Progression of diffuse chorioretinal atrophy among patients with high myopia: a 4-year follow-up study

2020 ◽  
pp. bjophthalmol-2020-316691
Author(s):  
Zhixi Li ◽  
Ran Liu ◽  
Ou Xiao ◽  
Xinxing Guo ◽  
Jian Zhang ◽  
...  
Keyword(s):  
High Myopia ◽  
Fundus Photography ◽  
Interventional Study ◽  
Follow Up Study ◽  
Chorioretinal Atrophy ◽  
Corrected Visual Acuity ◽  
Study Participants ◽  
Myopic Maculopathy ◽  
Best Corrected Visual Acuity

AimsTo investigate the progression pattern of diffuse chorioretinal atrophy (DCA) among Chinese participants with high myopia.MethodsThis is a longitudinal, non-interventional study. Participants with high myopia, defined as ≤−6 diopters spherical power, were included and followed up for 4 years, and underwent cycloplegic autorefraction, best-corrected visual acuity (BCVA) and fundus photography examinations. Newly established DCA, enlargement of existing DCA and development of other lesions of myopic maculopathy were regarded as DCA progression.ResultsOf the 484 participants with a mean age of 21.5±12.7 years (range, 6.8–69.7 years), 68 eyes (14.0%) showed DCA progression, with 88 lesion changes. The first appearance of DCA was identified in 21 eyes (23.9%). Of 88 eyes with DCA at baseline, 47 eyes (53.4%) showed progression, with 67 lesion changes, including 45 eyes (67.2%) with enlargement of DCA, 17 (25.3%) with a first appearance of lacquer cracks, 4 (6.0%) with development of patchy chorioretinal atrophy and 1 (1.5%) with increased numbers of lacquer cracks. Longer axial length (p<0.001), baseline DCA (p=0.005) and baseline DCA closer to the fovea (p=0.013) predicted DCA progression. Eyes had poorer BCVA at the follow-up if DCA was enlarging (p<0.001) or DCA was closer to the fovea at baseline (p=0.028) after adjusting for age,gender and cataract.ConclusionApproximately half of the participants with DCA had progression over a 4-year follow-up. Enlargement and newly developed DCA were common progression patterns. Larger areas of DCA and foveal involvement with DCA could be indicators of a worse BCVA later.

scholarly journals Observational study of clinical characteristics of dome-shaped macula in Chinese Han with high myopia at Zhongshan Ophthalmic Centre

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e021887 ◽  
Author(s):  
Xiujuan Zhao ◽  
Xiaoyan Ding ◽  
Cancan Lyu ◽  
Shiyi Li ◽  
Yu Lian ◽  
...  
Keyword(s):  
Visual Acuity ◽  
High Myopia ◽  
Choroidal Thickness ◽  
Clinical Characteristics ◽  
Serous Retinal Detachment ◽  
Protective Mechanism ◽  
Chinese Han ◽  
Corrected Visual Acuity ◽  
Myopic Maculopathy ◽  
Best Corrected Visual Acuity

PurposeTo evaluate the prevalence of dome-shaped macula (DSM) in highly myopic eyes among Chinese Han and to detect the correlation with myopic maculopathy and macular complications.MethodsA total of 736 Chinese Han patients (1384 eyes) with high myopia (refractive error≤6.0 diopters or axial length ≥26.5 mm) are reviewed based on information entered into a high-myopia database at Zhongshan Ophthalmic Centre. Subfoveal choroidal thickness (SFCT) and parafoveal choroidal thickness (PFCT) are measured. The prevalence of DSM in patients with myopic maculopathy is categorised from C0 to C4. Clinical features, including macular complications, SFCT and PFCT, are compared between myopic eyes with and without DSM.ResultsAmong the 1384 eyes, 149 (10.77%) show DSM. In highly myopic eyes without macular complications, the best corrected visual acuity is significantly worse in patients with DSM (p=0.002), and the ratio between subfoveal and parafoveal choroidal thickness (S/PCT) is significantly elevated in patients with DSM (p=0.021). The proportion of foveal schisis (17.24% vs 62.86%) is much lower in eyes with DSM compared with those without DSM. However, the proportions of extrafoveal schisis (39.66% vs 5.37%), foveal serous retinal detachment (SRD) (5.17% vs 0) and epiretinal membrane (ERM) (24.14% vs 10.74%) are much higher in eyes with DSM. The proportion of DSM was lower in C0 and C1, but higher proportion of DSM was found in C3 and C4.ConclusionsDSM is found in 10.77% of highly myopic eyes among Chinese Han. DSM might be a protective mechanism for foveal schisis and a risk factor for extrafoveal schisis, SRD and ERM.

scholarly journals Αγγειοειδείς ταινίες

2006 ◽  
Author(s):  
Ηλίας Γεωργαλάς
Keyword(s):  
Visual Acuity ◽  
Photodynamic Therapy ◽  
Laser Photocoagulation ◽  
Age Related Macular Degeneration ◽  
Fundus Photography ◽  
Angioid Streaks ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity ◽  
Group 1

Angioid streaks are irregular crack like dehiscences in Bruch's membrane that invariably radiate outward from the peripapillary area in all directions9. They are associated with a wide variety of systemic diseases, such as pseudoxanthoma elasticum, Ehler-Danlos syndrome, Paget's disease and sickle-cell hemoglobinopathies9.The prognosis in patients with angioid streaks is guarded because visual impairment occurs in 70% to 86% due to the occurrence of macular choroidal neovascularization (CNV)9,15,51. The natural history of such lesions is poor, with most resulting in fovea involvement and central vision loss9,187. Laser photocoagulation treatment of CNV may be beneficial in selected cases169,171,189,191. However, the recurrence rate is higher than with CNV associated with other macular disorders168,170 and the final results reported in the literature as being rather disappointing9. Recently, limited macular translocation176,177, as well as photodynamic therapy with verteporfin (PDT)151,152,154,155,157,182 were searched as alternative treatment modalities for subfoveal CNV due to angioid streaks in small series of patients with controversial results.The purpose of this study is to evaluate the effectiveness of conventional PDT with verteporfin in a large series of patients with subfoveal or juxtafoveal CNV due to angioid streaks and to compare it to the effectiveness of early retreatment PDT (8 weeks following initial therapy) in patients who experienced disease progression.MATERIALS AND METHODSA prospective analysis of 36 eyes of 33 consecutive patients with subfoveal or juxtafoveal CNV secondary to angioid streaks that were treated with PDT from January 2001 through January 2005 and completed at least 18 months of the follow-up time, was conducted. The greatest linear dimension of the entire lesion had to be 6000 pm or less. Eyes with best corrected visual acuity of less than 20/400 were not treated. None of the eyes had been previously treated by conventional laser photocoagulation for the macular CNV.Prior to the treatment, each patient had undergone a complete ocular examination including contact lens fundus biomicroscopy, color or red-free fundus photography, and digital fluorescein angiography (FA) using the Topcon Imagenet 2000 Digital Imaging System with TRC-50IA fundus camera (Topcon Corporation, Paramus, New Jersey, USA). Fluorescein angiograms were evaluated for lesion size and leakage of the neovascular membrane. Best-corrected visual acuity was determined in all patients using standard Snellen charts.Patients were divided in 2 groups. In group 1, retreatments were performed according to the standard protocol followed in the Treatment of Age-Related Macular Degeneration with Photodynamic Therapy Investigation (TAP) every 12 weeks107, 146. During this time, 17 eyes of 15 patients were included in the study in Group 1. In Group 2, 19 eyes of 17 patients received early retreatments (8 weeks after the previous PDT) when indicated according to the criteria of the TAP study for conventional 3-month retreatment.The follow-up time of the patients ranged from 18 to 66 months (mean 37.6 months). The re-examinations followed the same procedure as the first examination. Informed consent for examination and treatment was obtained from each patient after a full explanation of the procedure.Numerical data in the text and the tables are presented as mean (±SD). Improvement or decline of visual acuity was defined as a change of at least two lines.

Posterior scleral reinforcement using genipin-cross-linked sclera for macular hole retinal detachment in highly myopic eyes

2018 ◽  
Vol 102 (12) ◽  
pp. 1701-1704 ◽  
Author(s):  
Shuang-Qian Zhu ◽  
An-Peng Pan ◽  
Lin-Yan Zheng ◽  
Yue Wu ◽  
An-Quan Xue
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Macular Hole ◽  
High Myopia ◽  
Corrected Visual Acuity ◽  
Macular Hole Retinal Detachment ◽  
Posterior Scleral Reinforcement ◽  
The Mean ◽  
Best Corrected Visual Acuity

Background/aimsTo investigate the surgical outcomes of posterior scleral reinforcement (PSR) using genipin-cross-linked sclera to treat macular hole retinal detachment (MHRD) in highly myopic eyes.MethodsNineteen patients with high myopia (19 eyes) with MHRD were treated sequentially with genipin-cross-linked PSR and were followed at least for 1 year after the surgery. The best corrected visual acuity (BCVA), axial length (AL), optical coherence tomography (OCT) outcomes and the complications were evaluated.ResultsMacular hole was closed in 73.7% of the eyes, foveal reattachment rate was 100%. The mean logMAR BCVA improved from 1.27±0.55 preoperatively to 0.88±0.55 postoperatively. The preoperative AL (29.88±1.97 mm) was decreased (27.73±1.84 mm) after the operation (p<0.001).ConclusionsFor at least a 1-year period of follow-up, PSR with genipin-cross-linked sclera should be considered as a preferred surgical approach to treat MHRD in highly myopic eyes, especially when foveal retinoschisis is also documented.

Seven-Year Follow-Up of Screening for Hypertension and Diabetes at a Dental Clinic

2019 ◽  
Author(s):  
Göran Friman
Keyword(s):  
Antihypertensive Drugs ◽  
Study Data ◽  
Initial Screening ◽  
Pharmacological Treatments ◽  
Medical Screening ◽  
Follow Up Study ◽  
Undiagnosed Hypertension ◽  
Dental Setting ◽  
Study Participants

Objective: To describe the distribution of risk, diagnosis and pharmacological treatments for diabetes and hypertension after seven years among patients provided with opportunistic medical screening in a dental setting. Material and Methods: The initial screening’s 170 participants were asked to take part in a seven-year follow-up study. Data were collected through self-reported information in a written health declaration. Outcome measures: • Number of study participants who had passed away • Prescription of antidiabetics or antihypertensives • Changes in weight and height to calculate body mass index (BMI) Results: The follow-up study consisted of 151 participants. Twenty had passed away. The risk needs for medicating with antihypertensive drugs after seven years for those not receiving pharmacological treatment at the initial screening was 3.7 times greater (p=0.025 CI 1.2-11.3) for participants with a diastolic blood pressure (BP) ≥ 90 mm Hg (85 for diabetics) than for the others. The risk was 3.9 times greater (p=0.020 CI 1.2-12.6) for those with a systolic BP of 140-159 mm Hg and 54.2 times greater (p<0.0001 CI 9.8-300.3) for those with a systolic BP ≥ 160 mm Hg than for those with a systolic BP 140 mm Hg. There were no changes in BMI. Conclusion: At least one in ten cases of incorrect medication or undiagnosed hypertension may be identifiable through opportunistic medical screening

Corneal densitometry in patients with keratoconus undergoing intrastromal Ferrara ring implantation

2021 ◽  
pp. 112067212110206
Author(s):  
Pablo Felipe Rodrigues ◽  
Bernardo Kaplan Moscovici ◽  
Guilherme Ferrara ◽  
Luciano Lamazales ◽  
Marcela Mara Silva Freitas ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Medical Records ◽  
Spherical Equivalent ◽  
Interventional Study ◽  
Data Comparison ◽  
Corneal Densitometry ◽  
Corrected Visual Acuity ◽  
Ring Segment ◽  
The Mean

Objective: Evaluation of central corneal densitometry changes following Ferrara corneal ring segment implantation in patients with keratoconus, especially the correlation between corneal densitometry and keratometry. Methods: Retrospective, non-comparative, interventional study based on the review of medical records of patients diagnosed with keratoconus who underwent Ferrara corneal ring segment implantation. Pre and post-operative corneal densitometry measurements obtained with Pentacam HR (Oculus, Wetzlar, Germany) were analyzed. The follow-up time was 3 months, and data comparison was made, using specific statistical analysis, with the data of 3 months postoperatively. Results: The study sample consisted of 43 eyes of 36 patients. The mean corrected visual acuity improved from 0.82 LogMAR preoperatively (SD ± 0.33) to 0.19 LogMAR (SD ± 0.13) postoperatively. The mean spherical equivalent varied from −4.63 (SD ± 3.94) preoperatively to −2.16 (SD ± 2.63) postoperatively. Asphericity varied from −0.69 (SD ± 0.32) preoperatively to −0.27 (SD ± 0.31) postoperatively. The mean maximum K was 54.01D (SD ± 3.38) preoperatively and 51.50D (SD ± 2.90) postoperatively. The mean anterior densitometric value was 18.26 (SD ± 2.03) preoperatively and 17.66 (SD ± 1.84) postoperatively. Conclusion: Corneal densitometry is an interesting technology that should be studied in keratoconus patients. Our results suggest that the corneal densitometry in the cornea’s anterior layer reduces after ICRS implantation and correlates with corneal keratometry. Further studies should be performed to increase the knowledge in this field.

Sub-Threshold Micro Pulse Laser (810NM): Treatment for Chronic Central Serous Retinopathy

2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Mariam Shamim Kashif ◽  
Najia Uzair ◽  
Lubna Feroz ◽  
Asaad Mehmood
Keyword(s):  
Retinal Thickness ◽  
Case Series ◽  
Central Retinal Thickness ◽  
Central Serous Retinopathy ◽  
Invasive Treatment ◽  
Micropulse Laser ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity ◽  
Sd Oct

Purpose:  To find the effectiveness of sub-threshold (810nm) micropulse diode laser treatment (SMT) in chronic central serous retinopathy (CSR). Study Design:  Interventional case series. Place and Duration of Study:  Layton Rahmatulla benevolent trust eye hospital, from April 2019 to July 2020. Methods:  The patients of chronic CSR (≥ 6 months) participated in the study. We used Spectral Domain Optical coherence tomography (SD-OCT) to record baseline central retinal thickness (CT). Best corrected visual acuity (BCVA) was recorded with Snellen’s chart and converted to Log MAR for statistical analysis. All patients underwent treatment with sub-threshold laser (810nm) in micropulse mode with 5% duty cycle (DC). Results:  Twenty five eyes with chronic CSR were enrolled in the study. The patients were treated with laser and final assessment was made at 6 months. Mean BCVA at presentation was 0.46 Log MAR ± 0.12 and a mean baseline CT of 362.2 μm ± 32.6µm. At final follow-up there was a mean decrease in CT of 97.2 μm ± 21.8 from the baseline. After treatment mean BCVA was 0.33 Log MAR ± 0.12 and mean CT was 266 μm ± 20.9. Nineteen out of twenty-five eyes (76%) achieved a gain of vision between 1 to 3 lines and gain of 3 lines was achieved in 8% of cases. At the final follow-up there was incomplete resolution of sub retinal fluid in 4 eyes (16%) with no improvement in BCVA. Conclusion:  SMT (810 nm) is an effective and minimally invasive treatment modality for chronic CSR. Key Words:  Sub-Threshold micropulse laser, Central serous retinopathy, Central retinal thickness, sub retinal fluid.

scholarly journals Effect of phacoemulsification with intraocular lens implantation in eyes with cataract and functioning filtering blebs

2013 ◽  
Vol 13 (2) ◽  
pp. 33-41
Author(s):  
Devendra Maheshwari ◽  
Rengappa Ramakrishanan ◽  
Mohideen Abdul Kader ◽  
Neelam Pawar ◽  
Ankit Gupta
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Intraocular Lens Implantation ◽  
Corrected Visual Acuity ◽  
Lens Implantation ◽  
The Mean ◽  
One Year ◽  
Best Corrected Visual Acuity

Aim: To evaluate the effect of phacoemulsification with intraocular lens implantation in eyes with pre-existing trabeculectomy.Methods: This prospective single-center clinical study evaluated intraocular pressure in 60 eyes of 60 patients who underwent phacoemulsification and implantation of a foldable intraocular lens after a previous successful trabeculectomy. Patients who had a trabeculectomy more than one year prior to the study were included. Intraocular pressure, number of antiglaucoma medications, bleb appearance, and visual acuity were recorded preoperatively, and at each follow-up examination and 12 months after phacoemulsification.Results: The mean intraocular pressure before phacoemulsification was 12.42 mmHg (SD, 4.60 mmHg), which increased to 14.98 mmHg (SD, 4.18 mmHg), 14.47 mmHg (SD, 3.58 mmHg), 15.44 mmHg (SD, 3.60 mmHg), and 15.71 mmHg (SD, 3.47 mmHg) after one, three, six, and 12 months, respectively. At each follow-up visit, the mean IOP was significantly higher than the preoperative value (p < 0.001, p = 0.015, p ≤ 0.001, and p = 0.001 at month one, three, six, and 12, respectively). The mean preoperative best-corrected visual acuity was 0.98 logMAR (SD, 0.44 logMAR) and the mean postoperative best-corrected visual acuity at 12 months was 0.20 logMAR (SD, 0.21 logMAR) [p = 0.0001]. The mean preoperative number of antiglaucoma medications used was 0.57 (SD, 0.63), which increased to 0.65 (SD, 0.63 ), 0.70 (SD, 0.72 ) 0.68, (SD, 0.70), and 0.67 (SD, 0.77 ) at one, three, six, and 12 months, respectively, but there were no statistically significant differences. Bleb size decreased clinically after phacoemulsification. Nineteen of 60 eyes (32%) developed fibrosis of bleb with decreased bleb size.Conclusion: Phacoemulsification with intraocular lens implantation significantly increased intraocular pressure and increased the number of antiglaucoma medications in eyes with pre-existing functioning filtering blebs.

scholarly journals The effect of amblyopia on clinical outcomes of children with astigmatism

2021 ◽  
Vol 13 ◽  
pp. 251584142110408
Author(s):  
Burçin Çakır ◽  
Nilgün Özkan Aksoy ◽  
Sedat Özmen ◽  
Özlem Bursalı
Keyword(s):  
Visual Acuity ◽  
Clinical Outcomes ◽  
Medical Records ◽  
Convergence Insufficiency ◽  
Corrected Visual Acuity ◽  
Ocular Deviation ◽  
The Mean ◽  
The Difference ◽  
Best Corrected Visual Acuity

Background: Amblyopia is more common in children with high astigmatism, but factors contributing to development of amblyopia and visual outcomes are not fully understood. Objective: To evaluate the effect of amblyopia on the clinical outcomes in children with ⩾1.75 diopter (D) astigmatism. Methods: We reviewed the medical records of children with ⩾1.75 D astigmatism with and without amblyopia (amblyopes group and non-amblyopes group). The mean age, gender, amount and type of ocular deviation, presence of convergence insufficiency (CI), stereopsis, time of initial spectacle use and follow-up time, differences in best-corrected visual acuity (VoD) and spherical equivalent (SE) between eyes were assessed and compared between the groups. Best-corrected visual acuity (BCVA), mean SE, astigmatism measurements were assessed and compared between amblyopic, fellow, and non-amblyopic eyes. Results: The records included 68 eyes of 34 children with amblyopia and 56 eyes of 28 children without amblyopia. The mean age, gender, amount and type of ocular deviation, presence of CI, stereopsis, time of initial spectacle use, follow-up time, and the difference in SE did not differ between groups. In amblyopes, exodeviation was more common and statistically greater in near (33 cm) than at distance (6 m) (p = 0.005). The mean BCVA and astigmatism values were statistically different between amblyopic, fellow, and non-amblyopic eyes. Conclusion: A greater near than distance exodeviation and higher mean astigmatism value were found in amblyopic children with astigmatism.

scholarly journals Cataract Surgery and Uveitis

2016 ◽  
Vol 9 (3) ◽  
Author(s):  
Mumtaz Hussain ◽  
Muhammad Moin ◽  
Nazir Ahmad Aasi ◽  
Muhammad Waqas ◽  
Jawaid Mughal
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
General Hospital ◽  
Cataract Extraction ◽  
Extracapsular Cataract Extraction ◽  
Iol Implantation ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

The study of 30 patients was performed at Lahore General Hospital, and Institute Of Ophthalmology Mayo Hospital, Lahore from June 1989 to June 2003 for 14 years. Total number of eyes were 34 where 2 patients had both eyes. Age ranged from 12-65 years. Males were 11 and females were 19. all the patients had planned extracapsular cataract extraction with IOL implantation. Total follow up period ranged from 1-5 years and best corrected visual acuity in these patients after surgery was 6/12 to 6/6. Post operatively, eyes had vitreous membranes and glaucomatous reaction.

Femtosecond laser-assisted deep anterior lamellar keratoplasty: A safer option in keratoconus surgery

2021 ◽  
pp. 112067212110590
Author(s):  
Cristina Monterosso ◽  
Marco Antonini ◽  
Antonio Di Zazzo ◽  
Daniele Gaudenzi ◽  
Luigi Caretti ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Persistent Epithelial Defect ◽  
Corrected Visual Acuity ◽  
Anterior Lamellar Keratoplasty ◽  
Best Corrected Visual Acuity ◽  
Persistent Epithelial Defects

Purpose To evaluate postoperative safety of femtosecond laser deep anterior lamellar keratoplasty performed with an innovative anvil profile in keratoconus patients. Methods This is a single-center, retrospective cohort study. We reviewed medical records of 89 keratoconus patients that underwent femtosecond laser deep anterior lamellar keratoplasty surgery (46 eyes) and manual deep anterior lamellar keratoplasty (47 eyes). Inclusion criteria required: age > 18 years old, best-corrected visual acuity < 0.3 LogMAR, continuous suture of the graft, postoperative immunomodulant regimen with dexamethasone 0.1% for 6 months and at least 12 months follow-up. Previous eye surgery, hydrops, and other ocular disease were excluded. The main outcome measures were postoperative events: rejections, persistent epithelial defects, and graft failures. Results During the follow-up (20 ± 6 months) graft rejection was diagnosed in 0 of femtosecond laser deep anterior lamellar keratoplasty versus 6 (17%) of manual deep anterior lamellar keratoplasty [ p 0.027], persistent epithelial defect in 0 of femtosecond laser deep anterior lamellar keratoplasty versus in 4 (11%) of manual deep anterior lamellar keratoplasty [ p 0.048] and graft failure occurred in 4 (11%) of manual deep anterior lamellar keratoplasty. The best-corrected visual acuity, after removal of sutures, was better in the femtosecond laser deep anterior lamellar keratoplasty group 0.09 ± 0.08 LogMAR versus 0.16 ± 0.13 LogMAR in manual deep anterior lamellar keratoplasty [ p 0.035] group although refractive spherical equivalent and cylinder, topographic average keratometry and cylinder were similar. Conclusions Anvil-shaped femtosecond laser deep anterior lamellar keratoplasty in keratoconus surgery increases safety and readiness of recovery, decreasing the incidence of corneal rejection, epithelial defects, graft failures, and producing better best-corrected visual acuity after removal of sutures.

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