Current Issue : October - December Volume : 2016 Issue Number : 4 Articles : 7 Articles
Purpose: The main objective was to analyze the relationship between maximum cup depth (MCD),\nmean defect (MD), central corneal thickness (CCT), age and disc area, in patients with ocular hypertension\n(OHT) and primary open angle glaucoma (POAG). Methods: Cross-sectional study of\npatients diagnosed with OHT and POAG. Visual fields were obtained using an Octopus 300 analyzer,\nTOP strategy. MCD and disc area were obtained using a Heidelberg Retina Tomograph. Results:\nThe study sample comprised 234 eyes of 143 patients, 91 women and 52 men, mean age 63.55\nyears (SD 10.49). Mean values were: MCD 0.52 mm (SD 0.27), MD 2.78 dB (SD 5.02), CCT 543.5 �¼m\n(SD 36.63), IOP 16.73 mmHg (SD 2.93), and disc area 2.01 mm2 (SD 0.39). A significant correlation\nwas observed between MCD and age in patients under 60 years, between MCD and disc area, and\nbetween MD and disc area. Conclusions: Our study showed a correlation between MCD and age\nwhich was significant in patients under 60 years of age, between MCD and disc area and between\nMD and disc area, suggesting that the larger the disc area, the greater the MCD and the MD in patients\nwith OHT and POAG....
Background: Vitamin D deficiency and vitamin D receptor gene polymorphisms are known to be significantly\nassociated with high myopia. Whether this genetic variant may impact primary open-angle glaucoma is\nlargely unknown. This study investigated whether vitamin D receptor gene polymorphisms are altered in\nprimary open-angle glaucoma subjects carrying the risk allele, and whether vitamin D deficiency is an\nimportant factor in the development of glaucoma.\nMethods: Seventy-three POAG patients and 71 age-matched controls from the Han population were enrolled. Serum\nlevels of 1a, 25-Dihydroxyvitamin D3 were measured by enzyme-linked immunoabsorbent assay. Vitamin D receptor\npolymorphisms (Cdx-2, Fok I, Bsm I and Taq I) were analyzed using real-time polymerase-chain reaction high resolution\nmelting analysis.\nResults: Serum levels of 1a, 25-Dihydroxyvitamin in primary open-angle glaucoma patients were lower than in\nage-matched controls. Statistical analysis revealed a significant difference in the allelic frequencies of the BsmI and TaqI\ngenotypes between primary open-angle glaucoma patients and age-matched controls, while other polymorphisms did\nnot show any significant differences.\nConclusions: Vitamin D deficiency and the presence of the BsmI ââ?¬Ë?Bââ?¬â?¢ allele and the TaqI ââ?¬Ë?tââ?¬â?¢ allele are relevant risk factors in\nthe development of glaucoma....
Background: Good adherence to ocular hypotensive agents is important to control intraocular pressure and hence\nto prevent progressive glaucomatous optic nerve head damage. Periodic investigation of adherence is crucial in\nglaucoma treatment. The purpose of this study was to assess level of adherence to ocular hypotensive agents and\nto identify factors affecting adherence among glaucoma patients at a tertiary public eye care center.\nMethods: The study was a hospital-based cross-sectional study that was conducted in Menelik II Referral Hospital\nfrom June 1, 2015 to July 31, 2015. A systematic random sampling technique was used to select 359 study participants\nfrom the source population. The study patients were interviewed and their medical charts were reviewed using a\npretested structured questionnaire. Adherence was assessed using Morisky Medication Adherence Scale - 8 and\nadherence determinant factors were identified using multivariate binary logistic regression analysis. The association was\ndeclared statistically significant at p < 0.05.\nResults: Among the 359 study glaucoma patients, 42.6 % were adherent to their prescribed hypotensive agents.\nHigher educational level (AOR = 4.60, 95 % CI: 1.01ââ?¬â??21.03, p < 0.049), being self - employed (AOR = 6.14, 95 % CI:\n1.37ââ?¬â??27.50, p < 0.018) and taking lesser frequency of drops (AOR = 2.89, 95 % CI: 1.25ââ?¬â??6.66, p < 0.013) were significantly\nassociated with adherence, whereas being a farmer (AOR = 0.07, 95 % CI: 0.01ââ?¬â??0.75, p < 0.028), having very low monthly\nfamily income (AOR = 0.22, 95 % CI: 0.06ââ?¬â??0.77, p < 0.019) and self - purchasing of medications (AOR = 0.30, 95 % CI:\n0.10ââ?¬â??0.93, p < 0.036) were significantly associated with non-adherence.\nConclusions: The study has identified the adherence level to the prescribed ocular hypotensive agents to be\nsub-optimal and is influenced by different factors among glaucoma patients of the public tertiary center. We\nrecommend glaucoma care providers to pay due attention on the importance of adherence....
Purpose. To investigate the prognostic factors for visual outcome in traumatic cataract patients. Methods.The demographic features\nof traumatic cataract patients in Central China were studied.The factors that might influence the visual outcome were analyzed.\nThe sensitivity and specificity of OTS (ocular trauma score) in predicting VA were calculated. Results.The study enrolled 480 cases.\n65.5% of patients achieved VA at >20/60. The factors associated with the final VA were initial VA, injury type, wound location, the\nway of cataract removal, and IOL implantation. The sensitivities of OTS in predicting the VA at NLP (nonlight perception), LP/HM\n(light perception/hand motion), and �20/40 were 100%. The specificity of OTS to predict the final VA at 1/200-19/200 and 20/200-\n20/50 was 100%. Conclusion.The prognostic factors were initial VA, injury type, wound location, cataract removal procedure, and\ntheway of IOL implantation.TheOTS has good sensitivity and specificity in predicting visual outcome in traumatic cataract patients\nin long follow-up....
Background: To analyze the results of repeat selective laser trabeculoplasty (SLT).\nMethods: Inclusion criteria: participants with primary or secondary open-angle glaucoma (excluding uveitic) who\nhad undergone SLT 360Ã?° (SLT 1) with diminution of response over time followed by repeat SLT 360Ã?° (SLT 2). Six\nmonths of follow-up were required and at least 6 months in between SLT 1 and 2. The main outcome measures\nwere IOP reduction at 6 and 12 months and a comparison of the response between SLT 1 and 2.\nResults: One hundred thirty-seven patients met the inclusion criteria. If only one eye had repeat treatment, that eye\nwas chosen; if both eyes qualified, one was chosen at random. The baseline intraocular pressure (IOP) for SLT 1 = 20.3\n+/âË?â?? 5.2 mmHg and SLT 2 = 19.4 +/âË?â?? 5.0 was reduced to 16.4 +/âË?â?? 3.9 and 16.7 +/âË?â?? 4.7 at 1 year, respectively (p < .001).\nMedication use was not significantly changed, and was 2.2 +/âË?â?? 1.2 at baseline for SLT 1 and 2.1 +/âË?â?? 1.3 for SLT 2, and\nat 1 year was 1.9 +/âË?â?? 1.3 and 2.2 +/âË?â?? 1.2, respectively. A subanalysis of 62 patients matched for equivalent baselines\nshowed a baseline IOP = 18.7 +/âË?â?? 3.8 for SLT 1 and 18.7 +/âË?â?? 3.5 for SLT 2, reduced to 16.0 +/âË?â?? 4.3 and 15.3 +/âË?â?? 3.8 at\n1 year (p < .001).\nConclusion: Repeat SLT laser (360-degree treatment, followed by a loss of effect over time, then a second 360-degree\ntreatment) in this population resulted in IOP lowering similar to that of the initial treatment....
Aim: To share our experience in eyes with severe DME (exhibiting serous retinal detachment or\nlarge cysts) treated with simultaneous intravitreal ranibizumab and dexamethasone implant administration\nat the same setting as the first treatment step. Subjects and Results: Five eyes of three\npatients with DME who were either treatment naive or relatively undertreated were presented in\nthis report. As optical coherence tomography exhibited serous retinal detachment or severe cystoid\nedema with large cysts, intravitreal ranibizumab and dexamethasone implant were simultaneously\nemployed at the same setting as the first treatment step in those eyes. Panretinal photocoagulation\nwas also commenced bilaterally a week after the start of injections when at least one\neye had retinal neovascularization. Subsequent treatments of intravitreal ranibizumab and/or\ndexamethasone implant were administered. Patients were followed up for seven, eight and 13\nmonths respectively. All five eyes achieved a relative anatomic stability and experienced visual\nimprovement at the end of follow-up. Conclusion: In some cases with severe DME with or without\nproliferative diabetic retinopathy, simultaneous intravitreal ranibizumab and dexamethasone\nimplant administration at the same setting may be a better option to initiate the treatment over\nmono ranibizumab treatment. A randomized study comparing the mono anti-VEGF therapy and\nmono dexamethasone implant administration with simultaneous treatment may outline the place\nof this type of therapy in the treatment armamentarium of severe DME....
Background: Femtosecond-laser assisted clear cornea cataract surgery may hold promise in safer and more\neffective procedures. We decided to perform a comparative study to standard manual incision phacoemulsification\nsurgery.\nMethods: This is a single-center, single-intervention, and prospective comparative data evaluation of 133\nconsecutive cases subjected to cataract surgery. Group-A (Phaco), manual capsulorhexis & ultrasound\nphacoemulsification (n = 66); Group-B femtosecond-laser assisted capsulorhexis and lens fragmentation (n = 67),\nemploying the LenSx laser (Alcon Surgical, Ft. Worth, TX). All cases were evaluated for refraction, visual acuity,\nkeratometry, tomography, pachymetry, endothelial cell counts, intraocular pressure, and type of intraocular lens\n(IOL) implanted. The groups were matched for age, gender, pre-operative vision metrics, and cataract grade, and\nwere followed up to 1 year.\nResults: In group-A post-operative uncorrected distance visual acuity (UDVA) was 20/20 or better in 61.5 % and\n20/25 or better in 78.5 % of the eyes. The femtosecond laser group-B had improved outcomes (p = 0.075 and p = 0.\n042, respectively): post-operative UDVA was 20/20 or better in 62.7 % of the eyes and 20/25 or better in 85.1 %.\nLinear regression scatterplots of achieved versus attempted spherical equivalent had excellent regression\ncoefficients (r2 = 0.983 in group-A and 0.979 in group-B). There were 75.2 % cases in group-A and 80.6 % in group-B\n(p = 0.8732) within Ã?±0.50 D of targeted refractive equivalent. Slight trend of under-correction was noted in group-A.\nAverage residual manifest cylinder in the toric subgroup-A was -0.50 D (95 % Limit-of-Agreement (LoA) = -0.78 D),\nand in toric subgroup-B -0.45 D (LoA = -0.45 D).\nConclusions: Mean spherical equivalent refraction and visual acuity are comparable with laser cataract surgery\ncompared with manual capsulorhexis & ultrasound phacoemulsification. Improved astigmatism correction may be\namong the benefits of femtosecond laserââ?¬â??assisted cataract surgery. Transient corneal edema may be a first day\ntransient disadvantage in femtosecond laserââ?¬â??assisted cataract surgery....
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