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1.
J Zoo Wildl Med ; 50(4): 837-844, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31926513

RESUMO

This study surveyed six North American zoologic institutions to collect retrospective information on the incidence of ocular disease in the giant panda. Reported information included sex and age at presentation, as well as diagnosis, treatment, duration, and clinical outcome for each episode of ocular disease. Among the 42 animals included in the survey, 10 (23.8%) had clinical ocular abnormalities reported. Multiple disease episodes were reported in four animals, with 20 clinical episodes, and one additional animal who presented with corneal scarring from historic keratitis. Age at presentation varied from 0.4 to 26 yr (mean, 11.8 yr; median, 10.4 yr). Corneal abnormalities (including corneal opacity or haze, keratitis, corneal ulcers, and bullous keratopathy) were the most common pathologies reported, followed by conjunctivitis and/or ocular discharge. Additional reported abnormalities included limbal squamous cell carcinoma and lipid degeneration. Six cases resolved without intervention. Treatment protocols included topical and/or systemic medication with or without surgical intervention, which commonly resulted in resolution with or without persistent corneal scar. The prevalence of ocular disease identified in the giant panda in this study is higher than previous publications surveying ocular disease in the family Ursidae, indicating that this is an important source of morbidity in this species.


Assuntos
Animais de Zoológico , Oftalmopatias/veterinária , Ursidae , Animais , Oftalmopatias/epidemiologia , Feminino , Masculino , América do Norte/epidemiologia
2.
Isr Med Assoc J ; 21(9): 607-611, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31542906

RESUMO

BACKGROUND: Ophthalmic pathologies may further complicate the sensory input of patients with congenital hearing loss; however, data on children with coexisting impairment of vision and hearing is outdated, from before universal implementation of hearing screening programs. OBJECTIVES: To examine the different ophthalmic pathologies among children with congenital sensorineural hearing loss (SNHL) before or after the introduction of a universal newborn hearing screening program (UNHSP). METHODS: Retrospective cohort study was conducted of 91 children diagnosed with congenital SNHL between 2005 and 2016 in a tertiary pediatric hospital. All patients completed an ophthalmologic examination, including assessment of visual acuity, refraction, ocular motility, slit lamp examination, and indirect funduscopy. Radiological assessment and genetic analysis were offered to all caregivers. RESULTS: Average age at diagnosis was 4.1 years. Nineteen children (21%) were diagnosed with an ophthalmic condition, of which the most common were refractive pathologies. Diagnosis of an ophthalmic pathology was twice as likely in the pre-UNHSP era (14 children, 27%) compared to the post-UNHSP era (5 children, 13%). Out of 91 children, 57 (63%) underwent a computed tomography scan and/or magnetic resonance imaging. Imaging was positive for structural abnormalities in 23 children (40%). There was no correlation between imaging and ophthalmic conditions. Genetic analysis was performed in 67 patients (74%). CONCLUSIONS: The ophthalmic assessment of babies and children with congenital SNHL may yield in significant numbers of children with concomitant ophthalmic pathologies. Implementation of a UNHSP allows early diagnosis and treatment of coexisting ophthalmic and hearing conditions.


Assuntos
Oftalmopatias/diagnóstico , Oftalmopatias/epidemiologia , Perda Auditiva/diagnóstico , Perda Auditiva/epidemiologia , Programas de Rastreamento/métodos , Pré-Escolar , Estudos de Coortes , Comorbidade , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Nova Zelândia/epidemiologia , Estudos Retrospectivos
3.
Nepal J Ophthalmol ; 11(21): 11-18, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31523061

RESUMO

INTRODUCTION: HIV/AIDS is a disorder which affects multiple systems in our body but ophthalmic manifestations do occur in 70-80% of patients sometime during their lifetime. Eye is affected either directly by HIV virus or indirectly through various opportunistic infections. HIV related ophthalmic manifestations are wide and can affect any part of eye from a dnexal disorders to posterior segment diseases including the optic nerve and the optic tract. This study was done to know the prevalence of ocular manifestations in the known HIV positive case & to correlate the ocular manifestations in HIV positive patients with their CD4+ lymphocyte count and duration of disease. MATERIAL & METHODS: In the present study, we examined 200 known cases of HIV infection who attended the Out Patient Department of Government Eye Hospital, Amritsar, Punjab. Detailed ocular examination was done and the findings were correlated with CD4+ count and duration of the disease. RESULT: In the present study it was found that dry eye and HIV retinopathy were amongst the most common ocular manifestations accounting for 20.5% and 20% of the total cases. Next in the series was neuro ophthalmic complications which include dpapilledema, optic nerve atrophy, papillitis and also third nerve abnormalities. It consisted of 5.5% of the total cases. Almost equal in incidence was anterior uveitis consisting of 5% of the total. Next of importance was CMV retinitis of which 5 cases were seen which constituted 2.5% of the total and all these cases were observed in the patients with CD4+ count less than 50/mm3. p value for this was 0.008 which was statistically significant. Few cases of blephar it is, conjunctivitis, cellulitis, herpes zoster ophthalmic us and keratitis were also found which consisted of 2.5%, 0.5%, 1%,3%, and 2% respectively. CONCLUSION: Any HIV-infected person who at any stage experiences ocular symptoms also should get competent ophthalmologic care at the earliest. Any delay in treatment can lead to permanent visual loss. An improved coordination between two branches of ophthalmology and HIV medicine will need long coordination against this dreadful disease.


Assuntos
Oftalmopatias/epidemiologia , Infecções por HIV/complicações , HIV , Adulto , Oftalmopatias/etiologia , Feminino , Seguimentos , Humanos , Índia/epidemiologia , Masculino , Prevalência , Estudos Prospectivos
4.
Pan Afr Med J ; 33: 116, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31489094

RESUMO

This study aims to analyze the epidemiological, clinical, therapeutic and evolutionary profile of ocular manifestations in patients with Behçet's disease. We conducted a retrospective, descriptive study of the medical records of 121 patients managed by specialists with expertise in this disease over a period of one year and a half between January 2015 and June 2016. The average age of patients was 35 years, 63.6% of patients were male, ocular involvement was inaugural in 24% of cases. Patients had anterior uveitis (7.4%), posterior uveitis (15.7%), vasculitis (19%), irido-crystalline synechias (17.5%), macular edema (7.4%), optic atrophy (4.1%), papillary edema (2.5%) and peripheral retinal ischemia (1.7%). In our series, 41.3% of patients were under colchicine, 23.1% under oral corticosteroids, 9% under intravenous corticosteroids, 4.9% under topical corticosteroids, 8.2% under immunosuppressive drugs and 5.8% under vitamin K antagonists. After an average follow-up of 1 year, 40% of patients had stable visual acuity while receiving treatment, 23% had a significant decrease in visual acuity and 5% of cases had complete vision loss. Adequate therapy enables quick containment of the infection and decreases the frequency and severity of recurrences, thus leading to an improvement of the visual prognosis in our patients compared with outcomes in some previous case serie.


Assuntos
Síndrome de Behçet/complicações , Oftalmopatias/etiologia , Acuidade Visual , Corticosteroides/administração & dosagem , Adulto , Colchicina/administração & dosagem , Oftalmopatias/epidemiologia , Oftalmopatias/fisiopatologia , Feminino , Seguimentos , Humanos , Imunossupressores/administração & dosagem , Masculino , Prognóstico , Recidiva , Estudos Retrospectivos
5.
Graefes Arch Clin Exp Ophthalmol ; 257(9): 1981-1988, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31338586

RESUMO

PURPOSE: Vision of the elderly may be affected by typical age-related diseases like cataract and macular degeneration. Little is known about the effect of aging on visual difficulties and vision-related quality of life. This study was conducted to compare the ophthalmological health status of younger and older individuals within a large cohort study of residents of a greater metropolitan area (Berlin Aging Study II [BASE-II]). METHODS: A total of 1655 participants (805 men) aged 60 years and older and 494 participants (232 men) aged between 22 and 48 years from the Berlin Aging Study II were included in the analysis. The subjects were examined during a 2-day clinical examination period. History of ocular diseases, vision-related quality of life using the visual function questionnaire (VFQ- 25), refraction, distance and near visual acuity, tonometry, and color vision were provided. RESULTS: Older subjects performed significantly worse concerning distance and near visual acuity, color vision, and vision-related quality of life compared to young subjects. Intraocular pressure showed no significant difference between groups. Individuals are often unaware of existing eye diseases. CONCLUSION: The prevalence of ocular diseases and the impairment of vision increases with age. Although 98% of elderly subjects have reported to suffer from any ocular disease, subjective quality of life seems to be affected to a lesser extent.


Assuntos
Envelhecimento , Oftalmopatias/epidemiologia , Nível de Saúde , Qualidade de Vida , População Urbana , Acuidade Visual , Adulto , Distribuição por Idade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Berlim/epidemiologia , Oftalmopatias/fisiopatologia , Feminino , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários , Adulto Jovem
6.
Graefes Arch Clin Exp Ophthalmol ; 257(10): 2127-2135, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31321522

RESUMO

BACKGROUND: To estimate the prevalence of posterior segment eye lesions and to identify their ocular and systemic associations within the Gutenberg Health Study (GHS) in Germany. METHODS: Assessment and grading of fundus images as well as physical examination and history taking were performed in the cross-sectional analysis of 15,010 subjects (aged 35-74 years) using standardised procedures to determine the prevalence and associations of various posterior segment eye lesions. RESULTS: Fundus photographs of both eyes were available for 12,782 (85.2%; 50% female) subjects. The prevalence weighted to the region of Mainz and Mainz-Bingen in Germany was for choroidal nevi 2.4%, drusen of the optic nerve head 0.2%, tilted discs 1.5%, chorioretinal scars suggestive of toxoplasmosis 0.2%, retinitis pigmentosa 0.04% and persistent hyaloid artery 0.02%. Choroidal nevi were positively associated with a history of myocardial infarction (OR = 2.7, 95% confidence interval 1.2-6.2, p value = 0.017). Tilted discs were positively associated with increased intraocular pressure (OR = 1.09 per mm Hg (1.02-1.16), p = 0.011) and negatively associated with smoking (OR 0.4 (0.3-0.7), p = 0.0022). Participants with tilted discs had a mean spherical equivalent of - 3.6 dioptres (standard deviation 4.0) compared with - 0.4 dioptres (2.4) to those without. CONCLUSION: Our study is-to the best of our knowledge-the first to determine the prevalence of drusen of optic nerve head among Caucasians, to show a positive association between tilted discs and increased intraocular pressure and questions a possible link between choroidal nevi and myocardial infarction. It also showed that participants with tilted discs had a lower mean spherical equivalent than those without.


Assuntos
Oftalmopatias/diagnóstico , Segmento Posterior do Olho/diagnóstico por imagem , Adulto , Idoso , Topografia da Córnea , Estudos Transversais , Oftalmopatias/epidemiologia , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Disco Óptico/diagnóstico por imagem , Prevalência , Estudos Prospectivos , Microscopia com Lâmpada de Fenda
7.
Niger J Clin Pract ; 22(7): 988-996, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31293266

RESUMO

Background: Health-seeking behavior is important as it reveals the preventive, curative, and rehabilitative actions taken by individuals to rectify perceived ill-health. Aim and Objectives: To identify existing eye health-seeking behavior, factors influencing such behavior, and suggest ways in which the system can respond to the needs of the target population in order to reduce visual impairment and blindness. Methods: This was a descriptive cross-sectional study; 600 respondents were interviewed using a semistructured pretested questionnaire administered to every fifth new patient attending the eye clinic of University of Calabar Teaching Hospital (UCTH) for a period of 5 months by a single interviewer. People unable to respond appropriately were interviewed alongside their caregivers. Results: Poor distant vision was the most frequent ocular complaint in this study. The mean duration of complaint before presentation to any health facility was 370.65 ± 889.48 days with a range of 0-9,125 days. Nature of eye complaint was the most significant factor that determined how early respondents sought help (P < 0.001). Place of residence, nature of eye complaint, and employment status were significant determinants of the choice of place of first presentation for ocular complaints. Conclusion: There is need for improved eye health education and awareness for prompt presentation to an appropriate eye care professional at the onset of symptoms and even case finding for potentially blinding eye conditions.


Assuntos
Oftalmopatias/diagnóstico , Comportamentos Relacionados com a Saúde/etnologia , Conhecimentos, Atitudes e Prática em Saúde , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Pessoas com Deficiência Visual/estatística & dados numéricos , Adolescente , Adulto , Idoso , Cegueira/epidemiologia , Cegueira/etiologia , Criança , Pré-Escolar , Estudos Transversais , Oftalmopatias/epidemiologia , Feminino , Acesso aos Serviços de Saúde , Hospitais de Ensino , Humanos , Lactente , Recém-Nascido , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Atenção Primária à Saúde , Pesquisa Qualitativa , Fatores Socioeconômicos , Inquéritos e Questionários , Baixa Visão/epidemiologia , Baixa Visão/etiologia , Adulto Jovem
8.
BMC Ophthalmol ; 19(1): 145, 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31291941

RESUMO

BACKGROUND: Welders are at an increased risk of eye disorders as a result of their occupation, leading to enormous vocational and economic consequences. With limited published studies among welders in low resource settings, we sought to determine the prevalence, pattern and factors associated with ocular disorders among small-scale welders in Katwe, Kampala. METHODS: In a field-based cross-sectional study, we recruited 343 small-scale welders. Simple random sampling was done to select the study participants. A pretested questionnaire was used to collect information on demographics, ocular, general history, systemic and ocular examination. The proportion of small-scale welders with ocular disorders (defined as any abnormal finding on eye examination) was determined. The bivariate and multivariate analyses were carried out, using logistic regression methods at a level of significance of 0.05. RESULTS: The mean age of the participants was 36 years (SD ± 12). The overall prevalence of ocular disorders was found to be 59.9%. The common ocular disorders included conjunctiva disorders (32%) and presbyopia (27%). There was a statistically significant relationship between females (OR = 4.279, P-value = 0.007), age 35 and above (OR = 4.244, P-value< 0.001), history of foreign body removal (OR = 1.677, P-value = 0.041), and ocular disorders. CONCLUSIONS: There is a high prevalence of ocular disorders among small-scale welders. Conjunctiva disorders, presbyopia and myopia were the commonest. Being female, age 35 and above and foreign body removal, were significantly associated with ocular disorders among welders. Policies should be put in place to ensure all welders use proper personal -protective equipment (welding helmets), and also receive regular eye checkup and health education.


Assuntos
Oftalmopatias/epidemiologia , Doenças Profissionais/epidemiologia , Exposição Ocupacional/efeitos adversos , Medição de Risco/métodos , Acuidade Visual , Soldagem , Adolescente , Adulto , Idoso , Estudos Transversais , Oftalmopatias/diagnóstico , Oftalmopatias/etiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/diagnóstico , Doenças Profissionais/etiologia , Oftalmoscopia , Prevalência , Estudos Retrospectivos , Inquéritos e Questionários , Fatores de Tempo , Uganda/epidemiologia , Adulto Jovem
9.
Cesk Slov Oftalmol ; 74(6): 234-239, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31238691

RESUMO

BACKGROUND AND AIMS: To evaluate the characteristics and incidence of ophthalmic manifestations in patients with HIV (Human Immunodeficiency Virus) infection. MATERIALS AND METHODS: A retrospective evaluation of medical records of 147 patients with HIV infection (22 female, 125 male), the average age of 41 (range 22-79 years) examined by an ophthalmologist at the Clinic of Ophthalmology at the University Hospital Ostrava in years 1987 - 2015. RESULTS: Ophthalmic manifestations of HIV were observed in 16 patients (11.9 %). There was not observed ocular involvement in patients in asymptomatic stage of HIV infection. Ophthalmic complications were observed in 1 patients (0.7 %) in early symptomatic stage and 15 patients (10.2 %) with stage AIDS (Acquired Immune Deficiency Syndrome). The most frequent ocular symptoms were caused by the virus (HIV retinopathy, mikroangiopathy) - total of 13 infected (76.5 %). Three patients had opportunity infections (17.6 %). As a result of the underlying AIDS disease 5 patients died. Ocular findings were observed at 2 of those (40.0 %). CONCLUSION: Ocular manifestation are common finding in late stages of HIV infection. Ophthalmic examination is an integral part of the diagnostic algorithm of patients with HIV infection. Most frequently, ocular symptoms have been found within the group of patients with advanced part of disease, which is in relation with the body´s immune defense decrease thus death itself.


Assuntos
Oftalmopatias , Infecções por HIV , Adulto , Idoso , Oftalmopatias/epidemiologia , Oftalmopatias/virologia , Feminino , Infecções por HIV/complicações , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
10.
Korean J Ophthalmol ; 33(3): 287-293, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31179661

RESUMO

PURPOSE: To determine the frequency of ocular diseases in infants visiting the ophthalmology department of a tertiary care hospital. METHODS: This was a cross-sectional descriptive study conducted in the department of ophthalmology, Abbasi Shaheed Hospital, from January 2015 to May 2016. The study included 377 infants ranging in age from 1 day to less than 1 year who were, selected by a nonprobability consecutive sampling technique. A detailed history was taken, and a complete ocular examination was performed. Descriptive statistics were used to calculate the mean and standard deviation for age. Frequencies were calculated for ocular diseases along with the percentages. Outcome variables included various congenital and acquired diseases such as conjunctivitis, congenital cataract, glaucoma, nasolacrimal duct blockage, squint, trauma, and fundus abnormalities. RESULTS: The mean age of infants was 5.0 ± 3.7 months. There were 196 (52%) males and 181 (48%) females. The sample included 330 (87.5%) full term infants. Acquired ocular diseases occurred in 230 (61%) infants; and congenital diseases, in 147 (39%). The most common ocular disease was conjunctivitis, which occurred in 173 (46%) infants, followed by congenital blocked nasolacrimal duct, which occurred in 57 (15 %) infants. Conjunctivitis was more common among neonates than infants. CONCLUSIONS: Acquired ocular diseases were more common than congenital ocular diseases. The most common ocular pathology was conjunctivitis, followed by congenital nasolacrimal duct obstruction, in infants. Conjunctivitis was more common in neonates than infants.


Assuntos
Oftalmopatias/epidemiologia , Centros de Atenção Terciária/estatística & dados numéricos , Distribuição por Idade , Estudos Transversais , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Paquistão/epidemiologia , Estudos Prospectivos , Distribuição por Sexo
11.
BMC Health Serv Res ; 19(1): 430, 2019 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-31248402

RESUMO

BACKGROUND: Maternal and child health workers (MCHWs) are often the first point of contact with pregnant women, children, and caregivers. Therefore, they can play a significant role in early detection of causes of childhood blindness, facilitate prompt referral to specialized centers and provide health education to caregivers for preventive eye care. METHODS: This is a pre-test, post-test, single group, quasi-experimental study to evaluate the outcome of training MCHWs on common blinding childhood diseases. All MCHWs in Ifo Local Government Area were selected to participate in the study. Pre-training, qualitative data was obtained from two focus group discussions while quantitative data was obtained using a self-administered questionnaire. Three months post-training, quantitative data was obtained using the same self-administered questionnaire as was used pre-training. Total and percentage scores on the pre- and post-tests were calculated for each participant. A score of ≥70% was regarded as sufficient while < 70% score was regarded as insufficient. McNemar's test was used to determine differences in proportions between pre- and post-training quantitative measurements. RESULTS: Of the 65 MCHWs in the Local Government Area, 61 participated in the study giving a response rate of 93.8%. The age range of study participants was from 28 to 57 years with a mean age of 41 ± 8.3 years. The male: female ratio was 1:7.7. During the focus group discussions, measles was the most commonly mentioned cause of childhood blindness however, participants showed more knowledge of the signs and symptoms of new-born conjunctivitis. Based on a sufficient knowledge score of ≥70%, only one participant (1.6%) demonstrated sufficient knowledge on quantitative survey pre-training. Post-training, there was a statistically significant increase (20, 32.8%) in the proportion of participants with sufficient knowledge (McNemar's test p = .000). CONCLUSIONS: This study demonstrated that the training of MCHWs on common childhood blinding diseases (such as congenital cataract and congenital glaucoma) had the potential to improve knowledge regarding prevention, prompt recognition and early referral of common treatable potentially blinding diseases.


Assuntos
Cuidadores/educação , Oftalmopatias/diagnóstico , Conhecimentos, Atitudes e Prática em Saúde , Serviços de Saúde Materno-Infantil/organização & administração , Encaminhamento e Consulta/estatística & dados numéricos , Adulto , Criança , Diagnóstico Precoce , Oftalmopatias/epidemiologia , Oftalmopatias/prevenção & controle , Feminino , Grupos Focais , Humanos , Governo Local , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Gravidez , Pesquisa Qualitativa
12.
Wiad Lek ; 72(4): 575-578, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31055535

RESUMO

OBJECTIVE: Introduction: The sharp deterioration in the physical development of the younger generation is worrying. The morbidity of youth has increased by 29.9% compared with the last century. More than 33% of boys and girls, among first-year students with chronic diseases. The aim: Assessing the state of the students' body by examining the results of a survey among the second- and third-year students of the university using a specially designed questionnaire. PATIENTS AND METHODS: Materials and methods: The material on the assessment of the state of health and the characteristics of the organism has been processed by studying the results of a survey of young men and women aged 20-23, obtained on the basis of using the developed questionnaire. RESULTS: Results: Physical development has been studied in accordance with the state of health of the students, as well as a thorough study of a number of criteria: diseases of the musculoskeletal system were 37.1%, 49.7% and 43.45 among boys aged 20, 22 and 23 and respectively 33.3 %, 38.6% and 47.7% among girls in their 20s, 22s and 23s. The morbidity of eye was 18.0%, 3.8% and 9.9% among boys aged 20, 22 and 23 years and 17.7%, 17.1% and 7.7% among girls aged 20, 22 and 23 years. CONCLUSION: Conclusions: In the structure of morbidities are diseases of the musculoskeletal system, diseases of the nervous system and the organ of vision. Correlation of the characteristics of the level of students' health and their physical development have indicators on the level of educational adaptation and the number of diseases.


Assuntos
Nível de Saúde , Estudantes , Universidades , Oftalmopatias/epidemiologia , Feminino , Humanos , Masculino , Sistema Musculoesquelético/fisiopatologia , Inquéritos e Questionários , Adulto Jovem
13.
J Fr Ophtalmol ; 42(7): 722-729, 2019 Sep.
Artigo em Francês | MEDLINE | ID: mdl-31133401

RESUMO

INTRODUCTION: The goal of this study was to describe and analyze the ophthalmological manifestations found in 21 patients followed for Ehlers-Danlos Syndrome in our department. METHODS: This retrospective study analyzed 21 consecutive patients (17 women and 4 men) with Ehlers-Danlos syndrome seen in the Necker hospital, Paris, between April 2016 and November 2017. The mean age was 25.95 years (12-47). A complete evaluation was performed searching for symptoms, orthoptic evaluation and complete ophthalmologic examination with slit lamp examination of the anterior segment, pachymetry and fundus examination with fundus photography and OCT. RESULTS: Nineteen patients presented ophthalmological signs (90.5%). The most frequent ophthalmological signs were: ocular motility disorders in 15 patients (71.4%), with convergence insufficiency in 13 of them, blue sclera in 8 patients (38%) and dry eye syndrome in 7 patients (33%, with 2 patients with reduced Break-Up Time<10seconds and 5 with very reduced Break-Up Time<5seconds). Mean pachymetry was 539.25µm (365-612). One patient presented with bilateral keratoglobus (4.8%). High myopia was present in 2 patients (9.5%) and associated with retinal tears in one patient (4.8%). No patients presented with angioid streaks. DISCUSSION: In this study, the main ophthalmological sign was convergence insufficiency present in more than 60% of the patients. This highlights the importance of an orthoptic examination in patients with Ehlers-Danlos syndrome. Dry eye syndrome with tear film instability was frequent, even though the patients were young. Blue sclera was seen in 38% of the patients. We reported two patients with high myopia and one patient with keratoglobus in our cohort. No patients presented with angioid streaks, and mean pachymetry was normal in our series. CONCLUSION: An ophthalmological and orthoptic evaluation should be performed in all patients with Ehlers-Danlos syndrome to detect and treat ocular manifestations. If Ehlers-Danlos syndrome is suspected, ophthalmological examination can also provide support for the diagnosis.


Assuntos
Síndrome de Ehlers-Danlos/epidemiologia , Oftalmopatias/epidemiologia , Adolescente , Adulto , Criança , Estudos de Coortes , Síndrome de Ehlers-Danlos/complicações , Oftalmopatias/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paris/epidemiologia , Estudos Retrospectivos , Adulto Jovem
14.
Arch. Soc. Esp. Oftalmol ; 94(5): 211-217, mayo 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-180825

RESUMO

Objetivo: Determinar la epidemiología de todas las visitas a urgencias oftalmológicas incluyendo todos los grupos de edad durante los años 2014 y 2015 en dos hospitales de tercer nivel. Métodos: Fueron incluidos todos los pacientes que acudieron a urgencias oftalmológicas desde el 1 de enero de 2014 al 31 de diciembre de 2015. Las variables estudiadas fueron el sexo, la edad, el lugar de procedencia, la hora de llegada, el día de la semana, el mes y el año de la visita, el diagnóstico, el lugar de derivación al alta, el nivel de prioridad y el tiempo total de asistencia. Las patologías fueron clasificadas según los códigos CIE-9, MC. Resultados: Se produjeron un total de 39.869 visitas a urgencias entre los años 2014 y 2015. Estas fueron más frecuentes en el sexo femenino, los lunes y en los meses de abril, mayo y junio. La edad media fue de 46,24 años. El 73,42% de las visitas se clasificaron como no urgentes. La patología más frecuente atendida fue la conjuntivitis (17,28%), seguida de queratitis (15,31%) y desprendimiento de vítreo posterior (5,37%). La celulitis orbitaria fue la patología que cursó con un mayor porcentaje de ingresos (23%). La mayoría de los pacientes fueron derivados al alta a su domicilio (94,85%). Conclusiones: Dado que la gran mayoría de patologías atendidas en urgencias son no urgentes, es conveniente el establecimiento de medidas para conseguir una asistencia más eficiente, orientada a la patología urgente y que no consuma recursos innecesarios


Objectives: To determine the prevalence of ophthalmological emergency visits to two tertiary hospital in all age groups during years 2014 and 2015. Methods: All patients who attended Ophthalmological Emergency Department from 1 January 2014 to 31 December 2015 were included in the study. The demographic variables studied were gender, age, place of origin, time of arrival, day of the week, month and year of the visit, the diagnosis, destination on discharge, total time of the visit and priority. Pathologies were categorised using codes from ICD-9, CM. Results: A total of 39,869 visits were made between 2014 and 2015. Emergency consultations were more frequent among women, on Mondays, and from April to June. The mean age of the patients was 46.24 years old, and 73.42% of visits were classified as non-emergencies. The most frequent pathology was conjunctivitis (17.28%), followed by keratitis (15.31%), and vitreous detachment (5.37%). The pathology that led to more hospital admissions was orbital cellulitis (23%). The majority of patients (94.85%) were sent to their place of residence after the visit. Conclusions: Given that the great majority of Ophthalmological Emergency visits are categorised as non-emergencies, measures need to be set up in order achieve a more effective care focused on emergency pathology without using unnecessary resources


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Idoso , Serviços Médicos de Emergência/estatística & dados numéricos , Oftalmopatias/terapia , Oftalmopatias/epidemiologia , Prevalência , Estações do Ano , Espanha/epidemiologia
15.
Public Health ; 170: 103-112, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30991172

RESUMO

OBJECTIVES: To test a model of integrated pediatric eye care delivery and examine the prevalence and factors associated with childhood ocular morbidity in a peri-urban setting in Bangladesh. STUDY DESIGN: Cross-sectional, population-based study. METHODS: The study was conducted in three phases among children aged ≤15 years. Trained community health workers (CHWs) conducted awareness intervention and identified children with ocular problems. These children were then referred to the base hospital for examination and treatment by ophthalmologists. A pediatric ophthalmologist further examined the children with complicated eye diseases and ensured treatment at a tertiary public eye hospital. Awareness, referral patterns, and health-seeking behavior were also examined. All data were analyzed statistically using Statistical Package for Social Sciences. RESULTS: CHWs screened 33,549 eligible children and identified 1887 cases with ocular morbidity. The prevalence of ocular morbidity and childhood blindness were 5.63% (95% confidence interval [CI] = 5.27-6.16) and 0.060% (95% CI = 0.03-0.11), respectively. The most commonly observed ocular morbidities were refractive error (3.24%; 95% CI = 3.11-3.45), allergic eye conditions (1.2%; 95% = CI 0.74-1.27), and nasolacrimal duct obstruction (0.52%; 95% CI = 0.25-0.74). Blindness was more frequently seen in children aged <5 years than in those aged 5-15 years (χ2 = 7.25; P = 0.007). The causes of blindness were corneal opacity, congenital eye anomaly, cataract, retinopathy of prematurity, and retinoblastoma. The prevalence of ocular morbidity was higher among older children, boys, children with low parental education and income, and children from households dwelling in slums. CONCLUSIONS: This study demonstrated that in a setting where screening and treatment for vision problems remain low, ocular morbidity among children could be easily identified through well-designed community-based screening programs involving appropriately trained CHWs. Community mobilization, awareness, and early detection of childhood eye diseases, with effective referral mechanisms for accessing appropriate care, are crucially important to improve service delivery.


Assuntos
Oftalmopatias/epidemiologia , População Suburbana/estatística & dados numéricos , Adolescente , Bangladesh/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Prevalência , Fatores de Risco
16.
Nutrients ; 11(4)2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30978959

RESUMO

Clinical recommendations relating to dietary omega-3 essential fatty acids (EFAs) should consider an individual's baseline intake. The time, cost, and practicality constraints of current techniques for quantifying omega-3 levels limit the feasibility of applying these methods in some settings, such as eye care practice. This preliminary validation study, involving 40 adults, sought to assess the validity of a novel questionnaire, the Clinical Omega-3 Dietary Survey (CODS), for rapidly assessing long-chain omega-3 intake. Estimated dietary intakes of long-chain omega-3s from CODS correlated with the validated Dietary Questionnaire for Epidemiology Studies (DQES), Version 3.2, (Cancer Council Victoria, Melbourne, Australia) and quantitative assays from dried blood spot (DBS) testing. The 'method of triads' model was used to estimate a validity coefficient (ρ) for the relationship between the CODS and an estimated "true" intake of long-chain omega-3 EFAs. The CODS had high validity for estimating the ρ (95% Confidence Interval [CI]) for total long-chain omega-3 EFAs 0.77 (0.31-0.98), docosahexaenoic acid 0.86 (0.54-0.99) and docosapentaenoic acid 0.72 (0.14-0.97), and it had moderate validity for estimating eicosapentaenoic acid 0.57 (0.21-0.93). The total long-chain omega-3 EFAs estimated using the CODS correlated with the Omega-3 index (r = 0.37, p = 0.018) quantified using the DBS biomarker. The CODS is a novel tool that can be administered rapidly and easily, to estimate long-chain omega-3 sufficiency in clinical settings.


Assuntos
Registros de Dieta , Dieta , Oftalmopatias/epidemiologia , Ácidos Graxos Ômega-3/administração & dosagem , Inquéritos e Questionários/normas , Adulto , Estudos Transversais , Oftalmopatias/prevenção & controle , Ácidos Graxos Ômega-3/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Optometria/métodos , Reprodutibilidade dos Testes , Vitória/epidemiologia
17.
PLoS One ; 14(3): e0210845, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30925156

RESUMO

BACKGROUND: Temporal artery biopsy (TAB) is useful in assisting with giant cell arteritis (GCA) diagnosis but lacks sensitivity. The aim of our study was to assess the diagnostic impact of TAB histology in patients with suspected GCA on hospital admission. METHODS: A prospectively maintained database was queried for all TABs performed between 1-1-2000 until 31-12-2017 at the University Hospital of Ioannina. Thus, inclusion criteria were made on the grounds of every patient that underwent a TAB during the above-mentioned period, regardless of demographic, clinical and laboratory data. RESULTS: Two hundred forty-five TABs were included (149 females and 96 males), with a mean age of 64.5 (±3.5) years. The mean symptoms duration until admission to the hospital was 8.6 (±1.3) weeks and all had elevated acute phase reactants on admission. The reasons of admission were fever of unknown origin (FUO) in 114 (46.5%) patients, symptoms of polymyalgia rheumatica (PMR) in 84 (34.3%), new headache in 33 (13.5%), anemia of chronic disease (ACD) in 8 (3.32%) and eye disturbances in 6 (2.5%) patients. Positive results were found in 49 (20%) TABs. More specifically, in 14% of patients with FUO, 21% in those with PMR, while in patients with a new headache the percentage was 27%. Finally, 5 out of 6 (83.3%) of patients with ocular symptoms and only one (12.5%) of those suffering from ACD. Visual manifestations and FUO are correlated with a positive TAB. CONCLUSION: It seems that TAB is useful in assisting with GCA diagnosis, but lacks sensitivity.


Assuntos
Arterite de Células Gigantes/diagnóstico , Artérias Temporais/patologia , Idoso , Anemia/epidemiologia , Anemia/etiologia , Biópsia , Oftalmopatias/epidemiologia , Oftalmopatias/etiologia , Feminino , Febre de Causa Desconhecida/epidemiologia , Febre de Causa Desconhecida/etiologia , Arterite de Células Gigantes/patologia , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Polimialgia Reumática/epidemiologia , Polimialgia Reumática/etiologia , Estudos Prospectivos , Sensibilidade e Especificidade , Centros de Atenção Terciária
18.
Expert Rev Clin Pharmacol ; 12(4): 309-328, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30840840

RESUMO

INTRODUCTION: Ocular dysfunctions and toxicities induced by antiepileptic drugs (AEDs) are rarely reviewed and not frequently received attention by treating physicians compared to other adverse effects (e.g. endocrinologic, cognitive and metabolic). However, some are frequent and progressive even in therapeutic concentrations or result in permanent blindness. Although some adverse effects are non-specific, others are related to the specific pharmacodynamics of the drug. Areas covered: This review was written after detailed search in PubMed, EMBASE, ISI web, SciELO, Scopus, and Cochrane Central Register databases (from 1970 to 2019). It summarized the reported ophthalmologic adverse effects of the currently available AEDs; their risks and possible pathogenic mechanisms. They include ocular motility dysfunctions, retinopathy, maculopathy, glaucoma, myopia, optic neuropathy, and impaired retinal vascular autoregulation. In general, ophthalmo-neuro- or retino-toxic adverse effects of AEDs are classified as type A (dose-dependent), type B (host-dependent or idiosyncratic) or type C which is due to the cumulative effect from long-term use. Expert opinion: Ocular adverse effects of AEDs are rarely reviewed although some are frequent or may result in permanent blindness. Increasing knowledge of their incidence and improving understanding of their risks and pathogenic mechanisms are crucial for monitoring, prevention, and management of patients' at risk.


Assuntos
Anticonvulsivantes/efeitos adversos , Cegueira/induzido quimicamente , Oftalmopatias/induzido quimicamente , Animais , Anticonvulsivantes/administração & dosagem , Cegueira/epidemiologia , Progressão da Doença , Relação Dose-Resposta a Droga , Oftalmopatias/epidemiologia , Oftalmopatias/fisiopatologia , Humanos , Fatores de Tempo
19.
Autoimmun Rev ; 18(5): 493-500, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30844550

RESUMO

OBJECTIVE: To analyse the ocular manifestations of patients with GPA, their treatment and outcome. METHODS: Retrospective cohort study performed at the National Referral Center for Vasculitis, Cochin Hospital, Paris (France), from January 2005 to December 2015. Among 308 patients with a new diagnosis of GPA in accordance with the American College of Rheumatology classification criteria and/or revised Chapel Hill nomenclature definitions, we identified those with ocular involvement and a subsequent follow up in our center. RESULTS: The prevalence of ocular involvement in our GPA series was 38.6%; 63 patients were analysed with a median follow-up of 50.5 months (IQR: 17.8-82.8). Scleritis (18 patients, 28.6%) and episcleritis (18 patients, 28.6%) were the most common ophthalmologic manifestations, followed by orbital disease (13 patients, 20.6%). Bilateral involvement and visual acuity loss was seen in 29.1% and 16.7% of patients, respectively. Ocular involvement was the first GPA manifestation in 9 patients (14.3%), concomitant with systemic manifestation in 36 (57.1%), and occurred only during follow-up in 18 (28.6%). The indication for GPA treatment was suggested by ocular involvement in 12 patients (19.0%), by systemic features in 40 (63.5%) and by both ocular and systemic involvement in 11 (17.5%). Remission of ocular involvement was achieved in 51 patients (80.9%). In the remaining 12 (19.1%), symptoms persisted or even worsened, finally leading to rituximab (RTX) therapy in 8 of them (66.7%). Altogether, when used as first line or for refractory disease, ocular remission was achieved in 11 of the 12 cases (91.7%) treated with RTX versus 34 of the 47 cases (72.3%) treated with CYC (P = .260). Eye disease relapsed in 14 patients (22.2%). RTX allowed achievement of remission in 8 of them (57.1%). In the remaining six, other immunosuppressive drugs were used. CONCLUSIONS: Scleritis and episcleritis are the most common ocular manifestations in GPA, most of the time associated with other systemic manifestations. In >40% of cases, ocular manifestations were refractory to initial treatment or recurrent and led to RTX prescription, which appeared to be useful in these situations.


Assuntos
Oftalmopatias , Granulomatose com Poliangiite , Adulto , Estudos de Coortes , Oftalmopatias/diagnóstico , Oftalmopatias/epidemiologia , Oftalmopatias/etiologia , Oftalmopatias/terapia , Feminino , França/epidemiologia , Granulomatose com Poliangiite/complicações , Granulomatose com Poliangiite/diagnóstico , Granulomatose com Poliangiite/epidemiologia , Granulomatose com Poliangiite/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Rituximab/uso terapêutico , Resultado do Tratamento
20.
Can J Ophthalmol ; 54(1): 106-110, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30851761

RESUMO

OBJECTIVE: To report indications for eye removal, histopathological diagnosis, and surgical trends in enucleation versus evisceration over a 23-year period. DESIGN: Retrospective consecutive case series. PARTICIPANTS: All patients undergoing enucleation or evisceration at the Royal Alexandra Hospital in Edmonton, Canada, between January 1994 and December 2016. METHODS: Demographic information was recorded and archived hospital charts were accessed and reviewed for clinical diagnosis, histopathological diagnosis, and the type of implant used. Univariate and multivariable logistic regression analysis was performed. The study cohort was divided into 2 time periods by separating the first 10 years of the study period (1994-2004 inclusive) from the rest of the study time period (2005-2016 inclusive). RESULTS: A total of 786 patients with a mean age (±â€…SD) of 52 ±â€…23 years were included. The most common clinical diagnosis was blind painful eye (56%) followed by intraocular tumour (23%). Corresponding pathological examination of specimens revealed chronic inflammatory change (46%) and intraocular tumour (25%). Eyes with active infection were more likely to be eviscerated (odds ratio: 4.67; p < 0.001) when compared to other diagnostic groups, and all eyes diagnosed with intraocular tumours were enucleated. While most eyes in the study were enucleated, the proportion of eyes eviscerated increased over the study period (p = 0.010) from 8% between 1994-2004 to 14% between 2005-2016. CONCLUSIONS: While enucleation was performed more commonly overall, the incidence of evisceration increased throughout the study period. There were no instances of occult intraocular tumour in patients who were eviscerated.


Assuntos
Oftalmopatias/cirurgia , Enucleação Ocular/tendências , Evisceração do Olho/tendências , Olho/patologia , Previsões , Implantes Orbitários , Centros de Atenção Terciária/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Alberta/epidemiologia , Criança , Pré-Escolar , Oftalmopatias/diagnóstico , Oftalmopatias/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
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