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Significant Macular Oedema (significant + macular_oedema)
Selected AbstractsThe North Jutland County Diabetic Retinopathy Study (NCDRS)ACTA OPHTHALMOLOGICA, Issue 4 2010Clinically significant macular oedema, retinal lesions, visual acuity Abstract. Purpose:, This study set out to map the associations between retinal lesions, visual acuity (VA) and the presence of clinically significant macular oedema (CSMO) in diabetes subjects. Methods:, This cross-sectional study comprised 656 type 1 and 328 type 2 diabetes subjects undergoing retinopathy screening in the County of North Jutland, Denmark. Numbers of specific retinal lesions were quantified from retinal photographic recordings. Associations between CSMO, number of specific retinal lesions and VA were established. The percentages of eyes with CSMO ascribed to retinal lesions were calculated. Results:, The presence of CSMO, number of specific retinal lesions and VA were all significantly associated. The parameter with the highest statistical association with CSMO measured by Spearman's correlation coefficient was hard exudates (type 1: 0.524; type 2: 0.715), followed by microaneurysms (type 1: 0.298; type 2: 0.508), retinal haemorrhages (type 1: 0.227; type 2: 0.595), cottonwool spots (type 1: 0.207; type 2: 0.259) and VA (type 1: , 0.137; type 2: , 0,175). Conclusions:, All retinal lesions are significantly associated with CSMO and together can predict for up to 42.3% (in type 1 diabetes) and 64.3% (in type 2 diabetes) of CSMO cases. [source] Further survey of Australian ophthalmologist's diabetic retinopathy management: did practice adhere to National Health and Medical Research Council guidelines?CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 6 2010Joshua Yuen MPH Abstract Background:, To compare the self-reported management of diabetic retinopathy by Australian ophthalmologists with the 1997 National Health and Medical Research Council (NHMRC) guidelines. Methods:, Self-reported cross-sectional survey of patterns of practice. Questionnaires were sent to all Australian ophthalmologists, comprising questions regarding professional details, diabetic retinopathy screening attitudes/practices and specific hypothetical management scenarios. Data were analysed using Chi-squared and adjusted logistic regression. Result:, 480 of the 751 (64%) eligible Australian ophthalmologists participated. The majority (80%, n = 376) reported they consistently reviewed patient's glycaemic control, but only 55% and 41% regularly reviewed blood pressure and serum cholesterol control, respectively. Ophthalmologists generally adhered to NHMRC-recommended screening intervals, although only 38% agreed with the guidelines relating to screening of pre-pubertal diabetic patients. Fluorescein angiogram was used more than recommended, especially for mild non-proliferative diabetic retinopathy where 45% of respondents used this investigation. Practice duration >15 years was associated with more regular fluorescein angiogram use (OR = 3.74; 95% CI: 2.53,5.53, P < 0.001). In the clinical scenarios where clinically significant macular oedema was concurrently present with cataract or proliferative diabetic retinopathy, >26% referred to retinal subspecialists for management; 85% of the remaining ophthalmologists performed macular laser first. Respondents with practice duration >15 years were 7.8 times (P = 0.001) more likely to perform cataract surgery first. Conclusion:, Diabetic retinopathy management guidelines were generally well followed by Australian ophthalmologists. However, areas of practice variation existed including frequent use of fluorescein angiogram. Significant proportion of practitioners referred diabetic patients to retinal subspecialists, who were more likely to adhere to guideline recommendations. Ophthalmologists with greater experience (>15 years) were more likely to employ practices differing from NHMRC recommendations. [source] Prevalence and associations of diabetic retinopathy in indigenous Australians within central Australia: the Central Australian Ocular Health StudyCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 4 2010John Landers MBBS MPH PhD Abstract Purpose:, To determine the prevalence and associations of diabetic retinopathy (DR) within the indigenous Australian population living in central Australia. Methods:, 1884 individuals aged 20 years or older, living in one of 30 remote communities within the statistical local area of ,central Australia' were recruited for this study. This equated to 36% of those aged 20 years or older and 67% of those aged 40 years or older within this district. Participants were recruited as they presented to the eye clinic at each remote community. Following dilated slit-lamp fundoscopy, the amount of DR in participants with diabetes mellitus (DM) was quantified using the Early Treatment of Diabetic Retinopathy Study criteria. The presence of any DR and vision-threatening DR (clinically significant macular oedema and/or proliferative DR) in one or both eyes was presented. Results:, Of those with diabetes, 22.2% (25.4% of those aged 40 years or older) had any DR and 7.0% (8.4% of those aged 40 years or older) had vision-threatening DR. Both the presence of any DR and vision-threatening DR were associated with advancing age and HbA1c level, but neither subcategory was associated with sex or self-reported hypertension. Conclusion:, Our study has shown similar prevalence rates for DR in indigenous Australians compared with non-indigenous Australians. However, as DM is far more prevalent among indigenous Australians, the proportion of those affected by DR across the population should be considerably higher when compared with non-indigenous Australians. [source] Delivery of photocoagulation treatment for diabetic retinopathy at a large Australian ophthalmic hospital: comparisons with national clinical practice guidelinesCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 2 2002Parapun Bamroongsuk MD Abstract Objective: To determine if the delivery of photocoagulation for diabetic retinopathy at a large Australian ophthalmic hospital conforms with Australian National Health and Medical Research Council clinical practice guidelines. Methods: A retrospective medical record review was conducted of all patients who had initial laser treatment for diabetic retinopathy at the Royal Victorian Eye and Ear Hospital from January 1997 to December 1998. Results: The study included 322 eyes from 203 patients. The mean age was 65.8 years (range 18,89 years) and the mean duration of diabetes was 14.7 years (range 1,40 years). Panretinal photocoagulation (PRP) alone was performed in 37 eyes over a mean number of 2.6 sessions. The median waiting time for these procedures was 14 days (range 0,146 days) and the median follow-up time was 7.1 weeks (range 1,25 weeks). Focal treatment was performed (without PRP) in 238 eyes and 55.5% of these cases required repeat focal treatment for persistent clinically significant macular oedema. Median waiting time for focal treatment was 20 days (range 0,302 days) and the median follow-up time after treatment was 12.1 weeks (range 1.7,42.0 weeks). Focal and PRP treatment was used in 47 eyes that had maculopathy concurrently with proliferative retinopathy. Focal treatment was applied before (or at the same session as) the PRP wherever possible. Conclusions: The study indicates that the application of photocoagulation and follow up for diabetic retinopathy at this tertiary referral institution conforms closely with Australian clinical practice guidelines. [source] Safety and efficacy of intravitreal triamcinolone for cystoid macular oedema in uveitisCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 1 2001Stephanie Young FRACO ABSTRACT Purpose: To report the safety and efficacy of intravitreal triamcinolone in the treatment of inflammatory cystoid macular oedema (CMO) in six patients who were resistant to other forms of therapy. Methods: An open-label unmasked prospective non- randomized pilot study of six patients with idiopathic uveitis and visually significant macular oedema, resistant to periocular and/or systemic corticosteroid treatment, was carried out. Baseline examination and investigations were performed, including fundus fluorescein angiography, and the patients were given a single intravitreal injection of triamcinolone (4 mg/0.1 mL). The primary outcome measure was angiographic resolution of CMO. Patients were reviewed at intervals of 2,4 weeks for 12 months. Results: A single intravitreal injection of triamcinolone induced clinical and angiographic resolution of inflammatory macular oedema in all patients for varying periods of time up to 6 months. Five patients experienced increased intraocular pressure to 30 mmHg or greater which required treatment. Two patients developed posterior subcapsular cataract. Conclusion: One injection of intravitreal triamcinolone was an effective short-term treatment for resistant CMO in uveitis. As with steroids given by other routes, raised intraocular pressure and cataract may occur. As it was so effective in these eyes with resistant CMO, a larger study is warranted to evaluate this form of therapy. [source] | ||||||||||