Current Issue : January - March Volume : 2015 Issue Number : 1 Articles : 7 Articles
Background: This study assessed the barriers to sight impairment certification in the East London Borough of\nTower Hamlets amongst patients attending the Diabetic Retinopathy Screening Service (DRSS).\nMethods: All patients who attended DRSS between 1stApril 2009 and 31st of March 2010 and whose recorded best\ncorrected visual acuity (BCVA) at DRSS fulfilled the requirements for sight impairment in the UK were included. An\nadditional 24 patients whose general practitioners (GPs) reported them to be certified blind due to no perception\nof light (NPL) vision were re-examined to ascertain the reason for certification, and their potential social and visual\naids needs.\nResults: 78 patients were identified with certifiable vision and were reviewed: 10 deceased in the preceding\n12 months; 60 were not known to be certified. Of these, 57 attended further assessment, 27 were found to have\nnon-certifiable vision, 9 were referred for further interventions, 9 were certified and 9 were found to be eligible, but\ndeclined certification. Five patients were registered due to diabetic eye disease.\nOf those 24 reported by the GP of NPL vision, only 4 had true NPL, the rest had usable vision. Only two of them\nwere certified blind due to diabetes.\nConclusions: Our data shows that sight certification in patients with diabetes might be underestimated and these\npatients often have non-diabetes related visual loss. We propose that data on certifiable visual impairment could\nserve, along with existing certification databases, as a resource for quality of care standards assessment and service\nprovision for patients with diabetes....
Background: Occlusion break surge during phacoemulsification cataract surgery can lead to potential surgical\ncomplications. The purpose of this study was to quantify occlusion break surge and vacuum rise time of current\nphacoemulsification systems used in cataract surgery.\nMethods: Occlusion break surge at vacuum pressures between 200 and 600 mmHg was assessed with the Infiniti�®\nVision System, the WhiteStar Signature�® Phacoemulsification System, and the Centurion�® Vision System using\ngravity-fed fluidics. Centurion Active FluidicsTM were also tested at multiple intraoperative pressure target settings.\nVacuum rise time was evaluated for Infiniti, WhiteStar Signature, Centurion, and Stellaris�® Vision Enhancement\nsystems. Rise time to vacuum limits of 400 and 600 mmHg was assessed at flow rates of 30 and 60 cc/minute.\nOcclusion break surge was analyzed by 2-way analysis of variance.\nResults: The Centurion system exhibited substantially less occlusion break surge than the other systems\ntested. Surge area with Centurion Active Fluidics was similar to gravity fluidics at an equivalent bottle height.\nAt all Centurion Active Fluidics intraoperative pressure target settings tested, surge was smaller than with\nInfiniti and WhiteStar Signature. Infiniti had the fastest vacuum rise time and Stellaris had the slowest. No\nsystem tested reached the 600-mmHg vacuum limit.\nConclusions: In this laboratory study, Centurion had the least occlusion break surge and similar vacuum rise\ntimes compared with the other systems tested. Reducing occlusion break surge may increase safety of\nphacoemulsification cataract surgery...
Background: Valsalva retinopathy and traumatic macular hole are common conditions, but macular hole secondary\nto Valsalva retinopathy is rarely reported.\nCase presentation: A 34-year-old healthy man suffered Valsalva retinopathy after doing push-up exercise. During his\nfollow-up visits, the best-corrected visual acuity (BCVA) measurements, fundus examinations and spectral-domain\noptical coherence tomography (SD-OCT) tests were performed. Three months later, the premacular hemorrhage was\nnoticeably absorbed with an improvement of visual acuity. SD-OCT showed a lamellar macular hole with intact but\nthickened internal limiting membrane (ILM) with vitreal tractions on surface of the macular. Nine months after the first\nvisit, his vision acuity was 20/25. The fundus examination showed a complete absorption of the macular hemorrhage.\nSD-OCT showed that the lamellar macular hole has enlarged, with thickened ILM on the surface. Seventeen months\nafter the onset, the BCVA, fundus examination results and OCT findings were stable.\nConclusions: Macular hole secondary to Valsalva retinopathy had been rarely reported and its mechanism needs\nfurther understanding. SD-OCT can be used to observe the evolvement of Valsalva retinopathy....
Background: This meta-analysis aimed to investigate the association between type 2 diabetes (T2D) and the risk\nof cataract.\nMethods: Databases of Pubmed, Embase, and SpringerLink were retrieved for observational studies published\nbefore November 2013. The odds ratio (OR) and 95% confidence interval (CI) were used for estimating the\nassociation. All statistical analyses were performed by Stata 10.0 software.\nResults: A total of 8 studies involving 20837 subjects were included in the meta-analysis. The risk of any cataract\n(AC) in T2D patients was higher than that in non-diabetic subjects (OR = 1.97, 95% CI: 1.45-2.67, P < 0.001). The risks\nof cortical cataract posterior (CC) (OR = 1.68, 95% CI: 1.47-1.91, P < 0.001) and posterior subcapsular (PSC) (OR = 1.55,\n95% CI: 1.27-1.90, P < 0.001) were significantly elevated in T2D patients, while no significant association was found\nin nuclear sclerosis (NS) (OR = 1.36, 95% CI: 0.97-1.90, P = 0.070).\nConclusion: T2D patients had a higher risk of cataracts, excepting NS. Special attention should be paid on the\nophthalmic extermination, especially for cataract in T2D patients...
Background: At present there are no large scale nationally-representative studies from Sri Lanka on the prevalence\nand associations of Diabetic Retinopathy (DR). The present study aims to evaluate the prevalence and risk factors\nfor DR in a community-based nationally-representative sample of adults with self-reported diabetes mellitus from\nSri Lanka.\nMethods: A cross-sectional community-based national study among 5,000 adults (?18 years) was conducted in\nSri Lanka, using a multi-stage stratified cluster sampling technique. An interviewer-administered questionnaire was\nused to collect data. Ophthalmological evaluation of patients with ââ?¬Ë?knownââ?¬â?¢ diabetes (previously diagnosed at a\ngovernment hospital or by a registered medical practitioner) was done using indirect ophthalmoscopy. A binary-logistic\nregression analysis was performed with ââ?¬Ë?presence of DRââ?¬â?¢ as the dichotomous dependent variable and other\nindependent covariates.\nResults: Crude prevalence of diabetes was 12.0% (n = 536), of which 344 were patients with ââ?¬Ë?knownââ?¬â?¢ diabetes.\nMean age was 56.4 Ã?± 10.9 years and 37.3% were males. Prevalence of any degree of DR was 27.4% (Males-30.5%,\nFemales-25.6%; p = 0.41). In patients with DR, majority had NPDR (93.4%), while 5.3% had maculopathy. Patients with\nDR had a significantly longer duration of diabetes than those without. In the binary-logistic regression analysis\nin all adults duration of diabetes (OR:1.07), current smoking (OR:1.67) and peripheral neuropathy (OR:1.72)\nall were significantly associated with DR.\nConclusions: Nearly 1/3rd of Sri Lankan adults with self-reported diabetes are having retinopathy. DR was\nassociated with diabetes duration, cigarette smoking and peripheral neuropathy. However, further prospective\nfollow up studies are required to establish causality for identified risk factors....
Backgroud: Retinal racemose hemangioma (RRH) is a rare congenital disorder that often co-occurs with other\nocular complications. In this study, we present a case of RRH complicated with retinal vein obstruction in three\nbranches and provide a review of ocular complications and associations with RRH.\nCase presentation: One case of RRH is presented. Fundus examination, fluorescein angiography (FFA) and optical\ncoherence tomography (OCT) of the patient identified Group 3 RRH complicated with retinal vein occlusions in the\nsuperotemporal, inferotemporal, and inferonasal branches. Macular edema, which causes visual impairment, was\ndetected. A brief literature review was also presented. The PubMed database was searched for RRH or related\nkeywords to find reports of ocular complications or associations published on or before Dec. 31, 2013. A total of\n140 papers describing167 RRH cases were found. The mean age of diagnosis was 22.97 years. Ocular complications\nwere mentioned in 32 (19.16%) cases. Retinal vein occlusion (46.88%) was the major ocular complication in RRH,\nfollowed by hemorrhage (34.38%). Eight (4.79%) cases were associated with other ocular diseases such as\nSturgeââ?¬â??Weber syndrome , Morning glory disc anomaly and macroaneurysm.\nConclusions: Although RRH is a relatively non-progressive condition, its complications may lead to vision loss and\nshould be treated in time....
Background: Uncorrected Refractive Error is one of the leading cause amblyopia that exposes children to poor\nschool performance. It refrain them from productive working lives resulting in severe economic and social loses in\ntheir latter adulthood lives. The objective of the study was to assess the prevalence of uncorrected refractive error\nand its associated factors among school children in Debre Markos District.\nMethod: A cross section study design was employed. Four hundred thirty two students were randomly selected\nusing a multistage stratified sampling technique. The data were collected by trained ophthalmic nurses through\ninterview, structured questionnaires and physical examinations. Snellens visual acuity measurement chart was used\nto identify the visual acuity of students. Students with visual acuity less than 6/12 had undergone further\nexamination using auto refractor and cross-checked using spherical and cylindrical lenses. The data were entered\ninto epi data statistical software version 3.1 and analyzed by SPSS version 20. The statistical significance was set at\n? ? 0.05. Descriptive, bivariate and multivariate analyses were done using odds ratios with 95% confidence interval.\nResult: Out of 432 students selected for the study, 420 (97.2%) were in the age group 7ââ?¬â??15 years. The mean age\nwas 12 Ã?± 2.1SD. Overall prevalence of refractive error was 43 (10.2%). Myopia was found among the most dominant\n5.47% followed by astigmatism 1.9% and hyperopia 1.4% in both sexes. Female sex (AOR: 3.96, 95% CI: 1.55-10.09),\nhigher grade level (AOR: 4.82, 95% CI: 1.98-11.47) and using computers regularly (AOR: 4.53, 95% CI: 1.58-12.96) were\nsignificantly associated with refractive error.\nConclusion: The burden of uncorrected refractive errors is high among primary schools children. Myopia was\ncommon in both sexes. The potential risk factors were sex, regular use of computers and higher grade level of\nstudents. Hence, school health programs should work on health information dissemination and eye health care\nservices provision....
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