RESUMO
PURPOSE: Report incidence and risk of retinal detachment (RD)after coaxial phacoemulsification in high myopic patients. DESIGN: Retrospective consecutive interventional study. SETTING: Vissum-Instituto Oftalmologico de Alicante, Spain. PATIENT OR STUDY POPULATION: A total of 439 eyes from 274 high myopic patients with spherical equivalent (SE) >or= 6.00 diopters (D) or axial length >or= 26.00 mm. Mean age 62.2, axial length 27.88 +/- 2.11 mm (26.0 mm to 37.9 mm), SE -13.3 +/- 5.6 (-6.00 D to -46.0 D). MAIN OUTCOME MEASURES: Incidence of RD, vitreous loss, and neodymium yttrium aluminum garnet (Nd:YAG) capsulotomy were evaluated after surgery at one, three, six, and 12 months then annually with mean follow-up 61.5 +/- 29.6 months. RESULTS: Incidence of RD was 2.7% (12/439 eyes). In eyes with Assuntos
Miopia Degenerativa/complicações
, Facoemulsificação/efeitos adversos
, Complicações Pós-Operatórias
, Descolamento Retiniano/etiologia
, Adulto
, Idoso
, Idoso de 80 Anos ou mais
, Feminino
, Humanos
, Incidência
, Terapia a Laser
, Cápsula do Cristalino/cirurgia
, Implante de Lente Intraocular
, Masculino
, Microcirurgia
, Pessoa de Meia-Idade
, Estudos Retrospectivos
, Fatores de Risco
RESUMO
PURPOSE: This study aimed to evaluate the efficacy of photodynamic therapy (PDT) in treating chronic central serous chorioretinopathy (CSC). METHODS: We describe a non-randomized, multicentre, interventional case series. A total of 82 eyes of 72 patients with chronic CSC were treated by conventional PDT. LogMAR best corrected visual acuity (BCVA) (ETDRS charts) and central foveal thickness (CFT) measured by optical coherence tomography before and after PDT, number of PDT treatments and complications were used as outcome indicators. RESULTS: Mean follow-up was 12 +/- 10 months and mean age was 46 +/- 10 years. Mean logMAR BCVA changed from 0.53 (standard deviation [SD] 0.43) before PDT to 0.38 (SD 0.41) at 3 months and 0.48 (SD 0.50) at 6 months (p < 0.0001 and p = 0.007, respectively, Student's t-test for paired data). Mean BCVA at the end of follow-up was 0.37 (SD 0.45; p < 0.0001 from baseline). Macular detachment was resolved and subretinal fluid (SRF) disappeared in all cases. Central foveal thickness decreased from 325 microm (SD 95), to 229 microm (SD 70) at 1 month after PDT, 206 microm (SD 68) at 3 months, and 202 microm (SD 76) at 6 months (all p < 0.0001, Student's t-test for paired data). No cases developed severe visual loss or complications derived from PDT. Reactive retinal pigment epithelium hypertrophy appeared in nine cases after PDT. CONCLUSIONS: Photodynamic therapy with verteporfin may be useful in chronic CSC for improving BCVA and reducing SRF and CFT. Randomized studies with longer follow-up are needed to assess the real role of this treatment in chronic CSC.
Assuntos
Coriorretinopatia Serosa Central/tratamento farmacológico , Fotoquimioterapia , Fármacos Fotossensibilizantes/uso terapêutico , Porfirinas/uso terapêutico , Adulto , Idoso , Coriorretinopatia Serosa Central/fisiopatologia , Doença Crônica , Feminino , Seguimentos , Fóvea Central/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia de Coerência Óptica , Resultado do Tratamento , Verteporfina , Acuidade Visual/fisiologiaRESUMO
PURPOSE: To analyze the appearance and evolution of high intraocular pressure (IOP) and cataracts after high-dose intravitreous triamcinolone acetonide (TA) and photodynamic therapy (PDT) to treat choroidal neovascularization associated with age-related macular degeneration. PATIENTS AND METHODS: Retrospective, consecutive, nonrandomized, interventional case series. Fifty-one consecutive eyes with subfoveal (all types) choroidal neovascularization associated to age-related macular degeneration were treated by PDT and intravitreal 19.4+/-2.1 mg/0.1 mL TA. Changes in IOP and lens were considered as primary outcome indicators. Optic disk changes were also considered. RESULTS: Twenty nine of 49 eyes (59%) needed topical therapy for high IOP at month 12, and 11 of 47 (23%) at month 24. Cataracts appeared in 14 of 42 phakic eyes (33%) after 12 months follow-up and in 22 of 40 phakic eyes (55%) completing 24 months follow-up. One eye showed an increased cup-to-disk ratio. CONCLUSIONS: The use of high-dose intravitreal TA is associated with cataracts and IOP elevation in approximately 50% of cases. The need for topical treatment for high IOP decreases during the second year.