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Visual Prognosis (visual + prognosis)
Selected AbstractsManifestation of Coats' disease by age in TaiwanCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 4 2007Chien-Hsiung Lai MD Abstract Background:, To compare the differences in clinical manifestation of Coats' disease between younger and older patients in the Far East. Methods:, Coats' disease cases diagnosed at one Taiwanese hospital from July 1986 to June 2004 were retrospectively reviewed (n = 30; 32 eyes). Patients were stratified into groups according to the initial diagnosis of Coats' disease at the age of <20 years (Group Y) or ,20 years (Group O). The clinical manifestations of Coats' disease in Group Y (19 eyes) and Group O (13 eyes) were compared. Results:, A higher proportion of female patients was noted in Group O (P = 0.046). Diseases were generally limited geographically, with 14 eyes (73.7%) manifesting involvement greater than 6 clock hours in Group Y and four eyes (30.8%) in Group O. The involved area including retinal telangiectasia and exudates was smaller in Group O (P = 0.016). Patients without posterior pole involvement were associated with better visual outcome (adjusted odds ratio, 6.5; 95% confidence interval, 1.1,40.1, P = 0.044). Conclusion:, Coats' disease manifestation was different between different age groups. Treatment is important to prevent disease progression. Visual prognosis is associated with posterior pole involvement. [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] 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] 2164: Role of placental growth factor (PIGF) in wound healing after glaucoma filtration surgeryACTA OPHTHALMOLOGICA, Issue 2010T VAN BERGENArticle first published online: 23 SEP 2010 Purpose Failing filtering surgery due to excessive wound healing is a considerable challenge in ophthalmology, and largely contributes to progressive vision loss in glaucoma patients. Anti-VEGF therapy helps to prevent post-surgical scarring by inhibiting angiogenesis and collagen deposition, but does not influence inflammation (which is also an important player in postoperative wound healing). We will check the hypothesis that placental growth factor (PlGF) plays a role in scar formation after glaucoma filtration surgery, and that it may be a(n) (additional) target for improvement of the outcome of this surgery through its known anti-angiogenic and anti-inflammatory, and possibly anti-fibrotic properties. Methods The effect of an anti-PlGF antibody (ThromboGenics) will be investigated in vitro on the proliferation of endothelial cells (HUVEC), inflammatory cells (Jurkat cells) and of Tenon fibroblasts (TF). The effect of the antibody will also be investigated in vivo in a rabbit model for glaucoma surgery by measuring intra-ocular pressure (IOP), filtration bleb function and survival, and by (immuno-)histological analysis of angiogenesis (CD31), inflammation (CD45) and fibrosis (Sirius Red). Conclusion Our proposed research project will elucidate the potential role of PlGF-inhibition in the improvement of filtration surgery outcome, and will highlight any angiostatic, anti-inflammatory, and/or anti-fibrotic effects. PlGF-inhibition as an adjuvant anti-inflammatory therapy to anti-VEGF treatment in glaucoma surgery might open new perspectives for more efficient surgery. In conclusion, our project opens exciting perspectives for the treatment of the blinding condition of glaucoma, and thus might improve the visual prognosis of glaucoma patients. [source] 4365: The role of transpupillary thermotherapy in combined treatment of retinoblastomaACTA OPHTHALMOLOGICA, Issue 2010SV SAAKYAN Purpose Retinoblastoma (RB) is one of the most serious ophthalmic pathology in childhood. Treatment options that provide eye preservation include chemotherapy, brachytherapy, external beam radiation, cryotherapy and laser treatment. The aim of our study is to evaluate efficiency of transpupillary thermotherapy (TTT) as a part of combined treatment of RB. Methods Our group consists of 30 RB patients (34 eyes). All patients received systemic chemotherapy (Carboplatin and Vincristine). Tumor thickness before TTT varied from 0.9 to 2.6 mm, tumor base diameter varied from 2 to 10 mm. Seven patients had monolateral RB, others had bilateral lesion. Five patients were treated with brachytherapy before TTT. TTT was performed using infrared diode laser Nidec DC 3300. Exposure time was 60 seconds. Width of laser beam was from 1000 to 2000 nm. TTT power setting varied from 600 to 900 mW. Eleven patients had TTT more then once. Follow-up period after TTT was up to 24 months. Results Control examination after TTT showed good response to the treatment in 27 eyes (79.4%). After TTT we saw hyperpigmented scar on the eye fundus at the place of previous tumor location, on OCT it looked like hyper-reflective stripe replacing all layers of a retina. Seven eyes (20.6%) were resistant to TTT, five of them were successfully treated by additional brachytherapy. Two eyes were enucleated because of uncontrolled tumor growth. Evaluation of metastatic disease in all patients revealed no signs of metastasis at the time of treatment or during follow-up. Conclusion TTT can be used in combined treatment of RB for small multifocal lesions. The method is rather simple and uncomplicated. Patients treated with TTT have better visual prognosis in comparison with brachytherapy. [source] Predictable signs of benign course of polypoidal choroidal vasculopathy: based upon the long-term observation of non-treated eyesACTA OPHTHALMOLOGICA, Issue 4 2010Akiko Okubo Abstract. Purpose:, To find predictable signs of benign polypoidal choroidal vasculopathy (PCV). Methods:, Medical records of 13 eyes from 12 patients who were followed up for 5 years or longer without treatment among 258 consecutive patients with PCV were reviewed retrospectively. The main outcomes measured were best corrected visual acuity (BCVA) and fundus findings during the follow-up period. Results:, The average age at presentation was 68 years, and the average follow-up period after diagnosis was 80 months (range, 62,119 months). The initial mean logarithmic value of the minimal angle of resolution (logMAR) BCVA was 0.28 ± 0.26, and the final mean logMAR BCVA was 0.62 ± 0.72. The difference in the logMAR BCVA values between the two points was not statistically significant (p > 0.05). The trend of change from baseline at 2-year follow-up was consistent with those at 5-year follow-up in nine eyes. Fundus findings at the initial examination were classified into two patterns: (i) reddish-orange nodules and detachment of the retinal pigment epithelium with/without detachment of the neurosensory retina (nine eyes); (ii) reddish-orange nodules alone, or nodules and small subretinal haemorrhage (four eyes). In the eyes with the first pattern, clinical course and visual prognosis were variable. An absence of hard exudates could be a sign to maintain a benign clinical course or stable vision with this pattern. The eyes with the second pattern took a benign clinical course with stable vision. Conclusions:, There is certainly a group of PCV eyes with a benign prognosis. Considering the huge cost and risk of current therapies, the initial ocular findings could be deciding factors that determine the necessity for further treatment. [source] Tight orbit syndrome: a previously unrecognized cause of open-angle glaucomaACTA OPHTHALMOLOGICA, Issue 1 2010Graham A. Lee ABSTRACT. Purpose:, To describe a new syndrome of tight orbit and intractable glaucoma with a poor visual prognosis. Methods:, A retrospective observational case series of six patients seen at two centres between 2001 and 2007 assessing intraocular pressure (IOP), best-corrected visual acuity and visual field. Results:, Three men and three women, ranging in age at diagnosis from 14 to 53 years, demonstrated similar orbital features and progressive visual field loss despite intensive management with medication and laser and operative surgery. Highest IOPs ranged from 30 to 50 mmHg. Trabeculectomy and/or glaucoma drainage devices were attempted in five patients but all failed. One patient underwent orbital decompression with achievement of IOP control. Final IOP at last follow-up was variable; only two patients achieved IOP in the normal range, with the rest ranging from 25 to 40 mmHg. All patients had advanced visual field loss. Conclusion:, Tight orbit syndrome presents a serious clinical challenge. Despite maximum medical therapy and surgical intervention IOP is difficult to control, resulting in progressive visual field loss. [source] Long-term functional and anatomical results of OOKP and tibial OKP: Barcelona experienceACTA OPHTHALMOLOGICA, Issue 2009MF DE LA PAZ Purpose To report the long-term functional and anatomical results of OOKP and Tibial OKP performed at the Barraquer Eye Center from 1974-2006. Different factors like surgical technique, clinical diagnosis, age and post-operative complications are also analyzed and reported. Methods A retrospective study on 330 eyes of 227 patients who underwent OOKP or tibia OKP was performed. Kaplan Meier survival curves and multivariate analysis using Cox regression model of the different variables mentioned are presented. Results OOKP and Tibia OKP have comparable functional and anatomical results in the long-term. Best long-term functional and anatomical results are for patients with chemical burns, cicatricial trachoma and Stevens-Johnsons/Lyell syndrome. Thermal burns have a higher anatomical retention than other diagnostic categories. Younger patients have better visual prognosis and anatomical retention than older patients. Patients must be warned of the possibility of sight-threatening complications like extrusion of the prosthesis, retinal detachment and glaucoma. Conclusion Our more than 35 years experience with biological keratoprosthesis using the OOKP and the tibia OKP shows that the two techniques are comparable. Certain variables like clinical diagnosis, age and post-operative complications affect the anatomical and functional results in the long-term. [source] IL-8 vitreous levels in proliferative diabetic retinopathyACTA OPHTHALMOLOGICA, Issue 2007M GLOBOCNIK PETROVIC Purpose: To determine the levels of interleukin 8 (IL-8) in the vitreous of patients with proliferative diabetic retinopathy (PDR) and the role of IL-8 as a marker of visual prognosis after vitrectomy. Methods: Vitreous fluid samples were obtained at vitreoretinal surgery from 71 patients with diabetes type 2 and PDR, and from 17 age-matched non-diabetic patients with a macular hole (control group). PDR was classified as active and inactive, and subdivided according to the extent of large vessel gliotic obliteration. The cytokine levels were measured by Cytometric Bead Array method. To determine the role of IL-8 as visual prognostic marker after vitrectomy we investigated whether the vitreous levels of IL-8 were associated with poor visual outcome. Poor outcome was defined by visual acuity less than 20/200 at least 8 months after vitrectomy. Clinical and preoperative eye characteristics (visual acuity, iris neovascularisation, vitreous hemorrhage, macular detachment, macular edema, active neovascularisation, neovascularisation of the disk, and the presence of panretinal photocoagulation) were additionally analyzed. Results: The vitreous levels of IL-8 were significantly higher in patients with PDR in comparison to the control (P<0.001), in eyes with higher extent of large vessel gliotic obliteration (P<0.001) and was not significantly higher in eyes with active neovascularisation (P=0.9). After multiple logistic regression analysis, vitreous level of IL-8 (P=0.028) and macular detachment (P=0.039) were predictors for the poor visual outcome after vitrectomy. Conclusions: The vitreous level of IL-8 was associated with the higher extent of large vessel gliotic obliteration and with the poor visual outcome after vitrectomy. [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] Epidemiology of open- and closed-globe trauma presenting to Cairns Base Hospital, QueenslandCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 3 2006Andrew RE Smith MBBS MSc Abstract Purpose:, To review the epidemiology of serious ocular trauma presenting to Cairns Base Hospital, from the far north Queensland health districts. Methods:, A retrospective study of cases from January 1995 to November 2002 inclusive. Cases were analysed with respect to demographics, cause and nature of injury, method of transport and time to and type of ophthalmic treatment, and visual outcomes. Results:, There were 226 cases identified, including 71 open-globe and 155 closed-globe injuries. The annual rate of injury was 3.7 per 100 000 for open-globe and 11.8 per 100 000 in total. The Aboriginal and Torres Strait Islander population from the far north Queensland districts showed a disproportionate incidence, with 38% of the total number of injuries, despite representing only 12.3% of the population. Assault in the Aboriginal and Torres Strait Islander population resulted in 69.6% of injuries in men and 75.8% of injuries in women. Of all assaults 76.2% were alcohol-related. The majority (71.5%) of injuries in the Caucasian population were due to accidental blunt and sharp trauma. In total, 77.4% of injuries occurred in men, with an average age of 31 years. Of all open and closed injuries in the study, a final visual acuity of 6/12 or better was achieved in 47.8% of eyes and a final visual acuity of 6/60 or less occurred in 17.7% of patients, 20.8% patients were lost to follow up. In total, 14.1% of open injuries required enucleation/evisceration. Conclusions:, The incidence of ocular trauma in far north Queensland is equal to other Australian populations. However, there is a disproportionately high incidence in the Aboriginal and Torres Strait Islander population. Alcohol-related assault is a significant cause of visual loss in the Aboriginal and Torres Strait Islander population. Closed-globe injuries are more common than open globe; however, the latter have poorer visual prognosis. Initial visual acuity of all injuries correlated with final visual acuity. [source] Contact lens management of infantile aphakiaCLINICAL AND EXPERIMENTAL OPTOMETRY, Issue 1 2010Richard G Lindsay BScOptom MBA FAAO (DipCL) FCLSA FVCO The visual outcomes for infants 18 months or younger with cataracts have improved dramatically over the past couple of decades. Earlier detection of infantile cataract and prompt surgical removal,with subsequent visual rehabilitation with contact lenses,mean that these patients now have a much better visual prognosis. Advances in contact lens technology have led to a significantly higher success rate with contact lenses and this has been a major factor in improving the visual outcomes for aphakic infants. This review outlines the contact lens management of infantile cataract, including a detailed analysis of the various contact lens options available and a discussion regarding the important factors that can cause issues with contact lens wear and affect the overall visual rehabilitation of the infant. [source] | ||||||||||