Association of Glaucoma-Related, Optical Coherence Tomography–Measured Macular Damage With Vision-Related Quality of Life

The chapter is focused on one of the major cause of keratitis - Herpetic keratitis, its epidemiology, natural course, clinical forms, prognosis, diagnosis and treatment. The estimated global incidence of HSV keratitis is roughly 1,5 million, including 40,000 new cases of each year. Patients are usually affected in the early decades of live, therefore the disease has a severe impact on quality of life and quality of vision in young, productive adults. The author describes the detailed corneal characteristics, provides slit lamp photographs, optical coherence tomography scans and confocal microscopy results of different forms of the HSV keratitis: epithelial, stromal, necrotizing and endothelial. The chapter also discusses recent methods of diagnosis based on PCR testing as well as established and future methods of treatment based on the latest research results.

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Bedside optical coherence tomography for Terson’s syndrome screening in acute subarachnoid hemorrhage: a pilot study

Journal of Neurosurgery ◽

10.3171/2017.7.jns171302 ◽

2019 ◽

Vol 130 (2) ◽

pp. 517-524 ◽

Cited By ~ 1

Author(s):

Ciro Ramos-Estebanez ◽

Maryo Kohen ◽

Jonathan Pace ◽

Alireza Bozorgi ◽

Sunil Manjila ◽

...

Keyword(s):

Quality Of Life ◽

Optical Coherence Tomography ◽

Subarachnoid Hemorrhage ◽

Pilot Study ◽

Acute Phase ◽

Depressed Mood ◽

Potential Role ◽

Optical Coherence

OBJECTIVEApproximately 10% of patients with subarachnoid hemorrhage (SAH) become permanently, legally blind. The average cost of lifetime support and unpaid taxes for each blind person amounts to approximately $900,000. This study evaluates the feasibility and potential role of bedside optical coherence tomography (OCT) in Terson’s syndrome (TS) in patients with acute SAH (aSAH) and its potential role in blindness prevention.METHODSThe authors conducted an open-label pilot study, in which 31 patients with an angiographic diagnosis of aSAH were first screened for TS with dilated funduscopy and then with OCT in the acute phase and at 6-week follow-up visits. Outpatient mood assessments (Patient Health Questionnaire–depression module, Hamilton Depression Scale), and quality of life general (NIH Patient-Reported Outcomes Measurement Information System) and visual scales (25-item National Eye Institute Visual Functioning Questionnaire) were measured at 1 and 6 weeks after discharge. Exclusion criteria included current or previous history of severe cataracts, severe diabetic retinopathy, severe macular degeneration, or glaucoma.RESULTSOCT identified 7 patients with TS, i.e., a 22.6% incidence in our aSAH sample: 7 in the acute phase, including a large retinal detachment that was initially missed by funduscopy and diagnosed by OCT in follow-up clinic. Dilated retinal funduscopy significantly failed to detect TS in 4 (57.1%) of these 7 cases. Intraventricular hemorrhage was significantly more common in TS cases (85.7% vs 25%). None of the participants experienced any complications from OCT examinations. Neither decreased quality of life visual scale scores nor a depressed mood correlated with objective OCT pathological findings at the 6-week follow-up after discharge. There were no significant mood differences between TS cases and controls.CONCLUSIONSOCT is the gold standard in retinal disease diagnosis. This pilot study shows that bedside OCT examination is feasible in aSAH. In this series, OCT was a safe procedure that enhanced TS detection by decreasing false-negative/inconclusive funduscopic examinations. It allows early diagnosis of macular holes and severe retinal detachments, which require acute surgical therapy to prevent legal blindness. In addition, OCT aids in ruling out potential false-positive visual deficits in individuals with a depressed mood at follow-up.

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