Incidence and visual outcome of acute endophthalmitis after cataract surgery--the experience of an eye department in Scotland.

AIM: Endophthalmitis remains one of the most dreaded complications of modern cataract surgery. Its incidence in the UK has been estimated but accurate published data on the incidence at a regional level are scarce. This audit examines the incidence and visual outcome of endophthalmitis from a single eye department in Scotland (UK) over a 7-year period. Findings are compared with those from other series. METHODS: A retrospective consecutive audit of all cases of acute endophthalmitis treated between 1 January 2000 and 31 December 2006 at the Southern General Hospital in Glasgow (Scotland, UK) was undertaken. Details of each case (presentation, treatment and outcome of endophthalmitis) were recorded. Cross-tabulations were performed to identify prognostic factors of visual outcome. RESULTS: Twenty-five patients were treated for endophthalmitis over the audit period. The incidence of endophthalmitis was 0.20% (95% CI 0.10 to 0.30%). There were 12 (48%) culture-positive cases with coagulase-negative staphylococcus accounting for 58%. After treatment, 16 patients (64%) achieved driving-standard vision or better. Poor vision at presentation and streptococcal endophthalmitis were associated with poor visual outcome. CONCLUSION: The incidence of endophthalmitis in this series is comparable to larger studies, suggesting that accepted benchmarks, despite being estimates, reflect UK practice. Visual outcome, with treatment, can be favourable in a significant proportion of patients.

Predicting impairment of central vision from dimensions of the optic chiasm in patients with pituitary adenoma.

AIM: To study a possible relationship between dimensions of the optic chiasm and extent of visual field impairment in patients with pituitary adenoma. METHODS: Pre-operative magnetic resonance (MR) scans and Goldmann perimetry charts of patients having undergone resection of a pituitary adenoma were retrieved. Area of the chiasm (A (chiasm)), central height of the chiasm (H (chiasm)), and perpendicular height of tumour (H (tumour)) were measured on coronal images using standard software. Visual fields were quantified by subdividing the central 30 degrees of vision into 72 subunits each bounded by 15 degree meridians and 10 degree isoptres. RESULTS: Nineteen patients were included in this study. There was a strong statistically significant linear correlation between H (chiasm) and bitemporal (Pearson's coefficient r = -0.69, p = 0.001), binocular (r = -0.63, p = 0.004) and binasal (r = -0.52, p = 0.01) central field loss. A similar relationship was observed between H (tumour) and bitemporal (r = 0.55, p = 0.015) and binocular (r = 0.46, p = 0.05) central field loss. CONCLUSION: Height of the chiasm and height of the tumour can be used to predict extent of central visual impairment.

The prevalence of simple renal and hepatic cysts detected by spiral computed tomography.

AIM: To provide a definitive evaluation of the prevalence of simple renal and hepatic cysts using spiral computed tomography (CT). PATIENTS AND METHODS: Contrast-enhanced abdominal CT studies from 617 patients (295 women, 322 men) attending for investigations unrelated to renal or hepatic pathology were included. The number of renal cysts, their location and the diameter of the largest cyst were recorded. Hepatic cysts were recorded as being either present or absent. RESULTS: Two hundred and fifty-four patients (41%) were found to have simple renal cysts and 110 patients were found to have simple hepatic cysts (18%). Both renal and hepatic cysts became more common with age. Renal cysts were significantly more common at all ages in men (p=0.001), and increased in both size (p=0.02) and number (p<0.05) with age. CONCLUSION: A major discrepancy has, until now, existed between autopsy prevalence of renal cysts and prevalence as reported by in-vivo third-generation CT or sonography studies. Using newer spiral CT machines, we have generated prevalence data closer to post-mortem findings. We have also shown a significant, but age dependent, association between the presence of simple hepatic and simple renal cysts (p=0.001)