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Full Ophthalmological Examination (full + ophthalmological_examination)
Selected AbstractsSurveillance of vision and ocular disorders in children with Down syndromeDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 7 2007Elma Stephen MBBS MD MRCPCH Children with Down syndrome have a high prevalence of ocular disorders. The UK Down's Syndrome Medical Interest Group (DSMIG) guidelines for ophthalmic screening were locally implemented into a protocol that included neonatal eye examination by an opthalmologist and a comprehensive ophthalmological examination (cycloplegic refraction, ophthalmoscopy, and orthoptic assessement) by at least the age of 3 years, followed by preschool follow-up as indicated. We audited retrospectively surveillance for ocular disorders before and after the DSMIG-based guidelines were locally adopted in 1995. Results were compared for children born before and after the implementation of screening guidelines. A total of 81 children (43 females, 38 males) with Down syndrome were identified. After the DSMIG protocol, 34/36 children received a full ophthalmological examination in the neonatal period, compared with 9/27 children before 1995 (p<0.001). Neonatal screening resulted in the detection of cataracts in three infants. Mean age of first comprehensive ophthalmic screening outside the neonatal period was similar in the two groups (1y 6mo before guidelines vs 1y 9mo after), as were the proportion of children receiving preschool eye checks (27/30 before; 17/18 after). Overall, 65.7% children were screened in accordance with the guidelines, improving to 100% in recent years. At school age, 43% of the study population had significant refractive errors, with 27% having hypermetropia and astigmatism. Earlier prescription of glasses for refractive errors was seen (mean age 5y 6mo before guidelines; 3y 6mo after; p<0.001). Prevalence of other ocular disorders included strabismus (34/72, 47%), nasolacrimal duct obstruction (26/73, 35.6%), cataracts (5/64, 7.8%), and nystagmus (12/72, 16%). Establishment of the DSMIG-based local protocol has streamlined ocular surveillance. It is anticipated that this will improve developmental and functional outcomes in Down syndrome. [source] Significant improvements in near vision, reading speed, central visual field and related quality of life after ranibizumab treatment of wet age-related macular degenerationACTA OPHTHALMOLOGICA, Issue 4 2010Christina Frennesson Abstract. Purpose:, To investigate the effects on near visual acuity, reading speed, central visual field and related quality of life of ranibizumab treatment of wet age-related macular degeneration (AMD). Methods:, The study was a prospective, non-comparative consecutive case series, followed for 3 months and investigator-driven. Thirty eyes of 30 patients with wet AMD were included, mean age 75 years (range 69,95 years). In addition to a full ophthalmological examination , including best-corrected visual acuity (BCVA; Early Treatment Diabetic Research Study chart), fundus biomicroscopy, fundus photography, fluorescein angiography, indocyanine green angiography (occult cases) and ocular coherence tomography , near visual acuity, reading speed, central visual field and quality of life for related activities were also investigated at baseline and at 3 months after ranibizumab treatment. Results:, Mean BCVA increased from 62 ± 11 to 66 ± 14 letters at 3 months (7%; p = 0.018). Near vision improved from 9 ± 5 to 6 ± 3 points (33%; p = 0.0006) and reading speed increased from 59 ± 40 to 85 ± 50 words/min (44%; p < 0.0001). The mean deviation from normal of the visual field improved from ,9 ± 7 to ,6 ± 5 dB (33%; p < 0.0001). Quality of life improved for distance activities from 54 ± 28 to 63 ± 28 points (17%; p < 0.0001) but significantly (p = 0.024) more for near activities, from 49 ± 26 to 63 ± 26 points (29%; p < 0.0001). Reading newspaper text in the group in which the better eye was treated showed the highest increase in quality of life score of all: 116%. Conclusion:, The increase in BCVA after ranibizumab treatment is well established. The present study also showed significant improvements in other important visual qualities, such as near visual acuity, reading speed, central visual field and several activities influencing quality of life. The improvement was greater for near activities than for distance activities. Therefore, the beneficial effects of ranibizumab treatment shown here are more extensive than those reported previously. [source] Morphological and functional characteristics of the hyperautofluorescent parafoveal ring in retinitis pigmentosaACTA OPHTHALMOLOGICA, Issue 2009E LENASSI Purpose To evaluate the morphology and function of the hyperautofluorescent parafoveal ring in patients with retinitis pigmentosa (RP) using optical coherence tomography (OCT) and microperimetry (MP). Methods Twelve patients with RP who had hyperautofluorescent parafoveal ring were examined. In all patients, full ophthalmological examination, MP (Nidek Technologies MP1 Microperimeter), OCT (Topcon 3D OCT-1000) and fundus autofluoresence (AF) imaging (Heidelberg Engineering HRA) were performed. The results of OCT imaging and MP testing were superimposed on the AF image. We investigated whether the AF diameter correlated with photoreceptor inner segment/outer segment junction (IS/OS line). Results On the site of hyperautofluorescent ring, the integrity of the photoreceptor layer was affected and the IS/OS line was absent. In the encircled area of normal AF, a preserved photoreceptor layer with an IS/OS line was present. A strong correlation (r = 0.83, P < 0.0001) between the horizontal diameter of the encircled area of normal AF and the length of the IS/OS line was seen. The mean retinal sensitivity was significantly lower (P < 0.0001) over the area of hyperautofluorescent ring (2.0 dB, CI 1.1 to 2.8) compared to the mean retinal sensitivity of the encircled area of normal AF (9.2 dB, CI 6.6 to 11.9). Outside the ring, the majority of patients seemed to have an absence of photoreceptor layer with no light perception, even if AF pattern appeared well preserved. Conclusion The hyperautofluorescent ring demonstrates border of abnormal retinal morphology and function, which are only preserved within the area it encircles. It appears that the ring represents an area of intensive photoreceptor degradation. [source] Conjunctival impression cytology and tear-film changes in patients with familial Mediterranean feverACTA OPHTHALMOLOGICA, Issue 1 2009Aylin Karalezli Abstract. Purpose:, To evaluate the ocular surface changes and tear-film functions in patients with familial Mediterranean fever (FMF). Methods:, This prospective case,control clinical study examined 35 patients with FMF (group 1) and 35 controls (group 2). All patients underwent a full ophthalmological examination. Ocular surface changes were evaluated by determining cell content of surface conjunctival epithelium using conjunctival impression cytology and tear-film functions using Schirmer-I, break-up time (BUT), corneal fluorescein and Rose Bengal tests. Subjective ocular complaints were scored with a four-point scale. Between-group results were compared. Results:, In group 1, impression cytology revealed grade 0 changes in 15 eyes, grade 1 changes in 11 eyes and grade 2 changes in nine eyes in group 1; in group 2, it revealed grade 0 changes in 27 eyes, grade 1 changes in five eyes and grade 2 changes in three eyes (p = 0.013). Mean goblet cell density was 765 ± 45 cells/mm2 in group 1 and 1730 ± 100 cells/mm2 in group 2 (P < 0.001). Mean results on the Schirmer-I test results were 17.36 ± 3.18 mm in group 1 and 19.60 ± 4.17 mm in group 2 (p = 0.364). Mean BUT was 8.20 ± 1.60 seconds in group 1 and 9.93 ± 2.33 seconds in group 2 (p = 0.001). Mean corneal fluorescein and Rose Bengal staining scores were 3.26 ± 1.67 and 0.96 ± 0.71 in group 1 and 1.37 ± 0.34 and 0.40 ± 0.49 in group 2 (p = 0.037, p = 0.005). The presence of subjective ocular complaints was more frequent in group 1 than in group 2. Conclusion:, Despite normal tear production, the ocular surface and tear-film functions of FMF patients differ from those of healthy individuals. These changes may be related to the chronic inflammatory nature of FMF. [source] A boy born with multiple lesions of atrophodermaACTA PAEDIATRICA, Issue 3 2010Piero Pavone Abstract Aims:, The Atrophodermas include a large group of disorders appearing as localized or widespread depressed skin areas and characterized by underlying dermal atrophy. The present study aims to report a peculiar form of previously unreported focal dermal atrophy. Methods:, We studied over a period of 5 years a boy who manifested, since birth, multiple hypopigmented cutaneous atrophic lesions of the atrophoderma type in a mosaic distribution over the body and the legs. Results:, This boy did no develop other cutaneous or systemic stigmata except for an idiopathic thrombocytopenic purpura (ITP) manifested at age 2 years. Full serum, metabolic and infective analyses; full ophthalmological examination; ultrasound examination of the heart and internal organs; skeletal x-rays; brain magnetic resonance imaging; and DNA analysis of the PORCN (Focal Dermal Hypoplasia - FDH) gene in this boy yielded normal results. Pathological analysis of multiple skin specimens from an affected area revealed slightly reduced dermal thickness; hyperpigmentation of the basal layer; homogenized and disarrayed collagen bundles; perivascular chronic infiltrates of lymphocytes and histiocytes; and normal skin appendages. Currently, the child is healthy; he has mildly improved skin status with less-evident skin depression throughout the lesion areas and no further complication has been recorded. The histological and clinical appearance of the skin lesions and the course were against any known disorder in the group of the atrophodermas. Conclusions:, The cutaneous lesions seen in this boy represent a possibly new congenital skin disorder characterized by multiple, benign areas of focal dermal atrophy in a mosaic distribution. [source] | ||||||||||