RESUMO
BACKGROUND: Glasses for children are recommended and prescribed by different groups of professionals. We set out to compare the prescription practices of ophthalmologists, orthoptists and optometrists/opticians in Switzerland. METHODS: Online questionnaire on the prescription and recommendation of glasses in fictitious cases of children of different ages, refractive values and symptoms. The questionnaire was sent out to members of the Swiss Ophthalmological Society, Swiss Orthoptics and Schweizerischer Berufsverband für Augenoptik und Optometrie. RESULTS: 307 questionnaires were analysed. Optometrists/opticians recommended glasses with a significantly smaller cycloplegic refraction value (p < 0.005) than did orthoptists and ophthalmologists. In the example of a 14-year-old asymptomatic child, ophthalmologists recommended glasses at + 2.64 [Dpt], orthoptists at + 2.44 [Dpt] and optometrists/opticians at + 1.32 [Dpt]. Optometrists/opticians tended to recommend slightly higher correction values in glasses than did ophthalmologists and orthoptists. CONCLUSION: In Switzerland, optometrists/opticians recommend glasses with significantly smaller cycloplegic refraction values than do orthoptists and ophthalmologists, regardless of age or symptoms described in these fictitious cases.
Assuntos
Óculos/estatística & dados numéricos , Pesquisas sobre Atenção à Saúde , Hiperopia/epidemiologia , Hiperopia/reabilitação , Padrões de Prática Médica/estatística & dados numéricos , Prescrições/estatística & dados numéricos , Adolescente , Adulto , Idoso , Criança , Saúde da Criança/estatística & dados numéricos , Pré-Escolar , Feminino , Humanos , Hiperopia/diagnóstico , Masculino , Pessoa de Meia-Idade , Oftalmologistas/estatística & dados numéricos , Optometristas/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Prevalência , Suíça/epidemiologiaRESUMO
BACKGROUND: Retinal optical coherence tomography (OCT) permits quantification of retinal layer atrophy relevant to assessment of neurodegeneration in multiple sclerosis (MS). Measurement artefacts may limit the use of OCT to MS research. OBJECTIVE: An expert task force convened with the aim to provide guidance on the use of validated quality control (QC) criteria for the use of OCT in MS research and clinical trials. METHODS: A prospective multi-centre (n = 13) study. Peripapillary ring scan QC rating of an OCT training set (n = 50) was followed by a test set (n = 50). Inter-rater agreement was calculated using kappa statistics. Results were discussed at a round table after the assessment had taken place. RESULTS: The inter-rater QC agreement was substantial (kappa = 0.7). Disagreement was found highest for judging signal strength (kappa = 0.40). Future steps to resolve these issues were discussed. CONCLUSION: Substantial agreement for QC assessment was achieved with aid of the OSCAR-IB criteria. The task force has developed a website for free online training and QC certification. The criteria may prove useful for future research and trials in MS using OCT as a secondary outcome measure in a multi-centre setting.
Assuntos
Esclerose Múltipla/patologia , Retina/patologia , Tomografia de Coerência Óptica/normas , Atrofia/patologia , Humanos , Estudos Prospectivos , Controle de QualidadeRESUMO
In many blinding diseases of the retina, loss of function and thus severe visual impairment results from apoptotic cell death of damaged photoreceptors. In an attempt to survive, injured photoreceptors generate survival signals to induce intercellular protective mechanisms that eventually may rescue photoreceptors from entering an apoptotic death pathway. One such endogenous survival pathway is controlled by leukemia inhibitory factor (LIF), which is produced by a subset of Muller glia cells in response to photoreceptor injury. In the absence of LIF, survival components are not activated and photoreceptor degeneration is accelerated. Although LIF is a crucial factor for photoreceptor survival, the detailed mechanism of its induction in the retina has not been elucidated. Here, we show that administration of tumor necrosis factor-alpha (TNF) was sufficient to fully upregulate Lif expression in Muller cells in vitro and the retina in vivo. Increased Lif expression depended on p38 mitogen-activated protein kinase (MAPK) since inhibition of its activity abolished Lif expression in vitro and in vivo. Inhibition of p38 MAPK activity reduced the Lif expression also in the model of light-induced retinal degeneration and resulted in increased cell death in the light-exposed retina. Thus, expression of Lif in the injured retina and activation of the endogenous survival pathway involve signaling through p38 MAPK.
Assuntos
Citoproteção , Fator Inibidor de Leucemia/metabolismo , Sistema de Sinalização das MAP Quinases , Células Fotorreceptoras de Vertebrados/enzimologia , Células Fotorreceptoras de Vertebrados/patologia , Degeneração Retiniana/patologia , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo , Animais , Morte Celular/efeitos dos fármacos , Morte Celular/efeitos da radiação , Citoproteção/efeitos dos fármacos , Citoproteção/efeitos da radiação , Modelos Animais de Doenças , Regulação para Baixo/efeitos dos fármacos , Regulação para Baixo/efeitos da radiação , Ativação Enzimática/efeitos dos fármacos , Ativação Enzimática/efeitos da radiação , Células Ependimogliais/efeitos dos fármacos , Células Ependimogliais/enzimologia , Células Ependimogliais/patologia , Células Ependimogliais/efeitos da radiação , Injeções Intravítreas , Fator Inibidor de Leucemia/genética , Luz , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Sistema de Sinalização das MAP Quinases/efeitos da radiação , Camundongos , Camundongos Endogâmicos C57BL , Células Fotorreceptoras de Vertebrados/efeitos dos fármacos , Células Fotorreceptoras de Vertebrados/efeitos da radiação , Ratos , Degeneração Retiniana/enzimologia , Fator de Necrose Tumoral alfa/administração & dosagem , Fator de Necrose Tumoral alfa/farmacologia , Regulação para Cima/efeitos dos fármacos , Regulação para Cima/efeitos da radiação , Proteínas Quinases p38 Ativadas por Mitógeno/antagonistas & inibidoresRESUMO
BACKGROUND: While exophthalmus is quantifiable with readily available measurement tools, there is no such tool for hypoglobus/hyperglobus. Despite its possible life-threatening causes only few articles address the etiologies of vertical globe displacement in the current literature. The aim of our study was to describe etiologies of hypoglobus and to analyze the ratio of malignant diseases. PATIENTS AND METHODS: 3000 portrait photographs taken in our ophthalmology department between 2005 and 2009 were retrospectively screened for patients with vertical globe displacement. Pictures were assessed by three independent ophthalmology-trained observers and matched to the diagnosis based on patient records. RESULTS: 95 patients with supposed vertical globe displacement were identified. Vertical globe displacement was due to an intracranial or orbital disease in 45 patients including 6 patients with a malignant disease. Additional 10 patients had thyroid associated orbitopathy. 11 patients turned out to have mere facial asymmetry, 26 patients had strabism and four patients had an ocular prosthesis. CONCLUSIONS: The etiologies of hypoglobus ranges from orbital fractures to life-threatening malignant tumors. Distinction between apparent and true hypoglobus can be challenging.
Assuntos
Encefalopatias/epidemiologia , Exoftalmia/epidemiologia , Exoftalmia/patologia , Fraturas Orbitárias/epidemiologia , Neoplasias Orbitárias/epidemiologia , Centros de Atenção Terciária/estatística & dados numéricos , Doenças da Glândula Tireoide/epidemiologia , Adulto , Causalidade , Comorbidade , Feminino , Humanos , Masculino , Neoplasias Orbitárias/diagnóstico , Encaminhamento e Consulta/estatística & dados numéricos , Medição de Risco , Suíça/epidemiologiaRESUMO
BACKGROUND: The aim of our study was to analyze the incidence and prognostic value of intraocular hemorrhages caused by subarachnoid hemorrhages. PATIENTS AND METHODS: Retrospective data analysis of all patients with subarachnoid hemorrhage admitted to the University Hospital Zurich between 2005 and 2010. All patients have been classified according to Glasgow Coma, Hunt and Hess, WFNS and Fisher Scales. RESULTS: Out of 391 patients only 26 have been examined by an ophthalmologist. 11/26 (42%) showed Terson's syndrome, compared to 11/391 (2.8%) in the overall cohort. In patients with intraocular hemorrhages there was a trend for a lower GCS and higher Hunt and Hess, WFNS and Fisher scales. CONCLUSION: Intraocular hemorrhages are a relatively frequent, seemingly neglected complication of subarachnoid hemorrhages, and correlate with a higher mortality and morbidity in prospective studies. Routine fundoscopy of heavily impaired patients should be considered.