RESUMO
OBJECTIVE: To assess the safety and efficacy of combined cataract extraction, posterior chamber intraocular lens placement, pars plana vitrectomy, fluocinolone acetonide intravitreal implant (Retisert), and Ahmed valves with pars plana tube (CPR-PT) in eyes with chronic, posterior, noninfectious uveitis. METHODS: Retrospective study of patients who underwent CPR-PT. Outcome measures included visual acuity, intraocular pressure, inflammation, and complications. RESULTS: Eight eyes were included, with a mean follow-up of 18 months. Mean visual acuity improved from 1.89 to 0.14 logMAR (Snellen, counting fingers at 2 ft [0.6 m]) to 20/30; P=.01). Mean intraocular pressure remained stable at 16 to 17 mm Hg (P=.35). The number of glaucoma medications per eye decreased from 2.9 to 0.25 (P=.01). Systemic prednisone therapy was discontinued in all patients by 9 months postoperatively. Inflammation was well controlled in all eyes. CONCLUSION: The CPR-PT procedure allows rapid visual rehabilitation without major short-term complications.
Assuntos
Extração de Catarata , Implantes de Medicamento , Fluocinolona Acetonida/administração & dosagem , Implantes para Drenagem de Glaucoma , Implante de Lente Intraocular , Uveíte Posterior/complicações , Vitrectomia , Adulto , Anestesia Local , Anti-Hipertensivos/administração & dosagem , Catarata/complicações , Catarata/terapia , Doença Crônica , Feminino , Seguimentos , Glaucoma/complicações , Glaucoma/cirurgia , Humanos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Segmento Posterior do Olho , Complicações Pós-Operatórias , Estudos Retrospectivos , Esclerostomia , Técnicas de Sutura , Resultado do Tratamento , Uveíte Posterior/tratamento farmacológico , Acuidade Visual/fisiologia , Corpo Vítreo/efeitos dos fármacosRESUMO
We examined developmental differences, in location and extent of fMRI language activation maps, between adults and children while performing a semantic fluency task. We studied 29 adults and 16 children with echo planar imaging BOLD fMRI at 1.5 T using covert semantic verbal fluency (generation of words to categories compared to rest) using a block design. Post task testing was administered to assess performance. Individual data were analyzed with an a priori region of interest approach from t maps (t = 4) and asymmetry indices (AI). Group studies were analyzed using SPM 99 (Wellcome, UK; fixed effect, corrected P < 0.0001). We found no significant differences in location or laterality of activation between adults and children for a semantic verbal fluency task. Adults activated more pixels than children in left inferior frontal gyrus and left middle frontal gyrus, but AIs were the similar across ages (r(2) < 0.09). Extent or laterality of activation was not affected by performance (r(2) < 0.15). The brain areas that process semantic verbal fluency are similar in children and adults. The laterality of activation does not change appreciably with age and appears to be strongly lateralized by age 7 years.
