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1.
Ophthalmol Retina ; 4(6): 629, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32507276
2.
Br J Ophthalmol ; 2020 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-32561534

RESUMO

AIMS: To analyse the factors associated with myopia in school-aged children with preterm birth and with or without retinopathy of prematurity (ROP). METHODS: Children born prematurely between January 2010 and December 2011 were enrolled in this cross-sectional study when they reached school age between April 2017 and June 2018 in a referral centre. The main parameters were cycloplegic refraction, time spent outdoors and serum 25-hydroxyvitamin D (25(OH)D) concentration. RESULTS: A total of 99 eyes from 99 children with a mean age of 6.8 years underwent analysis. The average time spent outdoors was significantly higher in the non-myopic group (0.9 ± 0.5 hours/day) than in the myopic group (0.7 ± 0.3 hours/day) (p = 0.032). After adjustment for age, sex, number of myopic parents, ROP severity, near-work time and serum 25(OH)D concentration, more time spent outdoors was correlated with a lower odds of myopia (OR, 0.13 per additional hour per day; 95% CI, 0.02-0.98; p = 0.048). Mean serum 25(OH)D concentrations were similar between the myopic and non-myopic groups (49.7 ± 13.6 and 48.8 ± 14.0 nmol/mL; p = 0.806) and were not correlated with spherical equivalence power (r = -0.09; p = 0.418). Vitamin D insufficiency was present in 57% of the participants. CONCLUSIONS: Among preterm children with or without ROP, more time spent outdoors was associated with lower odds of myopia. The serum 25(OH)D concentration was not associated with myopia, but a high proportion of the participants had insufficient levels.

3.
Eur J Ophthalmol ; : 1120672120926855, 2020 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-32460537

RESUMO

INTRODUCTION: The Epstein-Barr virus is a rare causative pathogen identified in the posterior segment. The majority of cases were presented with a serious condition of acute retinal necrosis, and most of these eyes had poor outcomes. The clinical features and effective treatment options for this condition are still unclear. Case description: A 10-year-old boy with leukaemia and receiving immunosuppressive regimen presented with decreasing visual acuity to counting fingers in his left eye for 2 weeks. Fundus examination revealed disc swelling, retinitis, retinal exudates and haemorrhages. Aqueous polymerase chain reaction was positive for Epstein-Barr virus DNA but negative for cytomegalovirus, herpes simplex virus and varicella zoster virus DNA. Systemic acyclovir and intravitreal ganciclovir injection were administered. Seven months later, retinitis resolved with remnant retinal fibrosis, and visual acuity improved to 20/500. CONCLUSION: Epstein-Barr virus is rarely identified as a sole pathogen in retinitis. Peripapillary predilection might be another type of presenting feature apart from the more-commonly reported peripheral acute retinal necrosis.

4.
Graefes Arch Clin Exp Ophthalmol ; 258(7): 1367-1377, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32281001

RESUMO

PURPOSE: To evaluate prognostic factors in young patients with central retinal vein occlusion (CRVO). METHODS: Retrospective case series. CRVO patients aged ≤ 50 and follow-up ≥ 6 months were enrolled. The best corrected visual acuity (BCVA) and central retinal thickness (CRT) at baseline, 3 months, 6 months, and last visit were documented. Severity of retinopathy was graded by comparing to standard photos. Prognostic factors associated with visual outcome at 6 months were evaluated by multiple linear regression models. RESULTS: A total of 73 eyes from 69 patients with mean age 37.6 ± 8.5 were enrolled. Forty-seven (68%) patients were male. The mean follow-up duration was 25.9 ± 23.0 months. LogMAR BCVA improved from 0.979 ± 0.785 at baseline to 0.594 ± 0.748 at the 6 months (p < 0.001) and CRT improved from 475 ± 222 µm to 299 ± 104 µm (p < 0.001). Forty-eight (66%) eyes required anti-vascular endothelial growth factor (anti-VEGF) treatment. The mean number of injections was 2.25 ± 1.41 in the first 6 months and 75% of eyes received ≦ 3 injections during the clinical course. The baseline BCVA (coefficient 0.518, p < 0.001), grade of retinal hemorrhage (coefficient 0.230, p = 0.006), grade of retinal venous engorgement (coefficient 0.238, p = 0.011), grade of optic disc edema (coefficient - 0.226, p = 0.005), and diabetes mellitus (coefficient 0.264, p = 0.047) were the independent factors associated with visual outcome at 6 months. CONCLUSIONS: Baseline clinical features are useful for the prediction of visual outcome at 6 months in young CRVO patients.

5.
Acta Ophthalmol ; 2020 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-32243725

RESUMO

PURPOSE: To investigate the long-term surgical outcomes of macular hole retinal detachment (MHRD) following vitrectomy with macular plug in highly myopic eyes. METHODS: Thirty-five cases of highly myopic eyes with MHRD in 35 patients who underwent an initially successful vitrectomy with macular plug and were followed up for at least 3 years were reviewed. The anatomical outcomes were evaluated by fundus examination, fundus photographs and optical coherence tomography (OCT). Myopic features after the surgery were differentiated according to recommendations of the Meta-analysis of Pathologic Myopia (META-PM) Study Group. The best-corrected visual acuities (BCVAs) before and after surgery were analysed as the functional outcome. Main outcome measures time-course changes in BCVA and complications. RESULTS: The mean patient age was 61.0 ± 11.4 years. The follow-up was 45.2 ± 8.6 months (ranged from 36 to 71 months). The mean axial length was 29.3 ± 1.2 mm. All eyes demonstrated attached retina, but 2 eyes (5.7%) developed reopened macular holes until the last follow-up. Complications of postoperative rhegmatogenous retinal detachment were detected in 2 eyes (5.7%) within 1 year and retina reattached after the secondary vitrectomy. Three cases (8.6%) of prolonged subretinal fluid lasting more than 1 year were detected but finally absorbed completely. Comparing 1-3 years postoperatively, myopic features showed significant progression of myopic maculopathy category (p = 0.035). Functionally, significantly improved BCVA could be maintained postoperatively between 6 months and 3 years. However, vision of 14 eyes (40.0%) worsened within 1-3 years postoperatively, and visual deterioration was associated with progression of myopic maculopathy (p = 0.004) and pre-existing disease of glaucoma (p = 0.006). CONCLUSIONS: A vitrectomy combined with macular plug provided favourable outcomes in the long term, over the ≥3-year follow-up period.

6.
Mayo Clin Proc ; 95(4): 747-748, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32247348
7.
BMC Ophthalmol ; 20(1): 116, 2020 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-32199465

RESUMO

BACKGROUND: To evaluate the feasibility of a surgical technique using a sub-perfluoro-n-octane (PFO) injection of ocular viscoelastic device (OVD) to stabilize inverted internal limiting membrane (ILM) flap for the treatment of macular hole retinal detachment (MHRD). METHODS: This study was a retrospective, consecutive, interventional case series. Patients who underwent MHRD surgery with sub-PFO injection of OVD to stabilize inverted ILM flap onto the macular hole (MH) were reviewed. The color fundus and optical coherence tomography (OCT) images were collected and evaluated. The best-corrected visual acuity (BCVA) before and after surgery were compared as the functional outcome. RESULTS: The study included 8 eyes of 8 consecutive patients (mean age: 61.8 ± 7.1 years; mean follow-up period: 9.0 ± 2.5 months). All eyes (100%) achieved successful MH closure; 7 eyes (87.5%) demonstrated complete retinal reattachment, and 1 eye (12.5%) had minimal residual subretinal fluid parafoveally. Of the 8 patients, 7 patients (87.5%) had achieved improvement in BCVA after the primary surgery, whereas 1 eye remained stable. The average BCVA before and after the surgery at the last visit improved from 20/843 (1.63 ± 0.48 logMAR) to 20/200 (1.00 ± 0.39 logMAR) (P = 0.016). Anatomically, near-normal foveal contour was noted in five (62.5%) eyes at the final follow-up. CONCLUSIONS: The use of sub-PFO injection of OVD in MHRD surgery could stabilize inverted ILM flaps, achieve good anatomical results and improve postoperative BCVA.

8.
Retina ; 2020 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-31996587

RESUMO

PURPOSE: To evaluate the anatomical and functional outcomes of Type 1 retinopathy of prematurity 1 year after the intravitreal injection of aflibercept (IVA). METHODS: This prospective cohort study enrolled Type 1 retinopathy of prematurity patients who had been treated with IVA as first-line therapy from July 1, 2015, to June 30, 2017. Patients were followed up for at least 1 year after injection. The primary outcomes were retinopathy of prematurity regression, progression, reactivation, and the occurrence of associated complications after the use of IVA. The secondary outcomes were visual acuity and refractive error at 1 year after IVA. RESULTS: Seventeen eyes of nine patients were enrolled in our study. A single IVA injection resulted in resolution in 15 eyes (88.2%), whereas 2 eyes (11.8%) needed retreatment. The mean Snellen visual acuity and refractive error were 6/13 ± 0.34 and -1.94 ± 2.97 D, respectively. No major ocular complications or systemic adverse effects were noted during the follow-up period, except one patient (11%) passed away at the age of 14 months due to a pulmonary infection. CONCLUSION: Aflibercept is effective and well tolerated for the treatment of Type 1 retinopathy of prematurity; it is a potential treatment option as it achieves good anatomical, visual, and refractive outcomes.

9.
Sci Rep ; 10(1): 982, 2020 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-31969635

RESUMO

To investigate the epidemiology of eye-related emergency department (ED) visits and to determine if visual acuity (VA) could be an indicator for determining the timing for managing ocular emergencies, we have conducted the retrospective study which included patients visited the ED for eye-related reasons and had received ophthalmology consultations at a referral center in Taiwan in 2015. Among 46,514 consultations, 5,493 were ophthalmology consultations (11.8%). After exclusion, 5,422 were eligible for analysis. Among them, 1,165 (21.5%) had not likely emergent diagnoses, 4,048 (74.7%) had likely emergent diagnoses, and 209 patients (3.9%) could not be determined. The logMAR VA was 0.31 ± 0.48, 0.66 ± 0.78, and 1.00 ± 0.94 in groups with not likely emergent, likely emergent, and undetermined diagnoses, respectively. Among all eye-related ED visits, 10.3% of patients received ophthalmologic intervention or were admitted to the ophthalmology ward. A LogMAR VA score of 0.45 (decimal equivalent of 0.4) had the highest discrimination power for identifying whether a patient needed ophthalmology intervention or admission to ophthalmology ward (area under the curve: 0.802, sensitivity: 0.800, specificity: 0.672). In our study, we found VA could be an indicator for determining the priority and time of ocular emergencies requiring ophthalmic intervention in patients visiting the ED for eye-related reasons.

11.
Retina ; 40(3): 572-580, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30531421

RESUMO

OBJECTIVE: This study aims to examine retinal vascular findings for affected eyes and contralateral eyes as well in typical cases of unilateral persistent fetal vasculature. METHODS: We retrospectively reviewed all patients evaluated at Chang Gung Memorial Hospital, Linkou, for unilateral persistent fetal vasculature between January 2008 and July 2017. All patients underwent fluorescein angiography (FA) examination under general anesthesia. FA was performed using RetCam 3 (Clarity Medical Systems, Inc, Pleasanton, CA). RESULTS: Ten patients (eight male and two female) were identified as having adequate clinical data for the final analysis. The mean age at diagnosis was 13.7 ± 17.2 months (range 1-58). The mean axial length was shorter in the affected eyes as compared to the fellow eyes (17.27 ± 2.8 vs. 20.2 ± 1.7 mm; P = 0.024). In the affected eyes, nine cases (90.0%) showed a concomitant retrolental stalk, avascular peripheral retina, regional capillary dropout, and absence of foveal avascular zone. Hyperfluorescent stalk was seen in seven cases (70.0%). Four eyes (40.0%) showed leaking vessels. Terminal supernumerary branching was seen in two cases (20.0%). Popcorn hyperfluorescence was noted in one case (10.0%). In the fellow eyes, peripheral avascular zone was noted in nine eyes (90.0%), of which six (60.0%) had peripheral zones greater than two-disk diameters. Seven eyes (70.0%) presented with regional capillary dropout and abnormal choroidal filling. Three eyes (30.0%) had abnormal vessel straightening. Aberrant circumferential vessels and leaking spots were seen in two eyes (20.0%). Regional dilation of disk vessels, peripheral vessel dilation, and terminal bulbing were noted in one eye (10.0%). The mean best-corrected visual acuity of the fellow eyes was 20/39 (0.29 in logarithm of the minimum angle of resolution). CONCLUSION: Retinal vascular abnormalities in the affected eyes and fundoscopically normal fellow eyes of unilateral persistent fetal vasculature patients were found in 100% and 90.0% of patients, respectively. Fellow eyes had some subtle abnormalities that were only revealed through FA. These unilateral persistent fetal vasculature cases were still bilaterally affected.

12.
Retina ; 2019 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-31800460

RESUMO

PURPOSE: To determine the rates and risk factors of recurrent retinopathy of prematurity (ROP) treated by laser photocoagulation, intravitreal bevacizumab (IVB) monotherapy, or intravitreal ranibizumab (IVR) monotherapy. METHODS: In this retrospective cohort study, consecutive infants with Type 1 ROP who received laser, IVB, or IVR treatments were followed for at least 75 weeks of postmenstrual age. Data analysis was performed between March 2010 and February 2017 in Chang Gung Memorial Hospital, Linkou, Taiwan. RESULTS: A total of 176 infants (340 eyes) were included in this study. The mean follow-up was 197.3 ± 110 weeks. All of the baseline demographic and ROP characteristics among the laser, IVB, and IVR groups were similar. The overall recurrence rate after treatment was 44 of 340 eyes (12.9%). The IVB group had a recurrence rate of 10.0%, followed by the laser group (18.0%) and the IVR group (20.8%); however, these rates were not significantly different (P = 0.0528). Compared with the laser group, the IVB and IVR groups exhibited recurrence at later ages (43.4 ± 3.5 weeks for the IVB group, 42.3 ± 2.0 weeks for the IVR group, and 39.5 ± 2.8 weeks for the laser group; P = 0.0058). The mean interval of recurrence from initial treatment in the laser group was 3.6 ± 1.4 weeks compared with 8.8 ± 3.9 weeks and 8.3 ± 1.6 weeks in the IVB and IVR groups, respectively (P = 0.0001). Overall, the independent risk factors of recurrence included an early postmenstrual age at initial treatment (P = 0.0160), Zone I (P = 0.0007), low Apgar score (P = 0.0297), and multiple births (P = 0.0285). There was no significant difference in progression to retinal detachment among the three groups (laser: 3/61, 4.9%; IVB: 2/231, 0.9%;and IVR: 1/48, 2.1%; P = 0.2701). CONCLUSION: Laser, IVR, and IVB are effective for Type 1 ROP. Retinopathy of prematurity recurrence requiring re-treatment was encountered as late as 50 weeks of postmenstrual age after IVB or IVR but earlier after laser. Longer follow-up for infants treated with anti-vascular endothelial growth factor is needed, especially in patients with significant risk factors such as an early postmenstrual age at initial treatment, Zone I ROP, low Apgar score, and multiple births.

13.
Retina ; 2019 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-31764611

RESUMO

PURPOSE: To understand the epidemiology of retinopathy of prematurity (ROP) requiring treatment in Taiwan from 2002 to 2011. METHODS: This retrospective cross-sectional study enrolled 11,180 premature patients with a length of stay >28 days who survived during hospitalization. The incidence of the first ROP treatment was analyzed. RESULTS: Among ROP patients (n = 4,096), 6.5% (n = 265) received treatment. The most frequently performed treatment was laser administration (n = 199), followed by intravitreal anti-vascular endothelial growth factor (VEGF) injection (n = 38), scleral buckle or pars plana vitrectomy (n = 14), and cryotherapy (n = 14). The incidence of ROP requiring treatment increased during the study period, as did the use of intravitreal anti-VEGF injection. Shifts in the treatment modality from cryotherapy and scleral buckle/pars plana vitrectomy to laser treatment after 2003 and from laser treatment to intravitreal anti-VEGF injection after 2010 were observed. CONCLUSION: In Taiwan, the incidence of the use of intravitreal anti-VEGF injection for treating ROP increased between 2002 and 2011. Laser treatment was less frequently used than intravitreal anti-VEGF injection in 2011.

15.
JAMA Ophthalmol ; 137(10): e193129, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31600377
16.
Micromachines (Basel) ; 10(8)2019 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-31430967

RESUMO

: The present study applied Sn-0.7Cu-0.2Zn alloy solders to a photovoltaic ribbon. Intermetallic compounds of Cu6Sn5 and Ag3Sn formed at the Cu/solder/Ag interfaces of the module after reflow. Electron probe microanalyzer images showed that a Cu-Zn solid-solution layer (Zn accumulation layer) existed at the Cu/solder interface. After a 72 h current stress, no detectable amounts of Cu6Sn5 were found. However, a small increase in Ag3Sn was found. Compared with a Sn-0.7Cu photovoltaic module, the increase of the intermetallic compounds thickness in the Sn-0.7Cu-0.2Zn photovoltaic module was much smaller. A retard in the growth of the intermetallic compounds caused the series resistance of the module to slightly increase by 9%. A Zn accumulation layer formed at the module interfaces by adding trace Zn to the Sn-0.7Cu solder, retarding the growth of the intermetallic compounds and thus enhancing the lifetime of the photovoltaic module.

18.
Ophthalmic Surg Lasers Imaging Retina ; 50(6): 377-384, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-31233155

RESUMO

BACKGROUND AND OBJECTIVE: To investigate clinical features and surgical outcomes of vitrectomy in posterior or combined persistent fetal vasculature (PFV) in an Asian pediatric population. PATIENTS AND METHODS: This study was a retrospective, noncomparative, interventional case series relating the surgical outcome of PFV. Eyes that underwent pars plicata vitrectomy and/or lensectomy for posterior or combined PFV between 2006 and 2015 were included. The main outcome measures were the anatomic and functional results as well as the complications after the vitrectomy with or without lensectomy. RESULTS: A total of 25 eyes of 18 patients younger than 8 years of age were included in the study. The mean age of the patients receiving first pars plicata vitrectomy and/or lensectomy was 15.2 months ± 21.7 months (range: 1 month to 83 months). Postoperatively, successful anatomic correction in the posterior segment was observed in 20 eyes (80%). In addition, 19 of the 25 eyes (76%) had visual acuity (VA) better than 20/4000, and the mean logMAR VA of these 19 eyes was 1.74 (range: 0.48 to 2.30). The mean change of axial length of the eyes receiving surgery was 0.7 mm ± 1.4 mm (range: -1.0 mm to 2.4 mm; P = .18). None of the patients ended up with phthisis or glaucoma. CONCLUSIONS: This study suggests that vitrectomy and/or lensectomy in patients with posterior or combined PFV with macular involvement may result in an acceptable anatomical outcome; however, the functional outcome remained poor despite surgical intervention in these patients. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:377-384.].


Assuntos
Vítreo Primário Hiperplásico Persistente/cirurgia , Acuidade Visual/fisiologia , Vitrectomia/estatística & dados numéricos , Grupo com Ancestrais do Continente Asiático , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Vítreo Primário Hiperplásico Persistente/fisiopatologia , Complicações Pós-Operatórias , Estudos Retrospectivos , Vitrectomia/métodos
19.
Int Ophthalmol ; 39(12): 2767-2773, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31140024

RESUMO

PURPOSE: To evaluate a surgical technique using a perfluoro-n-octane (PFO)-assisted autologous internal limiting membrane (ILM) plug for refractory macular holes (MHs). METHODS: This study was a retrospective, consecutive, interventional case series. Patients with refractory MHs following PFO-assisted autologous ILM plugs were reviewed between October 1, 2017, and February 28, 2018. The anatomical results of MH preoperatively and postoperatively were evaluated by fundus examination and optical coherence tomography (OCT). The best-corrected visual acuities (BCVAs) before and after surgery were compared as the functional outcome. RESULTS: Six eyes of six consecutive patients with refractory MH were enrolled in this study. Successful MH closure and BCVA improvement after the surgeries were obtained in all eyes. There were four male and two female patients, and the mean age was 63.7 ± 11.1 years. Intraoperatively, the average number of autologous ILM grafts we harvested was 2.2 ± 0.4. The mean follow-up was 6.0 ± 1.7 months. The averaged BCVA before and after the surgery at the last visit improved from 20/356 to 20/153. The ILM graft tissue was still visible, as shown by OCT, in all 6 of 6 (100%) eyes during the follow-up period. CONCLUSIONS: This surgical technique using PFO-assisted autologous ILM plug may provide an option for the treatment of refractory MH.


Assuntos
Membrana Basal/cirurgia , Tamponamento Interno/métodos , Fluorcarbonetos/administração & dosagem , Perfurações Retinianas/cirurgia , Vitrectomia/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia de Coerência Óptica , Acuidade Visual
20.
Jpn J Ophthalmol ; 63(4): 297-303, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31104166

RESUMO

PURPOSE: To investigate the incidence, prevalence, and factors related to pterygium in Taiwan. STUDY DESIGN: An ecological study METHODS: We analyzed a random sample of 1 million individuals in Taiwan drawn from the National Health Insurance Database (NHIRD), established in 2005, for the period 2000 to 2011. Patients with pterygium were identified using ICD-9-CM diagnostic codes. The prevalence and annual age- and gender-adjusted incidence of pterygium were calculated for each county in Taiwan. The risk factors including ultraviolet (UV) exposure, outdoor occupation, educational level, and average socioeconomic status of each county of each index year were identified. Univariate and backward elimination multivariate selection by the mixed-effects model were performed to identify significant risk factors related to the incidence of pterygium in Taiwan. RESULTS: A total of 22,063 individuals with pterygium (10,125 men and 11,938 women) were identified in this study. The prevalence of pterygium was 2.14% in the overall population and 3.48% in the population aged 40 years or older. The occurrence of pterygium was greater in women. In addition, this study demonstrated that UV exposure and low educational level are correlated with the age- and gender-adjusted incidence of pterygium. CONCLUSION: Our study is the first to use the NHIRD to determine the prevalence (2.14%) and annual age- and gender-adjusted incidence of pterygium among the general population of Taiwan. The relationship of pterygium with UV exposure and educational level suggests a complex and multifactorial etiology for this disease.


Assuntos
Vigilância da População , Pterígio/epidemiologia , Medição de Risco , Adulto , Distribuição por Idade , Idoso , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Fatores de Risco , Distribuição por Sexo , Taiwan/epidemiologia , Adulto Jovem
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