Reduced fluence corneal cross-linking in mild to moderate keratoconus: One year-follow-up

2020 ◽  
pp. 112067212096656
Author(s):  
Seyed Reza Ghaffari ◽  
Saeed Khaheshi ◽  
Fateme Alipour ◽  
Somayye Mashhadi Farahani ◽  
Amir-Hooshang Beheshtnejad ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Eligible Patient ◽  
Case Series ◽  
Control Group ◽  
Data Analyst ◽  
Cell Counts ◽  
Group 2 ◽  
One Year ◽  
And Control

Purpose: To evaluate the safety and efficacy of reduced fluence CXL (lower dose of UV-A irradiation) in mild to moderate keratoconus. Setting: Farabi Eye Hospital, Tehran, Iran. Design: Non-randomized prospective comparative interventional case series. Every eligible patient included in the study (mild to moderate progressive keratoconus) was randomly allocated to case (reduced fluence) and control (standard) groups, except for bilateral patients. In these patients the eye with more advanced disease was allocated to control group and the other eye was randomly assigned in either case or control group. Operators performing refraction and images and the data analyst were masked, but patients and physicians were not. Methods: Forty-six eyes of 38 patients were recruited. Group 1 received 7 min (fluence of 3.8 J/cm2), while group 2 received 10 min of 9 mW/cm2 UV-A (fluence of 5.4 J/cm2). Visual, keratometric and biomechanical outcomes were compared between groups. Results: At last follow-up (mean12 months, range 6–24 months), there were no statistically significant differences in changes in uncorrected visual acuity, best corrected distance visual acuity, Kmax, Kmean, corneal hysteresis, corneal resistance factor, endothelial cell counts, demarcation line depth, and intraoperative pain scores between groups (all p-values < 0.05). Conclusion: The results of this study show comparable one-year outcomes between 3.8 and 5.4 J/cm2 accelerated CXL in mild to moderate keratoconus. Should the results of this study be confirmed in longer follow-ups, using a reduced fluence setting could be considered as an alternative to standard treatment in these patients.

scholarly journals Orthokeratology in Moderate Myopia: A Study of Predictability and Safety

2020 ◽  
Author(s):  
Kirti Singh ◽  
Mainak Bhattacharyya ◽  
Abhishek Goel ◽  
Ritu Arora ◽  
Nikhil Gotmare ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Contact Lenses ◽  
Corneal Thickness ◽  
Case Series ◽  
Tear Film ◽  
Control Group ◽  
Study Group ◽  
Soft Contact Lenses

Purpose: Literature is relatively silent on safety profile and predictability of orthokeratology lenses in terms of myopia correction and prevention of further progression, especially in semi-tropical countries; this study was designed to fill this gap. Methods: This prospective, intervention case series enrolled 30 eyes of 30 patients with myopia up to –5.5 diopters (D). Patients were randomized into two groups of 15 each; the study group was prescribed overnight orthokeratology (OK) lenses, while the control group used daily wear conventional soft contact lenses. Follow-up examinations were performed after 1 h and 6 h, and then at 1, 7, 15, 30 days, and 4 months post lens wear. Uncorrected visual acuity (UCVA), contrast sensitivity, keratometry, central corneal thickness (CCT), and tear film break up time (TBUT) were evaluated at each follow-up examination. Results: All patients attained a visual acuity of 0.00 Logarithm of the Minimum Angle of Resolution (logMAR) after one week of lens use, which was maintained throughout the study period. While patients allotted to the study group had a gain of 8.1 Snellen lines (UCVA), those in the control group gained 8.9 lines (BCVA) at the end of follow-up period. In the OK group, cornea showed a flattening of 0.8 D (mean keratometry) after single overnight usage of OK lens and overall flattening of 1.2 D compared to baseline, at the end of four months. The change in contrast sensitivity, corneal endothelial specular count, axial length and tear film status was not significant in either group. Conclusion: Orthokeratology is an effective and safe modality to correct moderate myopia in motivated young adults. No side effects were encountered after a short-term follow-up in participants who resided in semi-tropical environments.

scholarly journals One Year Outcomes and Stability of a Novel Scleral Anchored Intraocular Lens

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Edoardo Abed ◽  
Matteo Forlini ◽  
Edlira Bendo ◽  
Aurelio Imburgia ◽  
Alessandro Mularoni ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Anterior Segment ◽  
Case Series ◽  
Specular Microscopy ◽  
Iop Measurement ◽  
Prospective Case Series ◽  
One Year

Purpose. To assess one year results and stability of the implantation of a scleral anchored intraocular lens (IOL). Design. Interventional prospective case series. Methods. Sixty eyes of 60 patients affected by either aphakia or IOL dislocation were included in this study. Patients underwent vitrectomy, scleral fixation of the IOL, and, if present, dislocated IOL removal. Patients were evaluated preoperatively and at 1, 3, 6, and 12 months after surgery by best-corrected distance visual acuity (BCVA) assessment, intraocular pressure (IOP) measurement, corneal specular microscopy, and optical coherence tomography (OCT) of both the macula and anterior segment. Results. At twelve months, mean BCVA significantly improved ( p < 0.0001 ), and none of the patients experienced a decrease of visual acuity. A 10% decrease of endothelial cell count occurred after surgery. Cystoid macular edema occurred in three patients (5%). A transient increase of intraocular pressure was noted in 7 cases (12%). At one month, horizontal and vertical IOL tilt was 1.04 ± 0.87 and 0.74 ± 0.71 degrees, respectively, and did not significantly change in the follow-up ( p > 0.05 ). None of the patients had decentration or dislocation of scleral-fixated IOL during the follow-up. Conclusion. Implantations of scleral plug fixated IOL provide good visual results, low complication rate, and excellent stability of the lens until one-year follow-up.

scholarly journals An Attempt to Optimize the Outcome of Penetrating Keratoplasty in Congenital Aniridia-Associated Keratopathy (AAK).

2021 ◽  
Author(s):  
Christian Joe Farah ◽  
Fabian Fries ◽  
Lorenz Latta ◽  
Barbara Käsmann-Kellner ◽  
Berthold Seitz
Keyword(s):  
Visual Acuity ◽  
Penetrating Keratoplasty ◽  
Case Series ◽  
Autologous Serum ◽  
Eye Drops ◽  
Logrank Test ◽  
Congenital Aniridia ◽  
Group 2 ◽  
Group 1

Abstract Purpose To propose an optimized microsurgical and medical approach to reduce the risk of complications after penetrating keratoplasty (PKP) in patients with aniridia-associated keratopathy (AAK). Methods Retrospective observational case series of 25 PKP performed in 16 patients with AAK. Preoperative indications were endothelial decompensation and vascularised scars (68%) or graft failure (32%) due to limbal stem cell deficiency. The optimized approach included a combination of a small corneal graft size (around 7.0mm), interrupted 10-0-Nylon sutures, simultaneous AMT as a patch, large bandage contact lens, temporary lateral tarsorrhaphy, postoperative autologous serum eye drops, and systemic immunosuppression. Main outcome measures included: Visual acuity, transplant survival and complications encountered during follow-up of 107 weeks on average. Results A complete modified keratoplasty scheme was used in 10 of 25 PKP (group 1), while at least one of the modifications was missing in the other 15 PKP (group 2). After 8 weeks follow-up, the epithelium was closed in 23 eyes. Visual acuity improved in 19 eyes at 6 months follow-up, and remained stable in 6 eyes. None of the eyes showed a decrease in visual acuity. At the last post-operative follow-up, this visual improvement persisted in 14 eyes and graft survival rate after 156 weeks (3 years) was 69% in group 1 vs. 44% in group 2 (p = 0.39, logrank test). Secondary corneal neovascularisation (8%), scarring (4%), ulcer (4%) or graft rejection (8%) happened mostly in the second group which was missing at least one of the suggested modifications. Conclusions PKP in congenital aniridia must be considered as a high-risk keratoplasty. An optimized therapeutic approach seems to be promising in order to reduce the postoperative complication rate in these most difficult eyes.

scholarly journals Mamma Mia – A randomized controlled trial of an internet-based intervention for perinatal depression

2018 ◽  
Vol 49 (11) ◽  
pp. 1850-1858 ◽  
Author(s):  
Silje Marie Haga ◽  
Filip Drozd ◽  
Carina Lisøy ◽  
Tore Wentzel-Larsen ◽  
Kari Slinning
Keyword(s):  
Depressive Symptoms ◽  
Controlled Trial ◽  
Intervention Group ◽  
Depression Scale ◽  
Control Group ◽  
Group Data ◽  
Perinatal Depressive Symptoms ◽  
Group 2 ◽  
And Control

AbstractBackgroundStudies suggest that 10–15% of perinatal women experience depressive symptoms. Due to the risks, problems with detection, and barriers to treatment, effective universal preventive interventions are needed. The aim of this study was to assess the effectiveness of an automated internet intervention (‘Mamma Mia’) on perinatal depressive symptoms. Mamma Mia is tailored specifically to the perinatal phase and targets risk and protective factors for perinatal depressive symptoms.MethodsA total of 1342 pregnant women were randomized to an intervention (‘Mamma Mia’) and control group. Data were collected at gestational week (gw) 21–25, gw37, 6 weeks after birth, and 3 and 6 months after birth. We investigated whether (1) the intervention group displayed lower levels of depressive symptoms compared with the control group, (2) the effect of Mamma Mia changed over time, (3) the effect on depressive symptoms was moderated by baseline depressive symptoms, previous depression, and parity, and (4) this moderation changed by time. Finally, we examined if the prevalence of mothers with possible depression [i.e. Edinburgh Postnatal Depression Scale (EPDS)-score ⩾10] differed between the intervention and control group.ResultsParticipants in the Mamma Mia group displayed less depressive symptoms than participants in the control group during follow-up [F(1) = 7.03, p = 0.008]. There were indications that the effect of Mamma Mia was moderated by EPDS score at baseline. The prevalence of women with EPDS-score ⩾10 was lower in the Mamma Mia group at all follow-up measurements.ConclusionsThe study demonstrated the effects of the automated web-based universal intervention Mamma Mia on perinatal depressive symptoms.

scholarly journals Similar results for revision ACL with and without a lateral extra-articular reconstruction. A prospective evaluation

2018 ◽  
Vol 6 (12_suppl5) ◽  
pp. 2325967118S0019
Author(s):  
Juan Pablo Zicaro ◽  
Carlos Yacuzzi ◽  
Ignacio Garcia-Mansilla ◽  
Matias Costa-Paz
Keyword(s):  
Case Series ◽  
Lysholm Score ◽  
Consecutive Series ◽  
Return To Sports ◽  
Mri Imaging ◽  
Significant Difference ◽  
Group 2 ◽  
One Year ◽  
Group 1

Objectives Lateral extra-articular augmentation procedure (LEAP) has been proposed as an additional technique in the setting of revision ACL Reconstruction (ACLR). Few case series have been reported. The purpose of this study was to compare the clinical results and return to sports of a consecutive series of patients treated for revision ACLR with and without a LEAP. Methods We prospectively evaluated a series of patients treated for isolated revision ACL between 2014 and 2015 (group 1) and revision ACL associated with a LEAP from 2015 to 2016 (group 2). We analyzed the surgical technique and graft used for primary and revision ACL and for the LEAP. All patients were evaluated at one-year follow-up with Lysholm score and IKDC evaluation, return to sports and MRI evaluation. Results Thirty-six patients were evaluated, eighteen patients in each group. For the revision ACL procedures, 14 autografts and 4 allografts were used in group 1 and 16 autografts and 2 allografts in group 2. For the LEAP, in 13 cases we performed a lateral tenodesis using ilio-tibial band and in 5 patients we used allograft. The mean age was 32 years (SD 8,5) for group 1 and 28,4 (SD 6,5) for group 2. In group 1, the median Lysholm and IKDC scale was 90 (IQR 27) and 80 (IQR 40) respectively, and in group 2 the median was 90 (IQR 48) and 67,5 (IQR 33) respectively. The difference for IKDC was statistically significant (p=0,000). Eight patients return to sports in group 1 and seven in group 2. The MRI shown and homogeneous neoligament in 66% of patients in group 1 and 61% in group 2. Conclusion Despite there was a statistically significant difference in IKDC results in favor of group 2, we found no differences in return to sports, Lysholm score and MRI imaging when a LEAP was associated at one year follow-up.

Switch to Aflibercept in the Treatment of Neovascular AMD: One-Year Results in Clinical Practice

2015 ◽  
Vol 233 (3-4) ◽  
pp. 155-161 ◽  
Author(s):  
João Pinheiro-Costa ◽  
José M. Costa ◽  
João N. Beato ◽  
Paulo Freitas-da-Costa ◽  
Elisete Brandão ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Age Related Macular Degeneration ◽  
Neovascular Amd ◽  
Age Related ◽  
Intravitreal Aflibercept ◽  
The Mean ◽  
Group 2 ◽  
One Year ◽  
Group 1

Purpose: To report the clinical outcomes of intravitreal aflibercept therapy in eyes with refractory and recurrent neovascular age-related macular degeneration (AMD) switched from intravitreal bevacizumab or ranibizumab. Methods: This is a retrospective review of eyes with neovascular AMD switched to intravitreal aflibercept with at least 1 year of follow-up after the switch. All patients had had a minimum of 3 injections of bevacizumab or ranibizumab before the switch. Aflibercept was used in patients considered refractory to bevacizumab (group 1) and in recurrent patients on therapy with ranibizumab due to an institutional policy decision (group 2). Changes in best-corrected visual acuity, fluid on optical coherence tomography (OCT), central retinal thickness (CRT) and the frequency of injections were compared. Results: Eighty-five eyes of 69 patients were analyzed, 39 eyes in group 1 and 46 in group 2. The mean follow-up time was 31.6 months prior to the switch and 14.7 months on treatment with aflibercept. One year after the switch, there was a nonsignificant mean decrease of 2 letters in visual acuity in both groups (group 1: from 58.2 to 55.8 letters, p = 0.086; group 2: from 56.4 to 54.5 letters, p = 0.168), but the mean number of injections per month was significantly lower (from 0.76 to 0.57, p < 0.001). With the switch, 90.6% of the patients showed anatomic improvement with a reduction of fluid on OCT, and both groups presented significant improvement in CRT (group 1: 65.3 µm, p = 0.051; group 2: 91.0 µm, p < 0.001). Conclusion: Aflibercept appears to be a valuable tool for the management of patients with poor responses to other anti-vascular endothelial growth factor drugs. These patients could have anatomic improvement, and the injection intervals could be extended.

scholarly journals Solar maculopathy: prognosis over one year follow up

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Marwa Mahmoud Abdellah ◽  
Engy Mohammed Mostafa ◽  
Mohamed Abdelatif Anber ◽  
Islam Saad El Saman ◽  
Mohammed Ezz Eldawla
Keyword(s):  
Visual Acuity ◽  
Case Series ◽  
Good Prognosis ◽  
Spectral Domain ◽  
Ocular Coherence Tomography ◽  
The Mean ◽  
One Year ◽  
Retinal Hole ◽  
Sd Oct

Abstract Background To document the visual acuity, spectral domain optical coherence tomography (SD-OCT) findings and prognosis in10 eyes of 6 patients with foveal damage from solar retinopathy in 1 year. Methods This was a prospective, observational case series of patients presented by solar maculopathy at Ophthalmology department, Sohag University. All patients underwent visual acuity (VA) testing, refraction, dilated fundus examination fluorescein angiography (FA) and SD-OCT (spectral Domain ocular coherence Tomography) imaging and follow up for 1 year. Results The mean age was 16.5 years (range 9–27 years, both eyes are affected in 4 patients. The mean spherical equivalent (SE) was – 0.25 ± 0.50 D. The visual acuity of the affected eyes ranged from 0.4 to 0.9 on presentation. At presentation Significant foveal pathology was identified on SD-OCT in 10 eyes, All eyes showed disruption of the photoreceptor ellipsoid zone and the interdigitation zone on SD-OCT, Follow up of the cases continued for 1 year.100% of cases showed improvement in VA: 20% eyes regained 1, 50% eyes with VA of 0.9; two eyes 20% 0.8 and one eyes (10%) with 0.4. The improvement began after 1 week and reached its maximum and became stationary after the 6th month of follow up, the outer retinal hole persist in OCT in 80% of cases. Conclusion Solar maculopathy has a good prognosis yet shows no improvement after 6 months. Young age might pose as a risk factor.

scholarly journals Postural education program for elementary school: a one-year follow-up study

2015 ◽  
Vol 21 (3) ◽  
pp. 256-262 ◽  
Author(s):  
Alexandre Luis Ritter ◽  
Jorge Luiz de Souza
Keyword(s):  
Elementary School ◽  
Control Group ◽  
School Activities ◽  
Final Sample ◽  
Long Term Follow Up ◽  
Short And Long Term ◽  
One Year ◽  
And Control

AbstractThe objective of this study was to verify the short- and long-term effectiveness of the Elementary School Postural Program in the performance, generalization, and perception of daily school activities. The final sample consisted of 61 subjects divided into experimental (14 years ±0.93; ♀=22; ♂=10) and control group (15.38 years ±0.97; ♀=16; ♂=13), all participants attended a Brazilian public school in Porto Alegre, State of Rio Grande do Sul. The postural program included 20 sessions over a 10-week period. In each session, participants discussed and practiced routine actions that typically occurred at schools. Eight other meetings were required for the completion of the pre- and post-tests. The experimental group performed significantly better than the control group in the short-term evaluations, although there were no significant statistical differences in the long-term follow-up evaluations. The children demonstrated a good behavioral response to the postural program; nevertheless, the knowledge had not been completely mastered after a year.

scholarly journals Short-term absolute B-cell counts monitoring in systemic sclerosis patients treated with rituximab

2020 ◽  
Vol 58 (4) ◽  
pp. 395-400
Author(s):  
L. P. Ananieva ◽  
L. A. Garzanova ◽  
O. V. Desinova ◽  
O. A. Koneva ◽  
M. N. Starovoytova ◽  
...  
Keyword(s):  
B Cell ◽  
Peripheral Blood ◽  
Inflammatory Diseases ◽  
Inverse Correlation ◽  
Peripheral Circulation ◽  
Cell Counts ◽  
Immune Mediated ◽  
Group 2 ◽  
One Year

Objective. To evaluate B-cell counts in circulation of SS patients prior to initiation and one year after completion of RTM therapy.Subjects and methods. The study included 71 patients. Median follow up was 13,2±2,0 months (11-18 Mo.). Average cumulative RTM dose during the follow up period was 1,43±0,60 g, with 48 patients receiving < 2 g RTM (Group 1, mean dose 1,1±0,1 g) and 23 patients receiving ≥ 2 g RTM (Group 2, mean dose 2,2±0,6 g). CD19+ lymphocyte counts in peripheral blood were determined using flow cytometry in PSS patients and 20 healthy volunteers matched by sex and age. In SS patients B-cell counts were obtained before initiating RTM, within first month after first administration, then after 6 months and at the end of this study.Results. Baseline absolute and proportional В-lymphocyte counts in peripheral blood was almost similar in SS patients and healthy subjects. Highest counts were observed in SS patients with <3 years disease duration, showing inverse correlation between baseline absolute (R – 0,36, р=0,003) and proportional (R – 0,48, р=0,001) B cell counts and duration of the disease. Complete B-cell depletion from peripheral circulation was documented one month after RTM administration. It persisted in 79% 6 months later, although initiation of B- cell repopulation was documented in some patients. In one year after RTM initiation В-cell counts were significantly lower than at baseline. Complete or partial depletion was still there in the majority of patients with normal counts achieved only in 10% of SS patients. Inverse correlation was found between absolute B-cell count and cumulative RTM dose (R=-0,237, p=0,048).Conclusion. Higher RTM doses resulted in more pronounced В-lymphocytes depletion and more evident improvement of lung function. Current state of practice requires further research to identify most optimal regimens in the context of personalized therapy for SS and other immune-mediated inflammatory diseases. 

scholarly journals Influence of vitrectomyon the progressionof wet age related macular degeneration

2014 ◽  
Vol 7 (4) ◽  
pp. 13-21
Author(s):  
Yuriy Sergeyevich Astakhov ◽  
Gassan Basharovich Shaar ◽  
Nikita Yur’yevich Dal’
Keyword(s):  
Visual Acuity ◽  
Treatment Group ◽  
Macular Degeneration ◽  
Age Related Macular Degeneration ◽  
Control Group ◽  
Posterior Hyaloid ◽  
Age Related ◽  
One Year ◽  
Wet Amd

Purpose. To study the effects of vitrectomy on the course of wet age-related macular degeneration (AMD). Materials and methods. 99 patients (99 eyes) with wet AMD associated with vitreo-macular adhesion or posterior hyaloid traction were included in the study. During the first 6 months, all patients received anti-VEGF treatment according to a PRN regimen. Then, they were divided into two groups: in 45 patients vitrectomy was performed and 54 patients did not receive surgical treatment. The follow-up period duration was one year. Results. At the beginning of the study, visual acuity was 0.27 ± 0.17 in the control group, and 0.17 ± 0.15 in the treatment group. Most prominent differences in visual acuity between the two groups were observed during the first 6 months (visual acuity in the treatment group before surgery was 0.12 ± 0.1) (p < 0.01 and p < 0.001), at the same time during the following 6 follow-up months, this difference decreased (p < 0.05 and p < 0.01). 1 year from the study start, visual acuity in the control group was 0.24 ± 0.17, and 0.17 ± 0.13 in the treatment one. Conclusions. Vitrectomy surgery in patients with wet AMD in association with vitreo-macular adhesion or posterior hyaloid traction does not exacerbate the disease course, stabilizes visual functions and improves the quality of life.

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