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1.
BMJ Open ; 11(4): e047131, 2021 04 05.
Artigo em Inglês | MEDLINE | ID: mdl-33820793

RESUMO

OBJECTIVES: To investigate the prevalence of near-vision impairment (NVI) and effective spectacle coverage for near vision in those aged ≥40 years in Khammam and Warangal district in Telangana, India. DESIGN: A population-based cross-sectional study. SETTING: Khammam and Warangal district in Telangana, India. PARTICIPANTS: Of 6000 people enumerated, 5357 were examined (89%). 4526 participants without distance vision impairment were included in the analysis. MAIN OUTCOME MEASURES: The study teams visited selected households and conducted eye examinations. NVI was defined as binocular presenting near vision worse than N6. 'Unmet need' was deemed to be present if the unaided near vision was worse than N6 and improved to N6 with near correction among the participants who did not have spectacles for near vision. 'Met need' was deemed to be present when unaided near vision was worse than N6 but improving to N6 with their spectacles. The 'undermet need' was deemed to be present when aided near vision was worse than N6 but improved to N6 with correction. Based on these definitions, e-near-vision coverage (%) is calculated as follows: e-NVC (%)=met need/(met need+undermet need+unmet need) × 100. RESULTS: The mean age was 53.5 years (SD: 10.8 years), 2534/4526 (55.8%) were women, 1819/4526 (41.8%) had at least primary school education and 2368/4526 (52.3%) were from the Khammam district. The prevalence of NVI was 55.8% (95% CI 72.5 to 75.1; n=3343). Overall, the e-NVC (%) was 31.8%. It was 40.0% in Khammam and 23.2% in Warangal. CONCLUSION: NVI is common in Khammam and Warangal districts in Telangana with inadequate effective near-vision coverage. Effective service delivery models are needed to reach out and provide services to address NVI to achieve universal eye health coverage in the region.


Assuntos
Óculos , Transtornos da Visão , Adulto , Distribuição por Idade , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Transtornos da Visão/epidemiologia , Transtornos da Visão/terapia
2.
Med Clin North Am ; 105(3): 397-407, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33926637

RESUMO

Incidence of cataract, diabetic retinopathy, macular degeneration, and glaucoma will significantly increase by 2050. Visual impairment can increase morbidity and mortality in nonocular disease. There are different patterns of vision loss in cataract, diabetic retinopathy, age-related macular degeneration, and glaucoma. Internists and medical subspecialists play an important role in prevention, detection, and early treatment of eye disease. Awareness of screening guidelines for eye disease as well as a basic ocular history and simple penlight examination can decrease incidence of vision loss and its impact. Visual impairment places a significant financial burden on society.


Assuntos
Oftalmopatias/diagnóstico , Oftalmopatias/terapia , Oftalmopatias/complicações , Oftalmopatias/prevenção & controle , Humanos , Medicina Interna , Programas de Rastreamento/normas , Guias de Prática Clínica como Assunto , Transtornos da Visão/diagnóstico , Transtornos da Visão/etiologia , Transtornos da Visão/prevenção & controle , Transtornos da Visão/terapia
3.
Med Clin North Am ; 105(3): 409-423, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33926638

RESUMO

Primary care physicians see nearly half of all clinical visits, and 2% to 3% of those are for eye complaints. Taking a good ocular history is essential to establishing the diagnosis. Patient complaints fall into several categories including visual change, redness, and pain. Primary care physicians can screen for patients at risk of vision loss from glaucoma, diabetes, and toxic medication and ensure that patients have appropriate eye evaluations. Examination techniques such as direct ophthalmoscopy, evaluation of the red reflex, eversion of the upper lid, checking pupillary response, and using fluorescein to stain the cornea are helpful in evaluating patients' ocular complaints.


Assuntos
Oftalmopatias/diagnóstico , Emergências , Oftalmopatias/etiologia , Oftalmopatias/terapia , Traumatismos Oculares/diagnóstico , Traumatismos Oculares/etiologia , Traumatismos Oculares/terapia , Humanos , Programas de Rastreamento , Atenção Primária à Saúde , Transtornos da Visão/diagnóstico , Transtornos da Visão/etiologia , Transtornos da Visão/terapia
4.
J Clin Neurosci ; 86: 230-234, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33775333

RESUMO

BACKGROUND: Direct carotid cavernous fistula (CCF) occurs between the internal carotid artery (ICA) and the cavernous sinus. Carotid cavernous fistulas (CCFs) frequently present with chemosis, pulsatile proptosis, ocular bruit, vision loss, and occasionally intracerebral hemorrhage or seizure. In this article, we share our experience in endovascular treatment of six patients having this pathology with intracranial flow diverting stents with review of literatures. CASE DESCRIPTION: All six patients had posttraumatic direct CCF, most of their signs and symptoms were visual disturbance, chemosis, orbital bruit, headache, paralysis of extraocular muscles. They were treated with flow diversion stents with or without coils or liquid embolizing material; transvenous and transarterial routes were used. Most of them underwent multiple sessions, and their conditions were improved dramatically. CONCLUSION: The best and most effective method is to start the procedure by coiling to convert the high-flow fistula to an aneurysmal pouch with the smallest possible size in the cavernous sinus, and then close the defect site with one or two flow diversion devices (FDDs).


Assuntos
Fístula Carotidocavernosa/terapia , Traumatismos Craniocerebrais/terapia , Embolização Terapêutica/métodos , Procedimentos Endovasculares/métodos , Stents Metálicos Autoexpansíveis , Adulto , Fístula Carotidocavernosa/diagnóstico por imagem , Fístula Carotidocavernosa/etiologia , Traumatismos Craniocerebrais/complicações , Traumatismos Craniocerebrais/diagnóstico por imagem , Embolização Terapêutica/instrumentação , Procedimentos Endovasculares/instrumentação , Humanos , Masculino , Resultado do Tratamento , Transtornos da Visão/diagnóstico por imagem , Transtornos da Visão/etiologia , Transtornos da Visão/terapia , Adulto Jovem
5.
Zhongguo Zhen Jiu ; 41(1): 37-40, 2021 Jan 12.
Artigo em Chinês | MEDLINE | ID: mdl-33559440

RESUMO

OBJECTIVE: To observe clinical effect of acupuncture combined with conventional visual stimulation on cerebral visual impairment (CVI) in children aged 3-10 years and influence on the pattern visual evoked potential (P-VEP). METHODS: A total of 60 cases of children aged 3-10 years with CVI were randomly divided into an observation group and a control group, 30 cases in each group. The children in the control group received conventional visual stimulation therapy, 1 month as a course of treatment. On the basis of the control group, the children in the observation group was treated with acupuncture at Baihui (GV 20), Jingming (BL 1), Taiyang (EX-HN 5), Sibai (ST 2), etc. 3 times a week, and the treatment was given 4 weeks continuously as a course. Both groups received 3 courses of treatment. The visual acuity and P-VEP improvement were compared between the two groups before and after treatment. RESULTS: After treatment, the incubation period (P100-L) of the two groups was shorter than before treatment, and the amplitude (P100-A) was higher than before treatment (P<0.05); and the degree of above changes in the observation group was lager than the control group (P<0.05). The percentage of best corrected visual acuity of 0.6-0.8 in the observation group after treatment and follow-up 1 year after treatment was higher than before treatment (P<0.05), and was higher than the control group (P<0.05). CONCLUSION: Acupuncture combined with conventional visual stimulation can improve the incubation period (P100-L) and amplitude (P100-A) of P-VEP in children with CVI, and improve the best corrected visual acuity in children, the clinical effect is better than the conventional visual stimulation alone.


Assuntos
Terapia por Acupuntura , Encefalopatias , Pontos de Acupuntura , Criança , Pré-Escolar , Potenciais Evocados Visuais , Humanos , Transtornos da Visão/terapia
7.
Klin Monbl Augenheilkd ; 237(11): 1306-1311, 2020 Nov.
Artigo em Inglês, Alemão | MEDLINE | ID: mdl-33202463

RESUMO

Pituitary tumours are a common cause of functional impairment and degeneration of the anterior visual pathway. Depending on localization and size, they clinically manifest as initially reversible visual field defects. As part of interdisciplinary tumour management, ophthalmologic examinations are of particular importance concerning diagnostics, indication for tumour resection and documentation of functional surgical results. Based on the relationship between clinical dysfunction and manifest atrophy, together with the patient's age and the duration of symptoms, the ophthalmologist can provide insights into the postoperative visual prognosis. Under good conditions, surgical tumour resection often results in significant improvements to visual fields and acuity. Long-term ophthalmological controls are required in cases of persistent visual loss, radiotherapy or tumour remnants abutting the visual pathway.


Assuntos
Adenoma , Neoplasias Hipofisárias , Adenoma/complicações , Adenoma/diagnóstico , Adenoma/cirurgia , Humanos , Neoplasias Hipofisárias/complicações , Neoplasias Hipofisárias/diagnóstico , Neoplasias Hipofisárias/cirurgia , Transtornos da Visão/diagnóstico , Transtornos da Visão/etiologia , Transtornos da Visão/terapia , Testes de Campo Visual , Campos Visuais
8.
Tog (A Coruña) ; 17(2): 214-224, nov. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-198818

RESUMO

OBJETIVOS: conocer la efectividad del modelo de atención centrada en la persona en la rehabilitación visual. MÉTODO: se seleccionaron artículos publicados entre 2010 y 2019, recogidos en PUBMED y Web of Science. Se incluyeron aquellos dedicados a la terapia ocupacional y rehabilitación visual de personas con discapacidad visual desde un enfoque de atención centrado en la persona. Finalmente se incluyeron 14 artículos para esta revisión. RESULTADOS: de la búsqueda en PubMed se obtuvieron un total de 490 artículos y de Web of science 40, alcanzando un total de 530 artículos. Después de realizar la lectura del título, se seleccionaron 126 artículos. Tras la lectura de los resúmenes y/o el contenido completo, se excluyeron 112 por no cumplir los objetivos del estudio; resultando elegidos 13 artículos. Las diferentes investigaciones recopiladas justifican que la rehabilitación visual y la terapia ocupacional basadas en el modelo de atención centrada en la persona contribuyen a mejorar la calidad de vida de las personas con baja visión y su autonomía personal. CONCLUSIÓN: son necesarias más investigaciones que evidencien cómo la terapia ocupacional desde una atención centrada en la persona produce resultados positivos en la rehabilitación de personas con baja visión


OBJECTIVE: To know the effectiveness of the person-centered care model in visual rehabilitation. METHOD: Articles published between 2010 and 2019, collected in PUBMED and Web of Science, were selected. Those dedicated to occupational therapy and visual rehabilitation of people with visual disabilities from a person-centered care approach were included. Finally 14 articles were included for this review. RESULTS: A total of 490 articles were obtained from the PubMed search and 40 from Web of science, reaching a total of 530 articles. After reading the title, 126 articles were selected. After reading the abstracts and / or the full content, 112 were excluded because they did not meet the study objectives; resulting in 13 articles chosen. The different studies collected justify that visual rehabilitation and occupational therapy based on the person-centered care model contribute to improving the quality of life of people with low vision and their personal autonomy. CONCLUSION: More research is needed to show how occupational therapy from a person-centered care produces positive results in the rehabilitation of people with low vision


Assuntos
Humanos , Autonomia Pessoal , Avaliação da Deficiência , Educação de Pessoas com Deficiência Visual/métodos , Resultado do Tratamento , Assistência Centrada no Paciente/métodos , Transtornos da Visão/terapia , Serviços de Saúde para Pessoas com Deficiência , Assistência Centrada no Paciente/organização & administração , Qualidade de Vida , Transtornos da Visão/epidemiologia , Transtornos da Visão/reabilitação , Atividades Cotidianas
9.
Rev. bras. oftalmol ; 79(5): 302-308, set.-out. 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1137988

RESUMO

Abstract Purpose: Study aimed to determine compliance of patients with strabismic amblyopia undergoing occlusion treatment, followed from January 1 st, 2011 to January 1 st, 2017 at an Ophthalmology Reference Center, and identify risk factors for poor compliance. Methods: Retrospective, consecutive cohort study. Compliance reported at each visit was related to visual acuity, family history, changes in occlusion schedules and in patients' care team during treatment. The patients were divided into two groups according to the compliance: poor compliance group and compliance group (subdivided in full compliance subgroup and partial compliance subgroup). Results: Age at treatment beginning vary from 3.7 to 13.7 years, esotropia was the most frequent deviation and the occlusion was realized from 5 to 7 hours a day. Of 220 patients, compliance was achieved by 193 (87.7%), 114 (51.8%) in full compliance subgroup and 79 (35.9%) in partial compliance subgroup, and 27 do not achieved compliance (12.3%). Poor compliance was significantly related to a history of epilepsy, higher rate of suspension of treatment due to inefficacy, higher evasion rate, lower recurrence, and lower rate of maintenance of prophylactic occlusion after treatment. Good compliance was related to family history of strabismus, higher recurrence rate, and higher maintenance of prophylactic occlusion after treatment. No relations were found between poor compliance and changes in occlusion schedules or in patients' care team during treatment. Conclusion: Compliance with occlusion treatment of strabismic ambliopia was similar to other studies that included refractive and strabismic amblyopia and not related to changes in occlusion schedules or in patients' care team during treatment. Family history of strabismus was a protective factor.


Resumo Objetivo: Determinar a adesão de pacientes com ambliopia estrabísmica submetidos a tratamento oclusivo, acompanhados em Centro de Referência em Oftalmologia do Centro-Oeste do Brasil, e identificar fatores de risco para baixa adesão. Métodos: Estudo de coorte retrospectivo e consecutivo. A adesão relatada em cada visita foi relacionada à acuidade visual, história familiar, mudanças no tempo de oclusão e na equipe de atendimento ao paciente durante o tratamento. Os pacientes foram divididos em dois grupos de acordo com a adesão: grupo de não-adesão e grupo adesão (subdividido em subgrupo adesão total e subgrupo adesão parcial). Resultados: A idade ao início do tratamento variou de 3,7 a 13,7 anos, o desvio mais frequente foi a esotropia, o tempo médio de oclusão foi de 5 a 7 horas por dia. Dos 220 pacientes, 193 (87,7%) obtiveram adesão, 114 (51,8%) no subgrupo de adesão total e 79 (35,9%) no subgrupo de adesão parcial, e 27 não aderiram (12,3%). A não-adesão foi relacionada à história de epilepsia, maior taxa de suspensão do tratamento devido à ineficácia, maior taxa de evasão, menor recorrência e menor taxa de manutenção da oclusão profilática pós tratamento. A boa adesão foi relacionada à história familiar de estrabismo, maior taxa de recorrência e maior manutenção da oclusão profilática pós tratamento. Não houve relação entre não-adesão e mudanças nos horários de oclusão ou na equipe de atendimento durante o tratamento. Conclusão: A adesão ao tratamento oclusivo da ambliopia estrabísmica foi semelhante aos estudos que incluíram ambliopia refracional e estrabísmica e não se correlacionou a mudanças no tempo de oclusão ou na equipe de atendimento. A história familiar de estrabismo foi um fator de proteção.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Transtornos da Visão/terapia , Visão Binocular , Ambliopia/terapia , Estrabismo/terapia , Cooperação e Adesão ao Tratamento , Estudos Retrospectivos , Estudos de Coortes
10.
Klin Monbl Augenheilkd ; 237(11): 1326-1333, 2020 Nov.
Artigo em Inglês, Alemão | MEDLINE | ID: mdl-32869245

RESUMO

BACKGROUND: The demographic change in Germany will lead to an increase in irreversible age-related eye diseases. This will increase the need for specialised care facilities for visually impaired people. Due to reduced mobility, residents in such facilities often do not receive adequate ophthalmological care. New concepts must therefore be considered for this group of patients. One approach is to set up an ophthalmological examination unit within the facility combined with regular visits by an ophthalmologist. We now present the experience with such a model in a home for the blind. PATIENTS AND METHODS: The project was initiated in 2009. Since then there have been visits by medical staff of the Eye Center at Medical Center, University of Freiburg, every two weeks. All patient records (2010 - 2017) were reviewed systematically. The following data were extracted in a structured and anonymous way: Age at first presentation, gender, ophthalmological diagnoses and if a therapy was initiated. This data set was finally analysed descriptively. RESULTS: Out of 130 residents aged between 48 and 100 years, half were between 78 and 90 years old. The youngest resident was 48, the oldest 100 years old. The median visual acuity was 0.2. Sixty percent of the residents had at least mild visual impairment according to the WHO (visual acuity < 0.5; category 1 - 6). In one of 6 - 7 residents, visual acuity could not be determined using Snellen charts. The most frequent ophthalmological diagnoses included cataract (44%), age-related macular degeneration (36%) and glaucoma (29%). In 67 residents (52%), the ophthalmological examination lead to treatment, such as application of local therapy or planning an operation. CONCLUSION: In every second resident, the ophthalmologist's visit lead to treatment during the observation period. This underlines the difficulty of providing ophthalmological care even in specialised institutions for the blind and visually impaired, which is possibly due to the residents' mobility problems. The concept presented here has established a low-threshold, sustainable and high-quality ophthalmological service on site. These positive experiences indicate that corresponding measures may also be useful for other locations. However, in order to implement such a project on a larger scale, suitable financing and accounting modalities for the construction measures, the nursing staff and the ophthalmological procedure still need to be developed.


Assuntos
Instituição de Longa Permanência para Idosos , Casas de Saúde , Idoso , Idoso de 80 Anos ou mais , Cegueira/diagnóstico , Cegueira/epidemiologia , Cegueira/terapia , Alemanha/epidemiologia , Humanos , Pessoa de Meia-Idade , Transtornos da Visão/diagnóstico , Transtornos da Visão/epidemiologia , Transtornos da Visão/terapia
12.
Br J Hosp Med (Lond) ; 81(6): 1-10, 2020 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-32589541

RESUMO

Ocular complications in critical care patients are common. There has been a surge in intensive care admissions following the COVID-19 outbreak. The management of COVID-19 exposes patients to a number of specific risk factors for developing ocular complications, which include non-invasive ventilation, mechanical ventilation and prone positioning. Consequently, it is likely that there will be an increase in the number of ocular complications secondary to the management of COVID-19 patients in the intensive care unit setting, and these complications could lead to permanent visual loss and blindness. Increased awareness of eye care in the intensive care unit setting is therefore vital to help prevent visual loss and maintain quality of life for patients recovering from COVID-19.


Assuntos
Infecções por Coronavirus/terapia , Oftalmopatias/terapia , Unidades de Terapia Intensiva , Oftalmologia , Pneumonia Viral/terapia , Encaminhamento e Consulta , Doença Aguda , Betacoronavirus , Doenças da Túnica Conjuntiva/prevenção & controle , Doenças da Túnica Conjuntiva/terapia , Conjuntivite/prevenção & controle , Conjuntivite/terapia , Doenças da Córnea/prevenção & controle , Doenças da Córnea/terapia , Lesões da Córnea/prevenção & controle , Lesões da Córnea/terapia , Cuidados Críticos , Estado Terminal , Edema/prevenção & controle , Edema/terapia , Endoftalmite/prevenção & controle , Endoftalmite/terapia , Oftalmopatias/prevenção & controle , Glaucoma/diagnóstico , Glaucoma/terapia , Humanos , Ceratite/prevenção & controle , Ceratite/terapia , Lubrificantes/uso terapêutico , Pomadas/uso terapêutico , Pandemias , Transtornos da Visão/diagnóstico , Transtornos da Visão/terapia
13.
Indian J Ophthalmol ; 68(7): 1306-1311, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32587155

RESUMO

The severe acute respiratory syndrome coronavirus 2 (COVID-19) pandemic has disrupted our society on an unprecedented scale since its inception in December 2019. As the health-care system is finally re-organizing to mitigate the impact of the pandemic, it was necessary to re-structure primary eye care (PEC) activities as well on the same lines. A consensus meeting was held with leading eye-care experts on 2nd May 2020 to prepare a roadmap for PEC in the days to come. Guidelines are needed for PEC activities like vision testing, refraction, optical dispensing, counseling, etc., Some of the activities at vision centers (VCs) may be postponed or modified in light of the current pandemic situation. PEC workers need to strictly follow social distancing norms (minimum 3 feet) for minimizing risk of exposure and need access to appropriate personal protective equipment (PPE), like gloves, masks and shields while examining beneficiaries. For optometrists, sterilization of instruments and encouraging the people to remain silent during the examination is recommended. Because conjunctivitis may be an early sign which can present at VCs, extra precautions in the form of PPE has to be ensured while examining such patients. This is also an opportunity to start running telemedicine clinics for all emergent cases that cannot be managed at the primary level. The guidelines also need to be updated based on the context of the working environment and changes in government directives from time to time.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Gerenciamento Clínico , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pandemias , Equipamento de Proteção Individual/normas , Pneumonia Viral/epidemiologia , Transtornos da Visão/diagnóstico , Infecções por Coronavirus/transmissão , Humanos , Índia/epidemiologia , Oftalmologia/normas , Pneumonia Viral/transmissão , Saúde Pública , Transtornos da Visão/terapia
14.
Bratisl Lek Listy ; 121(6): 395-399, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32484702

RESUMO

AIMS: Visual snow is a neurological condition, for which an effective treatment has not been established.  The aim of this study was to find whether Repetitive Transcranial Magnetic Stimulation (rTMS) can improve the state of patients suffering from visual snow. To our knowledge, no other group has tested this method in the treatment of visual snow. METHODS: We applied rTMS of 10 and 10+1 Hz on the visual cortices of 9 patients with visual snow. Sham stimulation with the vertex as the target site was also tested. As a method of assessment, we used visual evoked potentials, questionnaires and visual snow diaries. For data evaluation, we used the Paired Sample T-test separately for each stimulation type. RESULTS: The Paired Sample T-test revealed a decreased sum of visual snow intensities extracted from visual snow diaries in the week after 10+1 Hz stimulation as compared to the figure in the week before (p=0.02). CONCLUSION: We detected a trend indicating an improvement of patients' condition based on the data from visual snow diaries. Research on a larger group of patients is required to confirm these findings; however, our study provides a framework to build upon (Tab. 4, Fig. 1, Ref. 22).


Assuntos
Estimulação Magnética Transcraniana , Transtornos da Visão , Córtex Visual , Potenciais Evocados Visuais , Humanos , Resultado do Tratamento , Transtornos da Visão/terapia
15.
J Fr Ophtalmol ; 43(6): 552-558, 2020 Jun.
Artigo em Francês | MEDLINE | ID: mdl-32451139

RESUMO

Ischemic optic neuropathies include any vascular disease of the optic nerve. Anterior ischemic optic neuropathies are classically distinguished from posterior ischemic optic neuropathies by the presence of optic disc edema in the former, and the absence thereof in the latter. Non-arteritic acute anterior ischemic optic neuropathy is the most common ischemic optic nerve disease. Its exact cause remains unknown. A disc at risk (small and crowded optic nerve) is a typical backdrop for the development of non-arteritic ischemic optic neuropathy. There is no curative or preventive treatment. Posterior ischemic optic neuropathy is exceedingly rare, compared to anterior ischemic optic neuropathy. It is more frequent in patients with cardiovascular risk factors or in the perioperative period. There is no treatment. In any case of ischemic optic neuropathy, an arteritic cause must be ruled out urgently through clinical and paraclinical examinations. The most frequent cause is giant-cell arteritis. In this case, emergency treatment with intravenous methylprednisolone is required in order to limit vision loss in the affected eye and to prevent vision loss in the other eye.


Assuntos
Neuropatia Óptica Isquêmica , Arterite de Células Gigantes/complicações , Arterite de Células Gigantes/diagnóstico , Arterite de Células Gigantes/epidemiologia , Arterite de Células Gigantes/terapia , Humanos , Neuropatia Óptica Isquêmica/diagnóstico , Neuropatia Óptica Isquêmica/epidemiologia , Neuropatia Óptica Isquêmica/etiologia , Neuropatia Óptica Isquêmica/terapia , Papiledema/complicações , Papiledema/diagnóstico , Papiledema/epidemiologia , Papiledema/terapia , Prognóstico , Fatores de Risco , Transtornos da Visão/diagnóstico , Transtornos da Visão/epidemiologia , Transtornos da Visão/etiologia , Transtornos da Visão/terapia
16.
Strabismus ; 28(1): 7-12, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32301677

RESUMO

Objective: Acute acquired concomitant esotropia (AACE) is a distinct subtype of esotropia. The purpose of this retrospective study was to describe the clinical characteristics and discuss the diagnostic and therapeutic management, and evaluate the effect of prism treatment.Methods: The records of 30 patients who presented with acute-onset diplopia at the General Hospital of Central Theater Command from August 2015 to November 2018 were reviewed. All patients underwent a complete medical history, ophthalmological and orthoptic examinations, and brain and orbital imaging. The patients were followed up between 2 and 8 months (mean 3.9 ± 1.2). Angle of strabismus, refractive error, stereopsis, and results of treatment with prisms were analyzed. Level of stereopsis was assessed before and after prismatic correction. Patient satisfaction was assessed with a telephone follow-up survey.Results: The mean age of the 30 patients was 29.7 ± 10.3 years (range 14-52). All patients complained about uncrossed diplopia, only at distance. The esophoria was concomitant in all cases ranging from 12 to 60 prism diopters (PD) at distance (mean 35.80 ± 14.17) and from 10 to 46 PD at near (mean 26.23 ± 11.46) (t = 6.51, P <.001). Cycloplegic spherical-equivalent refraction averaged -5.25 ± 1.67 D (range -0.50 to -8.13), 28 patients were myopic and 2 were emmetropic, all did not wear glasses for near work. All patients received brain and orbital computed tomography scans and magnetic resonance imaging and, in some cases, neurological examinations were performed. All of these examinations were normal. In 27 out of 30 patients treated with prisms, the diplopia resolved, whereas three patients were not satisfied with prismatic correction and underwent surgery. With prisms the esophoria was concomitant, ranging from 6 to 23 PD at distance fixation and from 4 to 18 PD at near fixation. Out of 30 patients, 23 patients were satisfied, 3 patients were not satisfied because their vision remained uncomfortable and 4 patients had an intermediate score.Conclusion: AACE was characterized by a sudden onset of concomitant non-accommodative esotropia with diplopia or visual confusion. In most cases, prismatic correction had a favorable effect with a resolution of diplopia. It offers a good treatment alternative in the early stage, when the angle of strabismus is unstable and surgery is not without risk.


Assuntos
Diplopia/terapia , Esotropia/terapia , Óculos , Transtornos da Visão/terapia , Doença Aguda , Adolescente , Adulto , Percepção de Profundidade/fisiologia , Diplopia/fisiopatologia , Esotropia/fisiopatologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Estudos Retrospectivos , Transtornos da Visão/fisiopatologia , Testes Visuais , Acuidade Visual/fisiologia , Adulto Jovem
17.
BMC Health Serv Res ; 20(1): 302, 2020 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-32293430

RESUMO

BACKGROUND: Visual impairments (VIs) have a negative impact on life and affect up to 60% of stroke survivors. Despite this, VIs are often overlooked. This paper explores how persons with VIs experience vision care within stroke health services and how VIs impact everyday life the first 3 months post stroke. METHODS: Individual semi-structured interviews were conducted with 10 stroke survivors 3 months post stroke, and analyzed using qualitative content analysis. RESULTS: The main theme, "Invisible" visual impairments, represents how participants experience VIs as an unknown and difficult symptom of stroke and that the lack of attention and appropriate visual care leads to uncertainty about the future. VIs were highlighted as a main factor hindering the participants living life as before. The lack of acknowledgement, information, and systematic vision rehabilitation leads to feelings of being unsupported in the process of coping with VIs. CONCLUSION: VIs are unknown symptoms pre stroke and sequelas after stroke that significantly affect everyday life. VIs and vision rehabilitation needs more attention through all phases of stroke health services. We request a greater awareness of VIs as a presenting symptom of stroke, and that visual symptoms should be included in stroke awareness campaigns. Further, we suggest increased competence and standardized evidence-based clinical pathways for VIs to advance all stroke health services including rehabilitation in order to improve outcomes and adaptation to future life for stroke survivors with VIs.


Assuntos
Acidente Vascular Cerebral/complicações , Sobreviventes/psicologia , Transtornos da Visão/psicologia , Transtornos da Visão/terapia , Adaptação Psicológica , Idoso , Feminino , Pesquisa sobre Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Acidente Vascular Cerebral/terapia , Sobreviventes/estatística & dados numéricos , Transtornos da Visão/etiologia
18.
Physiol Rev ; 100(4): 1467-1525, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32191560

RESUMO

Impairments of vision and hearing are highly prevalent conditions limiting the quality of life and presenting a major socioeconomic burden. For a long time, retinal and cochlear disorders have remained intractable for causal therapies, with sensory rehabilitation limited to glasses, hearing aids, and electrical cochlear or retinal implants. Recently, the application of gene therapy and optogenetics to eye and ear has generated hope for a fundamental improvement of vision and hearing restoration. To date, one gene therapy for the restoration of vision has been approved, and ongoing clinical trials will broaden its application including gene replacement, genome editing, and regenerative approaches. Moreover, optogenetics, i.e., controlling the activity of cells by light, offers a more general alternative strategy. Over little more than a decade, optogenetic approaches have been developed and applied to better understand the function of biological systems, while protein engineers have identified and designed new opsin variants with desired physiological features. Considering potential clinical applications of optogenetics, the spotlight is on the sensory systems, particularly the eye and ear. Multiple efforts have been undertaken to restore lost or hampered function in the eye and ear. Optogenetic stimulation promises to overcome fundamental shortcomings of electrical stimulation, namely, poor spatial resolution and cellular specificity, and accordingly to deliver more detailed sensory information. This review aims to provide a comprehensive reference on current gene therapeutic and optogenetic research relevant to the restoration of hearing and vision. We will introduce gene-therapeutic approaches and discuss the biotechnological and optoelectronic aspects of optogenetic hearing and vision restoration.


Assuntos
Perda Auditiva/terapia , Transtornos da Visão/terapia , Humanos , Optogenética , Próteses Visuais
19.
Curr Neurol Neurosci Rep ; 20(4): 8, 2020 03 26.
Artigo em Inglês | MEDLINE | ID: mdl-32219578

RESUMO

PURPOSE OF REVIEW: The goal of this review is to describe the presenting features of fulminant idiopathic intracranial hypertension (IIH) and outline the multimodal approach to its treatment. RECENT FINDINGS: Venous sinus stenting may be an appropriate alternative to optic nerve sheath fenestration or cerebrospinal fluid shunting in select patients with fulminant IIH. Prompt surgical intervention maximizes the chance of visual recovery in patients with fulminant IIH. "Fulminant IIH" is defined as intracranial hypertension with no secondary cause, severe vision loss within 4 weeks of symptom onset, and progressive vision loss over days. Rapid recognition of the fulminant phenotype of IIH by emergency department physicians, neurologists, and ophthalmologists is critical. Without appropriate triage and rapid medical and surgical intervention, patients with fulminant IIH are at high risk for profound, permanent vision loss. Prompt surgical intervention with optic nerve sheath fenestration, cerebrospinal fluid shunting, or venous sinus stenting minimizes the chance of poor visual outcome. If a delay is anticipated, serial lumbar punctures or temporary cerebrospinal fluid drainage and medical therapy may forestall irreversible vision loss.


Assuntos
Hipertensão Intracraniana/diagnóstico , Hipertensão Intracraniana/terapia , Procedimentos Neurocirúrgicos/métodos , Derivação Ventriculoperitoneal/métodos , Humanos , Hipertensão Intracraniana/epidemiologia , Pseudotumor Cerebral/diagnóstico , Pseudotumor Cerebral/epidemiologia , Pseudotumor Cerebral/terapia , Transtornos da Visão/diagnóstico , Transtornos da Visão/epidemiologia , Transtornos da Visão/terapia
20.
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
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