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1.
PLoS One ; 15(1): e0227557, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31961888

RESUMO

PURPOSE: To assess the 1-year effectiveness, safety, and treatment patterns of ranibizumab in patients with myopic choroidal neovascularization (mCNV) enrolled in the LUMINOUS study. METHODS: This 5-year, prospective, multicenter, observational, study enrolled 30,138 patients across all approved ranibizumab indications from outpatient ophthalmology clinics. 297 consenting patients (≥18 years) with mCNV who were treatment-naïve or prior-treated with ranibizumab or other ocular treatments were enrolled, and treated with ranibizumab according to the local product label. The main outcomes are visual acuity (VA; Early Treatment Diabetic Retinopathy Study letters or equivalent), adverse events during the study, and treatment exposure over 1 year. Results are presented by prior treatment status of the study eye and injection frequency. RESULTS: Of the 297 mCNV patients recruited in the study, 108 were treatment-naïve and 175 were prior ranibizumab-treated. At baseline, the mean age of patients was 57.6 years, and 59.0 years and 80.6% and 65.7% were female in the treatment-naïve and prior ranibizumab-treated groups, respectively. Most were Caucasian (treatment-naïve, 88.9%; prior ranibizumab-treated, 86.9%). The mean (±standard deviation [SD]) VA letter changes to 1 year were +9.7 (±17.99) from 49.5 (±20.51) and +1.5 (±13.15) from 58.5 (±19.79) and these were achieved with a mean (SD) of 3.0 (±1.58) and 2.6 (±2.33) injections in the treatment-naïve and prior ranibizumab-treated groups, respectively. Presented by injection frequencies 1-2, 3-4 and ≥5 injections in Year 1, the mean (SD) VA changes were +15.0 (±14.70), +7.7 (±19.91) and -0.7 (±16.05) in treatment-naïve patients and +1.5 (±14.57), +3.1 (±11.53) and -3.6 (±11.97) in prior ranibizumab-treated patients, respectively. The safety profile was comparable with previous ranibizumab studies. CONCLUSIONS: Ranibizumab treatment for mCNV showed robust VA gains in treatment-naïve patients and VA maintenance in prior ranibizumab-treated patients in a clinical practice setting, consisting mainly of Caucasians. No new safety signals were observed during the study.


Assuntos
Neovascularização de Coroide/complicações , Neovascularização de Coroide/tratamento farmacológico , Miopia/complicações , Ranibizumab/efeitos adversos , Ranibizumab/uso terapêutico , Segurança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
2.
Strabismus ; 28(1): 20-24, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31872790

RESUMO

Purpose: To assess eye axial length (AL), spherical equivalent (SE), astigmatic power, distance unaided visual acuity (UCVA), and their relationship in 7- and 8-year-old pupils in Kunming, Southern China.Methods: Grade I and grade II pupils underwent measurement of AL, UCVA, and refraction. The associations of AL with SE, UCVA and astigmatic power were studied.Results: Two hundred ninety one pupils enrolled with 50.2% girls. AL was 22.71 ± 0.61 mm in children with emmetropia (UCVA > 0.8, -0.50 < SE < +0.50D and astigmatism < 0.50D), it was 23.46 ± 2.42 mm in children with mild myopia (-1 ≤ SE < -0.50D and astigmatism < 0.50D), it was 23.96 ± 1.16 mm in children with myopia (SE < -1D and astigmatism < 0.50D), and it was 22.20 ± 1.16 mm in children with astigmatism (astigmatism ≥ 0.50D). AL was highly related to SE (r = 0.572, P < .0001) with the formula AL = 22.45-0.59*SE.Conclusion: In these 7- to 8-year old pupils, average AL was 22.88 ± 0.09 mm and average SE was -0.75 ± 0.13D. Astigmatic eyes demonstrated relative shorter AL while severe myopic eyes had the longest AL, although both had worse UCVA. One mm extra axial length corresponded to -1.69D extra myopia for 7- and 8-year-old pupils in Southern China.


Assuntos
Comprimento Axial do Olho/anatomia & histologia , Astigmatismo/complicações , Criança , China , Emetropia/fisiologia , Feminino , Humanos , Masculino , Miopia/complicações , Estudantes , Acuidade Visual/fisiologia
3.
Med Sci Monit ; 25: 7715-7719, 2019 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-31609961

RESUMO

BACKGROUND A belief has existed for many years that severe myopia is a direct indication for cesarean section or an instrumental vaginal delivery, although many academic papers negated this opinion. The aim of this study was to analyze the mode of delivery of myopic patients in the years 1990, 2000, and 2010. MATERIAL AND METHODS Medical records of 3027 women in labor from the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw were analyzed in 3 time periods: year 1990 - group 1 (G1), year 2000 - group 2 (G2), and 2010 - group 3 (G3). Maternal age, severity and proportion of myopia, ophthalmological consultations, and mode of delivery were assessed. RESULTS In G1 there were 992 patients, in G2 there were 1010 patients, and in G3 there were 1025 patients. Myopic women in labor accounted for 20% of G1, 12% of G2, and 20% of G3. The mean maternal age was ±29.4 years in G1, ±30 years in G2, and ±31.5 years in G3. Myopia was divided into 3 levels of severity depending on the degree of refractive error: low myopia -6 DS. The number of ophthalmological examinations needed in myopic patients to decide on the mode of delivery showed an increasing tendency over the evaluated years, but the rates of referrals for cesarean section/assisted delivery decreased. CONCLUSIONS The proportion of myopic women in labor receiving ophthalmological consultations showed an increasing trend over time. Despite publication of the Ophthalmology-Obstetrics Consensus of the Polish Society of Ophthalmology guidelines, myopia still remains an indication for cesarean section (cesarian section), but not to shorten the second stage of delivery.


Assuntos
Parto Obstétrico/tendências , Miopia/complicações , Complicações na Gravidez/etiologia , Adulto , Cesárea , Parto Obstétrico/métodos , Feminino , Humanos , Trabalho de Parto/fisiologia , Idade Materna , Complicações do Trabalho de Parto/epidemiologia , Complicações do Trabalho de Parto/fisiopatologia , Polônia , Gravidez , Estudos Retrospectivos
4.
Korean J Ophthalmol ; 33(5): 458-466, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31612657

RESUMO

PURPOSE: To investigate the clinical effects of different orientation and magnitude of cyclotorsion on the compensation capacity of the WaveLight EX500 photorefractive keratectomy (PRK) platform. METHODS: This retrospective study comprised 400 eyes of 200 patients who underwent bilateral simultaneous PRK due to compound myopic astigmatism. The subjects were separated according to the orientation of cyclotorsion into incyclotorsion and excyclotorsion groups, and by the magnitude of cyclotorsion into group 1 (0.50 to 2.50 degrees), group 2 (3.00 to 5.00 degrees), group 3 (5.50 to 7.50 degrees), and group 4 (8.00 to 9.50 degrees). RESULTS: The mean magnitude of cyclotorsion was 3.50 ± 2.4 degrees (0.50 to 9.50 degrees) in the incyclotorsion group and 3.32 ± 2.3 degrees (0.50 to 9.50 degrees) in the excyclotorsion group (p = 0.617). The postoperative refractive outcomes of the incyclotorsion and excyclotorsion groups were similar (p > 0.05 for all). The postoperative mean cylindrical refractive error was -0.32 ± 0.3 diopters (D, -1.25 to 0.00 D) in group 1, -0.47 ± 0.2 D (-2.00 to 0.00 D) in group 2, -0.62 ± 0.2 D (-1.00 to -0.25 D) in group 3, and -0.91 ± 0.2 D (-1.50 to -0.50 D) in group 4 (p < 0.001). Preoperative cylindrical refractive error was positively correlated with magnitude of cyclotorsion (r = 0.125 and p = 0.013), which was also positively correlated with postoperative cylindrical refractive error (r = 0.600 and p < 0.001). CONCLUSIONS: Incyclotorsion and excyclotorsion can be equally compensable in the WaveLight EX500 PRK platform for compound myopic astigmatism. A value of ≤2.50 degrees cyclotorsion magnitude was observed to be more compensable than higher degrees of cyclotorsion magnitude. Preoperative high astigmatism was associated with high cyclotorsion magnitude, which was also associated with a high degree of postoperative astigmatism.


Assuntos
Astigmatismo/cirurgia , Córnea/cirurgia , Lasers de Excimer/uso terapêutico , Miopia/cirurgia , Ceratectomia Fotorrefrativa/métodos , Refração Ocular/fisiologia , Acuidade Visual , Adolescente , Adulto , Astigmatismo/complicações , Astigmatismo/fisiopatologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Miopia/complicações , Miopia/fisiopatologia , Período Pós-Operatório , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
5.
Graefes Arch Clin Exp Ophthalmol ; 257(11): 2357-2365, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31485730

RESUMO

PURPOSE: To investigate the associations between macular complications and demographic, clinical, and optical coherence tomography characteristics (OCT) of highly myopic eyes with a dome-shaped macula (DSM). METHODS: We retrospectively analyzed the findings of 90 patients (167 eyes) with DSM who had vertical and horizontal OCT scans between January 2011 and June 2018. Demographic data, clinical characteristics, and OCT-derived morphologic parameters were determined, and the associations of these parameters with macular complications were evaluated. RESULTS: Among 167 eyes, the following patterns were observed: horizontally oriented DSM (71%), symmetric DSM (27%), and vertically oriented DSM (2%). Complications or abnormalities involving the macular area were detected by OCT in 63% (106/167) of the eyes. Specific complications were as follows: choroidal neovascularization (CNV) (37.1%), macular retinoschisis (9.0%), serous retinal detachment (RD) (7.8%), epiretinal membrane (4.2%), lamellar macular hole (3.0%), and macular hole (2.4%). The eyes with CNV had thinner choroid (P < 0.001) and lower macular bulge height (P = 0.04). The eyes with serous RD had thicker choroid (P < 0.001) and higher macular bulge height (P < 0.001). Serous RD was significantly more common when the macular height was greater than 250 µm (P = 0.001) and if the DSM pattern was vertical (P < 0.001). CONCLUSIONS: A greater bulge height and thicker choroid in highly myopic eyes with DSM may be protective against the development of myopic CNV. A thicker choroid, a higher macular bulge (> 250 µm), and a vertical DSM pattern are associated with a risk of developing serous RD.


Assuntos
Macula Lutea/patologia , Miopia/diagnóstico , Refração Ocular/fisiologia , Doenças Retinianas/etiologia , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Adulto , Idoso , Feminino , Angiofluoresceinografia/métodos , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Miopia/complicações , Miopia/fisiopatologia , Prognóstico , Doenças Retinianas/diagnóstico , Estudos Retrospectivos , Adulto Jovem
6.
Graefes Arch Clin Exp Ophthalmol ; 257(11): 2367-2373, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31418105

RESUMO

PURPOSE: The purpose of the present paper is to describe a surgical technique aimed at creating multiple layers of Internal Limiting Membrane (ILM) using Perfluorocarbon Liquid (PFCL) in order to favour the closure of large, chronic and myopic Macular Holes (MH). METHODS: Thirty patients belonging to 3 subgroups: large (> 500 µm), chronic (> 12 months) and myopic (> - 9 diopters), MHs, underwent surgery and completed 6 months follow-up. The ILM was engaged and peeled 360° around the MH, hinged to the rim and folded over the hole. A PFCL bubble spanning the vascular arcades was then injected and the ILM is grasped repeatedly to fold the distal edge towards the MH centre, creating multiple ILM layers over the MH. RESULTS: MH closed in 26/30 cases (86.6%) with no significant difference among subgroups. Vision improved 2.57 ± 1.56 Snellen lines from LogMAR 1.50 ± 1.19 to 1.19 ± 1.32 (p < 0.01). Ellipsoid Zone (EZ) interruption width reduced from 1129 ± 439 µm to 258 ± 507 µm (p < 0.001) and correlated to pattern of MH closure, post-BCVA and line improvement (p < 0.001 in all cases). DISCUSSION: The use PFCL allows multiple ILM layers and resulted in a high closure rate. Pattern of MH closure differs from those previously described leaving a plug of ILM tissue that interrupts retinal architecture often only in the inner layers. PFCL gravity and hydrophobicity displace aqueous while the intensely polar opposite faces of the ILM attract each other. The folded ILM plugs MH and bridges the gap and may help glial cell proliferation and migration.


Assuntos
Membrana Basal/transplante , Tamponamento Interno/métodos , Fluorcarbonetos/farmacologia , Miopia/complicações , Refração Ocular/fisiologia , Perfurações Retinianas/cirurgia , Retalhos Cirúrgicos , Idoso , Doença Crônica , Feminino , Seguimentos , Humanos , Macula Lutea/patologia , Masculino , Pessoa de Meia-Idade , Miopia/diagnóstico , Miopia/fisiopatologia , Perfurações Retinianas/diagnóstico , Perfurações Retinianas/etiologia , Estudos Retrospectivos , Tomografia de Coerência Óptica , Resultado do Tratamento , Acuidade Visual , Vitrectomia/métodos
8.
Invest Ophthalmol Vis Sci ; 60(8): 3135-3141, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31335951

RESUMO

Purpose: A posterior staphyloma has been reported to be present in some eyes with retinitis pigmentosa (RP), and the purpose of this study was to determine the macular curvature of non-highly myopic RP eyes. Methods: This was a retrospective, observational study. The medical charts of the right eyes of 143 patients with RP and 60 controls whose axial length ranged from 21.5 mm to 26.0 mm were reviewed. The mean curvature of Bruch's membrane within 6 mm of the central macula obtained from the horizontal optical coherence tomographic images were evaluated as the mean macular curvature index (MMCI). The relationships between the MMCI and other clinical factors were assessed. Results: The mean MMCI of RP patients (-13.73 ± 9.63 × 10-5 µm-1) was significantly lower than that of the controls (-6.63 ± 5.63 × 10-5 µm-1). This indicated a deeper concave shape of the macula in RP eyes (P < 0.001). The MMCI was significantly correlated with the age (r = 0.20; P = 0.016) and the axial length (r = -0.24; P = 0.004). Further analysis suggested a nonlinear effect of the ellipsoid zone width on the macular curvature in the RP eyes. Conclusions: There is a high incidence of steeper macular curvatures even in non-highly myopic RP eyes, and the steepness was also affected by the degree of photoreceptor degeneration.


Assuntos
Macula Lutea/patologia , Miopia/diagnóstico , Refração Ocular/fisiologia , Retinite Pigmentosa/diagnóstico , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Miopia/complicações , Miopia/fisiopatologia , Retinite Pigmentosa/complicações , Retinite Pigmentosa/fisiopatologia , Estudos Retrospectivos
9.
Invest Ophthalmol Vis Sci ; 60(8): 2958-2967, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31305862

RESUMO

Purpose: To explore the characteristics of tilted optic disc and peripapillary atrophy (PPA), and their associations with choroidal thickness (ChT) in young myopic patients. Methods: A total of 821 patients were enrolled in this cross-sectional study. Optic disc tilt ratio, PPA area, macular ChT (mChT), and peripapillary ChT (pChT) were measured. Subjects were divided into four groups purely on the basis of the axial length (AL). Relationships between ChT and the morphologic characteristics of optic disc were analyzed using logistic regression. Results: The prevalence of tilted optic disc and PPA increased as myopia severity increased. Every 0.1-mm2 increase in PPA area was associated with a 14.93-µm decrease in mChT and a 9.54-µm decrease in pChT; and every 0.1 increase in tilt ratio was correlated with a 5.38-µm increase in mChT and a 6.21 decrease in pChT. After stratifying by myopia severity, these trends were still observed in the high myopia group. A larger PPA area (odds ratio [OR] = 2.33; P < 0.01), a longer AL (OR = 1.34; P < 0.01), an increased pChT (OR = 1.11; P < 0.01), and a decreased mChT (OR = 0.93; P < 0.01) were associated with higher odds of having tilted optic disc. Conclusions: In young myopic patients, mChT was negatively associated with PPA area and positively associated with tilt ratio, while pChT was negatively associated with PPA area and tilt ratio. In this population, larger PPA area, longer AL, and thinner mChT were associated with higher odds of tilted optic disc.


Assuntos
Corioide/patologia , Anormalidades do Olho/etiologia , Miopia/complicações , Atrofia Óptica/etiologia , Disco Óptico/anormalidades , Adolescente , Adulto , Corioide/diagnóstico por imagem , Estudos Transversais , Anormalidades do Olho/diagnóstico por imagem , Feminino , Humanos , Pressão Intraocular , Masculino , Atrofia Óptica/diagnóstico por imagem , Disco Óptico/diagnóstico por imagem , Tamanho do Órgão , Tomografia de Coerência Óptica , Adulto Jovem
10.
Indian J Ophthalmol ; 67(7): 1061-1065, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31238411

RESUMO

Purpose: To compare clinical outcomes following implantation of two types of posterior chamber phakic intraocular lenses: Visian™ Implantable Collamer Lens with Centraflow (ICL, V4C Staar Surgical, Nidau, Switzerland) and Implantable Phakic Contact Lens (IPCL, V1, Caregroup Sight Solution, India) for the correction of myopia and myopic astigmatism. Methods: This retrospective case series included eyes which underwent phakic intraocular lens implantation with a minimum follow-up period of 1 year. Visual outcomes including safety, efficacy, refractive predictability, and stability were compared at 1 week and at 1, 6, and 12 months' postoperative visit. Complications and adverse events were analyzed. Results: The study included 119 and 203 eyes in the IPCL and ICL groups, respectively. At 1-year postoperative visit, median corrected distance visual acuity was 0.10 (interquartile range [IQR] 0,0.10) and 0 (IQR 0,0) in the IPCL and ICL cohorts, respectively (P = 0.066). An uncorrected visual acuity of 20/32 or better was achieved in 86.5% and 88.67% of the eyes, respectively (P = 0.574). Ninety and 94% of the eyes achieved a postoperative manifest spherical equivalent within ± 0.5D (P = 0.169, χ2 test). Three eyes (2.52%) in the IPCL group versus one eye (0.49%) in the ICL group developed visually significant cataract requiring surgical intervention (P = 0.113). No vision-threatening complications were noted in either cohort. The mean follow-up period was 94.69 ± 32.45 and 102.67 ± 61.82 weeks, respectively. Conclusion: Both groups demonstrated similar efficacy and safety profile. The IPCL is an effective and economically viable option for the correction of myopia.


Assuntos
Astigmatismo/cirurgia , Implante de Lente Intraocular/métodos , Miopia/cirurgia , Lentes Intraoculares Fácicas , Segmento Posterior do Olho/cirurgia , Refração Ocular/fisiologia , Acuidade Visual , Adulto , Astigmatismo/complicações , Astigmatismo/fisiopatologia , Feminino , Seguimentos , Humanos , Masculino , Miopia/complicações , Miopia/fisiopatologia , Período Pós-Operatório , Desenho de Prótese , Estudos Retrospectivos , Adulto Jovem
11.
Indian J Ophthalmol ; 67(7): 1155-1157, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31238434

RESUMO

Myopic strabismus fixus causes inability of the eye to elevate and abduct in the setting of a myopic superotemporally herniated globe. We report a novel surgical technique to manage an 18-year-old male with myopic strabismus fixus. Radiological imaging demonstrated a nasally deviated superior rectus (SR) and inferiorly displaced lateral rectus (LR). Silicone band assisted myopexy of SR and LR was done along with anchoring them to the sclera with a dacron suture. The patient had satisfactory alignment postoperatively and did not require any intervention over 1-year follow-up.


Assuntos
Movimentos Oculares/fisiologia , Miopia/cirurgia , Músculos Oculomotores/cirurgia , Procedimentos Cirúrgicos Oftalmológicos/métodos , Elastômeros de Silicone , Estrabismo/cirurgia , Técnicas de Sutura/instrumentação , Adolescente , Humanos , Masculino , Miopia/complicações , Miopia/fisiopatologia , Músculos Oculomotores/fisiopatologia , Estrabismo/complicações , Estrabismo/fisiopatologia
12.
Invest Ophthalmol Vis Sci ; 60(6): 2198-2207, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-31108550

RESUMO

Purpose: To investigate factors associated with visual field (VF) progression in treated myopic normal-tension glaucoma (NTG) using a novel posterior sclera reconstruction method involving swept-source optical coherence tomography (OCT). Methods: Fifty-six myopic patients on ocular hypotensive therapy with the diagnose NTG had five or more VF tests during a period of 72.63 ± 20.46 months in clinical follow-up. Glaucomatous VF progression was decided by the standards of Early Manifest Glaucoma Trial criteria. Coronally reconstructed OCT images were used to obtain the position of the deepest point of the eye (DPE), and parameterized the distance (Disc-DPE distance), depth (Disc-DPE depth) and angle (Disc-DPE angle) of the posterior sclera. The Cox proportional hazards model and Kaplan-Meier curves were used to determine the risk factors for VF progression. Results: Among 56 eyes, 28 showed VF progression. Eyes with progression had significantly different distance, depth, and angle of the DPE position (P = 0.049, P = 0.032, and P = 0.006, respectively). A multivariate Cox proportional hazard model revealed that the vertical tilt angle (hazard ratio [HR] 0.835, P = 0.026) and the DPE positioned temporal to fovea (HR 4.314, P = 0.001) were associated with VF progression. Among eyes with DPE positioned temporal to fovea, in addition to percentage reduction in IOP from baseline (HR 0.915, P = 0.012), shorter axial length (HR 0.542, P = 0.044) was found to be associated with VF progression. Conclusions: Eyes with a particular posterior sclera structure are at increased risk for glaucoma progression in treated myopic NTG patients. This finding highlights the significance of investigating posterior sclera structure and its relevance to initiate or augment treatment for myopic glaucoma patients.


Assuntos
Glaucoma de Baixa Tensão/patologia , Miopia/patologia , Segmento Posterior do Olho/patologia , Esclera/patologia , Tomografia de Coerência Óptica/métodos , Adulto , Idoso , Progressão da Doença , Feminino , Humanos , Estimativa de Kaplan-Meier , Glaucoma de Baixa Tensão/complicações , Masculino , Pessoa de Meia-Idade , Miopia/complicações , Reprodutibilidade dos Testes , Campos Visuais/fisiologia
13.
J Fr Ophtalmol ; 42(5): 457-463, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30979559

RESUMO

PURPOSE: The goal of this study was to assess changes in OCT parameters occurring in high myopic glaucoma patients, so as to enable early diagnosis and prevention of progressive glaucomatous damage. It was performed at the department of ophthalmology, Kasr Alainy Hospital, Cairo University, over a twenty-month period. METHODS: This study was a cross-sectional randomized single blinded study. It included 62 eyes of highly myopic individuals. Patients were divided into 2 groups: Group A included myopic non-glaucomatous individuals, and Group B included the myopic glaucoma patients. All patients had a full ophthalmological examination, as well as OCT assessment of the RNFL, GCC and ONH parameters. The VF was tested as well as AXL and CCT. Correlation of the data was performed. RESULTS: Regarding the GLV, its mean in group A was 11.88±6.71% versus 19.69±9.69% in group B; the difference between both groups was statistically significant (P=0.001). Regarding the cup area, the mean in group A was 0.51±0.41mm2, while that in group B was 1.25±0.72mm2; the difference between both groups was statistically significant (P<0.001). CONCLUSION: The ONH parameter, cup area, and the GCC parameter, GLV, are key parameters in supporting the diagnosis of glaucoma in myopic patients. Other parameters measured by OCT, such as inferior RNFL thickness, FLV, and C/D ratio, could aid in diagnosis as well.


Assuntos
Glaucoma/diagnóstico , Miopia/diagnóstico , Tomografia de Coerência Óptica/métodos , Adulto , Estudos de Casos e Controles , Estudos Transversais , Diagnóstico Precoce , Feminino , Glaucoma/complicações , Glaucoma/patologia , Glaucoma/fisiopatologia , Humanos , Pressão Intraocular , Masculino , Pessoa de Meia-Idade , Miopia/complicações , Miopia/patologia , Miopia/fisiopatologia , Fibras Nervosas/patologia , Fibras Nervosas/ultraestrutura , Disco Óptico/diagnóstico por imagem , Disco Óptico/patologia , Distribuição Aleatória , Índice de Gravidade de Doença , Método Simples-Cego
14.
Indian J Ophthalmol ; 67(3): 412-414, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30777973

RESUMO

Interpretation of optic disc cupping and neuroretinal rim is challenging in myopic eyes because of large, shallow, and tilted disc, myopic crescent, and macular degeneration. Color and red-free optic disc photographs do not reveal the cup/disc ratio often in myopic eyes. We report characteristics of multicolor optic disc photography in three myopic eyes. All eyes underwent multicolor imaging Spectralis SDOCT system (Heidelberg Engineering, Germany). Owing to use of three laser lights in a confocal design, multicolor optic disc photography was able to delineate the neuroretinal rim and optic cup more clearly than color and red-free optic disc photographs.


Assuntos
Glaucoma de Ângulo Aberto/diagnóstico , Pressão Intraocular/fisiologia , Miopia/diagnóstico , Disco Óptico/patologia , Doenças do Nervo Óptico/diagnóstico , Fotografação/métodos , Acuidade Visual , Feminino , Glaucoma de Ângulo Aberto/complicações , Glaucoma de Ângulo Aberto/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Miopia/complicações , Miopia/fisiopatologia , Doenças do Nervo Óptico/etiologia , Reprodutibilidade dos Testes
15.
Graefes Arch Clin Exp Ophthalmol ; 257(3): 657-662, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30671656

RESUMO

PURPOSE: This study aimed to investigate the characteristics of the extraocular muscles and the orbital connective tissue pulleys in Japanese patients with age-related distance esotropia (ARDE) and high myopia using magnetic resonance imaging (MRI). METHODS: This was a retrospective case-series study. High-resolution coronal MRI scans of 12 orbits were obtained in 6 patients with ARDE and high myopia (age range: 51-69 years). We analyzed the images to determine the positions of the rectus muscle pulleys relative to the center of the globe, the integrity of the lateral rectus-superior rectus muscle (LR-SR) band, and the LR angle (the angle between the major axis of the LR and the vertical plane). RESULTS: The distance esotropia ranged from 4 to 25∆, and 3 cases exhibited vertical deviations. The mean (±standard deviation (SD)) axial length was 28.5 (± 1.6) mm. The mean positions of the medial rectus muscle pulley and LR pulley were 1.3 mm inferior and 1.4 mm inferior, respectively, to those seen in the normal control group in our previous study (P = 0.002 and P = 0.05, respectively). All 12 orbits had abnormal elongated LR-SR bands, and 8 orbits (67%) displayed ruptured LR-SR bands. The LR angle (mean±SD; 18.8° ± 8.5°) increased significantly with the inferior displacement of the LR pulley (R2 = 0.77, P = 0.0002). CONCLUSIONS: Inferior displacement of the LR pulley and abnormal LR-SR bands were seen in Japanese ARDE patients with high myopia, as was found in ARDE patients without high myopia. The LR angle might be useful for judging the degree of LR pulley displacement.


Assuntos
Esotropia/diagnóstico , Movimentos Oculares/fisiologia , Imagem por Ressonância Magnética/métodos , Miopia/complicações , Músculos Oculomotores/patologia , Órbita/diagnóstico por imagem , Refração Ocular/fisiologia , Fatores Etários , Idoso , Esotropia/complicações , Esotropia/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Miopia/diagnóstico , Miopia/fisiopatologia , Músculos Oculomotores/fisiopatologia , Reprodutibilidade dos Testes , Estudos Retrospectivos
16.
Acta Ophthalmol ; 97(5): e729-e735, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30690902

RESUMO

PURPOSE: To determine the influence of baseline myopic macular degeneration (MMD) severity on outcomes with intravitreal aflibercept (IVT-AFL) in patients with myopic choroidal neovascularization (CNV). METHODS: MYRROR was a randomized, double-masked study in patients with myopic CNV treated with IVT-AFL/sham over 48 weeks. At baseline/week 48, images were retrospectively graded for MMD. RESULTS: At baseline, 115 eyes had a valid MMD grading result; at week 48, grading results were available for 99 eyes [IVT-AFL (n = 78)/sham (n = 21)]. Severity of baseline MMD was distributed as follows: category 1: 19/115 (17%); category 2: 67/115 (58%); category 3: 22/115 (19%); category 4: 7/115 (6%). Higher MMD category was associated with older age (nominal p = 0.007) and longer axial length (nominal p = 0.025). At week 48, patients in the mild and severe groups had visual acuity gains of +13.5 and +12.4 letters, respectively. Baseline MMD severity did not significantly affect visual/anatomical outcomes or number of treatments. Visual Functioning Questionnaire-25 scores improved more in mild (+5.6) versus severe (+0.4) MMD (nominal p = 0.03). There were no new safety events. CONCLUSIONS: Visual acuity gains, morphological outcomes and dosing frequency were not affected by baseline MMD severity in patients treated with IVT-AFL. A benefit with IVT-AFL treatment was observed for all baseline MMD stages included in this study.


Assuntos
Degeneração Macular/tratamento farmacológico , Miopia/complicações , Receptores de Fatores de Crescimento do Endotélio Vascular/administração & dosagem , Proteínas Recombinantes de Fusão/administração & dosagem , Acuidade Visual , Corioide/patologia , Relação Dose-Resposta a Droga , Feminino , Angiofluoresceinografia , Seguimentos , Fundo de Olho , Humanos , Injeções Intravítreas , Macula Lutea/patologia , Degeneração Macular/diagnóstico , Degeneração Macular/etiologia , Masculino , Pessoa de Meia-Idade , Miopia/diagnóstico , Miopia/fisiopatologia , Refração Ocular , Estudos Retrospectivos , Índice de Gravidade de Doença , Fatores de Tempo , Tomografia de Coerência Óptica , Resultado do Tratamento
17.
Acta Ophthalmol ; 97(6): 596-602, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30690920

RESUMO

PURPOSE: To examine visual acuity, refraction and ocular status before, during and after hyperbaric oxygen therapy (HBOT). METHODS: Twenty-nine patients underwent 40 standard protocol HBOT treatments. In all subjects, refraction and best corrected visual acuity were measured at baseline and after ten, 20, 30 and 40 treatments, and at a 12-week follow-up. A subgroup (n = 19) were given additional examinations at baseline, after 40 treatments and at follow-up including measuring central corneal thickness (CCT), corneal curvature, anterior chamber depth, lens thickness, axial length, fundus morphology, blood pressure and intraocular pressure (IOP). Lens colour and opalescence were graded using the Lens Opacities Classification System III (LOCS III). RESULTS: Myopic shifts [≥0.5 dioptre (D) spherical equivalent (SE)] occurred in 45 (77.6%) eyes. Median refractive changes of -0.75 D SE (right eye; p < 0.001) and -0.66 D SE (left eye; p < 0.001) were observed between pretreatment and treatment end (Wilcoxon signed rank test). Refraction returned to baseline at follow-up, except for a small persisting change towards myopia, median -0.25 D SE (left eye; p = 0.01). Using the LOCS III, median increases in lens nuclear colour, of 0.6 (right eye; p < 0.001) and 0.7 (left eye; p < 0.001), and opalescence of 0.7 (both eyes; p = 0.01) were found at the last examination. Small reductions were noted in CCT of -6.00 µm (right eye; p = 0.03) and -4.00 µm (left eye; p = 0.03), and IOP of -1.50 mmHg (left eye; p = 0.01). CONCLUSIONS: The transient myopic shift may have been due to lenticular refractive index changes. Reduced lens transparency is a potential consequence of HBOT.


Assuntos
Catarata/prevenção & controle , Oxigenação Hiperbárica/métodos , Cristalino/fisiopatologia , Miopia/terapia , Refração Ocular/fisiologia , Acuidade Visual , Adolescente , Adulto , Idoso , Catarata/etiologia , Catarata/fisiopatologia , Progressão da Doença , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Miopia/complicações , Miopia/fisiopatologia , Prognóstico , Estudos Prospectivos , Adulto Jovem
18.
Jpn J Ophthalmol ; 63(2): 172-180, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30604114

RESUMO

PURPOSE: To report the findings in 3 cases of bilateral negative electroretinograms (ERGs) with acute onset of photophobia. STUDY DESIGN: Retrospective case series. METHODS: The medical charts of the 3 patients were reviewed. RESULTS: A 43-year-old woman, a 68-year-old woman, and a 41-year-old woman were referred to Nagoya University Hospital. Their main symptom was bilateral acute photophobia. None of the patients had any systemic diseases or specific medical history. The decimal best-corrected visual acuity (> 0.8) and Humphrey visual fields (mean deviation > -3 dB) were relatively well preserved in all 3 patients. The optical coherence tomography (OCT) and fundus autofluorescence findings were essentially normal. Fluorescein angiography showed mild leakage in 1 patient but no abnormality in the other 2 patients. However, the ERGs of the 3 patients had the features of abnormal ERGs found in patients with incomplete congenital stationary night blindness (CSNB). Exome analyses found no pathogenic variants related to known CSNB-related genes. The symptoms and ERGs of the 3 patients have not progressed or recovered after a relatively long follow-up period. CONCLUSION: The ERG characteristics of 3 patients with bilateral photophobia were similar to those of incomplete CSNB, suggesting post-phototransductional abnormalities. The symptoms and genetic analyses indicated the possibility of an acquired condition rather than a hereditary retinal disease.


Assuntos
Oftalmopatias Hereditárias/complicações , Doenças Genéticas Ligadas ao Cromossomo X/complicações , Miopia/complicações , Cegueira Noturna/complicações , Fotofobia/diagnóstico , Acuidade Visual , Doença Aguda , Adulto , Idoso , Diagnóstico Diferencial , Eletrorretinografia/métodos , Oftalmopatias Hereditárias/diagnóstico , Oftalmopatias Hereditárias/fisiopatologia , Feminino , Angiofluoresceinografia , Seguimentos , Fundo de Olho , Doenças Genéticas Ligadas ao Cromossomo X/diagnóstico , Doenças Genéticas Ligadas ao Cromossomo X/fisiopatologia , Humanos , Miopia/diagnóstico , Miopia/fisiopatologia , Cegueira Noturna/diagnóstico , Cegueira Noturna/fisiopatologia , Fotofobia/etiologia , Estudos Retrospectivos , Tomografia de Coerência Óptica
19.
J Formos Med Assoc ; 118(3): 679-685, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30150097

RESUMO

PURPOSE: To investigate the microstructural characteristics of lattice degenerations before and after laser photocoagulation in myopic eyes by spectral-domain optical coherence tomography (SD-OCT). METHODS: Twenty-five eyes of 25 consecutive patients at the High Myopia Clinic of the National Taiwan University Hospital were retrospectively reviewed. Myopic eyes with peripheral lattice degeneration were enrolled in the study. Best-corrected visual acuity (BCVA), axial length measurement, color fundus photography was performed. SD-OCT analyses on the lattice degeneration were performed before and after prophylactic laser photocoagulation. All patients were followed for at least 6 months. RESULTS: In total, 25 myopic eyes with peripheral lattice degenerations were studied. The mean refractive error was -9.92 ± 4.77 Diopters (D) with 21 (84%) of the eye being highly myopic (Over -6.0 D). The average axial length was 27.7 ± 1.86 mm. In these myopic eyes, retinal thinning was the most common finding (92%), followed by vitreoretinal traction (72%), retinoschisis (44%), vitreous membrane with deposits (36%), and retinal break with subretinal fluid (4%). A blunting effect of the vitreoretinal tractions was found after laser photocoagulation. CONCLUSION: To our knowledge we firstly investigated the pre- and post-laser photocoagulation microstructural changes using SD-OCT. It demonstrated a beneficial effect of retinoplasty, which released vitreoretinal tractions after laser photocoagulation. Combined with the findings of subtle microstructural retinal breaks and subretinal fluid, early prophylactic laser treatment warrants sincere consideration in these myopic eyes.


Assuntos
Fotocoagulação a Laser/métodos , Miopia/cirurgia , Retina/patologia , Retinosquise/epidemiologia , Tomografia de Coerência Óptica , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Miopia/complicações , Miopia/diagnóstico por imagem , Erros de Refração , Estudos Retrospectivos , Taiwan , Acuidade Visual , Corpo Vítreo/patologia , Adulto Jovem
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