-up were found to have end stage glaucoma, previous retinal detachment, or age related macular degeneration. Of the total of 29 eyes, 17 devices (58.6%) were retained without extrusion or replacement during a total follow-up time of 107.9 person-years. Conclusion The Boston keratoprosthesis type II is a viable option for corneal blindness from severe autoimmune ocular surface diseases. Complications require prompt recognition and management to promote retention of the device and preservation of vision. [source] 4366: Treatment of choroidal neovascularization associated with choroidal nevusACTA OPHTHALMOLOGICA, Issue 2010E PILOTTO Purpose Purpose:To evaluate safety and efficacy of different treatments of choroidal neovascularization (CNV) associated with choroidal nevus at the posterior pole. Methods Methods: Six patients affected by choriodal nevus complicated by CNV were treated with photodynamic therapy with verteporfin (PDT; 50 J/cm2, 83 seconds) (five cases), or intravitreal anti-VEGF (bevacizumab, 1.25 mg) (one case). All patients underwent an ophthalmologic evaluation, including fluorescein and indocyanine green angiography, A-and B scan ultrasonography and OCT at presentation and at each follow-up examination. CNV was extrafoveal in all PDT treated cases, and a foveal serous detachment was detectable. CNV was subfoveal in the eye treated with anti-VEGF. Results Results: Mean follow-up was 15.5 months (range: 6 , 24). Visual acuity improved in four of the PDT treated cases and in the anti-VEGF treated eye, while it remained unchanged in the remaining PDT treated lesion. In all eyes resolution of the foveal serous detachment was detectable. In all PDT treated eyes a single treatment was performed with no recurrence during follow-up. Meanwhile anti-VEGF was repeated after three months for CNV recurrence. Conclusion Conclusions: PDT and anti-VEGF seem both effective in the treatment of CNV secondary to choroidal nevus but a larger study is required to evaluate long-term efficacy and safety expecially of anti-VEGF therapy. [source] 3235: Application of autologous cultivated corneal epithelium for restoring of corneal surfaceACTA OPHTHALMOLOGICA, Issue 2010D DOBROWOLSKI Purpose To present results of transplantations of cultured corneal epithelium in limbal stem cell insufficiency. Methods 26 patients were donors of limbal epithelium for corneal epithelial culture. Patients suffered from limbal deficiency in one eye after chemical or thermal burn. Limbal cells from 2 mm2 biopsy were seeded on amniotic membrane. Cultures were carried in standard conditions in supplememted DMEM in presence of 3T3 fibroblasts. After superficial keratectomy amniotic carries with epithelial cells were transplanted on denuded corneas. Stabilisation of corneal surface was evaluated. Results 3 months after surgery 61,5% of eyes showed stabile epithelium with corneal slight haze caused by the amnion. In 50,0% of eyes there was no recurrent conjuntival neovascularisation. 38,4% of eyes remained cloudy due to stromal revascularization. In 4 eyes total conjuctival pannus developed again. Visual acuity ranged from counting fingers to 0,5. Conclusion Grafting of cultured epithelium is a promising method in treatment of limbal stem cell insufficiency in burns. [source] Combined intravitreal anti-vascular endothelial growth factor (Avastin®) and photodynamic therapy to treat retinal juxtapapillary capillary haemangiomaACTA OPHTHALMOLOGICA, Issue 5 2010Stefan Mennel Abstract. Objective:, Retinal capillary haemangioma complications are characterized by progressive exudation with consecutive intraretinal and subretinal leakage. A successful therapy without side-effects has not been found. We report a case of retinal juxtapapillary capillary haemangioma causing consecutive leakage with macular involvement. The tumour was treated with a combination of anti-vascular endothelial growth factor (VEGF) and photodynamic therapy (PDT) and was followed for 1 year. Methods:, A 44-year-old woman with retinal juxtapapillary capillary haemangioma in the right eye experienced a decrease of visual acuity from 20/20 to 20/60 because of a severe leakage from the tumour involving the macula with lipid depositions. Two sessions of PDT (sparing the part of the haemangioma located within the optic disc) and five injections of bevacizumab were applied in a period of 5 months. Visual acuity, visual field testing, retinal thickness measurements, fundus photography and fluorescein angiography were performed to evaluate the treatment effect. Results:, One year after the last injection, visual acuity increased to 20/40. All lipid exudates at the posterior pole resolved. Retinal thickness decreased from 490 to 150 ,m with the restoration of normal central macular architecture. Leakage in fluorescence angiography reduced significantly, but hyperfluorescence of the tumour was still evident. Visual field testing and angiography did not show any treatment-related vaso-occlusive side-effects. Conclusion:, In this single case, the combination of anti-VEGF and PDT appeared to be an effective strategy for the treatment of retinal juxtapapillary capillary haemangioma without side-effects. Further studies with a greater number of eyes and adequate follow-up are necessary to support these first clinical results. [source] Use of heavy silicone oil (Densiron-68®) in the treatment of persistent macular holesACTA OPHTHALMOLOGICA, Issue 8 2009Alexandra Lappas Abstract. Purpose:, In this retrospective case series, we studied the effect of ,heavy' silicone oil on persisting macular holes. Patients with macular holes that failed to close after conventional macular hole surgery were retreated with the longterm internal tamponade Densiron-68®. Methods:, Twelve patients with primary macular holes that persisted after pars plana vitrectomy, peeling of the internal limiting membrane and internal gas tamponade with SF6 (sulphur hexafluoride) were retreated with heavy silicone oil, Densiron-68®, in the University Eye Hospital, Cologne. After 1.5,4 months the Densiron-68® was removed. Best corrected visual acuity (VA), slit-lamp examination, binocular fundus examination and optical coherence tomography (OCT) were used for evaluation pre- and postoperatively. The follow-up period was 3,7 months. Results:, Preoperatively, all patients displayed full-thickness macular holes, with a mean size of 502.25 ,m (± 129.39 ,m). Postoperatively, 11 of 12 macular holes were closed. One patient experienced a reopening of the macular hole. Mean VA was 20/250 (1.07 ± 0.22 logMAR) prior to treatment with Densiron-68® and 20/160 (0.84 ± 0.24 logMAR) postoperatively. Visual acuity increased from baseline in nine patients and decreased in one. Conclusions:, Retreatment of persisting macular holes with the heavy, longterm tamponade Densiron-68® resulted in anatomical closure of the hole in 11 of 12 cases. This result was accompanied by a functional improvement in VA in nine of 12 patients. [source] Prophylactic laser treatment of soft drusen maculopathy: a prospective, randomized Nordic studyACTA OPHTHALMOLOGICA, Issue 7 2009Christina I. Frennesson Abstract. Purpose:, This study aimed to investigate whether mild laser treatment of soft drusen maculopathy might reduce the incidence of choroidal neovascularization (CNV) and/or significantly reduce loss of visual acuity compared with outcomes in a control group. Methods:, A total of 135 patients (mean age 70.4 years) were randomized into a treatment group of 67 subjects and a control group of 68 subjects. The treatment group was subdivided into a group of 54 subjects with bilateral soft drusen and a group of 13 subjects with unilateral soft drusen in the study eye and advanced AMD in the fellow eye. The control group was subdivided into a bilateral group of 54 subjects and a unilateral group of 14 subjects. Sub-threshold or barely visible laser spots were scattered on and between drusen in the posterior pole. Inclusion of patients was stopped prematurely as other studies did not show any benefit from the treatment. Mean follow-up time was 3.7 years. Results:, More CNVs developed in the treated group (4/54 eyes in the bilateral group, 3/13 eyes in the unilateral group; 7/67 eyes in total) than in the control group (3/54 eyes in the bilateral group, 2/14 eyes in the unilateral group; 5/68 eyes in total) but these differences were not statistically significant for either the bilateral or unilateral groups (p = 0.20,0.32). No CNV developed in the bilateral treated group before 4 years of follow-up. Visual acuity was significantly reduced from baseline to the last follow-up in all groups (p < 0.0001,0.02) except the unilateral control group (p = 0.08), but there were no significant differences between the treated and control groups for either the bilateral or unilateral groups (p = 0.17,0.97). Conclusions:, Mild prophylactic laser treatment of soft drusen maculopathy was neither beneficial nor harmful and cannot be recommended. [source] Association of lens opacities, intraocular straylight, contrast sensitivity and visual acuity in European driversACTA OPHTHALMOLOGICA, Issue 6 2009Ralph Michael Abstract. Purpose:, To study the relationship between lens opacity and intraocular straylight, visual acuity and contrast sensitivity. Methods:, We investigated 2422 drivers in five clinics in different European Union (EU) member states aged between 20 and 89 years as part of a European study into the prevalence of visual function disorders in drivers. We measured visual acuity [Early Treatment Diabetic Retinopathy Study (ETDRS) chart], contrast sensitivity (Pelli,Robson chart) and intraocular straylight (computerized straylight meter). Lens opacities were graded with the Lens Opacities Classification System III (LOCS) without pupillary dilation. Participants answered the National Eye Institute Visual Functioning Questionnaire , 25. Results:, Intraocular straylight was related more strongly to LOCS score than to both visual acuity and contrast sensitivity. Visual acuity and contrast sensitivity were correlated to each other well, but to intraocular straylight to a much lesser extent. Self-reported visual quality was best related to contrast sensitivity; night driving difficulty was best related to visual acuity. Conclusion:, Straylight is found to have added value for visual function assessment in drivers, whereas if visual acuity is known contrast sensitivity has limited added value. [source] Effect of phacoemulsification on the primary open angle glaucoma control after trabeculectomy: a case-control studyACTA OPHTHALMOLOGICA, Issue 2009S AZIZ Purpose In this retrospective and comparative study, we analyzed the influence of phacoemulsification (PE) on the glaucoma control in case patients (trabeculectomy-phacoemulsification [CE]) compared with the control that underwent trabeculectomy (T) alone in eyes with primary open angle glaucoma (POAG). Methods Twenty one patients who underwent PE subsequent to T were identified, and 41 who underwent T alone were matched. Visual acuity (VA), intraocular pressure (IOP), bleb appearance, vertical cup disc ratio (VCDR), visual field (VF), glaucoma medications, iris manipulation and complications were documented. Mean follow up was 12 months. Success was defined when IOP , 21 mmHg with the abscense of glaucoma medication and/or further surgical intervention. Results Patients in CE group had no significant change in IOP from pre-operative measures to 12 months post-operative (p=0.001). The mean IOP reduced from 15.3 mm Hg to 14.7 mmHg postoperatively. The control group showed an average IOP reduction of 6 mm Hg in the last visit. In CE group, 19% required 1 or 2 glaucoma medications at one year fellow-up vs 19.5% in the control group. In CE group 9.5% showed flattening of previously formed bleb in the last visit (P<0.001), 9.7 % ended with flat bleb in the T group. The increase in VCDR for the CE group was statistically significant when compared to the control group (p<0.001). Patients in CE group were more likely to exhibit a change in VF (47.6% versus 7.3% respectively). The study is limited by the small number of cases available. Conclusion Corneal PE in eyes with filtering blebs does not adversely affect long-term glaucoma control in patients with POAG. [source] Intravitreal bevacizumab for treatment-naïve subfoveal occult choroidal neovascularization in age-related macular degenerationACTA OPHTHALMOLOGICA, Issue 4 2009Claudio Furino Abstract. Purpose:, This study aimed to evaluate the efficacy of multiple injections of intravitreal bevacizumab for treatment-naïve subfoveal occult choroidal neovascularization (CNV) in age-related macular degeneration (AMD). Methods:, Twelve eyes of 12 patients (mean age 76 ± 6 years) with mean best corrected visual acuity (BCVA) of 20/100 and occult subfoveal CNV at fluorescein angiography (FA), indocyanine-green (ICG) angiography and optical coherence tomography (OCT), showing intra- or subretinal fluid with or without retinal pigment epithelial detachment (PED), underwent multiple intravitreal injections (mean 2.4 ± 0.7) of 1.25 mg (0.05 ml) bevacizumab. Visual acuity and OCT findings were assessed at the end of follow-up. Results:, After a mean follow-up of 5.7 ± 2 months, BCVA improved from 20/100 (range 20/50,20/303) to 20/60 (range 20/28,20/200) (p = 0.038). Five eyes (42%) increased BCVA by , 3 lines, six eyes (50%) increased BCVA by < 3 lines and one eye (8%) remained stable. Macular thickness decreased from 298 ± 71 ,m to 223 ± 72 ,m (p = 0.017). No ocular or systemic side-effects were observed. Conclusions:, Short-term results suggest that multiple intravitreal injections of 1.25 mg bevacizumab are well tolerated and associated with significant improvements in BCVA and decreased retinal thickness by OCT in most patients with treatment-naïve occult CNV. Further evaluation of intravitreal bevacizumab for the treatment of occult CNV is warranted. [source] Photodynamic therapy with intravitreal application of triamcinolone acetonide in age-related macular degeneration: functional results in 54 patientsACTA OPHTHALMOLOGICA, Issue 2 2009Adjoa Frimpong-Boateng Abstract. Purpose:, This study aimed to investigate the functional results, efficacy and complications after photodynamic therapy (PDT) combined with intravitreal triamcinolone acetonide injection (IVTA) in patients with choroidal neovascularization (CNV) caused by age-related macular degeneration (AMD). Methods:, A retrospective analysis of clinical data for 54 patients with CNV resulting from AMD was carried out. All patients had a follow-up of 12 months. The patients were treated with standardized PDT and IVTA (4 mg) as a first-line treatment or following PDT failure. Visual acuity (VA), greatest linear diameter (GLD) of the CNV and foveal thickness were evaluated. Results:, Mean VA at baseline was 0.8 logMAR (0.4,1.4). After 12 months VA improved (> 2 lines) in 20.4% of patients and stabilized (± 2 lines) in 64.8%. There was no statistical significance in VA outcome between patients undergoing first-line treatment and patients with PDT failure; however, fewer PDT treatments were required to stop CNV activity in patients undergoing first-line treatment. At 12 months, a reduction in foveal thickness was seen in 67.7% of patients and a reduction in CNV GLD in 32.7%. Complications occurred in 22% of patients and included a transient rise in intraocular pressure, cataract and sterile hypopyon. Conclusions:, Our analysis shows that fewer PDT treatments were required to stop CNV activity when triamcinolone was used as first-line treatment. We can thus conclude that PDT combines synergistically with IVTA and the combination may lead to a cost reduction compared with PDT therapy alone. The overall complication rate of 22% is high and must be compared with complication rates caused by new intravitreal anti-VEGF (vascular endothelial growth factor) drugs in combination with PDT. [source] Is AZOOR an autoimmune disease?ACTA OPHTHALMOLOGICA, Issue 2007SF SEIDOVA Purpose: Acute zonal occult outer retinopathy (AZOOR) is one of the "white dot syndromes" a clinically heterogeneous group of inflammatory chorioretinopathies. The etiology is not yet clear. Methods: We present a 50 years female patient with a prior history of migraine. She experienced progressive visual loss and visual field defects in the last 3 years. Preceding each episode she experienced blue flickering photopsias. Results: Visual acuity was 0,3 in the right eye and 0,6 in the left eye. Biomicroscopy showed a normal anterior segment, fundus exam revealed pigment epithelial atrophy more pronounced in the worse eye. Electrophysiology showed a marked reduction in the photopic ERG in the more affected eye. MRI demonstrated multiple white matter lesions including a corpus callosum location. Lumbar puncture showed oligoclonal bands. Further tests demonstrated hearing impairment. Therapy was instituted during the three years course of the disease with steroids, immune suppressants and plasmapheresis with visual loss being progressive. New photopsia is currently present. Conclusions: The etiology of AZOOR remains unclear. With our patient being one of the few described in the literature with concomitant multiple sclerosis, the question remains on whether there is an underlying common process of inflammatory autoimmune reactions. Whether treatment is possible, remains to be evaluated. [source] Function of macular area in retinopathy of prematurityACTA OPHTHALMOLOGICA, Issue 2007AM SHAMSHINOVA Purpose: To assess the bioelectric activity of the retina at different stages of the retinopathy of prematurity (RP). Methods: 21 children with RoP (stage 1-4, 6-14 years old, born at 27-32 week of gestation with the birth weight of 730-1800g) were examined. In 4 of children the prophylactic laser coagulation of avascular retina was performed in the active phase. Visual acuity (VA) at the stage 1 of RoP amounted to 0,75; at the stage 2: 0,5; at the stage 3: 0,25 and at the stage 4: 0,02. Macular (MBN Moscow) and mf ERG( Roland Concult Germany) were examined. Results: There was no correlation between VA values and parameters of multifocal (mf) and macular (m) ERG. Patients with RP of stage1 showed a moderate reduction of b-wave magnitude of mERG at its normal latency. This correlated with mfERG data in central hexagons 15 degrees. The magnitude and latency of mERG were changed to a great extent in RP patients of stages 2-3. The waves N1 and P1 of mERG were also heavily decreased at normal latency. The patients with severe retinal abnormalities, like retinal detachment, have subnormal mERG-values with prolonged latency, and moderate decrease of retinal density in the central ring and considerable changes with eccentricity in mfERG. Conclusions: RP patients 1-4 stages showed considerable impairment of macular function independent of the ophthalmoscopic changes. Even occult or weak-manifested of the diseases in the macula might be accompanied with the moderate decrease of macular bioelectric activity, including the abrupt abnormalities of the electrogenesis and neuronal interactions in the macular area. Decline VA d'not always had relation with RP. The pathophysiologic rationale of the latter needs to be elucidated in the future studies. [source] Longterm visual prognosis in Usher syndrome types 1 and 2ACTA OPHTHALMOLOGICA, Issue 4 2006André M. Sadeghi Abstract. Purpose:, To estimate the age at diagnosis of retinitis pigmentosa and to determine visual acuity deterioration, visual field impairment and the frequency of cataracts in Usher syndrome types 1 and 2. Methods:, We carried out a retrospective study of 328 affected subjects with Usher syndrome types 1 and 2. Study subjects were divided into seven different age groups by decade. Data were analysed using descriptive statistics, general linear model anova and survival analysis. Results:, Retinitis pigmentosa was diagnosed significantly earlier in subjects with Usher syndrome type 1 than in those with type 2. Visual acuity was significantly more impaired in affected subjects with Usher syndrome type 1 than in those with type 2 from 50 years of age onwards. Survival analysis revealed a significant difference in visual field loss (, 10 degrees) between the two groups, with type 2 subjects tending to be more impaired, while comparison indicated no significant differences between the groups in any of the other visual field categories. Cataract was found to be generally more common in Usher syndrome type 1 than type 2. Conclusions:, Progressive loss of visual acuity and visual field begins to be substantial between the second and third decades of life in both Usher types. The rate of degeneration varies between individuals in both groups. The data are useful for the counselling of affected subjects with Usher syndrome types 1 and 2. [source] Cost-effectiveness analysis in glaucoma: what drives utility?ACTA OPHTHALMOLOGICA, Issue 3 2006Results from a pilot study in Sweden Abstract. Purpose:,To investigate the effect of different levels of visual field defect in glaucoma on utilities and to test if utilities could be assessed using a general questionnaire such as the EQ-5D. Methods:,A cross-sectional study in 199 patients with ocular hypertension or open-angle glaucoma grouped into 5 severity stages according to visual field defects was performed in 4 specialized ophthalmic centres. Descriptive analysis was performed for the sample and by stage, and the effect of vision loss on utility was investigated with multiple step-wise regression analysis. Results:,The mean age of the sample was 70 and the mean MD in the worse eye was ,13.1 dB (SD 10.2). Visual acuity (VA) was 0.63 and 0.87 in the worse and better eye, respectively, and the mean utility was 0.80 (SD 0.23). Utility decreased with increasing glaucomatous damage, ranging from 0.84 for mild disease to 0.72 for severe damage (MD ,2.5 to ,28.1), but the difference between the groups was not statistically significant when controlling for co-morbidity, except for the most severe stage (p < 0.01). In multiple regression analysis, visual field in the better eye was significantly correlated with utility, and there was an indirect correlation between visual field in the worse eye and utility: the effect of total VA on utility was significant, and MD in the worse eye was correlated with total VA. Conclusions:,Utility is strongly correlated with overall vision. Our results suggest a relationship between glaucomatous damage and utility, and patients with severe damage have a significantly lower utility. However, this should be further investigated in larger samples that include more patients with moderate-severe bilateral damage. [source] Laser photocoagulation for choroidal neovascular membrane associated with optic disc drusenACTA OPHTHALMOLOGICA, Issue 2 2004Marie N. Delyfer Abstract. Purpose:, To report two cases of choroidal neovascular membrane associated with optic disc drusen which were successfully treated using argon laser photocoagulation. Methods:, Choroidal neovascular complications of optic disc drusen were diagnosed in two of our patients, a 36-year-old woman and a 14-year-old girl. In both cases visual acuity was 20/100 in the affected eye. Fundus examination and angiography revealed a choroidal neovascular membrane. Computer tomography identified bilateral calcified drusen of the optic discs. Photocoagulation of neovascular tissues was immediately performed. Results:, Visual acuity improved progressively, reaching 20/20 10 months after treatment in one case and 20/30 in the other. No recurrence was observed during follow-up. Conclusion:, Early diagnosis and immediate laser photocoagulation of vision-threatening choroidal neovascular membranes associated with optic disc drusen helps stop progression towards the macula and improves longterm visual acuity. [source] Outcome after treatment of congenital bilateral cataractACTA OPHTHALMOLOGICA, Issue 6 2002Anna Lundvall ABSTRACT. Purpose:, To evaluate long-term functional outcome after treatment of dense congenital bilateral cataract. Methods:, The records of 22 consecutive children operated on before the age of 12 months at St. Erik's Eye Hospital over a 5-year period (1991,96) were reviewed retrospectively. Linear Snellen visual acuity (VA) at last check, presence of stereoacuity, nystagmus, strabismus and other complications are accounted for. Subject age at last check ranged from 4 to 9 years. Results:, Visual acuity could be estimated in 19 children: the median VA of the better eye was 0.4 (range: counting fingers , 0.8) and of the fellow eye 0.15 (range: amaurosis , 0.8). In nine otherwise healthy children who were operated on early (by 1 month of age), VA varied from 0.4 to 0.8 in the better eye. Four of these children achieved stereopsis. Pupillary block glaucoma developed in five eyes (in three children). Chronic glaucoma developed in eight eyes (in five children). Glaucoma occurred predominantly in children who underwent cataract extraction during the first week of life. Two of the latter had marked microphthalmos. Conclusion:, Good postoperative VA was achieved in most healthy children with dense bilateral congenital cataract when surgery was performed early (before 6,8 weeks of age). Chronic glaucoma developed predominantly when cataract extraction was performed during the first week of life. [source] The influence of level and polarity of figure-ground contrast on visionACTA OPHTHALMOLOGICA, Issue 4 2001Jonathan S. Pointer ABSTRACT. Purpose: To document the effect upon human foveal vision of changes in the level and polarity of figure-ground contrast under photopic controlled test conditions, with particular emphasis on performance at low contrast levels. Methods: Using a forced-choice psychophysical paradigm, threshold acuity estimates were derived at 9 discrete levels over a near-3 octave contrast range for Landolt ring-type stimuli of either positive or negative polarity. Data were obtained under binocular conditions from 10 young adults, each wearing their optimum low myopic spectacle correction. Results: Visual acuity declined linearly with reducing stimulus contrast, the deterioration increasing substantially at <10% figure-ground contrast regardless of stimulus polarity. Performance was slightly (but not statistically significantly) better for positive contrast stimuli. Conclusion: Irrespective of contrast polarity, a reduction in stimulus figure-ground contrast <10% produces an accelerated decrement in photopic foveal vision compared to the performance at levels >10%. Some clinical and practical implications of this outcome are considered with regard to the examination of patients with normal and compromised visual function. [source] Vitreoretinal surgery in Behçet's disease with severe ocular complicationsACTA OPHTHALMOLOGICA, Issue 2 2001Yusuf Özertürk ABSTRACT. Purpose: To investigate effects of vitreoretinal surgery in Behçet's disease. Materials and Method: Vitreoretinal surgery was applied to 26 eyes of 21 patients with Behçet's disease. Preoperative and postoperative visual acuities, number and duration of attacks, anterior and posterior segment pathologies were evaluated. Results: The mean age of the patients was 33 years and female/male ratio was 6/15. The mean follow-up was 23 months. Visual acuity increased in 15 eyes (58%), did not change in 11 eyes (42%). In the postoperative period, there was a significant decrease in mean number of uveitis attacks compared to the preoperative period (p=0.001), as well as a significant decrease in the mean duration of uveitis attacks (p=0.001). In the postoperative follow-up, intravitreal haemorrhage in 2 eyes (8%), posterior subcapsular cataract in 5 eyes (19%) and corticonuclear cataract in 2 eyes (8%) were observed. Posterior capsular opacification (PCO) developed in 5 of 16 eyes (31%) having ECLE-IOL. CME continued in 3 eyes (12%). Conclusion: Vitreoretinal surgery has favourable effect on the visual and anatomic prognosis in Behçet's patients with severe ocular complications. [source] Diode laser photocoagulation of choroidal neovascularization associated with retinal pigment epithelial detachmentACTA OPHTHALMOLOGICA, Issue 1 2001Francisco Gomez-Ulla ABSTRACT. Aims/Background: Association of choroidal neovascularization with pigment epithelial detachment is not an uncommon feature. Since this condition usually has a poor visual outcome, new treatments should be developed. Methods: We studied the anatomical and visual results of 11 eyes with this association as a manifestation of an Exudative Age Related Macular Degeneration which were treated with diode laser photocoagulation guided by indocyanine green angiography. The average follow up time was 25.5 months (from 12 to 48 months). Results: Complete closure with complete resolution of the exudates and flattening of the detachment was observed in five eyes (45%). Visual acuity in the final examination improved or remained stable in 6 cases (55%). Conclusion: These results indicate that diode laser photocoagulation guided by indocyanine green angiography is at least as effective as conventional lasers with shorter wavelengths for treatment of vascularized pigment epithelial detachments in Age Related Macular Degeneration. [source] Causes of blindness among hospital outpatients in EcuadorCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 2 2006Helene Cass MB BS MPH Abstract Background:, There is a lack of published information on the causes of blindness in Ecuador and the Latin American region in general. This study is designed to enumerate the proportions of ocular conditions contributing to blindness in an outpatient population of an ophthalmology hospital in the coastal region of Ecuador. Methods:, All cases presenting to an ophthalmology outpatient clinic over a 3-week period during September 2004 were reviewed (n = 802). Visual acuity was measured using a Snellen acuity chart and those who met the criteria for blindness were included in the study (n = 118). Blindness was defined under the World Health Organization protocol as visual acuity of <3/60. Both unilateral and bilateral blindness were included in the study. The diagnosis of ocular pathology contributing to blindness was recorded. Results:, Among those considered to have unilateral blindness (n = 88), cataract was the most common cause (43%). This was followed by corneal pathologies (17%) and glaucoma (15%). Among those considered to have bilateral blindness (n = 30), refraction was the most common cause (37%), followed by cataract (23%) and glaucoma (17%). Conclusion:, The major causes of blindness found in this study reflected those in estimated data for the region. More studies are needed to improve the quality and quantity of epidemiological data on blindness in Ecuador and Latin America. Many obstacles to successful implementation of prevention of blindness programmes in South America still need to be overcome. [source] | ||||||||||||||||