scholarly journals Baseline Visual Acuity of Women with Diabetic Macular Edema is Worse than Men: A Case-Control Study

2017 ◽  
Vol 2 (2) ◽  
pp. 52-57
Author(s):  
Abdullah Ozkaya ◽  
◽  
Hande Mefkure Ozkaya ◽  
Hatice Nur Tarakcioglu ◽  
Mehmet Ozveren ◽  
...  
2021 ◽  
Vol 10 (20) ◽  
pp. 4658
Author(s):  
Hanan Nussinovitch ◽  
Erez Tsumi ◽  
Raimo Tuuminen ◽  
Boris Malyugin ◽  
Yotam Lior ◽  
...  

Advancements in surgical techniques and increased life expectancy have made cataract surgery more common among very old patients. However, surgical outcomes seem impaired in patients older than 90 years, especially with ocular comorbidities. A retrospective case-control study of 53 eyes of 53 very old patients (mean 92.6 ± 3.0) and 140 eyes of 140 matched patients (mean 75.2 ± 7.6) was undertaken. Groups were matched in terms of gender and systemic and ocular comorbidities. In very old patients, higher phacoemulsification energy (cumulative dissipated energy [CDE], 25.0 ± 22.4 vs. 16.1 ± 10.7, p = 0.01) and rate of intraoperative floppy iris syndrome (IFIS, 9.4% vs. 1.4%, p = 0.02) were observed compared to controls. Uncorrected (UCVA) and best-corrected distance visual acuity (BCVA) gains were significantly poorer among the very old patients than among the control at postoperative day 30 (0.20 ± 0.70 vs. 0.56 ± 0.61 logMAR, p < 0.001 and 0.27 ± 0.64 vs. 0.55 ± 0.62 logMAR, p = 0.006, respectively). Even after including CDE and IFIS as covariates, age remained an independent factor for poor visual gain at 30 days (p < 0.001). Cataract surgery in very old patients may demand more experienced surgeons due to higher nuclear density and the rates of IFIS. Expectations in visual acuity gains should be aligned with the patient’s age.


2018 ◽  
Vol 2018 ◽  
pp. 1-16 ◽  
Author(s):  
Laurent Kodjikian ◽  
David Bellocq ◽  
Thibaud Mathis

Objectives of the Study. Summary of observational studies concerning the pharmacological management of diabetic macular edema (DME). Methods. A literature review was conducted using the PubMed database on 1 February 2018 to identify studies evaluating the efficacy of anti-VEGF and dexamethasone (DEX) implants for DME. Studies with more than 10 patients and follow-up of more than 6 months were selected. Analyses were carried out on the overall population and on subgroups defined according to baseline visual acuity (BVA) and the patients’ naïve or non-naïve status. Results. Thirty-two studies evaluating the efficacy of anti-VEGF and 31 studies evaluating the efficacy of DEX-implants were retained, concerning 6,842 and 1,703 eyes, respectively. A mean gain of +4.7 letters for a mean of 5.8 injections (mean follow-up: 15.6 months) and +9.6 letters for a mean of 1.6 injections (10.3 months) was found in the anti-VEGF and DEX-implant studies, respectively. Final VA appears to be similar for both treatment (62 letters for anti-VEGF, 61.2 letters for DEX-implant), and BVA appears lower for DEX-implant, which may partially explain the greater visual gain. The DEX-implant studies show greater gains in VA compared to the anti-VEGF studies, especially for higher BVA. Indeed, mean gains for the subgroups of patients with BVA<50 letters, 50<BVA<60 letters, and BVA>60 letters are +4.3, +5.8, and +3.1 letters, respectively, in the anti-VEGF studies and +10.5, +9.3, and +8.8 letters, respectively, in the DEX-implant studies. Regarding the patient’s initial status, only naïve status appears to confer the best functional response in DEX-implant studies. Conclusion. Observational studies investigating DEX-implant report clinically similar final VA when compared to anti-VEGF, but superior visual gains in real-life practice. This latter difference could be due to the better BVA, but also to the fact that less injections were administered in the anti-VEGF observational studies than in the interventional studies.


2019 ◽  
Vol 26 (3) ◽  
pp. 655-665 ◽  
Author(s):  
Yusuke Noguchi ◽  
Yugo Kawashima ◽  
Megumi Maruyama ◽  
Hiroko Kawara ◽  
Yoko Tokuyama ◽  
...  

Purpose Docetaxel is known to cause eye disorders. In this study, current status of eye disorders caused by docetaxel administration every 3 weeks in Japanese patients was examined. Methods This case-control study targeted patients who were newly administered docetaxel at the Kyoto Okamoto Memorial Hospital between 1 July 2015 and 30 June 2018. Eye disorder occurrence was defined as an event in which the pharmacist confirmed the symptoms in a patient interview and the ophthalmologist diagnosed the disorder. Results Of the 89 subjects, 7 (7.9%) had eye disorders. The symptoms were watering eyes (7.9%), a stye and eye discharge (2.2% each), corneal and conjunctival disorder, visual acuity reduction, and blepharedema (1.1% each). Four patients who presented with watering eyes, eye discharge, or corneal and conjunctival disorder showed improvement with the use of eye drops such as artificial tears. Two patients who presented with a stye showed improvement with the use of oral cefcapene. One patient with mild symptoms showed spontaneous improvement. However, one patient had irreversible visual acuity reduction. The multivariate logistic regression analysis revealed that a cumulative docetaxel dose of ≥300 mg/m2 (odds ratio: 15.50, 95% confidence interval: 1.37–175.00, p = 0.027) and concomitant cyclophosphamide use (odds ratio: 13.20, 95% confidence interval: 1.13–153.00, p = 0.039) were significant risk factors associated with eye disorders. Conclusion In conclusion, it was determined that docetaxel-related eye disorders might be influenced by the cumulative dose of docetaxel and concomitant cyclophosphamide use. In addition, relatively mild symptoms improved with medication.


2018 ◽  
Vol 08 (02) ◽  
pp. 008-014
Author(s):  
Abdullah Ozkaya ◽  
Mehmet Ozveren ◽  
Okkes Baz ◽  
Hatice Nur Tarakcioglu ◽  
Korhan Fazil ◽  
...  

Abstract Purpose: We aimed to evaluate the real life outcomes of ranibizumab in the treatment of diabetic macular edema (DME) patients with a baseline visual acuity<0.05 in decimals. Methods: Newly diagnosed DME patients with a visual acuity ≤0.05, treated with ranibizumab monotherapy, and completed a follow-up time of 12 months were included retrospectively. Patients were evaluated in regards to change in best corrected visual acuity (BCVA) and central retinal thickness, and the total visit and injection numbers. Results: A total of 24 eyes of 24 patients were included. Mean BCVA at baseline, month 3, 6, 9, and 12 was, 0.04±0.01, 0.12±0.12, 0.12±0.11, 0.17±0.19, and 0.21±0.21 (p<0.05 for all), respectively. One eye (4.2%) had VA loss of ≥3 lines, and six eyes (25.0%) had stable vision (loss of <3 line, or remained stable, or gained <1 lines), and 17 eyes (70.8%) had VA gain of ≥3 lines at month 12.The mean visit number at month 12 was 4.8±1 and the mean injection number was 4.0 ±1.4. Conclusion: Ranibizumab seemed to be effective in the treatment of DME patients with a low visual acuity in real life.


2021 ◽  
Author(s):  
Jignasa Mehta ◽  
Gabriela Czanner ◽  
Simon Harding ◽  
David Newsham ◽  
Jude Robinson

Abstract Background Falls are the second leading cause of accidental deaths worldwide mainly in older people. Older people have poor vision and published evidence suggests that it is a risk factor for falls. Less than half of falls clinics assess vision as part of the multi-factorial assessment of older adults at risk of falls despite vision being an essential input for postural stability. The aim of our study was to investigate the relationship between all clinically assessed visual functions and falls amongst older adults in a prospective observational individually age-matched case control study. Methods Visual acuity (VA), contrast sensitivity (CS), depth perception, binocular vision and binocular visual field were measured using routinely used clinical methods in falls participants (N = 83) and non-falls participants (N = 83). Data were also collected on socio-demographic factors, general health, number of medications, health quality, fear of falling and physical activity. Logistic regression analysis was carried out to determine key visual and non-visual risk factors for falls whilst adjusting for confounding covariates. Results Older adults have an increased risk of experiencing a fall if they have reduced visual function (odds ratio (OR): 3.49, 1.64–7.45, p = 0.001), specifically impaired stereoacuity worse than 85” of arc (OR: 3.4, 1.20–9.69, p = 0.02) and reduced (by 0.15 log unit) high spatial frequency CS (18 cpd) (OR:1.40, 1.12–1.80, p = 0.003). Older adults with a hearing impairment are also at higher risk of falls (OR: 3.18, 95% CI: 1.36–7.40, p = 0.007). The risk decreases with living in a less deprived area (OR: 0.74, 0.64–0.86, < 0.001), or socialising more out of the home (OR: 0.75, 0.60–0.93, p = 0.01). Conclusions The combination of social, behavioural and biological determinants are significant predictors of a fall. The non-visual risk factors include older adults, living in deprived neighbourhoods, socialising less outside of the home and those who have a hearing impairment. Impaired functional visual measures; depth perception and contrast are significant visual risk factors for falls above visual acuity.


Sign in / Sign up

Export Citation Format

Share Document