Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 27.717
Filtrar
1.
Pan Afr Med J ; 35: 1, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32117517

RESUMO

We report a case of sight threatening vitreous haemorrhage and retinal detachment as complication of sickle cell disease (SCD). A 35 years old female Nigerian patient had presented to ophthalmology clinic of Princess Marina Hospital, Botswana, with two weeks history of poor vision in the left eye. The loss of vision was due to vitreous haemorrhage and retinal detachment which was confirmed by direct and indirect ophthalmoscopy and B-Scan ultrasound. Prior to presentation, patient didn't have any follow up by an ophthalmologist as part of regular medical care for patients with SCD. We emphasize the importance of regular follow up for early detection, treatment and prevention of complication associated with sickle cell disease.


Assuntos
Anemia Falciforme/complicações , Descolamento Retiniano/diagnóstico , Hemorragia Vítrea/diagnóstico , Adulto , Feminino , Humanos , Oftalmoscopia , Descolamento Retiniano/etiologia , Ultrassonografia , Transtornos da Visão/diagnóstico , Transtornos da Visão/etiologia , Hemorragia Vítrea/etiologia
4.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(1): 31-35, 2020 Jan 10.
Artigo em Chinês | MEDLINE | ID: mdl-32062939

RESUMO

Objective: To understand the relationship between visual impairment and risk of all-cause mortality in the elderly aged 65 years and older in 8 longevity areas in China. Methods: The data of the elderly aged 65 years and older in the project in 2012 were obtained from Healthy Aging and Biomarkers Cohort Study, a sub-cohort of the Chinese Longitudinal Healthy Longevity Survey, including physical measurement and survival status, and a follow-up for survival outcomes were conducted in 2014 and 2017 respectively. Cox proportional hazard regression model was used to analyze the influence of visual impairment on mortality. Gender and age specific analysis was conducted. Results: A total of 1 736 elderly adults were included. A total of 943 deaths occurred during the 5-year follow-up period with a 5-year mortality rate of 54.3%. The 5-year mortality rate was 76.7% in the group with visual impairment, and 47.6% in the group without visual impairment (P<0.001). After adjusting for demographic information, life style and some disease factors, the risk of 5-year mortality in the group with visual impairment group was 1.30 times higher than that in the group without visual impairment (HR=1.30, 95%CI: 1.09-1.55). In the females, the risk for mortality in the group with visual impairment was 1.48 times higher than that in the group without visual impairment (HR=1.48, 95%CI:1.20-1.84). However, vision status was not associated with the risk for mortality in males (HR=1.02, 95%CI: 0.72-1.43). The risk for mortality in the group with visual impairment was 1.39 times higher than that in the group without visual impairment in the elderly aged over 90 years (HR=1.39, 95%CI: 1.13-1.70). Vision status was not associated with mortality risk in the elderly aged 65-79 years and 80-89 years (HR=1.37, 95%CI: 0.61-3.07; HR=0.95, 95%CI: 0.61-1.48). Conclusion: In the elderly people in China, visual impairment is a risk factor for mortality.


Assuntos
Longevidade , Transtornos da Visão , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos de Coortes , Feminino , Humanos , Estudos Longitudinais , Masculino , Modelos de Riscos Proporcionais , Fatores de Risco , Transtornos da Visão/mortalidade
5.
Medicine (Baltimore) ; 99(2): e17992, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31914011

RESUMO

INTRODUCTION: The study aimed to determine the effectiveness of an intervention for unhealthy visual behaviors of school-age children using a wearable device (Clouclip). METHOD: The design was a self-controlled prospective study. Clouclip, with the vibration alert disabled, was first applied to measure baseline near-work behaviors in the first week. The vibration alert was then enabled to signal unhealthy visual behaviors (near-work distance < 30 cm and >5 seconds, or near-work distance <60 cm for >45 minutes) for 3 weeks. Near-work behaviors were measured again at the first week and the first month after intervention, respectively. The changes in behaviors between the baseline and the first week and the first month after intervention were analyzed. RESULTS: Sixty-seven subjects were eligible for this experiment (the mean age 10.45 ±â€Š0.50 years, 34 boys). Children who logged sufficient wearing time (12.30 ±â€Š0.18 hours on weekdays and 12.16 ±â€Š0.23 hours on weekends) were included for analysis. The average daily near-work distance was significantly increased after the vibration intervention. The time ratio of near-work activity <30 cm to the total <60 cm and the frequency of continuous near-work (distance <60 cm and continuous time >30 minutes) were significantly decreased after the intervention. Although some of the effects were reversed with time following the intervention, some were observed to be maintained until the end of the observation period, and the improvement of the behaviors was more prominent in children who had a shorter near-work distance (<30 cm) at baseline. CONCLUSIONS: In conclusion, Clouclip can significantly modify near-work behaviors in school-age children and it can last a certain period of time. If these behaviors are causes of myopia development and progression, Clouclip might provide a strategy for managing myopia.


Assuntos
Comportamento Infantil/psicologia , Miopia/terapia , Transtornos da Visão/psicologia , Dispositivos Eletrônicos Vestíveis/efeitos adversos , Criança , Saúde da Família/educação , Saúde da Família/estatística & dados numéricos , Feminino , Humanos , Masculino , Miopia/etiologia , Miopia/psicologia , Prevalência , Estudos Prospectivos , Leitura , Transtornos da Visão/epidemiologia , Transtornos da Visão/prevenção & controle
6.
Cell Mol Life Sci ; 77(5): 779-780, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31897540

RESUMO

Prolonged life expectancies contribute to the increasing prevalence of age-related macular degeneration (AMD) that is already the leading cause of severe vision loss among the elderly in developed countries. In dry AMD, the disease culminates into vast retinal atrophy, whereas the wet form is characterized by retinal edema and sudden vision loss due to neovascularization originating from the choroid beneath the Bruch's membrane. There is no treatment for dry AMD and despite intravitreal injections of anti-vascular endothelial growth factor (VEGF) that suppress the neovessel formation, also wet AMD needs new therapies to prevent the disease progression and to serve patients lacking of positive response to current medicines. Knowledge on disease mechanisms is a prerequisite for the drug development, which is hindered by the multifactorial nature of AMD. Numerous distinguished publications have revealed AMD mechanisms at the cellular and molecular level and in this multi-author review, we take a bit broader look at the topic with some novel aspects.


Assuntos
Degeneração Macular/patologia , Retina/patologia , Transtornos da Visão/patologia , Idoso de 80 Anos ou mais , Humanos , Degeneração Macular/diagnóstico , Degeneração Macular/terapia , Transtornos da Visão/diagnóstico , Transtornos da Visão/terapia
7.
Cell Mol Life Sci ; 77(5): 835-851, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31901947

RESUMO

Lipocalins are a family of secreted adipokines which play important roles in various biological processes. Lipocalin-2 (LCN-2) has been shown to be involved in acute and chronic inflammation. This particular protein is critical in the pathogenesis of several diseases including cancer, diabetes, obesity, and multiple sclerosis. Herein, we discuss the general molecular basis for the involvement of LCN-2 in acute infections and chronic disease progression and also ascertain the probable role of LCN-2 in ocular diseases, particularly in age-related macular degeneration (AMD). We elaborate on the signaling cascades which trigger LCN-2 upregulation in AMD and suggest therapeutic strategies for targeting such pathways.


Assuntos
Lipocalina-2/genética , Lipocalina-2/metabolismo , Degeneração Macular/genética , Degeneração Macular/patologia , Transtornos da Visão/genética , Animais , Modelos Animais de Doenças , Humanos , Inflamação/patologia , Camundongos , Retina/patologia , Epitélio Pigmentado da Retina/patologia , Transdução de Sinais , Transtornos da Visão/patologia
8.
Medicine (Baltimore) ; 99(4): e18805, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31977873

RESUMO

RATIONALE: Anti-GQ1b antibody syndrome refers to a distinct variant of Guillain- Barré syndrome. Involvement of the optic nerve in anti-GQ1b antibody syndrome is extremely rare. PATIENT CONCERNS: Here, we report a case of anti-GQ1b antibody syndrome presenting with visual deterioration as the initial symptom. A 73-year-old man presented with a 5-day history of bilateral blurred vision and ptosis. He had a previous history of diarrhea starting 10 days before admission. Physical examination showed visual deterioration, ophthalmoplegia, and peripheral facial paralysis. Testing of both serum and cerebrospinal fluid was positive for anti-GQ1b immunoglobulin G antibodies and negative for anti-aquaporin 4antibodies. DIAGNOSIS: Anti-GQ1b antibody syndrome. INTERVENTIONS: The patient was treated with intravenous methylprednisolone and human immunoglobulin. OUTCOMES: After a 20-day follow-up, the patient's condition took a favorable turn. LESSONS: This case reminds us that anti-GQ1b antibody syndrome should be suspected in patients with visual deterioration and preceding infection.


Assuntos
Síndrome de Guillain-Barré/diagnóstico , Imunoglobulina G/sangue , Idoso , Autoanticorpos/sangue , Síndrome de Guillain-Barré/sangue , Síndrome de Guillain-Barré/classificação , Síndrome de Guillain-Barré/tratamento farmacológico , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Fatores Imunológicos/uso terapêutico , Masculino , Oftalmoplegia/diagnóstico , Oftalmoplegia/etiologia , Síndrome , Transtornos da Visão/etiologia
9.
Cell Mol Life Sci ; 77(5): 819-833, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31893312

RESUMO

Understanding the mechanisms that underlie age-related macular degeneration (AMD) has led to the identification of key molecules. Hypoxia-inducible transcription factors (HIFs) have been associated with choroidal neovascularization and the progression of AMD into the neovascular clinical phenotype (nAMD). HIFs regulate the expression of multiple growth factors and cytokines involved in angiogenesis and inflammation, hallmarks of nAMD. This knowledge has propelled the development of a new group of therapeutic strategies focused on gene therapy. The present review provides an update on current gene therapies in ocular angiogenesis, particularly nAMD, from both basic and clinical perspectives.


Assuntos
Proteínas Reguladoras de Apoptose/metabolismo , Fatores de Transcrição Hélice-Alça-Hélice Básicos/metabolismo , Terapia Genética/métodos , Subunidade alfa do Fator 1 Induzível por Hipóxia/metabolismo , Degeneração Macular/genética , Degeneração Macular/terapia , Proteínas Repressoras/metabolismo , Proteínas Reguladoras de Apoptose/antagonistas & inibidores , Proteínas Reguladoras de Apoptose/genética , Fatores de Transcrição Hélice-Alça-Hélice Básicos/antagonistas & inibidores , Fatores de Transcrição Hélice-Alça-Hélice Básicos/genética , Neovascularização de Coroide/genética , Neovascularização de Coroide/patologia , Humanos , Subunidade alfa do Fator 1 Induzível por Hipóxia/antagonistas & inibidores , Subunidade alfa do Fator 1 Induzível por Hipóxia/genética , Degeneração Macular/patologia , Proteínas Repressoras/antagonistas & inibidores , Proteínas Repressoras/genética , Transtornos da Visão/genética , Transtornos da Visão/patologia , Transtornos da Visão/terapia
10.
Cell Mol Life Sci ; 77(5): 781-788, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31897541

RESUMO

Age-related macular degeneration (AMD) is a leading cause of visual impairment of the elderly population. Since AMD is a multifactorial age-related disease with various genetic risk factors, the understanding of its complex pathophysiology is still limited. However, animal experiments, genome-wide association data and the molecular profiling of AMD patient samples have highlighted a key role of systemic and local immune processes that contribute to this chronic eye disease. In this overview article, we concentrate on the role of lymphocytes and mononuclear phagocytes and their interplay in triggering a persistent immune response in the AMD retina. We preferentially review findings from human immune cell analyses and complement these with related findings in experimental models. We conclude that both immune cell types as their signaling network may be a rich source to identify novel molecular targets for immunomodulation in AMD.


Assuntos
Linfócitos B/imunologia , Linfócitos T CD8-Positivos/imunologia , Degeneração Macular/imunologia , Fagócitos/imunologia , Células Th1/imunologia , Células Th17/imunologia , Idoso de 80 Anos ou mais , Proteínas do Sistema Complemento/imunologia , Humanos , Imunomodulação/fisiologia , Degeneração Macular/patologia , Retina/imunologia , Retina/patologia , Transtornos da Visão/imunologia
11.
Cell Mol Life Sci ; 77(5): 789-805, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31897543

RESUMO

Age-related macular degeneration (AMD) is a complex eye disease underlined by the death of photoreceptors and degeneration of retinal pigment epithelium (RPE) and choriocapillaris (CC). The mechanism(s) responsible for massive and progressive retinal degeneration is not completely known. Senescence, a state of permanent inhibition of cell growth, may be induced by many factors important for AMD pathogenesis and results in senescence-associated secretory phenotype (SASP) that releases growth factors, cytokines, chemokines, proteases and other molecules inducing inflammation and other AMD-related effects. These effects can be induced in the affected cell and neighboring cells, leading to progression of AMD phenotype. Senescent cells also release reactive oxygen species that increase SASP propagation. Many other pathways of senescence-related AMD pathogenesis, including autophagy, the cGAS-STING signaling, degeneration of CC by membrane attack complex, can be considered. A2E, a fluorophore present in lipofuscin, amyloid-beta peptide and humanin, a mitochondria-derived peptide, may link AMD with senescence. Further studies on senescence in AMD pathogenesis to check the possibility of opening a perspective of the use of drugs killing senescent cells (senolytics) and terminating SASP bystander effects (senostatics) might be beneficial for AMD that at present is an incurable disease.


Assuntos
Senescência Celular/fisiologia , Corioide/patologia , Degeneração Macular/patologia , Células Fotorreceptoras/patologia , Epitélio Pigmentado da Retina/patologia , Transtornos da Visão/patologia , Proliferação de Células/fisiologia , Humanos , Espécies Reativas de Oxigênio/metabolismo
13.
World Neurosurg ; 133: e129-e134, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31476453

RESUMO

OBJECTIVE: Choroidal hemangioma (CH) is a benign vascular tumor that induces subretinal fluid collection or exudative retinal detachment and consequent visual symptoms. Current standard treatments for CH include cryotherapy, diathermy, photocoagulation, photodynamic therapy, transpupillary thermotherapy, and radiation therapy. Stereotactic radiosurgery has recently been applied to the treatment of CH because of its characteristic stiff dose-fall-off and accuracy. We have adopted gamma knife radiosurgery (GKRS) to treat CH and have retrospectively assessed tumor volume reductions and improvements to visual acuity achieved thereby. METHODS: Fourteen patients with CHs were treated with GKRS from November 2006 to December 2017. Eight patients had circumscribed CH, and 6 exhibited diffuse CHs and were diagnosed with Sturge-Weber syndrome. The mean age of patients was 27.1 years (range: 8-68 years) and the mean duration of clinical or radiological follow-up was 40.2 months (range: 5-105 months). The mean volume of the tumors at the time of GKRS was 533.5 mm3 (range: 124-1150 mm3), and the mean prescribed marginal dose was 11.6 Gy (range: 10-16 Gy) with 50% isodose lines. RESULTS: The tumor volume decreased by the last follow-up in all patients. The visual acuity improved in 9 patients (64%) and decreased in 1 (7%). Six patients (43%) required trans-pars plana vitrectomy before or after GKRS. There were no symptomatic complications from radiation injury during the follow-up periods. CONCLUSIONS: GKRS could be an acceptable alternative treatment for symptomatic CH when standard therapy is not feasible.


Assuntos
Neoplasias da Coroide/cirurgia , Hemangioma/cirurgia , Radiocirurgia , Adolescente , Adulto , Idoso , Criança , Neoplasias da Coroide/complicações , Neoplasias da Coroide/patologia , Neoplasias da Coroide/terapia , Terapia Combinada , Feminino , Seguimentos , Hemangioma/complicações , Hemangioma/patologia , Hemangioma/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Carga Tumoral , Transtornos da Visão/etiologia , Adulto Jovem
14.
World Neurosurg ; 133: e211-e217, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31493596

RESUMO

BACKGROUND: Craniopharyngiomas show a high recurrence rate despite their pathologically benign nature. Thus, we analyzed the clinical features to elucidate the prognostic factors for the recurrence of craniopharyngiomas in adults with long-term follow-up. METHODS: This retrospective study reviewed and analyzed the preoperative features, surgical results, and tumor recurrence of patients who underwent an operation at a single institution from 2004 to 2013. RESULTS: This study analyzed the results of 64 consecutive adult patients, and the median follow-up period was 83.5 months (range 9-163 months). Ten patients had a history of surgery, whereas 4 had a history of adjuvant radiation. Retrochiasmatic tumors (n = 51, 79.7%) were more common than prechiasmatic tumors. Operations were performed via the transcranial approach in 31 (48.4%) patients and transsphenoidal approach in 33. Gross total removal was achieved in 44 (68.8%) patients, and the transsphenoidal approach showed a greater gross total removal rate than the transcranial approach did (97.0% vs. 38.7%, P < 0.001). Adjuvant radiotherapy was performed in 8 patients, and radiosurgery was performed in 2. Recurrence was identified in 25 (39.1%) patients in 45.0 months of the median time to recurrence. The overall actuarial 5- and 7-year progression-free survival rates were 71.8% and 63.6%, respectively. Multivariate analysis revealed that supra- and subdiaphragmatic tumor locations and subtotal removal were risk factors for long-term tumor recurrence. CONCLUSIONS: The long-term recurrence rate of craniopharyngiomas was high; therefore, long-term regular follow-up is mandatory. Adjuvant irradiation for remnant tumors showed a long-term tumor control rate comparable to that of completely removed tumors.


Assuntos
Craniofaringioma/epidemiologia , Recidiva Local de Neoplasia/epidemiologia , Neoplasias Hipofisárias/epidemiologia , Adulto , Idoso , Terapia Combinada , Craniofaringioma/complicações , Craniofaringioma/radioterapia , Craniofaringioma/cirurgia , Feminino , Seguimentos , Humanos , Hidrocefalia/etiologia , Hipofisectomia/métodos , Hipopituitarismo/etiologia , Masculino , Pessoa de Meia-Idade , Neoplasias Hipofisárias/complicações , Neoplasias Hipofisárias/radioterapia , Neoplasias Hipofisárias/cirurgia , Complicações Pós-Operatórias , Prognóstico , Intervalo Livre de Progressão , Radiocirurgia , Radioterapia Adjuvante , Estudos Retrospectivos , Transtornos da Visão/etiologia
15.
World Neurosurg ; 133: e241-e251, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31505289

RESUMO

BACKGROUND: Cystic sellar masses (CSMs) pose diagnostic and therapeutic challenges associated with subtotal cyst wall resection, cerebrospinal fluid (CSF) leak repair, and disease recurrence. Current magnetic resonance imaging (MRI) interpretation often cannot reliably differentiate CSMs, mandating adaptable intraoperative strategies. We reviewed our diagnostic and therapeutic experience after endoscopic endonasal approaches (EEAs) for CSMs. METHODS: A retrospective record review of patients with CSM managed via EEA at the University of Southern California from 2011 to 2018 was conducted. Patient demographics, preoperative characteristics, surgical details, pathologic findings, and postoperative outcomes were assessed. RESULTS: Analysis included 47 patients (mean age, 43.2 years); of these, 78.7% were women. Preoperative symptoms included headache (76.6%) and vision loss (42.6%). Histologically verified sellar pathology included 27 Rathke cleft cysts (RCCs) (57.4%), 17 cystic pituitary adenomas (CPAs) (36.2%), 2 arachnoid cysts (4.3%), and 1 xanthogranuloma (2.1%). Twelve patients (70.6%) with CPAs underwent complete resection and 5 (29.4%) underwent subtotal resection. All 27 patients with RCC and 2 patients with arachnoid cyst underwent complete fenestration and drainage. One xanthogranuloma was completely resected. There were 14 intraoperative (29.8%) and 4 postoperative CSF leaks (8.5%). Headaches, vision, and endocrinopathy improved in 69.2%, 80.0%, and 33.3% of patients with CPA and 73.9%, 71.4%, and 40.9% of patients with RCC, respectively. There were 2 RCC recurrences and 1 CPA recurrence over the follow-up period. CONCLUSIONS: Surgeons must prepare for versatile management strategies of CSMs based on pretest probability associated with MRI and intraoperative findings. Outcomes after EEA for CSMs show low complication profiles and excellent rates of headache and visual improvement, albeit lower rates of endocrine normalization.


Assuntos
Cistos do Sistema Nervoso Central/cirurgia , Cirurgia Endoscópica por Orifício Natural/métodos , Neuroimagem/métodos , Sela Túrcica , Adenoma/complicações , Adenoma/diagnóstico , Adenoma/diagnóstico por imagem , Adenoma/cirurgia , Adulto , Cistos do Sistema Nervoso Central/complicações , Cistos do Sistema Nervoso Central/diagnóstico , Cistos do Sistema Nervoso Central/diagnóstico por imagem , Vazamento de Líquido Cefalorraquidiano/etiologia , Drenagem , Fadiga/etiologia , Feminino , Cefaleia/etiologia , Humanos , Hipopituitarismo/etiologia , Complicações Intraoperatórias/etiologia , Masculino , Pessoa de Meia-Idade , Cavidade Nasal , Neoplasias Hipofisárias/complicações , Neoplasias Hipofisárias/diagnóstico , Neoplasias Hipofisárias/diagnóstico por imagem , Neoplasias Hipofisárias/cirurgia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Sela Túrcica/diagnóstico por imagem , Sela Túrcica/cirurgia , Transtornos da Visão/etiologia , Xantomatose/complicações , Xantomatose/diagnóstico , Xantomatose/diagnóstico por imagem , Xantomatose/cirurgia
16.
Eur J Ophthalmol ; 30(1): 175-180, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30644317

RESUMO

AIM: To find out and compare various predictors of glaucoma-related visual impairments in primary and secondary glaucoma. METHODS: A prospective observational study of patients, who were above 30 years of age. They were diagnosed as primary/secondary glaucoma with visual acuity <20/200 Snellen's/visual field showing less than 20° isopter in at least one eye, with a minimum follow-up of one year at a tertiary center. Patients were classified into advanced and end-stage glaucoma and outcome was assessed according to visual acuity and visual fields to see predictors of visual impairments. RESULTS: There were 169 (99 primary/70 secondary) glaucoma patients with mean age of 62.67 ± 11.9 and 54.65 ± 15.26 years, respectively. Trauma (21.4%), complicated cataract surgery (15.7%), and silicon oil tamponade (14.3%) were common causes of secondary glaucoma. There was significant delay in diagnosis in primary compared to secondary glaucoma (57.57% vs 32.85%) and non-compliance was significantly higher in primary glaucoma (34.3% vs 17.1%, p = 0.01). In univariate analysis, literacy, income status, locality, and delayed or missed diagnosis were found to be significant (p < 0.05) according to visual acuity criteria. Out of the 33 patients who had undergone glaucoma filtration surgery, 18 (54.5%) were in the end-stage group. While 105 (77.2%) of 136 patients who were not subjected to any glaucoma filtration surgery reached end-stage glaucoma as per visual fields criteria (p = 0.011). CONCLUSION: Lack of awareness, delayed diagnosis, low literacy, and income were associated with poor visual outcome. Patients who underwent glaucoma filtration surgery had significantly better visual outcome in comparison to patients managed medically.


Assuntos
Glaucoma de Ângulo Fechado/diagnóstico , Glaucoma de Ângulo Aberto/diagnóstico , Transtornos da Visão/diagnóstico , Adulto , Idoso , Feminino , Cirurgia Filtrante , Glaucoma de Ângulo Fechado/fisiopatologia , Glaucoma de Ângulo Fechado/cirurgia , Glaucoma de Ângulo Aberto/fisiopatologia , Glaucoma de Ângulo Aberto/cirurgia , Humanos , Índia , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Centros de Atenção Terciária , Transtornos da Visão/fisiopatologia , Transtornos da Visão/cirurgia , Acuidade Visual/fisiologia , Campos Visuais/fisiologia , Pessoas com Deficiência Visual
17.
Eur J Ophthalmol ; 30(1): 189-195, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30474390

RESUMO

PURPOSE: To determine the prevalence of symptoms of computer vision syndrome and to identify its associated factors. The secondary objective was to assess knowledge and practices related to preventing computer vision syndrome symptoms. METHODS: The data for this cross-sectional study were collected through a self-administered questionnaire distributed to 713 female undergraduates studying business and medicine in Saudi Arabia. The questionnaire included computer vision syndrome validated symptoms and factors associated with computer vision syndrome development. RESULTS: The most common symptom due to prolonged computer use was neck or shoulder pain, reported by 82.2% of the subjects. Overall, 66.5% of the subjects suffered from headache and 51.5% from dry eyes, in mild, moderate, or severe form. Business students were 1.6 times as likely as medical students to suffer from computer vision syndrome (odds ratio = 1.65; 95% confidence interval: 1.22, 2.24). The use of electronic devices for more than 5 h (odds ratio = 1.52; 95% confidence interval: 1.07, 2.16) was also associated with experiencing computer vision syndrome symptoms. Regarding computer vision syndrome prevention, factors such as hours of use, screen distance, screen brightness, and room illumination showed statistically significant difference between the two groups (p < 0.0001). CONCLUSION: The prevalence of computer vision syndrome symptoms was significantly higher among business students, who reported lower awareness and poor practice measures of computer use recommendations. Relevant awareness campaigns focusing on the appropriate use of computers are highly recommended.


Assuntos
Astenopia/epidemiologia , Computadores , Síndromes do Olho Seco/epidemiologia , Cervicalgia/epidemiologia , Dor de Ombro/epidemiologia , Estudantes/estatística & dados numéricos , Transtornos da Visão/epidemiologia , Adulto , Estudos Transversais , Feminino , Humanos , Prevalência , Fatores de Risco , Arábia Saudita/epidemiologia , Autorrevelação , Inquéritos e Questionários , Síndrome , Universidades
18.
Eur J Ophthalmol ; 30(1): NP1-NP4, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30301374

RESUMO

Twenty-six-year-old male patient admitted to the outpatient clinic with a complaint of decreased vision in both eyes. Visual acuity was 2/10 in the right and 7/10 in the left eye. Fundus examination revealed bilateral yellow-white subretinal lesions involving the macula. Fluorescein angiography showed hypofluorescent lesions in early and hyperflourescent lesions in the late phase. Optical coherence tomography angiography performed in the acute phase showed bilateral hypofluorescency at the choriocapillary level. A diagnosis of acute posterior multifocal placoid pigment epitheliopathy was given. After steroid treatment, visual acuity was improved to 10/10 and earlier lesions in optical coherence tomography angiography were found to be reduced. In conclusion, optical coherence tomography angiography is a noninvasive imaging technique that can be used in the diagnosis and follow-up of acute posterior multifocal placoid pigment epitheliopathy.


Assuntos
Angiofluoresceinografia/métodos , Tomografia de Coerência Óptica/métodos , /diagnóstico , Doença Aguda , Adulto , Glucocorticoides/uso terapêutico , Humanos , Masculino , Transtornos da Visão/diagnóstico , Transtornos da Visão/tratamento farmacológico , Transtornos da Visão/fisiopatologia , Acuidade Visual/fisiologia , /fisiopatologia
19.
Eur J Ophthalmol ; 30(1): 58-65, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30556423

RESUMO

BACKGROUND: Patients with congenital aniridia usually have some degree of foveal hypoplasia, thus representing a limiting factor in the final visual acuity achieved by these patients. The purpose of this study was to analyze whether the foveal morphology assessed by spectral-domain optical coherence tomography may serve as a prognostic indicator for best-corrected visual acuity in congenital aniridia patients. METHODS: Observational two-center study performed between January 2012 and March 2017 in the pediatric ophthalmology department at Vissum Alicante and Vissum Madrid, Spain. A total of 31 eyes from 19 patients with congenital aniridia were included. After a complete ophthalmological examination, a high-resolution spectral-domain optical coherence tomography with a three-dimensional scan program macular protocol was used. A morphological grading system of foveal hypoplasia was used varying from grade 1 in which there is a presence of a shallow foveal pit, extrusion of inner retinal layers, outer nuclear layer widening, and a presence of outer segment lengthening to grade 4 in which none of these processes occur. RESULTS: No correlation between central, mid-peripheral, and peripheral macular thickness and logMAR best-corrected visual acuity was found. The presence of outer segment lengthening was associated with better best-corrected visual acuity with a median best-corrected visual acuity, 0.30 logMAR, whereas the absence of this morphologic feature was associated with poorer VA with a median best-corrected visual acuity of 0.61 logMAR (p < 0.001). CONCLUSION: Foveal hypoplasia morphology can predict the best-corrected visual acuity. Specifically, the morphologic optical coherence tomography feature that is related to a better best-corrected visual acuity in congenital aniridia patients is the presence of outer segment lengthening.


Assuntos
Aniridia/diagnóstico , Fóvea Central/patologia , Tomografia de Coerência Óptica , Transtornos da Visão/diagnóstico , Acuidade Visual/fisiologia , Adolescente , Adulto , Aniridia/fisiopatologia , Criança , Pré-Escolar , Feminino , Fóvea Central/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Transtornos da Visão/fisiopatologia , Adulto Jovem
20.
Dev Med Child Neurol ; 62(1): 104-110, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31180136

RESUMO

AIM: To develop and validate the Visual Function Classification System (VFCS), which was created to classify how children with cerebral palsy (CP) use visual abilities in daily life. METHOD: The process of development and validation of the VFCS involved four phases: (1) drafting of the five levels from the analysis of literature and clinical experience; (2) validation of constructs and revision of the levels for concept meaningfulness, using nominal group process; (3) refinement by international Delphi survey; and(4) assessment of interrater reliability among professionals and with caregivers, and of test-retest reliability. RESULTS: Five nominal groups involved 29 participants; 65 people completed the first round and 51 the second round of the Delphi survey. Construct validity was demonstrated within an expert group and external validation through several stakeholders, with the involvement of patients and families to ensure meaningfulness of the concept. Discussions continued until consensus was reached about the construct and content of the five levels. Participants in the reliability study included 29 professionals, 39 parents, and a total sample of 160 children with CP (mean age [SD] 6y 6mo [3y 4mo]; median 5y 7mo, range 1-19y). Absolute interrater agreement among professionals was 86% (weighted κ=0.88; 95% confidence interval [CI] 0.83-0.93). Test-retest reliability was high (weighted κ=0.97; 95% CI 0.95-0.99). Parent-professional interrater reliability on 39 children was moderate (weighted κ=0.51; 95% CI 0.39-0.63). INTERPRETATION: The VFCS has been appropriately constructed and provides a reliable system to classify visual abilities of children with CP both in clinical and in research settings. WHAT THIS PAPER ADDS: The Visual Function Classification System is a valid and reliable system. It classifies visual abilities of children with cerebral palsy in clinical and research settings. At a clinical level, it can be used to harmonize communication among professionals and identify patients' strengths and weaknesses. In research settings, it can be used to stratify patients, define natural history evolution, and interpret intervention studies.


Assuntos
Atividades Cotidianas , Paralisia Cerebral/fisiopatologia , Índice de Gravidade de Doença , Transtornos da Visão/fisiopatologia , Adolescente , Adulto , Paralisia Cerebral/complicações , Criança , Pré-Escolar , Técnica Delfos , Feminino , Humanos , Lactente , Masculino , Reprodutibilidade dos Testes , Transtornos da Visão/classificação , Transtornos da Visão/diagnóstico , Transtornos da Visão/etiologia , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA