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2.
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
3.
Artigo em Inglês | MEDLINE | ID: mdl-33321894

RESUMO

This study aimed to investigate the association between ambient air pollutants and cataracts in the general population aged 50 years or older using data from the Korean National Insurance Service-National Sample Cohort. Cataract patients were defined as those diagnosed by a physician and having undergone cataract surgery. After matching the average concentrations of PM2.5, PM10, NO2, CO, SO2, and O3 in residential areas, the association between quartile level of air pollutants and incidence of cataract was analyzed using a multivariate Cox-proportional hazard risk model. Among the 115,728 participants, 16,814 (14.5%) were newly diagnosed with cataract and underwent related surgery between 1 January 2004, and 31 December 2015. Exposure to PM10, NO2, and SO2 was positively associated with cataract incidence, while O3 was negatively associated. The adjusted hazard ratio (HR) with 95% confidence interval was 1.069 (1.025-1.115) in PM10 and 1.080 (1.030-1.133) in NO2. However, the association between cataract and the quartile of PM2.5 measured during one year in 2015 was not clear. The HR of female participants aged 65 or older was significantly increased according to quartile of air pollutants. We identified exposure to PM10, NO2, SO2, and O3 associated with cataract development in Korean adults aged ≥ 50 years. This information may be helpful for policymaking to control air pollution as a risk factor for eye health.


Assuntos
Poluição do Ar , Catarata , Exposição Ambiental , Adulto , Fatores Etários , Idoso , Poluentes Atmosféricos/efeitos adversos , Poluição do Ar/efeitos adversos , Catarata/epidemiologia , Catarata/etiologia , Estudos de Coortes , Exposição Ambiental/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Material Particulado/efeitos adversos , Estudos Retrospectivos
4.
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
5.
Yakugaku Zasshi ; 140(9): 1095-1099, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32879241

RESUMO

The lens of the eye is an avascular and anuclear tissue that serves to focus objects on the retina. Cataract is opacity within the clear lens that changes the transparency and refractive index of the lens causing significant visual impairments. These impairments can severely restrict the ability to carry out daily activities. Cataracts is common among elderly person occurring in more than 80% of patients aged 80 or older. Notably, we have recently identified key compounds that are effective against cataract formation. Presbyopia is also an ocular disease that typically develops in people over the age of 45 while affecting almost 100% of people over the age of 65. Recent research suggests that age-related changes in hydrostatic pressure of the lens controlled by Na/K ATPase contribute to the development of presbyopia. In the lens, Na/K ATPase has been shown to be regulated by transient receptor potential cation channels, vanilloid 1 (TRPV1) and 4, thus suggesting the potential role of TRPV1 and TRPV4 in the development of presbyopia. This review article summarizes data obtained from our laboratory with my colleagues highlighting the critical role of aquaporin 0 (AQP0) in maintaining a healthy lens redox environment, key molecules that delay the onset of cataract in vivo, as well as potential mechanisms of lens hydrostatic pressure control that may be associated with presbyopia.


Assuntos
Aquaporinas/fisiologia , Catarata/tratamento farmacológico , Catarata/etiologia , Desenvolvimento de Medicamentos , Proteínas do Olho/fisiologia , Pressão Hidrostática , Cristalino/metabolismo , Oxirredução , Presbiopia/etiologia , ATPase Trocadora de Sódio-Potássio/metabolismo , ATPase Trocadora de Sódio-Potássio/fisiologia , Canais de Cátion TRPV/fisiologia
6.
Br J Radiol ; 93(1115): 20190633, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-32970475

RESUMO

OBJECTIVES: Tumors of the lacrimal sac are rare and life-threatening. Because of their rarity, no extensive clinical data on their management and prognosis exist. We investigated the application of definitive radiation therapy and its outcome in patients with lacrimal sac squamous cell carcinoma (LSSCC). METHODS: We retrospectively studied 17 patients with LSSCC at a single institution between 2003 and 2017. All the patients were treated with definitive radiotherapy, and 11 patients were delivered with cisplatin-based chemotherapy. The patients' clinical records were reviewed for symptoms, pathological types, the volume and dosimetry of the tumors and their adjacent structures, radiation coverage of lymph node drainage areas, treatment outcomes, and complications from definitive radiotherapy. RESULTS: Median follow-up was 38.9 months, and age at diagnosis was 48 years.The 2-year and 5-year overall survival, progression-free survival, locoregional control, and disease metastasis-free survival rates were 94.1 and 84.7%, 88.2 and 73.5%, 93.8%, 94.1, and 78.4%, respectively. A total dose of 6600-7000 cGy was prescribed to the tumor. Levels Ⅰb, Ⅶa, Ⅷ, and Ⅸ were covered with the clinical target volume regardless of lymph involvement. Acute Grade 3 radiation dermatitis occurred in seven patients (17.6%), but no acute Grade 4 or Grade 5 toxicity of any type occurred. Seven (41.2%, 7/17) of the treated eyes had moderated vision impairments; 17.6% (3/17) of patients developed cataracts, and glaucoma and radiation retinopathy were found in 5.9% (1/17) of patients. CONCLUSIONS: Definitive radiotherapy could be a treatment option for those who refuse surgery or have unresectable LSSCC. ADVANCES IN KNOWLEDGE: Radiation alone is a treatment option for LSSCC.


Assuntos
Carcinoma de Células Escamosas/radioterapia , Neoplasias Oculares/radioterapia , Ducto Nasolacrimal , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/mortalidade , Catarata/etiologia , Quimiorradioterapia/métodos , Intervalo Livre de Doença , Neoplasias Oculares/tratamento farmacológico , Neoplasias Oculares/mortalidade , Feminino , Glaucoma/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Intervalo Livre de Progressão , Lesões por Radiação/complicações , Radiodermatite/etiologia , Dosagem Radioterapêutica , Radioterapia Conformacional/métodos , Estudos Retrospectivos , Resultado do Tratamento , Transtornos da Visão/etiologia , Adulto Jovem
7.
Rev. cuba. oftalmol ; 33(3): e872,
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1139097

RESUMO

RESUMEN Para el ser humano la información suministrada por sus ojos resulta esencial en su interacción con el entorno. Por esta razón todos consideramos la vista como nuestro sentido más valioso. Es fácil comprender, por tanto, que cualquier individuo sometido a una operación oftalmológica desarrollará un alto grado de ansiedad; de ahí la importancia de su cooperación para evitar las complicaciones quirúrgicas, donde en muchas ocasiones la cirugía se realiza con anestesia local. Es por eso que evitar el dolor y abolir los movimientos oculares va a ser un paso previo fundamental en la cirugía. Con el advenimiento del desarrollo tecnológico aplicado a la Oftalmología, nuevos procedimientos quirúrgicos persiguen una recuperación visual y social temprana de los pacientes. Dentro de ellos la cirugía de catarata por facoemulsificación exige métodos anestésicos que permitan lograr este propósito, y en la actualidad ya podemos mencionar la anestesia tópica y la crioanalgesia como avances en este sentido, las cuales se aplican en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer". Se realizó una búsqueda de diversos artículos publicados en la plataforma de PubMed, con el objetivo de conocer el desarrollo y las características de los anestésicos aplicados en la cirugía de catarata(AU)


ABSTRACT The information obtained by human beings through their eyes is essential for their interaction with the environment. This is the reason why we all consider our sight as our most valuable sense. It is thus easy to understand that any individual undergoing eye surgery will develop a high degree of anxiety. Hence the importance of their cooperation to prevent surgical complications, since on many occasions surgery is performed with local anesthesia. Preventing pain and stopping eye movement are therefore a crucial previous step in surgery. With the application of technological development to ophthalmology, new surgical procedures have emerged aimed at the patients' visual recovery and early social reincorporation. One of those procedures is phacoemulsification cataract surgery, which requires anesthetic methods that make it possible to achieve such an end. Examples of advances in this field are topical anesthesia and cryoanalgesia, both of which are applied at Ramón Pando Ferrer Cuban Institute of Ophthalmology. A search was conducted for papers published on the PubMed platform with the purpose of becoming acquainted with the development and characteristics of the anesthetics used in cataract surgery(AU)


Assuntos
Humanos , Procedimentos Cirúrgicos Operatórios/métodos , Catarata/etiologia , Facoemulsificação/métodos , Anestesia/história , Desenvolvimento Tecnológico/efeitos adversos
8.
Rev. cuba. oftalmol ; 33(3): e888, graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1139092

RESUMO

RESUMEN La cirugía de catarata es uno de los procedimientos quirúrgicos más frecuentes de toda la medicina. El objetivo de la técnica es eliminar el cristalino opacificado y sustituirlo con lentes intraoculares para lograr una rehabilitación de la función visual. El cálculo preciso de la posición efectiva del lente es crítico para lograr un buen resultado refractivo. Esta es la única variable que no puede medirse en el preoperatorio y que debe predecirse, por lo que representa uno de los retos más grande para el cirujano de catarata, ya que puede influir ampliamente en el resultado visual del paciente. Investigaciones recientes proponen nuevos parámetros para la estimación de la posición efectiva del lente, que están relacionados con la geometría del cristalino. Se realizó una búsqueda con el objetivo de describir la importancia de una adecuada estimación de la posición efectiva del lente y para conocer las últimas fórmulas propuestas para el cálculo del lente. Se encontraron estudios de investigación recientes en varias partes del mundo que proponen nuevas fórmulas basadas en parámetros anatómicos del cristalino. Se utilizó la plataforma Infomed, específicamente la Biblioteca Virtual de Salud, con todos sus buscadores(AU)


ABSTRACT Cataract surgery is one the most common surgeries within medicine. The technique's objective is the removal of the natural lens of the eye that has developed an opacification, and its replacement with an intraocular lens to provide optimal visual acuity. An accurate assessment of the effective lens position is critical to achieve a good postoperative refractive outcome. This is the only variable that cannot be measured in the preoperative period and most be predicted, therefore it represents one of the greatest challenge for the cataract surgeon, since it can greatly influence the visual outcome of the patient. Recent research proposes new parameters of the estimation of the effective lens position that are related to the geometry of the lens. Research has been made in order describe the importance of an adequate estimation of the effective lens position and to learn more about the lastest formulas proposed for its calcutation. Many studies proposed new formulas based on lens geometry parameters. The Infomed platform, specifically the Virtual Health Library, was used with all its search engines(AU)


Assuntos
Humanos , Procedimentos Cirúrgicos Operatórios/reabilitação , Catarata/etiologia , Previsões , Lentes Intraoculares/efeitos adversos , Ferramenta de Busca/métodos
10.
Middle East Afr J Ophthalmol ; 27(1): 28-33, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32549721

RESUMO

OBJECTIVE: The objective of the study was to asses ocular findings' prevalence in children with primary congenital heart disease (CHD). PATIENTS AND METHODS: This is a prospective cross-sectional study of children with CHD treated at a specialized center in the South of Brazil between 2013 and 2015. They underwent a complete ocular examination, including measurement of visual acuity, refraction test, external motility, anterior and posterior biomicroscopy, and binocular indirect fundoscopy with retinal photographs. Two experienced examiners independently assessed fundus findings: one at the time of examination and image capture, while the other assessed only the captured images. RESULTS: Of a total of 146 children examined, 124 were included in this analysis (16% loss). Seventy children were male (55.5%). The average age was 9.3 years (minimum 1 month and maximum 15 years). Caucasians race were 81.2%, African Descendants race were 11.1%, and others were 7.7%. About 57.1% had already had heart surgery. About 14.8% had visual acuity below 0.6 and 2.8% below 0.1. Strabismus was found in 7.4% and cataracts in 1.7%. Retinal alterations were recognized in 13.5%, of which 4.8% were related to vascular narrowing or dilation and/or abnormal arteriovenous crossing; 7.14% were related to increased vascular tortuosity, while 1.6% were related to active toxoplasmic chorioretinitis lesions. Concomitant abnormalities in ocular motility, biomicroscopy, or ophthalmoscopy were detected in 24% of the cases. CONCLUSION: Children under the age of 15 years old with primary CHD have a high prevalence of ocular alterations, with external ocular and retinal manifestations, with higher occurrence rate among cyanotic cases. This leads us to strongly recommend the performance of a complete ophthalmological examination in such cases.


Assuntos
Catarata/etiologia , Cardiopatias Congênitas/complicações , Transtornos da Motilidade Ocular/etiologia , Doenças Retinianas/etiologia , Estrabismo/etiologia , Adolescente , Catarata/diagnóstico , Criança , Pré-Escolar , Estudos Transversais , Feminino , Fundo de Olho , Humanos , Lactente , Masculino , Transtornos da Motilidade Ocular/diagnóstico , Oftalmoscopia , Estudos Prospectivos , Refração Ocular/fisiologia , Doenças Retinianas/diagnóstico , Estrabismo/diagnóstico , Acuidade Visual/fisiologia
11.
Rev. cuba. oftalmol ; 33(2): e856, tab
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1139074

RESUMO

RESUMEN Objetivo: Determinar los resultados de la facotrabeculectomía por dos vías como tratamiento combinado de pacientes cubanos con glaucoma y catarata. Métodos: Se realizó un estudio observacional descriptivo longitudinal prospectivo en pacientes adultos cubanos tratados con facotrabeculectomía en el Servicio de Glaucoma del Instituto Cubano de Oftalmología "Ramón Pando Ferrer" entre junio del año 2016 y abril de 2017. El universo estuvo constituido por todos los pacientes operados con facotrabeculectomía por dos vías. La muestra la integraron pacientes operados por un mismo cirujano, quienes estuvieron de acuerdo con participar en la investigación. Se excluyeron aquellos con cirugía intraocular previa. Salieron del estudio los que no pudieron mantener el seguimiento en la institución. Se estudiaron las variables edad, sexo, color de la piel, agudeza visual mejor corregida, presión intraocular, número de medicamentos hipotensores oculares y complicaciones presentadas. El seguimiento fue por dos años con consultas al día siguiente, a los siete y a los treinta días; a los tres y a los seis meses; al año y a los dos años. Resultados: Se observaron 31 pacientes. La edad promedio fue de 70 años, con predominio del sexo femenino y el color de la piel no blanco; la agudeza visual mejor corregida preoperatoria media 0,58 y la posoperatoria 0,73. La presión intraocular media preoperatoria 22,04 mmHg y a los dos años 16,37 mmHg. La media de los medicamentos hipotensores preoperatorios fue 3,0 y 0,3 a los dos años. Las complicaciones más frecuentes resultaron la ruptura transquirúrgica de la cápsula posterior y la opacidad posquirúrgica de la cápsula posterior. Conclusiones: Con la facotrabeculectomía por dos vías disminuye la presión intraocular; mejora la agudeza visual mejor corregida y se reduce el número de fármacos hipotensores oculares al menos durante dos años. Las complicaciones asociadas a la técnica son mínimas(AU)


ABSTRACT Objective: Determine the results of two-site phacotrabeculectomy as combined therapy for Cuban patients with glaucoma and cataract. Methods: An observational prospective longitudinal descriptive study was conducted of Cuban patients undergoing phacotrabeculectomy at the Glaucoma Service of Ramón Pando Ferrer Cuban Institute of Ophthalmology from June 2016 to April 2017. The study universe was all the patients undergoing two-site phacotrabeculectomy. The sample was patients operated on by the same surgeon who consented to participate in the research. Patients with a history of intraocular surgery were excluded, as well as those who could not be followed up at the institution. The variables considered were age, sex, skin color, best corrected visual acuity, intraocular pressure, number of ocular hypotensive drugs, and complications developed. Follow-up extended for two years with visits on the next day, at seven and thirty days, at three and six months, and at one and two years. Results: Thirty-one patients were observed. Mean age was 70 years, with a predominance of the female sex and non-white skin color. Best corrected visual acuity was 0.58 preoperative and 0.73 postoperative. Mean preoperative intraocular pressure was 22.04 mmHg, whereas at two years it was 16.37 mmHg. Hypotensive drugs averaged 3.0 preoperative and 0.3 at two years. The most common complications were intraoperative posterior capsule rupture and postsurgical posterior capsule opacity. Conclusions: Two-site phacotrabeculectomy reduces intraocular pressure, improves best corrected visual acuity and lowers the number of ocular hypotensive drugs for at least two years. The complications associated to the technique are minimum(AU)


Assuntos
Humanos , Feminino , Idoso , Catarata/etiologia , Trabeculectomia/métodos , Glaucoma/epidemiologia , Terapia Combinada/métodos , Facoemulsificação/métodos , Epidemiologia Descritiva , Estudos Prospectivos , Estudos Longitudinais , Estudos Observacionais como Assunto
12.
Rev. cuba. oftalmol ; 33(2): e739, tab
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1139068

RESUMO

RESUMEN Objetivo: Relacionar la severidad del edema corneal poscirugía de catarata en pacientes con córnea guttata, considerados sin riesgo o bajo riesgo de edema posquirúrgico según densidad celular, con los parámetros de la microscopia endotelial. Métodos: Se realizó un estudio descriptivo, prospectivo de 42 pacientes con córnea guttata, considerados sin riesgo o bajo riesgo de edema posquirúrgico según la densidad celular, quienes fueron sometidos a la cirugía de catarata por el mismo cirujano en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer", desde abril del año 2016 a diciembre de 2017. Se determinó la severidad del edema corneal y se relacionó con el grado de córnea guttata, así como con los parámetros de la microscopia endotelial. Resultados: El 52,4 por ciento fueron mayores de 70 años y el 64,3 por ciento mujeres. No hubo edema en el 54,8 por ciento en las primeras 24 horas, y fue en el 26,2 por ciento leve y en el 19,0 por ciento mínimo, donde predominó la córnea guttata grado 3 y presentaban un bajo riesgo prequirúrgico. Sin embargo, no hubo diferencias en relación con el polimegatismo y el pleomorfismo. Conclusiones: La severidad del edema corneal en pacientes con córnea guttata posfacoemulsificación a los siete días no se asocia con el polimegatismo, ni con el polimorfismo prequirúrgico, pero sí con el conteo endotelial prequirúrgico(AU)


ABSTRACT Objective: Determine the relationship between the severity of corneal edema in cornea guttata patients undergoing cataract surgery considered to be at no risk or low risk for postsurgical edema in terms of cell density, and endothelial microscopy parameters. Methods: A descriptive prospective study was conducted of 42 cornea guttata patients considered to be at no risk or low risk for postsurgical edema in terms of cell density, who underwent cataract surgery performed by the same surgeon at Ramón Pando Ferrer Cuban Institute of Ophthalmology from April 2016 to December 2017. Corneal edema severity was determined and related to cornea guttata grade and endothelial microscopy parameters. Results: Of the patients studied, 52.4 percent were aged over 70 years and 64.3 percent were women. Edema was not observed in 54.8 percent in the first 24 hours, whereas it was mild in 26.2 percent and minimum in 19.0 percent. Grade 3 cornea guttata and low presurgical risk prevailed. However, no differences were found in relation to polymegethism and pleomorphism. Conclusions: At seven days, corneal edema severity in cornea guttata patients undergoing phacoemulsification is not associated to polymegethism or presurgical polymorphism, but it as associated to the presurgical endothelial count(AU)


Assuntos
Humanos , Feminino , Idoso , Catarata/etiologia , Edema da Córnea , Contagem de Células/métodos , Facoemulsificação/métodos , Estudos Observacionais como Assunto , Parâmetros/efeitos adversos , Epidemiologia Descritiva , Estudos Prospectivos , Microscopia/métodos
13.
PLoS One ; 15(5): e0232842, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32384131

RESUMO

OBJECTIVE: The risk of complications of nonsurgical hypoparathyroidism in Asia is unclear. We estimated the prevalence and risk of complications in patients with nonsurgical hypoparathyroidism. METHODS: We performed a retrospective cohort study using a nationwide claims database from 2005 to 2016. Among the entire Korean population, we identified 897 patients diagnosed with nonsurgical hypoparathyroidism during 2005-2015. We selected 210 patients with nonsurgical hypoparathyroidism during 2005-2008 who had no complications at baseline and followed them to 2016. Control subjects (n = 2075) were matched using propensity scores based on age, sex, and comorbid disease with a 1:10 ratio and monitored until 2016. RESULTS: The age-standardized prevalence of nonsurgical hypoparathyroidism was 0.2 cases per 100,000 persons in 2005. During a mean follow-up period of 9.5 years, patients with nonsurgical hypoparathyroidism had a higher risk of cardiovascular disease, especially arrhythmia (hazard ratio [HR], 2.03; 95% confidence interval [CI], 1.11-3.70) and heart failure (HR, 2.43; 95% CI, 1.22-4.83). The risk of vertebral fracture was higher in patients than in controls (HR, 2.27; 95% CI, 1.09-4.72). Patients had a significantly increased risk of renal disease (HR, 2.57; 95% CI, 1.56-4.21), seizure (HR, 5.74; 95% CI, 3.34-9.86), depression and bipolar disease (HR, 1.82; 95% CI, 1.30-2.56), and cataract (HR, 1.90; 95% CI, 1.30-2.79) compared with controls. CONCLUSIONS: The prevalence of nonsurgical hypoparathyroidism was very low in Korea but was associated with a higher risk of incident cardiovascular disease and vertebral fracture as well as known complications including renal disease, seizure, and cataract.


Assuntos
Hipoparatireoidismo/epidemiologia , Adulto , Doenças Autoimunes/epidemiologia , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/etiologia , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Estudos de Casos e Controles , Catarata/epidemiologia , Catarata/etiologia , Comorbidade , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/etiologia , Feminino , Fraturas Espontâneas/epidemiologia , Fraturas Espontâneas/etiologia , Humanos , Hipoparatireoidismo/complicações , Masculino , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Prevalência , Pontuação de Propensão , República da Coreia/epidemiologia , Convulsões/epidemiologia , Convulsões/etiologia , Fraturas da Coluna Vertebral/epidemiologia , Fraturas da Coluna Vertebral/etiologia , Cálculos Urinários/epidemiologia , Cálculos Urinários/etiologia , Adulto Jovem
14.
Invest Ophthalmol Vis Sci ; 61(4): 49, 2020 04 09.
Artigo em Inglês | MEDLINE | ID: mdl-32347918

RESUMO

Purpose: To determine the risk between degree of myopia and myopic macular degeneration (MMD), retinal detachment (RD), cataract, open angle glaucoma (OAG), and blindness. Methods: A systematic review and meta-analyses of studies published before June 2019 on myopia complications. Odds ratios (OR) per complication and spherical equivalent (SER) degree (low myopia SER < -0.5 to > -3.00 diopter [D]; moderate myopia SER ≤ -3.00 to > -6.00 D; high myopia SER ≤ -6.00 D) were calculated using fixed and random effects models. Results: Low, moderate, and high myopia were all associated with increased risks of MMD (OR, 13.57, 95% confidence interval [CI], 6.18-29.79; OR, 72.74, 95% CI, 33.18-159.48; OR, 845.08, 95% CI, 230.05-3104.34, respectively); RD (OR, 3.15, 95% CI, 1.92-5.17; OR, 8.74, 95% CI, 7.28-10.50; OR, 12.62, 95% CI, 6.65-23.94, respectively); posterior subcapsular cataract (OR, 1.56, 95% CI, 1.32-1.84; OR, 2.55, 95% CI, 1.98-3.28; OR, 4.55, 95% CI, 2.66-7.75, respectively); nuclear cataract (OR, 1.79, 95% CI, 1.08-2.97; OR, 2.39, 95% CI, 1.03-5.55; OR, 2.87, 95% CI, 1.43-5.73, respectively); and OAG (OR, 1.59, 95% CI, 1.33-1.91; OR, 2.92, 95% CI, 1.89-4.52 for low and moderate/high myopia, respectively). The risk of visual impairment was strongly related to longer axial length, higher myopia degree, and age older than 60 years (OR, 1.71, 95% CI, 1.07-2.74; OR, 5.54, 95% CI, 3.12-9.85; and OR, 87.63, 95% CI, 34.50-222.58 for low, moderate, and high myopia in participants aged >60 years, respectively). Conclusions: Although high myopia carries the highest risk of complications and visual impairment, low and moderate myopia also have considerable risks. These estimates should alert policy makers and health care professionals to make myopia a priority for prevention and treatment.


Assuntos
Catarata/etiologia , Glaucoma de Ângulo Aberto/etiologia , Degeneração Macular/etiologia , Miopia Degenerativa/complicações , Acuidade Visual , Fatores Etários , Catarata/epidemiologia , Catarata/fisiopatologia , Progressão da Doença , Feminino , Glaucoma de Ângulo Aberto/epidemiologia , Glaucoma de Ângulo Aberto/fisiopatologia , Humanos , Degeneração Macular/epidemiologia , Degeneração Macular/fisiopatologia , Masculino , Miopia Degenerativa/diagnóstico , Prevalência , Prognóstico , Medição de Risco
15.
Am J Ophthalmol ; 216: 55-58, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32247777

RESUMO

PURPOSE: To assess the efficacy of swept-source optical coherence tomography (SS-OCT) and ultrasound biomicroscopy (UBM) in detecting posterior capsule (PC) defect in patients with traumatic cataract. DESIGN: Observational case-series. METHODS: Sixty-seven eyes from 67 patients, with traumatic cataract severe enough to prevent slit lamp evaluation of the PC, were included in a simple sequence without randomization. Patients underwent both 50-MHz UBM and SS-OCT evaluation of the PC by different operators. Cataract surgery was then performed using a single technique. RESULTS: Sixty-seven eyes from 67 patients including 60 men and 7 women were studied. The mean age was 34 ± 14 years and the mean logarithm of minimal angle of resolution of visual acuity was 1.89 ± 0.71. The calculated sensitivity, specificity, and accuracy values for SS-OCT were 96.8% (95% confidence interval [CI] 83.81-99.43), 66.7% (95% CI 48.78-80.77), and 82% (95% CI 70.53-89.62), respectively. For UBM, sensitivity, specificity, and accuracy values were 82.6% (95% CI 62.86-93.02), 57.9% (95% CI 36.28-76.86), and 71.4% (95% CI 56.43-82.83), respectively. Positive predictive and negative predictive values for SS-OCT were 75% (95% CI 59.81-85.81) and 95.2% (95% CI 77.33-99.15) and for UBM were 70.4% (95% CI 51.52-84.15) and 73.3% (95% CI 48.05-89.1), respectively. CONCLUSION: Although both imaging techniques are effective, SS-OCT appears to be at least comparable, or superior in special circumstances, to UBM in detecting preoperative posttraumatic PC rupture. We recommend preoperative assessment of all traumatic cataracts with SS-OCT as a part of surgical planning.


Assuntos
Catarata/diagnóstico por imagem , Cristalino/lesões , Microscopia Acústica , Ruptura da Cápsula Posterior do Olho/diagnóstico por imagem , Cápsula Posterior do Cristalino/diagnóstico por imagem , Tomografia de Coerência Óptica , Adulto , Catarata/etiologia , Extração de Catarata , Ferimentos Oculares Penetrantes/diagnóstico por imagem , Ferimentos Oculares Penetrantes/etiologia , Reações Falso-Positivas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Acuidade Visual/fisiologia , Ferimentos não Penetrantes/diagnóstico por imagem , Ferimentos não Penetrantes/etiologia , Adulto Jovem
16.
Curr Opin Ophthalmol ; 31(3): 167-173, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32175941

RESUMO

PURPOSE OF REVIEW: The present article reviews the most common and most serious vision-threatening and life-threatening complications of vitreoretinal surgery. RECENT FINDINGS: Serious complications after vitreroretinal surgery are rare. Endophthalmitis for example has recently been estimated to occur in 0.08% of small gague vitrectomy. Other complications such as cataract are almost unavoidable, becoming visually significant in up to 80% of patients. The introduction of smaller gauge vitrectomy systems has reduced surgical times, conjunctival scarring and inflammation, and the rate of some complications such as retinal tears. Ocular venous air embolism is an exceedingly rare complication that is potentially life threating and therefore important for all vitreoretinal surgeons to be aware of. SUMMARY: Though vitreoretinal surgery is well tolerated and effective, it is inevitable that all surgeons will experience complications and are therefore best served by understanding the potential complications, strategies to reduce the likelihood of them occurring, and ways to address them when they do happen.


Assuntos
Complicações Pós-Operatórias , Vitrectomia/efeitos adversos , Cirurgia Vitreorretiniana/efeitos adversos , Catarata/etiologia , Cicatriz/etiologia , Endoftalmite/etiologia , Humanos , Inflamação/etiologia
17.
Br J Nutr ; 124(3): 306-315, 2020 08 14.
Artigo em Inglês | MEDLINE | ID: mdl-32189601

RESUMO

The present study aims to investigate the effect of wholegrain and legume consumption on the incidence of age-related cataract in an older Australian population-based cohort. The Blue Mountains Eye Study (BMES) is a population-based cohort study of eye diseases among older adults aged 49 years or older (1992-1994, n 3654). Of 2334 participants of the second examination of the BMES (BMES 2, 1997-2000), 1541 (78·3 % of survivors) were examined 5 years later (BMES 3) who had wholegrain and legume consumption estimated from the FFQ at BMES 2. Cataract was assessed using photographs taken during examinations following the Wisconsin cataract grading system. Multivariable-adjusted logistic regression models were used to assess associations with the 5-year incidence of cataract from BMES 2 (baseline) to BMES 3. The 5-year incidence of cortical, nuclear and posterior subcapsular (PSC) cataract was 18·2, 16·5 and 5·9 %, respectively. After adjustment for age, sex and other factors, total wholegrain consumption at baseline was not associated with incidence of any type of cataract. High consumption of legumes showed a protective association for incident PSC cataract (5th quintile: adjusted OR 0·37; 95 % CI 0·15, 0·92). There was no significant trend of this association across quintiles (P = 0·08). In this older Australian population, we found no associations between wholegrain intake at baseline and the 5-year incidence of three cataract types. However, intake of legumes in the highest quintile, compared with the lowest quintile, may protect against PSC formation, a finding needing replication in other studies.


Assuntos
Catarata/epidemiologia , Dieta/métodos , Fabaceae , Grãos Integrais , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Catarata/etiologia , Estudos de Coortes , Dieta/efeitos adversos , Feminino , Humanos , Incidência , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Fatores de Risco
18.
Radiat Res ; 193(4): 322-330, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32017666

RESUMO

Ionizing radiation exposure to the lens of the eye is a known cause of cataractogenesis. Administrative data from the Ontario Health Insurance Program was used to examine the association between low-dose radiation exposure from head CT scans and cataract extraction surgery for 16 million Ontarians over a 22-year period (1994-2015). Subjects were grouped based on the number of head CT scans they received, and a Cox proportional hazards analysis was used to determine if there was a correlation with cataract surgery. Covariates included in the analysis were age, sex, diabetes, hypertension and prior history of intraocular surgery. To account for the potentially long latency period between radiation exposure and cataract formation, the data were analyzed incorporating a 5- and 10-year lag between head CT scan exposure and cataract surgery. Both the 5- and 10-year lagged models followed a similar trend, where only the first three head CT scans significantly increased the risk of cataract surgery by 3-8%. Individuals receiving four or more head CT scans did not have an increased cataract risk and in several cases the risk was reduced. Overall, no positive dose-response relationship was seen between the number of head CT scans received and the risk of cataract surgery. Due to the nature of the data extracted from medical records, several uncertainties exist in the analysis related to dosimetry, ultraviolet light exposure and smoking status. Nonetheless, these results do not support an association between ionizing radiation from repeated head CT scans and cataract formation.


Assuntos
Catarata/epidemiologia , Cabeça/efeitos da radiação , Cristalino/efeitos da radiação , Tomografia Computadorizada por Raios X/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Catarata/diagnóstico por imagem , Catarata/etiologia , Catarata/fisiopatologia , Criança , Pré-Escolar , Feminino , Cabeça/diagnóstico por imagem , Cabeça/fisiopatologia , Humanos , Lactente , Recém-Nascido , Cristalino/fisiopatologia , Masculino , Pessoa de Meia-Idade , Ontário/epidemiologia , Doses de Radiação , Exposição à Radiação/efeitos adversos , Radiação Ionizante , Medição de Risco , Adulto Jovem
19.
Radiat Oncol ; 15(1): 25, 2020 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-32000814

RESUMO

BACKGROUND: To evaluate the long-term efficacy and toxicity of radiation therapy in patients with Stage IE primary ocular adnexal mucosa-associated lymphoid tissue lymphoma. METHODS: We designed a retrospective analysis to evaluate 81 patients with ocular adnexal mucosa-associated lymphoid tissue lymphoma treated with radiation therapy between 2006 and 2016. The median radiation dose was 30 Gy (range, 30-36 Gy in 15-18 fractions). Local control, progression-free survival, overall survival, and cumulative incidence of Grade 3 cataract were calculated by using the Kaplan-Meier method. RESULT: The median follow-up time was 74 months (range, 4-157 months). The 5-year local control was 100%. Although local relapse was suspected in 3 patients after radiation therapy, 2 patients were pathologically diagnosed as IgG4-related inflammation and in 1 patient as intense inflammatory cell infiltration. The 5-year progression-free survival was 94.4%. Five patients had relapse at distant sites. The 5-year overall survival was 98.8%. Twenty patients had Grade 3 cataract. The 5-year cumulative incidences of Grade ≥ 3 and Grade ≥ 2 cataract for 58 patients treated without a lens shield were 38 and 40%, respectively. The incidence of Grade ≥ 3 cataract was 42% for 50 patients treated with 6-MV X-rays (estimated lens dose: 29 Gy) and 17% for 8 patients treated with 9-MeV electrons (estimated lens dose: 24 Gy). CONCLUSIONS: Radiation therapy alone yielded excellent local control and long-term survival in Stage IE ocular adnexal mucosa-associated lymphoid tissue lymphoma. Long-term observation with careful attention to relapse at distant sites is necessary. In the case of suspected local relapse, IgG4-related disease should be carefully ruled out.


Assuntos
Neoplasias Oculares/radioterapia , Linfoma de Zona Marginal Tipo Células B/radioterapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Catarata/epidemiologia , Catarata/etiologia , Fracionamento da Dose de Radiação , Neoplasias Oculares/mortalidade , Neoplasias Oculares/patologia , Feminino , Humanos , Japão/epidemiologia , Linfoma de Zona Marginal Tipo Células B/mortalidade , Linfoma de Zona Marginal Tipo Células B/patologia , Masculino , Pessoa de Meia-Idade , Radioterapia/efeitos adversos , Estudos Retrospectivos , Análise de Sobrevida , Resultado do Tratamento
20.
Am J Ophthalmol ; 213: 153-160, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32006482

RESUMO

PURPOSE: To determine the ocular complications in school-age children and adolescents surviving at least 1 year following allogeneic bone marrow transplantation. DESIGN: Retrospective cohort study. METHODS: In this institutional study, 162 patients (7-18 years old) met our inclusion criteria with a mean age of 13.4 years at bone marrow transplantation. Follow-up ranged from 13 months to 12 years (mean 4 years; median 3.2 years). Patient charts were screened for cataract formation, dry eye, and other anterior and posterior segment diseases. RESULTS: Cataract formation was noted in 57 patients. Univariate analysis showed that fractionated total body irradiation, race, and use of cytarabine significantly increased the incidence of cataract formation (P < 0.05). Multivariate analysis of significant variables showed that total body irradiation was a risk factor for cataract formation. Of the 57 patients (97 eyes) who developed cataracts after bone marrow transplantation, 4 patients (6 eyes) required cataract surgery. After surgery, all patients had visual acuities of 20/20 to 20/25. Of the 162 patients, 51 developed dry eyes. Univariate analysis showed that age at transplantation; steroid use, chronic graft-versus-host disease; use of fludarabine, melphalan, and thiotepa; and receiving no pre-transplantation conditioning regimen prior to bone marrow transplant significantly increased the risk of dry eye syndrome (P < 0.05). In multivariate analysis, chronic graft-versus-host disease was a significant risk factor for dry eye syndrome. CONCLUSIONS: Due to the high incidence of cataract formation and dry eye disease in this population, this study proposes these patients be screened using examinations by a pediatric or general ophthalmologist at least every year.


Assuntos
Transplante de Medula Óssea/efeitos adversos , Oftalmopatias/etiologia , Adolescente , Segmento Anterior do Olho/patologia , Catarata/diagnóstico , Catarata/etiologia , Criança , Síndromes do Olho Seco/diagnóstico , Síndromes do Olho Seco/etiologia , Feminino , Seguimentos , Doença Enxerto-Hospedeiro/etiologia , Doenças Hematológicas/terapia , Humanos , Masculino , Segmento Posterior do Olho/patologia , Estudos Retrospectivos , Fatores de Risco , Transplante Homólogo , Acuidade Visual , Irradiação Corporal Total/efeitos adversos
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