RESUMO
Numerous surgical procedures have been proposed for cyclodialysis cleft repair. The authors describe a novel technique of cyclopexy with posterior infusion cannula in a patient with persistent hypotony and maculopathy secondary to a large cyclodialysis cleft after trauma.
Assuntos
Câmara Anterior/cirurgia , Cateterismo , Traumatismos Oculares/complicações , Hipotensão Ocular/etiologia , Hipotensão Ocular/cirurgia , Procedimentos Cirúrgicos Oftalmológicos/efeitos adversos , Reoperação/métodos , Adulto , Câmara Anterior/diagnóstico por imagem , Câmara Anterior/patologia , Corpo Ciliar/cirurgia , Traumatismos Oculares/cirurgia , Gonioscopia , Humanos , Pressão Intraocular , Edema Macular/etiologia , Microscopia Acústica , Esclera/cirurgia , Retalhos Cirúrgicos , Técnicas de SuturaRESUMO
PURPOSE: To compare the standard method of testing for a relative afferent pupillary defect (RAPD) using the Standard Swinging Flashlight Method (S-SFM) with 2 novel techniques, to evaluate the validity and reproducibility of each method, and to validate the clinical significance of detecting more subtle RAPDs by correlating the extent of glaucoma damage with the presence or absence of an RAPD as assessed by each method. PATIENTS AND METHODS: In this prospective, observational study 101 consecutive patients (68 diagnosed glaucoma patients, 20 glaucoma suspects including ocular hypertensives, and 13 controls) were screened for the presence or absence of an RAPD using the S-SFM, Magnifier-Assisted Swinging Flashlight Method (MA-SFM), and Ophthalmoscopic Swinging Flashlight Method . Humphrey visual field mean deviation (MD) of each eye and the intereye differences in MD and Disc damage likelihood score (DDLS) and intereye difference in DDLS were calculated. Sensitivities for each method (S-SFM, MA-SFM, and Ophthalmoscopic Swinging Flashlight Method) were calculated at increasing levels of change in DDLS and MD. Weighted κ scores were calculated for agreement between tests. RESULTS: MA-SFM is the most sensitive method for determining an RAPD in terms of both intereye difference in DDLS and intereye differences in MD at all levels of change. Weighted κ scores revealed substantial agreement between tests for the same method, and moderate to substantial agreement among the observers. CONCLUSIONS: This study confirms results of our earlier study suggesting that swinging flashlight test modified with magnification (MA-SFM) can provide a simple, inexpensive, reproducible method of detecting an RAPD.
Assuntos
Técnicas de Diagnóstico Oftalmológico , Distúrbios Pupilares/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Glaucoma/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Hipertensão Ocular/diagnóstico , Disco Óptico/patologia , Doenças do Nervo Óptico/diagnóstico , Estudos Prospectivos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Campos Visuais/fisiologiaRESUMO
OBJECTIVE: To determine if there is an unrecognized problem of congenital rubella syndrome (CRS) in Haiti, a country without a national rubella immunization program. METHODS: During March 2001 and June 2001, screening physicals were conducted on approximately 80 orphans at three orphanages in Haiti that accept disabled children. Children were classified as probable CRS cases based on established clinical criteria. Photo documentation of findings was obtained whenever possible. RESULTS: Six children met the criteria for probable CRS. Using data from surrounding Caribbean countries and from the United States of America prior to rubella immunization, we estimated that there are between 163 and 440 new cases of CRS per year in Haiti. CONCLUSIONS: CRS exists in Haiti, but its presence is generally unrecognized. A national rubella immunization policy should be considered.
Assuntos
Síndrome da Rubéola Congênita/epidemiologia , Adolescente , Criança , Feminino , Haiti , Humanos , LactenteRESUMO
Objective. To determine if there is an unrecognized problem of congenital rubella syndrome (CRS) in Haiti, a country without a national rubella immunization program. Methods. During March 2001 and June 2001, screening physicals were conducted on approximately 80 orphans at three orphanages in Haiti that accept disabled children. Children were classified as probable CRS cases based on established clinical criteria. Photo documentation of findings was obtained whenever possible. Results. Six children met the criteria for probable CRS. Using data from surrounding Caribbean countries and from the United States of America prior to rubella immunization, we estimated that there are between 163 and 440 new cases of CRS per year in Haiti. Conclusions. CRS exists in Haiti, but its presence is generally unrecognized. A national rubella immunization policy should be considered
Assuntos
Adolescente , Criança , Feminino , Humanos , Lactente , Síndrome da Rubéola Congênita/epidemiologia , HaitiRESUMO
Objective. To determine if there is an unrecognized problem of congenital rubella syndrome (CRS) in Haiti, a country without a national rubella immunization program. Methods. During March 2001, screening physicals were conducted on approximately 80 orphans at three orphanages in Haiti that accept disabled children. Children were classified as probable CRS cases based on established clinical criteria. Photo documentation of findings was obtained whenever possible. Results. Six children met the criteria for probable CRS. Using data from surrounding Caribbean countries and from the United States of America prior to rubella immunization, we estimated that there are between 163 and 440 new cases of CRS per year in Haiti. Conclusions. CRS exists in Haiti, but its presence is generally unrecognized. A national rubella immunization policy should be considered (AU)
