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1.
Aerosp Med Hum Perform ; 92(9): 728-733, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34645553

RESUMO

BACKGROUND: Glaucoma and ocular hypertension (OHT) are prevalent diseases with baseline intraocular pressure (IOP) elevations that future astronauts and spaceflight participants may suffer from. Preflight, in-flight, and postflight IOP measurements were collected aboard two U.S. Space Shuttle Program missions in normotensive control, OHT, and glaucomatous crewmembers. METHODS: Five subjects (three controls, one glaucomatous, one OHT) were studied aboard 2-wk Space Shuttle missions. Baseline IOP (triplicate; handheld tonometry) was recorded during training 12 mo preflight, in flight (114 d), and postflight (329 d). Subjective symptoms were recorded via questionnaires. Data were analyzed using a spreadsheet with two-sample t-tests. P-value < 0.05 determined significance. RESULTS: IOP increased for all in-flight vs. preflight measurements for controls (N 3, 48.9, 16.9, 5.85), OHT (N 1, 20.3), and glaucomatous (N 1, 32.2) groups. IOP eventually returned to baseline postflight [Return (R)35 d], except for the astronaut with OHT (R917). Subjective symptoms, likely multifactorial, included blurredvision, decreased visual acuity, and headaches. DISCUSSION: IOP increased during spaceflight and normalized upon return. Astronauts and commercial spaceflight participants may need screening for elevated IOP to potentially prevent sequelae related to glaucoma and OHT, the former which requires treatment in flight and the latter which may need prophylaxis. Previous studies have shown elevated IOP upon entry into microgravity with various normalization timeframes in flight and postflight. It is unclear how increased IOP relates to spaceflight-associated neuro-ocular syndrome (SANS); however, several hypotheses exist. Treatment strategies should be available for acute and chronic ocular pathology during spaceflight despite the unique challenges of eye-drop application in microgravity. Dalal SR, Ramachandran V, Khalid R, Manuel FK, Knowles JR, Jones JA. Increased intraocular pressure in glaucomatous, ocular hypertensive, and normotensive space shuttle crew. Aerosp Med Hum Perform. 2021; 92(9):728733.


Assuntos
Glaucoma , Voo Espacial , Astronautas , Glaucoma/epidemiologia , Humanos , Pressão Intraocular , Astronave
2.
Medicina (Kaunas) ; 57(9)2021 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-34577901

RESUMO

Background and Objectives: Vision impairments and related blindness are major public health problems. The prevalence of eye disease and barriers to optimal care markedly vary among different geographic areas. In the Abruzzo region (central Italy), an epidemiological surveillance on the state of ocular health in the population aged over 50 years was performed in 2019. Materials and Methods: Participants were sampled to be representative of the region's inhabitants. Data were collected through a telephone interview and an eye examination. Prevalence of cataract, glaucoma, retinopathy, and maculopathy was assessed. The Cohen's kappa (k) was used to measure the agreement between the presence of eye disease and awareness of the disease by the participants. Results: Overall, 983 people with a mean age of 66.0 ± 9.5 years were included in the study. The prevalence of cataracts, glaucoma, maculopathy, and retinopathy was 52.6%, 5.3%, 5.6%, and 29.1%, respectively. Among the total of the affected people, those aware of their condition were 21.8% (k = 0.12, slight agreement) for cataract, 65.4% (k = 0.78, substantial agreement) for glaucoma, 7.1% (k = 0.10, slight agreement) for maculopathy, and 0% for retinopathy (k = -0.004, agreement lower than that expected by chance). Refractive defects were corrected in the vast majority of participants. Conclusion: In the Abruzzo region, about two thirds of citizens aged 50 years or over suffer from cataract, glaucoma, retinopathy, or maculopathy, which are recognized as leading causes of blindness. Many people with eye disease do not know they have it. These data can be used by clinicians and policymakers to undertake clinical, political, and social actions.


Assuntos
Catarata , Glaucoma , Degeneração Macular , Idoso , Cegueira , Catarata/diagnóstico , Catarata/epidemiologia , Estudos Transversais , Glaucoma/epidemiologia , Humanos , Degeneração Macular/diagnóstico , Degeneração Macular/epidemiologia , Pessoa de Meia-Idade , Prevalência
3.
Arch Soc Esp Oftalmol (Engl Ed) ; 96(8): 415-421, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34340779

RESUMO

OBJECTIVE: To determine the prevalence and factors associated with the development of ocular hypertension and glaucoma, in patients undergoing penetrating keratoplasty, in the Eye Clinic of the city of Bogotá. METHOD: A retrospective cross-sectional study was conducted, and 130 eyes of patients undergoing penetrating keratoplasty were analyzed at the Eye Clinic in Bogotá, between January 2015 and August 2018. Demographic and clinical data were obtained, and it was determined by bivariate analysis, the association factors and the prevalence of the pathology under study. RESULTS: Prevalence of ocular hypertension was 27.69% and glaucoma 10%. Average age 48.93 ± 18.63 years; higher frequency of presentation in men (61.5%). Statistically significant association factors were male sex (PR 2.59), presence of peripheral anterior synechiae (PR 1.83), history of trauma (PR 2.16), prior PK (PR 2.10) and graft failure (PR 2.04). Post-KP glaucoma only had statistically significant association with bullous keratopathy (PR 2.76). CONCLUSIONS: Ocular hypertension and glaucoma had a high prevalence after penetrating keratoplasty, and the association factors were similar to those reported in other international studies. Knowing these factors, allows focusing surveillance and treatment in these patients to avoid blindness due to damage of the optic nerve or corneal graft.


Assuntos
Glaucoma , Ceratoplastia Penetrante , Hipertensão Ocular , Estudos Transversais , Glaucoma/epidemiologia , Humanos , Ceratoplastia Penetrante/efeitos adversos , Masculino , Pessoa de Meia-Idade , Hipertensão Ocular/epidemiologia , Prevalência , Estudos Retrospectivos , Fatores de Risco
4.
Indian J Ophthalmol ; 69(9): 2481-2483, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34427248

RESUMO

Purpose: The aim of this study was to report the incidence of presumed steroid response in contralateral eye of patients who underwent glaucoma filtration surgery. Methods: We reviewed records of 298 glaucoma patients (147 PACG [primary angle-closure glaucoma], 129 POAG [primary open-angle glaucoma], and 22 JOAG [juvenile open-angle glaucoma]) who underwent either trabeculectomy alone or trabeculectomy with cataract extraction. All patients received prednisolone acetate 1% eye drop postoperatively in the operated eye for up to 6 to 8 weeks. The contralateral eye received the same antiglaucoma medications as before. Information collected included age, sex, number of antiglaucoma medications in the fellow eye preoperatively, and VFI (visual field index). The preoperative intraocular pressure (IOP) in the contralateral eye was taken as the baseline. The maximum IOP recorded postoperatively up to a follow-up period of 6 to 8 weeks was noted. A steroid response was defined as rise in the IOP by ≥6 mmHg. Results: In this study, 298 eyes of 298 glaucoma patients were included. The mean age of patients was 60.1 ± 13.7 years. The mean number of antiglaucoma medications in the fellow eye pre-operatively was 2.4 ± 1.2. Mean preoperative and postoperative IOP in the fellow eye were 17.46 ± 7 and 19.37 ± 7.1 mmHg, respectively. Sixty-three eyes out of 298 eyes (21.14%) showed a rise in IOP by 6 mmHg. The maximum IOP difference noted was 15 mmHg. The average time interval to the defined steroid response was 16.13 days. The majority showed a steroid response within 19 days. Conclusion: Steroid response is a significant factor leading to elevated IOP postoperatively in the contralateral eye as well.


Assuntos
Glaucoma de Ângulo Aberto , Glaucoma , Trabeculectomia , Idoso , Glaucoma/epidemiologia , Glaucoma/cirurgia , Glaucoma de Ângulo Aberto/epidemiologia , Glaucoma de Ângulo Aberto/cirurgia , Humanos , Incidência , Pessoa de Meia-Idade , Esteroides
5.
Malawi Med J ; 33(1): 15-20, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-34422229

RESUMO

Purpose: To evaluate the clinical and socio-demographic profile of patients living with glaucoma and receiving care in a tertiary eye center in Zimbabwe. Method: A hospital-based retrospective study of clinical records of glaucoma patients from January 2014 to December 2018. The study involved collating demographic information of patients, visual acuities, (VA) intraocular pressure, (IOP), cup-to-disc ratios, (CDRs), average retinal nerve fibers thickness, (RNFL), cup volume, cup-to-disc area, vertical cup-to-disc ratio, (VCDR), rim area, disc area, glaucoma hemifield test, visual field indices and the management of glaucoma. Results: Nine thousand one hundred and eighty-five (9,185) folders were retrieved. Out of these, 432 (4.7%) qualified for the study and were analyzed. There were 267 (61.8%) males and 165 (38.2%) females. The mean age (± Standard deviation, SD) of the patients was 62.66 ± 15.94 years, (range 10 - 110 years). The means visual acuity (VA): OD =1.30 ± 1.06 Logarithm of the Minimum Angle of Resolution, (logMAR), OS = 1.33 ± 1.06 logMAR; IOP: OD = 29.51 ± 12.89 mmHg, OS: 29.17 ± 12.59 mmHg; CDRs: OD = 0.91 ± 0.14 D, OS = 0.92 ± 0.14 D; and the average RNFL thickness was 72.76 ± 18.26 µm and 71.24 ± 23.17 µm in the right and left eye respectively. The mainstay of treatment was medication only. Conclusion: There were more males than females receiving glaucoma care at the tertiary level. Glaucoma cases included juveniles but the mean age was mostly the elderly. It was characterized by high IOPs, large CDRs, and thin RNFL suggestive of late presentation.


Assuntos
Glaucoma/diagnóstico , Glaucoma/epidemiologia , Encaminhamento e Consulta/estatística & dados numéricos , Adolescente , Adulto , Grupo com Ancestrais do Continente Africano , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Glaucoma/terapia , Glaucoma de Ângulo Aberto/epidemiologia , Humanos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Retina/anatomia & histologia , Estudos Retrospectivos , Fatores Socioeconômicos , Campos Visuais/fisiologia , Adulto Jovem , Zimbábue/epidemiologia
6.
Middle East Afr J Ophthalmol ; 28(1): 29-35, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34321820

RESUMO

PURPOSE: The current study aims to know the glaucoma diagnoses and legal blindness from glaucoma among a tertiary referral center in Riyadh (King Abdulaziz Medical City [KAMC]-Riyadh patients). METHODS: This is a retrospective cohort study on chart review, where all eligible glaucoma patients attending the ophthalmology clinic at KAMC-Riyadh, between 2018 and 2019; were included. RESULTS: A total of 248 patients were included in the study; 142 patients (57.3%) were females and 106 (42.7%) were males. The mean age of the patients was 62.2 ± 18 years and most of them (93.5%) did not have a family history of glaucoma. Nearly one-quarter (26.6%; n = 66) of the included patients were legally blind, out of those, 36.4% had their right eye affected, 34.8% had their left eye affected, and 28.8% had both eyes affected. Legally, blind patients (LBGs) did not show a statistically significant reduction in the intraocular pressure (IOP) in the right eye (P = 0.103), on comparing the IOP in both visits. Nevertheless, there was a statistically significant reduction in the IOP of the left eye among the LBGs in both visits (P = 0.016). Regarding the nonblind group of patients, there were highly statistically significant reductions in both eyes (P < 0.001). CONCLUSION: The present findings show a high prevalence rate of legal blindness among glaucoma patients, with IOP reduction, age, and glaucoma diagnoses being the most important predictors among the study population.


Assuntos
Árabes , Cegueira , Glaucoma , Adulto , Idoso , Idoso de 80 Anos ou mais , Cegueira/diagnóstico , Cegueira/epidemiologia , Cegueira/etiologia , Feminino , Glaucoma/complicações , Glaucoma/diagnóstico , Glaucoma/epidemiologia , Hospitais , Humanos , Pressão Intraocular , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Arábia Saudita/epidemiologia
7.
Indian J Ophthalmol ; 69(8): 2088-2094, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34304184

RESUMO

Purpose: The aim of this study was to describe the effectiveness of goniotomy for childhood glaucoma in Indian eyes. Methods: Consecutive patients with pediatric glaucoma who underwent goniotomy between July 2017 and June 2020, in a single center in Northwest India were prospectively analyzed. Goniotomy was done as a primary procedure or a re-do surgery of the untreated angle in failed filtering surgery. Success was defined as intraocular pressure (IOP) ≦18 mm Hg with or without 2 topical medications. Results: A total of 172 eyes of 126 children underwent goniotomy during this period (37.9% of all pediatric glaucoma surgeries). Goniotomy comprised 132 of 211 (62.5%) primary pediatric glaucoma surgeries and 40 of 243 (16.5%) re-do surgeries. 145, 112, and 54 eyes had a six months, 1-year and 2-year follow-up, respectively. At 1 year, success rates in Primary Congenital Glaucoma (PCG) were 79.7% for primary surgery and 68.4% for re-do surgery. For non-PCG eyes, the success rate was 62% at 1 year. Among PCG subgroups, infantile and newborn glaucoma had 87.5% and 57.1% success rates, respectively. On logistic regression analysis, lower baseline IOP and lesser axial length at presentation were significantly predictive of successful outcomes (P = 0.03 and P = 0.02, respectively). At 1 year, in the primary surgery group, 50% had good vision (better than logMAR 0.5), 28.9% had moderate (better than LOGMAR 1.0) and 20% had severe visual impairment. There were no significant intraoperative or post-operative complications. Conclusion: Goniotomy appears to be an effective surgery for childhood glaucoma in Indian eyes. Being minimally invasive, it obviates the need for conjunctival and scleral dissection and antifibrotic agents.


Assuntos
Glaucoma , Trabeculectomia , Criança , Seguimentos , Glaucoma/epidemiologia , Glaucoma/cirurgia , Humanos , Índia/epidemiologia , Recém-Nascido , Pressão Intraocular , Estudos Retrospectivos , Resultado do Tratamento
8.
Indian J Ophthalmol ; 69(8): 2215-2221, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34304213

RESUMO

Purpose: To describe the demographic profiles, clinical characteristics, and clinical outcomes of patients presenting with glaucoma emergencies during the COVID-19 lockdown in India. Methods: This retrospective, cross-sectional, observational case series involved review of medical records of all patients presenting to the glaucoma service during the COVID-19 lockdown period and comparison with the previous year (March 23 to June 23, 2020 Vs 2019) in a tertiary center in India. Results: We found a 78.9% reduction in overall outpatient visits (54,345 vs. 257,339; P < 0.001) and 80.9% reduction in the number of glaucoma outpatient visits (4,788 vs. 25,083; P < 0.001). Additionally, the proportion of true glaucoma emergency visits significantly increased by 62.4% in 2020 Vs 2019 (1,408/4,788 (29.4%) vs. 4,542/25,083 (18.1%); P < 0.001). Lens-induced glaucomas were the most common glaucoma surgical emergency (13.4%) in 2020. Moreover, comparison of procedures demonstrated a proportionate decrease in incisional glaucoma surgeries (70/115 (60.86%) vs. 806/939 (85.83%); P < 0.001) and an increase in the proportion of emergency cataract surgeries (129/475 (27.15%) vs. 170/2715 (6.26%); P < 0.001) and transscleral cyclophotocoagulation (45/115 (39.13%) vs. 133/939 (14.16%); P = 0.0001) during 2020 vs. 2019. Conclusion: Our study demonstrated a 62% increase in the proportion of visits that were true glaucoma emergencies. Additionally, the proportions of emergency cataract surgeries increased by 4.3 times and the proportion of transscleral cyclophotocoagulation increased by 2.8 times during the pandemic. More nonincisional procedures and less diagnostic testing were performed to minimize postoperative visits and virus transmission. Further understanding of the profile of emergencies may help in developing novel strategies to anticipate future challenges in managing glaucoma care during subsequent waves of the pandemic.


Assuntos
COVID-19 , Glaucoma , Controle de Doenças Transmissíveis , Estudos Transversais , Glaucoma/epidemiologia , Glaucoma/cirurgia , Humanos , Índia/epidemiologia , Pandemias , Estudos Retrospectivos , SARS-CoV-2 , Centros de Atenção Terciária
9.
Transl Vis Sci Technol ; 10(8): 25, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34319388

RESUMO

Purpose: The purpose of this paper was to investigate the association between baseline metabolic risk factors and incident glaucoma over a 5-year period in rural Chinese adults. Methods: Population-based prospective cohort study. Participants aged 30 years and older without glaucoma at baseline who underwent comprehensive examinations at baseline and after a 5-year interval in the Handan Eye Study were enrolled. Incident glaucoma was defined as people without glaucoma in either eye at baseline that had developed glaucoma in at least one eye in the 5-year follow-up. Five metabolic syndrome components, mean blood pressure, fasting plasma glucose, total cholesterol, triglycerides (TGs), low density lipoprotein cholesterol, high-density lipoprotein cholesterol, and obesity, determined as body mass index ≥30 kg/m2 at baseline were considered as potential metabolic risk factors for incident glaucoma. Univariate and multivariate logistic regression analyses were carried out to determine baseline metabolic risk factors associated with incident glaucoma. Results: A total of 5184 participants were included in our study. During the 5-year follow-up, incident glaucoma developed in 82 subjects. Age (odds ratio [OR] = 1.060, 95% confidence interval [CI] = 1.034, 1.086, P < 0.001) and TGs level (OR = 1.213, 95% CI = 1.030, 1.429, P = 0.021) were independently and positively associated with incident glaucoma. Conclusions: Our study revealed that increased age and high TGs level, one of the baseline metabolic features, were independent risk factors for incident glaucoma. The data implied that the metabolic features be involved in the pathogenesis of glaucoma. Translational Relevance: This study shed the light on that the TGs level was involved in the pathogenesis of glaucoma.


Assuntos
Glaucoma , Hipertrigliceridemia , Adulto , China/epidemiologia , Glaucoma/epidemiologia , Humanos , Hipertrigliceridemia/epidemiologia , Incidência , Estudos Prospectivos
10.
Graefes Arch Clin Exp Ophthalmol ; 259(10): 3027-3034, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34169352

RESUMO

PURPOSE: To investigate the relationship between exfoliation syndrome (XFS) and systemic diseases. METHODS: A population-based, retrospective study with control group was conducted using the electronic medical database of Maccabi Health Services, the second largest Health Maintenance Organization (HMO) in Israel. Study population included Maccabi members from January 2003 to April 2016. Cases consisted of patients diagnosed with XFS regardless of glaucoma. The control group included Maccabi members without XFS, matched on age, sex, and ancestry, that were examined by an ophthalmologist within the last year. MAIN OUTCOME MEASURES: Associations between XFS and systemic diseases. RESULTS: We identified 16,388 patients with XFS, in whom 40.3% (n = 6613) had glaucoma. The control group included 14,015 patients. Mean age was 78.3 ± 8.9 years and 76.2 ± 8.5 years for the XFS and control group, respectively. In unconditional logistic regression analyses, after adjusting for age, sex, and ancestry, XFS was significantly associated with risk of cardiovascular diseases including hypertension (OR 1.07, 95% CI 1.01-1.13, p = 0.02), myocardial infarction (OR 1.21, 95% CI 1.17-1.31, p < 0.0001), and congestive heart failure (OR 1.70, 95% CI 1.55-1.88, p < 0.0001) as well as higher risk for high creatinine (OR 1.28, 95% CI 1.2-1.37, p < 0.0001). Diabetes mellitus and body mass index were inversely associated with XFS (OR 0.70, 95% CI 0.67-0.73, p < 0.0001 and OR 0.88, 95% CI 0.84-0.93, p < 0.0001, respectively). Overall cancer diagnoses were more common in the XFS group (OR 1.05, 95% CI 1.0-1.1, p = 0.05). XFS was associated with more hospitalizations (mean 5 ± 5.3 hospitalizations in the XFS group and 3.3 ± 4.0 in the controls, p < 0.0001). CONCLUSION: XFS is significantly associated with cardiovascular systemic diseases (in a population living in Israel and predominantly born in Russia).


Assuntos
Diabetes Mellitus , Síndrome de Exfoliação , Glaucoma , Hipertensão , Idoso , Idoso de 80 Anos ou mais , Síndrome de Exfoliação/complicações , Síndrome de Exfoliação/diagnóstico , Síndrome de Exfoliação/epidemiologia , Glaucoma/diagnóstico , Glaucoma/epidemiologia , Humanos , Estudos Retrospectivos
11.
BMC Med ; 19(1): 104, 2021 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-33971878

RESUMO

BACKGROUND: Sleep apnoea, a common sleep-disordered breathing condition, is characterised by upper airway collapse during sleep resulting in transient hypoxia, hypoperfusion of the optic nerve, and spike in intracranial pressure. Previous studies have reported conflicting findings on the association of sleep apnoea with glaucoma, and there are limited reports on the link between sleep apnoea and age-related macular degeneration (AMD). METHODS: Middle-aged and older participants from the longitudinal United Kingdom (UK) Biobank (n = 502,505) and the Canadian Longitudinal Study on Aging (CLSA; n = 24,073) were included in this analysis. Participants in the UK Biobank and the CLSA were followed for 8 and 3 years, respectively. Participants with diagnosed glaucoma or AMD at baseline were excluded from the analysis. In the UK Biobank, sleep apnoea and incident cases of glaucoma and AMD were identified through hospital inpatient admission, primary care records, and self-reported data. Multivariable Cox proportional hazards models were used to explore associations of sleep apnoea with incidence of glaucoma or AMD. RESULTS: During the 8-year follow-up in the UK Biobank, glaucoma incidence rates per 1000 person-years were 2.46 and 1.59 for participants with and without sleep apnoea, and the AMD incidence rates per 1000 person-years were 2.27 and 1.42 for participants with and without sleep apnoea, respectively. Multivariable adjusted hazard ratios of glaucoma and AMD risk for sleep apnoea were 1.33 (95% confidence interval [CI] 1.10-1.60, P = 0.003) and 1.39 (95% CI 1.15-1.68, P <  0.001) relative to participants without sleep apnoea. In the CLSA cohort, disease information was collected through in-person interview questionnaires. During the 3-year follow-up, glaucoma incidence rates per 1000 person-years for those with and without sleep apnoea were 9.31 and 6.97, and the AMD incidence rates per 1000 person-years were 8.44 and 6.67, respectively. In the CLSA, similar associations were identified, with glaucoma and AMD odds ratios of 1.43 (95% CI 1.13-1.79) and 1.39 (95% CI 1.08-1.77), respectively, in participants with sleep apnoea compared to those without sleep apnoea (both P <  0.001). CONCLUSIONS: In two large-scale prospective cohort studies, sleep apnoea is associated with a higher risk of both glaucoma and AMD. These findings indicate that patients with sleep apnoea might benefit from regular ophthalmologic examinations.


Assuntos
Glaucoma , Degeneração Macular , Síndromes da Apneia do Sono , Idoso , Envelhecimento , Bancos de Espécimes Biológicos , Canadá/epidemiologia , Seguimentos , Glaucoma/epidemiologia , Humanos , Incidência , Estudos Longitudinais , Degeneração Macular/epidemiologia , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Síndromes da Apneia do Sono/complicações , Síndromes da Apneia do Sono/epidemiologia , Reino Unido/epidemiologia
12.
Clin Exp Optom ; 104(6): 717-722, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34016010

RESUMO

CLINICAL RELEVANCE: The SARS-COV 2 virus, which is responsible for the COVID-19 pandemic, acts on the angiotensin converting enzyme 2 (ACE-2) receptor in the host cell. Ocular effects may occur because of the ACE-2 receptor in the retina. BACKGROUND: To investigate the impact of COVID-19 on the retinal layers and optic disc parameters in previously confirmed COVID-19 patients using spectral domain optical coherence tomography (SD-OCT). METHODS: This study included 60 eyes of 60 subjects; 35 of them were in the COVID-19 group and the remaining 25 were in the control group. Patients with the diagnosis of COVID-19 that had a negative result after treatment were included in the study. Macular and peripapillary retinal nerve fiber layer (RNFL) thickness measurements, each retinal layer thickness of all participants were done 14-30 days after COVID-19 symptom onset, following the negative result of real time reverse transcriptase-polymerase chain reaction test using SD-OCT. RESULTS: The mean value of central macular thickness was significantly higher in the COVID-19 group than the control group (p = 0.02). The mean values of the ganglion cell layer and inner nuclear layer thickness in the COVID-19 group were significantly thinner than control group (p = 0.04 and p = 0.04, respectively). Even though mean RNFL thickness measurements in all sections in the COVID-19 group was thinner than controls, there were no significant differences between groups (p > 0.05 for all). CONCLUSION: In the early recovery phase, changes in the macula, ganglion cell layer and inner nuclear layer could be seen. These patients should be followed up closely for the recognition of new pathologies that could be seen in the late recovery phase.


Assuntos
COVID-19/epidemiologia , Glaucoma/diagnóstico , Pandemias , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Adulto , Idoso , Comorbidade , Estudos Transversais , Feminino , Seguimentos , Glaucoma/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Estudos Prospectivos , SARS-CoV-2 , Adulto Jovem
13.
PLoS One ; 16(5): e0252064, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34015012

RESUMO

PURPOSE: This study aimed to assess the prevalence of common mental disorders and associated factors among adults with glaucoma at Gondar university comprehensive specialized hospital tertiary eye care and training center. Glaucoma predisposes patients to common mental problems and leads to wasteful, costly and inefficient use of medical services and complications of the diagnoses. So, determining the level and factors associated with common mental disorders among glaucoma patient would help to improve and integrate comprehensive ophthalmic services which address common mental disorder in a follow-up visit. METHODS: An institution-based cross-sectional study was conducted on 495 glaucoma patients selected by using systematic random sampling. Data were collected through face-to-face interview and chart review. Self-reported questionnaire (SRQ-20) was used to assess the presence of common mental disorders. Binary logistic regression analysis was done to identify factors associated with common mental disorders. Variables with P<0.05 were considered as factors significantly associated with common mental disorders. RESULT: Four hundred sixty-eight patients were included in this study with a response rate of 94.54%. The mean age of the participant was 58 ± 14.11 years. The prevalence of common mental disorders was found to be 29.5% (95% CI 25.4-33.3). Female sex (AOR = 3.79, 95% CI: 1.66-8.62) (p-value = 0.001), average monthly income of less than 1200 birr (AOR = 6.05 95% CI: 2.26-16.22) (p-value = 0.001), poor level of social support (AOR = 17.39 95% CI: 7.79-38.82) (p-value = 0.001), moderate and high risk of alcohol use (AOR = 10.42 95%CI: 2.74-39.54) (p-value = 0.001), presence of chronic medical illness (AOR = 3.85 95% CI: 2.07-7.16) (p-value = 0.001), receiving both drug and surgical treatment (AOR = 2.50, 95%CI: 1.30-4.83) (p-value = 0.006) and presence of systemic carbonic anhydrase inhibitors use (AOR = 3.16, 95%CI: 1.65-6.06) (p-value = 0.001) were significantly associated with increased level of common mental disorders. CONCLUSION: Significant numbers of glaucoma patients have CMD and found significantly associated with socio-economic, ocular and systemic clinical factors. Therefore, the integration of psychosocial care into the current treatment of patients with glaucoma would have a significant advantage to help these patients.


Assuntos
Depressão/epidemiologia , Glaucoma/epidemiologia , Transtornos Mentais/epidemiologia , Transtornos da Visão/epidemiologia , Adolescente , Adulto , Idoso , Depressão/patologia , Etiópia/epidemiologia , Olho/patologia , Feminino , Glaucoma/complicações , Glaucoma/patologia , Humanos , Masculino , Transtornos Mentais/complicações , Transtornos Mentais/patologia , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários , Centros de Atenção Terciária , Transtornos da Visão/complicações , Transtornos da Visão/patologia , Adulto Jovem
14.
Nepal J Ophthalmol ; 13(25): 98-103, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33981103

RESUMO

BACKGROUND: To determine the clinical profile and causes of various types of secondary glaucoma. MATERIALS AND METHODS: This was a hospital-based cross-sectional study conducted in a tertiary eye hospital of eastern Nepal from 1st June to 30th November, 2017. Patients who met the criteria for secondary glaucoma underwent detailed ophthalmic examination. RESULTS: Out of 7079 patients diagnosed with glaucoma or glaucoma suspects, 528 (7.4%) had secondary glaucoma. The mean age at presentation was 52 ± 17 years with male to female ratio of 1.5:1. The most common cause was lens induced 173 (32.8%) followed by neovascular 107 (20.3%), steroid induced 86 (16.3%), traumatic 76 (14.4%), post-vitrectomy 17 (3.2%), uveitic 11 (2.1%), pseudophakic 10 (1.9%), aphakic 8 (1.5%), post-keratoplasty 5 (0.9%) and miscellaneous included 35 (6.6%). Post-traumatic 31 (29.5%) was more prevalent below 41 years while lens induced glaucoma 86 (49%) above 60 years of age. At presentation, the average IOP was 40 ± 11 mmHg. 36 (6.8%) had no light perception in the presenting eye and a large number of participants 307 (58.1%) presented with visual acuity of <3/60 to perception of light. Glaucomatous optic atrophy was found in 22 (9.0%) cases. CONCLUSION: The causes of secondary glaucoma are diverse, lens induced glaucoma being most common. Most patients present late with poor vision, high IOP and even glaucomatous optic atrophy. So, early identification and treatment of the causes is important so that we can prevent the burden of blindness due to secondary glaucoma.


Assuntos
Glaucoma , Pressão Intraocular , Estudos Transversais , Feminino , Glaucoma/diagnóstico , Glaucoma/epidemiologia , Glaucoma/etiologia , Humanos , Masculino , Nepal/epidemiologia , Centros de Atenção Terciária
15.
Nepal J Ophthalmol ; 13(25): 112-121, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33981105

RESUMO

Glaucoma is a leading cause of blindness worldwide. The diagnosis and management of glaucoma is especially difficult in the developing countries. Lack of cost effective screening strategies, low income, low rates of literacy and inadequate infrastructures and human resources for eye care services are the obstacles for delivering glaucoma service. Majority of people with glaucoma in developing countries usually present at an advanced stage at the time of diagnosis; which negatively affects their quality of life. Further research, proper allocation of resources and collaborative effort by blindness prevention programs will hopefully provide new evidences on cost effective ways to screen and manage glaucoma in the future. This article aims to highlight the burden of glaucoma and ways to address the challenges in developing countries.


Assuntos
Países em Desenvolvimento , Glaucoma , Cegueira/diagnóstico , Cegueira/epidemiologia , Cegueira/etiologia , Glaucoma/diagnóstico , Glaucoma/epidemiologia , Humanos , Programas de Rastreamento , Qualidade de Vida
16.
Indian J Ophthalmol ; 69(6): 1418-1424, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34011712

RESUMO

Purpose: To understand the factors that explain compliance to anti-glaucoma medication (AGM) in terms of application,purchase, stocking and compliance behaviour. Methods: This was a cross-sectional study conducted in the outpatient department of an urban tertiary eye care center in South India. Interviews were completed with consenting, consecutive, literate primary glaucoma patients. The components of the questionnaire included duration, application, purchase, stocking and caregiver's role. Self-reported compliance in medication taking was tested for association with rest of the components by Chi-square test and discriminant analysis. Results: A total of 101 patients, aged 34-87 years, were interviewed. Majority (64.4%) were on AGM for more than two years. Early purchase was reported among 44.3% and stocking among 41.2%. Cost was high for income among 28.7%. Majority (91.1%) of them were not aware of side-effects. Fear of blindness was the major factor (68.1%) encouraging regular usage. Half (50.5%) of the patients though, still reported missing medication in the past month. Major reasons cited were relative priority (45.1%) and forgetfulness (35.3%). Self-reported compliance was not different by demographic variables or with responses to questions regarding duration (P = 0.070), application (0.825), time of purchase (0.272), stocking (0.598), and cost perception (0.415). Conclusion: Self-reporting of AGM compliance behaviour did not reflect with responses regarding application, purchase, stocking behaviour or cost perception. Awareness and knowledge of the above factors, with an aim of improving compliance by regulating counselling for even literate patients using AGM is called for.


Assuntos
Glaucoma , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Glaucoma/tratamento farmacológico , Glaucoma/epidemiologia , Humanos , Índia/epidemiologia , Adesão à Medicação , Pessoa de Meia-Idade , Inquéritos e Questionários
17.
Indian J Ophthalmol ; 69(5): 1264-1270, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33913874

RESUMO

Purpose: COVID-19 pandemic has affected the healthcare system worldwide hindering the continuum of treatment of chronic disease patients. The objective of the study is to analyze the barriers encountered by the glaucoma patients for the follow-up visit and medication adherence during the pandemic. Methods: This cross-sectional study included glaucoma patients who did not attend the scheduled appointment from April 1, 2020 to July 31, 2020 in a tertiary eye care center (88.21%). Eligible patients of age >18 years and advised antiglaucoma medication in Madurai Zone were interviewed with validated questionnaire through telephonic call. Results: 363 patients answered the questionnaire through telephonic interview. 57.3% of the patients were found to be non-adherent to medication. The main barriers for glaucoma follow-up visit during the pandemic were lockdown restriction, transport problem, and financial difficulties. The top barriers for medication adherence were non availability of medication (54.81%), financial difficulties (30.29%), did not feel much improvement with eye drops (20.19%). On multiple regression analysis, longer distance to hospital, low socioeconomic status, more than one antiglaucoma medication use, lack of awareness of glaucoma, non-complaint before COVID-19 and stress due to the pandemic were found to be significant factors for medication non adherence. Conclusion: COVID-19 pandemic has emphasized the need for reformation in health care system for accessibility of medical care to patients in rural areas. Decentralization of health system to primary care level and utilization of teleophthalmology should be considered by health care planners in future.


Assuntos
COVID-19 , Glaucoma , Oftalmologia , Telemedicina , Adolescente , Controle de Doenças Transmissíveis , Estudos Transversais , Seguimentos , Glaucoma/tratamento farmacológico , Glaucoma/epidemiologia , Humanos , Índia/epidemiologia , Adesão à Medicação , Pandemias , SARS-CoV-2
18.
Int Ophthalmol ; 41(8): 2797-2804, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33821387

RESUMO

PURPOSE: To evaluate the incidence of non-glaucomatous ocular disease in patients with asymmetric optic disc cupping. METHODS: A retrospective case series, including consecutive patients with cup-to-disc ratio (CDR) asymmetry greater than 0.2. All patients underwent a complete neuro-ophthalmological examination, automated perimetry with the Humphrey 24-2 visual fields program. Retinal nerve fibre layer thickness was measured by optical coherence tomography (OCT). The results of neuroimaging, macular OCT and blood tests were recorded as well. Patients were assigned a diagnosis of glaucomatous optic neuropathy (GON) or non-glaucomatous disease (NGD). The main outcome measure was the rate of non-glaucomatous ocular disease. RESULTS: A total of 120 (67 males) patients with a mean age of 71.1 ± 12.5 years met the inclusion criteria and were included in this study. The mean asymmetry in CDR between the eyes was 0.3 ± 0.13 (range, 0.2-0.9). Twenty patients (16.6%) had a visual field defect not typical for glaucoma and positive relative afferent pupillary defect was found in 24 patients (20%). Six patients were found to have newly diagnosed non-glaucomatous ocular disease: maculopathy in three patients, retinopathy in one patient and traumatic optic neuropathy in two patients. Patients with NGD were significantly younger than the patients with GON (59.8 ± 23.3 vs. 71.3 ± 11.5 years, P = 0.001). Optic disc pallor was found in 4/93 patients with glaucoma compared to 3/6 with newly diagnosed non-glaucomatous disease (4.7% vs. 50.0%, P = 0.03). CONCLUSIONS: Asymmetric optic disc cupping can be associated with non-glaucomatous disease and may warrant neuro-ophthalmological evaluation, especially in younger patients or those with optic disc pallor.


Assuntos
Glaucoma , Disco Óptico , Idoso , Idoso de 80 Anos ou mais , Glaucoma/diagnóstico , Glaucoma/epidemiologia , Humanos , Incidência , Pressão Intraocular , Masculino , Pessoa de Meia-Idade , Fibras Nervosas , Estudos Retrospectivos , Tomografia de Coerência Óptica , Testes de Campo Visual , Campos Visuais
19.
Optom Vis Sci ; 98(4): 362-366, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33852553

RESUMO

SIGNIFICANCE: The eye care needs of the homeless population in the United States are not well known. This study elucidates those needs for health care for the homeless programs and eye care practitioners. This information could result in an increase in the provision of necessary eye care services. PURPOSE: The purpose of this study was to assess the extent of visual and ocular conditions, the frequency of eyeglass orders and receipt of eyeglasses, and the frequency of ophthalmology referrals and receipt of ophthalmological care in an adult homeless population in Boston. METHODS: A cross-sectional retrospective chart review was conducted for patients of the Boston Health Care for the Homeless Program's Pine Street Inn eye clinic from September 26, 2016, to December 31, 2017. Data on sociodemographics, medical history, comprehensive eye examination findings, glasses orders and receipt, and ophthalmology referrals and receipt of care were collected and analyzed. RESULTS: A total of 424 patients were included in the study. The mean age of the study population was 52.7 (interquartile range, 46 to 60), and the majority were male (74%). The most common systemic conditions were hypertension (40.6%) and diabetes (23.8%). The most common refractive error was presbyopia (67.7%), followed by astigmatism (38.9%), hyperopia (34.0%), and myopia (30.7%). The most common ocular conditions were dry eye (28.6%), visually or clinically significant cataract (20%), and glaucoma/glaucoma suspicion (13.9%). Refractive correction was indicated for 356 patients (84%), but 82 (29%) did not receive ordered eyeglasses. Ophthalmology referrals were placed for 61 patients (14.4%), yet only 20 (32.8%) of those referrals were completed. CONCLUSIONS: A significant need for refractive correction and a large gap for ophthalmological care were found among the study population. Health care for the homeless programs and eye care practitioners should be aware of the visual and ocular needs of this patient population so as to better meet their needs.


Assuntos
Óculos/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Pessoas em Situação de Rua/estatística & dados numéricos , Erros de Refração/epidemiologia , Boston/epidemiologia , Catarata/epidemiologia , Estudos Transversais , Feminino , Glaucoma/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Encaminhamento e Consulta/normas , Erros de Refração/terapia , Estudos Retrospectivos , Testes Visuais
20.
Qual Life Res ; 30(8): 2311-2327, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33755897

RESUMO

PURPOSE: To study the prevalence and incidence of the most common eye diseases and their relation to health-related quality of life (HRQoL), depression, psychological distress, and visual impairment in the aging population of Finland. METHODS: Our study was based on two nationwide health surveys conducted in 2000 and 2011. Eye disease status data were obtained from 7379 and 5710 individuals aged 30 + years, of whom 4620 partook in both time points. Both surveys included identical indicators of HRQoL (EuroQol-5 Dimension [EQ-5D], 15D), depression (Beck Depression Inventory [BDI]), psychological distress (General Health Questionnaire-12 [GHQ-12]), visual acuity, and self-reported eye diseases. We assessed the impact of known eye diseases on these factors, adjusted for age, gender, and co-morbidities. RESULTS: Prevalence of self-reported eye diseases was 3.1/2.7% for glaucoma, 8.1/11.4% for cataract, and 3.4/3.8% for retinal degeneration in 2000 and 2011, and the average incidence between 2000 and 2011 was 22, 109, and 35 /year/10,000 individuals, respectively. These eye diseases were associated with a significant decrease in EQ-5D and 15D index scores in both time points. BDI and GHQ-12 scores were also worsened, with some variation between different eye diseases. Impaired vision was, however, the strongest determinant of declined HRQoL. During the 11-year follow-up the effect of eye diseases on HRQoL and mental health diminished. CONCLUSION: Declined HRQoL associated with eye diseases is more related to impaired vision than the awareness of the disease itself, and this declining effect diminished during the follow-up. Therefore, information directed to the public on the risks and prevention of blindness can and should be strengthened to prevent the deleterious effects of visual impairment.


Assuntos
Oftalmopatias , Glaucoma , Baixa Visão , Idoso , Estudos Transversais , Oftalmopatias/epidemiologia , Feminino , Glaucoma/epidemiologia , Humanos , Incidência , Saúde Mental , Prevalência , Qualidade de Vida/psicologia , Inquéritos e Questionários
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