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1.
Medicine (Baltimore) ; 100(32): e26880, 2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34397904

RESUMO

ABSTRACT: Poor oral hygiene can be potentially life-threatening in inpatients. However, no basic protocol on oral hygiene customized for inpatients exists, and lack of oral care related knowledge, attitude, and skills among caregivers could be detrimental to the general health of patients. This study sought to identify the oral care practices and oral health status of inpatients with varying physical activity limitations in a rehabilitation ward.Sixty-one inpatients in a rehabilitation ward were evaluated for their medical and physical conditions and oral health status. These were assessed using the bedside oral exam, decayed, missing, filled teeth index, plaque index, gingival index, and caries activity test.In total, 40 men and 21 women (mean age, 56.6 years) were included in this study. Among them, 50.8% of the patients could brush their teeth unassisted, whereas 49.2% required assistance from an assistant for oral care. The proportion of patients receiving nasogastric tube feeding was higher in the group that could not provide oral self-care; 36.7% and 33.3% of these patients showed moderate and severe dysfunction, respectively, based on bedside oral exam. Scores for the swallowing, tongue, and total domains of bedside oral exam were poorer for patients who could not provide oral self-care (P < .01). The caries activity test indicated a moderate risk for both groups.Our findings suggest that an oral care protocol that considers the physical activity limitations in inpatients in rehabilitation wards is necessary to minimize negative influences on the systemic health of these patients.


Assuntos
Atividades Cotidianas , Cárie Dentária , Saúde Bucal/normas , Higiene Bucal , Autocuidado , Cuidadores/educação , Cárie Dentária/diagnóstico , Cárie Dentária/prevenção & controle , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pacientes Internados/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Higiene Bucal/educação , Higiene Bucal/métodos , Índice Periodontal , Desempenho Físico Funcional , Centros de Reabilitação/estatística & dados numéricos , República da Coreia/epidemiologia , Autocuidado/métodos , Autocuidado/estatística & dados numéricos
2.
BMC Oral Health ; 21(1): 233, 2021 05 04.
Artigo em Inglês | MEDLINE | ID: mdl-33941148

RESUMO

BACKGROUND: This cross-sectional study aimed to examine the relationship between sleep habits and oral disease symptoms in adolescents. METHODS: Among 62,276 adolescents who participated in the 13th Korea Youth Risk Behavior Web-based Survey (2017), we selected a total of 54,766 adolescents (age, 12-18 years; male, 49.9%) for the final analysis, after excluding those who did not report their sleep duration. The 13th Korea Youth Risk Behavior Web-based Survey data were obtained from a stratified, multistage, clustered sample. Independent variables included general characteristics, oral health behavior, sleep types, sleep duration, and sleep quality; dependent variables comprised oral disease symptoms. Sleep was categorized according to bedtime astype A (bedtime < 1 a.m.) and type B (bedtime ≥ 1 a.m.). Data were analyzed using logistic regression analysis. Statistical significance was set at p < 0.05. RESULTS: After adjusting for all covariates, adolescents with type A sleep had a higher risk of toothache on chewing (OR = 1.08, 95% CI 1.02-1.15) than adolescents with type B. Adolescents who slept for 6 h or less each night had a higher risk of pain in the tongue and buccal mucosa (OR = 1.35, 95% CI 1.18-1.54), gingival pain, and bleeding (OR = 1.31, 95% CI 1.19-1.45) than those who slept for more than 8 h. Adolescents with low quality of sleep had a higher risk of toothache or throbbing (OR = 1.70, 95% CI 1.60-1.81), toothache on chewing (OR = 1.73, 95% CI 1.65-1.82), and halitosis (OR = 1.51, 95% CI 1.41-1.59) than those with high quality of sleep. CONCLUSIONS: Our findings indicate that some oral symptoms are related to sleep duration and quality. It is essential to inculcate good sleeping habits in adolescents by emphasizing the effects of inadequate sleep duration and quality.


Assuntos
Assunção de Riscos , Sono , Adolescente , Criança , Estudos Transversais , Humanos , Internet , Masculino , República da Coreia/epidemiologia , Inquéritos e Questionários
3.
Graefes Arch Clin Exp Ophthalmol ; 259(5): 1235-1241, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33409678

RESUMO

PURPOSE: To investigate the characteristics of eyes with dry eye disease (DED) whose lipid layer thickness (LLT) measured 100 nm on a LipiView II interferometer and compare the DED parameters of them to those with LLT below 100 nm. METHODS: A total of 201 eyes of 102 enrolled DED patients (mean age 56.4 ± 11.8 years) were classified into 3 groups according to their average LLT; < 60 nm as thin-LLT (n = 49), 60-99 nm as normal-LLT (n = 77), and 100 nm as thick-LLT (n = 75). LLT, meiboscore, Schirmer I test, tear film break-up time (TBUT), ocular surface staining (OSS), and ocular surface disease index (OSDI) were assessed. RESULTS: The OSS and TBUT were significantly worse in the thick-LLT group than in the normal-LLT group (p = 0.020, and p = 0.028, respectively). The OSDI was significantly higher in the thick-LLT group than in the thin-LLT group (p = 0.006). However, the meiboscore was not different among the three groups (p = 0.33). Age, OSS, and OSDI showed a positive correlation with LLT (r = 0.16, p = 0.023; r = 0.213, p = 0.003; and r = 0.338, p = 0.001, respectively). In sensitivity analyses, eyes with corneal erosions had a significantly higher average LLT (p = 0.015), higher OSDI (p = 0.009), shorter TBUT (p < 0.001), and shorter Schirmer I value (p = 0.024) than those with clear corneas. CONCLUSION: The average LLT of eyes with corneal erosions was thicker than those without erosions, suggesting that the LLT of 100 nm in the eyes with corneal erosions should not be regarded as a stable physiologic condition. Cautious interpretation of LLT along with other dry eye parameters is required.


Assuntos
Síndromes do Olho Seco , Glândulas Tarsais , Testes Diagnósticos de Rotina , Síndromes do Olho Seco/diagnóstico , Humanos , Lipídeos , Glândulas Tarsais/diagnóstico por imagem , Pessoa de Meia-Idade , Lágrimas
4.
Korean J Ophthalmol ; 34(2): 126-132, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32233146

RESUMO

PURPOSE: To evaluate the agreement in ocular biometry outcomes measured by three different devices, the IOL Master 500, IOL Master 700, and Lenstar LS900, and compare the refractive outcomes after cataract surgery obtained using those three devices. METHODS: Medical records of 178 eyes of 89 patients who underwent ocular biometry with the three devices were retrospectively reviewed, and 124 eyes met the inclusion criteria. Paired comparisons were performed for axial length (AL), mean keratometry (Km), and anterior chamber depth and quantified their agreement using Bland-Altman plots. Subgroup analyses were done according to the AL and the Km. Refractive outcomes were compared with respect to absolute prediction errors after cataract surgery in 54 eyes. RESULTS: Among 124 eyes, 12, 3, and 5 eyes failed to be measured of AL by IOL Master 500, IOL Master 700 and Lenstar LS900, respectively. The AL measured by Lenstar LS900 was longer than that measured by IOL Master 500 and IOL Master 700 (p < 0.001, p = 0.002, respectively). Subgroup analysis revealed that these results were statistically significant only in long eyes (AL >25.5 mm). Km measured using the IOL Master 500 was steeper than that measured with the IOL Master 700 or Lenstar LS900 (p = 0.001, p < 0.001, respectively). anterior chamber depth measured by IOL Master 500 was shallower than that measured by IOL Master 700 or Lenstar LS900 (p < 0.001, p < 0.001, respectively). Ocular biometry measurements by the three devices showed high agreement with narrow 95% limits of agreement. Absolute prediction errors from the 3 devices showed no statistically significant differences after cataract surgery. CONCLUSIONS: The IOL Master 700 and Lenstar LS900 demonstrated superior acquisition rates of biometric measurements compared with the IOL Master 500. Ocular biometry using the 3 different devices showed high agreement, although statistically significant differences were observed; however, since there was no difference in predicting the refractive outcomes, those differences are clinically negligible.


Assuntos
Câmara Anterior/diagnóstico por imagem , Catarata/fisiopatologia , Lentes Intraoculares , Refração Ocular/fisiologia , Tomografia de Coerência Óptica/métodos , Idoso , Extração de Catarata/métodos , Feminino , Seguimentos , Humanos , Masculino , Desenho de Prótese , Estudos Retrospectivos
5.
Korean J Ophthalmol ; 34(1): 35-45, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32037748

RESUMO

PURPOSE: To investigate the influence of donor age on corneal graft survival following primary penetrating keratoplasty (PK) with imported donor corneas. METHODS: The eyes of patients who underwent primary PK with imported donor corneas were classified retrospectively into two groups according to a donor-age cutoff of 65 years. Primary outcome measures were rejection-free graft survival and graft survival. Cox proportional hazard regression analysis was used to assess the factors affecting graft survival. Survival analysis was performed using the Kaplan-Meier method, while differences between groups were examined using a log-rank test. A subgroup analysis of low- and high-risk eyes according to preoperative diagnosis was also performed. RESULTS: A total of 140 eyes from 138 patients (age, 58 ± 18 years) were enrolled. Cox regression analysis revealed that the donor age of 65 years or older group presented an increased risk of both graft rejection and failure. Survival analysis revealed that rejection-free graft survival and graft survival rates were higher in eyes in the donor age of less than 65 years group. Finally, in the subgroup analysis, both rejection-free graft survival and graft survival rates were significantly higher in the donor age of less than 65 years group than in the donor age of 65 years or older group, but only in the low-risk subgroup. CONCLUSIONS: Donor age may correlate with graft survival in primary PK performed with imported donor corneas. Donor age could be a considerable factor in primary PK with imported donor corneas, especially in preoperatively low-risk patients.


Assuntos
Córnea/citologia , Doenças da Córnea/cirurgia , Rejeição de Enxerto/epidemiologia , Ceratoplastia Penetrante/métodos , Doadores de Tecidos , Adulto , Fatores Etários , Idoso , Doenças da Córnea/diagnóstico , Feminino , Seguimentos , Rejeição de Enxerto/etiologia , Sobrevivência de Enxerto , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prognóstico , República da Coreia/epidemiologia , Estudos Retrospectivos
6.
Korean J Ophthalmol ; 33(6): 500-505, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31833246

RESUMO

PURPOSE: To describe the clinical features of Korean patients with contact lens-induced limbal stem cell deficiency (CL-LSCD). METHODS: Medical records of 22 patients who were diagnosed with CL-LSCD between 2014 and 2019 were reviewed retrospectively. Outcome measures included demographics, clinical presentation, treatment, clinical course, and pattern of contact lens (CL) wear. RESULTS: Forty-two eyes of 22 patients were found to have typical changes associated with CL-LSCD. Twenty (91%) patients were women and mean age was 36 ± 12 years. All patients had myopia with mean spherical equivalent of -7.52 ± 3.2 diopter. Twenty (91%) patients had bilateral disease and the location of limbal involvement was diffuse in 20 eyes (47.6%) and partial in 22 eyes (52.4%, superior in 20 eyes and inferior in 2 eyes). Fourteen (63.6%) patients complained of decreased visual acuity. Average period of CL wear was 14 ± 9 years. Four patients used cosmetic colored CLs and four patients had a history of overnight CL wear. All 12 patients who completed follow-up (28 ± 42 weeks) showed improvement in visual acuity and ocular surface condition after cessation of CL wear and medical treatment. Of them, five (42%) patients showed full recovery while seven (58%) showed partial recovery. CONCLUSIONS: If a patient with a history of CL wear for an extended period of time presents with decreased visual acuity, practitioners should perform detailed examinations with suspicion of CL-LSCD, including fluorescein staining. CL-LSCD is usually reversible and close follow-up with conservative treatment is recommended as the initial treatment option.


Assuntos
Lentes de Contato Hidrofílicas/efeitos adversos , Doenças da Córnea/diagnóstico , Epitélio Corneano/patologia , Limbo da Córnea/patologia , Miopia/terapia , Células-Tronco/patologia , Adolescente , Adulto , Idoso , Doenças da Córnea/etiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , República da Coreia , Fatores de Tempo , Acuidade Visual/fisiologia , Adulto Jovem
7.
Korean J Ophthalmol ; 33(5): 467-474, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31612658

RESUMO

PURPOSE: To evaluate the protective effect of applying an ophthalmic viscosurgical device (OVD) to the ocular surface during cataract surgery and its ability to prevent dry eye syndrome. METHODS: Twenty-four patients aged 50 to 75 years who underwent cataract surgery at Seoul National University Bundang Hospital and agreed to participate in the study were included and divided into two groups: a study group who underwent cataract surgery after application of an OVD to the ocular surface, and a control group who underwent cataract surgery without application of an OVD. DisCoVisc was used as the OVD in the study group, while other factors including surgical techniques and administration of anesthetic agents were performed in both groups in the same manner. Indicators of dry eye syndrome including ocular staining score, tear break-up time, and tear osmolality were analyzed. Ocular surface disease index and a visual analog scale were analyzed for dry eye symptoms, and the amount of balanced salt solution used during surface irrigation and operation time were also analyzed. RESULTS: Significant improvement in the tear break-up time, corneal ocular staining score, and ocular surface disease index score in the study group compared with the control group one week after operation (by the Mann-Whitney test). Use of OVD was associated with longer operating time. CONCLUSIONS: OVD applied to the ocular surface during cataract surgery had a protective effect on the ocular surface one week after surgery.


Assuntos
Extração de Catarata/instrumentação , Catarata/complicações , Síndromes do Olho Seco/complicações , Ácido Hialurônico/administração & dosagem , Idoso , Síndromes do Olho Seco/tratamento farmacológico , Feminino , Seguimentos , Humanos , Período Intraoperatório , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Lágrimas/metabolismo , Resultado do Tratamento , Viscossuplementos/administração & dosagem
9.
Int J Dent Hyg ; 17(4): 336-342, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31344752

RESUMO

OBJECTIVES: To investigate registered nurses' awareness and implementation of oral health care in patients who are hospitalized in general wards or intensive care units (ICUs) in South Korea. METHODS: This research was performed as a descriptive survey of 149 nurses working in nine general hospitals with at least 100 beds in major Korean cities. RESULTS: Approximately half (40.9%) of the survey respondents reported providing oral health care for hospitalized patients but that relevant protocols were not available at most hospitals or wards (89.5%). Nurses working in an ICU were significantly more likely to provide oral health care than those working in general wards (83.9% vs 15.1%; P < .001). Most respondents (83.2%) were aware of the importance of providing oral health care for hospitalized patients; however, the proportion considering that such care should be provided by dental hygienists was greater than that considering it should be provided by nurses (36.4% vs 26.0%; P < .001). Agreement that oral health care should be provided for hospitalized patients by dental hygienists was highest in nurses working in ICUs (53.3%; P < .001). CONCLUSIONS: According to this survey, oral healthcare provision is generally low in hospitalized patients and differs between ICUs and general wards. Most respondents considered that dental hygienists should provide oral health care for hospitalized patients. There is an opportunity for nurses and dental hygienists to work collaboratively towards development of an evidence-based protocol for oral health care in hospitalized patients.


Assuntos
Higienistas Dentários , Saúde Bucal , Atenção à Saúde , Humanos , República da Coreia , Inquéritos e Questionários
10.
JAMA Ophthalmol ; 136(8): 912-918, 2018 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-29879279

RESUMO

Importance: There is a paucity of data addressing the risk of cataract development in pediatric patients with atopic dermatitis (AD). Objective: To investigate the association of AD with subsequent cataract development and cataract surgery in a Korean pediatric population. Design, Setting, and Participants: This population-based retrospective longitudinal cohort study used nationally representative data from the Korean National Health Insurance Service database from 2002 to 2013. Incident AD cases, consisting of patients younger than 20 years with AD and severe AD and were matched to 4 controls each using propensity score derived from age, sex, residential area, and household income. Main Outcomes and Measures: Incidence probabilities of cataract development and cataract surgery between the AD group and controls were compared using Kaplan-Meier methods and log-rank tests. Cox proportional hazard models were fitted for cataract and cataract surgery to determine the risk factors in the matched cohort. Results: Of 34 375 patients with incident AD (16 159 girls [47%]; mean [SD] age, 3.47 [4.96] years), there were 3734 severe AD cases (10.9%) with 137 500 matched controls. Development of cataracts was not different between the AD and control groups, (0.216% vs 0.227%; 95% CI, -0.041% to 0.063%; P = .32) or between the severe AD cohort and their controls (0.520% vs 0.276%; 95% CI, -0.073% to 0.561%; P = .06). Cataract surgery was performed more frequently in the AD cohort than in the control group (0.075% vs 0.041%; 95% CI, 0.017%-0.050%; P = .02) and in the severe AD cohort compared with their controls (0.221% vs 0.070%; 95% CI, 0.021%-0.279%; P = .03). Severe AD was associated with both development of cataract (adjusted hazard ratio, 1.94; 95% CI, 1.06-3.58, P = .03) and requirement for cataract surgery (adjusted hazard ratio, 5.48; 95% CI, 1.90-15.79, P = .002). Conclusions and Relevance: Absolute risk of cataract was rare, with or without AD, even after 10 years of observation. However, our results suggest that pediatric patients with AD have an increased risk for cataracts requiring surgery and that disease severity may increase the risk for cataract development and cataract surgery.


Assuntos
Extração de Catarata , Catarata/etiologia , Dermatite Atópica/complicações , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Bases de Dados Factuais , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Programas Nacionais de Saúde , Modelos de Riscos Proporcionais , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
12.
Cornea ; 37(1): 33-38, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29211700

RESUMO

PURPOSE: To investigate the influence of histocompatibility Y (H-Y) antigen matching on corneal graft survival in primary penetrating keratoplasty (PK). METHODS: Medical records of patients who underwent primary PK at Seoul National University Bundang Hospital between June 2005 and October 2015 were retrospectively analyzed. The eyes were classified into 2 groups: H-Y-compatible (115 eyes) and H-Y-incompatible (23 eyes). The H-Y-compatible group included donor/recipient combinations of male/male (57 eyes), female/male (44 eyes), and female/female (14 eyes). The H-Y-incompatible group included the male/female (23 eyes) combination alone. A subgroup analysis of low- and high-risk patients according to preoperative diagnoses was also performed. Survival analysis was conducted using the Kaplan-Meier method; differences between groups were assessed with a log-rank test. RESULTS: A total of 138 eyes from 136 patients (age: 58 ± 18 years) were enrolled. Rejection-free graft survival and graft survival were not significantly different between H-Y-compatible and H-Y-incompatible groups (χ = 0.4, P = 0.548; χ = 1.9; P = 0.17, respectively). Preoperative diagnoses of high-risk cases included those with corneal perforation or thinning (8.7%) and infectious keratitis (7.2%). Low-risk cases included corneal opacity (50.0%), bullous keratopathy (25.4%), keratoconus (5.8%), and corneal dystrophy (2.9%). In the high-risk group, rejection-free graft survival rate was significantly higher in the H-Y-compatible group (χ = 3.9, P = 0.049). CONCLUSIONS: H-Y antigen matching does not influence graft rejection and failure in cases of primary PK. However, matching the H-Y antigen could help reduce graft rejection, especially in preoperatively high-risk patients.


Assuntos
Doenças da Córnea/cirurgia , Sobrevivência de Enxerto/imunologia , Antígeno H-Y/imunologia , Ceratoplastia Penetrante , Idoso , Aloenxertos , Feminino , Rejeição de Enxerto/diagnóstico , Teste de Histocompatibilidade , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
13.
J Burn Care Res ; 39(4): 478-480, 2018 06 13.
Artigo em Inglês | MEDLINE | ID: mdl-28877133

RESUMO

The objective of this study was to evaluate tear dysfunction of burn patients objectively. We retrospectively reviewed medical records of patients who had been examined within 1 week after burn injury. Visual acuity, intraocular pressure, cilia burned state, tear film break-up time (TBUT), and fluorescein corneal staining were evaluated. Sixty-four eyes of 32 patients (man 27, female 5) were included. Mean age was 44.41 ± 12.76 years old. Mean best corrected visual acuity was logMAR 0.04 ± 0.08, mean intraocular pressure was 13.41 ± 3.13 mm Hg, and mean TBUT was 5.48 ± 3.18 seconds. Thirty-four eyes (53.13%) showed burned cilia, 36 eyes (56.25%) showed corneal erosion on fluorescein stating. Intraocular pressure and TBUT were lower in TBSA with burn involved ≥ 10% group than TBSA with burn involved < 10% group (P = .000; P = .058). The percentage of TBSA of burn involved and tear break up time showed statistically significant negative correlations (r = -0.262; P = .037). Many burn patients have discomfort due to tear dysfunction syndrome. Tear dysfunction may be caused by direct injury of eye burn itself and body fluid deficiency. We recommend that when we treat burn patients, we have to pay attention to their symptoms and manage patient's eye symptoms properly such as routine artificial tear lubricant treatment.


Assuntos
Queimaduras/complicações , Queimaduras/fisiopatologia , Lesões da Córnea/etiologia , Lesões da Córnea/fisiopatologia , Lágrimas , Adolescente , Adulto , Idoso , Feminino , Humanos , Pressão Intraocular , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Síndrome , Acuidade Visual
14.
Graefes Arch Clin Exp Ophthalmol ; 255(12): 2487-2492, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28889226

RESUMO

PURPOSE: To evaluate the level of stereopsis and fusion in patients with anisometropia according to the presence of amblyopia. METHODS: We included 107 children with anisometropia, divided into groups with non-amblyopic anisometropia (NA, n = 72) and amblyopic anisometropia (AA, n = 35). Normal subjects without anisometropia were enrolled in the control group (n = 73). Main outcome measures were the level of stereopsis and sensory fusion as evaluated by Titmus stereotest and Worth 4-dot test, respectively, using anisometropic glasses. RESULTS: The degree of anisometropia in the NA, AA, and control groups was 2.54 diopters (D), 4.29 D, and 0.30 D, respectively (P = 0.014). Stereopsis (arcsec) was significantly worse in the AA group than the NA and control groups (641.71, 76.25, 54.52, respectively, P < 0.001), while no significant difference was found between the NA and control groups. The rate of fusion was significantly lower in the AA than the NA group (14.3% vs. 65.3%, P < 0.001), and was significantly lower in the NA than the control group (65.3% vs. 80.6%, P = 0.001). CONCLUSIONS: The levels of stereopsis and sensory fusion with anisometropic glasses were significantly worse in the AA than in the NA group. The level of stereopsis in the NA group, however, did not differ significantly from that in the isometropic control, while the rate of fusion was significantly lower. Early prescription of anisometropic glasses is needed to improve visual acuity and binocularity in children with possible amblyopic anisometropia.


Assuntos
Ambliopia/fisiopatologia , Anisometropia/fisiopatologia , Percepção de Profundidade/fisiologia , Fusão Flicker/fisiologia , Visão Binocular/fisiologia , Acuidade Visual , Adolescente , Ambliopia/diagnóstico , Ambliopia/terapia , Anisometropia/diagnóstico , Anisometropia/terapia , Criança , Pré-Escolar , Óculos , Feminino , Humanos , Masculino , Estudos Retrospectivos , Testes Visuais
16.
Case Rep Ophthalmol ; 8(1): 250-258, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28559836

RESUMO

BACKGROUND: Posterior polymorphous corneal dystrophy (PPCD) is typically considered bilateral and asymptomatic. However, few case reports on patients with unilateral PPCD with asymmetric refractive error have mentioned anisometropic amblyopia development. In support of this, we report 3 cases of unilateral PPCD that presented as anisometropic astigmatism. Visual prognosis related to amblyopia development is discussed. CASE PRESENTATION: All 3 patients had a band lesion in the affected eye and a difference of at least 1.5 diopters in cylindrical refractive error between their eyes. The affected eye had a greater amount of astigmatism in all cases. Two patients (Cases 1 and 2) also had amblyopia in the affected eye. Case 1 was a 25-year-old male with a unilateral PPCD diagnosis and a band lesion involving the visual axis. Case 2 was an 11-year-old boy diagnosed with unilateral PPCD. The boy was treated with occlusion and atropine therapy over a 2-year period. Case 3 was a 4-year-old girl diagnosed with unilateral PPCD. The girl had a 30-month history of corrective spectacle use and had no amblyopia. In all cases, the corneal endothelial cell count was lower in the affected eye than in the unaffected contralateral eye. CONCLUSIONS: Practitioners should closely monitor patients with unilateral PPCD for astigmatic anisometropia and amblyopia development. Visual prognosis for patients with unilateral PPCD may be related to lesion position, age at diagnosis, astigmatism severity, and early-childhood corrective spectacle use.

17.
Dent Mater J ; 36(4): 476-481, 2017 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-28420834

RESUMO

The aims of this study were to identify the optimal concentration of coated orthodontic elastomerics using a layer-by-layer technique that can release chlorhexidine (CHX) as an antimicrobial material, and to measure the physical properties and antimicrobial effects of the coated elastomerics. Ethyl cellulose (EC) was used as the polymer, and five study groups with various combinations of solvents (i.e., ethanol and dichloromethane [DCM]) were included. The coated elastomerics were evaluated with a spectrophotometer to confirm the release of CHX, and their surfaces were observed by SEM. The CHX+EC+DCM group sustained antimicrobial release for the longest period (168 h, p<0.001) and exhibited the largest antimicrobial effect in an inhibition zone test using S. mutans for 7 days (p<0.05). This group had most effective physical properties and antimicrobial effects of coated elastomerics produced using a layerby-layer technique, and so its composition should be considered for use in clinical applications in orthodontics.


Assuntos
Anti-Infecciosos , Clorexidina , Aparelhos Ortodônticos , Humanos , Teste de Materiais
18.
Invest Ophthalmol Vis Sci ; 57(11): 4831-4836, 2016 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-27654410

RESUMO

Purpose: To investigate transepidermal water loss (TEWL) from the ocular area in dry eye disease (DED) and evaluate the correlation between ocular TEWL and other DED parameters. Methods: Transepidermal water loss from the ocular area in 56 eyes with DED and 38 healthy eyes was measured using a Tewameter TM300 that was equipped with custom made goggles (measuring temperature 24°C-26°C and relative humidity 35%-45%). The DED group was classified into two subgroups, aqueous deficient dry eye (ADDE) and evaporative dry eye (EDE). Correlations between ocular TEWL and other DED parameters, such as tear osmolarity, tear break-up time (TBUT), corneal staining, conjunctival staining, Schirmer I test, Ocular Surface Disease Index (OSDI), and Visual Analogue Scale score were evaluated. Results: Ocular TEWL was significantly higher in the DED group (63.0 ± 12.2 g/h/m2) than in the control group (54.7 ± 14.2 g/h/m2; P = 0.003). Although there was no significant difference, TEWL was higher in the ADDE subgroup (64.0 ± 10.7 g/h/m2) compared with the EDE subgroup (61.1 ± 14.9 g/h/m2). Tear break-up time, corneal staining score, and OSDI were significantly correlated with ocular TEWL (P < 0.05) in all participants. Ocular TEWL loss was negatively correlated with Schirmer I test value in the DED group. Conclusions: Ocular TEWL was significantly higher in DED patients compared with controls, reflecting higher tear evaporation in DED patients. Patients who have shorter Schirmer I test values tend to have higher TEWL values. Not only EDE but also ADDE patients may have increased tear evaporation.

19.
J Ocul Pharmacol Ther ; 32(7): 463-8, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27294831

RESUMO

PURPOSE: This study evaluates the efficacy of 3% diquafosol tetrasodium ophthalmic solution in Sjögren's syndrome (SS) and non-SS dry eye patients unresponsive to conventional artificial tear. METHODS: This retrospective study included 38 dry eye patients (11 with SS and 27 with non-SS) who were treated with 3% diquafosol due to lack of response to artificial tear treatment for more than 3 months. Signs such as tear film break-up time (TBUT), Schirmer-I test, and total ocular staining score (OSS), which consisted of corneal OSS and conjunctival OSS, were evaluated at baseline and the first visit after treatment. Symptoms were quantified using visual analog scale (VAS) and ocular surface disease index (OSDI) scores. Changes of parameters after treatment in all the patients and differences of changes in SS and non-SS were evaluated. RESULTS: In total population, total OSS and corneal OSS improved average 6 weeks after diquafosol treatment (all P < 0.05, paired t-test), although conjunctival OSS had no improvement. TBUT increased after treatment (P = 0.036), while Schirmer-I test, OSDI, and VAS showed no improvement. With respect to comparisons, total and corneal OSS improved in non-SS patients and TBUT improved in SS patients (all P < 0.05). CONCLUSIONS: Three percent diquafosol tetrasodium treatment could be considered as an additive or substitute treatment when artificial tear treatment is insufficient, as it improved OSS and TBUT. This study also demonstrated that diquafosol treatment is beneficial for TBUT improvement in SS, while it is beneficial for OSS improvement in non-SS dry eye patients.


Assuntos
Síndromes do Olho Seco/tratamento farmacológico , Lubrificantes Oftálmicos/química , Soluções Oftálmicas/uso terapêutico , Polifosfatos/uso terapêutico , Síndrome de Sjogren/tratamento farmacológico , Nucleotídeos de Uracila/uso terapêutico , Adulto , Idoso , Síndromes do Olho Seco/diagnóstico , Feminino , Humanos , Lubrificantes Oftálmicos/administração & dosagem , Masculino , Pessoa de Meia-Idade , Soluções Oftálmicas/administração & dosagem , Polifosfatos/administração & dosagem , Estudos Retrospectivos , Síndrome de Sjogren/diagnóstico , Nucleotídeos de Uracila/administração & dosagem
20.
Cornea ; 35(8): 1097-103, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27100658

RESUMO

PURPOSE: To determine the risk factors related to recurrence of pterygium using automated image analysis. METHODS: This study included 149 eyes of 149 patients who underwent pterygium excision and limbal-conjunctival autograft. Demographic variables including age and sex were collected. Image analysis was performed using anterior segment photographs taken preoperatively to measure relative length (horizontal length of pterygium invading cornea/horizontal corneal diameter), relative width (width of pterygium invading cornea/vertical corneal diameter), relative area (RA; area of pterygium invading cornea/total corneal area), and vascularity index (VI; degree of vascularity). In all patients, recurrence of pterygium was determined at 1 year after surgery. Association between these factors and recurrence rate was evaluated with univariate and multivariate analyses. RESULTS: Recurrence at 1 year was reported in 18.8% (28/149) of the patients. Univariate analysis showed that relative length (P = 0.001), relative width (P = 0.031), relative area (P = 0.009), and VI (P < 0.001) were significantly associated with increased risk of recurrence, whereas age and sex had no significant association with recurrence. In multivariate analysis, only VI (P < 0.001) had significant correlation with recurrence. Patients with VI ≥30 had significantly higher recurrence rate than those with VI <30 (33.3% vs. 8.1%, P < 0.001). CONCLUSIONS: Increased vascularity was associated with a higher risk of recurrence. Quantification of vascularity using automated image analysis might be useful in predicting the risk of recurrence.


Assuntos
Procedimentos Cirúrgicos Oftalmológicos , Pterígio/diagnóstico por imagem , Pterígio/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Autoenxertos , Túnica Conjuntiva/irrigação sanguínea , Túnica Conjuntiva/transplante , Feminino , Humanos , Limbo da Córnea/cirurgia , Masculino , Pessoa de Meia-Idade , Neovascularização Patológica/patologia , Fotografação , Pterígio/patologia , Recidiva , Estudos Retrospectivos , Fatores de Risco
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