Current Issue : April - June Volume : 2016 Issue Number : 2 Articles : 9 Articles
Background. To compare the efficacy of needle revision with 5-fluorouracil (5-FU) and mitomycin C (MMC) on dysfunctional\nfiltration blebs shortly after trabeculectomy. Methods. It is a prospective randomized study comparing needle revision augmented\nwith MMC or 5-FU for failed trabeculectomy blebs. Results. To date 71 patients (75 eyes) have been enrolled, 40 eyes in the MMC\ngroup and 35 in the 5-FU group. 68 patients (72 eyes) have completed 12-month follow-up, 38 eyes in theMMC group and 34 in the\n5-FU group. The mean IOP before and that after needle revision in the MMC group were 26.5 �± 4.3mmHg and 11.3 �± 3.4mmHg,\nrespectively (...
Background: Neovascular glaucoma is a refractive glaucoma. Recently, anti-VEGF factors have been used alone or\nin combination for the treatment of neovascular glaucoma. However, the medium- and long-term efficacy of such\ndrugs remains to be evaluated. This study was to determine the efficacy of intravitreal ranibizumab combined with\nAhmed glaucoma valve implantation for the treatment of neovascular glaucoma.\nMethods: In this prospective non-randomized study, 43 neovascular glaucoma patients (43 eyes) were assigned to\nreceive either 0.5 mg intravitreal ranibizumab for three to 14 days before Ahmed glaucoma valve implantation\n(injection group, n = 21) or Ahmed glaucoma valve implantation alone (control group, n = 22). The patients were\nfollowed up for six to 12 months. Differences in surgical success rate, intraocular pressure, best corrected visual\nacuity, anti-glaucoma medications and postoperative complications were compared between the two groups.\nSurgical success was defined as IOP > = 6 mm Hg and < = 21 mm Hg, with or without the use of anti-glaucoma\nmedications, and without severe complications or reoperation.\nResults: Of the 43 patients, 40 completed the 6-month follow-up and 37 completed the 1-year follow-up. Success\nrate was 73.7 % vs. 71.4 % at six months and 72.2 % vs. 68.4 % at 12 months in the injection group and the control\ngroup respectively. No significant difference was noted between the two groups (six months: P = 0.87, 12 months:\nP = 1.00). There were no significant differences in the two groups with respect to intraocular pressure, best\ncorrected visual acuity, anti-glaucoma medications or postoperative complications at six months or 12 months.\nConclusions: Single intravitreal ranibizumab (0.5 mg) before surgery has no significant effect on the\nmedium- or long-term outcomes of neovascular glaucoma treated with Ahmed glaucoma valve\nimplantation....
Purpose. To evaluate the relationship between internal carotid artery (ICA) stenosis and subfoveal choroidal thickness (SFCT) in\nthe elderly population. Methods. A total of 42 eyes of 21 patients with more than 70% ICA stenosis (Group 1) on one side and less\nthan 70% stenosis (Group 2) on the other side were recruited for this study. ICA stenosis was diagnosed using both the B-mode\nand Doppler ultrasound.The two groups were compared in terms of the percentage of stenosis, SFCT measurements, intraocular\npressure, ocular perfusion pressure, refractive error, and peak systolic velocity. Eyeswere examined with the RTVue-100OCT device\nby the EDI-OCT technique. Results. The mean age of the patients was 71.9 �± 10.8 years. The mean percentage of ICA stenosis was\n74 �± 4.9% in Group 1 and 47.5 �± 7.7% in Group 2. The mean SFCT was 231.9 �± 44.6 ...
Background: The existing literature contains no information regarding inflammatory cytokine expression in\nunilateral acute primary angle-closure (APAC) affected eyes and fellow eyes with primary angle closure suspect\n(PACS). To measure levels of various inflammatory cytokines in the aqueous humor (AH) of APAC affected eyes and\nfellow eyes with a diagnosis of PACS (18 unilateral APAC eyes and 18 fellow eyes with PACS), and determine the\nunderlying correlation between them.\nMethods: The total levels of 12 cytokines including granulocyte colony-stimulating factor (G-CSF), interleukin (IL)-6,\nIL-8, monocyte chemotactic protein (MCP)-1, MCP-3, macrophage-derived chemokine (MDC), macrophage\ninflammatory protein (MIP)-1�², and vascular endothelial growth factor (VEGF) etc. were assessed using the multiplex\nbead immunoassay technique. The level of cytokines in different groups was analyzed by a 2-related-samples\nnonparametric test. Data on patient demographics, preoperative intraocular pressure (IOP), number of glaucoma\nmedications, as well as several ocular biological parameters were also collected for correlation analysis.\nResults: The APAC patients had significantly higher levels of G-CSF, IL-6, IL-8, MCP-1, MCP-3, MDC, MIP-1�², and\nVEGF in the AH samples from unilateral APAC affected eyes than in fellow eyes with PACS (all P < 0.05). The\ncytokines showed positive correlations between each other (P < 0.0071).\nConclusions: Cytokine networks in the AH may have critical roles in the progression of APAC. Thus, different\ncytokine expression in both eyes of the same patient may help us to understand the different pathology in APAC\nand PACS....
Background: Diabetic retinopathy (DR) and age-related macular degeneration (AMD) are among the leading\ncauses of visual impairment and blindness in developing countries. This study aims to explore the awareness of\nthese retinal diseases in Nepal.\nMethod: A population based cross-sectional study conducted among individuals 60 years and older from the\nBhaktapur district of Nepal. One thousand consecutive subjects were enrolled and subjected to a structured\nquestionnaire.\nResult: Subject age ranged from 60 to 93 years with a meanof 69.5 years �± 7.1(S.D.). Males and females comprised\n45.1 and 55.9 % of the population, respectively. The majority was illiterate (78.2 %), and agriculture was the\npredominant occupation (79.8 %). 12.1 % were aware of the effect of diabetes on the eye, and among them, 99 %\nwere aware that diabetes was a blinding disease caused by DR.11.5 % of the subjects were aware of DR, and 10.1 %\nwere aware that subjects with diabetes should undergo periodic eye examinations. Only 7.6 % of subjects were\naware of AMD.7.5 and 7.4 % were aware about its aggravation with smoking and sunlight exposure, respectively.\nYounger age group, males, literates, service holders, best corrected visual acuity >0.3 LogMAR, were each\nsignificantly associated with an increase in awareness of diabetic retinopathy. Smokers and those with agricultural\noccupations were less aware regarding AMD. Those with diabetes,with or without DRwere significantly more aware\nthan those not having the disease.\nConclusion: Among the Bhaktapur population, awareness of DR and AMD was only 11.5 and7.6 % respectively.\nOlder age groups, females, illiterates, farmers, and those with poor visual acuity were less aware of these blinding\ndiseases. We recommend community-based eye health education programs targeted at raising awareness of these\ndiseases and preventive measures....
Purpose. To compare treatment areas and navigated macular laser photocoagulation (MLP) plans suggested by retro-mode scanning\nlaser ophthalmoscopy (RM-SLO) image versus optical coherence tomography (OCT) central retinal thickness map and treatment\nplanning among retina specialists. Methods. Thirty-nine eyes with diabetic or branch retinal vein occlusion-relatedME undergoing\nnavigated MLP with navigated photocoagulator had OCT and RM-SLO taken. OCTmap and RM-SLO image were imported to the\nphotocoagulator and aligned onto the retina. Two retina specialists placed laser spot marks separately based on OCT and RM-SLO\nimages in a randomfashion.Thespots placed by each physician were compared betweenOCT and RM-SLOand among physicians.\nThe areas of retinal edema on OCT and RM-SLO of the same eye were also compared. Results.The average number of laser spots\nusing RM-SLO and OCT template was 189.6 �± 77.4 and 136.6 �± 46.8, respectively, ...
Background: Glaucoma is an optic neuropathy characterized by retinal ganglion cells (RGC) loss and retinal nerve\nfiber layer (RNFL) injury: this results in functional and morphological changes. The first can be observed by Standard\nAutomated Perimetry (SAP), the second by Optic Coherence Tomography (OCT) that measures the RNFL and\nganglion cell complex (GCC) thicknesses. Nevertheless, diagnosis of early glaucoma may be difficult. Recently,\nMedeiros et al. derived an empirical formula combining the measurement of structural and functional tests to\nprovide an estimate of RGC. The aim of the current study is to analyse the correlation between RGC count,\nestimated by Medeirosââ?¬â?¢ formula, and the structural and functional parameters in patients examined for glaucoma\nand to evaluate SAP, OCT and RGC counts capability to discriminate the weight of the disease itself.\nMethods: Ninety four eyes of 50 consecutive patients clinically referring to glaucoma service of the Universitary Eye\nClinic were submitted to a complete ophthalmic evaluation including SAP and Spectral Domain OCT (SD-OCT) of\nRNFL and macular GCC. Average thickness of RNFL and macular GCC, parameters Global Loss Volume (GLV) and\nFocal Loss Volume (FLV) over the entire GCC map were taken into account. Estimates of RGC were obtained with\nthe help of a model already published by Medeiros et al. combining light sensitivities from SAP and retinal\nthickness from OCT. The RGC count was estimated in the entire visual field (central 24Ã?°) and in the GCC macular\narea and then compared with functional and morphological parameters applying Pearsonââ?¬â?¢s correlation coefficient.\nResults: After the classification of the patients by the Glaucoma Staging System 2 of Brusini, we noticed a good\ncorrelation among the functional parameters considered, even if the Visual Field Index is unable to identify early\nglaucoma. An analogous result can be observed for structural data (RNFL and GCC). The correlation detected\nbetween functional and structural parameters was moderate. Great differences in RGC counts were found between\ngroups at various stages of glaucoma. GLV showed highest level of correlation (r > âË?â??0.8) with RCG counts.\nConclusions: Estimate circumpapillary and macular RGC counts can discriminate various stages of the disease and\nthere is also a good/very good correlation with both functional and structural parameters. GLV could be used\ninstead of RGC counts in clinical practice...
Background: Glaucoma combined with an extremely shallow anterior chamber and cataracts remains as a\ncomplex condition to deal with. And the emergence of microincision vitrectomy surgery (MIVS) system may\nprovide an ideal option for the treatment of that. We report a clinical study of surgical outcomes of 23-gauge\ntransconjunctival pars plana vitrectomy (PPV) combined with lensectomy in the treatment of glaucomatous eyes\nwith extremely shallow anterior chamber and cataract.\nMethods: Prospective, nonrandomized and noncomparative case series study. Consecutive patients with secondary\nglaucoma, extremely shallow anterior chamber and cataract were recruited to have combined surgeries of 23-gauge\ntransconjunctival pars plana vitrectomy and lensectomy. The main outcomes were best corrected visual acuity (BCVA),\nintraocular pressure (IOP), anterior chamber depth (ACD), number of anti-glaucoma medications and surgeryassociated\ncomplications.\nResults: Seventeen consecutive patients with secondary glaucoma, extremely shallow anterior chamber and cataract\nwere recruited. The mean follow-up was 21.2 �± 8.8 months. Postoperatively, there was no significant improvement of\nBCVA (P = 0.25). The mean intraocular (IOP) decreased significantly from 43.14 �± 6.53 mmHg to 17.29 �± 1.80 mmHg\n(P < 0.001), and the mean depth of anterior chamber increased significantly from 0.507 �± 0.212 mm to 3.080 �±\n0.313 mm (P < 0.001). The mean number of anti-glaucoma medications decreased from 4.1 �± 0.8 to 0.6 �± 0.8\n(P < 0.001). No severe vision-threatening intra- or post-operative complications occurred.\nConclusions: Glaucoma with an extremely shallow anterior chamber and cataract can be managed well with the\ncombined surgeries of 23-gauge pars plana vitrectomy and lensectomy. The surgical procedure is an effective and\nsafe method to resolve the pupillary block and deepen the anterior chamber....
Purpose. To compare the final incision size and wound structure after the intraocular lens implantation from 2.0mm\ntransconjunctival single-plane sclerocorneal incision (TSSI) between the use of a motorized injector at first speed and the use of\na manual injector. Methods. Patients were divided into three groups as follows: Group A, a manual injector, Group B, a motorized\ninjector with 0.5 s pause time, and Group C, a motorized injector without pause time. The change in incision size and anterior\nsegment optical coherence tomography findings of the wound structure were analyzed. Results. 110 eyes were enrolled (Group A:\n40, Group B: 30, and Group C: 40). The averaged change in incision size (mm) was 0.08, 0.01, and 0.03 in Groups A, B, and C,\nrespectively (...
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