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1.
Medicine (Baltimore) ; 98(48): e18224, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770285

RESUMO

OBJECTIVES: The aim of this study was to verify the safety and stability of precision pulse capsulotomy (PPC) by comparison of the axial stability of the intraocular lens (IOL) and the capsulotomy parameters during 6 months of follow-up after cataract surgery using PPC or the conventional method (continuous curvilinear capsulorhexis, CCC). DESIGN: Prospective observational study. SETTING: Tertiary referral center. SUBJECTS: Fifty nine eyes of 59 candidates for cataract surgery. INTERVENTIONS: PPC (33 eyes) or CCC (26 eyes). OUTCOME MEASURES: The anterior capsule opacification grade and effective lens position (ELP) were measured 1 week and 1, 3, and 6 months postoperatively. RESULTS: No significant difference in the mean anterior capsule opacification grade or the effective lens position was found between the PPC and CCC groups at any time point; however, the standard deviation and root mean square of the effective lens position were significantly lower in the PPC group than in the CCC group during follow-up (P = .002 and P = .011, respectively). There was a significantly lower discrepancy between the intended vs achieved capsulotomy area and better circularity in the PPC group than in the CCC group at all time points. CONCLUSIONS: The overall variability in effective lens position was less when cataract surgery was performed using PPC than when performed using CCC. Circularity was better and had a more predictable size with PPC than with CCC.


Assuntos
Capsulorrexe , Catarata , Cápsula do Cristalino/cirurgia , Implante de Lente Intraocular , Facoemulsificação , Complicações Pós-Operatórias , Idoso , Capsulorrexe/efeitos adversos , Capsulorrexe/métodos , Catarata/diagnóstico , Catarata/epidemiologia , Feminino , Humanos , Implante de Lente Intraocular/efeitos adversos , Implante de Lente Intraocular/métodos , Lentes Intraoculares , Masculino , Pessoa de Meia-Idade , Facoemulsificação/efeitos adversos , Facoemulsificação/métodos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Ajuste de Prótese/métodos , República da Coreia , Acuidade Visual
2.
Isr Med Assoc J ; 21(9): 599-602, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31542904

RESUMO

BACKGROUND: Ocular trauma in the pediatric population may lead to cataract formation. Managing traumatic cataracts in a visually immature child is a major challenge and can result in poor visual outcome. OBJECTIVES: To review our long-term surgical experience with childhood unilateral traumatic cataracts. METHODS: A retrospective observational study of children with unilateral traumatic cataracts with minimal follow-up of 5 years was conducted. Main outcomes included final visual acuity (VA) and occurrence of complications. RESULTS: Of the 18 children included in the study, 83% were male. Mean follow-up time was 12.5 years. Median age at injury was 7.5 years. Eleven patients (61%) presented with penetrating trauma injuries and 7 (39%) with blunt trauma. Sixteen patients (89%) had cataracts at presentation, while in two the cataracts developed during follow-up. Of the 18 total, cataract removal surgery was conducted in 16 (89%) with intraocular lens (IOL) implantation in 14 (87.5%), while 2 remained aphakic (12.5%). Two (11%) were treated conservatively. Long-term complications included IOL dislocation in 5 (36%), glaucoma in 8 (44%), and posterior capsular opacity in 10 (71%). No correlation was found between final visual acuity and the time interval between injury and IOL implantation nor between final VA and age at trauma. However, the final VA did correlate with time of follow-up. CONCLUSIONS: Severe complications occurred in over 30% of the patients during a long follow-up (mean 12.5 years). This finding shows the importance of discussions between the operating physician and the parents regarding the prognosis and necessity of scheduled follow-up.


Assuntos
Extração de Catarata/estatística & dados numéricos , Catarata/epidemiologia , Traumatismos Oculares/epidemiologia , Implante de Lente Intraocular/estatística & dados numéricos , Complicações Pós-Operatórias/epidemiologia , Acuidade Visual , Adolescente , Causalidade , Criança , Pré-Escolar , Comorbidade , Traumatismos Oculares/cirurgia , Feminino , Seguimentos , Humanos , Israel/epidemiologia , Masculino , Estudos Retrospectivos , Tempo , Resultado do Tratamento
3.
Middle East Afr J Ophthalmol ; 26(2): 77-82, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31543664

RESUMO

PURPOSE: The purpose of this study is to report on the establishment of a Pediatric Ophthalmology Service for Malawi using childhood cataract surgery as a surrogate measure of its effectiveness. MATERIALS AND METHODS: A retrospective review of pediatric cataract surgery at Lions Sight First Eye Hospital, Blantyre, between 2011 and 2016. The paucity of comprehensive records allowed for the sampling of a maximum of 25 cases/year (n = 150) for comparison. Theatre records and population statistics were used to calculate childhood cataract surgical rates (CCSR). RESULTS: A total of 949 cataract operations were performed during the six years studied - 55.8% of these were boys. The number of operations per year remained generally stable. Of the 150 cases reviewed, the mean age at presentation was 6.01 years, with a trend toward a slightly younger age over the period. Over the years studied, the geographical distribution of referrals became more reflective of the population's distribution. Where the logarithm of the minimum angle of resolution (LogMAR) visions were available, these demonstrated a mean improvement from 2.008 (n = 43) preoperatively to 0.613 (n = 51) postoperatively. The mean follow-up was 106 days (0 days-3.25 years). Complication rates were low. The CCSR was 9.2/million population. CONCLUSIONS: A Pediatric Ophthalmology Service has been established in Malawi delivering safe, effective surgery on a country-wide scale for childhood cataract. Over the period studied, the age at presentation reduced, and there was an improvement in the geographical distribution of patients, likely due to an improvement in referral systems throughout Malawi.


Assuntos
Extração de Catarata/estatística & dados numéricos , Assistência à Saúde/organização & administração , Serviços de Saúde/provisão & distribução , Oftalmologia/organização & administração , Pediatria/organização & administração , Catarata/epidemiologia , Criança , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Malaui , Masculino , Estudos Retrospectivos
4.
Artigo em Inglês | MEDLINE | ID: mdl-31484296

RESUMO

The aim of this paper is to assess the eye health needs of school teachers in the Asutifi districts of Ghana. Presenting distance visual acuity was measured in each eye. Those with visual acuity of <6/12 in one or both eyes had subjective refraction. All underwent basic eye examination and near functional vision was assessed for teachers aged ≥35 years using the Near Activity Visual Questionnaire (NVAQ). Teachers with uncorrected presbyopia were given a near correction and NVAQ was assessed again at two weeks. Three hundred teachers were examined with mean (SD) age of 36.5 (9.7) years, 54.3% were male and 6.3% (95% CI: 3.8 to 9.8%) had a presenting acuity of <6/12 in one or both eyes. The estimated prevalence of moderate visual impairment was 0.7% (95% CI: 0.08 to 2.4%). Lens opacities (50%) and refractive error (18%) were the main causes of visual loss. Seventy-five out of 136 (55.1%, 95% CI: 46.6 to 63.4%) of teachers aged ≥35 years were presbyopic, 45.3% (95% CI: 36.9 to 53.7%) of whom had presbyopic correction. Lack of awareness was the major barrier to presbyopic correction. Median Rasch score for teachers given presbyopic correction (n = 39) decreased by 60.6% from 46.0 (IQR: 10.7 to 72.8) to 18.1 (IQR: 0 to 58.9) and overall satisfaction with near vision improved at follow up. Prevalence of presbyopia was high, and spectacles improved satisfaction with near vision.


Assuntos
Presbiopia/epidemiologia , Professores Escolares/estatística & dados numéricos , Adulto , Catarata/epidemiologia , Óculos , Feminino , Gana/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários , Transtornos da Visão/epidemiologia , Acuidade Visual , Adulto Jovem
5.
Zhonghua Yan Ke Za Zhi ; 55(8): 589-594, 2019 Aug 11.
Artigo em Chinês | MEDLINE | ID: mdl-31422637

RESUMO

Objective: To assess the prevalence and influence factors of cataract at different altitudes in Gansu Province. Methods: A total of 7 560 permanent residents aged 50 years and over in seven regions of Gansu Province (altitude, 900 meters to 3 500 meters) were selected as subjects, including 2 402 males and 5 158 females, with an average age of 62.04 years. The cluster random sampling method was used to conduct the survey at village or township health service centers. The investigation procedure included questionnaire survey, pre-investigation, visual acuity examination, intraocular pressure measurement, slit lamp microscopy and fundus examination. The diagnostic criterion for cataract was typical opacity of the lens or no other eye diseases that led to visual impairment but with visual acuity less than 0.7. The prevalence of cataract was calculated according to factors such as altitude, age and sex. The Chi-square test and two-element unconditional logistic regression were used for statistical analyses. Results: A total of 7 560 people were surveyed. The prevalence rate of cataract was 39.7%, and the age-standardized prevalence was 37.7%. The prevalence of cataract increased with age (χ(2)=2 107.19, P<0.01). It was 14.1% in the group of 50-59 years, 42.9% in the group of 60-69 years and 79.2% in the group of over 70 years. The prevalence of cataract also increased with altitude (χ(2)=33.66, P<0.01). It was 36.9% in the group of altitude less than 1 000 meters, 39.0% in the group of altitude between 1 000 meters and 1 999 meters, 45.9% in the group of altitude between 2 000 meters and 2 999 meters, and 51.5% in the group of altitude more than 3 000 meters. With age stratification, the prevalence of cataract at high altitude was higher than that at low altitude (χ(2)=26.74, 16.06, P<0.01). Multivariate regression analysis showed that the risk of cataract was higher in subjects at altitude of 2 000-2 999 meters than those below 1 000 meters (OR=1.42, 95%CI 1.11-1.82), and even higher in those at altitude of 3 000 meters (OR=1.76, 95%CI 1.01-3.06). Conclusions: High altitude and old age are important risk factors for cataract, and high altitude is an independent risk factor for cataract. It is necessary for local health institutions to take measures to reduce the prevalence of blindness and low vision, especially the blindness caused by cataract. (Chin J Ophthalmol, 2019, 55:589-594).


Assuntos
Altitude , Catarata , Baixa Visão , Idoso , Cegueira , Catarata/epidemiologia , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência
6.
Indian J Ophthalmol ; 67(7): 1068-1072, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31238413

RESUMO

Purpose: To prospectively evaluate the biometric changes in Indian pediatric cataract and postoperative refractive status. Methods: A total of 147 patients were recruited into three groups: age <6 months, age between 7 months and 18 months, and age between 19 and 60 months and prospectively observed for 6 months. Exclusion criteria were preterm birth, microphthalmia, microcornea, megalocornea, uveitis, glaucoma, and traumatic or complicated cataract. Axial length and keratometry, the primary outcome measures, were taken preoperatively under general anesthesia before surgery. These children were followed up for 6 months to look for refractive and biometric changes. T-test and linear regression with the logarithm of independent variables were done. Results: All unilateral cataractous eyes (n = 25) and randomly selected bilateral cases (n = 122) were included in the analysis, for a total of 147 eyes. Mean age was 17.163 ± 13.024 months; axial length growth was 0.21, 0.18, 0.06 mm/month, and keratometry decline was 0.083, 0.035, 0.001 D/month in age groups 0-6, 7-18, and 19-60 months, respectively. The visual acuity improved in log MAR from 1.020 to 0.745 at 6 months postoperatively. There was statistically significant (Spearman's correlation coefficient = -0.575, P < 0.001) between age and postoperative refraction. There were no intraocular lens (IOL)-related complications seen in the immediate postoperative period. Peripheral opacification was seen in 102 eyes and central opacification in 1 eye at a 6-month follow-up. Conclusion: Indian eyes have a lower rate of axial length growth and keratometry change in comparison with western eyes implying smaller undercorrection in emmetropic IOL power for Indian pediatric eyes to achieve a moderate amount of hyperopia.


Assuntos
Comprimento Axial do Olho/fisiopatologia , Biometria/métodos , Extração de Catarata/efeitos adversos , Catarata/epidemiologia , Lentes Intraoculares , Refração Ocular/fisiologia , Erros de Refração/fisiopatologia , Pré-Escolar , Feminino , Seguimentos , Humanos , Incidência , Índia/epidemiologia , Lactente , Masculino , Complicações Pós-Operatórias , Estudos Prospectivos , Erros de Refração/epidemiologia , Erros de Refração/etiologia
7.
Artigo em Chinês | MEDLINE | ID: mdl-31177725

RESUMO

Objective: To analyze the lens opacity of some hospitals in Hangzhou to provide evidence for further improvement of radiation protection. Methods: Physical examination data of 1720 radiological workers who underwent occupational disease physical examination in our hospital on January1, 2016and December 31, 2017 were collected. Lens turbidity, gender, age, type of work, radiological working age and other influencing factors were statistically analyzed, and logistic regression analysis was used for multipactor analysis. Results: A total of 112 cases of lens turbidity (turbidity rate 6.51%) , after lens turbidity, subcapsular majority (64 cases (57.14%) ) ; lens turbidity increased with age, and showed an increasing trend of radiation working age; the lens turbidity rate was different in different types of work, including nuclear medicine (23.33%) 、radiology (6.76%) 、interventional radiology (6.06%) 、dental radiology (4.26%) and radiotherapy (4.21%) . Type of work、age and length of service are risk factors for lens opacity; Age and type of work were independent risk factors for lens opacity. Conclusion: The turbidity of lens of radiologcial workers is related to age and workering age. Radiological workers engaged in nuclear medicine should strictly strengthen radiation protection.


Assuntos
Catarata , Cristalino , Exposição Ocupacional , Lesões por Radiação , Proteção Radiológica , Radiologia , Catarata/induzido quimicamente , Catarata/epidemiologia , China/epidemiologia , Odontologia , Humanos , Lesões por Radiação/epidemiologia , Radiografia
8.
BMC Ophthalmol ; 19(1): 137, 2019 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-31248388

RESUMO

BACKGROUND: Uveitis in the pediatric population is uncommon, accounting for 2 to 14% of all uveitis cases, yet resulting in significant ocular morbidity. A number of studies have focused on patterns and complications of uveitis in the pediatric age group (≤ 16 years). In this report, we studied children with uveitis syndromes focusing on demographics, anatomic distribution, etiologies, treatment, and complications. We additionally divided subjects into two age groups to look into any differential characteristics pertaining to the younger age group and the role of amblyopia as a cause of visual loss. METHODS: Retrospective chart review of 80 eyes of 49 uveitis patients aged ≤16 years. Subjects were categorized by age of onset into visually immature (≤8 years) and visually mature group (> 8 years). Data compared between the two age groups included demographics, disease characteristics, visual outcomes and complications. RESULTS: Idiopathic uveitis was the most common diagnosis (51%). Anterior uveitis complications (posterior synechiae and band keratopathy) were more common in the younger group (p = 0.002 and p = 0.03 respectively) while posterior uveitis manifestations (vitreous haze and vasculitis) were more common in the older age group (p = 0.04 and p < 0.001 respectively). Amblyopia was the most common cause of vision loss in the visually immature versus cataract in the visually mature. CONCLUSION: Anterior uveitis and its complications were more common in visually immature group in our cohort. Amblyopia was identified as the main cause of visual loss in the younger population.


Assuntos
Ambliopia/etiologia , Catarata/etiologia , Doenças da Córnea/etiologia , Medição de Risco/métodos , Centros de Atenção Terciária/estatística & dados numéricos , Uveíte/epidemiologia , Acuidade Visual , Distribuição por Idade , Fatores Etários , Ambliopia/epidemiologia , Catarata/epidemiologia , Criança , Pré-Escolar , Doenças da Córnea/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Líbano/epidemiologia , Masculino , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Uveíte/complicações , Uveíte/fisiopatologia
9.
Int J Med Sci ; 16(5): 623-629, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31217728

RESUMO

Purpose: Age-related macular degeneration (AMD) is the leading cause of blindness in the elderly in Western Countries. Evidence indicates that Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency, a common genetic abnormality, may protect against ischemic heart and cerebrovascular disease, ocular vascular disorders, and colorectal cancer. This study was undertaken to ascertain whether G6PD deficiency may protect against AMD. Materials and Methods: 79 men with late-stage AMD and 79 male, age-matched cataract controls without AMD were recruited in March-December 2016. Smoking status, clinical history, and drug use were recorded. A blood sample was taken from each participant. Complete blood count, hemoglobin, glucose, creatinine, cholesterol, triglycerides, transaminases, bilirubin, and erythrocyte G6PD activity were measured. Stepwise logistic regression was used to investigate the association between G6PD deficiency and AMD. Results: G6PD deficiency was found in 7 (8.9%) AMD patients and 8 (10.1%) controls, a not statistically significant difference. Stepwise logistic regression disclosed that AMD was significantly associated with increased diastolic blood pressure (OR=1.09, 95% CI=1.03-1.15, P=0.02) and LDL-cholesterol (OR=1.02, 95% CI=1.0001-1.03, P=0.049) and lower values of white blood cell (WBC) count (OR=0.71, 95% CI=0.56-0.88, P=0.02) and aspartate aminotransferase (AST) (OR=0.92, 95% CI=0.85-0.99, P=0.044). Conclusion: Results suggest that G6PD deficiency has no protective effect on nor is a risk factor for AMD. Larger studies are necessary to confirm whether increased diastolic blood pressure and LDL-cholesterol and lower values of WBC count and AST are risk factors for AMD.


Assuntos
Catarata/metabolismo , Deficiência de Glucosefosfato Desidrogenase/epidemiologia , Degeneração Macular/metabolismo , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Catarata/epidemiologia , Catarata/genética , Glucosefosfato Desidrogenase/genética , Glucosefosfato Desidrogenase/metabolismo , Deficiência de Glucosefosfato Desidrogenase/complicações , Deficiência de Glucosefosfato Desidrogenase/diagnóstico , Humanos , Itália/epidemiologia , Degeneração Macular/epidemiologia , Degeneração Macular/genética , Masculino , Pessoa de Meia-Idade , Fatores de Risco
10.
PLoS One ; 14(5): e0216398, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31071127

RESUMO

PURPOSE: To obtain new rapid assessment of avoidable blindness (RAAB) data on the prevalence, causes and trends of blindness, visual impairment and cataract surgery; and compare the new 2018 data with the older RAAB 2009 data. METHODOLOGY: The second nationwide RAAB used android based mRAAB technique and technology for data collection. Using the compact segment sampling probability proportionate to size, 5,050 participants from 101 clusters of 50 people aged 50 years and older were enrolled through house-to-house visits. Eligible participants received ophthalmic examination and interview by the ophthalmologist-led emuneration team as per the RAAB protocol. RESULTS: The age-sex adjusted magnitude of bilateral blindness in Bhutan was 1.0% (95% Confidence Interval, CI 0.5-1.4) with relatively higher prevalence in rural population (Odds Ratio, OR 1.5, p = 0.13) and women (OR 1.6, p = 0.06). Untreated cataract accounted for the most of blindness (53.8%), severe vision impairment (57.1%), and moderate visual impairment (65.3%); uncorrected refractive error was the main cause of early visual impairment (46.7%). Cataract Surgical Coverage was 86.1% with relatively better coverage in men (76.7% men; 73.1% female) and urban population (79.2% urban; 70.2% rural). Good cataract surgical outcome was achieved in 67.3% and leading cause of poor outcome was ocular comorbidity (43.6%). Accessibility was a significant barrier to the uptake of cataract surgical services. CONCLUSION: There is a 33% reduction in blindness from 1.5% to 1.0%, since the first RAAB survey in 2009. In order to further reduce blindness and visual impairment, Bhutan should continue to implement long-term strategic action plan for eye health focused on strengthening primary eye care and comprehensive eye care service.


Assuntos
Cegueira , Extração de Catarata , Catarata/epidemiologia , População Rural , População Urbana , Pessoas com Deficiência Visual , Idoso , Idoso de 80 Anos ou mais , Butão/epidemiologia , Cegueira/epidemiologia , Cegueira/cirurgia , Estudos Transversais , Feminino , Humanos , Masculino
11.
Pituitary ; 22(4): 405-410, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31144107

RESUMO

BACKGROUND: Patients with visual loss from macroadenomas compressing their optic apparatus may also have concomitant age-related visual pathology such as cataracts. How these two pathologies interact with each other is not well documented. OBJECTIVE: The interaction between these two pathologies in elderly patients is the subject of this study. METHODS: We identified a series of non-functioning macroadenoma patients over age 50 years with tumors compressing the chiasm who underwent transsphenoidal surgery at our institution between 2004 and 2018. Pre- and post-operative visual complaints, tumor size and extent of resection were analyzed. Prevalence of the diagnosis of cataract and prevalence of cataract surgery in each decade were compared with national averages. RESULTS: We identified 200 patients who met selection criteria. 18% of these patients had a diagnosis of cataract and 12.5% had cataract surgery. Compared with the Eye Diseases Prevalence Research Group (EDPRG) study, the prevalence of cataract surgery was 2.5 times the national average of 5.1%. 32% of these patients had no improvement in their vision after cataract surgery but 76% improved after transsphenoidal surgery. CONCLUSIONS: We reported a high prevalence of cataract surgery in patients over age 50 in patients with pituitary macroadenomas compressing the optic pathway compared with national averages in patients without adenomas. While visual loss from adenoma likely precipitated more cataract surgeries in this group of patients, some who may not have required it, those patients with cataracts who did not have their cataracts extracted were less likely to recover vision after transsphenoidal surgery. Addressing both pathologies is beneficial.


Assuntos
Catarata/epidemiologia , Neoplasias Hipofisárias/epidemiologia , Adenoma/epidemiologia , Adenoma/fisiopatologia , Adenoma/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Quiasma Óptico/fisiopatologia , Quiasma Óptico/cirurgia , Neoplasias Hipofisárias/fisiopatologia , Neoplasias Hipofisárias/cirurgia , Resultado do Tratamento
12.
Nutrients ; 11(5)2019 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-31137834

RESUMO

Oxidative stress and the subsequent oxidative damage to lens proteins is a known causative factor in the initiation and progression of cataract formation, the leading cause of blindness in the world today. Due to the role of oxidative damage in the etiology of cataract, antioxidants have been prompted as therapeutic options to delay and/or prevent disease progression. However, many exogenous antioxidant interventions have to date produced mixed results as anti-cataract therapies. The aim of this review is to critically evaluate the efficacy of a sample of dietary and topical antioxidant interventions in the light of our current understanding of lens structure and function. Situated in the eye behind the blood-eye barrier, the lens receives it nutrients and antioxidants from the aqueous and vitreous humors. Furthermore, being a relatively large avascular tissue the lens cannot rely of passive diffusion alone to deliver nutrients and antioxidants to the distinctly different metabolic regions of the lens. We instead propose that the lens utilizes a unique internal microcirculation system to actively deliver antioxidants to these different regions, and that selecting antioxidants that can utilize this system is the key to developing novel nutritional therapies to delay the onset and progression of lens cataract.


Assuntos
Antioxidantes/administração & dosagem , Catarata/prevenção & controle , Dieta , Suplementos Nutricionais , Cristalino/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Animais , Catarata/epidemiologia , Catarata/metabolismo , Catarata/patologia , Humanos , Cristalino/metabolismo , Cristalino/patologia , Estado Nutricional , Valor Nutritivo , Fatores de Proteção , Fatores de Risco
13.
PLoS One ; 14(4): e0215809, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31013319

RESUMO

PURPOSE: The aim of this study was to assess knowledge regarding cataract and associated factors among adults in Gondar town Northwest Ethiopia. METHODS: A community-based cross-sectional study was conducted on 836 adults age ≥18years, using multi-stage systematic random sampling technique, in Gondar town Northwest Ethiopia from April 15-May 7, 2017. Data were collected using pre-tested structured questionnaires through face to face interview. The collected data was entered to Epi info version 7 and analyzed using SPSS version 20. Binary logistic regression was used to identify associated factors. Those variables with p-value <0.05 and confidence interval ≠ 1 in multivariable logistic regression were considered as statistically significant factors for knowledge regarding cataract. RESULT: Among 845 eligible adults, 98.9% (836) of them were fully participated. The median age of participants was 28 years with an interquartile range of 17 years. Of the total participants, 67.2% (562) of them had awareness about cataract [95% CI, 63.8-70.2]. Among 562 participants, 61.7% of them had good knowledge about cataract [95% CI, 57.5-66.00]. It was also found that higher level of education [AOR = 2.86, 95%CI: 1.37-5.96], higher family monthly income [AOR = 1.92, 95%CI: 1.03-3.57], having previous eye examination [AOR = 1.53, 95% CI: 1.02-2.31] and positive family history of cataract [AOR = 1.76, 95%CI: 1.03-3.01] were positively associated with good knowledge. CONCLUSION: Significant portion of the participants had good knowledge about cataract, which was positively associated with higher level of education, higher family monthly income, presence of previous eye examination and positive family history of cataract. However, significant knowledge gap regarding the risk factors and prevention strategies was recognized. Hence, it might be logical to pay special attention in prospering knowledge on how to prevent the occurrence of the disease.


Assuntos
Catarata/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Adolescente , Adulto , Catarata/patologia , Catarata/terapia , Etiópia/epidemiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
14.
J Fr Ophtalmol ; 42(6): 551-571, 2019 Jun.
Artigo em Francês | MEDLINE | ID: mdl-30979558

RESUMO

The European Medicines Agency has defined Big Data by the "3 V's": Volume, Velocity and Variety. These large databases allow access to real life data on patient care. They are particularly suited for studies of adverse events and pharmacoepidemiology. Deep learning is a collection of algorithms used in machine learning, used to model high-level abstractions in data using model architectures, which are composed of multiple nonlinear transformations. This article shows how Big Data and Deep Learning can help in ophthalmology, pointing out their advantages and disadvantages. A literature review is presented in this article illustrating the uses of Deep Learning in ophthalmology.


Assuntos
Algoritmos , Big Data , Bases de Dados Factuais , Aprendizado de Máquina , Oftalmologia/tendências , Catarata/epidemiologia , Extração de Catarata , Retinopatia Diabética/diagnóstico , Humanos , Armazenamento e Recuperação da Informação , Degeneração Macular/diagnóstico , Degeneração Macular/tratamento farmacológico , Aprendizado de Máquina Supervisionado
15.
J Fr Ophtalmol ; 42(5): 441-450, 2019 May.
Artigo em Francês | MEDLINE | ID: mdl-30975438

RESUMO

PURPOSE: To evaluate the medical-surgical management of cataract surgery in children with chronic uveitis in various French pediatric ophthalmology centers. MATERIALS AND METHODS: Two-part study: first, a descriptive observational segment on the evaluation of French practices. A questionnaire was sent to the various pediatric ophthalmologists in France. A second retrospective chart review, including children with non-infectious chronic uveitis who had cataract surgery in the pediatric ophthalmology department of Bordeaux University Hospital from 2008 to 2017. RESULTS: Twenty-one ophthalmologists responded to the questionnaire. Only 23.8% systematically initiated immunosuppressive drugs (aside from corticosteroids) before surgery. A total of 88.2% prescribed oral corticosteroid treatment preoperatively. Eleven surgeons administered intravenous corticosteroid boluses during the surgery, and primary lens implantation is the most common method used in 95.2%. A total of 76.2% initiated oral steroid therapy after surgery. Postoperatively, all surgeons started local therapy with high-dose corticosteroids. At one year, 100% achieved improvement of visual acuity greater than or equal to 2 lines. On our service, 10 eyes (7 children) underwent cataract surgery. Seven were treated with systemic immunosuppressive drugs (aside from corticosteroids) and 80% of cases received oral corticosteroid therapy a few days before surgery. An intravenous corticosteroid bolus was administered preoperatively in 8 cases, and primary lens implantation was performed in 100% of cases. Postoperatively, 5 children received oral corticosteroid treatment. All were treated with local high dose steroids. At one year, the mean best-corrected visual acuity was 0.18 LogMar (0-0.7, SD: 0.25). CONCLUSION: When performed with an aggressive anti-inflammatory protocol, cataract surgery leads to a good visual outcome in selected children with chronic uveitis.


Assuntos
Extração de Catarata , Catarata/terapia , Padrões de Prática Médica/estatística & dados numéricos , Uveíte/cirurgia , Adolescente , Corticosteroides/uso terapêutico , Catarata/complicações , Catarata/epidemiologia , Extração de Catarata/efeitos adversos , Extração de Catarata/estatística & dados numéricos , Criança , Pré-Escolar , Doença Crônica , Terapia Combinada , Feminino , França/epidemiologia , Hospitais Pediátricos , Humanos , Implante de Lente Intraocular , Masculino , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Inquéritos e Questionários , Resultado do Tratamento , Uveíte/complicações , Uveíte/tratamento farmacológico , Uveíte/epidemiologia
16.
PLoS One ; 14(4): e0214684, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30933995

RESUMO

OBJECTIVE: This meta-analysis aims to evaluate the incidence of secondary glaucoma in patients under the age of 2 years who underwent congenital cataract surgery with or without primary intraocular lens (IOL) implantation. METHODS: An electronic literature search was performed in Medline, EMBASE, and Web of Science databases to retrieve studies between January 2011 and November 2018. Patients with congenital cataract who did primary IOL implantation, aphakia, or secondary IOL implantation followed by receiving extraction surgery were included in this study. Relevant studies meeting defined eligibility criteria were selected and reviewed systematically by meta-analysis. Long-term incidences of secondary glaucoma, which developed at least one year after cataract surgery, were considered and discussed as clinical outcomes in each cohort. The pooled data were analyzed according to a random effects model. RESULTS: Eight publications involving 892 eyes were included in the current meta-analysis. In the general population of eyes with congenital cataract, the long-term incidence of secondary glaucoma was lower (P = 0.06) in eyes with primary IOL (9.5%) than in eyes without primary IOL (15.1%), including aphakia and secondary IOL. The pooled risk ratio (RR) favors primary IOL implantation in all patients (RR = 0.63). For bilateral congenital cataract, the incidence was 6.7% in eyes with primary IOL implantation, which is significantly lower than the 16.7% in eyes with aphakia and secondary IOL implantation (P<0.05, RR = 0.44). However, for unilateral congenital cataract surgery, the incidence was very similar in eyes with and without primary IOL (12.4% vs 12.0%, P = 0.61, RR = 0.87). CONCLUSIONS: In patients under 2 years of age, primary IOL implantation for bilateral congenital cataract surgery is associated with a lower risk of secondary glaucoma.


Assuntos
Afacia Pós-Catarata/cirurgia , Extração de Catarata/efeitos adversos , Catarata/congênito , Glaucoma/etiologia , Glaucoma/prevenção & controle , Implante de Lente Intraocular , Afacia Pós-Catarata/epidemiologia , Opacificação da Cápsula/epidemiologia , Opacificação da Cápsula/etiologia , Opacificação da Cápsula/prevenção & controle , Catarata/epidemiologia , Extração de Catarata/estatística & dados numéricos , Glaucoma/epidemiologia , Humanos , Lactente , Recém-Nascido , Lentes Intraoculares/efeitos adversos , Lentes Intraoculares/estatística & dados numéricos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Fatores de Risco
17.
J Fr Ophtalmol ; 42(4): 368-374, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30898370

RESUMO

PURPOSE: To describe the visual results and postoperative complications of congenital cataract surgeries performed between 2005 and 2016. METHODS: A retrospective consecutive case series of congenital cataract surgeries was carried out at the Dijon University Hospital in France. Intraocular lens implantation was primary or secondary according to age. Pre- and post-operative assessment was performed through ophthalmologic consultations with orthoptic measurements. Visual function and adverse events were recorded. RESULTS: Fifty-six consecutive procedures were evaluated in 37 infants. Overall, 26.8% of patients had unilateral cataracts, and 73.2% had bilateral cataracts. Median age at surgery was 1.0 years [IQR (interquartile range): 0.3-5.2] and 2.7 years [IQR: 0.4-9.5] for unilateral and bilateral cataracts, respectively. Median best-corrected visual acuity (BCVA) at the last follow-up was 0.5logMAR [IQR: 0.2-0.8] and 0.1logMAR [IQR: 0.0-0.8] for the unilateral and bilateral group, respectively. Posterior capsule opacification (PCO) was the primary postoperative complication: 60.0% in unilateral cataract and 46.3% in bilateral cataracts (P=0.019). Median follow-up was 2.0 years [IQR: 1.0-5.0]. CONCLUSION: Congenital cataract surgery appears to be safe and effective when combined with early, conscientious amblyopia treatment. Bilateral congenital cataracts had better visual outcome than unilateral cataract.


Assuntos
Extração de Catarata , Catarata/congênito , Complicações Pós-Operatórias/epidemiologia , Acuidade Visual/fisiologia , Catarata/complicações , Catarata/epidemiologia , Catarata/terapia , Extração de Catarata/efeitos adversos , Extração de Catarata/reabilitação , Extração de Catarata/estatística & dados numéricos , Pré-Escolar , Feminino , França/epidemiologia , Humanos , Lactente , Implante de Lente Intraocular/efeitos adversos , Implante de Lente Intraocular/métodos , Implante de Lente Intraocular/estatística & dados numéricos , Lentes Intraoculares/efeitos adversos , Masculino , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Resultado do Tratamento
18.
Indian J Ophthalmol ; 67(4): 477-483, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30900578

RESUMO

Purpose: To report the prevalence and risk factors of cataract and its subtypes in older age group. Methods: A total of 6617 subjects were recruited from both rural and urban areas. A detailed history including data on demographic, socioeconomic and ocular history was obtained. Lens opacity was graded according to the Lens Opacity Classification System III (LOCS III). Results: Cataract was present in 1094 of the rural and 649 subjects in the urban population. Monotype subtype cataracts were found in 32% and 25% in rural and urban population and 12.68% and 18.6% were mixed cataracts in the rural and urban groups. In baseline characteristics history of diabetes, alcohol intake and presence of age-related macular degeneration were the risk factors in urban group. On multivariate analysis, the only significant risk factors for any cataract in subjects ≥60 years were increasing age in both rural [odds ratio (OR), 1.07] and urban (OR, 1.08) population, and HbA1c (OR, 1.14) in rural population. Overweight (OR, 0.6) was found to be a protective factor, and lower social economic status (OR, 1.52) a risk factor for cataract in urban population. A significant urban-rural difference was found in the prevalence of cataract and its subtypes (P ≤ 0.05). Conclusion: We found the risk factors for any cataract in older age group to be increasing age and HbA1c in rural group. Age and lower social economic status were found to be the risk factors in urban arm. A statistically significant difference was found on comparison of the prevalence of cataract and its subtypes between the rural and urban population.


Assuntos
Catarata/epidemiologia , Medição de Risco/métodos , População Rural , População Urbana , Idoso , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Fatores de Risco , Fatores Socioeconômicos
19.
Occup Environ Med ; 76(5): 317-325, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30890565

RESUMO

OBJECTIVES: To assess radiation exposure-related work history and risk of cataract and cataract surgery among radiologic technologists assisting with fluoroscopically guided interventional procedures (FGIP). METHODS: This retrospective study included 35 751 radiologic technologists who reported being cataract-free at baseline (1994-1998) and completed a follow-up questionnaire (2013-2014). Frequencies of assisting with 21 types of FGIP and use of radiation protection equipment during five time periods (before 1970, 1970-1979, 1980-1989, 1990-1999, 2000-2009) were derived from an additional self-administered questionnaire in 2013-2014. Multivariable-adjusted relative risks (RRs) for self-reported cataract diagnosis and cataract surgery were estimated according to FGIP work history. RESULTS: During follow-up, 9372 technologists reported incident physician-diagnosed cataract; 4278 of incident cases reported undergoing cataract surgery. Technologists who ever assisted with FGIP had increased risk for cataract compared with those who never assisted with FGIP (RR: 1.18, 95% CI 1.11 to 1.25). Risk increased with increasing cumulative number of FGIP; the RR for technologists who assisted with >5000 FGIP compared with those who never assisted was 1.38 (95% CI 1.24 to 1.53; p trend <0.001). These associations were more pronounced for FGIP when technologists were located ≤3 feet (≤0.9 m) from the patient compared with >3 feet (>0.9 m) (RRs for >5000 at ≤3 feet vs never FGIP were 1.48, 95% CI 1.27 to 1.74 and 1.15, 95% CI 0.98 to 1.35, respectively; pdifference=0.04). Similar risks, although not statistically significant, were observed for cataract surgery. CONCLUSION: Technologists who reported assisting with FGIP, particularly high-volume FGIP within 3 feet of the patient, had increased risk of incident cataract. Additional investigation should evaluate estimated dose response and medically validated cataract type.


Assuntos
Catarata/diagnóstico , Diagnóstico por Imagem/efeitos adversos , Medição de Risco/normas , Adulto , Catarata/epidemiologia , Estudos de Coortes , Diagnóstico por Imagem/estatística & dados numéricos , Feminino , Fluoroscopia/efeitos adversos , Fluoroscopia/métodos , Fluoroscopia/estatística & dados numéricos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos , Fatores de Risco , Inquéritos e Questionários
20.
Mol Med Rep ; 19(4): 3123-3131, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30816539

RESUMO

The present study aimed to identify the disease­causing gene of a four­generation Chinese family affected with congenital posterior subcapsular cataracts (CPSC), to additionally investigate the frequency of paired like homeodomain 3 (PITX3) mutations in Chinese patients with autosomal dominant congenital cataract (ADCC) and to analyze the pathogenesis of the mutations identified in the present study. Whole exome sequencing (WES) was utilized to identify the genetic cause of CPSC in the four­generation family. Sanger sequencing was performed to verify the WES results and to screen for mutations of the PITX3 gene in probands of an additional 194 Chinese ADCC families. Co­segregation analysis was performed in the family members with available DNA. Subcellular localization analyses and transactivation assays were performed for the PITX3 mutations identified. From the WES data, the c.608delC (p.A203GfsX106) mutation of PITX3 was identified in the four­generation family with CPSC. A second PITX3 mutation c.640_656del (p.A214RfsX42) was detected in two of the additional 194 ADCC families and one of these two families exhibited incomplete penetrance. Functional studies indicated that these 2 PITX3 mutant proteins retained a nuclear localization pattern, but resulted in decreased transactivation activity, similar to other previously identified PITX3 mutations. In the present study, 2 different mutations (p.A203GfsX106 and p.A214RfsX42) in PITX3 were identified as the causative defect in a four­generation family with CPSC and two ADCC families, respectively. The prevalence of PITX3 gene­associated cataract was 1.54% (3/195) in the Chinese congenital cataract (CC) family cohort. In vitro functional analyses of these 2 PITX3 mutations were performed, in order to enhance understanding of the pathogenesis of CC caused by PITX3 mutations.


Assuntos
Grupo com Ancestrais do Continente Asiático/genética , Catarata/genética , Estudos de Associação Genética , Predisposição Genética para Doença , Proteínas de Homeodomínio/genética , Mutação , Fatores de Transcrição/genética , Catarata/epidemiologia , Biologia Computacional/métodos , Feminino , Imunofluorescência , Regulação da Expressão Gênica , Proteínas de Homeodomínio/metabolismo , Humanos , Espaço Intracelular/metabolismo , Masculino , Ligação Proteica , Transporte Proteico , Fatores de Transcrição/metabolismo , Sequenciamento Completo do Exoma
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