Current Issue : October - December Volume : 2013 Issue Number : 4 Articles : 6 Articles
Background: It is unclear how retinal ischemia influences the changes of visual acuity, macular sensitivity, macular\r\nthickness, and macular volume after the performance of pars plana vitrectomy (PPV) for macular edema in patients\r\nwith central retinal vein occlusion (CRVO).\r\nMethods: Ten patients (10 eyes) with CRVO and macular edema underwent PPV. Retinal ischemia was evaluated\r\nfrom the area of capillary nonperfusion on fluorescein angiography, and the patients were classified into ischemic\r\nor nonischemic groups. Microperimetry was performed with a Micro Perimeter 1. Macular thickness and volume\r\nwere measured by optical coherence tomography.\r\nResults: In both groups, the mean macular thickness within the central 4�°, 10�°, and 20�° fields decreased significantly\r\nfrom baseline to 3 and 6 months after PPV (all P < 0.05). In the ischemic group, the mean macular sensitivity within\r\nthe central 4�°, 10�°, and 20�° fields increased from baseline to 3 and 6 months after PPV, but no significant difference\r\nwas observed.\r\nConclusions: These results suggest that PPV may be effective for improving macular thickness, volume, and sensitivity\r\nin patients with macular edema secondary to ischemic CRVO, although there was no significant difference....
Background: The ability to drive is important for ensuring quality of life for many older adults. Glaucoma is\r\nprevalent in this age group and may affect driving. The purpose of this study is to determine if glaucoma and\r\nglaucomatous visual field (VF) loss are associated with driving cessation, limitations, and deference to another driver\r\nin older adults.\r\nMethods: Cross-sectional study. Eighty-one glaucoma subjects and 58 glaucoma suspect controls between age 60\r\nand 80 reported if they had ceased driving, limited their driving in various ways, or preferred another to drive.\r\nResults: Twenty-three percent of glaucoma subjects and 6.9% of suspects had ceased driving (p = 0.01). Glaucoma\r\nsubjects also had more driving limitations than suspects (2.0 vs. 1.1, p = 0.007). In multivariable models, driving\r\ncessation was more likely for glaucoma subjects as compared to suspects (OR = 4.0; 95% CI = 1.1-14.7; p = 0.03). The\r\nodds of driving cessation doubled with each 5 decibel (dB) decrement in the better-eye VF mean deviation (MD)\r\n(OR = 2.0; 95% CI = 1.4-2.9; p < 0.001). Glaucoma subjects were also more likely than suspects to report a greater\r\nnumber of driving limitations (OR = 4.7; 95% CI = 1.3-16.8; p = 0.02). The likelihood of reporting more limitations\r\nincreased with the VF loss severity (OR = 1.6 per 5 dB decrement in the better-eye VF MD; 95% CI = 1.1-2.4; p = 0.02).\r\nNeither glaucoma nor VF MD was associated with other driver preference (p > 0.1 for both).\r\nConclusions: Glaucoma and glaucomatous VF loss are associated with greater likelihood of driving cessation and\r\ngreater limitation of driving in the elderly. Further prospective study is merited to assess when and why people\r\nwith glaucoma change their driving habits, and to determine if their observed self-regulation of driving is adequate\r\nto ensure safety....
Background: This report describes a recurrent orbital glomus tumor in an Asian patient.\r\nCase presentation: A healthy 50-year-old Korean man had progressive right exophthalmos and a soft mass on his\r\nright lower lid for 6 months. We evaluated the mass using CT and MRI, and performed excisional biopsy and\r\npathologic examination. Pathologically, the mass was a glomus tumor. Although proptosis of the right eye\r\ndecreased, one month after surgery it increased to almost the same level as before surgery.\r\nConclusions: This is the first report of an Asian patient with an orbital glomus tumor that demonstrated rapid\r\nre-growth after incision without pain or visual problems....
Background: A prospective, non-randomised, transversal and comparative study, carried out in INOVA Vision\r\nInstitute and Autonomous University of Aguascalientes. Pterygium is an important illness that affects 22% people\r\nfrom tropic and equatorial zones. Is an inflammatory process caused by UV rays, and it has a behavior similar to a\r\nneoplasm. For this study was taken into consideration 191 samples from the INOVA Vision Institute, Aguascalientes,\r\nMexico. Include 73 pterygia samples, which were obtained during resection under sterile conditions. 44 normal\r\nconjunctiva samples were obtained from the same patients when harvesting the conjunctival autograft, or from\r\nother patients undergoing extracapsular cataract extraction from the superior bulbar region. Tears from patients\r\nwith pterygium (n = 50) and normal volunteers (n = 24) were obtained using a calibrated glass micro capillary tube.\r\nThe surgical conjunctiva and pterygia samples were subjected to reverse-transcription polymerase chain reaction\r\n(RT-PCR), western blot, and immunohistochemistry. Tears were analyzed by enzyme-linked immunosorbent assays.\r\nMethods: This was a prospective, non-randomised study involving 191 biological samples taken from patients with\r\npterygium and normal volunteers, whom were operated under local anaesthesia by either complete resection of\r\nthe lesion with primary closure, or resection with conjunctival autograft. Tissue samples were fixed in 10%\r\nformaldehyde. Sections were routinely stained with hematoxylin and eosin. HCC expression was evaluated by\r\nreverse-transcription polymerase chain reaction (RT-PCR), immunohistochemistry, and by western blotting. All tears\r\nsamples were analyzed by enzyme-linked immunosorbent assays (ELISA).\r\nResults: Expression levels and distribution patterns of HCC in normal conjunctiva and pterygium. Higher levels of\r\nHCC mRNAs and proteins were detected in pterygium compared with a normal conjunctiva. Immunohistochemistry\r\nrevealed that HCC was localized in the apical cells of the epithelium in the normal conjunctiva. In contrast, HCC\r\nwas detected in all extension of epithelial tissue, from apical to basal cells in pterygia. The concentration of HCC\r\nprotein in tears was higher in patients with pterygium versus controls.\r\nConclusion: HCC may play an important role in protecting normal conjunctiva, and regulating inflammatory\r\nconditions of the anterior ocular surface....
Background: To investigate the outcome and prognostic factors for corneal graft recovery after severe corneal\r\ngraft rejection following penetrating keratoplasty (PKP) treated with topical and systemic steroids.\r\nMethods: Fifty-eight eyes in 58 patients with severe corneal graft rejection following PKP were treated with topical\r\nand systemic steroids. Factors affecting the reversibility and maintenance of graft transparency were analyzed.\r\nResults: Graft transparency was restored in 37 of 58 eyes (63.8%). Clarity of the graft was maintained in 25 of 37\r\neyes after transparency was restored, while corneal decompensation developed at a mean of 6.0 Ã?± 4.3 months in\r\nthe remainder. The interval between rejection and treatment with systemic steroids was shorter in cases that\r\nrecovered graft transparency (OR, 0.88, 95% CI. 0.80ââ?¬â??0.97, P = 0.0093). Corneal decompensation after the recovery of\r\ncorneal transparency tend to occur in cases of regraft (OR, 0.09, 95% CI. 0.01ââ?¬â??0.54, P = 0.0091).\r\nConclusions: Severe corneal graft rejection after PKP was reversible in approximately two-thirds of the cases, with\r\ngraft transparency being maintained in two-thirds of them when treated with both topical and systemic steroids.\r\nEarly treatment confers a benefit in terms of the recovery of graft transparency....
Background: The relationship between intraocular pressure (IOP) changes and hemodialysis has been evaluated for\r\nseveral decades. However, no report on an IOP rise in uveitis patients during hemodialysis has been previously\r\ndocumented. This report describes the case of an uveitis patient with repetitive IOP spikes associated with severe\r\nocular pain during hemodialysis sessions, which resolved after glaucoma filtering surgery.\r\nCase presentation: A 47-year-old male with diabetes and hypertension had complained of recurrent ocular pain in\r\nthe left eye during hemodialysis sessions. A slit-lamp examination showed diffuse corneal epithelial edema with\r\nseveral white keratic precipitates and inflammatory cells (Grade 3+) in the anterior chamber of the left eye. No\r\nvisible neovascularization or synechiae were visible on the iris or angle. Topical glaucoma eye-drops and\r\nintravenous mannitol before hemodialysis did not prevent subsequent painful IOP spikes in the left eye. At the end\r\nof hemodialysis, IOP averaged ~40 mmHg. After trabeculectomy with mitomycin C in the left eye, his IOP stabilized\r\nin the low-teens (range, 10ââ?¬â??14 mmHg) and no painful IOP spikes occurred during hemodialysis over the first\r\npostoperative year.\r\nConclusion: We present a case of recurrent painful IOP spikes during hemodialysis in a patient with unilateral\r\nanterior uveitis unresponsive to conventional medical treatment prior to hemodialysis. To our knowledge, this is the\r\nfirst case report of repetitive symptomatic IOP rise during hemodialysis in an uveitic glaucoma patient. This case\r\nhighlights the importance of the awareness of the possibility that IOP may rise intolerably during hemodialysis in\r\nuveitis patients with a compromised outflow facility....
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