Acuity In Group Research Articles

Outcomes of 25-Gauge Vitrectomy for Tractional and Nontractional Diabetic Macular Edema with Proliferative Diabetic Retinopathy.

The benefit of pars plana vitrectomy with internal limiting membrane peeling for tractional macular edema and diffuse nontractional macular edema in diabetic retinopathy has been reported. Although these studies had included various stages, use of conventional 20-gauge vitrectomy system, small number of cases, single-center study, and lack of retinal structure measurements were limitations. We compared one-year outcomes of 25-gauge vitrectomy for refractory diabetic macular edema with or without the tractional proliferative membrane in proliferative diabetic retinopathy (PDR) eyes and examined the prognostic factors for postoperative visual acuity. A total of consecutive 116 PDR eyes of 116 patients that underwent 25-gauge vitrectomy for tractional macular edema (TME group: 56 eyes) or nontractional macular edema (nTME group: 60 eyes) at six centers were retrospectively reviewed. Visual acuity (VA), central macular thickness (CMT), complications, and postoperative treatments before and 12 months after vitrectomy were compared. Mean VA improved significantly in each group (both P < 0.01), and mean CMT decreased significantly in each group (both P < 0.01). Thirteen eyes underwent additional vitrectomy, six eyes developed neovascular glaucoma, six eyes received intravitreal anti-VEGF injection, and thirteen eyes received subtenon triamcinolone acetonide injection. Multiple linear regression analysis showed that baseline VA and CMT in the TME group and kidney function in the nTME group were the predictable factors of the 12-month postoperative VA. Twenty-five-gauge vitrectomy effectively improved VA and macular structure both in TME and nTME groups. Baseline VA, CMT, and kidney function are important factors affecting postoperative VA.

Surgical techniques of intraocular lens-capsular bag complex stabilization during cataract phacoemulsification in patients with lens subluxation

Aim. To develop and to assess the efficacy of the method of one-step upper fixation of a single-piece intraocular lens to the iris during cataract phacoemulsification in patients with lens subluxation.&#x0D; Methods. The study included 32 patients (37 eyes) with complicated cataract grade 23 combined with grade 12 lens subluxation. Both groups underwent cataract phacoemulsification with consequent implantation of a capsular tension ring and a single-piece intraocular lens. Group 1 (21 eyes) underwent intraoperative one-step upper haptic fixation of a single-piece intraocular lens in vertical position. In group 2 (16 eyes) in 13 cases 61.5 months later a single piece intraocular lens was repositioned and both haptics were sutured to the iris.&#x0D; Results. In both groups no intraoperative complications occured. Visual acuity in group 1 on days 13 after the surgery was 0.770.19 and was stable during the follow-up. Intraocular pressure was 17.20.99 mm Hg. In group 2 the obtained good functional results 0.780.18 declined due to intraocular lens decentration, the intraocular pressure increased by 6.01.25 mm Hg (up to 24.20.65 mm Hg) which required an intraocular lens reposition in 81.3% of cases. According to ultrasound biomicroscopy, in both groups intraocular lens in all cases had intracapsular fixation and was in a central position.&#x0D; Conclusion. The developed method of a one-step single piece intraocular lens fixation by suturing the upper haptic to the iris during cataract phacoemulsification in patients with lens subluxation is an effective and safe procedure that allows complete rehabilitation of patients with phacodonesis during a one-step surgical intervention.

The timing of vitrectomy for open ocular trauma

Objective To investigate the timing of secondary vitrectomy for open ocular trauma. Methods A retrospective study. The data of 65 eyes of 65 cases with open ocular trauma from Feb.2013 to Feb.2018 were analyzed.All cases who received secondary vitrectomy were divided into two groups randomly.Group A, 36 patients, were treated with vitrectomy at 5-7 days after trauma. Group B, 29 patients, were treated with vitrectomy at 2-3 weeks after trauma. Results The followed-up time was 12 months. In group A, eyeball atrophy occurred in 2 eyes (5.56%), and 7 eyes (24.14%) in group B . The difference was statistically significant between the two groups(χ2=4.65, P=0.03). The visual acuity in group A improved significantly in 21 eyes(58.33%), improved slightly in 13 eyes(36.11%). The visual acuity in group B improved significantly in 4 eyes(13.79%), improved slightly in 8 eyes(27.59%). The difference was statistically significant between the two groups(χ2=21.864, P=0.000). Conclusion The efficacy of vitrectomy for the treatment of open ocular trauma at 5-7days is better. Key words: Trauma, ocular, open; Vitrectomy; Timing, operation

Comparison of the efficacy of two methods to extract intraocular magnetic foreign bodies

Objective To compare the efficacy of two different methods of intraocular magnetic foreign body extraction. Methods From Jan.2016 to Dec.2017, the data of 165 cases who received intraocular magnetic foreign bodies extraction in our hospital were analyzed retrospectively. All cases were randomly divided into two groups. Group A, 89 cases, received extraction of magnetic foreign bodies through the original wound, and group B, 76 cases, received extraction of intraocular magnetic foreign bodies through the vitreous. Postoperative the follow-up time was 12-15 months. Results The visual acuity of group A improved in 64 eyes (71.91%), remained unchanged in 6 eyes(6.74%). Visual acuity was improved in 66 eyes (86.89%) of group B, unchanged in 7 eyes(9.21%). The difference in visual acuity improvement rate was not statistically significant between the two groups (χ2=0.055, P=0.801). The rates of complication of the two groups were similar. Conclusion The efficacies of two methods of extraction of intraocular magnetic foreign bodies are similar. Key words: Foreign body, intraocular, magnetic; Extraction, magnetic attration, original wound; Extraction, through the vitreous

Preserved tactile acuity in older pianists.

A previous study from our lab demonstrated retention of high tactile acuity throughout the lifespan in blind subjects in contrast to the typical decline found for sighted subjects (Legge, Madison, Vaughn, Cheong & Miller, Percept Psychophys, 70 (8), 1471-1488, 2008). We hypothesize that preserved tactile acuity in old age is due to lifelong experience with focused attention to touch and not to blindness per se. Proficient pianists devote attention to touch - fingerings and dynamics - over years of practice. To test our hypothesis, we measured tactile acuity in groups of ten young (mean age 24.5 years) and 11 old (mean age 64.7 years) normally sighted pianists and compared their results to the blind and sighted subjects in our 2008 study. The pianists, like the subjects in 2008, were tested on two tactile-acuity charts requiring active touch, one composed of embossed Landolt rings and the other composed of dot patterns similar to braille. For both tests, the pianists performed more like the blind subjects than the sighted subjects from our 2008 study. For the ring chart, there was no significant difference in tactile acuity between the young and old pianists and no significant difference between the pianists and the blind subjects. For the dot chart, the pianists showed an age-related decline in tactile acuity, but not as severe as the sighted subjects from 2008. Our results are consistent with the hypothesis that lifelong experience with focused attention to touch acts to preserve tactile acuity into old age for both blind and sighted subjects.

Comparison of Visual Acuity and Central Macular Thickness in Neovascular Age-related Macular Degeneration Patients with Subretinal and Intraretinal Fluid Treated with Intravitreal Bevacizumab

&#x0D; &#x0D; &#x0D; Purpose: To compare visual acuity (VA) and central macular thickness (CMT) outcome of loading dose intravitreal bevacizumab treatment between neovascular AMD patients with character of predominant subretinal and intraretinal fluid. Methods: Prospective study of loading dose intravitreal bevacizumab treated age-related macular degeneration, of which has a baseline macular morphology of subretinal or intraretinal fluid. VA, CMT, and their changes were evaluated during and after loading dose was completed. &#x0D; Results: Thirty eight eyes (38 patients, mean age 66,95 years) were enrolled. 20 eyes were in subretinal fluid (SRF group) and 18 intraretinal fluid (IRF) group. Mean VA at baseline eventually was significantly different where SRF group (56,41 letters) were better than IRF group (43,72 letters). No statistically significant difference of mean VA change or CMT change between group, however VA in SRF group remained higher and CMT in SRF group were lower than IRF group. &#x0D; Conclusion: Neovascular AMD, with both SRF and IRF at baseline, benefits from loading dose intravitreal bevacizumab treatment although mean visual acuity and mean central retinal thickness are better in those with SRF. &#x0D; &#x0D; &#x0D;

Клинико-функциональные результаты применения методики пневмокомпрессии при факоэмульсификации возрастной катаракты

Purpose . The analysis of clinical and functional results using the method of intraocular lenses (IOL) pneumocompression in phacoemulsification (PE) of senile cataract for the prevention of posterior capsule opacification development. Material and methods. The study included 328 pseudophakic eyes of 328 patients, who underwent PE for senile cataract. The IOL pneumocompression was performed after the viscoelastic removal in 166 eyes (the main group); the standard PE – in 162 eyes of the control group. The type of IOL-posterior capsule interface and the visual acuity (VA) were examined at the 1st postoperative day; VA, structure and transparency of posterior capsule in pseudophakic eyes were studied after 1 year postoperatively. Results . The full contact of IOL with posterior capsule was found in 84.3% of eyes in the main group and in 31.5% of eyes in the control group. One year after operation the posterior capsule was transparent in 145 eyes (87.3%) of the group 1 and in 94 eyes (58%) of the group 2, thus the values of VA in the main group turned out to be higher, than in the control. Conclusion. The conducted research showed that IOL pneumocompression method in PE of senile cataract provided an optimal interface of IOL-posterior capsule in 84.3% of operated eyes. One year after operation the number of pseudophakic eyes with transparent optical part of posterior capsule in the main group exceeded the control by 30%. However, indices of uncorrected and best corrected VA were comparable in both groups at the first postoperative day, both values of VA 1 year after PE were reliably higher in the main group than in the control due to lower number of eyes with posterior capsule opacification.

Comparison of postoperative visual performance between bifocal and trifocal intraocular Lens based on randomized controlled trails: a meta-analysis

BackgroundTo compare the clinical performance of bifocal and trifocal intraocular lenses (IOLs) in cataract surgery, a meta-analysis on randomized controlled trials was conducted.MethodsA comprehensive literature retrieval of PubMed, Science Direct and EMBASE was performed in this systematic review. Clinical outcomes included visual acuity (VA), contrast sensitivity (CS), spectacle independence, postoperative refraction and surgical satisfaction.ResultsThere were 8 RCTs included in this study. The difference of uncorrected near VA (UNVA) between the bifocal IOLs and trifocal IOLs had no significance [MD = 0.02, 95%CI: (− 0.03,0.06)]. There was no significant difference in the distant-corrected near VA (DCNVA) with MD of 0.04 [95%CI (− 0.02, 0.10)]. Compared with trifocal group, the uncorrected intermediate visual acuity (UIVA) [MD = 0.09,95%CI:(0.01,0.17)] was significantly worse in the bifocal group. No difference was found in distance-corrected intermediate VA (DCIVA) [MD = 0.09, 95%CI: (− 0.04, 0.23)] between two groups. Analysis on AT LISA subgroup indicated the bifocal group had worse intermediate VA than trifocal group (AT LISA tri 839 M) [MD = 0.18, 95%CI: (0.12, 0.24) for UIVA and MD = 0.19, 95%CI: (0.13, 0.25) for DCIVA]. However, there was no statistically significant difference between the two groups in the uncorrected distance VA (UDVA) and corrected distance visual acuity (CDVA) [MD = 0.01, 95%CI: (− 0.01,0.04) for UDVA; MD = 0.00, 95%CI: (− 0.01,0.01) for CDVA].The postoperative refraction of bifocal group was similar to that of trifocal group [MD = -0.08, 95% CI: (− 0.19, 0.03) for spherical equivalent; MD = -0.09, 95%CI: (− 0.21, 0.03) for cylinder; MD = -0.09, 95% CI: (− 0.27, 0.08) for sphere]. No difference was found for spectacle independence, posterior capsular opacification (PCO) incidence and patient satisfaction between bifocal IOLs and trifocal IOLs. [RR = 0.89, 95% CI: (0.71, 1.12) for spectacle independence; RR = 1.81, 95% CI: (0.50, 6.54) for PCO incidence; RR = 0.98, 5% CI: (0.86, 1.12) for patient satisfaction].ConclusionPatients receiving trifocal IOLs, especially AT LISA tri 839 M, have a better intermediate VA than those receiving bifocal IOLs. Near and distance visual performance, spectacle independence, postoperative refraction and surgical satisfaction of bifocal IOLs were similar to those of trifocal IOLs.

Comparison of Short-term Outcomes of Aurolab Aqueous Drainage Implant with Ahmed Glaucoma Valve in Post–Penetrating Keratoplasty Glaucoma: A Retrospective Follow-up Study at a Tertiary Care Center

Comparison of short-term outcomes of the Aurolab aqueous drainage implant (AADI) with the Ahmed glaucoma valve (AGV) in post-penetrating keratoplasty glaucoma (PPKG). Retrospective study design. We analyzed the data of patients who underwent glaucoma drainage device (GDD) implantation for PPKG between the time period of 2008 to 2017. A total of 57 eyes of 55 patients were included. Parameters including age, sex, corneal graft clarity, duration between the keratoplasty and glaucoma surgery, visual acuity (VA), intraocular pressure (IOP), the number of antiglaucoma drugs (topical and oral) before surgery, and type of GDD were studied. The patients were divided into 2 groups: group I, patients undergoing AADI implantation; and group II, patients undergoing AGV implantation. Patients with at least 6 months follow-up were included. The postoperative VA and IOP were analyzed on day 1 and at 1 week, 4 weeks, 6 weeks, 3 months, and 6 months. The success of GDD was defined as complete success (IOP > 5 mmHg or <21 mmHg without topical antiglaucoma drug) or qualified success (IOP > 5 mmHg or <21 mmHg with up to 2 topical antiglaucoma drugs). Failure was defined as IOP < 5 mmHg or >21 mmHg with or without antiglaucoma medication; IOP < 21 mmHg with 3or more topical medications or use of systemic medications irrespective of the IOP; loss of perception of light; and/or need for further glaucoma surgery. Nineteen eyes in group I (mean age= 40.16±16.36 years) and 38 eyes in group II (mean age= 56.61±19.35 years) were studied. The mean baseline IOP in group I and group II was not significantly different (28.63±11.21 vs. 30±14.61 mmHg, P= 0.72). Mean postoperative IOP at 6 months was not significantly different in the 2 groups (12.11±4.86 mmHg vs. 14.95±6.35 mmHg, P= 0.2). There was statistically significant fall in IOP at each visit compared to preoperative IOP in both the groups (P= 0.001), but there was no significant difference between the 2 groups at any time point (P > 0.05). At 6 months overall success rate was 84.21% in both groups (P= 1.00), though the complete success was slightly higher in group II, which was nonsignificant (31.58% vs. 39.47%, P= 0.56). There was no significant difference between baseline and final VA in either group. Both AADI and AGV are equally effective in controlling IOP in post-penetrating glaucoma. The AADI, being a cost-effective implant, may be more suitable for developing countries.

Baseline Ocular Characteristics of Patients Undergoing Initiation of Anti-Vascular Endothelial Growth Factor Therapy for Diabetic Macular Edema.

Patients with diabetic macular edema (DME) have variable anatomic and visual responses to anti-vascular endothelial growth (VEGF) treatments based on their presenting visual acuity (VA). The aim of study is to report the baseline ocular and imaging characteristics of patients presenting with DME who were treatment-naïve and who initiated anti-VEGF in routine clinical practice. Single-center, cross-sectional study of 638 patients. Subjects were divided into two VA groups: Early Treatment Diabetic Retinopathy Study (ETDRS) less than 70 and ETDRS greater than 70 and ocular variables were compared between groups. Average central subfield thickness (CST) was 363.5 μm, cube volume was 11.7 mm3, and cube average thickness (CAT) was 326.1 μm. Additionally, 21.5% had subretinal fluid (SRF), and 50.5% had hard exudates on presentation. Eyes with ETDRS less than 70 had greater CAT (338.5 μm3 vs. 313.2 μm3; P < .001), greater cube volume (12.2 mm3 vs. 11.3 mm3; P < .001), greater CST (383.5 μm vs. 350.0 μm; P < .001), and SRF (25.5% vs. 17.3%; P = .012). Furthermore, 7.64% had glaucoma, 1.3% had dry age-related macular degeneration, 4.5% of patients were vitrectomized, and 28.7% were pseudophakic. Regarding diabetic stage, 37% had proliferative diabetic retinopathy (PDR) and 63% presented with nonproliferative diabetic retinopathy. Patients presenting with ETDRS less than 70 were more likely to have a history of vitrectomy (7.1% vs. 1.9%, P = .002) and presence of PDR (42.3% vs. 31.4%, P = .004). The results describe a population of patients from a routine clinical practice not entirely represented in clinical trials, with key differences in ocular characteristics seen between VA groups. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:69-75.].

Wide-angled endoillumination vs traditional scleral buckling surgery for retinal detachment - a comparative study.

PurposeTo evaluate the surgical outcomes of traditional scleral buckling (TSB) compared to chandelier-assisted scleral buckling (CSB) for rhegmatogenous retinal detachment repair.Patients and methodsA retrospective interventional comparative case series of 49 eyes that underwent SB procedure. Medical records of 27 and 22 eyes that underwent TSB and CSB surgery, respectively, were evaluated. Outcome measures included primary anatomical success, visual acuity (VA), and perioperative complications.ResultsPrimary reattachment rate was similar with 85.2% in the TCB group and 81.8% in the CSB group (P=1.00); eight patients needed one additional operation or gas injection with a final reattachment rate of 100% at 6 months. Mean VA in the CSB group improved from 20/60 at presentation to 20/35, 6 months postoperatively. In the TSB group, VA improved from 20/80 to 20/45 (P=0.90). Among the eyes that were successfully reattached with either SB approach, two eyes in each group had cataract progression and none of them required surgery during follow-up. No cases of endophthalmitis were observed.ConclusionCSB is a modified technique with an advantage of superior visualization compared with the traditional surgery, which simplifies the operation, enhance competency, and could be used as a valuable educational tool. It can provide similar anatomical and functional outcomes with no additional perioperative complications.

Clinical efficacy of phacoemulsification for the treatment of early primary angle-closure glaucoma

Objective To evaluate the efficacy of phacoemulsification for the treatment of early primary angle-closure glaucoma (PACG). Methods The data of 54 eyes of 47 cases of primary chronic angle-closure glaucoma from Sep. 2016 to Feb. 2018 were retrospectively analyzed. Patients were randomly divided into two groups. Group A, 29 eyes of 23 cases, underwent phacoemulsification and intraocular lens implantation. Group B, 25 eyes of 24 cases, underwent peripheral iridectomy. All patients were followed-up for 6 months. Results The preoperative intraocular pressure was (22.48±6.95) mmHg (1 mmHg=0.133 kPa) in group A and (22.48±6.95) mmHg in group B, the difference was not statistically significant (t=0.124, P=0.905). The intraoperative pressure of the two groups at any time points after surgery were lower than those before surgery, the difference was statistically significant (P<0.05). At 3 days and 6 months after surgery, the visual acuity of group A was improved, the difference were statistically significant between before and after surgery (t=-7.710, -7.012; P=0.000, 0.000). The visual acuity of group B was not changed 3 days and 6 months after surgery, the difference were not significant (t=0.184, 0.744; P=0.855, 0.460). The depth of central anterior chamber in group A after surgery was significantly deeper than that before surgery (t=-24.021, P=0.000). The peripheral anterior chamber in group A was significantly deeper than that before surgery (H=28.310, P=0.000). Conclusion Phacoemulsification and intraocular lens implantation for the treatment of early primary angle-closure glaucoma can reduce intraocular pressure and improve visual function. Key words: Glaucoma, angle-cloure; Phacoemulsification; Iridectomy, peripheral

Diabetic Nephropathy in Type 2 Diabetic Retinopathy Requiring Panretinal Photocoagulation.

PurposeTo investigate the risk factors of diabetic nephropathy in patients with diabetic retinopathy requiring panretinal photocoagulation (PRP) and the visual prognosis.MethodsA retrospective review of electronic medical records was conducted at Seoul St. Mary's Hospital, comprising 103 patients with type 2 diabetes mellitus and diabetic retinopathy who underwent PRP from 1996 to 2005. Patients with type 1 diabetes mellitus, non-diabetic renal disease, non-diabetic retinal disease, visually significant ocular disease, high-risk proliferative diabetic retinopathy, and advanced diabetic retinopathy were excluded. The patients were divided into three groups: no nephropathy (group 1, n = 45), microalbuminuria (group 2, n = 16), and advanced nephropathy (group 3, n = 42). Duration of diagnosis of retinopathy and nephropathy, glycosylated hemoglobin, visual acuity, complications, and treatment history were investigated.ResultsThe mean glycosylated hemoglobin of group 3 (8.4 ± 1.2) was higher than that of group 1 (7.7 ± 1.0) or group 2 (7.7 ± 1.0) (p = 0.04). Mean interval from PRP to diagnosis of nephropathy was 8.8 ± 6.0 years in group 2 and 8.7 ± 4.9 years in group 3. The significant decrease in visual acuity in group 3 (28 eyes, 35.9%) was significantly higher than that in group 1 (15 eyes, 18.1%, p = 0.01) or group 2 (6 eyes, 20.7%, p = 0.03). Only vitreous hemorrhage showed a significantly higher incidence in groups 2 and 3 than in group 1 (p = 0.02). Multivariate regression analysis revealed that female sex and lower glycosylated hemoglobin were significantly associated with a protective effect on development of nephropathy.ConclusionsIn the clinical setting, many patients with PRP-requiring diabetic retinopathy develop nephropathy an average of 8 to 9 years after PRP. Male sex and higher glycosylated hemoglobin could be risk factors of nephropathy.

Reductions in final visual acuity occur even within the first 3 days after a macula-off retinal detachment

PurposeTo determine if final visual acuity (VA) is affected by duration of macular detachment (DMD) within the first week of macula-off retinal detachment (RD).MethodsThis is a retrospective study of eyes...

Factors Associated With Lack of Vision Improvement in Children With Cortical Visual Impairment.

Improvement in vision has been noted in children with cortical visual impairment (CVI), resulting from disparate types of brain injury. The purpose of our study was to determine the risk factors associated with poor recovery of vision in this group of patients. Case records of children who were born before 2010 with at least 4 follow-up visits for CVI were reviewed for underlying etiologies of CVI, visual acuity (VA), and associated neurological and ophthalmological disorders. VA was assessed in 6 qualitative grades. Changes in VA were recorded as the difference between the grades of VA at presentation and the last follow-up visit. The outcome was calculated as a ratio of actual improvement to potential improvement in grades of qualitative VA. Multiple linear regression determined factors associated with lack of vision improvement in all children and based on etiology. Fifty-three children with CVI were identified. The median age at presentation was 13.6 months (range: 2.9-76.4 months) and the median follow-up was 5.8 years (1.1-16.3 years). CVI resulted from central nervous system (CNS) malformation (9.4%), hypoxic/inflammatory injury (15.1%), seizures (24.5%), and combined causes (51.0%). Vision improvement was noted in 83% of children. Lack of VA improvement was associated with older age at presentation in all children with CVI and within each etiological group except CNS malformation. None of the other investigated variables were associated with poor recovery of VA. Most of the children with CVI showed improvement in vision. Older age at presentation, but not etiology of CVI, was associated with poor improvement in VA.

Polypoidal choroidal vasculopathy (PCV): the 4-year review of the real-life treatment experiences.

PurposeThe purpose of this article was to study the real-life treatment results of polypoidal choroidal vasculopathy (PCV).DesignThis was a retrospective study.MethodsPatients with presumed age-related macular degeneration were reviewed, and PCV diagnosis was made using the EVEREST study criteria. Outcomes were changes in visual acuity (VA) and central retinal thickness, time between treatments, follow-up time, and number of treatments.ResultsThe prevalence of PCV was 30.8%. At the beginning, 195 eyes received monotherapy of anti-vascular endothelial growth factor (anti-VEGF) injections, either bevacizumab or ranibizumab, and only six eyes received the combination of anti-VEGF injection and photodynamic therapy (PDT) at the time of the first treatment. During the follow-up, some patients received “rescue or add-on” PDT when they had a poor response after anti-VEGF injections. After 4 years, the average number of injections was 8.25 and 9.15 for the anti-VEGF monotherapy and the combination groups, respectively. The average time between the first anti-VEGF injections and the first PDT was 21.4 months. The average VA in the anti-VEGF monotherapy group increased by 1.5 letters, whereas it decreased by 0.95 letters in the combination group (P=0.48).ConclusionThe review demonstrated the same visual outcomes between the combination therapy of anti-VEGF injections and rescue or add-on PDT vs monotherapy anti-VEGF injections in PCV treatment. When compared with EVEREST II and Planet studies, the “initial” or “rescue or add-on PDT” might have different effects on the final visual outcomes.

Macular Thickness and Mesopic Visual Acuity in Healthy Older Subjects

ABSTRACTPurpose/Aim: Impaired mesopic visual acuity (VA) is a risk factor for incident early age-related macular degeneration (AMD) This study examines relationships between macular thickness measurements and photopic or mesopic VA in healthy eyes.Materials and Methods: In 38 young and 39 older healthy individuals, total, inner, and outer retinal layer (IRL and ORL) thicknesses were measured in the macula region through spectral-domain optical coherence tomography (SD-OCT). Measurements were made across three subfields centered at the fovea: central foveal, pericentral, and peripheral. Best-corrected distance high-contrast (HC) and low-contrast (LC) VA were measured using Bailey-Lovie logMAR letter charts under photopic and mesopic luminance conditions. In addition, the low luminance deficit in VA (LLD, difference between photopic and mesopic VA) was calculated. Relationships were examined through Spearman correlation in each age group and through multiple linear regressions across all eyes.Results: No significant correlations were detected between photopic VA (HC-VA and LC-VA) and macular thickness measurements in each age group. In mesopic conditions, age and pupil size were independent predictors of HC-VA (p = 0.001) and age and pericentral ORL thickness predictors of LC-VA (p = 0.001). Central foveal thickness emerged as the unique independent predictor of LLD (HC-VA, p = 0.013 and LC-VA, p = 0.005). Only in the older age group, was central foveal thicknesses correlated with LLD (HC-VA, r = + 0.45; p = 0.004 and LC-VA, r = + 0.33, p = 0.038).Conclusions: Greater macular thicknesses were related to worse mesopic VA and low luminance deficit in healthy subjects.

Long-term results of photodynamic therapy or ranibizumab for polypoidal choroidal vasculopathy in LAPTOP study.

We previously reported that ranibizumab performed better on visual prognosis than photodynamic therapy (PDT) in a Ranibizumab (Lucentis) And Photodynamic Therapy On Polypoidal choroidal vasculopathy (LAPTOP) study. To determine if the first-choice treatment, either PDT or intravitreal ranibizumab, has a long-term effect in patients with polypoidal choroidal vasculopathy (PCV). We reviewed medical records of patientsrandomised to either PDT (29 eyes) or ranibizumab (27 eyes) from July 2009 to June 2011 in LAPTOP study. Retreatment or switching to other treatments were at the investigator's discretion after release from the 2-year LAPTOP study up to 5years. We evaluated visual acuity (VA), continuity of initial treatment, percentage of dry macula achievement and macular atrophy at 5 years. The logarithm of minimal angle of resolution VA was 0.56 in the PDT and 0.44 in the ranibizumab groups at baseline (p=0.101) and was 0.55 and 0.28 at 5years, respectively (p<0.05). More than 70% of the patients converted to aflibercept in following years. Achievement percentages of dry macula were 74% (PDT) and 63% (ranibizumab) at 5years, and macular atrophy was detected in 78% (PDT) and 60% (ranibizumab) with a mean area of 7.7 and 3.5 mm2, respectively (p=0.155). The better VA in the initial ranibizumab group compared with the PDT group at 2 years was retained at the 5-year follow-up.

Effect of discontinued oral antithrombotics during perioperative period of retinal detachment surgery

Objective To observe the effect of discontinued oral antithrombotics during perioperative period of retinal detachment surgery on the efficacy and cardio-cerebral-vascular system. Methods The data of 46 eyes of 46 cases of early retinal detachment, who sustained oral prophylactic antithrombotics were analyzed retrospectively.All cases were divided into 2 groups randomly: group A, the total of 25 eyes suspended oral antithrombotics at 7 days before vitrectomy and continued oral antithrombotics at 7 days after vitrectomy. The group B, the total of 21 eyes did not suspend oral administration of antithrombotic agents before vitrectomy. All cases of two groups underwent vitrectomy under non-contact wild-angle viewing system and chandelier. The visual recovery, postoperative hemorrhage and effect on cardio-cerebral-vascular system were analyzed. Results BCVA of two groups were improved after vitrectomy (P=0.001, 0.000). The difference of intra- and post-operative hemorrhage was not significant between the two groups (P=0.410, 0.940). No cardiovascular or cerebrovascular event occurred during perioperative period. The waiting time for vitrectomy of group A was longer than that of group B (P=0.000), and the rate of silicone oil tamponade of group A was higher than that of group B (P=0.023). At the last follow-up, the visual acuity of group B was significantly better than that of group A (P=0.000). Conclusion The oral antithrombotics could not be suspended during perioperation of vitrectomy. Key words: Detachment, retinal; Vitrectomy; Antithrombotics; Hemorrhage; Visual acuity

Endogenous Endophthalmitis: Has the Opioid Crisis Impacted the Rates and Severity of Intravenous Drug-Related Cases?

Purpose:Endogenous endophthalmitis is an intraocular infection associated with systemic illness and/or intravenous drug use (IVDU). Rising national rates of IVDU may have impacted rates and outcomes of endogenous endophthalmitis. The purpose of the current study is to compare rates and treatment outcomes in endogenous endophthalmitis with and without a history of IVDU.Methods:This is a single-center retrospective consecutive case series of 21 eyes of 17 patients with a diagnosis of endogenous endophthalmitis from May 2014 to December 2016. Clinical characteristics and treatment outcomes were compared between IVDU and non-IVDU groups.Results:A history of IVDU was present in 3 of 17 patients (18%), whereas the other 82% had systemic comorbidities. There was no statistically significant difference in presenting visual acuity (VA) between the IVDU and non-IVDU groups (20/630 vs 20/500, P = .75). Pars plana vitrectomy was performed at some point in the clinical course of 80% of eyes (4/5) in the IVDU group and 56% of eyes (9/16) in the non-IVDU group. Staphylococcus or Candida were the predominant causative organisms isolated in the IVDU and non-IVDU groups. Statistical analyses revealed trends towards worse last VA in the non-IVDU group compared with the IVDU group (20/1000 vs 20/110, P = .10).Conclusions:Compared with historical data from the same institution, there has not been an increase in the rates of IVDU-associated endogenous endophthalmitis at this tertiary referral center. VA outcomes are often poor in both groups, but there may be a better prognosis for IVDU-associated endogenous endophthalmitis.