scholarly journals Nd:YAG Laser Vitreolysis for Symptomatic Vitreous Floaters: Application of Infrared Fundus Photography in Assessing the Treatment Efficacy

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Xiaolei Sun ◽  
Jingyi Tian ◽  
Jinyan Wang ◽  
Jingjing Zhang ◽  
Ying Wang ◽  
...  

Background. Vitreous floater is a physically common phenomenon with aging and is related to visual impairment and decrease of quality of life. Nd:YAG vitreolysis is supposed to be an option for resolving floaters, but its clinical efficacy is undefined. We aimed to evaluate the efficacy of Nd:YAG vitreolysis in treating floater semiquantifiably by determining changes of floater areas on infrared fundus photography (IR). Methods. Patients with floaters and those who underwent Nd:YAG vitreolysis were retrospectively summarized from June 2015 to Nov 2017. Intraocular pressure, visual acuity, visual function questionnaire (VFQ-25) scores, and floater areas calculated using Image J software were recorded preoperatively and 6 months after YAG lasers. Results. 50 patients (25 female/25 male, with an average age of 60.34 years) with 55 eyes (29 OD and 26 OS) presenting floaters and underwent YAG vitreolysis treatment were included. Severe symptoms were reported in 17 eyes, moderate in 21 and mild in 17 eyes. No severe Nd:YAG vitreolysis procedure-related complications occurred in all patients except one mild retinal injury. There were no significant changes in intraocular pressure and visual acuity after the laser treatment. 43 eyes had improved symptoms; in 8, floaters had disappeared; and 4 had no changes according to VFQ-25 scores. The median of shadow areas of floaters before operation was 1.41 (0.29–12.85) cm2, which decreased to 0.12 (0–2.77) cm2 after the operations (t=5.849,  P=0.001). The mean VFQ-25 scores increased to 88.54 ± 12.74 from the baseline 71.44 ± 12.77 (t=11.82,  P=0.001). Pearson correlation analysis showed that the shadow areas of floaters were negatively correlated to VFQ-25 scores before (r=−0.73,  P=0.001) and after (r=−0.72,  P=0.001) treatments. Conclusion. Nd:YAG vitreolysis was effective and safe in alleviating the visual symptoms induced by floaters. Quantification of floater shadow areas on infrared fundus photography could serve as an objective index for assessing treatment efficacy of Nd:YAG vitreolysis.

2020 ◽  
Author(s):  
Joao Beato ◽  
Sonia Torres-Costa ◽  
Joao Esteves-Leandro ◽  
Manuel Falcão ◽  
Vitor Rosas ◽  
...  

Abstract BackgroundDiabetic retinopathy (DR) and cataract are major complications that lead to significant visual impairment of diabetic patients. This study aims to compare the changes in visual acuity, quality of life and satisfaction after phacoemulsification between type 2 diabetic and nondiabetic patients.MethodsFifty-seven diabetic patients (37 with no diabetic retinopathy [DR], 11 with mild/moderate nonproliferative DR and 9 with severe nonproliferative/proliferative DR) and 45 controls were submitted to first-eye cataract surgery by phacoemulsification alone or with co-adjuvant intravitreal injection of bevacizumab or triamcinolone. National Eye Institute Visual Function Questionnaire (NEI VFQ-25) was recorded preoperatively and 6 months after surgery; and satisfaction evaluated at 1-month. ResultsCorrected distance visual acuity (CDVA) of the operated eye at 1 and 6-months (p<0.001) was significantly higher than preoperative value in the controls and all diabetic subgroups. The final CDVA in the severe nonproliferative/proliferative DR subgroup was significantly lower compared to the controls and the remaining diabetic subgroups (p<0.05). The mean NEI VFQ-25 composite score significantly improved in both control (15.413.2 points) and diabetic (15.413.0 points) groups, without differences among the diabetic subgroups (p>0.05). Overall patient satisfaction was 93% in both control and diabetic groups. ConclusionThis study provides vision-related patient-reported outcomes that support the benefit from phacoemulsification in all stages of DR, as long as there is adequate monitoring and treatment of retinopathy.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Xiangzhong Xu ◽  
Huimin Ge ◽  
Jiajun Li ◽  
Weihong Shang ◽  
Yuke Ji ◽  
...  

Background. The vitreous body is an important part of the ocular body fluid. A foldable capsular vitreous body (FCVB) is designed to treat chronic adverse complications in severe ocular trauma and silicone oil-dependent eyes. This study is aimed at investigating a method for implanting an FCVB, its postoperative efficacy, and clinical value. Methods. A retrospective analysis was performed on data from 18 patients who underwent vitrectomy and FCVB implantation for severe ocular trauma and silicone oil-dependent eyes between March 2019 and May 2020. All treated eyes underwent clinical examinations involving the best-corrected visual acuity, intraocular pressure, FCVB position, anterior segment photography, and wide-angle fundus photography regularly after surgery. Results. Eighteen eyes from 18 patients were enrolled in this study. A total of 2.00–4.20 ( 3.46 ± 0.78 ) ml of silicone oil were injected into the FCVB during surgery. The patients were followed up at 1, 2, and 4 weeks and 3, 6, and 12 months after surgery. Twelve months after surgery, visual acuity improved in 7 (38.89%) eyes. In contrast, 10 (55.56%) eyes showed no obvious improvement, and 1 (5.56%) eye had decreased vision. Intraocular pressure at 12 months was 10.13 ± 3.52  mmHg, which was comparable to that before the surgery ( t = 0.38 , P = 0.71 ). The anterior chamber depth examined by slit lamp was 2.00–3.00 cornea thickness (CT) in 7 eyes, 1.00–2.00 CT in 2 eyes, and <1.00 CT in one eye. The anterior chamber disappeared in eight eyes. There were eight eyes with clear cornea, four eyes with localized opacity, and two eyes with obvious gray-white opacity. There was no case of severe FCVB deflection, rupture, or exposure during the observation period. Conclusion. FCVB implantation is an effective and safe treatment for eyes with severe ocular trauma and silicone oil-dependent eyes. It may support retinal reattachment, slow down eyeball atrophy, reduce the risk of chronic adverse complications such as corneal endothelial decompensation, and maintain intraocular pressure and preoperative visual function.


Author(s):  
Daniel Caballe-Fontanet ◽  
Cristina Alvarez-Peregrina ◽  
Neus Busquet-Duran ◽  
Eduard Pedemonte-Sarrias ◽  
Miguel Angel Sanchez-Tena

Background: Age-related macular degeneration (AMD) is a disease with an increasing incidence due to the general aging of the population that decreases the patient’s quality of life. This work aims to study whether selective cut optical filters improve the AMD patient’s quality of life. Methods: Prospective and longitudinal study in 79 patients. Visual acuity, contrast sensitivity, and the line differences in the Colenbrander test were measured. Patients answered The National Eye Institute 25-Item Visual Function Questionnaire (NEI VFQ-25), which measures the quality of life related to vision before and after using cut optical filters. Results: There was an improvement of 5.99 points (3.7–8.3) in NEI VFQ-25 after wearing filters. This improvement was 4.0 points for 450-nm filters and 12.7 points for 511-nm filters. For patients with visual acuity (VA) < 0.25, results of NEI VFQ-25 increased by 10.11 points (1.19–19.02) and for patients with late AMDs, results increased by 5.33 points (1.31–9.35). Conclusions: Selective filters improve the quality of life of patients with AMD. The success rate in the fitting of filters is better for those with VA lower than 0.25 and those with late or advanced AMD.


2021 ◽  
Vol 3 (1) ◽  
pp. 44-50
Author(s):  
Mitsuhiro Kamimura ◽  
◽  
Takako Ohnishi ◽  
Hisao Terada ◽  
Atsuto Mouri ◽  
...  

Introduction: Allergic conjunctivitis is treated with oral anti-allergy agents or topical eye drops, but the response is often incomplete, and symptoms persist. We considered that topical treatment with an antihistamine ointment (diphenhydramine-Restamin Cream®) on the eyelids could be effective as supplemental therapy. This study investigates the efficacy and safety of Restamin Cream® for allergic conjunctivitis. Methods: In patients with allergic conjunctivitis, Restamin Cream® was applied to both eyelids twice a day for 2 weeks. There was a 2-week observation period before treatment and a 2-week washout period after treatment. Patients recorded symptoms (eye itching and watering) on a visual analogue scale for the entire 6-week period. Assessment of quality of life, evaluation of conjunctivitis, and measurement of visual acuity and intraocular pressure were conducted at the start of observation, at initiation of treatment, at completion of treatment, and at the end of washout. Results: 7 patients were enrolled; 5 completed the study and 2 discontinued due to adverse reactions. The quality of life score and objective ocular findings improved in all 5 patients. Visual analogue scale scores for itching and watering also improved significantly in 3 and 2 patients, respectively. Adverse reactions included local skin irritation in 3/7 patients, and transient blurred vision and eye pain in 1 patient each. There were no changes of visual acuity or intraocular pressure. Conclusions: Application of diphenhydramine ointment to the eyelids was effective for allergic conjunctivitis.


2021 ◽  
pp. 112067212110483
Author(s):  
Andrea Oliveira da Silva ◽  
Christiane Rolim-de-Moura ◽  
Nara Lúcia Poli Botelho ◽  
Carolina PB Gracitelli ◽  
Nívea Nunes Ferraz

Purpose: To identify psychosocial indicators and evaluate the filtering surgeries impacts on quality of life (QOL) of children with primary congenital glaucoma (PCG) and their family. Methods: Parents of children with bilateral PCG who underwent filtering surgery were included. Data were collected through: (a) psychological inquiry to determine psychosocial indicators; (b) Children’s Visual Function Questionnaire (CVFQ). The associations between the CVFQ scores and visual acuity, intraocular pressure, optic disk cupping, horizontal corneal diameter, axial length, number of surgeries, and hypotensive eye drops were investigated. The statistical significance level was considered as p ⩽ 0.05. Results: The mean age of the nine mothers interviewed and their children (six boys and three girls) was 29 ± 5 years and 35 ± 18 months, respectively. The psychosocial indicators determined were: emotional impact of the diagnosis, disease knowledge, mother and family’s feelings on facing the surgical treatment, surgical result comprehension, treatment adherence, child's emotional and behavioral reactions, social support, and future expectations. In CVFQ analysis, QOL score was strongly associated with visual acuity ( r = −0.79; p = 0.01). Besides the treatment score was correlated to intraocular pressure ( r = −0.68; p < 0.05), optic disk cupping ( r = −0.85; p = 0.03), and corneal diameter ( r = −0.69; p = 0.02). Correlations were not found for number of surgeries and eye drops. Conclusions: This study confirmed the PCG surgical treatment impact on QOL and determined psychosocial indicators which may favor the suitable actions in psychological treatment and follow-up of the children and families.


2019 ◽  
Author(s):  
Xiangyang Zhang ◽  
Xuemin Tian ◽  
Baike Zhang ◽  
Lisa Guo ◽  
Xiaodan Li ◽  
...  

Abstract Background: To investigate the efficacy and safety of the foldable capsular vitreous body(FCVB) in the treatment of vitreoretinal diseases. Methods: A retrospective analysis was conducted involving 20 patients (20 eyes) who underwent FCVB implantation in our hospital from September 2017 to April 2018. All the patients underwent vitrectomyand FCVB implantation, a standard three-port vitrectomy was performed, and the FCVB was implanted into the vitreous cavity. At 6 months after surgery, the visual acuity chart, Goldmann applanation tonometer, fundus photography, B-ultrasound examination, and optical coherence tomography (OCT) examination were performed on the treated eyes.The patients’ vision, intraocular pressure, retinal reattachment, and FCVB status were observed. Results: Compared with the preoperative measurements, there was no change in visual acuity in 18 eyes at 6 months after FCVB implantation, and the difference was not significant (P=1.000); the intraocular pressure of these 18 eyes returned to normal, and the difference was significant (P=0.00001); in fundus photographyimages of these 18 eyes, B-ultrasound,OCT showed good retinal reattachment, FCVB distributed well in the vitreous cavity and evenly supported the vitreous retina and there was no obvious abnormality. The eyes were symmetrical, and the eyeball activity was normal. One patient developed eyeball atrophy after surgery, and one patient developed ocular inflammation after surgery. The condition improved after treatment. Conclusions: FCVB is an effective and safe vitreous substitute during the 6-month implantation period and is able to maintain eye shape, intraocular pressure and good aesthetics. Keywords: Vitreoretinal disease; vitrectomy; FCVB; intraocular pressure.


2019 ◽  
Author(s):  
Xiangyang Zhang ◽  
Xuemin Tian ◽  
Baike Zhang ◽  
Lisa Guo ◽  
Xiaodan Li ◽  
...  

Abstract Background: To investigate theefficacy and safety of the foldable capsular vitreous body(FCVB) in the treatment of vitreoretinal diseases. Methods: A retrospective analysis was conducted involving 20 patients (20 eyes) who underwent FCVB implantation in our hospital from September 2017 to April 2018. All the patients underwent vitrectomyand FCVB implantation, a standard three-port vitrectomy was performed, and the FCVB was implanted into the vitreous cavity. At 6 months after surgery, the visual acuity chart, Goldmann applanation tonometer, fundus photography, B-ultrasound examination, and optical coherence tomography (OCT) examination were performed on the treated eyes.The patients’ vision, intraocular pressure, retinal reattachment, and FCVB status were observed. Results: Compared with the preoperative measurements, there was no change in visual acuity in 18 eyes at 6 months after FCVB implantation, and the difference was not significant (P=1.000); the intraocular pressure of these 18 eyes returned to normal, and the difference was significant (P=0.00001); in fundus photographyimages of these 18 eyes, B-ultrasound,OCT showed good retinal reattachment, FCVB distributed well in the vitreous cavity and evenly supported the vitreous retina and there was no obvious abnormality. The eyes were symmetrical, and the eyeball activity was normal. One patient developed eyeball atrophy after surgery, and one patient developed ocular inflammation after surgery. The condition improved after treatment. Conclusions: FCVB is an effective and safe vitreous substitute during the 6-month implantation period and is able to maintain eye shape, intraocular pressure and good aesthetics.


2015 ◽  
pp. 71-75
Author(s):  
Van Nam Phan ◽  
Ba Ken Tran

Purpose: Study clinical feature of phacomorphic glaucoma. To evaluate the result of treatment phacomorphic glaucoma. Method: The retrospective, interventional study on 36 cases with phacomorphic glaucoma who underwent treated at Hue Central Hospital from 6/2010 to 6/2011. Standard of research: visual, IOP, before and after surgery, accompanying lesions and post-operative complications. The surgery is considered successful when postoperative IOP less than 21 mmHg. Results: Age 50-59 presented 30.5 percent, ≥ 60 presented 91.7 percent. There was a slight female preponderance (66.7%) compared to the male population (33.3%) which implies a statistically marginally significant difference. However there was no statistical significance difference when compared by the two subgroups. Patient in country presented 61,1% and city presented 38,9%. The duration between the onset of pain and surgery from 0 to < 5 days (77.8%), from 6 to 10 (16.7%) and >10 days presented 5.5%. The preoperative intraocular pressure 35 to 45mmHg (47.2%), 46-55 (30.6%), 56-65 (13.9%) and more than 65 presented 8.3%. The visual acuity preoperation less than 1metre count finger (94.5%), less than 3 metre count finger presented 5.5%. Close anterior chamber angle presented 80.6% and shallow was presented 19.4%. Corneal edema presented 100%, iritis presented 94.4%, dilated pupil larger 5mm presented 83.3%, Synchynea iris and cataract presented 72.2%. ECCE, implantation IOL combined trabeculectomy presented 11.1%, Phaco, implantation IOL combined trabeculectomy presented 69,5%, ECCE implantation IOL presented 5.6%, Phaco, implantation IOL presented 13.8%. Postoperative visual acuity from 1/10 to 5/10 presented 72.2%, no case have VA larger than 5/10. Postoperative 3 months VA 1/10 to 5/10 presented 72.2%, larger VA 5/10 presented 8.3%. Postoperative 3 months intraocular pressure ≤ 21mmHg presented 91.7%, 22 to 24mmHg presented 8.3%, no case have IOP ≥25mmHg. Postoperative edema presented 58.3%, iritis presented 58.3%. Key words: phacomorphic Glaucoma


Author(s):  
Victor Duque ◽  
Carolina de la Pinta ◽  
Ciriaco Corral ◽  
Carmen Vallejo ◽  
Margarita Martin ◽  
...  

Abstract Introduction: Choroidal metastases are the most frequent intraocular secondary tumours, with a prevalence of 2–7% according to the literature. Our aim was to review a clinical case of choroidal metastasis. We present a case of a 63-year-old male patient diagnosed in 2018 with lung adenocarcinoma cT4N0M1. The patient had three metastases in the brain, which were successfully treated with radiosurgery (RS). The patient was treated with chemotherapy with pemetrexed–cisplatin schedule. Five months after diagnosis, the patient presented with decreased vision in the right eye. After ophthalmologic evaluation, he was diagnosed with a right choroidal metastasis, which was treated with external beam radiotherapy with 20 Gy in five fractions, resulting in improved visual acuity and a complete clinical and radiological response. The patient took part in a clinical trial that continued with systemic chemotherapy. Twenty-two months after radiotherapy to the eye, the patient has good visual acuity without any side effects. Conclusions: Choroidal metastasis treated with radiotherapy achieves good local control, with limited side effects, allowing an improvement in visual acuity and consequently, an improvement in the patient´s quality of life.


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