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1.
Ophthalmologica ; 246(2): 141-149, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37023723

RESUMEN

INTRODUCTION: The aim of this study was to report surgical outcomes and risk factors for primary surgical failure following rhegmatogenous retinal detachment (RRD) repair. METHODS: In this retrospective cohort study, RRD patients who underwent primary surgery at a tertiary center between January 1, 2006, and December 31, 2020, were enrolled. Surgical failure was defined as reoperation within 60 days postoperatively due to retinal re-detachment and putative risk factors for surgical failure were analyzed. RESULTS: Of 2,383 eyes (2,335 patients), 1,342 (56.3%) underwent vitrectomy and 1,041 (43.7%) underwent scleral buckling. The surgical failure rate was 9.1% overall, and 6.0% and 13.1% for the vitrectomy and scleral buckling groups, respectively. In the multivariate logistic regression analysis, surgical failure was associated with surgical experience (first-year fellow vs. senior professor) (odds ratio [OR]: 1.66; p = 0.018), scleral buckling (OR: 2.33; p < 0.001), and longer axial length (AL; ≥26.5 mm) (OR: 1.49; p = 0.017). In each surgical approach, age <40 years (OR: 2.11; p = 0.029) in the vitrectomy group and age >40 years (OR, 1.84; p = 0.004), male sex (OR: 1.65; p = 0.015), and first-year fellows compared to senior professors (OR: 1.95; p = 0.013) in the scleral buckling group were associated with surgical failure. Lens status were not associated with the surgical failure rate. CONCLUSION: In this large retrospective study using data from Korea, vitrectomy was superior to scleral buckling in terms of primary anatomical outcomes in the management of RRD. First-year fellows were a risk factor for surgical failure, especially for scleral buckling. Longer AL was a significant parameter for predicting the success rates.


Asunto(s)
Desprendimiento de Retina , Curvatura de la Esclerótica , Vitrectomía , Adulto , Humanos , Masculino , Desprendimiento de Retina/diagnóstico , Desprendimiento de Retina/cirugía , Desprendimiento de Retina/etiología , Estudios Retrospectivos , Factores de Riesgo , Resultado del Tratamiento , Agudeza Visual , Vitrectomía/efectos adversos
2.
Ophthalmologica ; 246(3-4): 192-202, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36720210

RESUMEN

INTRODUCTION: The aim of the study was to determine the short-term real-world safety and efficacy of intravitreal brolucizumab injections in Korean patients with neovascular age-related macular degeneration (nAMD). METHODS: This multicenter retrospective study involved 294 eyes (treatment naïve 20 eye [6.8%] and nontreatment naïve 274 eyes [93.2%]) of 290 patients from 13 hospitals or retinal centers in South Korea. Patients with nAMD who received brolucizumab injection(s) between April 1 and November 30, 2021, with a follow-up ≥1 month, were included. Primary outcomes were safety, incidence of intraocular inflammation (IOI), and potential risk factors. The secondary outcome was efficacy, i.e., change in best-corrected visual acuity (BCVA) and optical coherence tomography-measured macular thickness and retinal fluid. RESULTS: The mean age was 71.63 ± 8.66. The follow-up period was 2.38 ± 0.79 months. The mean number of brolucizumab injections during the follow-up was 1.52 ± 0.58. The overall incidence of IOI was 13.9% (n = 41 eyes). Most IOI cases were of anterior uveitis (8.8%, 26 eyes), followed by retinal vasculitis (2.4%, seven eyes) and occlusive retinal vasculitis (0.3%, one eye). Most eyes showed IOI resolution (n = 40, 97.5%) and BCVA restoration (n = 39, 95.1%) with or without corticosteroid treatment during the follow-up. Age, sex, IOI history, or other anti-vascular endothelial growth factor injection histories were not associated with the occurrence of IOI. However, only thin subfoveal choroidal thickness (SFCT) was associated with the occurrence of IOI (odds ratio = 0.995, p = 0.020). BCVA at 1 month improved from baseline (baseline 0.518 ± 0.356 vs. 1 month 0.503 ± 0.383, p = 0.023), but the improvement was not maintained. Anatomical improvement was significant after 3 months. CONCLUSION: In Korean patients with nAMD, the incidence of IOI following brolucizumab injections was 13.9%. IOI was well-controlled with or without steroid treatment. Most IOI eyes (95.1%) were restored to the level of vision before. IOI occurrence and occlusive vasculitis was rare. In the short term, brolucizumab injection effectively improved vision at 1 month and dried retinal fluid for 3 months.


Asunto(s)
Degeneración Macular , Vasculitis Retiniana , Humanos , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Estudios Retrospectivos , Inflamación , Retina
3.
Retina ; 42(12): 2284-2293, 2022 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-36394885

RESUMEN

PURPOSE: To identify postoperative macula deviation after epiretinal membrane surgery and to investigate its clinical effects. METHODS: Patients who underwent idiopathic epiretinal membrane removal and followed up for >12 months were enrolled. Macular deviation was evaluated using disk margin-to-fovea distance, foveal angle, and horizontal and vertical asymmetry of retinal thickness and volume. Horizontal or vertical asymmetry was defined as percentile asymmetry between nasal and temporal quadrants or between superior and inferior quadrants, respectively. The association between macular deviation parameters and best-corrected visual acuity and metamorphopsia were evaluated. Baseline and postoperative parameters were compared depending on epiretinal membrane severity. RESULTS: Data from 102 eyes with a mean follow-up of 21.14 months were analyzed. Disk margin-to-fovea distance and foveal angle decreased with time and horizontal asymmetry of thickness and volume increased with time, showing nasal crowding and nasal tilting. Postoperative changes of disk margin-to-fovea distance and horizontal asymmetry were associated with best-corrected visual acuity. Severe epiretinal membrane eyes showed greater postoperative nasal deviation than mild epiretinal membrane eyes. CONCLUSION: Postoperative nasal crowding and tilting was quantitatively identified. The causative layers for nasal deviation might be the inner retinal layers, as the foveal angle decreased with time. Postoperative disk margin-to-fovea distance shortening and nasal-deviated horizontal asymmetry were correlated with best-corrected visual acuity improvement.


Asunto(s)
Membrana Epirretinal , Mácula Lútea , Humanos , Membrana Epirretinal/cirugía , Vitrectomía , Agudeza Visual , Tomografía de Coherencia Óptica
4.
Sci Rep ; 12(1): 10162, 2022 06 17.
Artículo en Inglés | MEDLINE | ID: mdl-35715561

RESUMEN

Despite many studies, optimal treatment sequences or intervals are still questionable in retinal vein occlusion (RVO) macular edema. The aim of this study was to examine the real-world treatment patterns of RVO macular edema. A retrospective analysis of the Observational Medical Outcomes Partnership Common Data Model, a distributed research network, of four large tertiary referral centers (n = 9,202,032) identified 3286 eligible. We visualized treatment pathways (prescription volume and treatment sequence) with sunburst and Sankey diagrams. We calculated the average number of intravitreal injections per patient in the first and second years to evaluate the treatment intensities. Bevacizumab was the most popular first-line drug (80.9%), followed by triamcinolone (15.1%) and dexamethasone (2.28%). Triamcinolone was the most popular drug (8.88%), followed by dexamethasone (6.08%) in patients who began treatment with anti-vascular endothelial growth factor (VEGF) agents. The average number of all intravitreal injections per person decreased in the second year compared with the first year. The average number of injections per person in the first year increased throughout the study. Bevacizumab was the most popular first-line drug and steroids were considered the most common as second-line drugs in patients first treated with anti-VEGF agents. Intensive treatment patterns may cause an increase in intravitreal injections.


Asunto(s)
Edema Macular , Oftalmología , Oclusión de la Vena Retiniana , Inhibidores de la Angiogénesis/uso terapéutico , Bevacizumab/uso terapéutico , Dexametasona/uso terapéutico , Glucocorticoides/uso terapéutico , Humanos , Inyecciones Intravítreas , Edema Macular/tratamiento farmacológico , Edema Macular/etiología , Oclusión de la Vena Retiniana/complicaciones , Oclusión de la Vena Retiniana/tratamiento farmacológico , Estudios Retrospectivos , Tomografía de Coherencia Óptica/efectos adversos , Resultado del Tratamiento , Triamcinolona/uso terapéutico , Factor A de Crecimiento Endotelial Vascular , Agudeza Visual
5.
BMC Ophthalmol ; 22(1): 4, 2022 Jan 03.
Artículo en Inglés | MEDLINE | ID: mdl-34980021

RESUMEN

PURPOSE: To evaluate the necessity and safety of primary posterior capsulotomy during phaco-vitrectomy for idiopathic epiretinal membrane (ERM). SETTING: Seoul National University Bundang Hospital, Seongnam, Korea. DESIGN: Retrospective consecutive cohort analysis. METHODS: This study enrolled 219 patients (228 eyes) who underwent combined 25-gauge phaco-vitrectomy for idiopathic ERM and cataract, divided into capsulotomy (-) group (152 eyes, 144 patients) and capsulotomy (+) group (76 eyes, 75 patients). The main outcomes were rate of posterior capsular opacity (PCO) occurrence and postoperative complications. Ophthalmic examinations were performed at baseline, 1, 3, 6, and 12 months postoperatively. RESULTS: PCO only occurred in capsulotomy (-) group (20 eyes, 13.2%), with mean onset of 10.59 months. Visually-significant PCO that needed Nd:YAG posterior capsulotomy was present in 9 eyes (45.0% of PCO eyes). The rate of cystoid macular edema (CME) was higher in capsulotomy (+) group (6.6% vs. 15.8%, p = 0.026) with longer duration (1.50 vs. 3.36 months, p = 0.019). Female sex and posterior capsulotomy were significant risk factors for CME occurrence (p < 0.05). CONCLUSION: Primary posterior capsulotomy during phaco-vitrectomy for idiopathic ERM obviated the need for Nd:YAG posterior capsulotomy, but visually-significant PCO that needed Nd:YAG laser was not common. Considering the low rate of visually-significant PCO and high rate of postoperative CME, routine posterior capsulotomy during phaco-vitrectomy may not be necessary for preventing PCO in ERM.


Asunto(s)
Catarata , Membrana Epirretinal , Terapia por Láser , Facoemulsificación , Catarata/complicaciones , Catarata/epidemiología , Membrana Epirretinal/cirugía , Femenino , Humanos , Facoemulsificación/efectos adversos , Capsulotomía Posterior , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Vitrectomía
6.
Genes (Basel) ; 12(8)2021 08 04.
Artículo en Inglés | MEDLINE | ID: mdl-34440381

RESUMEN

This study aimed to characterize Korean patients with pseudoxanthoma elasticum (PXE) presenting with angioid streaks. Retinal phenotypes were longitudinally evaluated by multimodal ophthalmic imaging, and targeted gene panel sequencing for inherited retinal diseases was conducted. Seven subjects from unrelated families (median age, 51.2 years) were enrolled and followed for a median of 3.2 years. Four asymptomatic patients were significantly younger than three symptomatic patients with decreased visual acuity at presentation (mean age; 38.1 vs. 61.5 years, p = 0.020). The asymptomatic patients maintained good vision (20/32 or better) and had no choroidal neovascularization (CNV) over the observation period. The symptomatic patients showed additional reduction in visual acuity and bilateral CNV occurrence during the longitudinal follow-up. Pathogenic ABCC6 variants were identified in all patients, leading to a diagnosis of PXE. Heterozygous monoallelic variants were identified in four patients and compound heterozygous variants were detected in three patients. Nine ABCC6 variants were identified, including one novel variant, c.2035G>T [p.Glu679Ter]. This is the first genetic study of Korean patients with PXE.


Asunto(s)
Estrías Angioides/diagnóstico , Seudoxantoma Elástico/diagnóstico , Adulto , Estrías Angioides/genética , Estrías Angioides/fisiopatología , Neovascularización Coroidal , Femenino , Angiografía con Fluoresceína , Heterocigoto , Humanos , Masculino , Persona de Mediana Edad , Proteínas Asociadas a Resistencia a Múltiples Medicamentos/genética , Seudoxantoma Elástico/genética , Seudoxantoma Elástico/fisiopatología , República de Corea , Estudios Retrospectivos , Agudeza Visual
7.
Sci Rep ; 11(1): 14623, 2021 07 16.
Artículo en Inglés | MEDLINE | ID: mdl-34272419

RESUMEN

To evaluate the long-term outcomes of ranibizumab (RBZ) vs. aflibercept (AFL) in treatment-naïve eyes with typical neovascular age-related macular degeneration (nAMD) and polypoidal choroidal vasculopathy (PCV). This multicenter, retrospective, matched-cohort analysis was conducted on data  up to 4 years of follow-ups. The primary outcome was the visual acuity (VA) change from baseline. The secondary outcomes included the number of injections, proportion of eyes without a yearly injection, and the number of eyes with treatment switching. Subgroup analyses were performed for typical nAMD and PCV. Typical nAMD was defined as nAMD other than PCV. We included VA-matched 215 eyes of 209 patients (131 and 84 eyes with RBZ and AFL, respectively). The crude mean VA changes from baseline were + 6.7 vs. + 2.6, + 2.1 vs. - 0.4, - 1.3 vs. - 1.8, and - 2.2 vs. - 5.0 letters in the RBZ and AFL groups, at 1, 2, 3, and 4 years, respectively (p > 0.05). The adjusted predicted VA by linear mixed model, proportion of eyes stratified by VA, and the survival curve for significant vision loss were comparable during the 4-year follow-up (p > 0.05). The mean number of injections were similar between the RBZ and AFL groups (2.9 vs. 3.0, respectively, p = 0.692). The subgroup analysis for typical nAMD and PCV showed similar results between the groups. The visual outcomes did not differ between RBZ and AFL during 4 years with comparable numbers of injections. Our study reflects the long-term, real-world clinical practice and treatment pattern of two treatments for typical nAMD and PCV.


Asunto(s)
Enfermedades de la Coroides/tratamiento farmacológico , Degeneración Macular/tratamiento farmacológico , Neovascularización Patológica/tratamiento farmacológico , Pólipos/tratamiento farmacológico , Ranibizumab/uso terapéutico , Receptores de Factores de Crecimiento Endotelial Vascular/uso terapéutico , Proteínas Recombinantes de Fusión/uso terapéutico , Anciano , Anciano de 80 o más Años , Inhibidores de la Angiogénesis/uso terapéutico , Pueblo Asiatico , Coroides/irrigación sanguínea , Evaluación de Medicamentos , Oftalmopatías/tratamiento farmacológico , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , República de Corea , Estudios Retrospectivos , Factores de Tiempo , Tomografía de Coherencia Óptica , Resultado del Tratamiento , Factor A de Crecimiento Endotelial Vascular/antagonistas & inhibidores , Agudeza Visual/efectos de los fármacos
8.
PLoS One ; 14(4): e0215297, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30995284

RESUMEN

PURPOSE: To longitudinally evaluate the visual function and structure of patients taking ethambutol by various modalities and identify useful tests for detection of subclinical ethambutol-induced optic toxicity. METHODS: This retrospective study enrolled 84 patients with newly diagnosed tuberculosis treated with ethambutol. Best-corrected visual acuity (BCVA), color vision, contrast sensitivity, fundus and retinal nerve fiber layer (RNFL) photography, automated visual field (VF) test, and optical coherence tomography (OCT) were performed: prior to starting; every month during administration, and 1 month after stoppage. We longitudinally compared visual function and structure with the baseline and identified the occurrence of subclinical toxicity. RESULTS: BCVA, color vision, and contrast sensitivity showed no change from the baseline. Mean temporal RNFL thickness was significantly increased at 6 months (p = 0.014). Subclinical toxicity was found in 22 eyes of 14 patients (i.e., 13% of 168 eyes), in the forms of VFI decrease (VF index, 9 eyes of 6 patients), quadrant RNFL thickness increase (5 eyes of 4 patients), and VF pattern defect (12 eyes of 6 patients). 73% of the patients showed recovery to the baseline at 1 month post-stoppage. The risk factors for occurrence of subclinical toxicity were age, cumulative dose, and medication duration. CONCLUSION: Mean temporal RNFL thickness increased after administration. The VFI, quadrant RNFL thickness, and VF pattern defect could prove useful in assessment of subclinical toxicity. Medication duration was shown to be a strong risk factor for occurrence of subclinical toxicity.


Asunto(s)
Percepción de Color/efectos de los fármacos , Sensibilidad de Contraste/efectos de los fármacos , Etambutol , Tomografía de Coherencia Óptica , Neuropatía Óptica Tóxica , Tuberculosis , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Etambutol/administración & dosificación , Etambutol/efectos adversos , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Tiempo , Neuropatía Óptica Tóxica/diagnóstico por imagen , Neuropatía Óptica Tóxica/patología , Neuropatía Óptica Tóxica/fisiopatología , Tuberculosis/diagnóstico por imagen , Tuberculosis/tratamiento farmacológico , Tuberculosis/patología , Tuberculosis/fisiopatología , Pruebas del Campo Visual
9.
BMC Ophthalmol ; 17(1): 36, 2017 Mar 31.
Artículo en Inglés | MEDLINE | ID: mdl-28359272

RESUMEN

BACKGROUND: A chalazion is a common eyelid disease that causes eye morbidity due to inflammation and cosmetic disfigurement. Corneal topographic changes are important factors in corneal refractive surgery, intraocular lens power calculations for cataract surgery, and visual acuity assessments. However, the effects of chalazia on corneal astigmatism have not been thoroughly investigated. The changes in corneal astigmatism according to chalazion size and location is necessary for better outcome of ocular surgery. The aim of this study is to evaluate changes in corneal astigmatism according to chalazion size and location. METHODS: In this cross-sectional study, a total of 44 eyes from 33 patients were included in the chalazion group and 70 eyes from 46 patients comprised the control group. Chalazia were classified according to location and size. An autokeratorefractometer (KR8100, Topcon; Japan) and a Galilei™ dual-Scheimpflug analyzer (Ziemer Group; Port, Switzerland) were utilized to evaluate corneal changes. RESULT: Oblique astigmatism was greater in the chalazion group compared with the control group (p < 0.05). Astigmatism by simulated keratometry (simK), steep K by simK, total root mean square, second order aberration, oblique astigmatism, and vertical astigmatism were significantly greater in the upper eyelid group (p < 0.05). Astigmatism by simK, second order aberration, oblique astigmatism, and vertical astigmatism were significantly greater in the large-sized chalazion group (p < 0.05). Corneal wavefront aberration was the greatest in the upper eyelid chalazion group, whole area group, and large-sized chalazion group (p < 0.05). CONCLUSIONS: Large-sized chalazia in the whole upper eyelid should be treated in the early phase because they induced the greatest change in corneal topography. Chalazion should be treated before corneal topography is performed preoperatively and before the diagnosis of corneal diseases.


Asunto(s)
Astigmatismo/etiología , Chalazión/complicaciones , Córnea/patología , Enfermedades de los Párpados/complicaciones , Párpados/patología , Agudeza Visual , Adulto , Astigmatismo/diagnóstico , Chalazión/diagnóstico , Topografía de la Córnea , Estudios Transversales , Enfermedades de los Párpados/diagnóstico , Femenino , Estudios de Seguimiento , Humanos , Masculino , Refracción Ocular , Estudios Retrospectivos
10.
Acta Ophthalmol ; 95(3): e230-e235, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-27874256

RESUMEN

PURPOSE: To investigate tear film stability and secretion according to serum 25-hydroxyvitamin D3 [25(OH)D] levels in dry eye patients. METHODS: In this retrospective observational study, the medical charts of 92 patients who visited the Department of Ophthalmology at Hallym University Kangnam Sacred Heart Hospital from April to August 2015 were reviewed. Serum 25(OH)D levels were measured. Subjects were divided into three groups according to serum 25(OH)D levels: sufficient, inadequate or deficient group. Eye discomfort was measured by ocular surface disease index (OSDI). Tear break-up time (TBUT), fluorescein staining score and Schirmer's tear secretion test were measured. RESULTS: The mean age was 53.38 ± 13.69 years. Mean serum 25(OH)D level was 14.41 ± 5.98 ng/ml. Tear break-up time (TBUT) and tear secretion were positively correlated with serum 25(OH)D levels (r = 0.389, p = 0.001; and r = 0.428, p < 0.001, Pearson correlation test). Tear break-up time (TBUT) and tear secretion were shorter in the vitamin D-deficient group compared to the sufficient group (p = 0.022 and p = 0.004). Fluorescein staining scores and OSDI scores were not different between the three groups. CONCLUSION: Tear break-up time (TBUT) and secretion were correlated with serum vitamin D levels. Vitamin D status may be an important factor for dry eye syndrome.


Asunto(s)
Síndromes de Ojo Seco/metabolismo , Lágrimas/metabolismo , Vitamina D/sangre , Técnicas de Diagnóstico Oftalmológico , Síndromes de Ojo Seco/diagnóstico , Femenino , Fluoresceína/farmacología , Colorantes Fluorescentes/farmacología , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Propiedades de Superficie
11.
Br J Ophthalmol ; 101(4): 462-466, 2017 04.
Artículo en Inglés | MEDLINE | ID: mdl-27364773

RESUMEN

BACKGROUND/AIMS: To evaluate the surgical outcomes of two-muscle surgery for childhood intermittent exotropia comparing large angles with moderate angles. METHODS: We retrospectively reviewed the medical records of 178 children who had undergone bilateral lateral rectus recession (BLR) or unilateral recess-resect (RR) for large-angle (≥40 prism dioptres (PD); group A) or moderate-angle (≥20 and <30 PD; group B) intermittent exotropia with a postoperative follow-up period of 6 months or more. The main outcome measures were postoperative deviation angle and surgical success rate, and the secondary outcome measure was effect/dose ratio. The effect/dose ratio was defined as the corrected angle of deviation at postoperative 6 months divided by the sum of the amount of lateral rectus recession in each eye in BLR and by the sum of the amount of lateral rectus recession and medial rectus resection in RR. Surgical success was defined as alignment between 10 PD of exodeviation and 5 PD of esodeviation both at distance and at near. RESULTS: There was a significant difference in mean angle of deviation at distance throughout the postoperative period (p<0.05). The final surgical success rate was significantly lower in group A than in group B (p<0.05). The effect/dose ratio for both BLR and unilateral RR was significantly greater in group A than in group B (p<0.05). CONCLUSIONS: The patients with childhood intermittent exotropia with large angles showed significantly higher rates of undercorrection, though they also showed greater effects of BLR or RR per millimetre (the effect/dose ratio), compared with moderate-angle exotropia.


Asunto(s)
Exotropía/cirugía , Músculos Oculomotores/cirugía , Procedimientos Quirúrgicos Oftalmológicos , Complicaciones Posoperatorias/cirugía , Niño , Preescolar , Percepción de Profundidad , Exotropía/fisiopatología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Músculos Oculomotores/fisiopatología , Complicaciones Posoperatorias/fisiopatología , Periodo Posoperatorio , Estudios Retrospectivos , Resultado del Tratamiento , Visión Binocular/fisiología
13.
Am J Ophthalmol ; 160(5): 937-943.e1, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26210864

RESUMEN

PURPOSE: To compare intraocular pressure (IOP) among rebound, noncontact, and Goldmann applanation tonometry (GAT) and their relationships to central corneal thickness in children. DESIGN: Diagnostic protocol comparison and evaluation. METHODS: In right eyes of 419 children, mean IOP, rates of successful measurement with 3 tonometries, and intermethod agreement by Bland-Altman plot were assessed. The influences of central corneal thickness, and of average IOP of 3 tonometries on IOP differences between tonometries, were evaluated. RESULTS: The mean age was 8.89 ± 3.41 years (3-15 years). There was significant difference in mean IOP of each tonometry; GAT showed the lowest values (P < .05). The IOP was successfully measured by noncontact tonometry in 89%, by rebound tonometry in 75%, and by GAT in 64% of children less than 10 years old, and in 100%, 98%, and 94% of children older than 10 years, respectively. The IOP of each tonometer positively correlated with central corneal thickness (P < .05). The mean differences and limits of agreement were 0.81 ± 6.19 mm Hg (noncontact minus rebound), 2.56 ± 4.62 mm Hg (rebound minus GAT), and 1.81 ± 4.76 mm Hg (noncontact minus GAT). Rebound and noncontact tonometry overestimated IOP relative to GAT for thicker central corneal thicknesses. Rebound tonometry overestimated IOP relative to GAT and noncontact tonometry at higher average IOP of 3 tonometries. CONCLUSIONS: Rebound, noncontact, and Goldmann applanation tonometries can be considered appropriate methods for children, though noncontact tonometry is the most accessible. Given the risk of false-positive diagnosis of pediatric glaucoma, attention should be devoted to children with IOP within a suspicious range or thicker cornea.


Asunto(s)
Glaucoma/diagnóstico , Presión Intraocular/fisiología , Tonometría Ocular/instrumentación , Adolescente , Niño , Preescolar , Córnea/patología , Diseño de Equipo , Femenino , Glaucoma/patología , Glaucoma/fisiopatología , Humanos , Masculino , Reproducibilidad de los Resultados , Estudios Retrospectivos
14.
Optom Vis Sci ; 92(7): e158-60, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-26017191

RESUMEN

PURPOSE: To describe an unusual case of endogenous Klebsiella endophthalmitis associated with prostatic abscess in an immunocompetent patient. CASE REPORT: A 59-year-old previously healthy man presented with rapidly progressive retinal vasculitis in the left eye. He received an empirical antibiotic and antiviral agent intravenously followed by oral prednisolone until the etiology was identified; however, intraocular inflammation in the left eye continued to worsen, followed by the development of subretinal abscess in the contralateral eye. Finally, a diagnosis of endogenous Klebsiella endophthalmitis associated with prostatic abscess was made through a culture of the vitreous acquired by diagnostic vitrectomy. However, we could not save the vision of the left eye despite the intensive treatment with intravenous and intravitreal injections of antibiotics. CONCLUSIONS: Rapidly progressive retinal vasculitis could be an initial sign of endogenous Klebsiella endophthalmitis even in an immunocompetent patient.


Asunto(s)
Absceso/microbiología , Endoftalmitis/microbiología , Infecciones Bacterianas del Ojo/microbiología , Infecciones por Klebsiella/microbiología , Klebsiella pneumoniae/aislamiento & purificación , Enfermedades de la Próstata/microbiología , Vasculitis Retiniana/microbiología , Absceso/diagnóstico , Absceso/tratamiento farmacológico , Antibacterianos/uso terapéutico , Ceftazidima/uso terapéutico , Quimioterapia Combinada , Endoftalmitis/diagnóstico , Endoftalmitis/tratamiento farmacológico , Infecciones Bacterianas del Ojo/diagnóstico , Infecciones Bacterianas del Ojo/tratamiento farmacológico , Glucocorticoides/uso terapéutico , Humanos , Inyecciones Intravítreas , Infecciones por Klebsiella/diagnóstico , Infecciones por Klebsiella/tratamiento farmacológico , Levofloxacino/uso terapéutico , Masculino , Persona de Mediana Edad , Prednisolona/uso terapéutico , Enfermedades de la Próstata/diagnóstico , Enfermedades de la Próstata/tratamiento farmacológico , Vasculitis Retiniana/diagnóstico , Vasculitis Retiniana/tratamiento farmacológico , Tomografía Computarizada por Rayos X , Agudeza Visual , Vitrectomía
15.
BMC Ophthalmol ; 14: 90, 2014 Jul 11.
Artículo en Inglés | MEDLINE | ID: mdl-25015110

RESUMEN

BACKGROUND: Fungal keratitis is difficult to treat that can result in corneal blindness requiring penetrating keratoplasty and in fungal endothalmitis. We report a case of fungal keratitis and onychomycosis simultaneously infected by Trichophyton. CASE PRESENTATION: A 77-year old male presented with ocular pain, conjunctival injection, and severe loss of vision in his left eye. His best corrected visual acuity was hand movements in the left eye, and slit-lamp examination showed a corneal ulcer with feathery margin and hypopyon. Bacterial and fungal smear/culture showed no organism, and there was no improvement in spite of treatment with topical fortified 5% cefazolin and 2% tobramycin. Trichophyton species was identified by repeated cultures. We found onychomycosis on the patient's foot, where the same fungal species were identified. Regimen was changed to topical itraconazole and systemic intravenous itraconazole. No clinical improvement was observed, so therapeutic penetrating keratoplasty and cryotherapy was done with continuation of antifungal therapy. The graft was clear at postoperative 1 month and no evidence of recurrence was found. CONCLUSION: It is important to identify the pathogen of keratitis because early identification of pathogen causing keratitis provides the appropriate treatment in early phase of keratitis. It is necessary to search for other fungal skin infections such as onychomycosis and athelete's foot considering the fungal keratitis following skin infection. In addition, fungal skin infection including onychomycosis should be treated for prevention of fungal keratitis as soon as possible.


Asunto(s)
Córnea/microbiología , Trasplante de Córnea/métodos , Infecciones Fúngicas del Ojo/microbiología , Dermatosis del Pie/microbiología , Queratitis/microbiología , Onicomicosis/microbiología , Trichophyton/aislamiento & purificación , Anciano , Antifúngicos/administración & dosificación , Córnea/patología , Infecciones Fúngicas del Ojo/complicaciones , Infecciones Fúngicas del Ojo/terapia , Estudios de Seguimiento , Dermatosis del Pie/complicaciones , Dermatosis del Pie/tratamiento farmacológico , Humanos , Queratitis/diagnóstico , Queratitis/terapia , Masculino , Onicomicosis/complicaciones , Onicomicosis/tratamiento farmacológico , Piel/microbiología , Agudeza Visual
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