A retrospective cohort study of radial optic neurotomy for severe central retinal vein occlusions.

BACKGROUND: Radial optic neurotomy (RON) is a new surgical procedure that has, until now, been studied only in a case series format. This study was designed to evaluate the efficacy of RON in improving visual acuity in patients suffering from central retinal vein occlusion (CRVO) with visual acuity equal to or worse than 20/100. METHODS: A retrospective cohort study was conducted of consecutive CRVO patients, consisting of 19 who underwent RON and 38 observation subjects matched on presenting visual acuity. RESULTS: The observation group worsened by 0.25 logMAR units from baseline, whereas the surgery group improved by 0.29 logMAR. Multivariate linear regression modelling found that, having controlled for other significant predictors and confounders, the change in visual acuity in the surgery patients was 0.63 logMAR units better than in the observation patients. INTERPRETATION: Our data suggest that RON is a promising treatment for visual acuity loss in severe CRVO causing visual acuity equal to or worse than 20/100. These results should be interpreted cautiously because of the limitations of the study, including the retrospective study design and the use of Snellen visual acuity. Our data suggest that further evaluation of RON is warranted.

Characteristics and predictors of recurrence of anterior and intermediate uveitis in a Canadian referral centre.

OBJECTIVE: To describe the characteristics of uveitis in a Canadian referral centre and to identify predictors of uveitis recurrence. DESIGN: Retrospective cohort study. PARTICIPANTS: Two hundred eighty-five patients with anterior uveitis, intermediate uveitis, or panuveitis. METHODS: We conducted a retrospective study of all patients presenting with anterior uveitis, intermediate uveitis, or panuveitis to the sole uveitis subspecialist at the regional referral centre between September 2004 and March 2006. Patients with posterior uveitis were excluded. Characteristics such as onset, severity, anatomical subtype, systemic association or etiology, recurrence rate, response to treatment, and complications were identified. Regression analysis was used to determine predictors of uveitis recurrence. RESULTS: Three hundred sixty-four eyes from 285 patients were enrolled. Anatomical subtypes were 313 anterior, 36 intermediate, and 15 panuveitis. Systemic associations included ankylosing spondylitis (11.3%), inflammatory bowel disease (6%), sarcoidosis (4.1%), and herpes infections (3.8%). A human leukocyte antigen B27 (HLA-B27)-related association was found in 86 patients (23.6%). Patients with uveitis-associated complications or back symptomatology were more likely to have a recurrence (odds ratios 3.86 and 2.29, respectively). CONCLUSIONS: Common associations were ankylosing spondylitis, inflammatory bowel disease, sarcoidosis, and herpes infections. Patients with uveitis complications and back symptomatology were significantly more likely to have uveitis recurrences.

Discussing resident participation in cataract surgery.

OBJECTIVE: To investigate the proportion of patients who would consent to resident participation in cataract surgery. STUDY DESIGN: Prospective observational case series. PARTICIPANTS: Consecutive series of patients presenting for consideration of cataract surgery. METHODS: A specifically worded discussion of resident participation in cataract surgery was developed on the basis of literature recommendations and was used when obtaining consent for cataract surgery from eligible patients. The main outcome measure was the proportion of patients who consented to resident participation in their cataract surgery. RESULTS: Of the 106 patients eligible for enrollment in the study, 101 (95.3%) consented to resident participation in their cataract surgery. CONCLUSIONS: Despite suggestions in the previous literature to the contrary, surgeons can be reassured that the vast majority of patients, when informed by means of the wording described in this study, will consent to resident participation in their cataract surgery.

Navigator-gated three-dimensional MR angiography of the pulmonary arteries using steady-state free precession.

PURPOSE: To assess the quality of a navigator-gated, free breathing, steady-state free precession (SSFP) technique in comparison to a single breathhold for pulmonary artery imaging in normal volunteers. MATERIALS AND METHODS: Sagittal sections of the left pulmonary arteries of 10 volunteers were obtained with a three-dimensional SSFP sequence using both a single breathhold of 30 seconds and a navigator-gated version of the same sequence. The images were compared and rated by a blinded cardiovascular radiologist for image quality, sharpness, and artifact. RESULTS: On a scale ranging from -2 to 2, in which positive numbers denote that the navigator method was favorable compared to the single breathhold method, image quality was rated 0.7+/-1.4, sharpness 0.6+/-1.5, and artifact 0.1+/-1.4. Thus, there was no statistical difference between the two methods. CONCLUSION: The navigator-gated SSFP sequence is able to acquire images equal in quality to the breathhold sequence. This may be of clinical importance for pulmonary imaging in patients who are unable to sustain a long breathhold.