Ophthalmological criteria for choice of optimal mode of delivery in pregnant women with myopia

2019 ◽  
Vol 13 (2) ◽  
pp. 155-163
Author(s):  
O. V. Kolenko ◽  
E. L. Sorokin ◽  
A. A. Fil
Keyword(s):  
Risk Factor ◽  
Intraocular Pressure ◽  
Retinal Detachment ◽  
Pregnant Women ◽  
High Myopia ◽  
Rhegmatogenous Retinal Detachment ◽  
Mode Of Delivery ◽  
Pregnancy And Childbirth ◽  
Pregnancy And Delivery ◽  
Optimal Mode

This review examines the evolution of views and opinions on issues related to the management of pregnancy and childbirth in women with high myopia. Special attention is given to the threat of retinal detachment and its prevention during pregnancy and delivery; the need for improving the diagnosis of retinal abnormalities is also addressed. Our analysis indicates that since the early 1980s, pregnancy associated peripheral vitreochorioretinal dystrophy was considered a leading risk factor for rhegmatogenous retinal detachment during childbirth. Here, we present data on the eye hemodynamics and intraocular pressure in women at the time of delivery. We also discuss current strategies of pregnancy management in women with peripheral vitreochorioretinal dystrophy. In addition, absolute and relative indications for natural delivery in women with high myopia are presented together with ophthalmological requirements for natural delivery.

PERINATAL ASPECTS OF PREGNANCY AND CHILDBIRTH ON THE BACKGROUND OF VITAMIN D LACK IN PREGNANT WOMEN

2021 ◽  
Vol 74 (10) ◽  
pp. 2585-2587
Author(s):  
Vitaliy V. Maliar
Keyword(s):  
Vitamin D ◽  
Blood Serum ◽  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Test System ◽  
Perinatal Complications ◽  
Pregnancy And Childbirth ◽  
Wide Range ◽  
Pregnancy And Delivery

The aim: To study the features of the course of gestation and perinatal outcomes of delivery in women with vitamin D lack. Materials and methods: The article presents the results of studies of the characteristics of the course of pregnancy and delivery outcomes in 50 patients with vitamin D lack compared with a group of 50 somatically healthy pregnant women with normal level of 25 (OH) D. In order to establish a lack of vitamin D in pregnant women in the 10-12, 20-22, 30-32 weeks of gestation electrochemiluminiscence method by using a test system EURIMMUN (Germany) in the blood serum level of 25-hydroxycalciferol (25 (OH) D) in pregnant women. Results: When analyzing the structure of complications in women with vitamin D lack during pregnancy and childbirth we found out that risk of premature birth and premature births dominated among all the complications, respectively (58.0% and 36.0%) against (12.0% and 16.0%), p <0.05. Vitamin D lack in pregnant women is often associated with a wide range of obstetric and perinatal complications, namely: preeclampsia, gestational diabetes, bacterial vaginosis , premature rupture of membranes, placental abruption, abnormal labor activity, fetal distress that required delivery by Caesarean section. Conclusions: An analysis of the course of pregnancy and childbirth in women of thematic groups proved the expediency of an individual approach to the therapy of obstetric pathology among women with vitamin D lack. Despite the level of 25 (OH) D in the blood serum of a pregnant woman of 30 ng / ml and below, it is advisable to prescribe vitamin D for prophylaxes and treatment of Vitamin D deficiency in mother and fetus.

Clinical Profile of Myopic Patients as a Risk Factor for Primary Open Angle Glaucoma - A Prospective Observational Study in Gorakhpur, Uttar Pradesh

2021 ◽  
Vol 8 (33) ◽  
pp. 3084-3089
Author(s):  
Ram Kumar Jaiswal ◽  
Ramyash Singh Yadav ◽  
Mridula Ranjan ◽  
Dipti Wahi ◽  
Chiranji Rai
Keyword(s):  
Risk Factor ◽  
Intraocular Pressure ◽  
Observational Study ◽  
High Myopia ◽  
Central Corneal Thickness ◽  
Prospective Observational Study ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Corneal Thickness ◽  
Open Angle

BACKGROUND Myopia is a complex trait including both genetic and environmental factors as well as gene-environment interactions. It has been recognized as a risk factor for development of glaucoma. Both Myopia and raised IOP are known to increase mechanical stress at optic nerve head leading to glaucomatous nerve damage. This study intends to evaluate the clinical profile of myopic subjects and its correlation with Primary open angle glaucoma (POAG). METHODS A prospective observational study done from November 2019 to December 2020 after taking proper informed consent and ethical clearance. 164 eyes of 96 patients studied were divided into three groups, Group 1: low myopia (< -3.00D), Group 2: moderate myopia (-3.00 D to -5.75 D), Group 3: high myopia (≥ -6.00 D). A complete ocular examination was performed. Intraocular pressure was measured using Goldmann applanation tonometer. Visual field analysis using Humphrey automated perimetry was done in patients with suspected primary open angle glaucoma (POAG). Angle parameters and central corneal thickness (CCT) were measured using anterior segment optical coherence tomography (AS-OCT). RESULTS 164 eyes of 96 Myopic subjects were studied with no dropout during study period. Mean age was 46.05 yr. (range: 25-75 yr.). The refraction ranged from -0.50 DS to -17.00 DS. There was no statistically significant difference between Intraocular pressure (IOP), Central corneal thickness (CCT), corrected IOP and Nasal and Temporal Trabecular-iris Angle (TIA) between male and female of same age group. Mean IOP and mean CCT were found to vary significantly with age and with higher degree of myopia. Corrected IOP, Nasal and Temporal TIA increase significantly with higher degree of myopia. Cup-disc ratio (CDR) was found to be significantly higher in patients with moderate to high degree of Myopia. CONCLUSIONS Myopia is an important risk factor for development of primary open angle glaucoma, with its incidence increasing in patients with moderate to high myopia. KEYWORDS Myopia, Primary Open Angle Glaucoma, Intraocular Pressure, Central Corneal Thickness, Trabecular Iris Angle

Cryopexy in primary rhegmatogenous retinal detachment: a risk factor for postoperative proliferative vitreoretinopathy?

1996 ◽  
Vol 234 (12) ◽  
pp. 739-743 ◽  
Author(s):  
Mireille Bonnet ◽  
Jacque Fleury ◽  
Sylvie Guenoun ◽  
Atés Yaniali ◽  
Christine Dumas ◽  
...  
Keyword(s):  
Risk Factor ◽  
Retinal Detachment ◽  
Proliferative Vitreoretinopathy ◽  
Rhegmatogenous Retinal Detachment

Rhegmatogenous Retinal Detachment in Nonsyndromic High Myopia Associated with Recessive Mutations in LRPAP1

2020 ◽  
Vol 4 (1) ◽  
pp. 77-83 ◽  
Author(s):  
Moustafa S. Magliyah ◽  
Sulaiman M. Alsulaiman ◽  
Sawsan R. Nowilaty ◽  
Fowzan S. Alkuraya ◽  
Patrik Schatz
Keyword(s):  
Retinal Detachment ◽  
High Myopia ◽  
Rhegmatogenous Retinal Detachment ◽  
Recessive Mutations

scholarly journals Retinal Detachment in Pregnant Patients with Myopia (Diagnostic Examinations, Delivery Methods). Clinical Cases

Medicina ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 85-95
Author(s):  
N. V. Popova ◽  
◽  
N. V. Yablokova ◽  
A. P. Goydin ◽  
◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Pregnant Women ◽  
Reproductive Period ◽  
Operative Delivery ◽  
Delivery Methods ◽  
Modern Approach ◽  
Female Population ◽  
Pregnancy And Childbirth ◽  
Literature Evidence ◽  
Long Time

By the beginning of the reproductive period, myopia accounts for 25-30% of the female population in Russia. For a long time, it has been believed that pregnancy and childbirth can provoke the development of peripheral dystrophies and, as a result, retinal detachment, which is an absolute indication for surgical delivery. However, there is literature evidence about the possibility of natural delivery for patients with retinal detachment. Detection of peripheral dystrophies during examination in pregnant women is an indication for preventive laser treatment. The modern approach to choosing the method of delivery of pregnant women, taking into account the state of the visual organ, based not on the presence of the degree of myopic refraction, but on the retinal status (the presence of PVCRD and retinal detachment), can significantly reduce the frequency of operative delivery for ophthalmological indications.

scholarly journals Recurrent Retinal Detachment after Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment

2020 ◽  
Author(s):  
Yan Fu ◽  
Yue-ling Zhang ◽  
Zhaohui Gu ◽  
Ren-Fei Geng ◽  
Xin-Yu Yuan
Keyword(s):  
Visual Acuity ◽  
Risk Factor ◽  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Univariate Analysis ◽  
Visual Outcomes ◽  
Primary Surgery ◽  
Pars Plana

Abstract Background The recurrence of retinal detachment (RD) following rhegmatogenous retinal detachment (RRD) is a relatively common complication that threatens vision and needs further surgery. The purpose of this study is to investigate the risk factors and visual outcomes of recurrent RD following pars plana vitrectomy (PPV) for primary RRD.Methods This was a retrospective follow-up of 343 eyes that underwent initial PPV surgery for primary RRD. Patients were divided into a recurrence group and a reattachment group. The main outcome measures included the causative factors, visual outcomes of RD recurrence, and the perioperative factors most affecting the recurrence of RD.Results After retinal reattachment, we observed recurrence of RD after PPV for primary RRD in 42 out of 343 eyes (12.2%) during the follow-up period. Most recurrence (69%) occurred within 6 months after surgery. Univariate analysis showed that the primary risk factor significantly associated with recurrent RD was the presence of proliferative vitreoretinopathy (PVR) ≥ Grade C ( P = 0.003). Logistic regression analysis showed that a PVR ≥ Grade C (odds ration [OR]: 9.421, 95% confidence interval [CI]: 2.432 - 56.39; P =0.020) was a significant predictor for the development of recurrent RD. The recurrence of RD resulted in a significant decline in best-corrected visual acuity (BCVA) at the last follow-up visit compared with the reattachment group ( P =0.000). Eyes with PVR prior to primary surgery or at the diagnosis of re-detachment showed a worse final BCVA.Conclusions The presence of PVR ≥ Grade C was the predominant risk factor for the recurrence of RD. PVR prior to primary surgery, or at the diagnosis of re-detachment, limited the recovery of final visual acuity.

scholarly journals Analysis of Changes in Corneal Topography after 27-Gauge Transconjunctival Microincision Vitrectomy Combined with Cataract Surgery

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Tomoyuki Watanabe ◽  
Tamaki Gekka ◽  
Akira Watanabe ◽  
Tadashi Nakano
Keyword(s):  
Intraocular Pressure ◽  
Retinal Detachment ◽  
Cataract Surgery ◽  
Macular Hole ◽  
Epiretinal Membrane ◽  
Rhegmatogenous Retinal Detachment ◽  
Corneal Topography ◽  
High Order ◽  
Before And After ◽  
Port System

Purpose. To investigate changes in the corneal shape before and after vitrectomy, over a period of time, using a 27-gauge system. Methods. Forty-five eyes underwent a combination of cataract surgery and vitrectomy. The surgeries were performed using a 27-gauge transconjunctival vitrectomy system, in which the corneal topography could be performed up to three months after the surgery. The surgeries were performed for an epiretinal membrane in 11 eyes, a macular hole in 14 eyes, and rhegmatogenous retinal detachment in 20 eyes. All of the surgeries were performed by the same surgeon, and in all cases, a 4-port 27-gauge vitrectomy device was used. Cataract surgery in all patients was performed with a 2.4 mm corneoscleral incision at 11 o’clock. The surgeries were performed without suturing the operative wound in all cases. Corneal topography was performed using a TMS-4 topographer (Tomey Corporation, Tokyo, Japan). The examinations were performed the day before and 1 day, 1 week, 1 month, and 3 months after the surgery. The results of corneal topography for the spherical, regular astigmatic, asymmetric, and high-order irregular astigmatic components were compared before and after surgery. Results. No significant differences were seen in any of the components in the epiretinal membrane group, but significant differences were seen in the asymmetric components and the high-order irregular astigmatic components between the macular hole and rhegmatogenous retinal detachment groups (p<0.05). There were no significant changes in intraocular pressure on any measurement time in the postoperative period compared to preoperative intraocular pressure. Conclusion. Irregular astigmatism was seen after surgery when 27-gauge vitrectomy with a 4-port system was performed together with cataract surgery with a 2.4 mm incision.

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