Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 23.004
Filtrar
1.
Indian J Ophthalmol ; 69(4): 987-989, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33727474

RESUMEN

A 42-year-old male patient presented with profound impairment of vision in both eyes, just as he was recovering from COVID-19. A known diabetic and hypertensive, he suffered from COVID-19 pneumonia further complicated by ARDS, septicaemia and acute kidney injury. His vision on presentation was finger counting close to face bilaterally with multiple, yellowish lesions at the posterior pole. Based on the clinical findings and previous blood culture report, it was diagnosed as candida retinitis and treated with oral and intravitreal anti-fungals. The lesions were regressing at follow-up. This is a post COVID-19 presumed candida retinitis case report.


Asunto(s)
/diagnóstico , Candidiasis/diagnóstico , Infecciones Fúngicas del Ojo/diagnóstico , Infecciones Oportunistas/diagnóstico , Retinitis/diagnóstico , Administración Oral , Adulto , Antifúngicos/uso terapéutico , Candidiasis/tratamiento farmacológico , Candidiasis/microbiología , Infecciones Fúngicas del Ojo/tratamiento farmacológico , Infecciones Fúngicas del Ojo/microbiología , Fluconazol/uso terapéutico , Humanos , Inyecciones Intravítreas , Masculino , Infecciones Oportunistas/tratamiento farmacológico , Infecciones Oportunistas/microbiología , Retinitis/tratamiento farmacológico , Retinitis/microbiología , Tomografía de Coherencia Óptica , Agudeza Visual/fisiología , Voriconazol/uso terapéutico
2.
Eur J Endocrinol ; 184(2): 277-287, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33539318

RESUMEN

Background: Tripterygium glycosides (TG) has been used to treat a spectrum of inflammatory and autoimmune diseases. Our preliminary studies have shown that TG is effective in the treatment of active Graves' ophthalmopathy (GO). Objective: We aimed to compare the efficacy and tolerability of TG with intravenous methylprednisolone (iv.MP) in patients with active moderate-to-severe GO. Methods: This study was an observer-masked, single-centre, block-randomised trial. Patients with active moderate-to-severe GO were randomly assigned to receive iv.MP (500 mg once per week for 6 weeks followed by 250 mg per week for 6 weeks) or with TG (20 mg tablet three times per day for 24 weeks). The primary endpoints were the overall response rate and the patients' quality of life at 12 and 24 weeks. Results: In this study, 161 patients were enrolled and randomised from 2015 to 2019. A total of 79 were randomly assigned to receive iv.MP and 82 to receive TG. A greater overall response rate was found in the TG group compared with the iv.MP group at week 24 (90.2% vs 68.4%, P = 0.000). Similarly, the patients' quality of life of the TG group showed a significantly higher response than the iv.MP group at week 24 (89.02% vs 72.15%, P = 0.001). The TG therapy showed a better CAS response than the iv.MP (91.5% vs 70.9% improved, P < 0.05), and up to 91.2% of patients were inactive. Also, the TG group showed a significantly higher improved rate of diplopia, proptosis, visual acuity, soft tissue involved and the decrease of eye muscle motility than the iv.MP group at week 24. Significantly more patients in the iv.MP group than the TG group experienced adverse events. Conclusion: Compared with iv.MP treatment, TG therapy is more effective and safer for patients with active moderate to severe GO.


Asunto(s)
Glicósidos/uso terapéutico , Oftalmopatía de Graves/tratamiento farmacológico , Extractos Vegetales/uso terapéutico , Tripterygium , Administración Intravenosa , Adulto , Antitiroideos/uso terapéutico , Diplopía/fisiopatología , Exoftalmia/fisiopatología , Dolor Ocular/fisiopatología , Femenino , Glucocorticoides/uso terapéutico , Enfermedad de Graves/tratamiento farmacológico , Oftalmopatía de Graves/fisiopatología , Humanos , Hipotiroidismo/tratamiento farmacológico , Masculino , Metilprednisolona/uso terapéutico , Persona de Mediana Edad , Músculos Oculomotores/fisiopatología , Índice de Severidad de la Enfermedad , Método Simple Ciego , Tiroxina/uso terapéutico , Resultado del Tratamiento , Agudeza Visual/fisiología
3.
Can J Ophthalmol ; 56(2): 88-95, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33444561

RESUMEN

OBJECTIVE: To describe the impact of the coronavirus disease 2019 (COVID-19) pandemic on the characteristics of retinal detachments (RD) at a tertiary centre. DESIGN: Retrospective consecutive case series. PARTICIPANTS: One hundred and ninety eyes of 188 patients with primary, rhegmatogenous RD. METHODS: Patients with RD who presented over a 1-year period (September 14, 2019 to September 13, 2020). The relationship between demographic, anatomic, and visual acuity parameters were compared before and after onset of the pandemic using generalized estimating equations. MAIN OUTCOME MEASURES: Macular status and corrected distance visual acuity on presentation. RESULTS: One hundred and eighty-seven eyes, divided into 2 cohorts: pre-COVID (n = 100 September 14, 2019 to March 13, 2020) and post-COVID (n = 87, March 14, 2020 to September 13, 2020). Of the eyes, 63.2% (n = 87) presented with macular detachment in the post-COVID group compared with 45% (n = 100) in the pre-COVID group (odds ration [OR], 2.14; 95% confidence interval [CI],1.19-3.86; p = 0.011). As well, eyes in the pre-pandemic cohort had significantly fewer detached quadrants on initial examination (OR, 0.53; 95% CI, 0.30-0.93; p = 0.026). Patients in the post-COVID group had a significantly worse corrected distance visual acuity at baseline (mean difference [MD] = -0.35 logMAR, 95% CI, -0.60 to -0.09; p = 0.008), but not at 1 month or at final follow-up. No differences were seen between groups with respect to demographics, lens status, treatment, time to presentation, or chronicity. Pneumatic retinopexy was the most commonly performed procedure in both cohorts, with a 71.5% success rate. CONCLUSIONS: Closures after the COVID-19 pandemic affected the characteristics of RDs at presentation with respect to macular detachment, extent of RD, and presenting visual acuity. At final follow-up, final visual acuity and anatomic outcomes were similar between the 2 groups. These data are helpful for future patient education, triaging, and treatment decision making.


Asunto(s)
/epidemiología , Desprendimiento de Retina/epidemiología , Adulto , Anciano , Crioterapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ontario/epidemiología , Desprendimiento de Retina/fisiopatología , Desprendimiento de Retina/cirugía , Estudios Retrospectivos , Curvatura de la Esclerótica/métodos , Agudeza Visual/fisiología , Vitrectomía
5.
Curr Opin Ophthalmol ; 32(Suppl 2): S1-S11, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33332882

RESUMEN

PURPOSE OF REVIEW: Fitting rigid gas permeable contact lenses (RGP CLs) in keratoconic patients is the most common visual rehabilitation option to improve patients' quality of life, but require long patient and practitioner chair time. The purpose of this review is to provide evidence-based clinical practice guidelines (CPG) in the management of patients with keratoconus with RGP CLs. RECENT FINDINGS: An extensive literature review from 1990 to 2017 identified 354 potentially relevant publications. Fifty-two articles were reviewed and included in the CPG. An international expert panel of eight contact lens practitioners, with vast experience in keratoconus management reviewed and appraised the CPG following the Appraisal of Guidelines for Research and Evaluation II consortium requirements. The developed CPG clearly outlines a strategy for the successful fitting of RGP CLs in patients with keratoconus. This includes how to calculate parameters of the first diagnostic lens, criteria for assessing good fit and a standardized schedule of wear time and follow-up appointments. SUMMARY: The current evidence and consensus-based CPG helps guide clinicians in a successful strategy for fitting RGP CLs in patients with keratoconus.


Asunto(s)
Lentes de Contacto , Queratocono/terapia , Guías de Práctica Clínica como Asunto , Consenso , Medicina Basada en la Evidencia , Humanos , Queratocono/fisiopatología , Queratocono/psicología , Ajuste de Prótesis , Calidad de Vida/psicología , Trastornos de la Visión/rehabilitación , Agudeza Visual/fisiología , Personas con Daño Visual/rehabilitación
6.
Curr Opin Ophthalmol ; 32(1): 54-61, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33122488

RESUMEN

PURPOSE OF REVIEW: Advances in cataract surgery have allowed surgeons to achieve superior refractive outcomes but have also led to higher patient expectations. Despite ever-evolving technology, residual refractive errors still occur. Postcataract refractive enhancements may be required to deliver satisfactory visual outcomes. This review aims to discuss the potential causes of residual refractive errors and the various enhancement modalities to correct them. RECENT FINDINGS: A thorough preoperative workup to detect and address underlying pathologic causes of impaired vision should be performed prior to enhancement or corrective procedures. Corneal-based procedures are the safest and most accurate methods of correcting mild cases of residual refractive error. Hyperopic, high myopic, and high astigmatic errors are best managed with lens-based enhancements. Piggyback intraocular lenses (IOLs) are safer and more effective compared with IOL exchange. Toric IOL rotation and IOL exchange are ideally performed in the early postoperative period. SUMMARY: A multitude of options exist for effective correction of residual refractive errors. The choice on how to best manage these patients depends on many factors such as the cause of refractive error, type of IOL used, ocular comorbidities, and patient preference.


Asunto(s)
Facoemulsificación/efectos adversos , Errores de Refracción/etiología , Errores de Refracción/terapia , Procedimientos Quirúrgicos Refractivos , Humanos , Implantación de Lentes Intraoculares , Refracción Ocular/fisiología , Errores de Refracción/fisiopatología , Agudeza Visual/fisiología
7.
Curr Opin Ophthalmol ; 32(1): 45-53, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33122489

RESUMEN

PURPOSE OF REVIEW: Corneal refractive surgery has achieved spectacle-free vision for millions of patients, but this aging population is now developing cataracts. Many of these patients may wish to avoid reliance on glasses after cataract surgery. Presbyopia-correcting intraocular lenses (IOLs) offer a solution, but corneal changes after refractive surgery may compound higher order aberrations and dysphotopic symptoms associated with these IOLs. This review aims to discuss potential factors that could aid in determining suitable postkeratorefractive candidates for presbyopia-correcting IOLs. RECENT FINDINGS: Studies investigating which preoperative measures influence outcomes are lacking. The few studies that have examined presbyopia-correcting IOLs in postkeratorefractive patients report that satisfactory outcomes are possible. However, recommendations for preoperative thresholds appear limited to expert opinion and studies involving virgin corneas. SUMMARY: As the number of presbyopia-correcting IOLs and postkeratorefractive patients grows, continued investigation into relevant preoperative factors and appropriate IOLs is required to make evidence-based decisions. The current literature shows that with rigorous counseling and appropriate patient selection, presbyopia-correcting IOLs can provide postkeratorefractive patients with satisfactory results and spectacle independence. In addition, the development of postoperative modifiable IOLs may prove to be the preferred option.


Asunto(s)
Implantación de Lentes Intraoculares , Lentes Intraoculares Multifocales , Presbiopía/cirugía , Percepción de Profundidad/fisiología , Humanos , Queratomileusis por Láser In Situ/efectos adversos , Queratectomía Fotorrefractiva/efectos adversos , Presbiopía/etiología , Presbiopía/fisiopatología , Agudeza Visual/fisiología
8.
Curr Opin Ophthalmol ; 32(1): 3-12, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33122490

RESUMEN

PURPOSE OF REVIEW: The aim of this article is to review techniques to maximize all-distance uncorrected visual acuity and minimize photic phenomena after the implantation of multifocal and extended-depth of focus (EDOF) intraocular lenses (IOLs). This review examines the role of femtosecond laser-assisted cataract surgery (FLACS) in postoperative minimization of astigmatism and optimization of outcomes with multifocal and EDOF lenses. RECENT FINDINGS: By incorporating intraoperative and preoperative imaging, femtosecond platforms such as those that utilize iris or conjunctival vessel registration, can enable a precision of corneal incisions and toric IOL markings that enable the lowest possible postoperative levels of astigmatism. Current studies suggest that with increasing IOL complexity, that is, trifocal versus bifocal, image degradation with even low levels of postoperative astigmatism are increased. To this end, current data support the utility of femtosecond laser arcuate incisions to enable the achievement of 0.5 D or less postoperative astigmatism for best outcomes with multifocal lenses. SUMMARY: The synergistic combination of multifocal/EDOF IOLs with FLACS is an extremely promising route in achieving postoperative spectacle independence for patients. The marriage of the precision of FLACS with the increasing complexity of multifocal/EDOF IOLs will fuel nomogram adjustment and systematic improvements, such as the Wörtz-Gupta formula. Such strategies provide an unprecedented precision to cataract surgery that makes FOCUSED (Femtosecond Optimized Continuous Uncorrected Sight with EDOF and Diffractive Multifocal IOLs) a reality.


Asunto(s)
Percepción de Profundidad/fisiología , Terapia por Láser/métodos , Implantación de Lentes Intraoculares/métodos , Lentes Intraoculares Multifocales , Facoemulsificación , Agudeza Visual/fisiología , Astigmatismo/fisiopatología , Humanos , Seudofaquia/fisiopatología , Refracción Ocular/fisiología
9.
Curr Opin Ophthalmol ; 32(1): 25-30, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33165017

RESUMEN

PURPOSE OF REVIEW: The manuscript presents a review of published studies regarding the outcomes, causes, and complications of phakic intraocular lens (pIOLs) bilensectomy.All pIOLs will be explanted at some point, therefore is important to know the visual and refractive outcomes following bilensectomy. RECENT FINDINGS: There are few publications about the outcomes following pIOL bilensectomy; in all of them, cataract remains the main cause of bilensectomy. Other causes are endothelial cell density loss and pupil ovalization. The mean time between pIOL implantation and bilensectomy is longer in eyes implanted with an anterior chamber pIOL than in eyes implanted with a posterior chamber pIOL. There is a significant improvement in uncorrected and corrected distance visual acuity after bilensectomy. Some sight-threatening complications like retinal detachment and low endothelial cell density (ECD) after surgery have been reported. Current publications suggest that endothelial cell density loss is more frequent in eyes that underwent bilensectomy for an anterior chamber pIOL. SUMMARY: Good visual and refractive outcomes are achieved after bilensectomy, regular endothelial cell density measurements should be performed in all patients implanted with an anterior chamber pIOL to perform a safe bilensectomy.


Asunto(s)
Iris/cirugía , Implantación de Lentes Intraoculares/métodos , Lentes Intraoculares Fáquicas , Refracción Ocular/fisiología , Pérdida de Celulas Endoteliales de la Córnea/diagnóstico , Humanos , Complicaciones Intraoperatorias , Miopía/cirugía , Complicaciones Posoperatorias , Agudeza Visual/fisiología
10.
Curr Opin Ophthalmol ; 32(1): 13-18, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33196544

RESUMEN

PURPOSE OF REVIEW: There are several different approaches to handling regular and irregular astigmatism during cataract surgery, but still much debate on which solutions are most effective given unique patient circumstances. In this review, we examine recent literature and studies to highlight some of the most effective ways to plan preoperatively, manage regular and irregular astigmatism during cataract surgery, as well as managing postoperative complications. RECENT FINDINGS: Recent developments in technology have provided increased courses of action for astigmatism management during cataract surgery. Additional options of toric IOLs with presbyopic platforms, light adjustable lenses, intraocular pinhole lenses, online technological tools and platforms, wavefront or topographic laser technology, and phototherapeutic keratectomy are all effective solutions to managing regular and irregular astigmatism. In this review, we will explore optimal approaches for unique situations. SUMMARY: With increased technology, research, and methods, correcting regular and irregular astigmatism during cataract surgery is achievable in most patients. With in-depth preoperative planning, analysis of patient-specific factors, and a tailored approach, surgeons can obtain excellent uncorrected vision for patients.


Asunto(s)
Astigmatismo/cirugía , Implantación de Lentes Intraoculares/métodos , Facoemulsificación/métodos , Astigmatismo/fisiopatología , Humanos , Queratomileusis por Láser In Situ , Queratectomía Fotorrefractiva , Seudofaquia/fisiopatología , Refracción Ocular/fisiología , Agudeza Visual/fisiología
11.
Public Health ; 190: 30-36, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33338900

RESUMEN

OBJECTIVE: This study estimated the prevalence of uncorrected refractive error (URE) and its determinants in a socially vulnerable older population living in Armenia. STUDY DESIGN: The study design used in the stidy is a cross-sectional study. METHODS: A total of 485 people responded to a survey on sociodemographic characteristics, spectacle use, and ophthalmic services' use. All participants underwent a comprehensive ophthalmic examination including assessment of presenting and best-corrected visual acuity, measuring intraocular pressure and dilated eye fundus examination. Patients who had presenting visual acuity (<6/12) but improved ≥ one line with/without available spectacles after refraction in the better eye were considered to have URE. Descriptive statistics described the sample and estimated the prevalence of the URE in the population. Logistic regression models were used to evaluate its determinants. RESULTS: The mean age of participants was 74.5 (7.27) years, ranging from 51 to 94 years. Women constituted the majority of participants (86%). The prevalence of URE in the better eye was 26%. In bivariate analysis, those who were older and who had less than 10 years of education had higher odds of URE than younger and more educated respondents. In multivariable analysis, only education remained associated with URE (OR = 3.71; 95% CI: 1.10-12.5). The rate of normal vision (≥6/12) improved from 58.9% to 81.5%, whereas the rate of visual impairment (<6/12) decreased from 41.1% to 18.5% after best correction in the better eye. CONCLUSION: The prevalence of URE was high in this study population. The findings warrant the need for eye screening and provision of affordable spectacle correction to the target population in Armenia.


Asunto(s)
Anteojos/estadística & datos numéricos , Vigilancia de la Población/métodos , Errores de Refracción/epidemiología , Poblaciones Vulnerables/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Armenia/epidemiología , Estudios Transversales , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Examen Físico , Prevalencia , Encuestas y Cuestionarios , Agudeza Visual/fisiología
12.
Cornea ; 40(1): 123-124, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32889957

RESUMEN

PURPOSE: To report a case of acute corneal endothelial graft rejection with the concurrent onset of coronavirus disease 2019 (COVID-19) symptoms. METHODS: Case report. RESULTS: A 31-year-old African American woman with a history of asthma, sleep apnea, obesity (body mass index of 40), and bilateral keratoconus was noted to have acute corneal endothelial graft rejection 3 months after uncomplicated penetrating keratoplasty of the left eye. The patient developed dysgeusia and subjective fever on the same day as ocular discomfort, and she was subsequently diagnosed with COVID-19 with only these 2 classic symptoms of the viral infection. CONCLUSIONS: Severe acute respiratory syndrome coronavirus 2 is known to cause conjunctivitis and has demonstrated transmissibility through ocular secretions. Acute immune and inflammatory dysregulations have been seen in cases of COVID-19 through various mechanisms. COVID-19 infection may potentially compromise ocular immune privilege contributing to acute corneal graft rejection.


Asunto(s)
/diagnóstico , Epitelio Posterior/patología , Rechazo de Injerto/diagnóstico , Queratocono/cirugía , Queratoplastia Penetrante , Enfermedad Aguda , Adulto , Disgeusia/diagnóstico , Femenino , Rechazo de Injerto/etiología , Humanos , Reacción en Cadena de la Polimerasa , Reoperación , Agudeza Visual/fisiología
14.
BMC Ophthalmol ; 20(1): 490, 2020 Dec 17.
Artículo en Inglés | MEDLINE | ID: mdl-33334311

RESUMEN

BACKGROUND: The aim of this retrospective study was to compare the efficacy and safety profile of a single XEN-microstent in different types of primary and secondary open angle glaucoma. METHODS: A single XEN microstent was implanted in patients with primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG), pseudoexfoliation glaucoma (PEX) and secondary glaucoma (Sec.Gl). The intraocular pressure (IOP), the active substances of the applied IOP-lowering drugs, the best corrected visual acuity (BCVA) and the mean deviation (MD) of the perimetry were measured at baseline and at regular follow-ups, scheduled at 2 days and 1, 3, 6 and 12 months after surgery. RESULTS: 153 eyes were included in this analysis. 113 eyes were affected by POAG (74%), 5 eyes by NTG (3%), 22 eyes by PEX (14%) and 13 eyes by Sec. Gl (9%). Mean IOP decreased in all treatment groups during the 12 months of follow-up (complete group: 23.9 ± 7.4 to 15.4 ± 5.1 mmHg (p < 0.01); POAG: 22.8 ± 6.5 to 15.1 ± 4.6 mmHg (p < 0.01); NTG: 16.6 ± 3.4 to 11.6 ± 2.2 mmHg (p < 0.05); PEX: 28.0 ± 7.9 to 17.1 ± 6.6 mmHg (p < 0.01); Sec.Gl: 28.9 ± 13.9 to 15.5 ± 6.9 mmHg (p < 0.05)). In the 153 eyes the average number of IOP-lowering drugs applied decreased from 2.6 ± 1.2 to 0.8 ± 1.3 12 months after surgery (p < 0.01). BCVA and mean deviation of automated standard perimetry remained stable in all groups during follow-up. CONCLUSION: As in eyes suffering from POAG, IOP and number of IOP-lowering drugs applied can be effectively reduced by XEN implantation in eyes suffering from NTG, PEX and secondary glaucoma while leaving BCVA and visual field unchanged. TRIAL REGISTRATION: Trial was registered at DRKS (registration number: DRKS00020800 , Registered 25.February 2020 - Retrospectively registered).


Asunto(s)
Implantes de Drenaje de Glaucoma , Glaucoma de Ángulo Abierto/cirugía , Stents , Anciano , Anciano de 80 o más Años , Antihipertensivos/administración & dosificación , Femenino , Estudios de Seguimiento , Glaucoma de Ángulo Abierto/fisiopatología , Humanos , Presión Intraocular/efectos de los fármacos , Presión Intraocular/fisiología , Masculino , Persona de Mediana Edad , Implantación de Prótesis , Estudios Retrospectivos , Tonometría Ocular , Resultado del Tratamiento , Agudeza Visual/fisiología , Pruebas del Campo Visual , Campos Visuales/fisiología
15.
Niger J Clin Pract ; 23(11): 1500-1506, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33221772

RESUMEN

Objective: To evaluate the relationship between visual acuity (VA) and endocrine status among patients with giant sellar tumors pre and postsurgical treatment. Methods: A 7-year single institution prospective cohort study of patients with giant sellar tumors treated by pterional transylvian microsurgical resection. Patients were evaluated and followed-up by a collaborative team of ophthalmologists and neurosurgeons. Results: Sellar tumors represent 25% of our brain tumors cases (n = 257). Giant sellar tumors were 61 (23.7%) cases. Pituitary adenomas occurred in 40 patients and in 24 of these, the tumor was a functional adenoma. The age range was 16 to 75 years with a mean of 43.7 ± 3.3 years. Visual impairment (n = 60), headache (n = 55), and endocrinopathy (24) were among the common manifestations. VA and visual field defects were experienced by 59 and 39 patients, respectively. For both eyes, endocrine active tumors presented with poorer preoperative VA profile using mean logMAR VA [(χ2 = 10.3, P = 0.002 OD) and (χ2 = 8.9, P = 0.003 OS)]. Postoperatively, the mean logMAR VA profiles of endocrine active tumors showed a significantly better response when compared to endocrine inactive tumors in both eyes [(χ2 = 5.53, P = 0.029 OD) and (χ2 = 6.77, P = 0.037 OS)]. Conclusion: Visual acuity defects are almost invariable in patients with giant sellar tumor and may be associated with an endocrine profile. Surgical resection with normalization of hormone status is rewarded with VA improvement.


Asunto(s)
Adenoma/cirugía , Neoplasias Encefálicas/patología , Neoplasias Encefálicas/cirugía , Neoplasias Hipofisarias/cirugía , Trastornos de la Visión/etiología , Agudeza Visual/fisiología , Adolescente , Adulto , Anciano , Neoplasias Encefálicas/complicaciones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Hipofisarias/complicaciones , Periodo Posoperatorio , Periodo Preoperatorio , Estudios Prospectivos , Recuperación de la Función/fisiología , Resultado del Tratamiento , Trastornos de la Visión/diagnóstico , Campos Visuales/fisiología , Percepción Visual/fisiología , Adulto Joven
16.
Arch. Soc. Esp. Oftalmol ; 95(11): 523-527, nov. 2020. ilus, tab, graf
Artículo en Español | IBECS | ID: ibc-197742

RESUMEN

OBJETIVO: El objetivo de este estudio es analizar si una lente intraocular (LIO) monofocal (TECNIS Eyhance®, Johnson&Johnson Surgical Vision, Inc., Santa Ana, CA) de foco extendido proporciona una mejor agudeza visual (AV) intermedia que otras LIO monofocales (TECNIS 1-pieza®, Johnson&Johnson Surgical Vision, Inc., Santa Ana, CA) de la misma plataforma. MÉTODOS: Se realizó un estudio observacional prospectivo y aleatorizado con pacientes que necesitaban cirugía de cataratas en ambos ojos. Un grupo de pacientes recibió el implante con la LIO TECNIS 1-pieza y otro grupo recibió la LIO Eyhance de foco extendido monofocal. Un mes desde la cirugía en el segundo ojo se evaluó la AV intermedia corregida (66 cm) y se obtuvieron las curvas de desenfoque. También se exploró la correlación de aberraciones de orden elevado y esféricas con AV intermedia, tamaño pupilar con AV intermedia y edad con AV intermedia. RESULTADOS: El estudio analizó a 30 pacientes (60 ojos), 15 de ellos en el grupo TECNIS 1-pieza y 15 en el grupo Eyhance. Ambos grupos consiguieron una AV lejana de 0,00 logMAR. En contraste, para la visión intermedia la AV fue mejor con las LIO Eyhance de foco extendido monofocal (0,16 ± 0,12 LogMAR), siendo la diferencia estadísticamente significativa (p < 0,001). Además, se observó que la AV intermedia binocular guardaba una correlación significativa con las aberraciones corneales (6 mm) RMS de alto orden (ρ 0,476) y Z40 (ρ 0,483) con la LIO Eyhance. CONCLUSIONES: La nueva LIO monofocal de foco extendido (Eyhance) ofrece suficiente profundidad de foco para proporcionar a los pacientes una visión confortable sin afectar la visión lejana


PURPOSE: The purpose of this study was to analyse whether an extended depth of focus (EDOF) monofocal intraocular lens (IOL) (TECNIS Eyhance™, Johnson&Johnson Surgical Vision, Inc., Santa Ana, CA) provides better intermediate visual acuity (VA) than another monofocal IOL (TECNIS 1-piece™, Johnson&Johnson Surgical Vision, Inc., Santa Ana, CA) from the same platform. METHODS: Randomised prospective observational study. Patients who required cataract surgery in both eyes were included. Patients in one group were implanted with Tecnis 1-piece IOL and those in the other group with Eyhance EDOF monofocal IOL. One month after surgery in the second eye, we assessed the corrected intermediate VA (66 cm) and obtained defocus curves. We also explored the correlation of: high-order and spherical aberrations with intermediate VA, pupil size with intermediate VA and age with intermediate VA. RESULTS: We analysed 30 patients (60 eyes), 15 patients in the TECNIS 1-piece group and 15 in the Eyhance group. Both groups achieved a far VA of 0.00 logMAR. In contrast, for intermediate vision, VA was better with the Eyhance EDOF monofocal IOLs (0.16 ± 0.12 LogMAR), the difference being statistically significant (p < 0.001). In addition, binocular intermediate VA was found to be significantly correlated with corneal (6 mm) RMS high-order aberrations (ρ 0.476) and Z40 (ρ 0.483) with the Eyhance IOL. CONCLUSIONS: The new EDOF monofocal IOL (Eyhance) offers sufficient depth of focus to provide patients with comfortable vision without impairing far vision


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Extracción de Catarata/métodos , Lentes Intraoculares/normas , Agudeza Visual/fisiología , Implantación de Lentes Intraoculares/métodos , Catarata/fisiopatología , Distribución Aleatoria , Resultado del Tratamiento , Estadísticas no Paramétricas
17.
Graefes Arch Clin Exp Ophthalmol ; 258(12): 2621-2628, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33009973

RESUMEN

PURPOSE: To estimate the impact of delayed care during the coronavirus disease 2019 (COVID-19) pandemic on the outcomes of patients with neovascular age-related macular degeneration (AMD). METHODS: Consecutive patients with diagnosis of neovascular AMD were consecutively enrolled between March 9, 2020, and June 12, 2020, (during and immediately after the Italian COVID-19 quarantine). During the inclusion (or pandemic) visit (V0), patients received a complete ophthalmologic evaluation, including optical coherence tomography (OCT). Best-corrected visual acuity (BCVA) and OCT findings from the two preceding visits (V-1 and V-2) were compared with data at V0. RESULTS: One-hundred patients (112 eyes) were enrolled in this study. The time interval between following visits was 110.7 ± 37.5 days within V0 and V-1 and 80.8 ± 39.7 days within V-1 and V-2, respectively (P < 0.0001). BCVA was statistically worse at the V0 visit as compared with the immediately preceding (V-1) visit (0.50 ± 0.43 LogMAR and 0.45 ± 0.38 LogMAR at the V0 and V-1 visits, respectively; P = 0.046). On structural OCT, 91 out of 112 (81.2%) neovascular AMD eyes displayed the evidence of exudative disease activity at the V0 visit, while 77 (68.7%) eyes exhibited signs of exudation at the V-1 visit (P = 0.022). No differences in terms of BCVA and OCT findings were detected between the V-1 and V-2 visits. In multiple regression analysis, the difference in BCVA between V0 and V-1 visits was significantly associated with the interval time within these two visits (P = 0.026). CONCLUSION: The COVID-19 pandemic-related postponement in patient care proved to be significantly associated with worse short-term outcomes in these patients.


Asunto(s)
Inhibidores de la Angiogénesis/uso terapéutico , Betacoronavirus , Neovascularización Coroidal/tratamiento farmacológico , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Neovascularización Retiniana/tratamiento farmacológico , Tiempo de Tratamiento , Degeneración Macular Húmeda/tratamiento farmacológico , Anciano , Anciano de 80 o más Años , Bevacizumab/uso terapéutico , Neovascularización Coroidal/diagnóstico por imagen , Neovascularización Coroidal/fisiopatología , Femenino , Humanos , Inyecciones Intravítreas , Masculino , Persona de Mediana Edad , Pandemias , Cuarentena , Ranibizumab/uso terapéutico , Receptores de Factores de Crecimiento Endotelial Vascular/uso terapéutico , Proteínas Recombinantes de Fusión/uso terapéutico , Neovascularización Retiniana/diagnóstico por imagen , Neovascularización Retiniana/fisiopatología , Líquido Subretiniano , Tomografía de Coherencia Óptica , Resultado del Tratamiento , Factor A de Crecimiento Endotelial Vascular/antagonistas & inhibidores , Agudeza Visual/fisiología , Degeneración Macular Húmeda/diagnóstico por imagen , Degeneración Macular Húmeda/fisiopatología
18.
Medicine (Baltimore) ; 99(43): e22889, 2020 Oct 23.
Artículo en Inglés | MEDLINE | ID: mdl-33120835

RESUMEN

To determine the surgical outcomes and prognostic factors of cytomegalovirus (CMV) retinitis-related retinal detachment (RD) in acquired immune deficiency syndrome (AIDS) patients following vitrectomy.A retrospective charts review was carried out on AIDS patients who were diagnosed with CMV retinitis-related RD and treated with vitrectomy between 2002 and 2016. The main outcome measures were the rates of primary anatomical success and final visual acuity (VA) success defined as postoperative VA ≥20/200. Kaplan-Meier curves on the time to retinal redetachment were performed. Multivariate logistic regression models based on a directed acyclic graph were used to identify independent factors associated with achieving VA success.Forty five AIDS patients (52 eyes) were included. Over a mean follow-up period of 41.7 months, primary anatomical success was achieved in 44 eyes (84.6%) and VA success was achieved in 34 eyes (65.4%). Receiving highly active antiretroviral therapy (HAART) prior to RD (adjusted odds ratio [aOR]=4.9, P = .043), better preoperative VA (aOR = 4.3, P = .006), undergoing vitrectomy within 3 months (aOR=6.7, P = .008), absence of optic atrophy (aOR=58.1, P < .001), and absence of retinal redetachment (aOR=38.1, P = .007) increased the odds of achieving final VA success.Vitrectomy provided favorable anatomical reattachment in AIDS patients with CMV retinitis-related RD. Majority of patients was able to retain functional vision postoperatively. The use of HAART and early vitrectomy increased the probability of achieving both anatomical and VA success.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/complicaciones , Retinitis por Citomegalovirus/complicaciones , Desprendimiento de Retina/etiología , Desprendimiento de Retina/cirugía , Vitrectomía/efectos adversos , Infecciones Oportunistas Relacionadas con el SIDA/complicaciones , Infecciones Oportunistas Relacionadas con el SIDA/virología , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Síndrome de Inmunodeficiencia Adquirida/virología , Adulto , Terapia Antirretroviral Altamente Activa/métodos , Estudios de Casos y Controles , Citomegalovirus/genética , Retinitis por Citomegalovirus/diagnóstico , Retinitis por Citomegalovirus/tratamiento farmacológico , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Tailandia/epidemiología , Resultado del Tratamiento , Agudeza Visual/fisiología , Vitrectomía/estadística & datos numéricos , Vitrectomía/tendencias
19.
PLoS Negl Trop Dis ; 14(9): e0008585, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32956360

RESUMEN

Hansen's disease (HD) belongs to the group of neglected diseases and can cause physical deformities and disabilities, in addition to leading to social discrimination. Ocular involvement in HD is estimated at 70-75% worldwide. About 10-50% suffer from severe ocular symptoms and loss of vision occurs in approximately 5% of cases. Ocular changes may persist or worsen even after patients are considered cured and it is necessary to better understand these conditions in order to determine the need for additional public policies. The objective of this study was to identify the prevalence of ocular involvement in patients with HD at two specialist referral centers for treatment of the disease. A cross-sectional study was conducted with ophthalmological evaluations of patients with HD from June 2017 to June 2018. Diagnostic ocular findings, corrected visual acuity, and refractive error were described. Findings were correlated with patients' clinical and epidemiological variables. A total of 86 patients were evaluated, with a mean age of 50.1 years, predominantly males (59.3%), and with multibacillary HD (92%). The prevalence of ophthalmologic changes was 100% and the most common were dysfunction of the Meibomian glands (89.5%) and dry eye syndrome (81.4%). Cataracts were observed in 22 patients (25.6%), but best corrected visual acuity was normal or near normal in 84 patients (97.7%) and there were no cases of bilateral blindness. Patients with some degree of physical disability had more ophthalmological alterations, involving both the ocular adnexa (p = 0.03) and the ocular globe (p = 0.04). Ocular involvement is common in patients with Hansen's disease, reinforcing the importance of ophthalmologic examination in the evaluation and follow-up of these patients.


Asunto(s)
Síndromes de Ojo Seco/patología , Infecciones Bacterianas del Ojo/patología , Lepra/patología , Glándulas Tarsales/patología , Agudeza Visual/fisiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Brasil , Catarata/patología , Estudios Transversales , Femenino , Humanos , Masculino , Glándulas Tarsales/microbiología , Persona de Mediana Edad , Enfermedades Desatendidas , Prevalencia , Adulto Joven
20.
Graefes Arch Clin Exp Ophthalmol ; 258(12): 2655-2660, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32960319

RESUMEN

PURPOSE: To quantify the shrinking in outpatient and intravitreal injections' volumes in a tertiary referral retina unit secondary to virus causing coronavirus disease 2019 (COVID-19). METHODS: In this retrospective cross-sectional study, we reviewed the charts of all patients who had a visit at a medical retina referral center during the Italian quarantine (from 9th of March 2020 to 3rd of May 2020). Number and characteristics of these data were compared with data from the same period in 2019 (from 9th of March 2019 to 3rd of May 2019). RESULTS: In the 2019 study period, there were 303 patients attending clinic (150 males, 153 females). In the 2020 study period, patients decreased to 75 (48 males, 27 females; P = 0.022 comparing gender prevalence between the two periods) with an overall reduction of 75.2%. Mean ± SD age was 71.4 ± 14.3 years (range 25-93 years) in the 2019 study period and 66.7 ± 13.1 years (range 32-91 years) in the 2020 study period (P = 0.005). The largest drop in outpatient volume was recorded in AMD patients (- 79.9%). Regarding the intravitreal treatments, there were 1252 injections in the 2019 period and 583 injections in the 2020 period (- 53.6% in injections). The drop in intravitreal treatments was larger in patients with posterior uveitis, retinal vein occlusion, and diabetes (- 85.7%, - 61.9%, and - 59.6%, respectively). CONCLUSION: The volume of outpatient visits and intravitreal injections declined during the COVID-19 quarantine. The short- and long-term impacts are that routine in-person visits and intravitreal injections are expected to increase after the quarantine and, even more, after the pandemic.


Asunto(s)
Inhibidores de la Angiogénesis/uso terapéutico , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Visita a Consultorio Médico/estadística & datos numéricos , Pacientes Ambulatorios/estadística & datos numéricos , Neumonía Viral/epidemiología , Enfermedades de la Retina/tratamiento farmacológico , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Inyecciones Intravítreas , Italia/epidemiología , Masculino , Persona de Mediana Edad , Pandemias , Cuarentena , Derivación y Consulta/estadística & datos numéricos , Enfermedades de la Retina/diagnóstico , Enfermedades de la Retina/fisiopatología , Estudios Retrospectivos , Factor A de Crecimiento Endotelial Vascular/antagonistas & inhibidores , Agudeza Visual/fisiología
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...