scholarly journals Coats’ disease: trends and long-term treatment outcomes in a tertiary referral centre

2021 ◽  
Vol 13 ◽  
pp. 251584142110559
Author(s):  
Avadhesh Oli ◽  
Divya Balakrishnan ◽  
Subhadra Jalali
Keyword(s):  
Visual Acuity ◽  
Treatment Outcomes ◽  
Term Treatment ◽  
Lower Stage ◽  
Long Term Treatment ◽  
Coats Disease ◽  
The Mean ◽  
Anatomical Outcomes

Background: The long-term treatment outcomes in Coat’s disease – particularly in the era of newer pharmacotherapies such as anti-vascular endothelial growth factor (VEGF) agents and depot steroids – are poorly understood. Aim: To describe the clinical features and treatment outcomes of 148 eyes with Coats’ disease assessed in a referral centre over 30 years. Materials and methods: We conducted a retrospective chart review of patients diagnosed with Coats’ disease between 1 June 1987 and 31 July 2017. The demographic, clinical and treatment data were collected and long-term functional and anatomical outcomes were analysed based on the treatment either with conventional therapy (cryo/laser) or along with adjuvants like intravitreal steroids or anti-VEGFs. Results: The mean age at presentation was 15.22 years (median 11). Familial exudative vitreoretinopathy was the most common referral diagnosis, 76/148 (51.5%), followed by Coats’ disease, 37/148 (25%), and retinoblastoma, 35/148 (23.6%). Stage 3B was most common at presentation (31.8%), followed by 2B (22.3%) and 2A (16.9%). A total of 107 patients were treated either with conventional therapy or in combination with adjuvants. The mean follow-up period was 24.95 months. The visual acuity improved from baseline logMAR 2.17 (Snellen-20/2958) to logMAR 1.88 (Snellen-20/1517) at final follow-up ( p = 0.004). The improvement in visual acuity was better when the presenting BCVA was <1 logMAR (Snellen 20/200), p = 0.004. No statistically significant change in BCVA was noted between conventional and adjuvant groups, p = 0.5. However, the final anatomical outcome was good in 78/99 (78.8%) in the conventional group and 45/49 (91.8%) in the adjuvant group, respectively ( p = 0.046). Conclusion: In this series of patients with Coats’ disease over three decades, the use of intravitreal steroids or anti-VEGFs as adjuvants resulted in better anatomical outcomes. A better baseline visual acuity, lower stage of the disease, and older age at presentation were found to be the factors leading to favourable visual outcomes. Summary In the current series of 148 eyes with Coats’ disease, adjuvant treatment with intravitreal steroids or anti-VEGFs resulted in better outcomes as compared with conventional cryotherapy or laser photocoagulation alone. Patients with Coats’ disease who had presented with better visual acuity at baseline, lower stage of the disease and older age had better final visual outcomes.

Intravitreal bevacizumab monotherapy in myopic choroidal neovascularisation: 5-year outcomes for the PAN-American Collaborative Retina Study Group

2017 ◽  
Vol 102 (4) ◽  
pp. 455-459 ◽  
Author(s):  
Jay Chhablani ◽  
Remya Mareen Paulose ◽  
Andres F Lasave ◽  
Lihteh Wu ◽  
Cristian Carpentier ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Adverse Events ◽  
Real Life ◽  
Intravitreal Bevacizumab ◽  
Term Treatment ◽  
Choroidal Neovascularisation ◽  
Long Term Treatment ◽  
The Mean

PurposeTo report the long-term anatomical and visual outcomes of intravitreal bevacizumab (IVB) monotherapy in naive choroidal neovascularisation (CNV) caused by myopia.MethodsRetrospective analysis of naive CNV secondary to myopia that underwent antivascular endothelial growth factor monotherapy was performed. Collected data included demographic details, clinical examination details including visual acuity at presentation and follow-up with imaging and treatment details. Main outcome measures were resolution of CNV activity at the last visit. Secondary outcomes included change in visual acuity, number of injections and adverse events.ResultsThirty-three eyes of 31 subjects with a mean age of 51.48±16.4 years were included. The mean follow-up was 66.47 months. 27 eyes had type 2 CNV and the rest seven eyes had type 1 CNV. The mean number of IVB injections per eye was 4.9. Mean visual acuity at baseline reduced from 0.65±0.33 logMAR units (Snellen equivalent=20/89) to 0.73±0.50 logMAR units (20/107) at final follow-up (p=0.003). The mean central macular thickness decreased from 309.31±86 µm at baseline to 267.5±70.89 µm at the last visit (p=0.03). However, visual acuity was maintained (±1 line of baseline) in 13 eyes (39.4%), ≥2 line improvement in nine (27.3%) eyes and more than two lines worsening in 11 eyes (33.3%). Foveal atrophy was observed at baseline and last visit in 6 (12.5%) and 14 (29.1%), respectively (p=0.007). No systemic adverse events were observed.ConclusionIVB monotherapy is safe and effective for long-term treatment of CNV secondary to myopia in real life.

Long-Term Treatment Outcomes for Heroin Dependence: The 11-Year Follow-Up of the ATOS Study

2013 ◽  
Author(s):  
Christina Marel ◽  
Maree Teesson ◽  
Shane Darke ◽  
Katherine Mills ◽  
Joanne Ross ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Term Treatment ◽  
Heroin Dependence ◽  
Long Term Treatment

scholarly journals Clinical outcomes of EUS-guided drainage of debris-containing pancreatic pseudocysts: a large multicenter study

2017 ◽  
Vol 05 (02) ◽  
pp. E130-E136 ◽  
Author(s):  
Dennis Yang ◽  
Sunil Amin ◽  
Susana Gonzalez ◽  
Daniel Mullady ◽  
Steven Edmundowicz ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Clinical Outcomes ◽  
The United States ◽  
Term Treatment ◽  
Pancreatic Pseudocysts ◽  
Endoscopic Drainage ◽  
Technical Success ◽  
Long Term Treatment

Abstract Background and study aims Data on clinical outcomes of endoscopic drainage of debris-free pseudocysts (PDF) versus pseudocysts containing solid debris (PSD) are very limited. The aims of this study were to compare treatment outcomes between patients with PDF vs. PSD undergoing endoscopic ultrasound (EUS)-guided drainage via transmural stents. Patients and methods Retrospective review of 142 consecutive patients with pseudocysts who underwent EUS-guided transmural drainage (TM) from 2008 to 2014 at 15 academic centers in the United States. Main outcome measures included TM technical success, treatment outcomes (symptomatic and radiologic resolution), need for endoscopic re-intervention at follow-up, and adverse events (AEs). Results TM was performed in 90 patients with PDF and 52 with PSD. Technical success: PDF 87 (96.7 %) vs. PSD 51 (98.1 %). There was no difference in the rates for endoscopic re-intervention (5.5 % in PDF vs. 11.5 % in PSD; P = 0.33) or AEs (12.2 % in PDF vs. 19.2 % in PSD; P = 0.33). Median long-term follow-up after stent removal was 297 days (interquartile range [IQR]: 59 – 424 days) for PDF and 326 days (IQR: 180 – 448 days) for PSD (P = 0.88). There was a higher rate of short-term radiologic resolution of PDF (45; 66.2 %) vs. PSD (21; 51.2 %) (OR = 0.30; 95 % CI: 0.13 – 0.72; P = 0.009). There was no difference in long-term symptomatic resolution (PDF: 70.4 % vs. PSD: 66.7 %; P = 0.72) or radiologic resolution (PDF: 68.9 % vs. PSD: 78.6 %; P = 0.72) Conclusions There was no difference in need for endoscopic re-intervention, AEs or long-term treatment outcomes in patients with PDF vs. PSD undergoing EUS-guided drainage with transmural stents. Based on these results, the presence of solid debris in pancreatic fluid collections does not appear to be associated with a poorer outcome.

Chronic pain program management outcomes: Long-term follow-up for Veterans and civilians

2021 ◽  
pp. e20210054
Author(s):  
Eleni G. Hapidou ◽  
Eric Pham ◽  
Kate Bartley ◽  
Jennifer Anthonypillai ◽  
Sonya Altena ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Treatment Outcomes ◽  
Term Treatment ◽  
Men And Women ◽  
Rehabilitation Programs ◽  
Long Term Treatment ◽  
Veteran Status ◽  
Interdisciplinary Pain Management

LAY SUMMARY Interdisciplinary pain rehabilitation programs are effective in treating chronic pain. Not many studies have explored how Veterans differ from civilians in responding to treatment. In this study, several measures were administered at different time points to examine and compare the long-term treatment outcomes of Veteran and civilian men and women. Results from 67 participants showed an overall long-term improvement in levels of pain-related disability, anxiety, and depression, as well as many other pain-related variables. While no differences in treatment outcomes between Veterans and civilians were found, men and women showed some differences. Women reported higher depressive symptoms overall and more pain-related disability than men at follow-up from the program. This study demonstrates the long-term effectiveness of interdisciplinary pain management programs regardless of Veteran status. It highlights some differences between genders. Previous studies have not compared the long-term outcomes of Veterans and civilians from an interdisciplinary program.

scholarly journals Flow-diverting devices in the treatment of unruptured ophthalmic segment aneurysms at a mean clinical follow-up of 5 years

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Przemysław Kunert ◽  
Katarzyna Wójtowicz ◽  
Jarosław Żyłkowski ◽  
Maciej Jaworski ◽  
Daniel Rabczenko ◽  
...  
Keyword(s):  
Aneurysm Rupture ◽  
Term Treatment ◽  
Long Term Treatment ◽  
Therapeutic Procedures ◽  
Endovascular Methods ◽  
The Mean ◽  
Ophthalmic Segment Aneurysms ◽  
Annual Risk

AbstractA shift toward the endovascular treatment of ophthalmic segment aneurysms is noticeable. However, it is not clear if the long-term treatment results improve with the development of endovascular methods. The aim of this study was to present the outcomes of the treatment of unruptured ophthalmic aneurysms using flow diverting devices (FDD) with or without coiling. This retrospective study included 52 patients with 65 UIAs treated in 2009–2016. The mean aneurysm size was 8.8 mm. Eight aneurysms were symptomatic. Therapeutic procedures included: 5 failed attempts, 55 first sessions with FDD deployment (bilateral procedures in 3) and 3 retreatment procedures. To cover 55 ICAs, 25 Silk, 26 Pipeline, 9 Fred and 1 Surpass FDD were used. FDD with coiling was applied in 19(29.2%), mainly for symptomatic and larger aneurysms. Mean radiological and clinical follow-up was 12 and 61 months, respectively. Postprocedural deterioration was noted in 3(5.8%) patients, but in long-term the modified Rankin Scale grades 0–2 were achieved in 98.1% of patients. One patient died from the treated aneurysm rupture (annual risk—0.07%). Raymond–Roy occlusion classification class I or II was achieved in 98.5% in the long term, with similar results in both groups. Complications occurred in 40.4% of patients and the most frequent were: imperfect FDD deployment (15%), failed attempt of FDD deployment (9.6%) and late FDD stenosis (9.6%). Flow-diverting devices, with additional coiling in selected cases, may offer a very high proportion of satisfactory outcomes. However, in our experience the high risk of complications remains.

scholarly journals Joint-preserving surgical treatment options for irreparable posterosuperior rotator cuff tear

2021 ◽  
Author(s):  
Florian Grubhofer ◽  
Jon JP Warner
Keyword(s):  
Rotator Cuff ◽  
Treatment Outcomes ◽  
Treatment Options ◽  
Term Treatment ◽  
Therapeutic Options ◽  
Rotator Cuff Tears ◽  
Long Term Treatment ◽  
Long Term Follow Up

AbstractTreatment of irreparable rotator cuff tears in young active patients is challenging. A variety of therapeutic options are available. Only a few joint-preserving treatment options show reliable improvements over a long-term follow-up period. However, the treatment outcomes of joint preservation procedures are not comparable to those of RTSA, as patients are typically younger and have higher expectations. It is remarkable that most of the joint-preserving therapeutic options for irreparable rotator cuff ruptures lack long-term treatment results. This article highlights the indications, technical aspects, and treatment outcomes of the most commonly performed joint-preserving surgeries for irreparable rotator cuff rupture.

scholarly journals Imaging Findings and Long-Term Treatment Outcomes in Coats’ Disease

2020 ◽  
Author(s):  
Beril Tülü Aygün ◽  
Gökhan Demir ◽  
Ali Demircan ◽  
Dilek Yaşa ◽  
Aslı Kırmacı ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Term Treatment ◽  
Imaging Findings ◽  
Long Term Treatment ◽  
Coats Disease

scholarly journals Oral tacrolimus in refractory inflammatory bowel disease - long term treatment outcomes and follow-up in a UK cohort

Gut ◽  
2011 ◽  
Vol 60 (Suppl 1) ◽  
pp. A207-A207
Author(s):  
J. Landy ◽  
S. T. Peake ◽  
N. Karim ◽  
N. Ikin ◽  
S. Ng ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Treatment Outcomes ◽  
Bowel Disease ◽  
Term Treatment ◽  
Long Term Treatment ◽  
Inflammatory Bowel

scholarly journals Long-Term Treatment Outcomes in Type 3 Neovascularization: Focus on the Difference in Outcomes between Geographic Atrophy and Fibrotic Scarring

2020 ◽  
Vol 9 (4) ◽  
pp. 1145 ◽  
Author(s):  
Jae Hui Kim ◽  
Jong Woo Kim ◽  
Chul Gu Kim ◽  
Dong Won Lee
Keyword(s):  
Treatment Outcomes ◽  
Term Treatment ◽  
Geographic Atrophy ◽  
Final Visit ◽  
Type 3 Neovascularization ◽  
Long Term Treatment ◽  
The Mean ◽  
The Difference ◽  
Type 3

Background: To evaluate the difference in the long-term treatment outcomes of type 3 neovascularization between eyes with geographic atrophy and those with fibrotic scars. Methods: This retrospective study included 195 eyes diagnosed with type 3 neovascularization and treated with anti-vascular endothelial growth factor (VEGF) agents. The included eyes were divided into three groups according to the fundus findings at the final visit: patients with fovea-involving geographic atrophy (GA group), patients with fovea-involving fibrotic scars (scar group), and patients with no fovea-involving geographic atrophy or fibrotic scars (non-GA/scar group). The best-corrected visual acuities (BCVA) of the three groups at the final visits were compared. Results: The mean follow-up period was 47.5 ± 20.7 months. The mean logMAR BCVA at the final visit was 1.18 ± 0.58 in the GA group (n = 58), 1.67 ± 0.58 in the scar group (n = 62), and 0.69 ± 0.64 in the non-GA/scar group (n = 75). The BCVA was significantly worse in the scar group than in the GA (p < 0.001) and the non-GA/scar groups (p < 0.001). Conclusion: Eyes with fibrotic scars showed the poorest visual outcomes in type 3 neovascularization among the studied groups. Preventing the development of fibrotic scars should be considered an important treatment goal.

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