Prognostic Factors for Postoperative Visual Acuity in Patients with Rhinogenic Optic Neuropathy

Purpose. To examine the prognostic factors related to postoperative visual acuity in patients with rhinogenic optic neuropathy. Study Design. Retrospective observational study. Materials and Methods. We retrospectively studied the medical records for 15 eyes of 15 patients who underwent surgery for the treatment of rhinogenic optic neuropathy between 31 January 2010 and 30 April 2018 at Toyama University Hospital. The patient age, sex, preoperative and postoperative visual acuity, duration from visual deficit to surgery, use of steroids, type of rhinogenic optic neuropathy, and the part of sinus lesion were analyzed. We also examined postoperative visual acuity for patients whose preoperative visual acuity was less than light perception. Results. The type of optic neuropathy was sinusitis in 7 cases, mucocele in 5 cases, and pyocele in 3 cases. Visual acuity was improved in 9 cases and deteriorated or unchanged in 6 cases. Patients in the improvement group were significantly younger than those in the nonimprovement group (p=0.01). In univariate regression analysis, preoperative visual acuity and type of optic neuropathy significantly related to postoperative visual acuity. Finally, 4 of the 15 cases (27%) had preoperative visual acuity less than light perception, but there was an improvement in postoperative visual acuity in 2 of 4 cases (50%). Conclusions. Preoperative visual acuity is the predictive factor for postoperative visual acuity in patients with rhinogenic optic neuropathy, but even if the preoperative visual acuity is less than light perception, it can be improved by surgical treatment.

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Prognostic factors for postoperative visual outcome in surgically treated suprasellar meningiomas

Medicinski pregled ◽

10.2298/mpns1606146g ◽

2016 ◽

Vol 69 (5-6) ◽

pp. 146-152 ◽

Cited By ~ 2

Author(s):

Desanka Grkovic ◽

Sofija Davidovic

Keyword(s):

Visual Acuity ◽

Tumor Size ◽

Visual Function ◽

Tumor Resection ◽

Visual Outcome ◽

Duration Of Symptoms ◽

Postoperative Visual Acuity ◽

Preoperative Visual Acuity ◽

History Of ◽

Meningioma Surgery

Introduction. The prognosis of postoperative visual acuity in patients with surgically treated suprasellar meningiomas is influenced not only by the size and precise localization of meningiomas in the optochiasmatic region and their compressive effect, but also by certain parameters, such as the age of patient, duration of symptoms, and preoperative visual acuity. The purpose of this study was to analyze the influence of these factors on postoperative visual acuity in the patients with surgically treated optochiasmatic meningioma as well as to determine their prognostic value in the recovery of visual function after surgery. Material and Methods. The study sample consisted of 43 patients operated for suprasellar meningioma. All tumors were diagnosed by computed tomography or nuclear magnetic resonance scans. Visual acuity was analyzed both before surgery and six months after surgery. The effects of age, preoperative visual loss, duration of visual symptoms and tumor size on visual outcome were analyzed. Results. Postoperative improvement of visual acuity was observed in 50% of eyes (68.4% of patients). Visual outcome was better in the younger patients. The patients with better preoperative visual acuity had better postoperative visual acuity outcome. Chances of achieving better postoperative visual function and favorable tumor resection outcome were inversely proportional to the increased length of history of disease and tumor size. Conclusion. Postoperative visual acuity prognosis in suprasellar meningioma surgery was favorably affected by the mean duration of symptoms of less than 24 months, tumor size less than 30 mm, and preoperative visual acuity loss below 0.1.

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Visual Outcomes of Macula-Involving Rhegmatogenous Retinal Detachment in Patients with and Without Age-Related Macular Degeneration

10.21203/rs.3.rs-1178939/v1 ◽

2022 ◽

Author(s):

P. Barrett Paulk ◽

Dala Eloubeidi ◽

John O. Mason III ◽

Christine A. Curcio ◽

Jason N. Crosson ◽

...

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Macular Degeneration ◽

Rhegmatogenous Retinal Detachment ◽

Age Related Macular Degeneration ◽

Light Perception ◽

Postoperative Visual Acuity ◽

Age Related ◽

Functional Vision ◽

Better Than

Abstract Background Patients presenting with macula-off rhegmatogenous retinal detachment (RRD) with concomitant age-related macular degeneration (AMD) and their treating physicians would benefit from knowledge regarding the visual prognosis after repair. The prognosis for such patients is not well known. The purpose of this study is to compare visual outcomes in macula-off RRD in eyes with AMD versus a group of comparison eyes without AMD. Methods This was a retrospective chart review of 1,149 patients. A total of 191 eyes met study criteria, 162 non-AMD eyes (controls) and 29 AMD eyes. The main outcome measure was postoperative visual acuity in control eyes versus AMD eyes, and this was compared using Fisher’s exact test. Results There was a statistically significant difference in postoperative visual acuity by AMD status, with those without AMD having a higher frequency of Count Fingers (CF), Hand Motion (HM), Light Perception (LP), or No Light Perception (NLP) vision (p = 0.023). More specifically 5.56% of non-AMD eyes and 3.45% of AMD eyes were 20/40 or better, 77.16% of non-AMD and 55.17% of AMD eyes were worse than 20/40 and better than 20/200, 10.49% of non-AMD eyes and 37.93% of AMD eyes were 20/200 or worse, and there were 11 eyes in the non-AMD group with CF, HM, LP, or NLP vision while there was only 1 eye in the AMD group with CF vision. Conclusions Though postoperative visual acuity was worse in the non-AMD group with a higher frequency of patients having final vision of CF, HM, LP, or NLP, this is not likely a clinically significant finding. Rather, it is a function of the difference in sample size and composition between the two groups. Importantly, this study suggests AMD patients can expect similar outcomes to non-AMD patients after RRD repair. Our study suggests that approximately 58% of patients with AMD can expect to maintain functional vision better than 20/200. We conclude that AMD patients can achieve functional vision after RRD surgery, similar to those without AMD. These findings may be helpful in guiding realistic expectations of AMD patients with RRD.

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Outcomes of Steroid Therapy in Combination with Endoscopic Optic Nerve Decompression Surgery for Direct Traumatic Optic Neuropathy: A Case-Series

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.07.12657 ◽

2021 ◽

Vol 104 (7) ◽

pp. 1166-1171

Keyword(s):

Visual Acuity ◽

Optic Nerve ◽

Optic Neuropathy ◽

Poor Prognosis ◽

Combined Treatment ◽

Treatment Protocol ◽

Case Series ◽

Light Perception ◽

Traumatic Optic Neuropathy ◽

Nerve Decompression

Background: Direct traumatic optic neuropathy (TON) carries a poor prognosis. However, the outcome of this injury is diverse and is related to time to treatment and treatment protocol. Objective: To evaluate the outcomes of the combined treatment protocol in patients with direct TON. Materials and Methods: The authors retrospectively reviewed the medical records of patients between January 2015 and August 2019. Main outcome was visual acuity (VA) improvement after the treatment. Results: Thirteen patients (15 eyes) were included. The mean age was 38.61 years with a range of 13 to 65 years. Initial VA varied from no light perception (NPL) in seven eyes of six patients, light perception (PL) in one eye, counting fingers in two eyes, 20/200 in three eyes, and 20/60 in two eyes. Average timing to treatment was 2.8 days (range 0 to 7 days). There were no side effects of high-dose corticosteroids treatment in all patients. During a follow-up period of three months, six of 13 patients (46.1%) had VA improvement. Conclusion: Despite poor prognosis of direct TON, the combined treatment protocol provides a favorable successful rate with most patients on having stable vision, and some having visual improvement from reducing intracanalicular pressure of the optic nerve. Keywords: Endoscopic optic nerve decompression; Traumatic optic neuropathy; Visual acuity; Case series

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Factors Influencing Visual Outcome after Penetrating Keratoplasty Combined with Intraocular Lens Implantation

European Journal of Ophthalmology ◽

10.1177/112067210301300203 ◽

2003 ◽

Vol 13 (2) ◽

pp. 134-138 ◽

Cited By ~ 3

Author(s):

J.B. Jonas ◽

R.M. Rank ◽

W.M. Budde ◽

G. Sauder

Keyword(s):

Visual Acuity ◽

Intraocular Lens ◽

Penetrating Keratoplasty ◽

Visual Outcome ◽

Intraocular Lens Implantation ◽

Postoperative Visual Acuity ◽

Factors Influencing ◽

Lens Implantation ◽

Preoperative Visual Acuity

Purpose To establish which factors influence visual outcome after penetrating keratoplasty combined with intraocular lens implantation. Methods This retrospective noncomparative clinical interventional case series study included 135 consecutive patients (mean age 70.2 ± 13.6 years) who underwent central penetrating allogenic keratoplasty combined with intraocular lens (IOL) implantation, all operated by the same surgeon. There were 79 triple procedures, 33 keratoplasties combined with an exchange of IOL, and 23 penetrating keratoplasties combined with a secondary implantation of a posterior chamber lens. Mean follow-up was 28.3 ± 18.7 months (range 3.3–112 months). Reasons for keratoplasty were herpetic or traumatic corneal scars or defects (46), Fuchs corneal endothelial dystrophy (22), pseudophakic or aphakic bullous keratopathy (49), corneal endothelial decompensation due to other reasons (15), and keratoconus (3). Main outcome measures were postoperative visual acuity and gain in visual acuity. Results Mean postoperative visual acuity and mean gain in visual acuity were 0.33 ± 0.21 (median 0.30) and 0.25 ± 0.20 (median 0.20), respectively. Compared with the preoperative measurements, mean visual acuity increased in 129 patients (129/135, 95.6%). Factors influencing postoperative visual outcome and gain in visual acuity were preoperative visual acuity (p<0.005), reason for keratoplasty (p<0.005), and diameter of the graft (p = 0.046). Postoperative visual outcome was independent of age, sex, right or left eye, presence of diabetes mellitus, preoperative refractive error, length of follow-up, duration of surgery, and preoperative intraocular pressure. Conclusions The most important factors influencing visual outcome after central penetrating allogenic keratoplasty combined with IOL surgery are preoperative visual acuity, graft size, and reason for keratoplasty. Other factors such as age, sex, diabetes mellitus, and preoperative refractive error do not substantially influence postoperative visual outcome.

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Natural Course and Prognostic Factors of Ethambutol Toxic Optic Neuropathy

10.21203/rs.3.rs-76098/v1 ◽

2020 ◽

Author(s):

Ye Ji Kim ◽

Soo Hyun Lim ◽

Ungsoo Kim

Keyword(s):

Visual Acuity ◽

Prognostic Factors ◽

Optic Neuropathy ◽

Natural Course ◽

Systemic Diseases ◽

Old Patients ◽

Toxic Optic Neuropathy ◽

Initial Visual Acuity ◽

Risk Patients ◽

Recovery Group

Abstract Background: To investigate the natural course and prognostic factors of ethambutol toxic optic neuropathy (ETON).Methods: Medical charts of 87 patients diagnosed with ETON were reviewed retrospectively, and the visual acuity and history of ethambutol medication were analyzed. Based on the final visual acuity, patients were divided into two groups: recovery and no-recovery groups. We investigated the prognostic factors, including the sex, age, duration of medication, initial visual acuity, and systemic diseases (diabetes mellitus, hypertension, renal disorders, etc.). Results: In this study, 37 men and 50 women, with ages ranging from 22 to 91 years, were included. Although a poor initial visual acuity was noted in the old patients, a short duration of medication had a weak negative correlation with the initial visual acuity. Follow-up of over 1 year could be performed for 28 out of 87 patients, including nine men and 19 women, with a mean age of 70.0 ± 8.2 years. Ten eyes of seven (25%) patients, including three men and four women, did not recover vision after discontinuation of ethambutol. Patients were significantly older in the no-recovery group than in the recovery group (73.9 ± 8.3 and 68.7 ± 8.1 years, respectively). The poor initial visual acuity and presence of systemic diseases affected the prognosis of ETON. Conclusion: Three-fourth of patients with ETON had visual recovery after discontinuation of ethambutol. High-risk patients with poor prognostic factors, including old age, presence of systemic diseases, and poor initial visual acuity, should be screened in early stages of ETON.

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COMEPA (COVID-19 Medicina Policlinico Palermo): a study in hospitalized patients

Geriatric Care ◽

10.4081/gc.2021.9895 ◽

2021 ◽

Vol 7 (3) ◽

Author(s):

The COMEPA group

Keyword(s):

Internal Medicine ◽

Intensive Care Unit ◽

Intensive Care ◽

Prognostic Factors ◽

Clinical Practice ◽

Medical Records ◽

University Hospital ◽

Efficacy And Safety ◽

The Past ◽

The University

Coronavirus disease 2019 (COVID-19) has dramatically changed our lives. In the past months, hospitals were saturated of patients; therefore, it is still important to have simple and standardized prognostic factors and to evaluate the efficacy and safety of medications commonly used for COVID-19. We aimed to collect data of the patients hospitalized in Internal Medicine and Geriatrics Wards at the University Hospital (Policlinico) ‘P. Giaccone’ in Palermo, Italy (COMEPA, COVID-19 Medicina Policlinico Palermo), with the main purpose of finding prognostic tools that can be easily used in clinical practice in order to identify patients hospitalized for/with COVID-19 at higher risk of negative outcomes, such as mortality, transfer to Intensive Care Unit (ICU) and institutionalization, as well as evaluating the efficacy/safety of medications commonly used for COVID-19. For reaching these aims, the medical records of approximately 600 patients will be recorded, having data on several parameters and including as outcomes mortality, ICU placement, institutionalization. With the COMEPA study, we therefore plan to update current literature, giving new data on prognostic factors and on the efficacy/safety of some medications used for COVID-19.

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Epidemiologic Characteristics of and Prognostic Factors for COVID-19 Among Hospitalized Patients: Updated Implications From Hubei Province, China

Frontiers in Public Health ◽

10.3389/fpubh.2021.726491 ◽

2021 ◽

Vol 9 ◽

Author(s):

Xiang Liu ◽

Linzhi Zhu ◽

Tingjuan Lu ◽

Xibang Liu ◽

Demin Jiao ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Prognostic Factors ◽

Logistic Regression Analysis ◽

Medical Records ◽

Hubei Province ◽

Child Hospital ◽

G Ratio ◽

Univariate Analyses ◽

Epidemiologic Characteristics

Introduction: The roles of some indicators in the prognosis of patients with coronavirus disease-19 (COVID-19) remain unclear and controversial. This study aimed to explore the epidemiologic characteristics of and prognostic factors for COVID-19 to provide updated recommendations for its prevention, diagnosis, and treatment.Methods: For this retrospective study, demographic, epidemiologic, and clinical data were extracted from the medical records of patients admitted to the Maternal and Child Hospital of Hubei Province (Optical Valley) with COVID-19 between February 19, 2020, and March 19, 2020. The primary outcome was the prognosis that was determined at discharge as mentioned in the medical records. Descriptive statistics, univariate analyses, and stepwise logistic regression analysis were used for data analysis.Results: Of the 1,765 patients included, 93.1% were cured and the mortality was 1.8%. Univariate analyses identified 63 factors significantly associated with COVID-19 prognosis. Logistic regression analysis revealed that a poorer prognosis was associated with undergoing resuscitation, complex disease manifestations, consultation with outside specialists, elevated basophil or lymphocyte counts, an albumin (ALB)/globulin (A/G) ratio > 2.4, and elevated levels of serum aspartate aminotransferase (AST) or creatinine. Patients had a better prognosis if the following conditions were met: dry cough reported as an initial symptom, fatigue as a clinical manifestation, and a diagnosis based on laboratory testing.Conclusion: To prevent clinical deterioration, clinicians should provide special care to patients who underwent resuscitation, with a critical disease, or requiring consultation with outside specialists. Extra attention should be paid to patients with high basophil or lymphocyte counts, a high A/G ratio, and elevated AST or creatinine levels.

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Outcome and Prognostic Factors for Traumatic Endophthalmitis over a 5-Year Period

Journal of Ophthalmology ◽

10.1155/2014/747015 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 12

Author(s):

Simona Delia Nicoară ◽

Iulian Irimescu ◽

Tudor Călinici ◽

Cristina Cristian

Keyword(s):

Prognostic Factors ◽

Medical Records ◽

Pars Plana Vitrectomy ◽

Light Perception ◽

Delayed Treatment ◽

Ocular Lesions ◽

Open Globe ◽

Pars Plana ◽

Inflammatory Drugs ◽

Open Globe Injuries

Purpose. To evaluate the outcome and identify the prognostic factors of traumatic endophthalmitis over a 5-year period.Methods. We reviewed the medical records of all the traumatic endophthalmities that we treated in our department over the last 5 years (2009–2013). We extracted the following parameters: age, gender, wound anatomy, associated ocular lesions, treatment, and initial and final visual acuities. We used the program SPSS version 20.0.0. for the statistical analysis of our data.Results. During the last 5 years, we treated 14 traumatic endophthalmities, representing 46.66% of all types of endophthalmities. The infection rate in open globe injuries was 8.13% and 34.78%, if an intraocular foreign body (IOFB) was associated. All the patients were males with the median age of 37 years. Initial visual acuities varied between light perception and 0.4 and the timing of treatment from a few hours to 10 days. We administered antibiotic and anti-inflammatory drugs, systemically and intravitreally, in all cases. We performed pars plana vitrectomy in 64.28% of cases. In 57.14% of cases, the final visual acuity was 0.1 or more.Conclusions. IOFBs increased significantly the risk for endophthalmitis. The worse prognostic factors were retinal detachment at presentation and delayed treatment. This trial is registered withIRCT2014082918966N1.

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Endoscopic Approach to Traumatic Visual Loss

Otolaryngology ◽

10.1016/s0194-5998(97)70243-2 ◽

1997 ◽

Vol 116 (6) ◽

pp. 652-655 ◽

Cited By ~ 28

Author(s):

Stilianos E. Kountakis ◽

Alberto A. J. Maillard ◽

Richard Urso ◽

Charles M. Stiernberg

Keyword(s):

Visual Acuity ◽

Optic Nerve ◽

Visual Loss ◽

Endoscopic Approach ◽

Light Perception ◽

Hand Motion ◽

Postoperative Visual Acuity ◽

Level I ◽

Total Blindness

OBJECTIVE: To review our experience with the use of endoscopic optic nerve decompression in traumatic blindness. METHOD: We did a retrospective analysis of patients with traumatic blindness that underwent endoscopic decompression of the optic canal to determine postoperative visual acuity and correlate if to preoperative visual loss and intraoperative findings. The setting was a Level I university trauma center. We identified 8 patients treated with both surgery and steroids over a 10-month period beginning in 1993 (Seven males, one female). RESULTS: Four of six patients with total blindness (no light perception) had improvements in visual acuity. In three patients, visual acuity returned to preinjury levels. One patients with total blindness was operated on 6 weeks after injury and had a visual acuity of 20/800 at 1-year follow-up. Two patients with hand motion preoperatively had improvement in visual acuity. In one patient, vision returned to normal (20/20), and in the other it improved to 20/200). Five patients were operated on after megadose steroid treatment for at least 48 hours failed; four of five noted dramatic improvements in visual acuity. CONCLUSION: The endoscopic approach may be used to successfully decompress the optic nerve in traumatic blindness.

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Transorbital Endoscopic Medial Orbitotomy and Decompression of the Optic Nerve in Patients with Endocrine Ophthalmopathy Complicated by Optical Neuropathy

Russian Sklifosovsky Journal Emergency Medical Care ◽

10.23934/2223-9022-2020-9-1-167-172 ◽

2020 ◽

Vol 9 (1) ◽

pp. 167-172

Author(s):

O. V. Levchenko ◽

A. A. Kalandari ◽

N. Y. Kutrovskaya ◽

K. V. Revazyan

Keyword(s):

Visual Acuity ◽

Surgical Treatment ◽

Optic Nerve ◽

Optic Neuropathy ◽

Satisfactory Result ◽

Postoperative Period ◽

Conservative Therapy ◽

Early Postoperative Period ◽

Medial Wall ◽

Endocrine Ophthalmopathy

AIM OF STUDY: to improve the results of surgical treatment of patients with endocrine ophthalmopathy complicated by optical neuropathy. For this, medial orbitotomy and decompression of the optic nerve were performed for a patient with endocrine ophthalmopathy, CAS<3, OD=18 mm, OS=23 mm and visual acuity OD=1.0 OS=0.2, using transorbital transconjunctival endoscopic access. The first step was a retro caruncular incision. After that, we defined an access to the medial wall of the orbit with its subsequent resection. Then, we performed ethmoidectomy and approach to the optic nerve canal. Upon completion of bone decompression, we opened periorbitis.RESULTS. The postoperative period was uneventful. In the early postoperative period, regression of exophthalmos was observed OD=18 mm, OS=20 mm, improvement in visual acuity OD=1.0 OS=0.5 . No complications were recorded. A satisfactory result was obtained.CONCLUSION. Transorbital endoscopic medial orbitotomy and optic decompression can be effectively used in the treatment of patients with endocrine ophthalmopathy complicated by optic neuropathy, refractory to conservative therapy. The technique is promising and requires further randomized studies.

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