RESUMO
PURPOSE: To assess whether smoking status affects 1-year visual outcomes in eyes treated with vascular endothelial growth factor inhibitors for neovascular age-related macular degeneration. METHODS: Retrospective analysis of data from a prospectively designed, multicenter, observational database. Nine hundred and eighty seven treatment-naive eyes of patients with neovascular age-related macular degeneration were tracked by the Fight Retinal Blindness! outcome registry in Australia, New Zealand, Singapore, and Switzerland who had documented smoking status at baseline and commenced vascular endothelial growth factor inhibitor therapy from January 2006 to December 2016. Generalized additive models were used to display visual acuity results. RESULTS: There was a significant difference in mean improvement in visual acuity at 12 months between nonsmokers, ex-smokers, and current smokers (7.7 vs. 6.1 vs. 3.5 letters of change; P = 0.046) among patients who completed 12 months of treatment when adjusted for age, baseline visual acuity, and choroidal neovascular membrane lesion type and nested for practice. There was no significant difference in the median number of injections over 12 months of treatment by smoking status. Current smokers were a mean of 6.2 years younger than nonsmokers when they started treatment (P < 0.001). CONCLUSION: This study found inferior 12-month visual outcomes in patients who continued to smoke while receiving vascular endothelial growth factor inhibitor therapy for neovascular age-related macular degeneration.
Assuntos
Inibidores da Angiogênese/uso terapêutico , Neovascularização de Coroide/tratamento farmacológico , Fumar/efeitos adversos , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Degeneração Macular Exsudativa/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Bevacizumab/uso terapêutico , Neovascularização de Coroide/fisiopatologia , Bases de Dados Factuais , Feminino , Seguimentos , Humanos , Injeções Intravítreas , Masculino , Ranibizumab/uso terapêutico , Receptores de Fatores de Crescimento do Endotélio Vascular/uso terapêutico , Proteínas Recombinantes de Fusão/uso terapêutico , Sistema de Registros , Estudos Retrospectivos , Fumar/fisiopatologia , Resultado do Tratamento , Transtornos da Visão/etiologia , Acuidade Visual/fisiologia , Degeneração Macular Exsudativa/fisiopatologiaRESUMO
Abnormal fluctuations in anterior chamber (AC) depth including deepening and mydriasis with paradoxical shallowing and miosis have been described during phacoemulsification cataract surgery in previously vitrectomized eyes. Contributory factors include zonular laxity and reduction of vitreous volume. This report describes a technique to stabilize AC depth and allow safer sculpting and removal of lens matter.
Assuntos
Câmara Anterior/patologia , Complicações Intraoperatórias/prevenção & controle , Facoemulsificação/métodos , Vitrectomia , Drenagem/instrumentação , Humanos , Facoemulsificação/efeitos adversos , Irrigação Terapêutica/instrumentaçãoRESUMO
Campaigns to reduce road traffic accidents have paid little attention to the way headgear could interfere with vision. Binocular visual field measurement was undertaken in six healthy volunteers wearing four different types of anorak. All four anoraks greatly reduced the horizontal and superior field of vision. The anorak producing the worst reduction resulted in a width of vision of 99 degrees and only 15 degrees of vision above eye level, versus 167 degrees and 52 degrees respectively without an anorak. Anorak wearers should turn their heads to look sideways before crossing the road.