RESUMO
AIMS: To assess the effect of assisted conception (AC) on retinopathy of prematurity (ROP) and ROP screening. Follow-up to the study by McKibbin et al. METHODS: Retrospective study utilising computerised databases of ROP screening, live births, AC and multiple births between 1st April 2000 and 31st August 2003 at St James's Hospital (SJUH) Leeds. chi(2) tests of significance were used. RESULTS: ROP screening was undertaken in 11/265 (4.2%) of AC births versus 1.6% of all SJUH births. This is significantly less than the 20.3% of AC babies screened in McKibbin et al study (P=<0.01). There was no ROP detected in the 11 AC babies. Of all AC births, 36.9% were one of twins and 1.5% from triplet births compared to 46.0% one of twins and 18.6% one of triplets in McKibbin's study. CONCLUSIONS: The percentage of AC babies requiring ROP screening has fallen since McKibbin et al study which was performed between August 1991 and December 1994. This appears to be at least partially due to the reduced multiple birth rates. This reduction in the multiple birth rates follows evidence that reducing the number of embryos transferred does not reduce the number of couples taking home a baby and Human Fertility and Embryology Association guidelines recommending 'no more than two embryos should be transferred in an IVF cycle'. Changes in clinical practice at SJUH have significantly reduced the likelihood of AC babies requiring ROP screening and developing ROP.
Assuntos
Técnicas de Reprodução Assistida/efeitos adversos , Retinopatia da Prematuridade/etiologia , Transferência Embrionária/efeitos adversos , Feminino , Seguimentos , Humanos , Recém-Nascido , Prole de Múltiplos Nascimentos , Gravidez , Resultado da Gravidez , Técnicas de Reprodução Assistida/estatística & dados numéricos , Retinopatia da Prematuridade/diagnóstico , Retinopatia da Prematuridade/epidemiologia , Estudos RetrospectivosRESUMO
Retinopathy of prematurity (ROP) is a well-recognized condition in premature babies born today and in the recent past. One would not normally expect to come across evidence of its existence among older patients. We present a case of apparent regressed ROP in a lady born in May 1939, prior to the documented reports of the first cases.
Assuntos
Retinopatia da Prematuridade/diagnóstico , Fatores Etários , Feminino , Angiofluoresceinografia , História do Século XX , Humanos , Recém-Nascido , Pessoa de Meia-Idade , Retinopatia da Prematuridade/históriaAssuntos
Anormalidades Congênitas/epidemiologia , Fertilização in vitro/estatística & dados numéricos , Gravidez Múltipla/estatística & dados numéricos , Retinopatia da Prematuridade/epidemiologia , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Gravidez , Resultado da Gravidez , RiscoRESUMO
A 43 year old intravenous drug abuser presented to the accident and emergency department with a three week history of bilateral visual loss and frontal headaches. Fundoscopy revealed bilateral retinal cotton wool spots and haemorrhages and an ophthalmic opinion was requested. His blood pressure was subsequently found to be 210/140. A diagnosis of malignant hypertension was made and blood pressure was gradually controlled on oral antihypertensives. This case illustrates the importance of checking the blood pressure of all patients presenting with visual loss.
Assuntos
Dependência de Heroína , Hipertensão Maligna/diagnóstico , Abuso de Substâncias por Via Intravenosa , Transtornos da Visão/diagnóstico , Adulto , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea , Diagnóstico Diferencial , Cefaleia/diagnóstico , Dependência de Heroína/complicações , Humanos , Hipertensão Maligna/tratamento farmacológico , Masculino , Hemorragia Retiniana/diagnóstico , Retinite/diagnósticoRESUMO
PURPOSE: To assess the incidence and visual morbidity of lens matter dislocation during phacoemulsification and the relationship between this complication and surgical experience. SETTING: Teaching and district general hospitals. METHODS: A multiple-choice questionnaire was sent to members of the Northern and Midlands Ophthalmological Societies. They were asked about the incidence of lens matter dislocation, the visual outcome of the cases, and their surgical experience. RESULTS: Forty-seven of the 177 survey respondents (26.5%) were using phacoemulsification. The incidence of lens matter dislocation was 1.1%; 49.0% of the surgeons had experienced at least one case. The incidence increased significantly when surgeons assessed their expertise with phacoemulsification toward the expert end of the scale. Final visual acuity was worse than 6/12 in 35.0% of cases. CONCLUSIONS: The incidence of lens matter dislocation with phacoemulsification is significant and related to an incorrect assessment of expertise by the surgeons. The considerable visual morbidity associated with this complication can be minimized using the management strategy discussed.
Assuntos
Competência Clínica , Subluxação do Cristalino/epidemiologia , Facoemulsificação/efeitos adversos , Competência Clínica/estatística & dados numéricos , Inglaterra/epidemiologia , Humanos , Incidência , Complicações Intraoperatórias/epidemiologia , Complicações Intraoperatórias/etiologia , Complicações Intraoperatórias/terapia , Subluxação do Cristalino/etiologia , Subluxação do Cristalino/terapia , Oftalmologia/educação , Inquéritos e Questionários , Acuidade VisualRESUMO
This study was performed to assess the workload imposed by treatment for infertility on a retinopathy of prematurity (ROP) screening programme. We reviewed the records of all babies born between August 1991 and December 1994 as a result of treatment in the Assisted Conception Unit of this hospital, and of all babies screened for ROP over the same period. Of the babies born after assisted conception treatment, 20% fulfilled the ROP screening criteria. ROP of any stage was present in 23% of all the assisted conception babies screened. This group also accounted for a large proportion of those reaching stage 3 disease and of those requiring treatment.
Assuntos
Infertilidade Feminina/terapia , Retinopatia da Prematuridade/prevenção & controle , Inglaterra/epidemiologia , Feminino , Fertilização in vitro , Humanos , Recém-Nascido , Infertilidade Feminina/epidemiologia , Retinopatia da Prematuridade/epidemiologia , Estudos Retrospectivos , Trigêmeos , Gêmeos , Carga de TrabalhoRESUMO
Seventy randomly selected patients with Paget's disease of bone were examined for ocular complications. The prevalence of macular degeneration and cataract was 24.3%. Only one patient was found to have angioid streaks. Eight patients had peripapillary chorioretinal atrophy. These findings suggest that the prevalence of serious ocular complications of Paget's disease is not as high as previously thought. The significance of peripapillary chorioretinal atrophy requires further evaluation.