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1.
Medicine (Baltimore) ; 98(38): e17223, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31567980

RESUMO

The purpose of the study was to investigate the relationship between corneal deformation amplitude (DA), which is the amount of corneal displacement at highest degree of concavity measured by Corvis Scheimpflug Technology (ST), and various optic nerve head parameters in patients with primary open-angle glaucoma (POAG).Fifty-eight POAG patients were included in this observational study. For each patient, DA with Corvis ST, color optic disc photography, and optic nerve head imaging by enhanced depth imaging with a Heidelberg spectralis optical coherence tomography (OCT), Cirrus OCT, and Heidelberg retina tomograph (HRT) were obtained. Pearson correlation was used to analyze the relationship between DA and optic nerve head parameters before and after adjusting for age, intraocular pressure, central corneal thickness, and axial length.Corneal DA was negatively associated with lamina cribrosa (LC) depth (r = -0.390, P = .003) after adjusting for confounders. It showed positive relationship with parapapillary atrophy (PPA) area (r = 0.321, P = .046). In addition, the corneal DA was negatively correlated with cup volume (r = -0.351, P = .017) and mean cup depth (r = -0.409, P = .005) measured by HRT.Corneal DA is related with optic nerve head parameters in patients with POAG. Patients with lower corneal DA showed greater LC depth, greater cup area, deeper cup, and smaller PPA than those with higher corneal DA.


Assuntos
Córnea/patologia , Glaucoma de Ângulo Aberto/patologia , Disco Óptico/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oftalmoscopia , Disco Óptico/diagnóstico por imagem , Retina/patologia , Tomografia de Coerência Óptica
2.
Medicine (Baltimore) ; 98(39): e17054, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574802

RESUMO

RATIONALE: To report the visual status and results of phacoemulsification cataract surgery in a young patient with Alport syndrome associated with bilateral anterior lenticonus. The milestone of this report is the use of anterior segment optical coherence tomography (AS-OCT) to confirm the central protrusion of the anterior surface of the crystalline lens. PATIENT CONCERNS: A 23-year-old young woman presented with severe progressive visual loss in both eyes, which started several years ago. DIAGNOSES: Refractive status was indicative of high myopia with astigmatism and vision was not improved with optimal correction to better than 0.1 in the right eye and 0.2 in the left eye (visual acuities given in decimal notation). Slit-lamp examination showed transparent cornea, anterior lenticonus and posterior sub-capsular cataract in both eyes. The classical appearance of oil droplet was evident using retro-illumination on the slit lamp. INTERVENTIONS: The natural lenses were replaced with intraocular lens (IOL). OUTCOMES: An excellent refractive status achieved associated with an uncorrected distance visual acuity 0.9 and 0.8 in the right and left eye, respectively. LESSONS: AS-OCT is a valuable device for confirming the budging of the anterior crystalline lens surface.


Assuntos
Cápsula do Cristalino/patologia , Cápsula do Cristalino/cirurgia , Córtex do Cristalino/patologia , Córtex do Cristalino/cirurgia , Nefrite Hereditária/patologia , Nefrite Hereditária/cirurgia , Facoemulsificação , Feminino , Humanos , Cápsula do Cristalino/diagnóstico por imagem , Córtex do Cristalino/diagnóstico por imagem , Nefrite Hereditária/diagnóstico por imagem , Tomografia de Coerência Óptica , Baixa Visão/diagnóstico por imagem , Baixa Visão/etiologia , Baixa Visão/cirurgia , Adulto Jovem
3.
Medicine (Baltimore) ; 98(35): e16886, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31464918

RESUMO

RATIONALE: Posterior scleritis is an ocular inflammatory disorder that can be associated with both infectious and non-infectious immune reactions. Behcet disease is a chronic, relapsing, multisystemic inflammatory disorder with uveitis. There are no reported cases of posterior scleritis with Bechet disease. PATIENT CONCERNS: A 50-year-old man previously diagnosed with systemic Behcet disease presented with ocular pain and decreased vision in the left eye. DIAGNOSIS: Posterior scleritis associated with Behcet disease was diagnosed based on optical coherence tomography showing choroidal folds, as well as contrast computed tomography and ultrasound sonography demonstrating thickening of the posterior sclera. INTERVENTIONS: Treatment with systemic corticosteroids was initiated. Since inflammation relapsed during steroid tapering, anti-tumor necrosis factor-alpha (TNF-α) therapy was used in combination, and tapering of steroids was possible without recurrence of inflammation for 12 months. OUTCOMES: Posterior scleritis was resolved and visual acuity improved. With the continuation of TNF-α therapy, oral prednisolone was successfully tapered and discontinued. No relapse of inflammation was observed at follow-up 1 year after discontinuation of prednisolone. LESSONS: Ophthalmologists should be aware of the possibility of rare manifestation of posterior scleritis in patients with Behcet disease, and that combined use of systemic steroids and anti-TNF-α therapy may resolve the scleritis without recurrence of inflammation.


Assuntos
Corticosteroides/uso terapêutico , Síndrome de Behçet/complicações , Esclerite/diagnóstico por imagem , Fator de Necrose Tumoral alfa/uso terapêutico , Corticosteroides/farmacologia , Humanos , Masculino , Pessoa de Meia-Idade , Esclerite/tratamento farmacológico , Esclerite/etiologia , Tomografia de Coerência Óptica , Resultado do Tratamento , Fator de Necrose Tumoral alfa/farmacologia , Ultrassonografia , Acuidade Visual/efeitos dos fármacos
4.
BMC Ophthalmol ; 19(1): 174, 2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31395040

RESUMO

BACKGROUND: A patient's health literacy is fundamental for navigating the health system and managing disease. This study aimed to compare the health literacy levels of patients with chronic retinal disease in Denmark. METHODS: This cross-sectional questionnaire study used the validated HLS-EU-Q16 questionnaire to determine the health literacy of 225 patients with age-related macular degeneration (AMD), diabetic macular edema (DME) or retinal vein occlusion (RVO), receiving intravitreal treatment at the retinal clinic, Zealand University Hospital, Denmark. Patients were consecutively included as participants for the study. All patients had the option of having the survey read aloud to them. RESULTS: Health literacy levels between the patient groups did not differ significantly, however, the proportion of patients with poor health literacy was high-65% of AMD patients, 73% of DME patients, and 63% of patients with RVO. CONCLUSIONS: Low health literacy of patients with retinal disease signify a need for more health literacy research in the field of retinal diseases, to secure that patients have the timely and appropriate knowledge and competencies to manage their condition.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Alfabetização em Saúde/estatística & dados numéricos , Educação de Pacientes como Assunto/normas , Doenças Retinianas/psicologia , Acuidade Visual , Idoso , Doença Crônica , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Retinianas/diagnóstico , Estudos Retrospectivos , Fatores Socioeconômicos , Inquéritos e Questionários , Fatores de Tempo , Tomografia de Coerência Óptica
5.
BMC Ophthalmol ; 19(1): 176, 2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31395052

RESUMO

BACKGROUND: This report describes a case in which hyperopic femtosecond laser-assisted in situ keratomileusis (FS-LASIK) was performed following small incision lenticule extraction (SMILE) lenticule in situ implantation. CASE PRESENTATION: The hyperopic left eye of a 46-year-old patient with refraction of + 7.75 diopters sphere (DS)/- 1.25 diopters cylinder (DC) × 5° and corrected distance visual acuity (CDVA) of 20/50 mistakenly underwent the SMILE procedure for myopic astigmatism (- 8.50 DS/- 1.50 DC × 175°) due to medical negligence. The extracted lenticule was subsequently re-implanted in situ. After 8 months, the left eye underwent FS-LASIK to correct hyperopia and astigmatism (+ 5.0 DS/- 0.75 DC × 100°). Two years after FS-LASIK, corneal tomography showed no ectasia and microscopy revealed transparent cornea. The left eye exhibited CDVA of 20/50 with refraction of - 0.75 DS/- 0.25 DC × 165°. CONCLUSIONS: SMILE lenticule in situ implantation offers a solution for corneal volume and thickness restoration. FS-LASIK provides feasible correction of refractive error following lenticule re-implantation. Future studies are needed for determining the effectiveness of the treatment.


Assuntos
Substância Própria/patologia , Transplante de Córnea/métodos , Hiperopia/cirurgia , Ceratomileuse Assistida por Excimer Laser In Situ/efeitos adversos , Miopia/etiologia , Refração Ocular/fisiologia , Acuidade Visual , Topografia da Córnea , Seguimentos , Humanos , Hiperopia/fisiopatologia , Masculino , Pessoa de Meia-Idade , Miopia/fisiopatologia , Miopia/cirurgia , Reoperação , Fatores de Tempo , Tomografia de Coerência Óptica
6.
BMC Ophthalmol ; 19(1): 178, 2019 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-31399077

RESUMO

BACKGROUND: This study is to evaluate the accuracy of machine learning for differentiation between optic neuropathies, pseudopapilledema (PPE) and normals. METHODS: Two hundred and ninety-five images of optic neuropathies, 295 images of PPE, and 779 control images were used. Pseudopapilledema was defined as follows: cases with elevated optic nerve head and blurred disc margin, with normal visual acuity (> 0.8 Snellen visual acuity), visual field, color vision, and pupillary reflex. The optic neuropathy group included cases of ischemic optic neuropathy (177), optic neuritis (48), diabetic optic neuropathy (17), papilledema (22), and retinal disorders (31). We compared four machine learning classifiers (our model, GoogleNet Inception v3, 19-layer Very Deep Convolution Network from Visual Geometry group (VGG), and 50-layer Deep Residual Learning (ResNet)). Accuracy and area under receiver operating characteristic curve (AUROC) were analyzed. RESULTS: The accuracy of machine learning classifiers ranged from 95.89 to 98.63% (our model: 95.89%, Inception V3: 96.45%, ResNet: 98.63%, and VGG: 96.80%). A high AUROC score was noted in both ResNet and VGG (0.999). CONCLUSIONS: Machine learning techniques can be combined with fundus photography as an effective approach to distinguish between PPE and elevated optic disc associated with optic neuropathies.


Assuntos
Oftalmopatias Hereditárias/diagnóstico , Aprendizado de Máquina/normas , Disco Óptico/diagnóstico por imagem , Doenças do Nervo Óptico/diagnóstico , Neurite Óptica/diagnóstico , Células Ganglionares da Retina/patologia , Acuidade Visual , Diagnóstico Diferencial , Humanos , Fibras Nervosas/patologia , Curva ROC , Reprodutibilidade dos Testes , Tomografia de Coerência Óptica/métodos
7.
Vestn Oftalmol ; 135(3): 39-45, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31393446

RESUMO

PURPOSE: To assess the changes in photoreceptor retinal layers and the choroid in comparison with bioelectrical activity of the macula in patients with retinitis pigmentosa (RP). MATERIAL AND METHODS: The study included 10 patients (20 phakic eyes) with RP. Mean age was 27±18.5 years; mean best corrected visual acuity was 0.38±0.22. In addition to standard ophthalmological examination and fundus photography, each patient underwent an electrophysiological study on an electroretinograph MBN (Russia) recording general electroretinogram (ERG), maximal ERG (cone-rod response), 30 Hz flicker ERG and macular ERG (mERG). Choroidal thickness (CT) measurement and segmentation of the retina with following calculation of the thickness of different retinal layers was performed on SD-OCT RS-3000 Advance 'Nidek', Japan), it included obtainment of the 6-mm-diameter map in accordance with the Early Treatment Diabetic Retinopathy Study (ETDRS). RESULTS: The study revealed a decrease in thickness of the choroid, retina, and the photoreceptor layers: 1) the layer with photoreceptor outer segment (OS) and retinal pigment epithelium (RPE) and 2) the layer with photoreceptor inner segment (IS) and outer nuclear layer. Decreased thickness of these layers is associated with the reduction of bioelectric activity of the macula as seen with mERG. CONCLUSION: Decreased thickness of the retina, choroid and photoreceptor layers in all segments of the macula according to EDTRS standards is associated with reduced bioelectric activity of the macula recorded with mERG.


Assuntos
Retinite Pigmentosa , Tomografia de Coerência Óptica , Adolescente , Adulto , Criança , Corioide , Humanos , Pessoa de Meia-Idade , Células Fotorreceptoras de Vertebrados , Federação Russa , Adulto Jovem
8.
Vestn Oftalmol ; 135(3): 55-66, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31393448

RESUMO

INTRODUCTION: Pregnancy is a risk factor for progression of diabetic retinopathy (DR). Despite the common opinion about the regression of DR after childbirth, it is possible for the disease to progress aggressively, which can cause loss of visual functions when treated untimely. PURPOSE: To present clinical cases with different course of development of DR in pregnant women with type 1 diabetes mellitus (DM1). MATERIAL AND METHODS: Five pregnant women with DM1 lasting more than 8 years were examined. Glycemic level of all patients was higher than normal (glycated hemoglobin (HbA1c) of more than 6.1%). Ophthalmologic examination was carried out including fundus photography, optical coherence tomography (OCT) of the macular area, Angio-OCT. RESULTS: The most significant factors in the progression of DR in pregnant women are DR1 compensation, severity and stabilization of DR during the preconception period, presence of a concomitant pathology. Timely detection of signs of progression of DR and therapeutic measures taken during pregnancy, in particular laser coagulation, were shown to stabilize the course of the disease and prevent loss of vision in pregnant women with DM1. CONCLUSION: Clinical course of DR in pregnancy can vary between absence of manifestation, stabilization, and progression. Progression of DR during pregnancy is determined by a number of factors including compensation of DM during the preconception period and throughout pregnancy, severity and stabilization of retinopathy during the preconception period, and presence of a concomitant pathology. Timely detection of the signs of DR progression and its treatment, in particular laser coagulation of the retina, can help stabilize the course of the disease during pregnancy. The course of DR may be aggressive in some pregnant women involving progression in the postpartum period, which warrants active monitoring of patients with retinopathy after childbirth.


Assuntos
Diabetes Mellitus Tipo 1 , Retinopatia Diabética , Diabetes Gestacional , Feminino , Hemoglobina A Glicada , Humanos , Gravidez , Retina , Tomografia de Coerência Óptica
9.
Vestn Oftalmol ; 135(3): 90-98, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31393451

RESUMO

Pseudophakic cystoid macular edema (CMO) known to appear in 0.1-2.35% of patients after phacoemulsification is one of the common causes of vision decrease during the postoperative period. The authors analyze a case of CMO development in a pseudophakic patient diagnosed 7 months after uncomplicated phacoemulsification. Optical coherence tomography (OCT) was suggested for patients with low vision and a sensation of shroud before the eye for early diagnosis of pathological process. Intravitreal injection of the 0.7 mg dexamethasone micro-implant performed soon after establishing diagnosis was proved to be viable for postoperative CMO arrest in patients without previous treatment. One month after intravitreal implant injection the visual acuity in the patient's eye improved from 0.4 to 0.7, and retinal thickness in the macular area decreased from 705 to 255 µm. The result remained stable for 10 months. Intravitreal micro-implant appeared to have higher efficiency in contrast with traditional treatment methods (according to literature data), which was attributed to direct drug delivery to the area of pathological process. The use of 0.7 mg dexamethasone implant did not increase the intraocular pressure indicating its potential viability for patients with compensated glaucoma.


Assuntos
Edema Macular , Dexametasona , Implantes de Medicamento , Glucocorticoides , Humanos , Injeções Intravítreas , Tomografia de Coerência Óptica
10.
Beijing Da Xue Xue Bao Yi Xue Ban ; 51(4): 753-757, 2019 Aug 18.
Artigo em Chinês | MEDLINE | ID: mdl-31420635

RESUMO

OBJECTIVE: To construct swept source optical coherence tomography (SS-OCT) imaging system for root canal endoscopy, and to evaluate the accuracy of diagnosing artificial root fractures. METHODS: An ultra-high-speed (40 kHz) swept laser source was developed based on the piezoelectric tuning filter and the Fourier domain mode locking (FDML) swept laser technology (patent number: 200620135940.2). Ultra-miniature gradient index lens technology (patent number: 201320241218.7) was used to create a thin endoscopic probe with a diameter of 0.86 mm for real-time image transmission. The SS-OCT light source had a wavelength of 1 310 nm and a bandwidth of 100 nm. The axial and transverse image resolutions were 15 µm and 25 µm, respectively. Artificial fractures were created on human mandibular premolars with single root and the premolar roots were prepared to 41 horizontal sections (1 mm thick). 27 root sections with fractures (width: 52-284 µm) and 14 the sections without fractures were observed under an optical stereomicroscope with a cold light source as the gold standard. The horizontal root sections were scanned by self-developed SS-OCT imaging system for root canal endoscopy with a central wavelength of 1 310 nm and bandwidth of 100 nm. The data were reconstructed with 30 µm thick slices at an interval of 30 µm. Two observers, a radiologist and an endodontist, were trained and independently evaluated all the reconstructed images blindly. The diagnostic performance of SS-OCT imaging system was calculated, and statistical analysis was performed. RESULTS: SS-OCT root canal endoscopic imaging system composed of high-speed swept laser source, fiber coupler, endoscopic probe, reference arm and differential detector. Root sections could be scanned by SS-OCT and imaged in realtime at a depth of 1 to 2 mm. The kappa value for interobserver agreement was 0.792, and the intraobserver agreement was 1.000 and 0.709 for two observers respectively. All of 27 fractured root sections and 12 of 14 root sections without fractures were accurately diagnosed while 2 unfractured root sections were misdiagnosed. The sensitivity was 1.000 and the specificity was 0.857 for diagnosis of artificial root fractures by SS-OCT. The positive predictive value (PPV), negative predictive value (NPV) and the overall accuracy rate were 0.931, 1.000 and 0.951 respectively. CONCLUSION: The swept source optical coherence tomography imaging system for root canal endoscopy is a promising imaging method for observing root fractures..


Assuntos
Cavidade Pulpar , Tomografia de Coerência Óptica , Endoscopia , Humanos , Tratamento do Canal Radicular , Raiz Dentária
11.
Cornea ; 38(9): 1154-1160, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31394554

RESUMO

PURPOSE: This study aimed to predict the best-corrected visual acuity (BCVA) based on swept-source optical coherence tomography (SS-OCT) parameters in eyes with keratoconus. METHODS: We retrospectively reviewed 135 eyes of 135 patients with keratoconus (mean age: 31.9 ± 12.4 years). The average keratometry value and BCVA (logarithm of the minimal angle of resolution [Snellen]) were 48.68 ± 5.44 diopter and 0.20 ± 0.36 (20/25), respectively. Eleven parameters were calculated using SS-OCT. Apart from the corneal height and elevation, all the other parameters were calculated from both anterior and posterior corneal OCT data. The patients were divided into 2 groups, 1 for creating the prediction equation (prediction group, 86 eyes) and another for verifying the equation (verification group, 49 eyes). In the former, individual correlations between the BCVA and SS-OCT parameters were analyzed. A stepwise multiple regression analysis was performed with the BCVA as a dependent variable and SS-OCT parameters as independent variables. After its creation, the accuracy of the prediction equation was verified in the verification group. RESULTS: All the parameters, except for age and total corneal cylinder, showed statistically significant correlations with BCVA (P < 0.0001). Using the stepwise multiple regression analysis, we selected 2 explanatory variables: root mean square of anterior corneal elevation (standardized regression coefficient: 1.221; P < 0.0001) and total coma aberration (standardized regression coefficient: -0.575; P = 0.001; adjusted R = 0.546). The prediction was correct in 84.6% of the eyes within ±1 line of Snellen BCVA. CONCLUSIONS: Using the equation we derived from SS-OCT parameters is a promising method to predict visual function in patients with keratoconus.


Assuntos
Córnea/fisiopatologia , Topografia da Córnea/métodos , Ceratocone/diagnóstico , Tomografia de Coerência Óptica/métodos , Acuidade Visual/fisiologia , Adulto , Feminino , Humanos , Ceratocone/fisiopatologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Adulto Jovem
12.
BMC Ophthalmol ; 19(1): 179, 2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31409322

RESUMO

BACKGROUND: Vogt-Koyanagi-Harada (VKH) disease is a T-cell-mediated autoimmune disorder characterized by bilateral granulomatous panuveitis with various systemic manifestations. Although VKH disease rarely occurs in the pediatric population, the clinical course tends to be aggressive, and the visual prognosis is worse than that in adult patients due to severe ocular complications secondary to recurrent inflammation. CASE PRESENTATION: A 3-year-old girl with probable VKH was referred to Kobe University Hospital. She had severe bilateral panuveitis with posterior synechiae of the iris, marked optic disk swelling, and serous retinal detachment in both eyes, and her best corrected visual acuities (BCVAs) were 20/200 OD and 20/125 OS. A third course of therapy was administered because serous retinal detachment remained after two courses of therapy. She was treated with three courses of high-dose intravenous corticosteroid therapy, followed by slow tapering of oral corticosteroids. Her BCVAs recovered to 20/16 OU, and relapse of ocular inflammation and side effect of treatment were not observed during the 1.5-year follow-up period. CONCLUSIONS: We experienced a pediatric patient with probable VKH disease who was treated with three courses of high-dose intravenous corticosteroid therapy. With the favorable clinical course in our patient, initial treatment with repeated high-dose intravenous corticosteroid therapy might be beneficial in pediatric VKH disease.


Assuntos
Angiofluoresceinografia/métodos , Pressão Intraocular/fisiologia , Metilprednisolona/uso terapêutico , Tomografia de Coerência Óptica/métodos , Síndrome Uveomeningoencefálica/diagnóstico , Acuidade Visual , Pré-Escolar , Feminino , Fundo de Olho , Glucocorticoides/uso terapêutico , Humanos , Oftalmoscopia , Recidiva , Síndrome Uveomeningoencefálica/tratamento farmacológico , Síndrome Uveomeningoencefálica/fisiopatologia
13.
BMC Ophthalmol ; 19(1): 182, 2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31409385

RESUMO

BACKGROUND: To compare and correlate anterior segment measurements of myopic eyes implanted with Implantable Collamer lens (ICL V4c) by using anterior segment optical coherence tomography (AS-OCT), Pentacam and ultrasound biomicroscopy (UBM). METHODS: Anterior chamber depth (ACD), distance between corneal endothelium and anterior surface of ICL(C-ICL) and central vault were measured in 82 phakic myopic eyes of 82 patients who underwent ICL surgery, by using AS-OCT, Pentacam and UBM consecutively at 3 months follow up. The correlation and agreement of instruments were accessed by using Intraclass correlation coefficient (ICC) and the Bland-Altman plot. RESULTS: AS-OCT showed higher ACD, C -ICL and central vault measurements than both of Pentacam and UBM (P < 0.001), while Pentacam showed lower measurements than UBM (P < 0.05). The Pearson correlation coefficient (r) was 0.91 to 0.96, and ICC was 0.95 to 0.98 for all measurements between difference devices (all P < 0.001). The 95% limits of agreement of ACD, C-ICL, vault measurements were 0.13 to 0.38 mm, - 0.07 to 0.27 mm, 0.08 to 0.34 mm between AS-OCT and Pentacam, - 0.03 to 0.33 mm, - 0.16 to 0.31 mm, - 0.10 to 0.26 mm between AS-OCT and UBM, and - 0.29 to 0.07 mm, - 0.25 to 0.20 mm, - 0.31 to 0.05 mm between Pentacam and UBM, respectively. CONCLUSIONS: AS-OCT demonstrated significantly higher value, while Pentacam demonstrated significantly lower value than UBM for ACD, C-ICL and central vault measurements in myopic eyes after ICL surgery. Measurements with these instruments were highly correlated, but could not replace each other especially for vault. This study provided valuable information about how to judge the results of anterior segment parameters of eyes implanted with ICL V4c from different devices. TRIAL REGISTRATION: Registration number: ChiCTR-OOC-16008987 . Retrospectively registered: 08 August 2016.


Assuntos
Segmento Anterior do Olho/diagnóstico por imagem , Microscopia Acústica/métodos , Miopia/diagnóstico , Lentes Intraoculares Fácicas , Refração Ocular/fisiologia , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Adulto , Feminino , Seguimentos , Humanos , Masculino , Miopia/fisiopatologia , Miopia/cirurgia , Período Pós-Operatório , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fatores de Tempo , Adulto Jovem
14.
BMC Ophthalmol ; 19(1): 183, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31412813

RESUMO

BACKGROUND: To evaluate the efficacy of epiretinal membrane removal in patients with good best-corrected visual acuity (BCVA) for improving visual function and quality of life (QOL). METHODS: This prospective case study compared 37 subjects with preoperative BCVA ≦ 0.046 logMAR (Good group) to 35 patients with 0.10-0.52 logMAR (Moderate group) at 3 and 6 months. Linear mixed-effect models were used for statistical analysis. The primary outcome was the horizontal metamorphopsia score (MH) at 6 months postoperatively (post-6 M), while secondary outcomes were postoperative BCVA, vertical metamorphopsia score (MV), aniseikonia, stereopsis and central foveal thickness. In the Good group, QOL was assessed using the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25) at 6 and 12 months. RESULTS: MH was significantly improved at post-3 M and post-6 M in the both groups but there were no significant differences between the two groups. MV showed no improvement at the final observation in either group. LogMAR BCVA was significantly improved at post-6 M in the Good group, which had significantly better vision than the Moderate group. Preoperative vertical and horizontal aniseikonia scores remained unchanged in the Good group at post-6 M but worsened in the Moderate group. The NEI VFQ-25 score improved in the Good group, reflecting improved general health, general vision, and mental health. CONCLUSIONS: Early epiretinal surgery for patients with BCVA ≦ 0.046 logMAR was effective for improvement of HM, BCVA, and QOL and prevented worsening of aniseikonia. TRIAL REGISTRATION: UMIN000021220 . Registered 10 September 2015. UMIN Clinical Trials Registry.


Assuntos
Percepção de Profundidade/fisiologia , Membrana Epirretiniana/cirurgia , Qualidade de Vida , Acuidade Visual/fisiologia , Vitrectomia/métodos , Idoso , Membrana Epirretiniana/diagnóstico , Membrana Epirretiniana/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Prospectivos , Retina/diagnóstico por imagem , Tomografia de Coerência Óptica
15.
BMC Ophthalmol ; 19(1): 186, 2019 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-31419954

RESUMO

BACKGROUND: This study aims to investigate the choroidal thickness and choroidal vascular density parameters and their correlation with severity of diabetic retinopathy (DR) in diabetes mellitus (DM) patients. METHODS: An observational cross-sectional study was conducted of 104 eyes, which were divided into 4 groups: Healthy controls (n = 38), DM with no DR eyes (n = 22), panretinal photocoagulation-untreated non-proliferative DR eyes (PRP-untreated NPDR eyes) (n = 24), PRP-untreated proliferative DR eyes (PRP-untreated PDR eyes) (n = 20). Optical coherence tomography (OCT) was performed. The total choroidal area (TCA), stromal area (SA), the luminal areas (LA) and the ratio of the luminal to choroidal area (L/C ratio) were compared. The choroidal parameters were also compared between PRP untreated and PRP-treated DR eyes. RESULTS: The L/C ratio values were 0.68 ± 0.06 in controls and 0.63 ± 0.04 in DM eyes (P < 0.001). But there were no statistically significant differences in retinal nerve fiber layer (RNFL) thickness, retinal thickness and subfoveal choroidal thickness (SCT) measurements between the two groups (P = 0.407, P = 0.654 and P = 0.849; respectively). The vessel density values were significantly different in DM with no DR eyes, PRP-untreated NPDR eyes and PRP-untreated PDR eyes (P < 0.001 for SCT, TCA and SA). The L/C ratio values in the three groups were significant different (P = 0.019). There was no significant difference in SCT, TCA, LA, SA and the L/C ratio between PRP-untreated and PRP-treated DR eyes. CONCLUSION: Eyes of patients with DM showed the L/C ratio decreased compared with normal controls. The SCT increased, but L/C ratio significantly decreased with severity of DR eyes compared with DM and normal eyes. Changes in the L/C ratio may predict DR development before they are otherwise evident clinically. Choroidal blood flow deficit can be an early pathologic change in DR.


Assuntos
Corioide/patologia , Diabetes Mellitus Tipo 2/complicações , Retinopatia Diabética/diagnóstico , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Capilares/patologia , Corioide/irrigação sanguínea , Estudos Transversais , Retinopatia Diabética/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Vasos Retinianos/diagnóstico por imagem , Estudos Retrospectivos , Índice de Gravidade de Doença
16.
BMC Ophthalmol ; 19(1): 171, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31382925

RESUMO

BACKGROUND: To investigate the area of foveal avascular zone (FAZ) and macular vessel density (VD) after correction for magnification error in unilateral amblyopia using optical coherence tomography angiography (OCTA). METHODS: Participants comprised 15 patients with unilateral amblyopia due to anisometropia with or without strabismus (mean age, 9.8 ± 3.4 years; range, 6-17 years). OCTA images were obtained by using spectral-domain OCT with angiography software. The OCTA scanning protocol used was 3 × 3-mm volume scan centered on the fovea. OCTA images were corrected for magnification errors using individual axial length (AL), and an adjusted 2.3 × 2.3-mm square was derived as a region of interest. The FAZ area and VD in both superficial capillary plexus (SCP) and deep capillary plexus (DCP) layers, foveal minimum thickness (FMT) were assessed using built-in OCTA software and ImageJ software (NIH, Bethesda, MD). RESULTS: LogMAR in the amblyopic eyes was significantly poorer than that of the fellow eye (p < 0.001). AL was significantly shorter in the amblyopic eye than in the fellow eye (p < 0.001). FAZ area of SCP in amblyopic eyes was significantly smaller than that of fellow eyes (p < 0.001). No significant differences were seen in FAZ area of DCP, VD of SCP, VD of DCP, and FMT between amblyopic and fellow eyes (p = 0.07, 0.43, 0.55, and 0.25, respectively). CONCLUSIONS: Our present study after magnification error correction found smaller FAZ area of SCP in the amblyopic eye compared with the fellow eyes, but there was no significant difference in the macular VD between the amblyopic and fellow eyes.


Assuntos
Ambliopia/diagnóstico , Angiofluoresceinografia/métodos , Macula Lutea/irrigação sanguínea , Vasos Retinianos/patologia , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Adolescente , Ambliopia/fisiopatologia , Capilares/patologia , Criança , Estudos Transversais , Feminino , Fóvea Central , Fundo de Olho , Humanos , Macula Lutea/diagnóstico por imagem , Masculino , Estudos Retrospectivos
17.
Asia Pac J Ophthalmol (Phila) ; 8(4): 280-284, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31369405

RESUMO

PURPOSE: The aim of this study was to provide a retrospective analysis of the presentation, demographics, and treatment regimens for ocular toxoplasmosis at a large tertiary referral uveitis center. DESIGN: Retrospective cohort study. PARTICIPANTS: A total of 48 patients with ocular toxoplasmosis who presented to Sydney Eye Hospital participated in this study. METHODS: This is a retrospective review of patient files who presented to Sydney Eye Hospital between 2007 and 2016 with clinical features consistent with ocular toxoplasmosis. Baseline risk factors and treatment details were recorded and analyzed. Main outcome measures were visual acuity and relapse rate compared with other studies in ocular toxoplasmosis. RESULTS: The median age was 35.5 (interquartile range 21-50) with 30 (60%) patients having no previous symptomatic episodes or evidence of chorioretinal scarring. Visual acuity at presentation was 0.51 or 6/19 (SE 0.096) and at follow-up 0.31 or 6/12 (SE 0.094). Nine patients experienced a recurrence during the period of observation with median time to recurrence 2.2 years (SE 0.45) and the relapse rate was 0.09/person-years. Location of lesion was predominantly within the vascular arcades (n = 44) with macular involvement in 9 patients. Most patients received clindamycin therapy (n = 34) with pyrimethamine and sulfadiazine was used for those with macula involvement. CONCLUSIONS: Patients with ocular toxoplasmosis had fewer recurrences compared with other published series and had better visual recovery. The majority of patients received clindamycin and oral prednisolone which were well tolerated with pyrimethazine and sulfadiazine reserved for those with macula-involving disease.


Assuntos
Anti-Infecciosos/administração & dosagem , Infecções Oculares Parasitárias/diagnóstico , Glucocorticoides/administração & dosagem , Centros de Atenção Terciária , Toxoplasmose Ocular/diagnóstico , Acuidade Visual , Administração Oral , Adulto , Anticorpos Antiprotozoários/análise , Austrália/epidemiologia , DNA de Protozoário/análise , Quimioterapia Combinada , Infecções Oculares Parasitárias/tratamento farmacológico , Infecções Oculares Parasitárias/epidemiologia , Feminino , Angiofluoresceinografia/métodos , Seguimentos , Fundo de Olho , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Prognóstico , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodos , Toxoplasma/genética , Toxoplasma/imunologia , Toxoplasma/isolamento & purificação , Toxoplasmose Ocular/tratamento farmacológico , Toxoplasmose Ocular/epidemiologia , Adulto Jovem
18.
Asia Pac J Ophthalmol (Phila) ; 8(4): 314-318, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31397675

RESUMO

PURPOSE: The aim of this study was to examine the hyperreflective dots seen in choroid on spectral domain optical coherence tomography (SDOCT) in eyes with diabetic macular edema (DME) and correlate it with visual acuity. DESIGN: Consecutive, cross-sectional case series of patients with DME between January 2017 and December 2017. METHODS: Eyes with DME having central foveal thickness ≥250 µm were included. SDOCT was performed using Spectralis system (Heidelberg Engineering, Germany). Hyperreflective choroidal foci (HCF) were defined as well-circumscribed dots within choroid having reflectivity equal to or higher than adjacent retinal pigment epithelium. HCF were counted manually within 1500 µm of fovea using a horizontal line scan by a blinded observer. Eyes were divided in 3 groups: group A (no HCF), group B (1-10 HCF), and group C (>10 HCF). RESULTS: One hundred nineteen eyes of 60 DME patients were included. Sixty (50.4%) eyes were in group A, whereas 42 (33.6%) and 17 (14.2%) eyes belonged to group B and group C, respectively. The mean logMAR best corrected visual acuity was significantly lower in group B (0.76 ±â€Š0.79) and C (1.2 ±â€Š0.78) as compared with group A (0.22 ±â€Š0.49) (P = 0.001). Mean central foveal thickness in group A (300.4 ±â€Š122.4 µm) was significantly lower than group B (455.52 ±â€Š209.1 µm) and group C (529.4 ±â€Š196.4 µm) with P value of 0.001. CONCLUSIONS: The present study describes HCF as novel prognostic SDOCT biomarker in DME whose presence denotes poor visual acuity. Further longitudinal studies are required to substantiate our findings.


Assuntos
Corioide/patologia , Retinopatia Diabética/complicações , Edema Macular/diagnóstico , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Estudos Transversais , Retinopatia Diabética/diagnóstico , Feminino , Angiofluoresceinografia/métodos , Seguimentos , Fundo de Olho , Humanos , Edema Macular/etiologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Epitélio Pigmentado da Retina/patologia , Estudos Retrospectivos , Índice de Gravidade de Doença
19.
Medicine (Baltimore) ; 98(35): e16589, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31464893

RESUMO

RATIONALE: Lipid deposition on the cornea without previous infection, inflammation, vascularization, or trauma is idiopathic lipid keratopathy. In vivo laser confocal microscopy (IVCM) and anterior segment optical coherence tomography (AS-OCT) are 2 noninvasive methods that can help identify the structures and morphological characteristics of the focus. PATIENT CONCERNS: A 63-year-old woman with ipsilateral corneal lipid deposits developing from a small white spot into a yellow-white superotemporal elliptic shape within a year. AS-OCT showed peripheral deep stromal deposits. IVCM showed hyper-reflective material with typical crystalline-like or needle-like structures in the superotemporal area. DIAGNOSIS: Idiopathic lipid degeneration. INTERVENTIONS: Topical steroids eye drops 3 times a day for a month and further consultation every 3 months. OUTCOMES: This patient of idiopathic lipid keratopathy was observed every 3 months and till now we have reviewed this patient twice. Topical steroids eye drops were only used during the first month. No further development was observed about the lesion and the patient's visual acuity remained good. CONCLUSION: IVCM and AS-OCT can help identify the characteristic crystalline-like or needle-like hyper-reflective material that could help diagnosis of idiopathic lipid degeneration.


Assuntos
Córnea/diagnóstico por imagem , Doenças da Córnea/tratamento farmacológico , Metabolismo dos Lipídeos , Esteroides/administração & dosagem , Administração Tópica , Córnea/metabolismo , Doenças da Córnea/diagnóstico por imagem , Doenças da Córnea/metabolismo , Feminino , Humanos , Metabolismo dos Lipídeos/efeitos dos fármacos , Microscopia Confocal , Pessoa de Meia-Idade , Esteroides/farmacologia , Tomografia de Coerência Óptica , Resultado do Tratamento , Acuidade Visual
20.
EuroIntervention ; 15(5): 434-451, 2019 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-31258132

RESUMO

This consensus document is the second of two reports summarizing the views of an expert panel organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) on the clinical use of intracoronary imaging including intravascular ultrasound (IVUS), optical coherence tomography (OCT), and near infrared spectroscopy (NIRS)-IVUS. Beyond guidance of stent selection and optimization of deployment, invasive imaging facilitates angiographic interpretation and may guide treatment in acute coronary syndrome. Intravascular imaging can provide additional important diagnostic information when confronted with angiographically ambiguous lesions and allows assessment of plaque morphology enabling identification of vulnerability characteristics. This second document focuses on useful imaging features to identify culprit and vulnerable coronary plaque, which offers the interventional cardiologist guidance on when to adopt an intracoronary imaging-guided approach to the treatment of coronary artery disease and provides an appraisal of intravascular imaging-derived metrics to define the haemodynamic significance of coronary lesions.


Assuntos
Síndrome Coronariana Aguda , Intervenção Coronária Percutânea , Síndrome Coronariana Aguda/cirurgia , Consenso , Angiografia Coronária , Vasos Coronários , Humanos , Tomografia de Coerência Óptica , Ultrassonografia de Intervenção
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