scholarly journals Ophthalmological findings in children with non-syndromic craniosynostosis: preoperatively and postoperatively up to 12 months after surgery

2021 ◽  
Vol 6 (1) ◽  
pp. e000677
Author(s):  
Evangelia Ntoula ◽  
Daniel Nowinski ◽  
Gerd Holmstrom ◽  
Eva Larsson
Keyword(s):  
Visual Acuity ◽  
University Hospital ◽  
Cranial Sutures ◽  
Sagittal Craniosynostosis ◽  
Syndromic Craniosynostosis ◽  
Disc Oedema ◽  
Before And After ◽  
Congenital Condition ◽  
Skull Deformity

AimsCraniosynostosis is a congenital condition characterised by premature fusion of one or more cranial sutures. The aim of this study was to analyse ophthalmic function before and after cranial surgery, in children with various types of non-syndromic craniosynostosis.MethodsChildren referred to Uppsala University Hospital for surgery of non-syndromic craniosynostosis were examined preoperatively. Visual acuity was measured with Preferential Looking tests or observation of fixation and following. Strabismus and eye motility were noted. Refraction was measured in cycloplegia and funduscopy was performed. Follow-up examinations were performed 6–12 months postoperatively at the children’s local hospitals.ResultsOne hundred twenty-two children with mean age 6.2 months were examined preoperatively. Refractive values were similar between the different subtypes of craniosynostosis, except for astigmatism anisometropia which was more common in unicoronal craniosynostosis. Strabismus was found in seven children, of which four had unicoronal craniosynostosis.Postoperatively, 113 children were examined, at mean age 15.9 months. The refractive values decreased, except for astigmatism and anisometropia in unicoronal craniosynostosis. Strabismus remained in unicoronal craniosynostosis. Two new cases with strabismus developed in unicoronal craniosynostosis and one in metopic, all operated with fronto-orbital techniques. No child had disc oedema or pale discs preoperatively or postoperatively.ConclusionOphthalmic dysfunctions were not frequent in children with sagittal craniosynostosis and preoperative ophthalmological evaluation may not be imperative. Children with unicoronal craniosynostosis had the highest prevalence of strabismus and anisometropia. Fronto-orbital techniques used to address skull deformity may be related to a higher prevalence of strabismus postoperatively.

scholarly journals Coronary risk of patients with valvular heart disease: prospective validation of CT-Valve Score

Open Heart ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e001380
Author(s):  
Rasmus Bo Hasselbalch ◽  
Mia Marie Pries-Heje ◽  
Sarah Louise Kjølhede Holle ◽  
Thomas Engstrøm ◽  
Merete Heitmann ◽  
...  
Keyword(s):  
Heart Disease ◽  
Valvular Heart Disease ◽  
Primary Outcome ◽  
Multislice Ct ◽  
Cost Effective ◽  
University Hospital ◽  
Before And After ◽  
History Of ◽  
Artery Disease

ObjectiveTo prospectively validate the CT-Valve score, a new risk score designed to identify patients with valvular heart disease at a low risk of coronary artery disease (CAD) who could benefit from multislice CT (MSCT) first instead of coronary angiography (CAG).MethodsThis was a prospective cohort study of patients referred for valve surgery in the Capital Region of Denmark and Odense University Hospital from the 1 February 2015 to the 1 February 2017. MSCT was implemented for patients with a CT-Valve score ≤7 at the referring physician’s discretion. Patients with a history of CAD or chronic kidney disease were excluded. The primary outcome was the proportion of patients needing reevaluation with CAG after MSCT and risk of CAD among the patients determined to be low to intermediate risk.ResultsIn total, 1149 patients were included. The median score was 9 (IQR 3) and 339 (30%) had a score ≤7. MSCT was used for 117 patients. Of these 29 (25%) were reevaluated and 9 (7.7%) had CAD. Of the 222 patients with a score ≤7 that did not receive an MSCT, 14 (6%) had significant CAD. The estimated total cost of evaluation among patients with a score ≤7 before implementation was €132 093 compared with €79 073 after, a 40% reduction. Similarly, estimated total radiation before and after was 608 mSv and 362 mSv, a 41% reduction. Follow-up at a median of 32 months (18–48) showed no ischaemic events for patients receiving only MSCT.ConclusionThe CT-Valve score is a valid method for determining risk of CAD among patients with valvular heart disease. Using a score ≤7 as a cut-off for the use of MSCT is safe and cost-effective.

The Effect of Platelet Rich Plasma on the Treatment Outcome of Minigraft/NB-UVB Therapy in Stable Vitiligo: Clinical Evaluation and Effect on Tissue levels of bFGF

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Samar Abdallah Mohamed Salem ◽  
Marwa Yassin Soltan ◽  
Nashwa El Khazragy ◽  
Tabarek Abdulkhaleq Fezea
Keyword(s):  
Treatment Outcome ◽  
Platelet Rich Plasma ◽  
University Hospital ◽  
Similar Response ◽  
Ethical Aspects ◽  
Progressive Loss ◽  
End Of Treatment ◽  
Before And After ◽  
Additive Treatment

Abstract Background Vitiligo is an acquired pigmentary disorder resulting from loss of melanocytes which causes depigmentation of the skin. Clinically, it is characterized by the progressive loss of melanocytes causing the appearance of well-circumscribed milky white cutaneous macules and patches Aim of the Work to evaluate the efficacy of PRP as an additive treatment to the minigraft/NB-UVB treatments for stable localized vitiligo and the effect of this treatment on the expression of bFGF in the lesional treated vitiliginous skin compared before and after the course of treatment. Patients and Methods The study represents a prospective interventional comparative study. It was conducted on 17 patients diagnosed as stable vitiligo. All patients were selected from the dermatology outpatient vitiligo clinic of Ain-Shams University hospital from April 2018 to June 2019. All subjects who participated in this study gave written informed consents. The study was approved by the research ethical committee of Ain-Shams University (Approval Number: FWA 000017585) and fulfilled all the ethical aspects required in human research. Results We found that the addition of PRP to minigraft resulted in earlier repigmentation as assessed by VESTA score; however, at the follow up end (one month following the end of treatment), both modalities resulted in a similar response as regards the repigmentation percent and improvement in VESTA score. The addition of the PRP to the minigraft didn’t result in a superior improvement than minigraft alone. Conclusion Both minigraft and PRP-assisted minigraft followed by NB-UVB sessions are effective method to induce repigmentation in stable vitiligo.

scholarly journals Assessment of the Efficacy of Photodynamic Therapy in Patients with Chronic Central Serous Chorioretinopathy

2020 ◽  
Vol 75 (6) ◽  
pp. 298-308
Author(s):  
Kateřina Manethová ◽  
Jan Ernest ◽  
Michal Hrevuš ◽  
Naďa Jirásková
Keyword(s):  
Photodynamic Therapy ◽  
Central Serous Chorioretinopathy ◽  
Functional Results ◽  
University Hospital ◽  
Prospective Clinical Study ◽  
Chronic Central Serous Chorioretinopathy ◽  
Chronic Form ◽  
Before And After ◽  
The Mean

Purpose: The aim of this prospective clinical study was to evaluate the anatomical and functional results of the treatment of 54 eyes with chronic form of central serous chorioretinopathy (CSC) using photodynamic therapy in a reduced (half) verteporfin (HD-PDT) dosing regimen. Materials and Methods: Our prospective study included 54 eyes of 52 patients (40 males, 12 females) at an average age of 50.1 years (median 49.5, range 30–75 years) treated at the Ophthalmology Clinic of the First Faculty of Medicine and Military University Hospital in Prague from January 2012 to January 2018 for chronic form of CSC with a minimum disease duration of 3 months. In our study, we evaluated the improvement of the best corrected visual acuity (BCVA) and central retinal thickness (CRT) before treatment and at 1, 3, 6 and 12 months after HD-PDT. Results: The mean baseline BCVA was 68.91 ± 10.5 ETDRS letters (median 71; range 35–85) and the mean baseline CRT was 385.6 ± 118.5 µm (median 367, 5 µm; range 245–1000 µm). At the end of the follow-up period, the average BCVA was 79 ± 11 ETDRS letters (median 82; range 38–93). The improvement in BCVA before and after treatment was statistically significant in all measurements (p < 0.0001). The mean CRT at the end of the follow-up period was 263.5 ± 52 µm (median 258.5 µm; range 162–404 µm). The decrease in CRT at all timepoints was statistically significant compared to baseline (p < 0.0001). In our set of patients, at the end of the follow-up period, the retinal finding was improved or stabilized in 50 eyes (92.6 %). In this study, we observed in 2 cases the development of secondary choroidal neovascularization (CNV). Conclusion: HD-PDT is a long-term safe and effective method of treating chronic forms of CSC. However, despite a reduced dose of verteporfin, complications may occur.

scholarly journals Bowman layer transplantation in eyes with progressive advanced keratoconus

2019 ◽  
Vol 12 (4) ◽  
pp. 43-50
Author(s):  
O. G. Oganesyan ◽  
V. R. Getadaryan ◽  
P. V. Makarov ◽  
A. A. Grdikanyan
Keyword(s):  
Visual Acuity ◽  
Contact Lenses ◽  
Corneal Transplantation ◽  
Corneal Stroma ◽  
Functional Safety ◽  
Indication For Surgery ◽  
Corrected Visual Acuity ◽  
Before And After ◽  
Observation Period

Purpose: to study the efficiency of Bowman layer transplantation (BLT) in corneal stroma for the treatment of progressive keratoconus (KC).Material and methods. 30 patients (30 eyes) with progressive KC stages III to IV (according to Amsler — Krumeich classification), underwent BLT into a mid-stromal pocket. At the time of surgery, the patients were 14 to 37 (averagely 26.6 ± 6.2 years). Before and after the surgery, the maximum keratometry index (Kmax) and the corneal thinnest point (CTP) values were determined. Also, we evaluated visual acuity before and after surgery in scleral contact lenses, endothelial cells density (ECD) and the depth of graft location. The indication for surgery was the refusal of corneal transplantation, progression of KC, contraindications for ultraviolet crosslinking or implantation of intracorneal ring segments based on the CTP and Kmax values. The follow-up continued 6 to 36 months (averagely, 26.6 ± 6.0 months).Results. Throughout the observation period, no intra or postoperative complications associated with BLT or deterioration of CTP, Kmax or best corrected visual acuity (BCVA) in scleral lenses were noted.Conclusions. Kmax, CTP and ECD values remaining stable during the follow-up is the evidence of a stabilizing BLT effect on the KC progression. The absence of BCVA decrease in scleral lenses indicates a functional safety of BLT.

Evaluation and Monitoring of the Clinical Pathway for Thyroidectomy

2008 ◽  
Vol 74 (1) ◽  
pp. 29-36 ◽  
Author(s):  
VÍCtor Soria-Aledo ◽  
Benito Flores-Pastor ◽  
Mari Fe Candel-Arenas ◽  
AndrÉS Carrillo-Alcaraz ◽  
ÁLvaro Campillo-Soto ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Clinical Pathway ◽  
Length Of Hospital Stay ◽  
University Hospital ◽  
Before And After ◽  
Clinical Variation ◽  
Evaluation And Monitoring ◽  
Surgery Department ◽  
Mean Cost

The aim of this study is to present the evaluation and monitoring of a clinical pathway for thyroidectomy 1 year after its implementation and after 4 years’ follow up. We compare the results of an evaluation and monitoring indicators series before and after the establishment of the clinical pathway for thyroidectomy in the Surgery Department of Morales Meseguer Hospital, a general university hospital in Murcia, Spain. Implementation of the clinical pathway led to a reduction in length of hospital stay for all the surgery patients (4.8 ± 2.1 and 3.6 ± 1.9 days before and after pathway implementation, respectively; P < 0.001). Implementation of the clinical pathway led to a reduction in cost in all the operated patients (3357 ± 966 and 2695 ± 970 US$ before and after implementing the clinical pathway, respectively; P < 0.001). Evolution of the mean hospital cost according to year of study shows a reduction from 2000 (3400 ± 1056 US$) to 2004 (2404 ± 666 US$) with a slight increase during 2005 (2721 ± 1335 US$) (P < 0.001). Implementation of the clinical pathway for thyroidectomy has successfully reduced clinical variation and therefore the length of hospital stay and mean cost of the process. In subsequent years, no such major improvements have been made with regard to hospital stay, although they are still clearly better than those before pathway implementation.

Unilateral transverse cordotomy for bilateral abductor vocal fold immobility

2012 ◽  
Vol 126 (9) ◽  
pp. 913-917 ◽  
Author(s):  
J M Bernstein ◽  
S M Jones ◽  
P H Jones
Keyword(s):  
Vocal Fold ◽  
Case Series ◽  
University Hospital ◽  
Symptom Scale ◽  
Voice Change ◽  
Airway Function ◽  
Scale Scores ◽  
Before And After ◽  
Vocal Fold Immobility

AbstractObjective:We present a case series with airway compromise due to bilateral abductor vocal fold paralysis or fixation, treated with unilateral transverse cordotomy.Methods:Of eight consecutive patients with dyspnoea due to bilateral paramedian vocal fold immobility, seven underwent unilateral transverse cordotomy between August 2006 and April 2010 at University Hospital of South Manchester, UK. Airway and voice outcomes were compared before and after surgery.Results:All seven treated cases derived subjective airway function improvement; there was no aspiration. The eighth case had inadequate access. None of the seven treated patients required contralateral cordotomy or permanent tracheostomy. One treated case required a temporary tracheostomy; unilateral transverse cordotomy facilitated eventual decannulation. Two patients died of cancer at five and six weeks, variously. At a mean follow up of 22 months, four cases showed unchanged or slightly worse Voice Symptom Scale and Grade-Roughness-Breathiness-Asthenia-Strain scale scores.Conclusion:In patients with bilateral abductor vocal fold immobility, unilateral transverse cordotomy results in improved dyspnoea with either no voice change or only slight worsening. This is a more conservative procedure than bilateral transverse cordotomy, with the potential for better preservation of voice and breath support.

scholarly journals Evaluation of efficacy and safety of new high-density dyes for chromovitrectomy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Valerio Piccirillo ◽  
Sandro Sbordone ◽  
Francesco Sorgente ◽  
Adele Ragucci ◽  
Antonello Iovine ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Central Macular Thickness ◽  
Efficacy And Safety ◽  
Safety And Efficacy ◽  
Macular Surgery ◽  
Ocular Coherence Tomography ◽  
Before And After

AbstractThe purpose of this study is to evaluate the safety and efficacy of two novel heavy dyes for macular surgery: DoubledyneTM and TwinTM. One eye from each of 144 patients undergoing surgery for macular hole or macular pucker was included in the study. The eyes were randomly divided into two groups according to the dye used during surgery. Best correct visual acuity (BCVA), intraocular pressure (IOP) and retinal morphology assessed by ocular coherence tomography (OCT) were evaluated before and 1, 3, 6 and 12 months after surgery. Only one surgeon performed each operation and provided a score ranging from 1 (poor) to 10 (excellent) for quality of staining and comfort in surgery. Statistical analysis was carried out with SPSS to compare parameters before and after surgery and between the two groups. No statistical differences were recorded in quality of staining (p = 0.11), in surgery comfort (p = 0.17) and total time of surgery (p = 0.44) between the two groups. BCVA statistically improved and central macular thickness (CMT) statistically decreased after surgery in both groups (p < 0.05). No toxic dye-related complications or long-term ones affecting the retina were observed in either group. According to this data, although confirmation in further studies with larger populations and longer follow up is required, DoubledyneTM and TwinTM proved to be safe and effective dyes for macular surgery.

scholarly journals The Role of Subthreshold Micropulse Yellow Laser as an Alternative Option for the Treatment of Refractory Postoperative Cystoid Macular Edema

2020 ◽  
Vol 9 (4) ◽  
pp. 1066
Author(s):  
Tommaso Verdina ◽  
Rossella D’Aloisio ◽  
Andrea Lazzerini ◽  
Cecilia Ferrari ◽  
Edoardo Valerio ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Cystoid Macular Edema ◽  
Retrospective Chart Review ◽  
Topical Steroids ◽  
Before And After ◽  
Laser Treatments ◽  
Posterior Capsule Rupture ◽  
Yellow Laser

Background: To evaluate the efficacy and the safety of subthreshold micropulse yellow laser (SMYL) in the treatment of chronic postoperative cystoid macular edema (PCME), which is refractory to standard therapies. Methods: A retrospective chart review of ten eyes of ten patients affected by refractory PCME who underwent SMYL was performed. Five PCME cases were subsequent to uncomplicated cataract surgery (CS), two cases to complicated CS (CCS) with posterior capsule rupture and three cases occurred after retinal detachment surgery (RD). All conditions were refractory to conventional treatments prior to SMYL interventions for at least 4 months, including nonsteroidal anti-inflammatory eyedrops, topical steroids, oral indomethacin, sub-Tenon’s triamcinolone injections and Dexamethasone intravitreal implants. All patients underwent one or more treatments with 577 nm SMYL photo-stimulation, with 7 × 7 grids with confluent spots and a 5% duty cycle covering the whole edematous retina, including the foveal center. Best corrected visual acuity (BCVA) and central macular thickness (CMT) were obtained using OCT, and evaluated before and after the treatment at 1, 2, 3 and 6-month follow-ups. Results: A complete subfoveal macular edema resolution was observed in all of the eyes, with statistically significant improvements in terms of BCVA and CMT in all of the follow-up timelines (at 6 months, p = 0.002 and p = 0.005, respectively). The mean number of laser treatments was 1.3. At the final follow-up, a complete subfoveal edema reabsorption was observed in all patients with visual acuity improvement. No complications were observed in any case. Conclusions: SMYL seems to be a safe and effective treatment for the long-term resolution of refractory PCME and may be a useful alternative to expensive and invasive therapeutic options.

scholarly journals The effectiveness of subtenon triamcinolone injection for the treatment of macular edema in children with retinitis pigmentosa

2021 ◽  
Vol 16 (1) ◽  
pp. 5-12
Author(s):  
Lyudmila A. Katargina ◽  
Ekaterina V. Denisova ◽  
Maria A. Khrabrova ◽  
Natalia A. Osipova
Keyword(s):  
Visual Acuity ◽  
Carbonic Anhydrase ◽  
Retinitis Pigmentosa ◽  
Macular Edema ◽  
Repeated Injection ◽  
Carbonic Anhydrase Inhibitors ◽  
Before And After ◽  
Subtenon Injection ◽  
Observation Period

Aim: This study aimed to assess the functional and anatomical results of subtenon triamcinolone injections in children with retinitis pigmentosa (PR) and cystic macular edema (CME), refractory to local carbonic anhydrase inhibitors. Material and methods: We examined 11 children (9 girls, 2 boys) aged 9 to 17 years who underwent subtenon injections of triamcinolone (22 eyes). The follow-up period ranged from 1.6 to 33.1 months (average 9.711.6 months), the number of triamcinalone injections ranged from 1 to 11, averaging 3. Before and after injection, best corrected visual acuity (BCVA), the thickness and structure of the retina in the macular zone (optical coherence tomography [OCT] was performed by using the NIDEK RS-3000, Japan or the Spectralis, Heidelberg Engineering, Germany), and intraocular pressure (IOP) were assessed. Results: The CME height at the end of the observation period decreased in 10 cases (45.5%), and the average central retinal thickness decreased from 70 to 594 m (on average, 219.1183.4 m). In 12 eyes (54.5%), the CME height at the end of the observation period did not change significantly. BCVA improved in two eyes (9.1%) and did not change in the other cases. Two children (18%) developed ophthalmic hypertension in both eyes after two injections of triamcinalone. In one child, IOP returned to normal on the background of hypothetical therapy. In another child, due to non-compensation of IOP at the maximum hypotensive mode, sinus trabeculectomy was performed in both eyes, and IOP normalization was achieved. Conclusion: Subtenon injection of triamcinolone in children with CME against a background of PR is in most cases is an effective and safe method of treatment and can be recommended if carbonic anhydrase inhibitors are ineffective at reducing/ resorbing edema and maintaining or improving visual function. Considering that the action of triamcinolone is short lived, and its repeated injection is required, and the resorption of CME and an increase in visual acuity are not always achievable, it is necessary to continue the search for more effective treatment methods.

scholarly journals Evaluation of Plasma Assisted Noninvasive Surgery (PANIS) As a New Approach for the Treatment of Conjunctival Concretions: A Clinical Case Series

2021 ◽  
Vol 6 (12) ◽  
pp. 899-903
Author(s):  
Farhad Nejat ◽  
Khosrow Jadidi ◽  
Shima Eghtedari ◽  
Nazanin-Sadat Nabavi ◽  
Pooneh Malekifar
Keyword(s):  
Visual Acuity ◽  
Case Series ◽  
Refractive Errors ◽  
Normal Range ◽  
Ocular Surface Disease Index ◽  
New Approach ◽  
Noninvasive Surgery ◽  
Before And After ◽  
Straightforward Approach

Background and Objective: Plasma is one of the newest therapies recently used. This study aimed to evaluate a quick treatment modality of conjunctival concretions using plasma as a noninvasive procedure. Methods: Six eyes of six patients with conjunctival concretions were evaluated. The procedure was performed using plasma spots generated by the white handpiece of the Plexr device. The eyelid was everted and concretions sublimated by plasma spots from the upper and lower eyelids. Refractive Errors, visual acuity (BCVA and UCVA), Ocular Surface Disease Index (OSDI), and Intraocular pressure (IOP) were measured before and after six months of the procedure. Results: The results of 6 months follow-up show that this effective method had no recurrence or side effects. Treatment was effective in all of the patients. No complication and recurrence was observed. The OSDI score was improved to the normal range. This method had no effects on Refractive Errors, Visual Acuity, and IOP. Conclusion: Based on the results, it seems that the PANIS method can be used as a practical, quick, and straightforward approach for the treatment of conjunctival concretions.

Sign in / Sign up

Export Citation Format

Share Document