Clinical Outcomes of the Implementation of IOP Monitoring, in and Out of Office Time, to 1500 Patients-A Cohort Study.

BACKGROUND: The aim of this study was to present the clinical outcomes of IOP monitoring in and out of office time and determine its value in our clinical practice. MATERIAL AND METHODS: We reviewed the records of 1500 patients (glaucoma suspects or glaucoma patients), who were admitted for IOP monitoring during almost 12 years. All patients were hospitalized because their within-office-hours exams were considered inadequate and inconclusive for decision making. RESULTS: A total of 744 patients (49.6% out of 1500) needed change of treatment. A total of 121 patients (8% out of 1500) were programmed for interventional therapy (laser or surgery). A total of 68 patients (4.5% out of 1500) were declassified as overdiagnosed and overtreated. In 250 patients (16.7% out of 1500), hidden adherence problem appeared. In 720 patients (48% out of 1500), peak IOP occurred during out-of-office hours. CONCLUSIONS: IOP phasing is a useful tool in clinical practice. In many cases with inconclusive diagnosis, as well as in patients with advanced or labile glaucomas, IOP monitoring data add complementary information, useful for decision making, and may contribute not only to diagnosis and successful IOP modulation, but also in personalized therapeutic strategy and individual patients' motivation.

Cataract Surgery during the COVID-19 Pandemic: Insights from a Greek Tertiary Hospital.

BACKGROUND: COVID-19 has affected everyday clinical practice, having an impact on the quality of healthcare provided, even in eye clinic departments. The aim of this study is to evaluate the consequences of this worldwide pandemic on cataract surgery in a Greek tertiary university hospital. METHODS: A total of 805 patients were included in this study. The number of cataract surgeries (CS), the type, the unilateral or bilateral appearance as well as the stage of cataract were recorded for the months between January and June 2019 (pre-COVID period) and compared with the same period in 2021 (during the pandemic outbreak) in the Department of Ophthalmology of Thessaloniki General Hospital G. Papanikolaou. RESULTS: A significant reduction in the number of CS as well as a significant increase in advanced and/or bilateral cataracts in 2021 compared to the pre-COVID period were observed. CONCLUSION: The COVID-19 pandemic has affected equally the value of ophthalmic interventions as well as the patients' quality of life, being a powerful reminder of the significant physical and psychological benefits of CS, especially for older adults and patients with comorbidities.

Objective analysis of retinal function in HIV-positive children without retinitis using optical coherence tomography.

PURPOSE: To assess the retinal nerve fiber layer thickness in children with human immunodeficiency virus disease without cytomegalovirus retinitis or visual symptoms. METHODS: Thirty-eight eyes of 19 human immunodeficiency virus-positive children (group A) with visual acuity of 20/20 or better, normal color vision testing and no ophthalmoscopically detectable disorders were prospectively examined. All subjects of group A had no history of cytomegalovirus retinitis and CD4 counts consistently above 100. Patients in group B (40 eyes of 21 patients) were human immunodeficiency virus-negative age-matched control subjects. Thickness of retinal nerve fiber layer along a 3.4-mm-diameter circle centered on the optic nerve head was evaluated using third-generation optical coherence tomography. CD8 T-lymphocyte count, presence of systemic infection, hemoglobin, hematocrit and serum beta-microglobulin levels were also recorded. RESULTS: The mean overall retinal nerve fiber layer thickness in groups A and B were 89.2 +/- 24.01 microm and 102.82 +/- 29.168 microm (SD) respectively. The difference was considered extremely significant (P < 0.0001). Group A had significantly thinner average nerve fiber layer in temporal, nasal, superior and inferior retinal areas. CONCLUSIONS: Significant retinal nerve fiber layer thinning occurs in human immunodeficiency virus-positive children with no visual impairment or ophthalmologic evidence or retinitis.