Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 27.256
Filtrar
1.
Zhonghua Yan Ke Za Zhi ; 57(1): 6-10, 2021 Jan 11.
Artigo em Chinês | MEDLINE | ID: mdl-33412637

RESUMO

Multifocal intraocular lens (MIOL) can help cataract patients get a full range of vision, restore binocular stereopsis, improve pseudo-accommodation power, and correct regular corneal astigmatism with limits. However, MIOL also have shortcomings, including decreased contrast sensitivity, night glare, halos and other negative dysphotopsias, despite strictly controlled indications. Sometimes dysphotopsia can be relieved spontaneously after surgery in a period of time. During this process neuroadaptation plays an important role. This article explains the concept and mechanism of neuroadaptation, the location of neuroadaptation in the central nervous system, cognitive training, the preoperative evaluation of MIOL implantation, and the treatment for postoperative dissatisfaction. Correct understanding of the important role of neuroadaptation will provide theoretic foundation for cataract specialists and facilitate the handling of complications after MIOL implantation. (Chin J Ophthalmol, 2021, 57: 6-10).


Assuntos
Catarata , Lentes Intraoculares , Lentes Intraoculares Multifocais , Humanos , Implante de Lente Intraocular , Acuidade Visual
2.
Zhonghua Yan Ke Za Zhi ; 57(1): 11-16, 2021 Jan 11.
Artigo em Chinês | MEDLINE | ID: mdl-33412638

RESUMO

Congenital cataract is the first main cause of avoidable blindness in children. The manifestations of congenital cataract are diverse and complex, often associated with other ocular structural abnormalities. The infantile eyeballs are in the growth and development stage, the structure of eyeball wall is fragile, and the blood-ocular barrier is immature. Therefore, congenital cataract surgery features relatively higher surgical technical requirements with higher postoperative complications occurrence. Congenital cataract is not a miniature version of age-related cataract, which has its own unique surgical principles. In this article, issues including the preoperative characteristics of congenital cataract, surgical timing and techniques, and follow-up treatment, were discussed based on expert clinical experiences of Zhongshan Ophthalmic Center and relevant literatures. (Chin J Ophthalmol, 2021, 57: 11-16).


Assuntos
Extração de Catarata , Catarata , Oftalmologia , Cegueira , Criança , Humanos , Lactente , Complicações Pós-Operatórias , Estudos Retrospectivos
3.
Zhonghua Yan Ke Za Zhi ; 57(1): 17-22, 2021 Jan 11.
Artigo em Chinês | MEDLINE | ID: mdl-33412639

RESUMO

Dry eye is a common ocular surface disease that can occur in part of patients before cataract surgery. A variety of incentives during the perioperative period can decrease the stability of the tear film, cause or aggravate dry eye symptoms, and therefore reduce the visual outcome and life quality of the patients. In order to standardize the management of dry eye during the perioperative period of cataract surgery, the Cataract Group of the Ophthalmology Branch of the Chinese Medical Association conducted a comprehensive discussion on the evaluation and improvement of the preoperative ocular surface conditions, the intraoperative ocular surface protection, as well as the diagnosis and treatment of postoperative dry eye. The consensus of opinions has been reached for reference of Chinese ophthalmologists. (Chin J Ophthalmol, 2021, 57:17-22).


Assuntos
Catarata , Síndromes do Olho Seco , Oftalmologia , Grupo com Ancestrais do Continente Asiático , Catarata/prevenção & controle , Consenso , Síndromes do Olho Seco/prevenção & controle , Humanos , Período Perioperatório
4.
Zhonghua Yan Ke Za Zhi ; 57(1): 34-40, 2021 Jan 11.
Artigo em Chinês | MEDLINE | ID: mdl-33412640

RESUMO

Objective: To investigate the changes of axial length, corneal refractive power, and refractive state in infants with congenital cataract surgery. Methods: Retrospective cohort study. Medical records of 103 patients who underwent congenital cataract surgery in the Eye Hospital of Wenzhou Medical University Hangzhou Branch from January 1, 2015 to December 31, 2018 were reviewed. There were 61 boys and 42 girls in the study. The mean age at the surgery of 103 congenital cataract patients was (3.95±1.94) months. In patients receiving bilateral cataract surgery, only the left eye was selected for analysis. The patients were followed up for at least 1 year. The patients were divided into the groups of <4 months old and 4-12 months old according to the age at cataract surgery. The change in the axial length, corneal refractive power, and refractive state of each patient at 1 year after surgery was analyzed. Independent sample t-test, one way variance analysis and simple linear regression were used for statistical analysis. Results: There were 71 cases of bilateral cataract, including 33 in the group of <4 months old and 38 in the group of 4-12 months old, and 32 cases of unilateral cataract, including 17 in the group of <4 months old and 15 in the group of 4-12 months old. The change in the axial length of bilateral cataract children in the <4-month-old group was (2.46±1.33) mm at 1 year after surgery, which was greater than (1.52± 1.00) mm in the group of 4-12 months old (t=3.21; P<0.01). In the same surgery age group, there was no significant difference in the change of axial length among bilateral cataract eyes, unilateral cataract eyes and the contralateral eyes at 1 year after surgery (both P>0.05). One year after surgery, the axial length of the eyes in patients with bilateral cataract, the affected eyes and the fellow eyes in patients with unilateral cataract all was highly correlated with the logarithm of the actual age (r=0.68, 0.52, 0.73; all P<0.01). The corneal refractive power showed a decreased trend with the increase of age. The change in the corneal refractive power of the bilateral cataract children in the <4-month-old group at 1 year after surgery was (1.43±2.87) D, and in the group of 4-12 months old was (0.68±2.10) D, but the difference was not statistically significant (P>0.05). The chang in spherical equivalent of bilateral cataract children was (2.02±2.60) D in the <4-month-old group, greater than that in the group of 4-12 months old [(0.69±1.89) D; t=2.15; P<0.05]. The change of spherical equivalent one year after surgery in 4-12 months group, unilateral cataract eyes was significantly greater than that of bilateral cataract eyes [(2.05±0.95) D vs. (0.69±1.89) D; t=2.49; P<0.05]. The spherical equivalent of both bilateral and unilateral cataract children was highly correlated with the actual age (r=-0.51, -0.54; both P<0.01). Conclusions: The axial length is increased, the corneal refractive power is decreased, and the spherical equivalent is decreased at 1 year after surgery for congenital cataract in infants. The younger the age at cataract surgery, the greater the change in the axial length, myopia drift, and corneal refractive power. (Chin J Ophthalmol, 2021, 57: 34-40).


Assuntos
Extração de Catarata , Catarata , Criança , Feminino , Seguimentos , Humanos , Lactente , Implante de Lente Intraocular , Masculino , Refração Ocular , Estudos Retrospectivos
5.
Zhonghua Yan Ke Za Zhi ; 57(1): 48-55, 2021 Jan 11.
Artigo em Chinês | MEDLINE | ID: mdl-33412642

RESUMO

Objective: To compare the difference and agreement of corneal refractive power and astigmatism measured by the new swept-source anterior segment optical coherence tomography (SS-AS-OCT) device (CASIA2) and Scheimpflug imaging device (Pentacam) in age-related cataract patients. Methods: In this cross-sectional study, 112 eyes of 112 patients with age-related cataract were examined before phacoemulsification in the Tianjin Medical University Eye Hospital from April to May 2020. The steep keratometry (Ks), flat keratometry (Kf), mean keratometry (Km), degree and axis of astigmatism of the corneal anterior and posterior surfaces and the total cornea were recorded. The difference in astigmatism was analyzed by the arithmetic method and the vector method. The difference of data was evaluated using Paired t test or Wilcoxon test. The agreement of data was evaluated using Bland-Altman plots. Results: The patients were 44 males and 68 females with an average age of (67±10) years. There were no statistically differences in the Ks and Km values of the corneal anterior surface between the Pentacam and the CASIA2 (both P>0.05). There was significant difference in the Kf values of the corneal anterior surface between the Pentacam and the CASIA2 [(44.24±1.73) D vs. (44.14±1.64) D; t=2.278; P<0.05]. The Ks, Kf, and Km values of the posterior surface of the cornea measured by the Pentacam and the CASIA2 were (-6.60±0.29) D vs. (-6.45±0.28) D, (-6.34±0.27) D vs. (-6.17±0.25) D, and (-6.47±0.26) D vs. (-6.31±0.25) D, respectively. The Ks, Kf, and Km values of the total cornea measured by the two instruments were (45.08±1.84) D vs. (43.94±1.64) D, (44.18±1.85) D vs. (43.02±1.64) D, and (44.63±1.82) D vs. (43.48±1.60) D, respectively. There were significant differences in the Ks, Kf, and Km values of the posterior surface of the cornea and the total cornea (t=-14.440, -13.522, -17.186, 21.016, 21.819, 22.981; all P<0.01). The degree and axis of astigmatism of the corneal anterior and posterior surfaces and the total cornea showed no statistically significant difference (all P>0.05). Vector operation results showed that the astigmatism difference vector (DV) of the Pentacam and the CASIA2 on the anterior surface of the cornea was 0.06 D@57°±0.64 D,>0.50 D in 47 eyes (41.96%). The astigmatism DV on the posterior surface of the cornea was 0.07 D@174°±0.21 D, >0.50 D in 2 eyes (1.79%). The astigmatism DV on the total cornea was 0.13 D@3°±0.69 D,>0.50 D in 59 eyes (52.68%). The results of the two devices were positively correlated (r values of the Ks, Kf, Km, and astigmatism degree on the anterior surface of the cornea were 0.970, 0.968, 0.976, and 0.697, respectively, on the posterior surface of the cornea were 0.918, 0.875, 0.925, and 0.517, respectively, and on the total cornea were 0.951, 0.955, 0.959, and 0.622, respectively; all P<0.01). Bland-Altman analysis showed that the Ks, Kf, Km, and astigmatism degree of the corneal anterior and posterior surfaces measured by the two devices were consistent, with 2.68% to 8.04% of the measured values outside 95% limits of agreement (95%LoA). The 95%LoA of the total corneal Ks, Kf, and Km between the two devices was 0.01 to 2.28 D, 0.06 to 2.27 D, and 0.10 to 2.20 D, respectively, with a wide 95%LoA range and poor consistency. Conclusions: The corneal refractive power and astigmatism measured by the CASIA2 and the Pentacam shows little difference on the anterior surface of the cornea, with good agreement. However, the refractive power results of the posterior surface of the cornea and the total cornea show great difference, suggesting that these two instruments cannot be used interchangeably in clinical practice. (Chin J Ophthalmol, 2021, 57: 48-55).


Assuntos
Astigmatismo , Catarata , Idoso , Astigmatismo/diagnóstico por imagem , Catarata/diagnóstico por imagem , Córnea/diagnóstico por imagem , Topografia da Córnea , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Tomografia de Coerência Óptica
6.
Zhonghua Yan Ke Za Zhi ; 57(1): 56-62, 2021 Jan 11.
Artigo em Chinês | MEDLINE | ID: mdl-33412643

RESUMO

Objective: To analyze the distribution characteristics of the anterior corneal astigmatism in 140 000 cataract patients from 18 hospitals in China. Methods: Retrospective study. A total of 143 889 patients (143 889 right eyes) over the age of 40 years with age-related catarac were admitted to 18 Aier eye hospitals in China from July 2015 to October 2018. The average values of the three measurements of the magnitude of anterior corneal astigmatism, the meridian of corneal astigmatism, anterior chamber depth, corneal refractive power, and axial length measured by IOLMaster 500 were obtained. The data acquisition method of each sub-center was to collect and analyze the electronic case data in accordance with the inclusion and exclusion criteria, and to provide them for the sponsor Wuhan Aier Eye Hospital. Non-normal distribution data are presented as M (P25, P75). Mann-Whitney test, Kruskal-Wallis test, Chi-square test were used to analyze the distribution differences of the magnitude of corneal astigmatism and the meridian of corneal astigmatism in gender, age, anterior chamber depth, corneal refractive power and axial length. Results: Among the 143 889 patients, 84 319 were females and 59 570 were males, the median age was 72 (65, 78) years old, the median corneal astigmatism was 0.84 (0.51, 1.33) D; the corneal astigmatism was ≥0.75 D in 80 895 patients (56.22%) and was ≥1.00 D in 57 304 patients (39.83%). The median corneal astigmatism was 0.87 (0.53, 1.37) D in women and 0.82 (0.50, 1.29) D in men; with statistical difference (U=-14.891; P<0.05). The proportion of with-the-rule (WTR) astigmatism was 33.26% (28 046/84 319) for women and 34.26% (20 408/59 570) for men; The proportion of against-the-rule (ATR) astigmatism was 49.08% (41 385/84 319) for women and 46.91% (27 945/59 570) for men, with statistical difference (χ²=70.913; P<0.05). With the increase of age, the magnitude of corneal astigmatism first decreased from 0.94 (0.57, 1.48) D to 0.75 (0.46, 1.18) D, and then increased to 1.19 (0.74, 1.79) D, with statistical difference (H=1 263.438; P<0.05), and the change was at 61 to 70 years old. With the increase of age, the proportion of WTR astigmatism decreased from 77.50% (396/511) to 12.50% (3/24), the proportion of ATR astigmatism increased from 11.15% (57/511) to 79.07% (34/43), and the proportion of oblique astigmatism changed little from 17.02% (16/94) to 19.92% (245/1 230), the distribution difference was significant (χ²=10 174.496; P<0.05). As the anterior chamber became shallow, the magnitude of corneal astigmatism significantly increased from 0.82 (0.51, 1.31) D to 1.05 (0.61, 1.56) D, and the proportion of ATR astigmatism increased from 47.32% (60 207/127 227) to 51.69% (184/356) (H=409.961, χ²=120.995, both P<0.05). With the corneal refractive power rising, the magnitude of corneal astigmatism increased from 0.80 (0.49, 1.33) D to 0.95 (0.58, 1.53) D, the proportion of ATR astigmatism decreased from 52.84% (4 963/9 392) to 39.97% (9 023/22 577); the difference was significant (H=808.562, χ²=752.147, both P<0.05). When the axial length was>25.00 mm, the magnitude of corneal astigmatism was highest [1.04 (0.62, 1.65) D], and the proportion of ATR astigmatism was also highest [49.00% (10 964/22 376)]; the difference was significant (H=2 071.198, χ²=131.130, all P<0.05). Conclusions: The meridian of corneal astigmatism in middle-aged and elderly cataract patients is mainly ATR astigmatism. With the increasing of age, the magnitude of corneal astigmatism decreases first and then increases. The turning point from the proportion of WTR astigmatism to the proportion of ATR astigmatism is 65 years old. The shallower the anterior chamber is, the more the magnitude of corneal astigmatism and the proportion of ATR astigmatism increase. When the axial length is>25.00 mm, both the magnitude of corneal astigmatism and the proportion of ATR astigmatism reach the peak. (Chin J Ophthalmol, 2021, 57: 56-62).


Assuntos
Astigmatismo , Catarata , Idoso , Astigmatismo/epidemiologia , Biometria , Catarata/epidemiologia , China/epidemiologia , Córnea , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
7.
Zhonghua Yan Ke Za Zhi ; 57(1): 63-70, 2021 Jan 11.
Artigo em Chinês | MEDLINE | ID: mdl-33412644

RESUMO

Objective: To explore the visual outcome of cataract surgery and its influencing factors in China. Methods: A case-control study. The information of 2 078 479 patients who underwent cataract extraction of 31 provinces (municipalities and autonomous regions) recorded in the National Cataract Surgery Information Reporting System during January to December, 2017 were analyzed. The postoperative visual outcomes of 3 days after surgery and 3 months after surgery were analyzed. The effects of age, gender, preoperative corrected visual acuity, past medical history, and surgical methods on the results of cataract surgery were analyzed. Surgery effect was divided into ideal effect, moderate effect and poor effect according to the best corrected visual acuity after operation. Wilcoxon rank sum test and multinomial logistic regression model were used for statistical analysis. Results: There were 1 197 942 female patients (57.64%) and 880 537 male patients (42.36%) in all 2 078 479 cases. The average age was (69±11) years old. The main type of cataract was age-related (1 928 440 cases; 92.78%). There were 1 608 385 cases, 1 126 961 cases and 389 020 cases with complete corrected visual acuity before surgery, 3 days after surgery and 3 months after surgery, respectively. The median difference of corrected visual acuity of preoperative versus three days after surgery, and preoperative versus three months after surgery were -0.48, -0.52 respectively (after logarithm of the minimum angle of resolution conversion). The interquartile ranges were 0.60 and 0.73 respectively. The differences were statistically significant (Z=551 599.30, 206 815.35; both P<0.01). Multivariate analysis showed that postoperative complications (moderate effect: OR=0.50, 95%CI: 0.46 to 0.55; ideal effect: OR=0.31, 95%CI: 0.28 to 0.33), preoperative pupil abnormal (moderate effect: OR=0.52, 95%CI: 0.44 to 0.61; ideal effect: OR=0.55, 95%CI: 0.47 to 0.63), preoperative intraocular pressure abnormalities (moderate effect: OR=0.86, 95%CI: 0.79 to 0.93; ideal effect: OR=0.45, 95%CI: 0.42 to 0.49), history of hypertension (moderate effect: OR=0.90, 95%CI: 0.85 to 0.95; ideal effect: OR=0.88, 95%CI: 0.83 to 0.93) and history of diabetes (moderate effect: OR=0.86, 95%CI: 0.80 to 0.93; ideal effect: OR=0.92, 95%CI: 0.86 to 0.99) were predictors of worse outcome. Good preoperative corrected visual acuity (0.2 to 0.4 for moderate effect: OR=2.20, 95%CI: 2.06 to 2.34; for ideal effect: OR=5.25, 95%CI: 4.94 to 5.59; 0.5 to 0.7 for moderate effect: OR=1.08, 95%CI: 0.96 to 1.21; for ideal effect: OR=6.35, 95%CI: 5.69 to 7.08; above 0.8 for moderate effect: OR=0.73, 95%CI: 0.60 to 0.89; for ideal effect: OR=6.58, 95%CI: 5.51 to 7.86), small incision extracapsular extraction (moderate effect: OR=3.19, 95%CI: 2.35 to 4.33; ideal effect: OR=6.79, 95%CI: 5.13 to 8.97) and phacoemulsification (moderate effect: OR=2.12, 95%CI: 1.60 to 2.81; ideal effect: OR=3.34, 95%CI: 2.59 to 4.32) were predictors of better outcome. Conclusions: Visual acuity of patients in China improve significantly after cataract surgery. However, some patients still suffer moderate visual impairment. The effect of surgery can be affected by many factors, such as preoperative corrected visual acuity, preoperative intraocular pressure, preoperative pupil status, surgical approach and postoperative complications, etc. (Chin J Ophthalmol, 2021, 57: 63-70).


Assuntos
Extração de Catarata , Catarata , Facoemulsificação , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Catarata/epidemiologia , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Resultado do Tratamento
9.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi ; 37(12): 1384-1386, 2020 Dec 10.
Artigo em Chinês | MEDLINE | ID: mdl-33306828

RESUMO

OBJECTIVE: To explore the clinical and genetic characteristics of a child featuring developmental delay. METHODS: The child was subjected to whole exome sequencing. Candidate variant was verified by Sanger sequencing. RESULTS: Whole genome sequencing revealed that the child has carried compound heterozygous variants c.2607-1G>C and c.899 + 2dupT of the RAB3GAP1 gene, which were respectively derived from her mother and father. CONCLUSION: A rare case of Warburg micro syndrome type 1 was diagnosed. The phenotype of the child was consistent with the literature, in addition with dysplasia of palatine arch, prominent high palatal arch and tooth dysplasia. Above finding has provided a basis for genetic counseling and prenatal diagnosis for the family.


Assuntos
Anormalidades Múltiplas , Catarata/congênito , Córnea/anormalidades , Hipogonadismo , Deficiência Intelectual , Microcefalia , Atrofia Óptica , Proteínas rab3 de Ligação ao GTP , Anormalidades Múltiplas/genética , Adulto , Catarata/genética , Criança , Feminino , Humanos , Hipogonadismo/genética , Deficiência Intelectual/genética , Masculino , Microcefalia/genética , Mutação , Atrofia Óptica/genética , Sequenciamento Completo do Exoma , Proteínas rab3 de Ligação ao GTP/genética
10.
Vestn Oftalmol ; 136(6. Vyp. 2): 133-141, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33371641

RESUMO

The search for optimal design and material of the intraocular lens (IOL) that would prevent posterior capsule opacification (PCO) is still a relevant problem. PURPOSE: To compare the influence of three models of hydrophobic acrylic IOLs on the development of PCO within one year after phaco surgery. MATERIAL AND METHODS: The study included 72 patients (91 eyes) who were followed up for 12 months after implantation of one of three models of posterior chamber hydrophobic acrylic IOLs: MIOL-2 (Reper-NN, Russia, 24 eyes, 1st group), SA60AT and US60MP (Alcon, USA, 41 and 26 eyes, 2nd and 3rd groups, respectively). Posterior capsule images were taken and then processed with the EPCO 2000 (Evaluation of Posterior Capsular Opacification) software. The area of posterior capsule adjacent to the center of IOL's optic of 4.0 mm in diameter was estimated. PCO score was calculated as the weighted sum of opacification areas multiplied by the degree (from 0 to 4). RESULTS: Within 1 year of the follow-up, mean visual acuity was at least 1.0 (20/20). Significant PCO progression was observed as early as 3 months after surgery. Despite that, opacification density in all three groups at every follow-up visit did not exceed grade 2; maximal PCO score (0.0315, median) was seen 12 month after surgery in the 1st group. At the same time, differences in PCO score between the groups were not significant. Nd:YAG laser posterior capsulotomy was performed only in one patient from the 1st group 12 month after surgery. Difference in the percentage of clear posterior capsules was significant only 12 month after surgery between the 1st and 3rd groups (p=0.024). CONCLUSION: All three models of hydrophobic acrylic IOLs showed comparably high vision outcomess during 12 months of the follow-up with somewhat better PCO score and percentage of clear posterior capsules in eyes with US60MP.


Assuntos
Opacificação da Cápsula , Catarata , Lentes Intraoculares , Facoemulsificação , Resinas Acrílicas , Opacificação da Cápsula/diagnóstico , Opacificação da Cápsula/etiologia , Opacificação da Cápsula/prevenção & controle , Catarata/diagnóstico , Catarata/etiologia , Humanos , Implante de Lente Intraocular , Lentes Intraoculares/efeitos adversos , Facoemulsificação/efeitos adversos , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Estudos Prospectivos , Desenho de Prótese , Federação Russa
11.
Vestn Oftalmol ; 136(6. Vyp. 2): 142-146, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33371642

RESUMO

PURPOSE: To study best corrected visual acuity (BCVA) and identify its relationship with various factors in eyes with pseudophakia in long-term periods after removal of congenital cataract (CC) in the first year of life. MATERIAL AND METHODS: The study included 54 children (72 eyes) aged 4 to 12 years who had undergone CC removal with intraocular lens (IOL) implantation at the age of 2-11 months. Examination included: visual acuity testing, Flicker ERG 30 Hz electroretinography (MBN, Russia), optical coherence tomography (HRT-OCT) on the Heidelberg Spectralis (Heidelberg Engineering, Germany) platform. RESULTS: The best results were obtained after removal of bilateral congenital cataract (BCC): BCVA in 58.0% of cases was 0.15-0.3, and in 12.0% of cases - 0.4-0.8. BCVA was 0.1 or less in 95.5% of cases and only one child had 0.2 after removal of unilateral congenital cataract (UCC). The best BCVA was achieved in children operated on the 2-5 month of age (BCVA more than 0.3 in 68.7%; only children from that group had 0.5-0.8), without any concomitant pathology and with normal indicators of ERG Flicker 30 Hz. Deviations from physiological formation of the macula were revealed using OCT. The direct relationship was shown between BCVA, and the maximal retinal thickness in parafovea and choroidal thickness in the subfoveal area. CONCLUSION: BCVA significantly varies after CC removal with IOL implantation in infancy: 0.02-0.8. The main factors influencing BCVA in that case are: laterality of cataract, child age at the time of operation, duration of visual deprivation, concomitant eye pathology and refractive amblyopia accompanying incomplete correction of aphakia.


Assuntos
Extração de Catarata , Catarata , Catarata/complicações , Catarata/diagnóstico , Criança , Pré-Escolar , Seguimentos , Humanos , Implante de Lente Intraocular , Estudos Retrospectivos , Federação Russa , Acuidade Visual
12.
Vestn Oftalmol ; 136(6. Vyp. 2): 171-176, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33371646

RESUMO

Vitreoretinal surgery (VRS) is the «gold standard¼ for surgical treatment of patients with proliferative diabetic retinopathy (PDR). However, the timing for the removal of primary cataract in this category of patients remains uncertain. PURPOSE: To evaluate the effectiveness of multistage surgical treatment of patients with advanced PDR complicated with primary cataract. MATERIAL AND METHODS: The study involved 94 cases of surgical treatment of patients with PDR and complicated primary cataract. These patients were divided into two groups depending on the treatment tactics. In the first group, patients were subjected to a two-step surgical procedure: VRS with silicone oil tamponade performed as the first step in their treatment followed by phacoemulsification, silicone oil removal, and IOL implantation, respectively, as the second step. In subgroup 1a - VRS was performed with standard pharmacological support. In subgroup 1b - intravitreal injection of angiogenesis inhibitors preceded VRS. In the second group, the first step was phacoemulsification performed simultaneously with vitreoretinal surgery with silicone oil tamponade; the second step consisted of removing silicone oil from the vitreous cavity. Subgroup 2a - surgical treatment was performed with standard pharmacological support (similar to subgroup 1a). Subgroup 2b - intravitreal injection of anti-VEGF drugs preceded VRS. RESULTS: Visual functions improved in 88.8% and 83.4% of cases in subgroups 1a and 1b, and in 51.3% and 66.7% in subgroups 2a and 2b, respectively. CONCLUSIONS: The study confirms the effectiveness of staged (multi-step) surgical treatment of patients with advanced proliferative diabetic retinopathy and complicated primary cataract. Conducting phacoemulsification sometime later along with silicone oil removal in PDR patients with preoperative intravitreal injection of angiogenesis inhibitors is a gentler approach for the anatomic structures of the eye during the first stage (VRS) and contributes to the reduction in the number of intraoperative and postoperative complications.


Assuntos
Catarata , Diabetes Mellitus , Retinopatia Diabética , Facoemulsificação , Descolamento Retiniano , Catarata/complicações , Catarata/diagnóstico , Retinopatia Diabética/complicações , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/cirurgia , Humanos , Facoemulsificação/efeitos adversos , Complicações Pós-Operatórias/etiologia , Descolamento Retiniano/complicações , Descolamento Retiniano/diagnóstico , Óleos de Silicone , Vitrectomia
13.
Vestn Oftalmol ; 136(6. Vyp. 2): 177-182, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33371647

RESUMO

PURPOSE: To evaluate the effectiveness of complex treatment, including eyelid hygiene, on the condition of ocular surface in dry eye patients before cataract surgery. MATERIAL AND METHODS: The study included 56 female age-related cataract patients (64±4.3 years old) with dry eye caused by Meibomian gland dysfunction (MGD). The main group patients (n=28) underwent eyelid hygiene therapy (2 times a day, 1 month) that involved Blefarogel cleansing, Blefarolotion, Blefarogel-1. The main and control (n=28) group patients performed (during the month): «fat-water¼ type nanoemulsion instillation (3 times a day); preservative free vitamin-A application (at night). Methods included dry eye symptoms assessment (OSDI scale); TBUT; Shirmer-1 test; lissamine green vital staining with xerosis indicator calculation (van Bijsterveld scale); "lid wipers" symptom evaluation; Norn compression test. Statistical evaluation included: mean and standard deviation calculation (M±s); significance of differences assessment (Mann-Whitney U-test; Wilcoxon's T-test). RESULTS: The main group patients (artificial tear, keratoprotection, eyelid hygiene) showed a statistically significant more pronounced decrease in OSDI (from 33.2±3.1 points to 15.2±1.8 points) and a significantly more pronounced increase in TBUT (from 4.8±0.5 s to 6.9±0.4 s) than in control group patients (artificial tear, keratoprotection; respectively, from 32.7±3.2 to 20.8±3.1 points and from 4.85±0.5 to 5.8±0.4 s; p<0.05). Apparently, this was associated with a significantly more pronounced relief of the MGD signs in main group patients (from 2.1±0.1 to 1.1±0.2 points; p<0.05) as a result of eyelid hygiene. In the control group, the dynamics of MGD severity (from 2.08±0.3 to 2.11±0.5 points) was statistically insignificant. CONCLUSION: Eyelid hygiene (based on Blefarogel cleansing, Blefarolotion, Blefarogel-1) increases the effectiveness of dry eye treatment in MGD patients, compared with isolated tear substitution and keratoprotection.


Assuntos
Catarata , Síndromes do Olho Seco , Doenças Palpebrais , Idoso , Síndromes do Olho Seco/diagnóstico , Síndromes do Olho Seco/etiologia , Síndromes do Olho Seco/prevenção & controle , Doenças Palpebrais/diagnóstico , Doenças Palpebrais/etiologia , Doenças Palpebrais/prevenção & controle , Feminino , Humanos , Higiene , Glândulas Tarsais , Pessoa de Meia-Idade , Lágrimas
14.
Lancet Public Health ; 5(12): e682-e691, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33271081

RESUMO

BACKGROUND: Vision loss is an important public health issue in China, but a detailed understanding of national and regional trends in its prevalence and causes, which could inform health policy, has not been available. This study aimed to assess the prevalence, causes, and regional distribution of vision impairment and blindness in China in 1990 and 2019. METHODS: Data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 were used to estimate the prevalence of moderate and severe vision impairment and blindness in China and compare with other Group of 20 (G20) countries. We used GBD methodology to systematically analyse all available demographic and epidemiological data at the provincial level in China. We compared the age-standardised prevalences across provinces, and the changes in proportion of vision loss attributable to various eye diseases in 1990 and 2019. We used two different counterfactual scenarios with respect to population structure and age-specific prevalence to assess the contribution of population growth and ageing to trends in vision loss. FINDINGS: In 2019, the age-standardised prevalence was 2·57% (uncertainty interval [UI] 2·28-2·86) for moderate vision impairment, 0·25% (0·22-0·29) for severe vision impairment, and 0·48% (0·43-0·54) for blindness in China, which were all below the global average, but the prevalence of moderate and severe vision impairment had increased more rapidly than in other G20 countries from 1990 to 2019. The prevalence of vision loss increased with age, and the main causes of vision loss varied across age groups. The leading causes of vision impairment in China were uncorrected refractive error, cataract, and macular degeneration in both 1990 and 2019 in the overall population. From 1990 to 2019, the number of people with moderate vision impairment increased by 133·67% (from 19·65 to 45·92 million), those with severe vision impairment increased by 147·14% (from 1·89 to 4·67 million), and those with blindness increased by 64·35% (from 5·29 to 8·69 million); in each case, 20·16% of the increase could be explained by population growth. The contributions to these changes by population ageing were 87·22% for moderate vision impairment, 116·06% for severe vision impairment, and 99·22% for blindness, and the contributions by age-specific prevalence were 26·29% for moderate vision impairment, 10·91% for severe vision impairment, and -55·04% for blindness. The prevalence and specific causes of vision loss differed across provinces. INTERPRETATION: Although a comprehensive national policy to prevent blindness is in place, public awareness of visual health needs improving, and reducing the prevalence of moderate and severe vision impairment should be prioritised in future work. FUNDING: China National Key Research and Development Programme and Beijing Municipal Special Funds for Medical Research on Public Welfare Development and Reform.


Assuntos
Cegueira/epidemiologia , Cegueira/etiologia , Adolescente , Adulto , Fatores Etários , Idoso , Envelhecimento , Catarata/complicações , Criança , Pré-Escolar , China/epidemiologia , Feminino , Carga Global da Doença , Saúde Global , Humanos , Degeneração Macular/complicações , Masculino , Pessoa de Meia-Idade , Prevalência , Erros de Refração/complicações , Fatores de Risco , Índice de Gravidade de Doença , Adulto Jovem
15.
Adv Gerontol ; 33(4): 761-764, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33342109

RESUMO

About 1,3 billion people live on our planet with visual disorders such as cataract and glaucoma, the prevalence of which is significantly higher in the elderlypopulation. Eye diseases remain a global medical, social and economic problem, associated with both the progression of the disease to blindness and the lack of pathogenetic therapy methods. A retrospective analysis of the long-term dynamics and structure of cases of ophthalmological diseases of patients treated in a large multidisciplinary hospital was carried out. The age and nosological structure of eye diseases is described. Natural features of the structure of diseases relative to different age groups have been revealed, as well as patterns in dynamics have been found.


Assuntos
Catarata , Glaucoma , Cegueira , Catarata/diagnóstico , Catarata/epidemiologia , Glaucoma/diagnóstico , Glaucoma/epidemiologia , Humanos , Prevalência , Estudos Retrospectivos , Federação Russa/epidemiologia
16.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi ; 38(11): 826-830, 2020 Nov 20.
Artigo em Chinês | MEDLINE | ID: mdl-33287475

RESUMO

Objective: To explore the association between long-term low-dose radiation exposure and other influencing factors with the risk of lens opacity on medical radiation workers. Methods: In July 2019, a retrospective cohort study was conducted by collecting the basic demographic information, dose data and health inspection result of 2708 radiologists in 22 hospitals of Guangzhou from the Occupational Health Inspection Information System and the Personal Dose Monitoring System of the Guangdong Prevention and Treatment Center for Occupational Disease between 2010 to 2018. The association between the average annual effective dose and lens opacity risk was calculated by using Time-Dependent Cox Regression Model. Results: From 2010 to 2018, the incidence density of lens opacity was 185.90/10000 person years. Compared with the radiation workers in the age <30 years group (93.74%) , the 5-year normal rate of lens in the age ≥50 years group (72.51%) was lower (P<0.01) ; Compared with the radiation workers in the exposure age <10 years group (92.69%) , the 5-year normal rate of lens in more than 20 years exposed group (83.05%) was lower (P<0.01) . Multifactor analysis showed that age was an independent influencing factor for lens opacity in medical radiation workers (HR=14.485, P<0.01) . The risk of lens opacification increased by 4.9%, 10.1% and 15.5% in 30-, 40- and 50-years group, respectively. Gender, cigarette, alchol, type of work, length of service and annual effective dose had no significant effect on lens opacity (P>0.05) . Conclusion: Age is the main influencing factor of lens opacification in medical radiation workers, their radiation working time and intensity should be strictly controlled and radiation protection should be done.


Assuntos
Catarata , Cristalino , Exposição Ocupacional , Radiação , Catarata/epidemiologia , Catarata/etiologia , Humanos , Estudos Retrospectivos
17.
Artigo em Russo | MEDLINE | ID: mdl-33161660

RESUMO

The study substantiates possibility of using data retrieved from electronic medical records (EMR) for analyzing comorbidity under diseases of the eye and its adnexa. The purpose of the study is to analyze prevalence and evaluate risk of development of comorbidity in patients with ophthalmologic pathology, based on the data presented in EMR. The total number of patients included into comprised 12 120 individuals. The 653 diagnoses were established and 122 703 requests for medical care were registered. The calculation was applied concerning prevalence, comorbidity index, relative risk of comorbidity. The study established prevalence and level of relative risk of development of opportunistic diseases characteristic for senile cataract and glaucoma. The obtained data on comorbidity may testify in-depth mechanisms of interaction of diseases at cellular, protein or genetic levels. The understanding of mechanisms of interaction of main and concomitant diseases can result in development of new methods of diagnostic, treatment and prevention of diseases. Thus, establishment of glaucoma diagnosis can induce physician to look for possible presence or high probability of development of prostate neoplasm that implies periodic control of prostate-specific antigen. The presented results demonstrate how EMR data can be used to identify, estimate prevalence and risk of comorbidity and also reveals pathogenic mechanisms of interaction between primary and recurrent diseases that can be applied in clinical practice.


Assuntos
Catarata , Registros Eletrônicos de Saúde , Doença Crônica , Comorbidade , Humanos , Masculino , Prevalência
18.
Harefuah ; 159(11): 835-839, 2020 Nov.
Artigo em Hebraico | MEDLINE | ID: mdl-33210857

RESUMO

INTRODUCTION: Cataract surgery is one of the most performed surgeries worldwide. Cataract extraction and intra-ocular lens artificial implantation have made a revolution in the past years mainly due to advanced surgical techniques, usage of protecting viscoelastic agents that protect the cornea and anterior chamber, improved design and material of the implanted folded artificial lens, special lenses including toric and multifocal lenses and development of advanced formulas and calculators for predicated IOL power calculation. Recently, femtosecond laser was introduced to cataract surgery, replacing several manual steps of the surgery. The laser was suggested to improve accuracy, safety and refraction results of the surgery. In this article, we will review the literature and investigated the above claims.


Assuntos
Extração de Catarata , Catarata , Lentes Intraoculares , Catarata/etiologia , Humanos , Implante de Lente Intraocular , Refração Ocular , Acuidade Visual
19.
Yakugaku Zasshi ; 140(11): 1351-1363, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-33132271

RESUMO

Epidemiological studies have shown that coffee consumption may be associated with a lower risk of developing several chronic disorders. To elucidate the molecular mechanism of the effects of coffee, we analyzed molecular response upon exposure to coffee extract using cellular and animal models of these diseases. As obesity is recognized as a major risk factor for these chronic diseases, we investigated the effect of coffee on adipogenesis using mouse preadipocyte 3T3-L1 cells. We found that coffee induced proteasomal degradation of IRS-1, leading to reduction of PPARγ expression, a master transcription factor for adipogenesis. Reduction in weight as well as in IRS-1 expression was detected in the fat tissues of the high fat-diet-fed mice when reared with 60% coffee for 7 weeks. As for Alzheimer's disease, we analyzed the effect of coffee on amyloid ß (Aß) production in human neuronal SH-SY5Y cells. We found a 20% reduction in Aß production when treated with 2.5% coffee for 2 d. This reduction was due to proteasomal degradation of BACE1 (ß-secretase), which was activated by protein kinase A. In addition, coffee ameliorates LPS-induced inflammatory responses in RAW264.7 macrophages by reducing NFκB activity and Nrf2 activation. Roasted coffee prevents selenite-induced cataractogenesis by ameliorating antioxidant loss. Pyrocatechol, a component of roasted coffee, also reduced Aß production and exhibits anti-inflammatory effects by a similar mechanism as coffee. Our results suggest that roasting coffee beans to generate pyrocatechol is necessary for the preventive effects of coffee intake on the chronic diseases.


Assuntos
Doença de Alzheimer/prevenção & controle , Catarata/prevenção & controle , Doença Crônica/prevenção & controle , Café , Ingestão de Líquidos/fisiologia , Adipogenia , Doença de Alzheimer/metabolismo , Secretases da Proteína Precursora do Amiloide/metabolismo , Peptídeos beta-Amiloides/metabolismo , Animais , Ácido Aspártico Endopeptidases/metabolismo , Catecóis , Células Cultivadas , Café/química , Modelos Animais de Doenças , Manipulação de Alimentos , Temperatura Alta , Humanos , Proteínas Substratos do Receptor de Insulina/metabolismo , Camundongos , Fator 2 Relacionado a NF-E2/metabolismo , NF-kappa B/metabolismo , PPAR gama/metabolismo , Complexo de Endopeptidases do Proteassoma/metabolismo , Células RAW 264.7
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA