Lens-sparing vitrectomy for stage 4A retinopathy of prematurity in infants with aggressive-posterior ROP: Anatomic and functional results

2020 ◽  
pp. 112067212094693
Author(s):  
Sara Macor ◽  
Silvia Pignatto ◽  
Antonio Capone Jr ◽  
Stefano Piermarocchi ◽  
Paolo Lanzetta
Keyword(s):  
Retinal Detachment ◽  
Retinopathy Of Prematurity ◽  
Functional Outcomes ◽  
Vitreous Hemorrhage ◽  
Functional Results ◽  
Postmenstrual Age ◽  
Refractive Correction ◽  
Anatomic Success

Aim: To assess long-term anatomic and functional outcomes of early lens-sparing vitrectomy (LSV) for stage 4A retinopathy of prematurity (ROP) in infants with aggressive-posterior ROP (AP-ROP) which progressed to retinal detachment despite laser treatment. Methods: Chart review of infants who underwent early 25-gage LSV for stage 4A ROP. Outcomes were anatomic success, mean visual acuity (VA), development of postoperative complications, and refractive changes. Follow-up examinations were performed at 1, 3, 6, 12, and then every 6 months. Results: Ten eyes of seven preterm infants who underwent LSV were included. Mean follow-up was 36 ± 13.4 months and mean postmenstrual age (PMA) at last follow-up was 37 ± 13.7 months. Mean gestational age (GA) and weight at birth was 26 ± 1.4 weeks and 639 ± 180 g. Two eyes had vitreous hemorrhage 4 and 14 days after surgery, respectively. At last follow-up anatomic success was 100%, mean VA was 20/80 and eight eyes (80%) had high myopic refractive correction (mean spherical equivalent –11.25 D). Conclusion: Early LSV for stage 4A ROP with AP-ROP and progression to retinal detachment is efficacious in terms of anatomic and functional outcomes. Anatomic success is associated with visual improvement despite possible myopic refraction changes during follow-up.

Two-Year Outcomes of Infants with Stage 2 or Higher Retinopathy of Prematurity: Results from a Large Multicenter Registry

2019 ◽  
Vol 37 (02) ◽  
pp. 196-203
Author(s):  
Veeral N. Tolia ◽  
Kaashif A. Ahmad ◽  
Jack Jacob ◽  
Amy S. Kelleher ◽  
Nick McLane ◽  
...  
Keyword(s):  
Primary Care ◽  
Retinal Detachment ◽  
Premature Infants ◽  
Retinopathy Of Prematurity ◽  
Laser Surgery ◽  
Significant Risk ◽  
Inclusion Criteria ◽  
Multicenter Registry

Objective To define the incidence of ophthalmologic morbidities in the first 2 years of life among infants diagnosed with stage 2 or higher retinopathy of prematurity (ROP). Study Design We prospectively enrolled premature infants with stage 2 or higher ROP. The infants were followed up for 2 years, and we report on data collected from outpatient ophthalmology and primary care visits. Results We enrolled 323 infants who met inclusion criteria, of which 112 (35%) received treatment with laser surgery (90) or bevacizumab (22). Two-year follow-up was available for 292 (90%) of the cohort. The most common ophthalmologic conditions at follow-up were hyperopia (35%), astigmatism (30%), strabismus (21.9%), myopia (19.2%), anisometropia (12%), and amblyopia (12%). Severe ophthalmologic morbidities such as retinal detachment and cataracts were rare, but occurred in both treated and untreated infants. Overall, 22.6% of the infants were wearing glasses at 2 years, including 8.5% of the untreated infants. Conclusion Patients with stage 2 or higher ROP remain at significant risk for ophthalmological morbidity through 2 years of age. Infants with regression of subthreshold ROP who do not require treatment represent an underrecognized population at long-term ophthalmological risk. ClinicalTrials.gov Identifier NCT01559571.

scholarly journals Titrated Cyclocryopexy - A report on long term results

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Nasir Saeed ◽  
Tariq Farooq Babar ◽  
Sanaullah Jan ◽  
Ibrar Hussain ◽  
Mohammad Daud Khan
Keyword(s):  
Retinal Detachment ◽  
Cohort Analysis ◽  
Vitreous Hemorrhage ◽  
Pressure Control ◽  
Long Term Results ◽  
Retrospective Cohort Analysis ◽  
Snellen Chart ◽  
Advanced Glaucoma

Objective: To determine the efficacy and safety of a titrated cyclocryopexy in advanced glaucomatous eyes in term of intraocular pressure control and complications. Material and Methods: Retrospective Cohort analysis of a titrated cyclocryopexy in 30 eyes of 25 patients with uncontrolled glaucoma during July 1996 to July 2003 at Hayatabad Medical Complex, Peshawar. Inclusion criteria applied was; patients having uncontrolled IOP with maximum medical therapy, previous trabeculectomy and a minimum follow-up of 2 years. All patients were assessed for glaucoma. Numbers of cryoapplications were determined according to the IOP. Four to 12 applications in one sitting were used. Repeat cryoapplication were applied at least after six-weeks of previous therapy if IOP was not controlled. Results: A total of 30 eyes of 25 patients were studied. IOP control of less than 21 mm Hg was achieved in 83% of the eyes. Mean IOP was reduced from 29 ± 4.96 pre-op to 17 ± 7.36 at two years follow-up. Forty percent of the eyes ne eded single session, 40% received 2 sessions and other 20% needed sessions. All the patients lost at least one line of Snellen chart at 2 years follow-up, 70% retained useful vision, 20% retained light perception and 10% lost perception of light. Serious complications included phthisis, persistent vitreous hemorrhage with retinal detachment, and total retinal detachment and persistent vitreous hemorrhage in 1 eye each. Conclusion: Cyclocryopexy appears to be an effective procedure in cases of advanced glaucoma with an acceptable risk / benefit ratio. If done in a titrated manner the number of complications are reduced in severity.

Long-term outcomes of lumbar microdiscectomy in the pediatric population: a large single-institution case series

2019 ◽  
Vol 24 (5) ◽  
pp. 549-557
Author(s):  
Malia McAvoy ◽  
Heather J. McCrea ◽  
Vamsidhar Chavakula ◽  
Hoon Choi ◽  
Wenya Linda Bi ◽  
...  
Keyword(s):  
Conservative Management ◽  
Functional Outcomes ◽  
Pediatric Patients ◽  
Clinical Presentation ◽  
Case Series ◽  
Csf Leak ◽  
Single Institution ◽  
The Mean

OBJECTIVEFew studies describe long-term functional outcomes of pediatric patients who have undergone lumbar microdiscectomy (LMD) because of the rarity of pediatric disc herniation and the short follow-up periods. The authors analyzed risk factors, clinical presentation, complications, and functional outcomes of a single-institution series of LMD patients over a 19-year period.METHODSA retrospective case series was conducted of pediatric LMD patients at a large pediatric academic hospital from 1998 to 2017. The authors examined premorbid risk factors, clinical presentation, physical examination findings, type and duration of conservative management, indications for surgical intervention, complications, and postoperative outcomes.RESULTSOver the 19-year study period, 199 patients underwent LMD at the authors’ institution. The mean age at presentation was 16.0 years (range 12–18 years), and 55.8% were female. Of these patients, 70.9% participated in competitive sports, and among those who did not play sports, 65.0% had a body mass index greater than 25 kg/m2. Prior to surgery, conservative management had failed in 98.0% of the patients. Only 3 patients (1.5%) presented with cauda equina syndrome requiring emergent microdiscectomy. Complications included 4 cases of postoperative CSF leak (2.0%), 1 case of a noted intraoperative CSF leak, and 3 cases of wound infection (1.5%). At the first postoperative follow-up appointment, minimal or no pain was reported by 93.3% of patients. The mean time to return to sports was 9.8 weeks. During a mean follow-up duration of 8.2 years, 72.9% of patients did not present again after routine postoperative appointments. The total risk of reoperation was a rate of 7.5% (3.5% of patients underwent reoperation for the same level; 4.5% underwent adjacent-level decompression, and one patient [0.5%] ultimately underwent a fusion).CONCLUSIONSMicrodiscectomy is a safe and effective treatment for long-term relief of pain and return to daily activities among pediatric patients with symptomatic lumbar disc disease in whom conservative management has failed.

scholarly journals Recovery of Visuospatial Neglect Subtypes and Relationship to Functional Outcome Six Months After Stroke

2021 ◽  
pp. 154596832110329
Author(s):  
Margaret J. Moore ◽  
Kathleen Vancleef ◽  
M. Jane Riddoch ◽  
Celine R. Gillebert ◽  
Nele Demeyere
Keyword(s):  
Functional Outcomes ◽  
Stroke Severity ◽  
Visuospatial Neglect ◽  
Recovery Pattern ◽  
Stroke Impact Scale ◽  
Impact Scale ◽  
Significant Difference ◽  
Initial Severity

Background/Objective. This study aims to investigate how complex visuospatial neglect behavioural phenotypes predict long-term outcomes, both in terms of neglect recovery and broader functional outcomes after 6 months post-stroke. Methods. This study presents a secondary cohort study of acute and 6-month follow-up data from 400 stroke survivors who completed the Oxford Cognitive Screen’s Cancellation Task. At follow-up, patients also completed the Stroke Impact Scale questionnaire. These data were analysed to identify whether any specific combination of neglect symptoms is more likely to result in long-lasting neglect or higher levels of functional impairment, therefore warranting more targeted rehabilitation. Results. Overall, 98/142 (69%) neglect cases recovered by follow-up, and there was no significant difference in the persistence of egocentric/allocentric (X2 [1] = .66 and P = .418) or left/right neglect (X2 [2] = .781 and P = .677). Egocentric neglect was found to follow a proportional recovery pattern with all patients demonstrating a similar level of improvement over time. Conversely, allocentric neglect followed a non-proportional recovery pattern with chronic neglect patients exhibiting a slower rate of improvement than those who recovered. A multiple regression analysis revealed that the initial severity of acute allocentric, but not egocentric, neglect impairment acted as a significant predictor of poor long-term functional outcomes (F [9,300] = 4.742, P < .001 and adjusted R2 = .098). Conclusions. Our findings call for systematic neuropsychological assessment of both egocentric and allocentric neglect following stroke, as the occurrence and severity of these conditions may help predict recovery outcomes over and above stroke severity alone.

Long-term Follow-up of Visual Acuity in Eyes With Stage 5 Retinopathy of Prematurity After Closed Vitrectomy

1995 ◽  
Vol 120 (3) ◽  
pp. 308-316 ◽  
Author(s):  
YUKI FUCHINO ◽  
HIDEYUKI HAYASHI ◽  
TOSHIHIRO KONO ◽  
KENJI OHSHIMA
Keyword(s):  
Visual Acuity ◽  
Retinopathy Of Prematurity ◽  
Long Term Follow Up

scholarly journals Influences of Central Bouquet Alterations on the Visual Outcome in Eyes Receiving Epiretinal Membrane Surgery

2021 ◽  
Vol 11 (3) ◽  
pp. 926
Author(s):  
Max Philipp Brinkmann ◽  
Stephan Michels ◽  
Carolin Brinkmann ◽  
Mario Damiano Toro ◽  
Nicole Graf Johansen ◽  
...  
Keyword(s):  
Visual Outcome ◽  
Functional Results ◽  
Internal Limiting Membrane ◽  
Ilm Peeling ◽  
Epiretinal Membranes ◽  
Staging Systems ◽  
Before And After ◽  
Pars Plana

Background: Previous studies have shown that epiretinal membranes (ERMs) may be associated with abnormal outer retinal anatomy. However, long-term morphological and functional results of pars plana vitrectomy (PPV) with ERM and internal limiting membrane (ILM) peeling in eyes with central bouquet (CB) alterations have not yet been investigated. Methods: In a retrospective, consecutive study all patients underwent best corrected visual acuity (BCVA) testing and spectral domain optical coherence tomography (SD-OCT) before and after a mean of 20 months (range 3–70 months) postoperatively. CB abnormalities and ERMs were classified according to Govetto’s staging systems. Results: Of the 67 eyes, 22 (34%) showed CB abnormalities at baseline. The mean BCVA increased from 0.42 at baseline to 0.20 LogMAR at final follow-up (p < 0.001). Neither ERM stage (p = 0.06) nor CB stage (p = 0.939) at baseline were significant predictors of vision improvement following surgery. Conclusions: Our results show that baseline BCVA, but not classification of CB changes and ERM at baseline, seems to be a useful predictor for functional outcomes following PPV with ERM and ILM peeling in the long-term.

Five-Year Prospective Roentgen Stereophotogrammetric and Clinical Outcomes of the BioPro MTP-1 Hemiarthroplasty

2021 ◽  
pp. 107110072110613
Author(s):  
Vinay V. Balesar ◽  
Lennard A. Koster ◽  
Bart L. Kaptein ◽  
Stefan B. Keizer
Keyword(s):  
Prospective Study ◽  
Clinical Outcomes ◽  
Condition Number ◽  
Clinical Assessment ◽  
Functional Outcomes ◽  
Metatarsal Bone ◽  
Migration Patterns ◽  
Patient Questionnaires

Background: Mixed results for functional outcomes and long-term fixation have been reported for first metatarsophalangeal arthroplasty. This prospective study was designed to evaluate the migration of the BioPro metatarsophalangeal-1 (MTP-1) joint hemiprosthesis with Roentgen stereophotogrammetric analysis (RSA). Migration patterns of the prosthesis, prosthesis-induced erosion of the metatarsal bone, and clinical outcomes were evaluated sequentially to 5 years postoperation (PO). Methods: Eleven female patients received the BioPro-1 hemiprosthesis. Prosthesis translation and metatarsal erosion were measured with RSA at immediately PO, 6 weeks, and 3, 6, 12, 36, and 60 months postoperatively. Clinical assessment was done by patient questionnaires. Results: RSA data of 9 patients were available for analysis. Median (range) number of markers used in RSA analysis, condition number, and mean error of markers around the prosthesis were 4 (3-7), 320 (208-862), and 0.13 (0.02-0.28), respectively. Progressive subsidence was seen up to 3 years PO (mean 2.1 mm, SE 0.32). Progressive metatarsal erosion was found from 1 year PO (mean 0.49 mm, SE 0.15). Pain, function, and quality scores improved after surgery and did not deteriorate at later follow-up moments. Conclusion: Model-based RSA of the BioPro-1 prosthesis shows nonstabilizing medial and distal translation and metatarsal erosion. Despite the measured migration and erosion, clinical outcomes improved and remained similar up to 5 years postoperation.

scholarly journals Tubularized proximally-incised plate in distal/midshaft hypospadias repair

2017 ◽  
Vol 39 (2) ◽  
Author(s):  
Antonio Marte ◽  
Lucia Pintozzi
Keyword(s):  
Perioperative Complications ◽  
Foley Catheter ◽  
Case Series ◽  
Functional Results ◽  
Inclusion Criteria ◽  
Urethral Plate ◽  
Age At Surgery ◽  
Long Term Follow Up

The aim of this study was to verify the validity, feasibility, and the functional results, by uroflowmetry, of Tubularized proximallyincised plate technique in selected case of distal/midshaft hypospadias. Out of 120 patients scheduled to undergo TIP (or Snodgrass) procedure, 23 were selected between January 2013 and January 2016 (19.1%). This case series comprised 16 patients with distal and 7 with midshaft hypospadias. Mean age at surgery was 2.9 years. The inclusion criteria were a deep and wide glandular groove and a proximal narrow urethral plate. The procedure was carried out as described by Snodgrass but the incision of the urethral plate, including the mucosal and submucosal tissue, was made only proximally, between the original meatus and the glandular groove in no case extending to the entire length of the plate. Postoperatively a foley catheter was left in place from 4 to 7 days. Uroflowmetry was performed when the patients age ranged from 2.5 to 5.7 years (mean age 3.11 years and mean follow-up 1.8 years, body surface 2). No patient presented fistulas nor perioperative complications. At uroflowmetry, eighteen patients presented values above the 25<sup>th</sup> percentile and 5 showed a borderline flow. All patients in this group remained stable without urinary symptoms. In selected cases, the tubularized proximally-incised plate yields satisfactory cosmetic and functional results for the treatment of midshaft proximal hypospadias. A long-term follow-up study is needed for further evaluation. Patient selection is crucial for the success of this technique.

Efficacy of intravitreal conbercept injection in the treatment of retinopathy of prematurity

2018 ◽  
Vol 103 (4) ◽  
pp. 494-498 ◽  
Author(s):  
Yichen Bai ◽  
Huanjie Nie ◽  
Shiyu Wei ◽  
Xiaohe Lu ◽  
Xiaoyun Ke ◽  
...  
Keyword(s):  
Retinopathy Of Prematurity ◽  
Laser Photocoagulation ◽  
Primary Outcome ◽  
Safety And Efficacy ◽  
Postmenstrual Age ◽  
Zone Ii ◽  
The Mean ◽  
Secondary Outcomes ◽  
Number Of Injections

BackgroundTo evaluate the safety and efficacy of intravitreal conbercept (IVC) injection in the treatment of retinopathy of prematurity (ROP).MethodsPatients with ROP who underwent IVC injection in Zhujiang Hospital from June 2015 to July 2016 were studied retrospectively. The primary outcome was defined as the regression of plus disease. The secondary outcomes were defined as the presence of recurrence, number of injections and the final regression of disease.ResultsA total of 48 eyes of 24 patients with ROP were included. Among them, 9 eyes of 5 patients had zone I ROP, 35 eyes of 18 patients had zone II ROP and 4 eyes of 2 patients had aggressive posterior ROP. The mean gestational age was 28.5±1.6 weeks, the mean birth weight was 1209.6±228.6 g, the mean postmenstrual age of first injection was 34.2±1.9 weeks and the mean follow-up period was 31.0±4.7 weeks. Forty of 48 eyes (83.3%) received IVC only once, and the regression of plus disease occurred at an average of 3.5±1.5 weeks after the first injection of conbercept. For eight recurrent eyes (16.7%), four eyes received a second IVC and the remaining four eyes received laser photocoagulation, and the regression of plus disease occurred in 3 weeks. No lens opacity, vitreous haemorrhage, entophthalmia or retinal detachment was observed during follow-up.ConclusionIVC injection is an effective treatment for ROP.

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