Visual Aquity Research Articles

Evolution of visual acuity in patients with wet type of AMD and good initial visual aquity

Abstract Purpose The evaluation of wet type of AMD after intravitreal injections with anti‐angiogenic factors in patients with good initial visual aquity. Correlation between final and initial visual acuity, as well as with the number of injections Methods 101 patients of average age 76 participated in the study. All of them suffered from wet type of AMD. Study group included 24 of them with good initial visual acuity, defined as visual acuity of 6/10 of the decimal scale or higher. The remaining 77 patients served as control group. The initial evaluation included full ophthalmologic examination, OCT imaging and fluorescein angiography. The decision for the treatment was based on the findings of the first examination and of the monthly reevaluation thereafter. Results In the 24 patients of the study group, visual acuity increased significantly from 0,61 (+/‐0,2) to 0,82 (+/‐0,2) in decimal scale or from 0,27 (+/‐0,22) to 0,14 (+/‐0,2) in LOGMAR scale (p<0,001). The average number of intravitreal injections was 4,9 in a mean monitoring time of 9 months. In this team the final visual acuity depends on the initial one (p= 0,013), but not on the number of intravitreal injections (p> 0,05). Conclusion the final visual acuity in the group with good initial visual acuity correlates well with the initial visual acuity and does not correlate with the number of injections. This finding shows the significance of early diagnosis of subretinal neovascularisation in AMD, when the vision is still high.

Keratoprosthesis surgery: Eastern European and Russian devices

Abstract Purpose To present the development and current status of keratoprosthesis surgery in Eastern Europe. Methods Collection of data from coauthors and other surgeons involved in k‐pro surgery. Results Large numbers of surgeries were performed in Filatov's Institute in Odessa (Ukraine), where over 1000 different types of devices developed by Puchkovskaya, Yakimienko and Golubenko were imlanted since 1966. The last model, s.c. "universal separable device" was implanted in over 750 with the best results (extrusion occured in about 2.5% cases). K‐pro devices in Russia were mostly developed by S. Fyodorov Z. Moroz, V. Zuyev, ?. Krasnov, V. Volkov, R. Gundorova, N. Ushakov and V. Bedilo. Over 1500 surgeries sine 1969 resulted in the visual aquity improvement in 94% of cases. Haptics were made of titanium, stainless steel and also biocompatible materials (xenopericardium). In Poland about 100 surgeries were performed using mostly Russian and Ukrainian devices. The results were less favorable than in countries of origin. Small numbers were also implanted in other East European states. Conclusion In former Soviet Union keratoprosthesis surgery was well developed in selected centers (Moscow, Odessa). Surgeons in these places have gained extraordinary experience performing hundredes of surgeries. The results presented by the authors were excellent, however they were less favorable in the hands of surgeons from other countries.

Regression of Sight-Threatening Macular Edema in Type 2 Diabetes Following Treatment With the Anti–Tumor Necrosis Factor Monoclonal Antibody Infliximab

Diabetic retinopathy and diabetic macular edema (DME) are leading causes of blindness in an increasing number of patients with diabetes (1). Reduction of visual aquity in DME results from accumulation of fluid produced from a rupture of the blood-retinal barrier into the inner nuclear layer of the retina (1,2). Although the etiology of DME is unclear, an altered local expression of the pleiotropic cytokine tumor necrosis factor (TNF) may play an important pathogenetic role (2–5). Standard treatment of clinically significant DME consisting of laser photocoagulation reduces the risk of vision loss in 60% of cases, but recurrences are common, even among those patients who achieve an initial response (1). Various pharmacological therapies are currently under study, including intavitreal triamcinolone injections (6) or high doses of nonsteroidal anti-inflammatory agents that lower retinal expression of TNF (7). The monoclonal anti-TNF antibody Infliximab neutralizes TNF actions and has been used for inflammatory arthritic conditions and Crohn’s disease since 1998 with a favorable safety profile (8). Because of the limitations of current treatments for DME, and based on our recent findings indicating that Infliximab is an effective therapy for cystoid macular edema associated with uveitis (9–11), we decided to give Infliximab for sight-threatening refractory DME. Four women, aged 52–76 years, with type 2 …

Surgeon factor on laser in situ keratomileusis in low and moderate myopia

The purpose of this study was to evaluate the effectiveness and predictability of laser in situ keratomileusis (LASIK) procedure performed by three surgeons in low and moderate myopia. One hundred twenty nine eyes from 68 patients underwent LASIK procedure, performed by three different surgeons (X, Y, Z) using the same procedure and same instruments were reviewed. These patients are divided into two groups, group A (below – 6.00 diopters) and group B (between – 6.00 and –10.00 diopters). Patients were observed on day 1, day 7, 1st month and 3rd month. Results: The evaluation of effectiveness and predictability is based upon uncorrected visual acuity (UCVA) and spherical equivalent refraction, respectively. The variation dispersion between attempted correction and achieved correction is measured using coefficient of determination (R2). The statistical analysis shows indifferent results for the three surgeons. The conclusion was that the effectiveness and predictability of LASIK procedure performed by the three surgeons in both groups are indifferent. Hence, this study suggests that the surgeon factor does not affect the result of LASIK procedure. (Med J Indones 2003; 12: 148-54) Keywords: LASIK, spherical equivalent, visual aquity