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1.
BMC Ophthalmol ; 21(1): 334, 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34525998

RESUMO

PURPOSE: To evaluate the relevance of external limiting membrane (ELM) on the visual and morphological results in eyes with diabetic macular edema (DME) that underwent pars plana vitrectomy (PPV) with epiretinal membrane (ERM) and internal limiting membrane (ILM) peeling. METHODS: Medical records of patients with DME who underwent PPV at our unit between January 2017 and December 2019 were reviewed. We assessed preoperative and postoperative best-corrected visual acuity (BCVA), central macular thickness (CMT) using spectral domain OCT (optical coherence tomography). Exclusion criteria were previous PPV; incomplete data; concomitant diseases including retinal vein occlusion, age-related macular degeneration, uveitis; and a follow-up of less than 12 months. The surgeries were performed using 23- or 27-gauge vitrectomy. The ELM was graded depending on its configuration (grade 0 = intact, grade 1 to 3: disruption of varying extent). RESULTS: Ninety-nine eyes were enrolled. The postoperative follow up averaged 23.7 months. The preoperative and final BCVA averaged 0.71 ± 0.28 and 0.52 ± 0.3 logMAR, respectively (p = 0.002). The CMT averaged 515.2 ± 209.1 µm preoperatively and 327 ± 66.1 µm postoperatively (p = 0.001). Eyes with intact ELM (n = 8) had a significantly better BCVA compared to those with ELM disruption (0.28 ± 0.14 vs. 0.7 ± 0.25 logMAR, p = 0.01). The final CMT was similar among the groups (intact ELM: 317 ± 54.6 µm; ELM disruption: 334 ± 75.2, p = 0.31). CONCLUSIONS: PPV with ERM and ILM peeling is an effective treatment of DME. Eyes with intact ELM preoperatively had a significantly better final visual outcome. To maximize the benefit for patients with DME we recommend early PPV as long as ELM is intact.


Assuntos
Diabetes Mellitus , Retinopatia Diabética , Membrana Epirretiniana , Edema Macular , Membrana Basal/cirurgia , Retinopatia Diabética/complicações , Retinopatia Diabética/cirurgia , Membrana Epirretiniana/cirurgia , Humanos , Lactente , Edema Macular/cirurgia , Retina , Estudos Retrospectivos , Tomografia de Coerência Óptica , Acuidade Visual , Vitrectomia
2.
Medicine (Baltimore) ; 100(35): e27069, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34477141

RESUMO

ABSTRACT: To investigate the difference in chorioretinal microcirculation between acute central serous chorioretinopathy (aCSC) and chronic central serous chorioretinopathy (cCSC) using optical coherence tomography angiography.In total, 65 patients previously diagnosed with central serous chorioretinopathy (33 aCSC and 32 cCSC) were included in our cross-sectional study. All patients underwent complete ophthalmologic assessment including logarithm of the minimum angle of resolution best-corrected visual acuity, fundus fluorescein angiography, and optical coherence tomography angiography. Sixty eyes of 60 refractive error and age matched healthy people were selected as control.The vessel density of inner retina in patients with aCSC were higher than that in patients with cCSC (51.32 ±â€Š2.01 vs 49.15 ±â€Š3.68, P = .004), however, the vessel density of superficial choroid layer in aCSC were significantly lower than that in cCSC (49.83 ±â€Š6.96 vs 53.42 ±â€Š6.28, P = .033). Further analysis of the data reveals the presence of a distinct choroidal neovascularization (CNV) in 8 patients (25%) with cCSC while there was no evidence of CNV in patients with aCSC.Our study can contribute to a better understanding of the difference in retinochoroid microcirculation between aCSC and cCSC. The vessel density of inner retina was lower and the vessel density of superficial choroid was higher in cCSC, and patients with cCSC were more susceptible to CNV than patients with aCSC.


Assuntos
Capilares/fisiopatologia , Coriorretinopatia Serosa Central/classificação , Microcirculação/fisiologia , Adulto , Neovascularização de Coroide/fisiopatologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Acuidade Visual/fisiologia
3.
BMC Pediatr ; 21(Suppl 1): 306, 2021 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-34496780

RESUMO

We looked at existing recommendations and supporting evidence on the effectiveness of screening for visual disorders in newborns and small infants, and in children between six months and five years of age.We conducted a literature search up to the 5th of August 2019 by using key terms and manual search in selected sources. We summarized the recommendations and the strength of the recommendations when and as reported by the authors. We summarized the main findings of systematic reviews with the certainty of the evidence as reported on the accuracy of screening tests for detecting visual alterations; the efficacy of treatment for improving visual acuity, school performance, and quality of life; and potential harms derived from vision screening and treating visual alterations.Although there is little evidence supporting its validity and effectiveness, examining all newborns for congenital cataract and retinoblastoma through the red reflex examination is widely accepted due to the severity of both diseases and the good outcomes reached by early detection and treatment.Overall, there is a moderate certainty of evidence that visual screening in children between three and five years provides a moderate net benefit, as assessed by the US Preventive Services Task Force: vision screening tests are accurate for detecting amblyopia and its risk factors, and their treatment is associated with visual improvement. There is uncertain evidence on whether vision screening in children under three years of age provides net benefits. Among populations with a low prevalence of vision abnormalities, screening the youngest is associated with an increased rate of false positives, leading to unnecessary additional assessment.


Assuntos
Ambliopia , Seleção Visual , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Qualidade de Vida , Revisões Sistemáticas como Assunto , Acuidade Visual
4.
Cesk Slov Oftalmol ; 77(4): 184-189, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34507494

RESUMO

AIM: To evaluate the effect of crosslinking (CXL) therapy on the change in the quality of visual acuity and the change in the topographic properties of the cornea - curvature, pachymetry, and change of astigmatism, coma abberation and CLMIaa (Cone Localisation and Magnitude Index). METHODS: A retrospective analytical study included 29 eyes of 24 patients who had progressed in the last 12 months and were suitable candidates for CXL surgery. The monitored parameters were the steepest, flatest and mean anterior instantaneous curvature (AICS, AICF, AICM) and the steepest, flatest and mean posterior instantaneous curvature (PICS, PICF, PICM) of the cornea, corneal thickness in the centre of the cornea (PACHC) and in the thinnest point of the cornea (PACHT), corneal astigmatism (ASTIG). coma (COMA), Cone Localization and Magnitude Index (CLMIaa) and uncorrected distance visual acuity (UDVA) with corrected distance visual acuity (CDVA). Data were analysed before surgery and 12 months after surgery. The AIC, COMA, CLMIaa and ASTIG parameters were analysed by paired t test. As the parameters of UDVA, CDVA, PIC and PACH did not meet the conditions of normal distribution, the Wilcoxon test was used to investigate the change in these parameters after CXL. RESULTS: Twelve months after the procedure, we recorded an improvement in UDVA (p = 0.371) and CDVA (p = 0.825), an increase in PICS, PICF and PICM (p = 0.902; p = 0.87 and p = 0.555), a decrease in PACHCC (p = 0.294) and a decrease in CLMIaa (p = 0.113) that did not reach statistical significance. The decrease in PACHT (p = 0.027), decrease in COMA (p = 0.037) and decrease in anterior corneal curvature of AICS, AICF and AICM were statistically significant (p = 0.019; p = 0.010 and p = 0.005). The decrease in the value of astigmatism did not show statistical significance, as p = 0.297. CONCLUSION: CXL corneal therapy has been shown to be an effective method to stabilize the cornea in progressive keratoconus, and to improve the higher order of coma. This contributes to the possible improvement of UDVA and CDVA.


Assuntos
Ceratocone , Colágeno , Córnea , Substância Própria , Topografia da Córnea , Reagentes para Ligações Cruzadas , Humanos , Ceratocone/tratamento farmacológico , Fármacos Fotossensibilizantes/uso terapêutico , Estudos Retrospectivos , Riboflavina/uso terapêutico , Acuidade Visual
5.
BMC Ophthalmol ; 21(1): 331, 2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34507529

RESUMO

BACKGROUND: To evaluate macular microstructure alterations in the parafoveal nonperfusion areas of eyes with branch retinal vein occlusions (BRVO), and to investigate their impact on retinal sensitivity. METHODS: This was a cross-sectional study including thirteen BRVO patients with parafoveal capillary nonperfusion areas (NPA). Multiple modalities including microperimetry, optical coherence tomography angiography, and optical coherence tomography were performed to measure retinal sensitivity and thickness, and to identify the microstructure changes and perfusion status. RESULTS: The retinal sensitivity and thickness in the NPA were significantly lower than those in the perfusion areas (PA) (P = 0.001, P = 0.003). Microstructure changes, including disorganization of the retinal inner layers (DRIL), disruption of the outer retinal layers, and cysts were more frequently observed in NPA (P = 0.002, P = 0.018, P = 0.068). Within NPA, the retinal sensitivity of areas with DRIL, and outer retinal layers disruption was significantly lower than that of the areas without DRIL (P = 0.016), and with intact outer retinal layers (P < 0.001), respectively. 1dB increase in retinal sensitivity was correlated with 2.2 µm (95 % confidence interval, 1.71-2.7) increase of the thickness (P < 0.001). The retinal sensitivity was significantly lower at points with both DRIL and outer retinal layers disruption than at the points with DRIL or outer retina layers disruption alone (P = 0.001, P = 0.001). CONCLUSIONS: Alterations in the macular microstructure are associated with ischemia, especially DRIL. DRIL and outer retinal layers disruption are imaging features that have important implications for local retinal sensitivity in the ischemic areas, and where the microstructure of both inner and outer retinal layers is disrupted the function is further destructed.


Assuntos
Oclusão da Veia Retiniana , Estudos Transversais , Angiofluoresceinografia , Humanos , Retina/diagnóstico por imagem , Oclusão da Veia Retiniana/diagnóstico , Vasos Retinianos/diagnóstico por imagem , Estudos Retrospectivos , Tomografia de Coerência Óptica , Acuidade Visual
6.
BMC Ophthalmol ; 21(1): 322, 2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34488687

RESUMO

BACKGROUND: Full-thickness macular hole (FTMH) is a rare complication in retinitis pigmentosa (RP) patients and may increase intraoperative challenges. Furthermore, lens capsular flap transplantation and inverted internal limiting membrane (ILM) flap were reported to close complicated FTMH successfully. Here, we present a case of bilateral advanced RP complicated by a FTMH treated with a novel lens capsular flap transplantation and inverted internal limiting membrane flap. CASE PRESENTATION: A 46-year-old presented to our hospital with a complaint of progressively blurred vision and metamorphopsia in both eyes. Spectral-domain optical coherence tomography revealed a FTMH with retinoschisis in the right eye and another FTMH in the left eye. ILM peeling with inverted ILM flap technique was performed on the right eye and ILM peeling with anterior lens capsular flap technique was performed on the left eye. Post-operative follow-up showed successful closure of the FTMH and improved vision in both eyes. CONCLUSIONS: In our present case, flap-assisted techniques for retinitis pigmentosa with macular hole result in excellent visual and anatomic outcomes.


Assuntos
Perfurações Retinianas , Retinite Pigmentosa , Membrana Basal , Humanos , Pessoa de Meia-Idade , Perfurações Retinianas/diagnóstico , Perfurações Retinianas/etiologia , Perfurações Retinianas/cirurgia , Retinite Pigmentosa/complicações , Estudos Retrospectivos , Tomografia de Coerência Óptica , Acuidade Visual , Vitrectomia
7.
J Glob Health ; 11: 05020, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34484707

RESUMO

Background: Around the globe, various self-quarantine, social distancing, and school-closure policies were implemented during the coronavirus disease-19 (COVID-19) outbreak to reduce disease transmission. Many economies/territories were compelled to consider digital learning modalities. In particular, increased digital learning engagement with digital devices and mounting psychosocial stress due to social isolation are likely to pose adverse risks for youth visual health globally. This study examines the association between increased digital device use, psychosocial stress, and myopia symptoms among Chinese youth during the COVID-19 pandemic. Methods: This is a retrospective observational population study consisting of 3918 participants enrolled in primary, secondary, and university in China. Participants are recruited through an online survey, which included self-reported information on daily digital device use, psychosocial stress level, condition of visual acuity, and demographic information. We utilize statistical tools including χ2 test, paired sample t test, and multiple multivariate logistic regression. Results: Each hour increase in digital device use is associated with 1.25 odds ratio OR (95% confidence interval (CI) = 1.21-1.30; P < 0.001) increased risk of developing myopic symptoms, each additional hour of digital device use weighted by near-view and blue-light exposure is associated with OR = 1.04 OR (95% CI = 1.03-1.05; P < 0.001) and OR = 2.25 (95% CI = 1.94-2.60; P < 0.001) increased risk respectively. Subjects reporting under stressful conditions are between OR = 1.98 (95% CI = 1.67-2.36; P < 0.001) and OR = 2.03 (95% CI = 1.71-2.42; P < 0.001) more likely to develop myopic symptoms, relative to those citing less stress. Conclusions: The COVID-19 pandemic led to favorable conditions for myopigenic behavioral changes characterized by extended sedentary engagement with digital devices, which are significantly associated with higher risks of myopia incidence. Relatedly, psychosocial stress accompanying prolonged social isolation during the pandemic is a less noticeable, albeit significant risk factor for myopia development.


Assuntos
COVID-19 , Educação à Distância , Pandemias , Isolamento Social , Acuidade Visual , Adolescente , China , Humanos , Miopia , Fatores de Risco
8.
Artigo em Inglês | MEDLINE | ID: mdl-34444199

RESUMO

The purpose of the study was to evaluate changes in best corrected visual acuity, central retinal thickness, area and flow in the neovascular membrane and to compare therapeutic outcomes from baseline in patients who received three doses of Beovu (brolucizumab) at three-month follow-up. MATERIAL AND METHODS: A prospective observational study conducted at the Prof. K. Gibinski University Clinical Center of the Medical University of Silesia in Katowice. Eight patients with exudative form of age-related macular degeneration (AMD) were observed. RESULTS: The mean best corrected visual acuity (BCVA) outcome increased with each subsequent visit. The mean central retinal thickness (CRT) result also improved (decreased) with each subsequent visit, except for the last measurement. A statistically significant change in neovascular membrane area was observed after the first injection. In further treatment, the membrane area underwent changes that were not statistically significant. A statistically significant change in neovascular membrane flow was demonstrated after the first and second injections. DISCUSSION: Our study confirmed the efficacy of brolucizumab in the treatment of patients with exudative AMD in terms of improvements in best corrected visual acuity (BCVA), central retinal thickness (CRT), neovascular membrane area, and neovascular membrane flow area.


Assuntos
Inibidores da Angiogênese , Degeneração Macular Exsudativa , Inibidores da Angiogênese/uso terapêutico , Anticorpos Monoclonais Humanizados , Humanos , Injeções Intravítreas , Tomografia de Coerência Óptica , Resultado do Tratamento , Acuidade Visual , Degeneração Macular Exsudativa/tratamento farmacológico
10.
Transl Vis Sci Technol ; 10(9): 8, 2021 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-34351366

RESUMO

Purpose: The purpose of this study was to determine if a battery of polarization-modulated stimuli, quantified as a single metric, is effective in identifying macular disease in the presence/absence of cataract or pseudophakia. Methods: Using a modified liquid crystal display, polarization pattern perception (PPP) for a formulated battery of geometric and logMAR stimuli was evaluated in participants that had either no eye pathology (healthy participants) or were grouped according to the presence of cataract, pseudophakia, and/or age-related macular degeneration (AMD). PPP was quantified as response frequencies to individual stimuli, and as a novel monocular polarization sensitivity score (Ps) based on perception of the stimulus battery set. Results: Stimulus response frequencies were pattern-dependent and, compared with healthy participants, reduced for cataract and AMD groups but not for subjects with pseudophakia. Compared with healthy eyes (n = 47, median Ps = 17), Ps was significantly reduced by AMD (n = 59, median Ps = 1, P < 0.001) and, to a lesser extent, by cataracts (n = 80, median Ps = 6, P < 0.001). There was no significant difference between Ps for healthy and pseudophakic eyes (n = 47, median Ps = 13, P = 0.323). There was no significant correlation between Ps and logMAR visual acuity. Conclusions: In the absence of significant cataract, or in pseudophakia, a set of polarization-modulated visual stimuli, quantified as the Ps score, distinguishes AMD from healthy maculae. Translational Relevance: Perception of polarization-modulated stimuli, previously shown to be macula-dependent in a laboratory setting, is effective as a test of macular function in health and disease in a clinic setting.


Assuntos
Catarata , Degeneração Macular , Catarata/diagnóstico , Humanos , Degeneração Macular/diagnóstico , Pseudofacia , Refração Ocular , Acuidade Visual
11.
BMC Ophthalmol ; 21(1): 306, 2021 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-34425775

RESUMO

BACKGROUND: Our aim was to determine associations of pachymetry, keratometry, and their changes with haze formation and corneal flattening after collagen cross-linking, and to analyse the relationship between postoperative haze and visual outcome. METHODS: Retrospective analysis was performed on 47 eyes of 47 patients with keratoconus using the Pentacam HR Scheimpflug camera before and 1, 3, 6 and 12 months after cross-linking. Corneal backscattered light values in grey scale unit were recorded in the anterior, center and posterior corneal layers and in four concentric rings. Surface area- and thickness-corrected grey scale unit values were assessed with an additional calculation. Friedman test with post hoc Wilcoxon signed-rank test was used to analyse changes in visual acuity, pachymetry, keratometry and densitometry. Spearman's rank correlation test was used to detect correlations of haze formation and corneal flattening with pachymetry, keratometry and their postoperative change. Generalized estimating equations analysis was used to investigate the influence of densitometry values on postoperative visual acuity after controlling for the effect of preoperative keratometry. RESULTS: One year after treatment, significant flattening was observed in maximum and mean keratometry readings (p < 0.001). Significantly increased densitometry values were observed in three central rings compared to baseline (post hoc p < 0.0125). According to receiver operating characteristic curve, densitometry value of the anterior layer of 0-2 mm ring was the most characteristic parameter of densitometry changes after cross-linking (area under the curve = 0.936). Changes in haze significantly correlated with preoperative maximum keratometry (R = 0.303, p = 0.038) and with the changes in maximum keratometry (R = -0.412, p = 0.004). Changes in maximum keratometry correlated with preoperative maximum keratometry (R = -0.302, p = 0.038). Postoperative haze had a significant impact on uncorrected and best corrected distance visual acuity (ß coefficient = 0.006, p = 0.041 and ß coefficient = 0.003, p = 0.039, respectively). CONCLUSIONS: Our findings indicate that in more advanced keratoconus more significant corneal flattening effect parallel with haze formation can be observed after cross-linking. Despite significant reduction of keratometry, postoperative corneal haze may limit final visual acuity.


Assuntos
Substância Própria , Fármacos Fotossensibilizantes , Colágeno , Topografia da Córnea , Reagentes para Ligações Cruzadas , Humanos , Estudos Retrospectivos , Raios Ultravioleta , Acuidade Visual
12.
Zhonghua Yan Ke Za Zhi ; 57(8): 595-600, 2021 Aug 11.
Artigo em Chinês | MEDLINE | ID: mdl-34344120

RESUMO

Objective: To investigate causes and management of surgical complications of Descemet membrane endothelial keratoplasty (DMEK) in initial cases. Methods: A retrospective study. A total of 52 eyes of 52 patients underwent DMEK by one surgeon in Peking University Third Hospital from February 2017 to December 2019, including 17 males and 35 females, aged (66±12) years. All patients' demographic characteristics, previous surgical history, intraoperative and postoperative complications were recorded. Results: Intraoperative complications included difficulties in unfolding the graft in 6 cases (11.5%), inverted grafts in 5 cases (9.6%), grafts rushing out of the anterior chamber in 2 cases (3.8%), grafts injected behind the iris in 3 cases (5.8%) and hemorrhage in 1 case. Partial graft detachment that occurred in 28 cases (53.8%) was the most frequent postoperative complication. Rebubbling was performed in 25 cases (48.1%). Pupillary block occurred in 9 cases (17.3%) and was managed by reducing air under a slit lamp. Primary graft failure occurred in 3 cases (5.8%) and viral infection occurred in 2 cases (3.8%). Conclusions: The rate of complications of DMEK in initial cases is higher than that of Descemet stripping automated endothelial keratoplasty. Intraoperative graft inversion and postoperative graft detachment are the most common complications. It is important to select appropriate indications and discover or manage intraoperative and postoperative complications in time to reduce the incidence of complications. (Chin J Ophthalmol, 2021, 57:595-600).


Assuntos
Doenças da Córnea , Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior , Doenças da Córnea/etiologia , Doenças da Córnea/cirurgia , Lâmina Limitante Posterior/cirurgia , Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior/efeitos adversos , Endotélio Corneano , Feminino , Humanos , Masculino , Complicações Pós-Operatórias , Estudos Retrospectivos , Acuidade Visual
13.
Zhonghua Yan Ke Za Zhi ; 57(8): 614-617, 2021 Aug 11.
Artigo em Chinês | MEDLINE | ID: mdl-34344123

RESUMO

Nowadays, myopia morbidity keeps increasing in China. As the improvements of technique and safety in corneal refractive surgeries, an increasing number of patients with refractive error tend to choose these treatments. The 26-year-old woman with myopia in this case, whose UCVA was 0.1 in OD and 0.2 in OS, had corneal macula in the nasal side of the left eye owing to a corneal trauma occurred more than 10 years ago. After sufficient preoperative examinations, FS-LASIK was performed on the right eye and PTK combined with PRK was performed on the left eye. The UCVA was 1.2 in both eyes 3 months postoperatively, and the corneal macula was mostly cleared in the left eye. It is demonstrated that PTK combined with PRK is an effective and safe way to correct the diopter as well as remove the lesions for the lowly or moderately myopic patients accompanied with superficial corneal opacity. (Chin J Ophthalmol, 2021, 57: 614-617).


Assuntos
Ceratomileuse Assistida por Excimer Laser In Situ , Miopia , Ceratectomia Fotorrefrativa , Adulto , China , Córnea , Feminino , Humanos , Lasers de Excimer , Miopia/cirurgia , Refração Ocular , Tomografia de Coerência Óptica , Acuidade Visual
14.
Klin Monbl Augenheilkd ; 238(7): 803-807, 2021 Jul.
Artigo em Inglês, Alemão | MEDLINE | ID: mdl-34376010

RESUMO

In the present cases, the use of the Ophtec Arificial Iris model C1 is described in patients with traumatic or postoperative aniridia/aphakia. In one of the patients, it was combined with perforating keratoplasty because of corneal scarring. In both of the presented cases, improvement in visual acuity and a satisfactory aesthetic result without any serious complications can be shown. However, the short follow-up time must be emphasised.


Assuntos
Aniridia , Afacia , Lentes Intraoculares , Aniridia/cirurgia , Humanos , Iris/cirurgia , Ceratoplastia Penetrante , Acuidade Visual
15.
East Mediterr Health J ; 27(7): 679-686, 2021 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-34369582

RESUMO

Background: Despite the widespread literate on health inequalities and their determinants, changes in health inequalities over time have not received enough attention. Aims: To measure and decompose the over-time changes in economic inequality in presenting visual acuity measured using Logarithm of the Minimum Angle of Resolution. Methods: We analysed 4706 participants who had complete data on presenting visual acuity and economic status in 2009 and 2014 in the Shahroud Eye Cohort Study. We measured changes in presenting visual acuity concentration indices and decomposed them the using a longitudinal approach. Results: Both the presenting visual acuity and economic status deteriorated between 2009 and 2014. The mean (standard deviation) for presenting visual acuity and economic status scores in 2009 versus 2014 were 0.090 (0.2) versus 0.103 (0.2) and 0.01 (1.0) versus 0.0005 (1.07), respectively. Presenting visual acuity concentration index (95% confidence interval) in the first versus second phases of the study were -0.245 (-0.212 to -0.278) versus -0.195 (-0.165 to -0.225), respectively. Longitudinal decomposition of this change in concentration indices during the 5-year period indicated that the most important contributor to reduction in economic inequality of presenting visual acuity was deterioration of presenting visual acuity among people with higher economic status due to their ageing. Conclusion: Unexpectedly, reduction in economic inequality in presenting visual acuity was due to presenting visual acuity deterioration among the higher economic status group rather than its amelioration among the lower economic status group. Therefore, the needs of all socioeconomic groups should be considered separately to modify presenting visual acuity in each group and, consequently, reduce the economic inequality in presenting visual acuity.


Assuntos
Disparidades nos Níveis de Saúde , Estudos de Coortes , Humanos , Fatores Socioeconômicos , Acuidade Visual
16.
J Refract Surg ; 37(8): 552-561, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34388067

RESUMO

PURPOSE: To compare the outcomes obtained with models of asymmetric and non-asymmetric intracorneal ring segments (ICRS) in keratoconic eyes with asymmetric topo-graphic patterns. METHODS: In this prospective observational study, ICRS were implanted alternately in patients with the same tomographic patterns of keratoconus assigned to four groups. Patients with the "duck" phenotype received one asymmetric or non-asymmetric ICRS and patients with the "snowman" pheno-type received two asymmetric or non-asymmetric ICRS. Visual, refractive, astigmatism, keratometric, and corneal aberrometry changes were evaluated over a 6-month follow-up period. RESULTS: Sixty-eight eyes were analyzed. No significant difference was observed between the use of one asymmetric and one non-asymmetric ICRS in duck phenotypes. In snowman keratoconus, the inferior-superior index decreased significantly (P = .03) with asymmetric but not with non-asymmetric ICRS implantation. Total corneal higher order aberrations and coma rates were lower, but not significantly so, after the implantation of two asymmetric ICRS in snowman phenotypes (2.85 ± 0.89 to 2.60 ± 0.91 µm, P = .20 and 2.64 ± 0.93 to 2.39 ± 0.98 µm, P = .21), and significantly higher after the implantation of two non-asymmetric ICRS (2.56 ± 1.28 to 3.08 ± 1.62 µm, P = .02 and 2.34 ± 1.27 to 2.84 ± 1.62 µm, P = .02). CONCLUSIONS: Asymmetric ICRS did not improve the outcomes of ICRS implantation in duck keratoconus. However, the implantation of two asymmetric ICRS was more effective than that of two non-asymmetric ICRS for decreasing vertical asymmetry and preventing increases in corneal aberration in the snowman phenotype of keratoconus. [J Refract Surg. 2021;37(8):552-561.].


Assuntos
Ceratocone , Substância Própria/diagnóstico por imagem , Substância Própria/cirurgia , Topografia da Córnea , Humanos , Ceratocone/cirurgia , Próteses e Implantes , Implantação de Prótese , Refração Ocular , Estudos Retrospectivos , Acuidade Visual
17.
J Refract Surg ; 37(8): 524-531, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34388068

RESUMO

PURPOSE: To evaluate visual outcomes, satisfaction, and spectacle independence in non-presbyopic hyperopic patients who underwent bilateral refractive lens exchange with a trifocal intraocular lens (IOL) and to compare them with presbyopic hyperopic patients. METHODS: In this retrospective study, patients younger than 40 years underwent bilateral refractive lens exchange with a diffractive trifocal IOL (FineVision Micro F; PhysIOL SA) for hyperopia with at least 3 months of follow-up. A control group of patients older than 50 years was matched by axial length, sex, and follow-up. Safety, efficacy, predictability, patient satisfaction, and spectacle independence were evaluated. RESULTS: One hundred thirty-three patients (average age = 36.94 ± 2.91 years; range = 21.50 to 40 years) were included in this study. After a mean follow-up of 8.83 ± 5.69 months (range = 2.75 to 77.63 months), the safety and efficacy indexes and predictability within ±1.00 diopters (D) were 1.02%, 0.98%, and 99.62%, respectively, which was not different from the control group (P > .05). No intraoperative complications were recorded. The only postoperative complication was posterior capsule opacification in 21 eyes (7.89%), which was similar to the control group (P > .05). Ninety-seven percent of patients in each group expressed that they were satisfied and all of them in each group reported that they did not use spectacles for distance, intermediate, or near vision. CONCLUSIONS: Refractive lens exchange and trifocal IOL implantation for hyperopia in patients without presbyopia provided the same good visual outcomes as in presbyopic patients with a high rate of patient satisfaction and spectacle independence. [J Refract Surg. 2021;37(8):524-531.].


Assuntos
Hiperopia , Lentes Intraoculares , Facoemulsificação , Adulto , Estudos de Casos e Controles , Humanos , Hiperopia/cirurgia , Satisfação do Paciente , Desenho de Prótese , Refração Ocular , Estudos Retrospectivos , Acuidade Visual , Adulto Jovem
18.
J Refract Surg ; 37(8): 538-544, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34388073

RESUMO

PURPOSE: To analyze the results of new intraocular lens (IOL) formulas (Emmetropia Verifying Optical [EVO], Kane, Olsen, and Barrett Universal II), traditional formulas (Haigis and SRK/T), and modified Wang-Koch axial length adjustment formulas with the SRK/T and Holladay 1 (SRK/Tmodified-W/K and H1modified-W/K) in Chinese patients with long eyes. METHODS: In this retrospective case series, patients with an axial length of 26 mm or greater having uneventful femtosecond laser-assisted cataract surgery with one trifocal IOL model were enrolled. The actual postoperative spherical equivalent of the manifest refraction was compared with the formula-predicted refraction based on the implanted IOL power. A subgroup analysis was performed based on the axial length. RESULTS: A total of 113 eyes was enrolled. Using User Group for Laser Interference Biometry constants, the modified Wang-Koch formulas had the lowest percentage of eyes with hyperopic outcomes. The Barrett Universal II, Olsen, Kane, and EVO 2.0 formulas produced a statistically lower median absolute error than the SRK/Tmodified-W/K and SRK/T formulas (P < .05). The Barrett Universal II formula produced higher percentages of eyes within ±0.50 diopters (D) of the prediction error than the SRK/T formula (P < .05). In eyes with axial lengths of less than 28 mm, there were no significant differences in the prediction accuracy of the eight formulas. In eyes with axial lengths of 28 mm or greater, the new IOL formulas yielded the lowest median absolute error, followed by the H1modified-W/K and Haigis formulas. The SRK/Tmodified-W/K formula had the highest mean absolute error and the lowest percentages of eyes within ±0.25 and ±0.50 D of endpoint. The traditional formulas yielded the highest risk of refractive surprise. CONCLUSIONS: All formulas achieved good results in eyes with axial lengths of less than 28 mm with trifocal IOL implanted. The newer formulas tend to produce better outcomes for eyes with high myopia. The SRK/Tmodified-W/K formula provided improved accuracy only in eyes with axial lengths of 30 mm or greater. [J Refract Surg. 2021;37(8):538-544.].


Assuntos
Lentes Intraoculares , Miopia , Facoemulsificação , Comprimento Axial do Olho , Biometria , Humanos , Implante de Lente Intraocular , Miopia/cirurgia , Óptica e Fotônica , Refração Ocular , Estudos Retrospectivos , Acuidade Visual
19.
J Refract Surg ; 37(8): 510-515, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34388076

RESUMO

PURPOSE: To evaluate the effects of femtosecond laser small incision lenticule extraction (SMILE) on treating unilateral myopic anisometropia in children with spectacles or contact lens intolerance. METHODS: This was a retrospective study that included children with unilateral myopic anisometropic amblyopia who underwent a SMILE procedure at Alpha Vision Center, Zagazig, Egypt, from January 2014 to December 2016. RESULTS: One hundred twenty-four eyes of 124 patients were included in this study. The postoperative corrected distance visual acuity (CDVA) at the 3-month and 1-, 2-, 3-, and 4-year follow-up visits improved significantly (P < .05) compared to the preoperative CDVA, indicating the safety of the procedure. At the 3-month postoperative visit, 23% of cases showed improvement of one or more lines of CDVA, whereas only 2% of cases showed a decline of only one line. Moreover, the postoperative uncorrected distance visual acuity compared favorably to the preoperative CDVA, denoting the efficacy of the refractive correction. The spherical equivalent was within ±0.50 diopters of the intended correction in 75% of the cases and within ±1.00 diopters in 89% of the cases. The intraoperative complications were scarce and relatively innocuous. CONCLUSIONS: SMILE is a safe and effective alternative method for correcting myopic anisometropic amblyopia in children with spectacles or contact lens intolerance with good refractive results. A larger study with longer follow-up periods is necessary to determine the long-term effects of SMILE. [J Refract Surg. 2021;37(8):510-515.].


Assuntos
Anisometropia , Miopia , Anisometropia/cirurgia , Criança , Substância Própria/cirurgia , Seguimentos , Humanos , Lasers de Excimer/uso terapêutico , Miopia/cirurgia , Refração Ocular , Estudos Retrospectivos , Resultado do Tratamento , Acuidade Visual
20.
Niger J Clin Pract ; 24(8): 1206-1210, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34397032

RESUMO

Objective: To determine the pattern and risk factors of pterygium in adults at the Guinness Eye Centre Onitsha, Nigeria. Materials and Methods: Consecutive adults aged ≥30 years with pterygium were studied. Each patient had comprehensive ocular examination including visual acuity, anterior segment, and adnexal assessment and fundoscopy. The pterygium was graded in terms of severity and type. Results: A total of 156 patients with pterygium participated; 92 (59%) females versus 64 (41%) males (F:M =3:2). The age range was 30-65 years; mean: 43.9 ± 8.4 years. The majority of the study population (36.5%) was of the age group 40-49 years. The subjects were predominately traders 78 (50%) and 93 (59.6%) of the pterygium patients were outdoor workers. Bivariate analysis indicated that those involved in outdoor work were six times at greater risk of developing pterygium than indoor workers (P = 0.001; OR = 6.2). Out of the 156 pterygium patients seen, 107 (68.6%) of them complained of associated symptoms. Redness of the eye was the commonest symptom reported by 79 (50.9%) cases while 8 (5.1%) cases complained of burning sensation. There was a preponderance of nasal pterygia with temporal pterygia being the least. Blinding pterygium was seen in three eyes (1.3%). Conclusion: Pterygium is a common disorder presenting at eye clinics. Outdoor workers are at a greater risk of developing pterygium. Thus, health education is of great importance.


Assuntos
Pterígio , Adulto , Idoso , Túnica Conjuntiva , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Pterígio/epidemiologia , Pterígio/etiologia , Fatores de Risco , Acuidade Visual
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