scholarly journals Mommy, why can’t I see clearly?

2020 ◽  
Vol 2 (3) ◽  
pp. 244-250
Author(s):  
Nurulhuda Md Amin ◽  
Safiyah Jameelah Mohd Yusof ◽  
Nor Fadzillah Abd Jalil ◽  
Raja Norliza Raja Omar ◽  
Mushawiahti Mustapha
Keyword(s):  
Visual Acuity ◽  
Marfan Syndrome ◽  
Crystalline Lens ◽  
Visual Axis ◽  
Ectopia Lentis ◽  
Lens Subluxation ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity ◽  
Iris Claw

Ectopia lentis or crystalline lens subluxation is one of the major criteria to diagnose Marfan syndrome. It may vary from mild lens subluxation to lens dislocation. Herewith is a case report of a 4-year-old autistic boy who had never been diagnosed with Marfan syndrome. He presented to the clinic after his parents noticed he had difficulty focusing on near objects. His bilateral best-corrected visual acuity was 6/60. On examination, there was bilateral lens subluxation superotemporally and lens equator blocking his visual axis. He was sent to the paediatric team and further Marfan workout showed dilated aortic root. He was then diagnosed with Marfan syndrome. He underwent bilateral lens aspiration, anterior vitrectomy, and iris-claw lens implantation. His postoperative bilateral visual acuity on day 1 was 6/30 and his best-corrected visual acuity 3 months after surgery was 6/9 for both eyes. In conclusion, ophthalmologists play an important role in diagnosing and managing Marfan syndrome. Early diagnosis is important to help preserve vision and improve quality of life.

scholarly journals Pars Plana Lensectomy and Iris-Claw Artisan Intraocular Lens Implantation in Patients with Marfan Syndrome

2021 ◽  
Author(s):  
Saeed Karimi ◽  
Zahra Karjou ◽  
Mohadeseh Yaghoobi ◽  
Homayoun Nikkhah ◽  
Sare Safi
Keyword(s):  
Visual Acuity ◽  
Marfan Syndrome ◽  
Crystalline Lens ◽  
Safe Procedure ◽  
Iol Implantation ◽  
Lens Subluxation ◽  
Pars Plana Lensectomy ◽  
Pars Plana ◽  
The Mean ◽  
Iris Claw

Abstract Purpose: To evaluate the visual and anatomical outcomes of pars plana lensectomy and iris-claw artisan intra-ocular lens (IOL) implantation in the patients with subluxated crystalline lens secondary to Marfan syndrome.Methods: In this retrospective case series, we evaluate the records of all patients with Marfan syndrome and moderate to severe crystalline lens subluxation who underwent pars plana lensectomy/anterior vitrectomy and implantation of iris-claw artisan IOL at referral hospital from September 2015 to October 2019.Results: Twenty-one eyes of fifteen patients (10 males and 5 females) with the mean age of 24.47 ± 19.14 years were included. Mean best-corrected visual acuity was improved from 1.17 ± 0.55 logMAR to 0.64 ± 0.71 logMAR at the final follow-up visit (P <0.001). The mean intraocular pressure did not change significantly (P = 0.971). The final refraction showed a mean sphere of 0.54 ± 2.46 D and a mean cylinder -0.81 ± 1.03 at the mean axis of 57.92 ± 58.33 degrees. One eye developed rhegmatogenous retinal detachment two months after surgery.Conclusion: Pars plana lensectomy and iris-claw artisan IOL implantation seem to be a useful, impressive and safe procedure with a low rate of complications in Marfan patients with moderate to severe crystalline lens subluxation. Visual acuity was significantly improved with the acceptable anatomical and refractive outcomes.

Surgical management of pterygium in a rural hospital using bare sclera versus conjunctival autograft technique

2017 ◽  
Vol 5 (5) ◽  
pp. 2076
Author(s):  
Dinesh P. ◽  
Sundip Shenoy ◽  
Nidhi Pandey ◽  
Pavan Kumar Reddy D.
Keyword(s):  
Visual Acuity ◽  
Connective Tissue ◽  
Medical Sciences ◽  
Visual Axis ◽  
Recurrence Rates ◽  
Conjunctival Autograft ◽  
Corrected Visual Acuity ◽  
Department Of Ophthalmology ◽  
Best Corrected Visual Acuity ◽  
Conjunctival Autografting

Background: Pterygium is defined as a triangular fibrovascular subepithelial ingrowth of degenerative bulbar conjunctival tissue over limbus onto the cornea. Commonly seen among farmers, fishermen, stone cutters and welders. Both blue and ultraviolet light have been implicated in its causation. Histologically the true Pterygium shows elastotic degeneration of the subconjunctival connective tissue. Pterygium warrant treatment when they encroach the visual axis, induces significant astigmatism or become cosmetically bothersome. My present study was undertaken to evaluate the efficacy, safety and recurrence rates of conjunctival autograft and bare sclera techniques in treatment of progressive true pterygium in a rural hospital.Methods: The prospective study was done in the Department of Ophthalmology, Adichunchanagiri Institute of Medical Sciences, B.G Nagara, Mandya District, Karnataka, India. The study was conducted for a period of 18 months. About 70 patients who presented with progressive pterygium were included in the study.Results: In our study pterygium recurred in 10 cases (14.28%), among which pterygium recurred in 8 cases (22.85 %) using bare sclera technique and in 2 patients (5.71%) using conjunctival autograft technique, best corrected visual acuity remained stable in 37 cases (52.85 %), improved in 33 cases (47.14 %) and worsened in none (0%) of the cases.Conclusions: Conjunctival autografting is a safe and effective procedure in the management of pterygium. The recurrence rate following limbal conjunctival autografting is significantly lower than that following primary conjunctival closure by bare sclera technique.

scholarly journals Evaluation of vision-related quality of life with autologous internal limiting membrane transplantation for refractory macular hole.

2019 ◽  
Author(s):  
dongqing yuan ◽  
Weiwei Zhang ◽  
Songtao Yuan ◽  
Ping Xie ◽  
Qinghuai Liu
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Macular Hole ◽  
Internal Limiting Membrane ◽  
Ilm Peeling ◽  
Corrected Visual Acuity ◽  
Hole Index ◽  
Related Quality ◽  
Best Corrected Visual Acuity

Abstract Background: To evaluate the vision-related quality of life of vitrectomy combined with autologous internal limiting membrane(ILM) transplantation for refractory macular hole． Methods: A prospective and nonrandomized clinical study was carried out. There were fourty eyes with refractory macular hole included and all eyes received 23G vitrectomy and ILM peeling with autologous ILM transplantation. Preoperative and postoperative basic conditions were recorded, including best corrected visual acuity (BCVA), intraocular pressure, central retinal thickness (CRT) measurement by Optical coherence tomography (OCT) examination, macular hole index (MHI) and operative complications. The Chinese version of visual-related quality of life scale -25 (CVRQoL-25) was used to evaluate the visual related quality of life of patients after operation. The correlation between the quality of life and the postoperative visual acuity and the size of the macular hole before operation was tested by Spearman rank correlation test. Results: All patients were followed up for three months after surgery, and 38 patients achieved anatomical closure. The mean postoperative logMAR BCVA was 1.09±0.33, which has significantly improved than that before operation (P=0.000). The vision-related quality of life of patients after surgery was closely related to the macular hole index (r=0.375, P=0.017), but was negatively correlated with the best corrected visual acuity before and after surgery (r=-0.495, P=0.001; r=-0.760，P=0.000). It was also found that the vision-related quality of life of patients positively correlated with the postoperative CRT ( r=0.414，P=0.008). Conclusions: The anatomical structure of refractory macular hole patients with ILM peeling combined with autologous ILM transplantation was largely reduced, and the visual acuity of the patients improved significantly. Meanwhile, the vision-related quality of life was significantly improved after surgery. Trial Registration: ChiCTR-INR-16008660, date of registration: 2016/06/17

scholarly journals LETTER TO THE EDITOR Excision of Congenital Bilateral Persistent Pupillary Membrane in a Child with Exotropia

2015 ◽  
Vol 9 (1) ◽  
pp. 33-35
Author(s):  
Michiko Iida ◽  
Tatsuya Mimura ◽  
Mari Goto ◽  
Yuko Kamei ◽  
Aki Kondo ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Surgical Treatment ◽  
Histopathological Examination ◽  
Crystalline Lens ◽  
Ocular Tissues ◽  
Corrected Visual Acuity ◽  
The Right ◽  
Best Corrected Visual Acuity ◽  
High Hyperopia

Purpose : To report the clinical and histopathological findings of a patient who had bilateral persistent pupillary membrane with exotropia and high hyperopia. Methods : Case Report: A 7-year-old boy presented with a persistent pupillary membrane in both eyes. His best corrected visual acuity (BCVA) was 20/20 in the right eye and 20/32 in the left eye with exotropia of 18 prism diopters. He underwent surgical resection of both membranes. At 5 months postoperatively, BCVA was 20/20 with final bilateral refraction of +6.5 D in both eyes. Exotropia and photophobia showed improvement immediately after surgery. Histopathological examination revealed typical features of normal iris tissue in the excised membranes. Conclusion : Bilateral persistent pupillary membranes were excised successfully without injury to other ocular tissues, including the crystalline lens. Surgical treatment may be required for the management of persistent pupillary membrane associated with visual impairment such as exotropia or photophobia.

Unilateral spontaneous filtering bleb dissecting into the cornea in a patient with high myopia

2019 ◽  
pp. 112067211987715
Author(s):  
Pablo Sanjuán ◽  
Borja Salvador-Culla ◽  
Maria Isabel Canut ◽  
Rafael I Barraquer
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
High Myopia ◽  
Anterior Segment ◽  
Cataract Extraction ◽  
Posterior Chamber ◽  
Visual Axis ◽  
Filtering Bleb ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Purpose: To report a case of a unilateral spontaneous filtering bleb dissecting into the cornea in a patient with high myopia. Clinical case: A 33-year-old woman with high myopia (–18 D) presented with discomfort in the left eye. Ocular history included pars plana vitrectomy and cataract extraction and posterior chamber intraocular lens implantation in the left eye. Best-corrected visual acuity was 0.65 and intraocular pressure was 20 mmHg. Slit-lamp examination showed a filtering bleb in the upper-temporal quadrant, which extended and dissected the proximal cornea without affecting the visual axis. The morphology and content of the bleb was studied with anterior segment optical coherence tomography, which ruled out a corneal-scleral fistulization into the subconjunctival space. The spontaneous filtering bleb was resected surgically. Due to her high myopia, two strips of fascia lata were used to strengthen the area. In the postoperative period, a complete resection of the bleb was confirmed, without apparent leaking points and with a well-vascularized conjunctiva. No complications were noted. The patient maintained the same best-corrected visual acuity and intraocular pressure than before surgery. Conclusion: The formation of a spontaneous filtering bleb is a rare entity in patients with high myopia, whose risk increases due to their thinned sclerae. The risk is even greater if they have undergone ocular surgeries. Resection of the filtering bleb in our case halted the progression of the corneal dissection, therefore respecting the transparency of the visual axis and preserving visual acuity.

Vision-related quality of life in patients treated for myopic choroidal neovascularization: A post hoc analysis of the OLIMPIC study

2019 ◽  
Vol 30 (5) ◽  
pp. 1069-1075
Author(s):  
Gianni Virgili ◽  
Mariacristina Parravano ◽  
Francesco Viola ◽  
Monica Varano
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Choroidal Neovascularization ◽  
Early Treatment ◽  
Pathologic Myopia ◽  
Corrected Visual Acuity ◽  
Related Quality ◽  
Best Corrected Visual Acuity

Purpose: To investigate vision-related quality of life in patients referred to the Italian Retina Services for intravitreal ranibizumab treatment for choroidal neovascularization due to pathologic myopia. Design: Post hoc analysis of a multicenter, interventional phase IIIb study (OLIMPIC). Methods: Patients with either previously untreated (naïve) or treated choroidal neovascularization due to pathologic myopia were enrolled. Vision-related quality of life was measured using the Italian version of the Impact of Vision Impairment Questionnaire with scores from 0 (no impact) to 5 (severe impact). Burden of illness data were collected regarding income, and personal and public resource use. Results: In the 200 included subjects, mean best-corrected visual acuity in the better eye was 68.3 Early Treatment Diabetic Retinopathy Study letters (standard deviation: 15.2) compared with 42.5 Early Treatment Diabetic Retinopathy Study letters (standard deviation: 23.3) in the worse eye. The proportion of better eyes affected by choroidal neovascularization was 147/200 (73.5%). In multivariable analyses, lower better eye, but not worse eye, best-corrected visual acuity was associated with lower vision-related quality of life (per 10 fewer letters, beta: + 0.17, p < 0.001). An annual income below 20,000 euros was also associated with lower vision-related quality of life (beta: + 0.38; standard error: 0.13, p = 0.004). Moreover, in univariate analyses, increasing income level was linearly associated with better presenting best-corrected visual acuity in the better eye (p < 0.003), with a difference of 15 Early Treatment Diabetic Retinopathy Study letters for patient income <20,000 euros compared with >70,000 euros. Conclusion: Italian patients with myopic choroidal neovascularization and a low income presented with lower better-eye best-corrected visual acuity and lower vision-related quality of life compared with those with a higher income. Future research should investigate disease awareness and candidacy issues that may influence the quality of life of patients.

scholarly journals Evaluation of vision-related quality of life with autologous internal limiting membrane transplantation for refractory macular hole.

2019 ◽  
Author(s):  
Dongqing Yuan ◽  
Weiwei Zhang ◽  
Songtao Yuan ◽  
Ping Xie ◽  
Qinghuai Liu
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Macular Hole ◽  
Internal Limiting Membrane ◽  
Ilm Peeling ◽  
Corrected Visual Acuity ◽  
Hole Index ◽  
Related Quality ◽  
Best Corrected Visual Acuity

Abstract Background: To evaluate the vision-related quality of life of vitrectomy combined with autologous internal limiting membrane(ILM) transplantation for refractory macular hole． Methods: A prospective and nonrandomized clinical study was carried out. There were fourty eyes with refractory macular hole included and all eyes received 23G vitrectomy and ILM peeling with autologous ILM transplantation. Preoperative and postoperative basic conditions were recorded, including best corrected visual acuity (BCVA), intraocular pressure, central retinal thickness (CRT) measurement by Optical coherence tomography (OCT) examination, macular hole index (MHI) and operative complications. The Chinese version of visual-related quality of life scale -25 (CVRQoL-25) was used to evaluate the visual related quality of life of patients after operation. The correlation between the quality of life and the postoperative visual acuity and the size of the macular hole before operation was tested by Spearman rank correlation test. Results: All patients were followed up for three months after surgery, and 38 patients achieved anatomical closure. The mean postoperative logMAR BCVA was 1.09±0.33, which has significantly improved than that before operation (P=0.000). The vision-related quality of life of patients after surgery was closely related to the macular hole index (r=0.375, P=0.017), but was negatively correlated with the best corrected visual acuity before and after surgery (r=-0.495, P=0.001; r=-0.760，P=0.000). It was also found that the vision-related quality of life of patients positively correlated with the postoperative CRT ( r=0.414，P=0.008). Conclusions: The anatomical structure of refractory macular hole patients with ILM peeling combined with autologous ILM transplantation was largely reduced, and the visual acuity of the patients improved significantly. Meanwhile, the vision-related quality of life was significantly improved after surgery. Trial Registration: ChiCTR-INR-16008660, date of registration: 2016/06/17

scholarly journals MANUAL AND YAG-LASER ANTERIOR CAPSULORHEXIS SURGERY OF CONGENITAL ECTOPIA OF THE LENS IN MARFAN SYNDROME IN CHILDREN

2018 ◽  
Vol 13 (1) ◽  
pp. 26-30
Author(s):  
L. A. Katargina ◽  
T. B. Kruglova ◽  
N. N Arestova ◽  
N. S Egiyan
Keyword(s):  
Marfan Syndrome ◽  
Crystalline Lens ◽  
Instrumental Method ◽  
Laser Technique ◽  
Mechanical Pressure ◽  
Anterior Capsule ◽  
Yag Laser ◽  
Lens Subluxation ◽  
Advantages And Disadvantages

Purpose. is to optimize the tactics of performing anterior capsulorhexis in children with congenital lens subluxation in Marfan syndrome with the use of manual and YAG - laser technique. Material and methods. There were observed 25 patients (34 eyes) aged 4 to 11 years old with lens subluxation: 7 children (10 eyes) with congenital cataract and 18 patients (24 eyes) of the clear crystalline lens in Marfan syndrome. The degree of ectopia was different: 14 eyes - 1 degree, 16 eyes-2 degree and 4 eyes-3 degree of crystal ectopia. Manual circular continuous capsulorexis performed 15 eyes in 12 childrens, YAG-laser capsulectomy-19 eyes in 13 children. Results. Use of YAG - laser equipment allowed to excise planned part of of the anterior capsule without mechanical pressure on not fixed lens. Full of YAG-laser anterior capsulorhexis could not be executed in eyes with 3 degree subluxation of the lens (a significant portion of the anterior capsule is covered with an iris). Manual method allowed to execute anterior capsulorhexis at any degree of subluxation of the lens, but required multiple manipulations on the anterior capsule because of clinical and anatomical features anterior capsule in eyes with subluxation of the lens, which significantly prolonged the time of surgery, increasing the risk of developing exudative and proliferative reactions. YAG - laser anterior capsulotomy (dissection of the anterior capsule by YAG laser) with the completion of capsulotomy with the help of instrumental method increases the quality of the surgery. Conclusion.To perform anterior capsulorhexis in children with lens subluxation 1 and 2 degrees can be applied a manual and YAG-laser methods, each of which has its advantages and disadvantages.

scholarly journals Conbercept for Treatment of Neovascular Age-Related Macular Degeneration and Visual Impairment due to Diabetic Macular Edema or Pathologic Myopia Choroidal Neovascularization: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Pengxiang Zhou ◽  
Siqian Zheng ◽  
Ente Wang ◽  
Peng Men ◽  
Suodi Zhai
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Macular Degeneration ◽  
Macular Edema ◽  
Age Related Macular Degeneration ◽  
Pathologic Myopia ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Best Corrected Visual Acuity

Background: Conbercept is a new anti-vascular endothelial growth factor (VEGF) drug. Here, we systematically conducted the efficacy, safety, compliance, and pharmacoeconomic evaluation of intravitreal conbercept (IVC) compared with other treatments in patients with neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), or pathologic myopia choroidal neovascularization (pmCNV).Methods: Databases of PubMed, Embase, Cochrane Library, ClinicalTrials.gov, SinoMed, China National Knowledge Infrastructure, and WanFang Data were systematically searched from the inception to July 27, 2021. Randomized clinical trials and pharmacoeconomic studies comparing IVC with control groups in adults with nAMD, DME, or pmCNV were reviewed and selected. Meta-analyses were performed using the fixed-effects model when pooled data were homogeneous. Heterogeneous data were analyzed using the random-effects model. Primary outcomes included visual improvement rate, mean change in visual acuity or best corrected visual acuity, and pharmacoeconomic outcomes. Additional outcomes were the mean change in fundus examination values, adverse events (AEs), quality-of-life measures, and number of injections.Results: Among 3,591 screened articles, 22 original studies with 1,910 eyes of patients were finally included. For nAMD and DME, IVC was significantly associated with better visual acuity or best corrected visual acuity improvement and fundus quantitative measures than placebo, laser photocoagulation (LP), or intravitreal triamcinolone acetonide (IVT). However, IVC showed non-inferior efficacy to intravitreal ranibizumab (IVR) according to low quality of evidence, and there was lack of trials comparing the priority of IVC to other anti-VEGF regimens. No definitive increased risk of ocular or non-ocular AEs were observed in the study groups. All patients with AEs recovered after symptomatic treatments, and no severe AEs occurred. Patients treated with IVC might have higher quality-of-life scores than those in IVR in nAMD or LP in DME. Additionally, IVC showed cost–utility advantages in nAMD and cost-effectiveness advantages than IVR in pmCNV in China.Conclusion: IVC is well-tolerated and effective for improving vision acuity and quantitative measures in fundus condition in patients with nAMD and DME compared with LP, IVT, and placebo, but gains comparable efficacy to IVR. However, well-designed, large-sample, and long-term evaluation of IVC shall be conducted in additional studies worldwide.

The efficacy of “IOL-Vip Revolution” telescopic intraocular lens in age-related macular degeneration cases with senile cataract

2018 ◽  
Vol 29 (6) ◽  
pp. 615-620
Author(s):  
Medine Yilmaz Dag ◽  
Filiz Afrashi ◽  
Serhad Nalcaci ◽  
Jale Mentes ◽  
Cezmi Akkin
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Intraocular Lens ◽  
Corneal Thickness ◽  
Anterior Chamber Depth ◽  
Age Related Macular Degeneration ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Best Corrected Visual Acuity

Purpose: To evaluate the efficacy of the IOL-Vip Revolution telescopic intraocular lens in age-related macular degeneration patients. Methods: A total of 13 eyes of 12 age-related macular degeneration patients with senile cataract were enrolled. Selection of the patients was done by means of a low vision diagnostic and rehabilitative program (IOL-Vip software) that evaluates residual visual function. After standard phacoemulsification surgery, the incision site was enlarged and the IOL-Vip Revolution system was implanted in the capsular bag. The outcome measures were best corrected visual acuity, contrast sensitivity, anterior chamber depth, endothelial cell density, central corneal thickness, and quality-of-life questionnaire. Results: The mean age of the subjects was 72.3 ± 8.5 years. The mean positive power of the intraocular lens was 59 ± 2 D and the negative intraocular lens power was standard (–46 D). Pre- and postoperative best corrected visual acuity were 1.08 ± 0.14 and 0.81 ± 0.16 logMAR in the operated eye and 1.13 ± 0.36 and 1.01 ± 0.40 logMAR in the unoperated eye, respectively. The best corrected visual acuity was increased significantly in both operated and unoperated eyes (p = 0.005 and 0.021, respectively). Quality of life and anterior chamber depth increased significantly (p = 0.018 and 0.008, respectively), while endothelial cell density decreased (p = 0.002). No significant differences were detected in central corneal thickness or contrast sensitivity (p = 0.133 and 0.684, respectively). Conclusion: The results showed that IOL-Vip Revolution telescopic intraocular lens is a promising treatment option in age-related macular degeneration patients. The rehabilitation program may have an important role in the restored clinical results, which also provided visual improvement in the unoperated eyes.

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