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1.
Int Ophthalmol ; 44(1): 164, 2024 Mar 29.
Artículo en Inglés | MEDLINE | ID: mdl-38551696

RESUMEN

PURPOSE: To compare anti-vascular endothelial growth factor (anti-VEGF) treatment in pachychoroid neovasculopathy (PNV) and age related macular degeneration (AMD). METHODS: Cases having pro re nata (PRN) anti-VEGF treatment for choroidal neovascularization were reviewed and grouped as PNV and AMD. Groups were compared according to central foveal thickness (CFT), best corrected visual acuity (BCVA), and total injection over 12 months. The correlation of beginning choroidal thickness, CFT, and BCVA with final BCVA was analyzed. RESULTS: Forty-seven PNV and 65 AMD cases were reviewed. Both the PNV group (p = 0.0001) and the AMD group (p = 0.003) had a significant improvement in BCVA and a significant decrease in CFT (p = 0.0001). However, BCVA was better at the 3-, 6-, and 12-month follow-up in PNV (p = 0.003, 0.002, 0.02). No significant CFT difference was observed between groups. The total number of injections was 5.7 ± 1.7 for PNV and 5.2 ± 1.5 for AMD (p = 0.09). Beginning BCVA was positively correlated with final BCVA in both groups. CONCLUSION: The PRN treatment regimen was effective for PNV and AMD in terms of visual and anatomical outcomes. Visual response was better in PNV with PRN treatment with the same number of injections.


Asunto(s)
Degeneración Macular , Ranibizumab , Humanos , Inhibidores de la Angiogénesis , Factor A de Crecimiento Endotelial Vascular , Tomografía de Coherencia Óptica/métodos , Resultado del Tratamiento , Inyecciones Intravítreas , Degeneración Macular/diagnóstico , Degeneración Macular/tratamiento farmacológico , Estudios Retrospectivos
2.
Medicina (Kaunas) ; 59(2)2023 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-36837465

RESUMEN

The aim of this study was to compare the outcomes of diabetic macular edema (DME) treated with aflibercept (AFB) or ranibizumab (RNB) only, and after switching from RNB to AFB. This was a retrospective, real-world, multicenter (7 cities) 24 month study. Overall, 212 eyes in the AFB group, 461 in the RNB group, and 141 in the RNB to AFB group were included. The primary endpoints were differences in visual acuity (VA) and central macular thickness (CMT) from baseline to the final visit. The secondary outcomes were the percentage of eyes that achieved ≥10 letters gain and ≥10 letters loss in vision at month 12 and 24, and the percentage of eyes that achieved a thinning of ≥20% in CMT at month 3 and month 6. The results showed that VA did not significantly differ at baseline (AFB: 0.62 ± 0.38, RNB: 0.61 ± 0.36, RNB to AFB: 0.61 ± 0.38), at checkpoints, or at the final visit (AFB: 0.46 ± 0.38, RNB: 0.5 ± 0.37, RNB to AFB: 0.53 ± 0.36) (p > 0.05). Though the mean CMT at baseline was significantly thicker in the RNB to AFB group (479 ± 129.6 µm) when compared to the AFB (450.5 ± 122.6 µm) and RNB (442 ± 116 µm) groups (p < 0.01), similar measurements were obtained after 12 months. The percentages of eyes that gained or lost ≥10 letters in the AFB, RNB, and RNB to AFB groups at year 1 and 2 were similar, as was the percentages of eyes that demonstrated ≥20% CMT thinning at month 3 and 6. Our study showed similar visual improvements in non-switchers (AFB and RNB groups) and switchers (RNB to AFB group) through 2 years follow-up, however, AFB patients required fewer injections, visits, or need for additional treatments.


Asunto(s)
Diabetes Mellitus , Retinopatía Diabética , Edema Macular , Humanos , Ranibizumab/uso terapéutico , Inhibidores de la Angiogénesis , Estudios Retrospectivos , Turquía , Bevacizumab/uso terapéutico , Factor A de Crecimiento Endotelial Vascular , Tomografía de Coherencia Óptica , Resultado del Tratamiento
3.
Int Ophthalmol ; 43(10): 3755-3765, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37389762

RESUMEN

PURPOSE: It was aimed to evaluate the retinochoroidal microvascular alterations of pediatric beta-thalassemia patients and investigate the effect of blood transfusion on perfusion among transfusion-dependent thalassemia (TDT), by means of optical coherence tomography angiography (OCTA). METHODS: In this multicentered, prospective, cross-sectional study, 56 TDT, 14 non-TDT (NTDT), and 63 healthy children were evaluated. The vessel density (VD) in superficial capillary plexus (SCP), deep capillary plexus, radial peripapillary capillary network, choriocapillaris, and the foveal avascular zone area (FAZ) were evaluated by OCTA. Before and after transfusion values ​​of the TDT group were compared, and correlations were made with blood values ​​and iron accumulation. RESULTS: Foveal and parafoveal zones were significantly thinner among TDT patients, with larger FAZ area. Macula VD of SCP and ppVD was lowest in NTDT group. In the TDT group, a decrease in retinal nerve fiber thickness and ppVD values was detected ​​after transfusion. A negative significant relationship was found between both hemoglobin (Hb), hematocrit (Htc), and ppVD. CONCLUSIONS: OCTA provides a better insight into retinal and choriocapillaris vascular impairment influenced by tissue hypoxia and oxidative stress in different clinical phenotypes of beta-thalassemia.


Asunto(s)
Vasos Retinianos , Talasemia beta , Humanos , Niño , Angiografía con Fluoresceína/métodos , Vasos Retinianos/diagnóstico por imagen , Talasemia beta/complicaciones , Talasemia beta/diagnóstico , Tomografía de Coherencia Óptica/métodos , Estudios Transversales , Estudios Prospectivos
4.
Int Ophthalmol ; 42(12): 3777-3787, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-35829865

RESUMEN

PURPOSE: This study aimed to report the visual and anatomical outcomes of intravitreal anti-VEGF treatment for diabetic macular edema (DME) in a real-world clinical setting from Turkey over 36 months. METHODS: This is a retrospective, multicenter (7 sites) study. The medical records of 1072 eyes (both previously treated and naive eyes) of 706 consecutive patients with visual impairment due to center-involving DME treated with intravitreal anti-VEGF injections between April 2007 and February 2017 were reviewed. The eyes were divided into mutually exclusive three groups based on the duration of follow-up (12, 24, or 36 months). Primary outcome measures were changes in visual acuity (VA) and central macular thickness (CMT) from baseline to final visit in each cohort, frequency of visits and intravitreal anti-VEGF injections. As secondary endpoints, VA outcomes were assessed in subgroups stratified by baseline VA [<70 ETDRS letters and ≥70 ETDRS letters] and loading dose status of anti-VEGF injections. RESULTS: VA increased by a mean of 8.2 letters (12-month cohort, p < 0.001), 5.3 letters (24-month cohort, p < 0.001), and 4.4 letters (36-month cohort, p = 0.017) at final visits. The eyes with <70 VA letters achieved more significant VA improvement at final visits in all cohorts compared with eyes with >70 VA letters (p < 0.001). The mean decreases in CMT from baseline to last visits at 12-, 24-, and 36- month cohorts were -100.5 µm, -107.7 µm, and -114.3 µm, respectively (p < 0.001). The mean number of injections given were 4.6, 2.3, and 1.8 during years 1 to 3, respectively. Patients who received loading dose showed greater VA gains than those who did not in all follow-up cohorts. CONCLUSION: Our study revealed that anti-VEGF treatment improved VA and CMT over a follow-up of 36 months. Although these real-life VA outcomes following anti-VEGF therapy for DME were similar to other real-life studies, they were inferior to those noted in randomized controlled trials, mainly due to undertreatment.


Asunto(s)
Inhibidores de la Angiogénesis , Diabetes Mellitus , Retinopatía Diabética , Edema Macular , Humanos , Inhibidores de la Angiogénesis/uso terapéutico , Bevacizumab/uso terapéutico , Retinopatía Diabética/complicaciones , Retinopatía Diabética/diagnóstico , Retinopatía Diabética/tratamiento farmacológico , Inyecciones Intravítreas , Edema Macular/diagnóstico , Edema Macular/tratamiento farmacológico , Edema Macular/etiología , Ranibizumab/uso terapéutico , Estudios Retrospectivos , Turquía/epidemiología , Factor A de Crecimiento Endotelial Vascular/antagonistas & inhibidores
5.
Int Ophthalmol ; 38(2): 645-653, 2018 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-28378149

RESUMEN

OBJECTIVE: This study evaluates the effect of axial length and hyperopia error on macular choroidal thickness as well as choroidal vessel lumen diameter and area with EDI-OCT in short eyes. MATERIALS AND METHODS: The study includes 64 volunteers who are over 18 years of ages and applied to Eye Clinic of Ankara Training and Research Hospital. Choroidal thickness, choroidal vessel lumen diameter and areas were measured with Spectralis® OCT device using EDI technique. RESULTS: The study group included 44 volunteers with hyperopic refractive error, and control group included 20 emmetropic volunteers. Macular choroid was statistically significantly thicker in all quadrants as the hyperopia error increased (p < 0.001). There was a statistically significant negative correlation between axial lengths and macular choroidal thicknesses in all quadrants (p < 0.001). There was a statistically significant difference in choroidal vessel lumen diameter and area between hyperopia groups for both large and small vessels (p < 0.01). The relationships between mean axial length and mean large choroidal vessel diameter and mean area measurements were negatively correlated and they were statistically significant. On the other hand, there was no such negative correlation with small choroidal vessels that have small diameter and area. CONCLUSION: Macular choroid thickens as the hyperopic error increases as well as axial length decreases in short eyes. The diameters and areas of noticeable large choroidal vessels in EDI-OCT also increase. These findings in EDI-OCT measurements may play a role in developing population nomograms, as a correcting parameter and in understanding the pathophysiology of certain diseases in short eyes.


Asunto(s)
Coroides/patología , Hiperopía/fisiopatología , Adolescente , Adulto , Anciano , Longitud Axial del Ojo/patología , Coroides/irrigación sanguínea , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tomografía de Coherencia Óptica , Agudeza Visual/fisiología , Adulto Joven
6.
Retina ; 34(1): 32-7, 2014 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-23751943

RESUMEN

PURPOSE: The aim of this study was to determine the effect of posterior vitreous detachment on outcome of anti-vascular endothelial growth factor injection. METHODS: Sixty-one eyes with age-related macular degeneration that had received intravitreal bevacizumab or ranibizumab injections were retrospectively reviewed. The vitreomacular interface was evaluated, and eyes were grouped according to the presence of posterior vitreous detachment (Group 1, n = 25) or vitreomacular adhesion (Group 2, n = 36). All patients received three loading doses of intravitreal anti-vascular endothelial growth factor injections at monthly intervals, and subsequently, pro re nata regimen was performed. Best-corrected visual acuity and central foveal thickness measurement at follow-up were evaluated. The development of posterior vitreous detachment during the follow-up was also reported. RESULTS: The best-corrected visual acuity changes at each visit compared with baseline were significantly better in Group 1 (P = 0.01, 0.02, 0.02, 0.009, 0.009, respectively at third, sixth, ninth, 12th month, and last visit). When best-corrected visual acuity was classified according to the change in visual acuity of 10 letters or more, the rate of improved or stable best-corrected visual acuity was greater in Group 1 (P = 0.02). During the follow-up, 5 eyes (14.3%) developed posterior vitreous detachment. CONCLUSION: Vitreomacular adhesion seems to have an adverse effect on the visual prognosis of anti-vascular endothelial growth factor treatment for age-related macular degeneration.


Asunto(s)
Inhibidores de la Angiogénesis/uso terapéutico , Factor A de Crecimiento Endotelial Vascular/antagonistas & inhibidores , Desprendimiento del Vítreo/fisiopatología , Degeneración Macular Húmeda/tratamiento farmacológico , Anciano , Anticuerpos Monoclonales Humanizados/uso terapéutico , Bevacizumab , Femenino , Estudios de Seguimiento , Humanos , Inyecciones Intravítreas , Masculino , Pronóstico , Ranibizumab , Retina/patología , Estudios Retrospectivos , Tomografía de Coherencia Óptica , Agudeza Visual/fisiología , Degeneración Macular Húmeda/fisiopatología
7.
Eye Contact Lens ; 39(4): e25-7, 2013 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-23001020

RESUMEN

PURPOSE: To report a patient of lipoid proteinosis (LP) with bilateral keratoconus. METHODS: A 16-year-old boy presented to our institution with a complaint of gradual decrease in vision over the past 4 years in both eyes and a contact lens intolerance. He had a hoarse voice and multiple areas of hyperpigmented lesions over the head and neck region. Slit lamp biomicroscopy of the both eyes showed multiple round solid pearly lesions along the upper and lower lid margins and a mild central corneal ectasia in both eyes. Central corneal thickness and the keratometric values were measured by using Scheimpflug imaging (Pentacam), and the results were compatible with keratoconus. The histopathologic examination of the lesions taken from bilateral eyelid margins showed hyalinosis, papillomatosis, and depositions of eosinophilic material around the blood vessels, which were compatible with LP. CONCLUSIONS: With this report, we describe a case of LP with keratoconus. As seen in our case, LP and its characteristic eyelid margin lesions in keratoconus patients can be associated with a contact lens intolerance.


Asunto(s)
Queratocono/patología , Proteinosis Lipoidea de Urbach y Wiethe/patología , Adolescente , Lentes de Contacto , Humanos , Masculino
8.
Int J Ophthalmol ; 16(9): 1503-1511, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37724284

RESUMEN

AIM: To evaluate the retinochoroidal microvascular circulation and anatomical structure of diabetic and non-diabetic patients with epiretinal membrane (ERM) with the help of optical coherence tomography angiography (OCT-A) and compare them with healthy control subjects. METHODS: In this prospective, cross-sectional study, a total of 165 eyes were evaluated, including 50 eyes of patients with diabetic ERM, 54 eyes of idiopathic ERM (iERM) patients, and 61 eyes of healthy controls. Macula and disc angiography was performed by OCT-A. Macular vessel density (VD) ratio was evaluated by dividing the VD of the foveal region by the VD of the parafoveal region. Statistical calculations were evaluated at the 95% confidence interval. RESULTS: Macula superficial VD values of ERM cases were lower than that in the control group, while foveal VD was higher in ERM cases. Macula deep VD values of ERM cases were lower in all quadrants, except the fovea. The width of the foveal avascular zone (FAZ) area was significantly lower in the ERM groups, and the FAZ width was lowest in iERM group. Macula superficial VD ratio was significantly higher in the ERM groups, but there was no significant difference between ERM groups. Macula deep VD ratio was significantly higher in the iERM group than in the control group. CONCLUSION: Diabetic and idiopathic ERMs differ in their mechanism of formation and clinical presentation, as well as their effect on retinal vascular structures. If the relationship of increase of retinal thickness with vascular integrity can be demonstrated with OCT-A, then, OCT-A can be used as a guide for ERM prognosis.

9.
Eur J Ophthalmol ; 33(1): 398-407, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-35924358

RESUMEN

PURPOSE: To provide consensus on the clinical use of intravitreal dexamethasone (DEX) implant for the treatment of diabetic macular edema (DME) in Turkey. METHODS: A panel of 22 retina experts prepared 77 statements of recommendation, and 80 retinal specialists practicing in Turkey were chosen to vote either in support or against each one. A Delphi-based method was used through which the ophthalmologists were able to view all of the results anonymously after two rounds and modify their subsequent answers. The survey was conducted via a mini website, and statements without consensus were resent to the specialists with the latest vote results a week later. RESULTS: A total of 72 ophthalmologists answered the first and second round questions. After the first stage, consensus was achieved on 55 of the statements, leaving 22 without agreement. After the second stage, consensus was reached on 11 of the remaining statements. Strong consensus was achieved on statements regarding the etiopathogenesis of DME and the first-line indications and safety of the DEX implant procedure. The panel recommended the use of DEX implant for patients with an arterial thromboembolic event in the last three months and also agreed that pro re nata DEX implant treatment not only provides better outcomes for DME patients but also reduces the treatment burden for those who could not receive an adequate number of anti-vascular endothelial growth factor (VEGF) injections. CONCLUSION: This study provides clinical consensus and recommendations about the use of DEX implant in the clinical practice of DME management in Turkey.


Asunto(s)
Diabetes Mellitus , Retinopatía Diabética , Edema Macular , Humanos , Edema Macular/diagnóstico , Edema Macular/tratamiento farmacológico , Edema Macular/etiología , Dexametasona , Inhibidores de la Angiogénesis/uso terapéutico , Técnica Delphi , Turquía , Factor A de Crecimiento Endotelial Vascular , Implantes de Medicamentos/uso terapéutico , Inyecciones Intravítreas , Glucocorticoides , Resultado del Tratamiento , Diabetes Mellitus/tratamiento farmacológico
10.
Beyoglu Eye J ; 7(1): 39-46, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35265801

RESUMEN

Objectives: To assess multifocal electroretinogram (mf-ERG) values in patients with diabetic macular edema (DME) who were treated with intravitreal ranibizumab (IVR). Methods: Thirty eyes of patients with DME, who underwent three consecutive monthly injections of IVR and as required thereafter, were evaluated. Best corrected visual acuity (BCVA) (log MAR), optical coherence tomography (OCT) features [diameters of cyst and subretinal fluid, hyperreflective dots (HRDs)], and mf-ERG were evaluated at baseline, 1 month, and 6 months throughout the follow-up period. The correlation of mf-ERG values and OCT features, BCVA, and the duration of disease were investigated. Results: In the study group, the baseline P1 and N1 amplitudes were significantly lower than the control group, and P1 and N1 implicit times were significantly higher in patients with DME than in the control group in all rings (All p<0.05) The mean response density (P1 amplitude, nV/deg2) values increased over 6 months in rings 1, 2, and 3 (p<0.001, p=0.003, p=0.006). There was a negative correlation between the diameter of the cyst and the initial response density of P1 (for horizontal diameter: r=-0.658, p=0.03; for vertical diameter: r=-0.597, p=0.037; for the area of the cyst, r=-0.603, p=0.021). There was a significant negative correlation between the subretinal fluid and HRD reduction and the response density of P1 increase (all p<0.05). At baseline and 6 months, the correlation between BCVA and the P1 and N1 amplitude of the central ring was significant (for baseline P1: r=-0.649, p=0.01; for N1: r=-0.575, p=0.02; for 6-month P1, r=-0.603, p<0.001; for N1: r=-0.591, p=0.005). Conclusion: The combination of OCT and mf-ERG can be used to evaluate the functional recovery in DME.

11.
Artículo en Inglés | MEDLINE | ID: mdl-20128557

RESUMEN

Takayasu's, or "pulseless," disease is a rare, idiopathic, chronic granulomatous vasculitis that affects large arterial blood vessels. Ocular manifestations occur as a consequence of obliteration of the carotid artery, and ocular ischemia may develop. A 14-year-old girl with progressive visual loss and ocular ischemic syndrome secondary to Takayasu's disease is described.


Asunto(s)
Catarata/etiología , Ojo/irrigación sanguínea , Isquemia/etiología , Enfermedades de la Retina/etiología , Arteritis de Takayasu/complicaciones , Adolescente , Catarata/diagnóstico , Diagnóstico Diferencial , Progresión de la Enfermedad , Femenino , Angiografía con Fluoresceína , Estudios de Seguimiento , Fondo de Ojo , Humanos , Isquemia/diagnóstico , Angiografía por Resonancia Magnética , Enfermedades de la Retina/diagnóstico , Arteritis de Takayasu/diagnóstico , Factores de Tiempo
12.
Acta Cytol ; 52(3): 309-12, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-18540295

RESUMEN

OBJECTIVE: To assess ocular surface changes in patients with chronic renal failure (CRF), to compare the results with the duration of illness. STUDY DESIGN: Impression cytology from 48 patients with CRF on regular hemodialysis and 16 age- and sex-matched control subjects were studied. Specimens were taken from the temporal bulbar conjunctiva using cellulose acetate filter paper. RESULTS: Among the patients with CRF who were ill for 0-10 years, 25 patients (78.1%) disclosed grade 0-1, and 7 patients (21.9%) disclosed grade 2-3 cytologic changes, whereas in those with the duration of CRF > 10 years, 9 patients (56.2%) had grade 0-1 and 7 patients (43.8%) had grade 2-3 changes. Specimens from the control group revealed 93.8% grade 0-1 and 6.2% grade 2-3 changes (p < 0.05). CONCLUSION: The ocular surfaces of patients with CRF differ significantly from those of normal individuals, and the severity of conjunctival changes is related to the duration of CRF.


Asunto(s)
Conjuntiva/patología , Células Epiteliales/patología , Fallo Renal Crónico/patología , Adulto , Núcleo Celular/patología , Citoplasma/patología , Femenino , Células Caliciformes/patología , Humanos , Fallo Renal Crónico/complicaciones , Masculino , Metaplasia , Persona de Mediana Edad , Factores de Riesgo , Factores de Tiempo
13.
J Binocul Vis Ocul Motil ; 68(2): 54-58, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30196757

RESUMEN

INTRODUCTION AND PURPOSE: To investigate the role that dynamic retinoscopy can play in reducing the occurrence of infantile accommodative esotropia and facilitating emmetropization in infants with high hyperopia. PATIENTS AND METHODS: 211 orthotropic infants under 1 year of age (3.5 to 12 months) identified as having ≥5 diopters of hyperopia in their more hyperopic eye on a routine eye exam. On enrollment, infants underwent an assessment of accommodation using dynamic retinoscopy as well as a cycloplegic refraction. Infants who showed normal accommodation were followed without spectacles. If dynamic retinoscopy showed subnormal accommodation, partial hyperopic correction that allowed for full binocular accommodative responses at near were prescribed. Main outcome measures were the occurrence of esotropia, changes in refractive error, and visual acuity. RESULTS: Of the 211 infants enrolled, 146 showed normal accommodation and were followed without glasses (Group 1). None of these patients developed strabismus. Sixty-five patients showed subnormal accommodation and received partial hyperopic correction (Group 2). Thirty-four of the 65 (52%) in Group 2 did not develop strabismus (Group 2A) and 31 of the 65 (48%) developed strabismus (Group 2B). All 3 groups showed a reduction of hyperopia of 0.37D ± 0.25/year, 0.50D ± 0.28/year, and 0.60D ± 0.20/year in groups 1, 2A, and 2B, respectively. None of the differences between groups were statistically significant. CONCLUSIONS: Normal accommodation on dynamic retinoscopy in orthotropic hyperopic infants is a predictor of continued good alignment and such infants can be followed without spectacles. Partial spectacle correction based on dynamic retinoscopy may have a beneficial effect on reducing the development of strabismus without impeding emmetropization. Early binocular accommodative behavior seems to be predictive of infants at risk of developing strabismus.


Asunto(s)
Acomodación Ocular/fisiología , Emetropía/fisiología , Esotropía/diagnóstico , Retinoscopía/métodos , Preescolar , Esotropía/fisiopatología , Enfermedades Hereditarias del Ojo/fisiopatología , Femenino , Estudios de Seguimiento , Humanos , Hiperopía/fisiopatología , Lactante , Masculino , Refracción Ocular/fisiología , Visión Binocular/fisiología , Agudeza Visual/fisiología
14.
Turk J Ophthalmol ; 47(3): 156-160, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28630791

RESUMEN

Diabetic macular edema is the most common cause of visual impairment in patients with diabetes mellitus. The pathogenesis of macular edema is complex and multifactorial. For many years, laser photocoagulation has been considered the standard therapy for the treatment of diabetic macular edema; however, few patients achieve significant improvements in visual acuity. Today the intravitreal administration of anti-inflammatory or anti-angiogenic agents together with the use of laser photocoagulation represents the standard of care for the treatment of this complication. The intravitreal route of administration minimizes the systemic side effects of corticosteroids. Steroid-related ocular side effects are elevated intraocular pressure and cataract, while injection-related complications include endophthalmitis, vitreous hemorrhage, and retinal detachment. In order to reduce the risks and complications, intravitreal implants have been developed recently to provide sustained release of corticosteroids and reduce repeated injections for the management of diabetic macular edema. In this review, the efficacy, safety, and therapeutic potential of intravitreal corticosteroids in diabetic macular edema are discussed with a review of recent literature.

15.
J Ophthalmol ; 2017: 8597629, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28392940

RESUMEN

Purpose. To assess the different check sizes of pattern visual evoked potential (PVEP) in diabetic patients without retinopathy according to HbA1c levels and diabetes duration. Methods. Fifty-eight eligible patients with type 2 diabetes mellitus and 26 age- and sex-matched healthy controls were included in the study. Only the right eye of each patient was analyzed. All of the patients underwent a comprehensive ophthalmic examination, and the PVEPs were recorded. Results. There was a statistically significant difference in P100 latency in 1-degree check size and in N135 latency in 2-degree check size between controls and patient groups which have different HbA1c levels. There were statistically significant, positive, and weak correlations with diabetes duration and P100 latency in 7-minute and 15-minute check sizes and N135 latency in 15-minute check size. Conclusions. It was showed that there were prolongations in P100 latency only in 1-degree check size and in N135 only in 2-degree check size in diabetic patients without retinopathy. There was statistically significant correlation between diabetes duration and P100 and N135 latencies in different check sizes.

16.
Eur J Ophthalmol ; 26(4): 303-6, 2016 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-26659019

RESUMEN

PURPOSE: To describe and compare ocular surface changes in patients with type 2 diabetes treated with either oral antidiabetic drugs (OAD) or insulin. METHODS: Forty eyes of 20 patients treated with OAD, 40 eyes of 20 patients treated with insulin, and 10 nondiabetic controls seen at Ministry of Health Ankara Educational and Research Hospital, 1st Eye Clinic, were studied. All subjects underwent routine ophthalmic examinations, Schirmer test, tear film break-up time analysis, and conjunctival impression cytologic analysis. Patients treated with OAD or insulin and a control group were compared for tear function parameters, goblet cell density, and squamous metaplasia grade. The relation between status of retinopathy and ocular surface disorder and serum HbA1c levels of diabetic patients were also noted. RESULTS: The tear film break-up time values were significantly lower in patients treated with OAD (p<0.05). There was no statistically significant difference in Schirmer test results of the 3 groups. Goblet cell density and squamous metaplasia grade were similar in all groups. The median grade was grade 1, in which epithelial cells are slightly larger, more polygonal, have eosinophilic staining cytoplasm, and goblet cells are decreased in number. Status of retinopathy did not seem to relate to ocular surface disorder. The serum HbA1c level of diabetic patients treated with insulin or OAD was similar (p>0.05). CONCLUSIONS: Precorneal tear film stability was worse in patients treated with OAD; however, impression cytology analysis and Schirmer test results were similar in all groups.


Asunto(s)
Conjuntiva/efectos de los fármacos , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Células Epiteliales/efectos de los fármacos , Células Caliciformes/efectos de los fármacos , Hipoglucemiantes/uso terapéutico , Insulina/uso terapéutico , Administración Oral , Adulto , Anciano , Recuento de Células , Femenino , Hemoglobina Glucada/metabolismo , Humanos , Masculino , Metaplasia , Persona de Mediana Edad , Coloración y Etiquetado , Lágrimas/metabolismo
17.
Can J Ophthalmol ; 51(5): 331-335, 2016 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-27769322

RESUMEN

OBJECTIVE: This study aimed to evaluate the anatomical and functional outcomes of secondary pars plana vitrectomy (PPV) after failed scleral buckling (SB) surgery and to compare it with primary PPV for rhegmatogenous retinal detachment (RRD), including complicated proliferative vitreoretinopathy cases. DESIGN: Retrospective series in a tertiary care centre. PARTICIPANTS: One hundred and twenty consecutive patients. METHODS: The medical records of patients who underwent PPV with silicone oil tamponade for RRD were reviewed. Forty-four eyes were operated on for primary RRD (primary PPV group), and 76 eyes were operated on for failed SB surgery (secondary PPV group). The single-operation anatomical success rate, final anatomical success rate, and best-corrected visual acuity preoperatively, at 6 months, at 1 year, and at final follow-up were analyzed. RESULTS: The single-operation anatomical success rate was 74.2% in the primary PPV group and 77% in the secondary PPV group (p = 0.48). The final anatomical success rate was 90.3% in the primary PPV group and 91.8% in the secondary PPV group (p = 0.55). The number of cases with visual acuities of 3 visual categories (20/50 or better, 20/200 to 20/50, less than 20/200) was not statistically different at each time point. CONCLUSIONS: Consequent PPV with silicone oil tamponade for failed SB surgery seems not to have inferior anatomical and functional outcomes when compared with primary PPV for RRD.


Asunto(s)
Endotaponamiento , Desprendimiento de Retina/cirugía , Curvatura de la Esclerótica , Aceites de Silicona/administración & dosificación , Vitrectomía/métodos , Vitreorretinopatía Proliferativa/cirugía , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias , Recurrencia , Desprendimiento de Retina/fisiopatología , Estudios Retrospectivos , Insuficiencia del Tratamiento , Resultado del Tratamiento , Agudeza Visual/fisiología , Vitreorretinopatía Proliferativa/fisiopatología
18.
Cornea ; 24(2): 221-3, 2005 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-15725892

RESUMEN

PURPOSE: To report a case of cystoid macular edema (CME) in iridocorneal endothelial syndrome. METHODS: Case report. RESULTS: The authors describe the clinical history and ocular examination of a 38-year-old woman with iridocorneal endothelial syndrome and CME. This association has never been reported before. The mechanism of CME is unknown. CONCLUSION: CME may cause visual deterioration in iridocorneal endothelial syndrome. We emphasize the importance of posterior segment examination in these cases.


Asunto(s)
Enfermedades de la Córnea/complicaciones , Endotelio Corneal/patología , Enfermedades del Iris/complicaciones , Edema Macular/complicaciones , Prednisolona/análogos & derivados , Adulto , Antiinflamatorios no Esteroideos , Enfermedades de la Córnea/diagnóstico , Quimioterapia Combinada , Femenino , Angiografía con Fluoresceína , Glucocorticoides/uso terapéutico , Humanos , Enfermedades del Iris/diagnóstico , Ketorolaco Trometamina/uso terapéutico , Edema Macular/diagnóstico , Prednisolona/uso terapéutico , Síndrome , Trastornos de la Visión/etiología , Agudeza Visual
19.
Ophthalmic Surg Lasers Imaging ; 34(3): 223-5, 2003.
Artículo en Inglés | MEDLINE | ID: mdl-12757100

RESUMEN

A patient with intrusion of a scleral sponge implant after retinal reattachment surgery is described. Retinal incarceration occurred during primary retinal reattachment surgery and the patient underwent additional cryopexy and radial sponge implant. However, the retina remained detached and pars plana vitrectomy was performed with silicone oil endotamponade to reattach the retina. The interval between placement of the sderal buckle and development of intrusion was 3 months. The buckle was sutured to the sclera with mattress sutures. During the postoperative follow-up period, the intraocular pressure was elevated and controlled with topical antiglaucomatous medication. The encircling band was cut but left in place to avoid perforation, and the retina remained attached. Intrusion of a buckle after retinal reattachment surgery is a rare complication that usually does not require surgical intervention. Cutting the silicone band without removing it may be a treatment option.


Asunto(s)
Migración de Cuerpo Extraño/etiología , Complicaciones Posoperatorias , Prótesis e Implantes/efectos adversos , Desprendimiento de Retina/cirugía , Curvatura de la Esclerótica/efectos adversos , Adulto , Criocirugía , Humanos , Presión Intraocular , Masculino , Reoperación , Elastómeros de Silicona , Aceites de Silicona/administración & dosificación , Suturas , Agudeza Visual , Vitrectomía
20.
J Cataract Refract Surg ; 39(7): 1002-7, 2013 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-23692885

RESUMEN

PURPOSE: To assess the results of phacoemulsification and posterior chamber intraocular lens (PC IOL) implantation in patients with cataract secondary to anterior uveitis. SETTING: Department of Ophthalmology, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey. DESIGN: Case series. METHOD: Consecutive patients with anterior uveitis and cataract were prospectively studied for outcomes after phacoemulsification and PC IOL implantation. RESULTS: Fifty-five eyes (48 patients; mean age 44.9 years ± 15.6 [SD]) were included. Patients were followed for 6 months. The etiology of uveitis was presumed idiopathic anterior uveitis (n = 22), herpes simplex virus-associated anterior uveitis (n = 10), Fuchs heterochromic iridocyclitis (n = 10), and anterior uveitis associated with collagen vascular disease (n = 13). Preoperative complications secondary to uveitis included posterior synechiae (12 eyes), glaucoma (26 eyes), and sequelae of cystoid macular edema (CME) (21 eyes). At the final visit, the corrected distance visual acuity (CDVA) was 20/40 or better in 52 eyes (94.5%) and 20/20 in 33 eyes (60.0%). The CDVA was worse than 20/40 in 3 eyes because of preoperative anterior and posterior segment abnormalities. Postoperative complications were CME, recurrent uveitis, and posterior capsule opacity in 7 eyes (12.7%) each; fibrinous anterior chamber reaction in 6 eyes (10.9%); raised intraocular pressure in 4 eyes; peripheral anterior synechiae in 1 eye (1.8%); and hypotony in 1 eye (1.8%). CONCLUSION: Patients with a history of anterior uveitis and cataract having phacoemulsification with PC IOL implantation had excellent visual results with a relatively low complication rate. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.


Asunto(s)
Catarata/etiología , Implantación de Lentes Intraoculares , Facoemulsificación , Uveítis Anterior/complicaciones , Adulto , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Seudofaquia/fisiopatología , Resultado del Tratamiento , Uveítis Anterior/fisiopatología , Agudeza Visual/fisiología , Adulto Joven
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