scholarly journals Stability of visual acuity after cessation of occlusion therapy in patients of amblyopia

2017 ◽  
Vol 5 (7) ◽  
pp. 3065
Author(s):  
Arjumand Nazir ◽  
Fayaz A. Wani ◽  
Sumaya Shah ◽  
Saleema Dar
Keyword(s):  
Visual Acuity ◽  
Full Time ◽  
Inclusion Criteria ◽  
Short Term ◽  
Abrupt Cessation ◽  
Corrected Visual Acuity ◽  
Different Types ◽  
Gradual Group ◽  
The Difference ◽  
Pre Treatment

Background: It is generally recognized that most children with amblyopia have an improvement of visual acuity (VA) with treatment, little is known about the course of vision once treatment is decreased or stopped in a child. The treatment of amblyopia in children is frequently discussed in the literature; however, there is a lack of research into which method of treatment cessation is the most appropriate once therapy has been completed. We undertook this specifically designed prospective study to directly compare the potential relationship between the method of therapy cessation and the short-term (12-weeks) recurrence of amblyopia.Methods: Fifty children of 5-14 years of age group with different types of amblyopia fulfilling the inclusion criteria were included in the study. Once BCVA was achieved, the subjects were randomized into one of two groups; abrupt cessation group or therapy tapering group. In subjects of tapered group occlusion was reduced from full-time occlusion to 50% of waking hours at BCVA and then additional by 50% at the 4-week’s study visit with occlusion being discontinued completely at the 8-week’s visit. All subjects in the abrupt cessation group stopped their full-time occlusion completely at the Best corrected visual acuity (BCVA). All subjects were followed for 3 consecutive 4-weeks intervals, for a total of 12 weeks, to assess the short-term recurrence rate of amblyopia.Results: The overall results show that at 12-weeks study outcome visit, 9 of the 50 subjects developed recurrence. Out of the total of 9 recurrences, 5 (20%) occurred in abrupt cessation group and 4 (16%) occurred in gradual cessation group. Comparing the time of occurrence of recurrence of amblyopia between the 2 studied groups, the recurrence of amblyopia was more during first 4 weeks of study 60% in abrupt group, whereas in gradual group all the recurrences occurred between 8 and 12 weeks visits. The pre-treatment VA and BCVA had a significant impact on the recurrence of amblyopia.Conclusions: In present study, the results demonstrate that the overall risk of amblyopia recurrence is 18% and the difference in the risk of amblyopia recurrence between the abrupt cessation group and the gradual cessation group (20% vs. 16%) is not statistically significant.

Comparison of the Effectiveness of Intravitreal Ranibizumab for Diabetic Macular Edema in Vitrectomized and Nonvitrectomized Eyes

2016 ◽  
Vol 236 (2) ◽  
pp. 67-73 ◽  
Author(s):  
Yoshito Koyanagi ◽  
Shigeo Yoshida ◽  
Yoshiyuki Kobayashi ◽  
Yuki Kubo ◽  
Muneo Yamaguchi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Treatment Option ◽  
Central Macular Thickness ◽  
Intravitreal Ranibizumab ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
The Difference ◽  
Best Corrected Visual Acuity

Purpose: To compare the effectiveness of intravitreal ranibizumab (IVR) for diabetic macular edema (DME) between eyes with and without previous vitrectomy. Procedures: We prospectively assessed the best-corrected visual acuity (BCVA) and central macular thickness (CMT) after IVR for 6 months. Results: There were no significant differences in the baseline BCVA and CMT between both groups. In the nonvitrectomized group (n = 15), the mean changes of BCVA and CMT from baseline to month 6 were significant (p < 0.01). In the vitrectomized group (n = 10), the improvement appeared to be slower, and the mean BCVA improvement was not significant (p = 0.5), although the mean CMT decrease was significant (p < 0.05). There were no significant differences in the mean changes of BCVA and CMT between both groups at 6 months. Conclusions: The difference in the effectiveness of IVR between both groups was not significant. IVR can be a treatment option even for vitrectomized DME eyes.

scholarly journals The effect of amblyopia on clinical outcomes of children with astigmatism

2021 ◽  
Vol 13 ◽  
pp. 251584142110408
Author(s):  
Burçin Çakır ◽  
Nilgün Özkan Aksoy ◽  
Sedat Özmen ◽  
Özlem Bursalı
Keyword(s):  
Visual Acuity ◽  
Clinical Outcomes ◽  
Medical Records ◽  
Convergence Insufficiency ◽  
Corrected Visual Acuity ◽  
Ocular Deviation ◽  
The Mean ◽  
The Difference ◽  
Best Corrected Visual Acuity

Background: Amblyopia is more common in children with high astigmatism, but factors contributing to development of amblyopia and visual outcomes are not fully understood. Objective: To evaluate the effect of amblyopia on the clinical outcomes in children with ⩾1.75 diopter (D) astigmatism. Methods: We reviewed the medical records of children with ⩾1.75 D astigmatism with and without amblyopia (amblyopes group and non-amblyopes group). The mean age, gender, amount and type of ocular deviation, presence of convergence insufficiency (CI), stereopsis, time of initial spectacle use and follow-up time, differences in best-corrected visual acuity (VoD) and spherical equivalent (SE) between eyes were assessed and compared between the groups. Best-corrected visual acuity (BCVA), mean SE, astigmatism measurements were assessed and compared between amblyopic, fellow, and non-amblyopic eyes. Results: The records included 68 eyes of 34 children with amblyopia and 56 eyes of 28 children without amblyopia. The mean age, gender, amount and type of ocular deviation, presence of CI, stereopsis, time of initial spectacle use, follow-up time, and the difference in SE did not differ between groups. In amblyopes, exodeviation was more common and statistically greater in near (33 cm) than at distance (6 m) (p = 0.005). The mean BCVA and astigmatism values were statistically different between amblyopic, fellow, and non-amblyopic eyes. Conclusion: A greater near than distance exodeviation and higher mean astigmatism value were found in amblyopic children with astigmatism.

scholarly journals Intestinal absorption of different types of folate in healthy subjects with an ileostomy

2002 ◽  
Vol 88 (3) ◽  
pp. 235-242 ◽  
Author(s):  
Erik J. M. Konings ◽  
Freddy J. Troost ◽  
Jacqueline J. M. Castenmiller ◽  
Harry H. S. Roomans ◽  
Piet A. van den Brandt ◽  
...  
Keyword(s):  
Folic Acid ◽  
Folate Intake ◽  
Limiting Factor ◽  
Short Term ◽  
Relative Absorption ◽  
Different Types ◽  
The Difference ◽  
Folate Bioavailability ◽  
Serum Response ◽  
Food Folate

Our knowledge on the absorption of folate is incomplete. The deconjugation process as a possible limiting factor in the absorption of folates was investigated. The study also attempted to validate the use of the area under the serum response curve (AUC) from food compared with folic acid as a proxy variable for food folate bioavailability. Folate absorption was determined in healthy ileostomy volunteers (n11) using a single-dose short-term protocol. In a randomised crossover design, volunteers received spinach meals and a supplement. Based on analysis of test meals and ileostomy effluents, there was no difference in folate absorption between spinach with a mono-:polyglutamate ratio 40:60 and the same spinach with a 100:0 ratio. The absolute absorption of spinach folate (79 %) calculated from the difference between folate intake and folate content of ileostomy effluents was approximately equal to the relative absorption (81 %) calculated from the AUC after consumption of spinach meals in relation to the AUC after consumption of the folic acid supplement. We conclude that the deconjugation process is not a limiting factor in the absorption of spinach folates. Comparison of AUC of food folatev.folic acid in a short-term protocol may be suitable for assessing food folate bioavailability.

scholarly journals The Efficacy of Questionnaire-based Evaluation in Determining the Incidence of Recent Pseudophakic Dysphotopsia

2018 ◽  
Vol 3 (1) ◽  
pp. 25-29
Author(s):  
Szilvia Pál ◽  
Andreea Dana Fișuș ◽  
Florina Vultur ◽  
Karin Horvath
Keyword(s):  
Visual Acuity ◽  
Visual Function ◽  
Disease Index ◽  
Inclusion Criteria ◽  
Ocular Surface Disease Index ◽  
Corrected Visual Acuity ◽  
Lens Implantation ◽  
Early Postoperative Complication ◽  
Visual Phenomena ◽  
A Prospective Study

Abstract Background: Dysphotopsias are optical side effects experienced by patients who underwent cataract surgery. This unwanted photic phenomenon has gained ground and is a major postoperative concern. Visual acuity is not sufficient in evaluating the postoperative visual function. The aim of this study was to determine the efficacy of using a preexistent questionnaire in determining the presence of dysphotopsia. Material and method: We conducted a prospective study, using the modified Visual Function Index (VF-14) and the Ocular Surface Disease Index (OSDI) surveys, completed on patients that underwent uncomplicated phacoemulsification with intraocular lens implantation between November 2016 and November 2017. Patients included in the study had no known ocular comorbidities and had no other possible postoperative explanation for these visual phenomena. Three weeks after the surgery, the questionnaire was filled up by one individual examiner. Results: Of the 50 patients considered, 37 patients met all the inclusion criteria and were successfully enrolled in the study, with a mean age of 75.88 years. Dysphotopsia phenomena were present in 13.51% of cases; 60% of these patients described the presence of positive dysphotopsia, and 40% complained of temporal shadows. The best corrected visual acuity was over 0.8 in 75.67% of the cases. Conclusion: Although there is no objective test to diagnose this early postoperative complication, pseudophakic dysphotopsia should not be overlooked and additional chair time is needed.

scholarly journals Outcomes of a Single-Segment Intrastromal Corneal Ring in Early Keratoconus Versus Early Pellucid Marginal Degeneration

2021 ◽  
Author(s):  
Seyed Javad Hashemian ◽  
Parya Abdolalizadeh ◽  
Leila Ghiasian ◽  
Hossein Aghaei ◽  
Ali Hadavandkhani ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Early Stage ◽  
Interventional Study ◽  
Short Term ◽  
Single Segment ◽  
Corrected Visual Acuity ◽  
Intrastromal Corneal Ring ◽  
Ring Segment ◽  
Outpatient Center

Abstract Purpose: To determine the effect of a single-segment intrastromal corneal ring segment (ICRS;Intacs-SK) on early keratoconus (KCN) or pellucid marginal degeneration (PMD).Methods: It is a prospective interventional study. One-hundred-twenty-four eyes (99 patients) with KCN and 36 eyes (26 patients) with PMD at early stage (the maximum keratometric reading less than 55 diopters) were included to ICRS implantation using femtosecond laser at a tertiary university-based hospital and a private outpatient center. The uncorrected distance and spectacle-corrected visual acuity (UDVA and SCDVA), manifest spherical and cylindrical refractions, and keratometry indices were measured preoperatively and postoperatively, 1 week, 2 and 6 months.Results: One week after surgery, significant improvements were observed in UDVA, SCDVA, cylinder and keratometry readings of both KCN and PMD groups (all P<0.05) with no significant changes afterwards. No significant change occurred in the sphere refraction of PMD group (P=0.10) in contrast to KCN group (P<0.001). Corneal irregularity of KCN group in central 3 and 5 mm zones increased at 1 week (both P<0.001) and then continued to decrease up to 6 months. However, the corneal irregularity of PMD group had significant reduction only at 1 week in 5-mm zone (P=0.02) and 2 months in 3-mm zone (P=0.01) postoperatively. The final efficacy indexes were 1.44±0.71 and 0.87±0.40 in KCN and PMD groups, respectively. Conclusion: Visual acuity and keratometry values reached stability at 1 week, after one-segment Intacs-SK implantation in KCN and PMD groups. The short-term efficacy of the procedure was more in early KCN compared to early PMD.

Ethical Values Reassessed: Rethinking the Covid19 Pandemic First Triage Guidelines

2021 ◽  
Vol 66 (Special Issue) ◽  
pp. 89-89
Author(s):  
Sabine Hauser ◽  
◽  
Rouven Porz ◽  
Maria Aluaș ◽  
◽  
...  
Keyword(s):  
Public Health ◽  
Health Professionals ◽  
Point Of View ◽  
Ethical Values ◽  
Short Term ◽  
Political Values ◽  
Meta Level ◽  
Different Types ◽  
The Difference

"In March 2020, many countries in commissions and medical societies moved very quickly to draft fair and transparent triage guidelines; this in order to plan ahead for possible resource bottlenecks in the treatment of COVID-19 patients in intensive care units. There are a lot of consciously chosen (but also less reflected) ethical values in these guidelines. Our presentation compares the values of eight of such guidelines, but first shows how to read such values in the first place. Many health professionals are hardly aware of the explicit presentation of ethical-philosophical values. From a methodological point of view, this presentation is based on a hermeneutic-ethical approach. The guidelines are interpreted, an interpretation aid is developed, and the values of the guidelines are reconsidered in comparison. On a meta-level, we could identify different types of values, besides medical and ethical values, the guidelines were also filled with procedural, structural and legal-political values. On a content level, the unreflective handling of the value of autonomy, which often competes with the value of public health, is particularly evident. This competition is little reflected. Another point of divergence between the guidelines is the degree of precision or the difference between long-term and short-term medical prognosis. We believe that with our analysis we can contribute to making value discussions in health care more open and explicit. We would like to present these conclusions for discussion at this year’s EACME conference in Cluj. "

Performing corneal tunnel incision with keratotomy scars intersection in patients after radial keratotomy during phacoemulsification

2021 ◽  
pp. 94-98
Author(s):  
H.P. Takhchidi ◽  
◽  
E.N. Panteleev ◽  
A.S. Semakina ◽  
I.V. Afanasova ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Clinical Study ◽  
Anterior Chamber ◽  
Corneal Tissue ◽  
Optical Coherence ◽  
Radial Keratotomy ◽  
Corrected Visual Acuity ◽  
The Difference ◽  
Optical Coherence Tomograph ◽  
Best Corrected Visual Acuity

Purpose. A clinical study of safety and changes of refraction during intersection of a keratotomy scar while performing the corneal tunnel incision in phacoemulsification with IOL implantation. Material and methods. The clinical study included 11 patients (19 eyes) suffering from cataract and patients with previously performed anterior radial keratotomy. A tunnel incision 2.2 mm wide was performed with the location of the scar in its center. In case of insufficient area of the corneal tissue between the scars to involve only one keratotomy scar into the tunnel incision, the adjacent scar was transected at the final stage of tunnel formation when entering the anterior chamber. The other stages of phacoemulsification were carried out in a standard way. During the operation, the state of the keratotomy scar was assessed. A day, a week and a month later after the operation, the patients underwent biomicroscopy, autorefractokeratometry, visometry with an assessment of the values of subjective and objective cylindrical correction. In order to assess the postoperative state of the keratotomy scar and the incision zone, OCT of the cornea was performed using an RTVue 100 optical coherence tomograph (Optovue, Inc, USA) in Line, Crossline, 3D cornea modes. Results. In all cases, during the operation and also the next day, biomicroscopically the cornea was transparent, there was no keratotomy scar dehiscence. There is a dynamic of the best corrected visual acuity value by 1 month after surgery and the difference between the value for subjective and objective cylinder correction as well. The next day after the operation, in all cases the keratotomy scar on the OCT scans is uniform, comparable in width, the architectonics of the tunnel incision does not differ from that of standard phacoemulsification. Conclusion. Performing a corneal tunnel incision with the beginning of the formation outside the zone of the keratotomy scar and with further intersection of the scar with the plane of the blade so that most of it is in the projection of the center of the tunnel incision, as well as the intersection of the adjacent keratotomy scar at the end of the formation of the tunnel incision when entering the anterior chamber in case of insufficient the area of the corneal tissue between the incisions is safe at all stages of phacoemulsification and in the postoperative period. Changes in the values of best corrected visual acuity over time and the difference between the values of subjective and objective cylinder correction require further study on a larger sample and using various keratometry methods. Key words: radial keratotomy, phacoemulsification, tunnel incision, intersection of the keratotomy scar, cornea optical coherence tomography.

Neovaskulinės amžinės geltonosios dėmės degeneracijos gydymo ranibizumabu 24 mėnesių morfologiniai ir funkciniai pokyčiai

2015 ◽  
Vol 21 (3.2) ◽  
pp. 413-416
Author(s):  
Vilma Jūratė Balčiūnienė ◽  
Rosita Lažaunykaitė
Keyword(s):  
Visual Acuity ◽  
Macular Thickness ◽  
Age Related Macular Degeneration ◽  
Central Macular Thickness ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Before And After ◽  
The Mean ◽  
The Difference ◽  
Best Corrected Visual Acuity

Key words: ranibizumab, age-related macular degeneration, central macular thickness. Research objective. To evaluate influence of treatment with vascular endothelial growth factor inhibitor, ranibizumab, for best corrected visual acuity and central macular thickness in patients with neovascular age-related macular degeneration. Materials and methods. In this retrospective study were included treatment – naive patients. Intravitreal injections were performed at Lithuanian University of Health Sciences Kaunas Clinics Eye clinic. In this study were analysed the 24-month morphological and functional outcomes of intravitreal ranibizumab injections. Best corrected visual acuity was meassured using the Snellen chart (Landolt’s rings C optotypes). Optical coherence tomography images were obtained using the spectral – domain OCT (NIDEK RS – 3000 Advance (NIDEK CO LTD, Japan). The central thickness measurements were obtained from macular thickness maps using the digital caliper tool. Results. In this study were included 88 patients. Best corrected visual acuity before treatment was 0.36 ± 0.22. The difference between visual acuity before and after first injection was 0.04 ± 0.22 (p = 0.03). Before fifth injection visual acuity was 0.41 ± 0.21, after – 0.46 ± 0.22 (p = 0.05). Central macular thickness before treatment was 297.81 ± 106.04 μm. The difference between central macular thickness before and after first injection was 85.21 ± 113.37 μm (p &lt; 0.001). Before second injection central macular thickness was 273.57 ± 87.49 μm, after – 234.51 ± 58.96 μm (p = 0.002). Before fourth injection central macular thickness was 237.20 ± 40.87 μm, after – 219.10 ± 42.26 μm (p = 0.04). The mean central macular thickness significantly decreased from 298.15 ± 104.78 to 229.08 ± 56.57 (p &lt; 0.001). In 24 month of treatment the average number of ranibizumab injections was 3.61 ± 1.55. Conclusions. Our study’s results showed that over 24 month best corrected visual acuity improvement was statistically significant after first and fifth injection. Baseline compared with last injection, there was not statistically significant difference. Central macular thickness improvement statistically significant was after first, second and fourth injection. There was statistically significant decreased baseline compared with the last injection. The mean number of ranibizumab injections was 3.61 ± 1.55 in 24 month.

scholarly journals The efficacy of intravitreal conbercept for chronic central serous chorioretinopathy: a retrospective clinical study

2019 ◽  
Author(s):  
Jianbo Mao ◽  
Caiyun Zhang ◽  
Chenyi Liu ◽  
Lijun Shen ◽  
Jimeng Lao ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Clinical Study ◽  
Central Serous Chorioretinopathy ◽  
Central Macular Thickness ◽  
Chronic Central Serous Chorioretinopathy ◽  
Corrected Visual Acuity ◽  
Retrospective Clinical Study ◽  
The Difference ◽  
Best Corrected Visual Acuity

Abstract Background: To evaluate the efficacy and safety of conbercept for patients with chronic central serous chorioretinopathy (CSC). Methods: A retrospective clinical study. This study included twenty-seven patients (32 eyes) who were diagnosed with chronic CSC in our hospital from November 2015 to March 2018. All the patients received intravitreal conbercept with one intravitreal injection and pro re nata (PRN). Follow-up observations occurred at 1 week and 1, 2, 3, and 6 months after initial injection. Observed indicators included best-corrected visual acuity (BCVA), central macular thickness (CMT) and presence of subretinal fluid (SRF). Results: During the 6-month follow-up, the mean number of injections required and performed was 1.50±0.67. The BCVA at the first visit, 1-week, 1-, 2-, 3- and 6-month follow-ups after the first injection was 0.44±0.26, 0.39±0.29, 0.38±0.29, 0.33±0.29, 0.31±0.30, and 0.31±0.29, respectively. The difference between the BCVA at each follow-up and the first visit was statistically significant (F=9.717, P<0.05). CMT at the first visit, 1-week, 1-, 2-, 3- and 6- month after first injection was 323.25±158.49μm, 263.78±122.52μm, 222.34±92.46μm, 195.63±69.18μm, 189.25±68.71μm, and 200.47±86.30μm, respectively. The difference between the CMT at each follow-up and the first visit was also statistically significant (F=17.072, P<0.05). Full resolution of fluid was achieved in 7 (21.9%) eyes at 1 month, 14 (43.8%) eyes at 2 months, 19 (59.4%) eyes at 3 months and 23 (71.9%) eyes at 6 months after the initial treatment of anti-VEGF injection. No severe adverse event was noted relevant to the therapy. Conclusion: Intravitreal injection of conbercept can effectively reduce the CMT and improve the BCVA in chronic CSC in a short term of 6 months. Keywords: Chronic central serous chorioretinopathy, Conbercept, Best-corrected visual acuity, Central macular thickness.

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