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Clinical Risk Score for Prediction of Urgency in Carotid Cavernous Sinus Fistulas. 预测颈动脉海绵窦瘘急症的临床风险评分。
IF 2.2 Q3 OPHTHALMOLOGY Pub Date : 2023-01-01 DOI: 10.2147/OPTH.S419844
Pawasoot Supasai, Kanwasee Kanjana, Yosanan Yospaiboon

Purpose: To develop a clinical risk score for the prediction of urgency in patients with carotid cavernous sinus fistulas (CCFs) and test for the discriminative ability of the diagnostic prediction.

Methods: The medical charts of 60 patients with CCFs were retrospectively reviewed. The clinical characteristics of direct and dural CCFs were analyzed by logistic regression. The clinical risk score was developed from the coefficient in the multivariable regression model and used to predict direct CCFs which were more urgent than the dural type. The score prediction was reported as an area under the receiver operating characteristic (AuROC) curve and 95% confidence interval (95% CI).

Results: In a univariable analysis, the clinical characteristics which increased the risk of direct CCFs were age, gender, trauma, underlying diseases, visual acuity (VA) at presentation, bruit, chemosis, and dilated retinal vessels. However, in multivariable analysis, the significant predictors were limited to age, trauma, bruit, underlying diseases and logMAR VA. Regression coefficient of each predictor was converted to a risk score and summation of scores from these predictors for each patient was calculated. The total risk score predicted the urgent direct CCFs correctly with AuROC of 97.77% (95% CI; 93.57, 100).

Conclusion: The clinical risk score for the prediction of urgent direct CCFs has been developed and used in the patients with CCFs in our setting. The discriminative ability of the score prediction is high. This simple clinical risk score may help clinicians suspect direct CCFs and urgently refer the patients to have prompt angiography and treatment.

目的:建立预测颈动脉海绵窦瘘(CCFs)患者急症的临床风险评分,并检验其诊断预测的判别能力。方法:回顾性分析60例CCFs患者的病历资料。采用logistic回归分析直接和硬脑膜CCFs的临床特点。临床风险评分由多变量回归模型中的系数得出,用于预测直接CCFs,后者比硬脑膜型更为紧急。评分预测报告为受试者工作特征(AuROC)曲线下的面积和95%置信区间(95% CI)。结果:在一项单变量分析中,增加直接CCFs风险的临床特征是年龄、性别、创伤、基础疾病、就诊时视力(VA)、瘀伤、化脓和视网膜血管扩张。然而,在多变量分析中,显著的预测因子仅限于年龄、创伤、bruit、基础疾病和logMAR VA。每个预测因子的回归系数转换为风险评分,并计算每个患者这些预测因子的评分总和。总风险评分正确预测紧急直接CCFs, AuROC为97.77% (95% CI;93.57, 100)。结论:用于预测急迫性直接CCFs的临床风险评分已被开发并应用于本院CCFs患者。分数预测的判别能力较高。这个简单的临床风险评分可以帮助临床医生怀疑直接CCFs,并紧急推荐患者及时进行血管造影和治疗。
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引用次数: 0
Direct and Dural Carotid Cavernous Sinus Fistulas: Comparison of Clinical Characteristics. 直接颈动脉海绵窦瘘与硬膜颈动脉海绵窦瘘的临床特点比较。
IF 2.2 Q3 OPHTHALMOLOGY Pub Date : 2023-01-01 DOI: 10.2147/OPTH.S410930
Pawasoot Supasai, Kanwasee Kanjana, Yosanan Yospaiboon

Purpose: To compare the clinical characteristics of patients with direct and dural carotid cavernous sinus fistulas (CCFs).

Methods: The medical records of 60 patients diagnosed with CCFs were retrospectively reviewed. The collected data included demographic characteristics, clinical findings, and ocular manifestation. The clinical characteristics of the direct and the dural CCFs were compared on head-to-head basis. Logistic regression analysis was used to demonstrate the direction and magnitude of the difference and reported as odds ratio with its 95% confidence interval.

Results: There were 28 patients (46.67%) with direct CCFs, and 32 patients (53.33%) with dural CCFs. Patients with direct CCF were mostly male (p=0.023), younger age (p<0.001), had history of trauma (p<0.001), and more visual impairment at presentation (p=0.025), when compared to those with dural CCFs. In addition, patients with direct CCF had significantly more chemosis (p=0.005), proptosis (p=0.042), bruit (p<0.001) and dilated retinal vessels (p=0.008) than those with dural CCF. Thirty patients (50%) had increased intraocular pressure (IOP). Mean IOP of the affected eyes was significantly higher than the unaffected eyes (p<0.0001). In patients with normal IOP, mean IOP of the affected eyes was also higher than the unaffected eyes (p=0.0027).

Conclusion: Patients with direct CCF were younger age, associated with trauma, and more visual impairment at presentation. Chemosis, proptosis, bruit and dilated retinal vessels were detected more in the direct CCF than the dural CCF. Despite normal IOP, affected eyes had significantly higher IOP than the unaffected eyes. Information on these clinical characteristics may be helpful in discrimination of the direct type, which is more urgent for further investigation and treatment.

目的:比较直接颈动脉海绵窦瘘与硬膜颈动脉海绵窦瘘的临床特点。方法:回顾性分析60例CCFs患者的病历资料。收集的资料包括人口统计学特征、临床表现和眼部表现。比较直接和硬脑膜CCFs的临床特点。采用Logistic回归分析来证明差异的方向和幅度,并以95%置信区间的优势比报告。结果:直接CCFs患者28例(46.67%),硬膜CCFs患者32例(53.33%)。直接CCF患者以男性居多(p=0.023),年龄较轻(p < 0.05)。结论:直接CCF患者年龄较轻,与外伤相关,就诊时视力障碍较多。与硬膜CCF相比,直接CCF中更容易发现视网膜血管增生、突出、瘀伤和扩张。尽管IOP正常,但受影响的眼睛的IOP明显高于未受影响的眼睛。这些临床特征的信息可能有助于直接型的区分,这是更迫切需要进一步的调查和治疗。
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引用次数: 2
Association Between Vitamin Deficiencies and Ophthalmological Conditions. 维生素缺乏与眼科疾病之间的关系。
IF 2.2 Q3 OPHTHALMOLOGY Pub Date : 2023-01-01 DOI: 10.2147/OPTH.S401262
Austin Pereira, R Damilola Adekunle, Michele Zaman, Michael J Wan

Vitamin deficiencies can have adverse effects on health, including on the visual system. The ocular manifestations of a vitamin deficiency are related to the underlying biochemical function of the particular nutrient. While vitamin deficiencies are not common in developed counties, they are still prevalent in parts of the developing world and in specific, vulnerable populations. Vitamin deficiencies can cause or contribute to many ophthalmological conditions and eye diseases may even be the first presenting finding of a vitamin deficiency. As such, it is important for ophthalmologists to be aware of the ocular manifestations of vitamin deficiencies, especially given that the complications can be severe and effectively treated if identified early. This review summarizes the literature on the main vitamins known to have characteristic ocular manifestations: vitamins A, B1, B2, B9, B12, C, D, E and K. The function, epidemiology, manifestations, workup, and management of each vitamin is discussed in detail.

维生素缺乏会对健康产生不利影响,包括视觉系统。维生素缺乏的眼部表现与特定营养素的潜在生化功能有关。虽然维生素缺乏症在发达国家并不常见,但在发展中国家的部分地区和特定的脆弱人群中仍然普遍存在。维生素缺乏会导致或促成许多眼科疾病,眼部疾病甚至可能是维生素缺乏的第一个表现。因此,对于眼科医生来说,了解维生素缺乏的眼部表现是很重要的,特别是考虑到如果及早发现,并发症可能很严重,并且可以有效地治疗。本文综述了目前已知的具有特征性眼部表现的主要维生素:维生素A、B1、B2、B9、B12、C、D、E和k的文献,并详细讨论了每种维生素的功能、流行病学、表现、检查和管理。
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引用次数: 0
The Combined Utilization of Epithelial Thickness Mapping and Tomography in Keratorefractive Surgery Screening: One Imaging Modality is Not Sufficient. 角膜屈光手术筛查中上皮厚度测绘和断层扫描的联合应用:一种成像方式是不够的。
IF 2.2 Q3 OPHTHALMOLOGY Pub Date : 2023-01-01 DOI: 10.2147/OPTH.S404019
Wyatt M Corbin, Carter J Payne, Hamed Momeni-Moghaddam, Yasmyne C Ronquillo, Phillip C Hoopes, Majid Moshirfar

Increasing popularity and utility of epithelial thickness mapping (ETM) in keratorefractive surgery screening may begin to inappropriately devalue the use of tomography. An increasing body of research suggests that the interpretation of ETM based solely on the corneal resurfacing function may be insufficient to screen and select patients for refractive surgery. ETM and tomography are complementary and, when used together, may provide the safest and most optimal tools for keratorefractive surgery screening.

角膜屈光手术筛查中上皮厚度测绘(ETM)的日益普及和应用可能会开始不恰当地贬低断层扫描的使用。越来越多的研究表明,仅仅基于角膜表面功能的ETM解释可能不足以筛选和选择屈光手术患者。ETM和断层扫描是互补的,当一起使用时,可以为角膜屈光手术筛查提供最安全和最优的工具。
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引用次数: 0
Timing of the Initial Postoperative Care After Cataract Surgery: A Patient's Perspective. 白内障术后初始护理的时机:一个病人的观点。
IF 2.2 Q3 OPHTHALMOLOGY Pub Date : 2023-01-01 DOI: 10.2147/OPTH.S413602
Sloan W Rush, Samuel Huseman, Ryan B Rush

Purpose: To evaluate patient preferences in regards to the timing of the initial postoperative examination after undergoing cataract surgery.

Methods: A retrospective, consecutive case series analysis from a single private practice institution was performed using a standardized phone survey on patients who underwent cataract surgery. Subjects were classified into one of two possible study groups according to the timing of their initial postoperative cataract surgery examination: Group A received the initial postoperative cataract surgery examination on the same day as the surgery, whereas Group B received the initial postoperative cataract surgery examination on the day following the operation.

Results: There were 80 subjects contacted for the phone survey of which 70 (35 in each study group) completed the survey and therefore were included in the analysis. Group A subjects responded favorably in regards to preference and realizing reduced time and cost savings compared to Group B (p < 0.0001 for both). There were no subjects in Group A who would have preferred next-day initial postoperative care, whereas 31.4% of subjects in Group B would have preferred same-day care if given the opportunity.

Conclusion: Patients undergoing cataract surgery both prefer and report time and cost savings with same-day initial postoperative care compared to next-day initial postoperative care. Patient preferences regarding their postoperative care should be one of the many factors that a surgeon ought to take into consideration when providing follow-up care after cataract surgery.

目的:评估白内障手术后患者对初次术后检查时机的偏好。方法:采用标准化电话调查方法,对一家私人诊所的白内障手术患者进行回顾性、连续的病例系列分析。根据受试者术后首次白内障手术检查的时间,将受试者分为两组:A组患者在手术当天接受术后首次白内障手术检查,B组患者在术后第二天接受术后首次白内障手术检查。结果:电话调查共联系了80名受试者,其中70人(每个研究组35人)完成了调查,因此被纳入分析。与B组相比,A组受试者在偏好方面反应良好,并且实现了减少的时间和成本节约(p < 0.0001)。A组没有患者选择术后第二天护理,而B组有31.4%的患者选择术后第二天护理。结论:与术后次日护理相比,白内障手术患者均倾向于当日护理,并报告当日护理节省了时间和费用。患者对术后护理的偏好应是外科医生在提供白内障术后随访护理时应考虑的众多因素之一。
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引用次数: 0
Axial Length Correction in Evaluation of Refractive Predictability and Biometry Agreement [Response to Letter]. 眼轴长度校正在评估屈光可预测性和生物测量一致性中的应用[回复信件]。
IF 2.2 Q3 OPHTHALMOLOGY Pub Date : 2023-01-01 DOI: 10.2147/OPTH.S435340
Bjørn Gjerdrum, Kjell Gunnar Gundersen, Christian Nilsen, Morten Gundersen, Per Jensen
RI)
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引用次数: 0
Visual Outcomes, Quality of Vision, Patient Satisfaction and Spectacle Independence After Bilateral Implantation of the Synergy™ Intraocular Lens. 双侧植入Synergy™人工晶状体后的视力结果、视力质量、患者满意度和眼镜独立性。
IF 2.2 Q3 OPHTHALMOLOGY Pub Date : 2023-01-01 DOI: 10.2147/OPTH.S421185
Joaquin O De Rojas, Helga P Sandoval, Richard Potvin, Kerry D Solomon

Purpose: To evaluate vision, visual quality, patient satisfaction and spectacle independence after bilateral implantation of the TECNIS Synergy™ intraocular lens.

Setting: Two clinical practices in the USA.

Design: Ambispective unmasked non-randomized clinical trial.

Methods: Patients with a history of uneventful bilateral femtosecond laser assisted cataract surgery with the study IOL implanted, targeted for emmetropia, at least 3 months prior to the study visit were enrolled. Monocular and binocular visual acuity (VA) were measured at distance, intermediate and near, along with binocular mesopic VA. Low contrast binocular VA and reading speed in mesopic and photopic conditions were also measured. Patient satisfaction, spectacle independence, visual symptoms, and functional vision questionnaires were completed.

Results: Results from 52 subjects were available for analysis. Mean binocular unaided visual acuity was ~0.1 logMAR (20/20) from distance to 33 cm, with 81% of subjects having 0.2 logMAR (20/25) vision or better at all test distances and 92% reporting never needing glasses at any distance. Average reading speed at 40 cm was only 10 words/minute slower in dim light (p = 0.03). Mesopic and low contrast acuity appeared good. Halos were the most frequent and bothersome visual disturbances, with the greatest effect on driving at night. Eighty-eight percent of subjects reported being "completely" or "mostly" satisfied with their overall unaided vision.

Conclusion: This hybrid technology IOL provided a range of binocular visual acuity from distance to 33 cm and good functional vision, even in dim light. Patients should be advised of the likelihood of visual disturbances, particularly halos.

目的:评价双侧人工晶状体植入术后的视力、视觉质量、患者满意度和眼镜独立性。背景:美国的两个临床实践。设计:双视角非随机临床试验。方法:在研究访视前至少3个月接受过双侧飞秒激光辅助白内障手术并植入人工晶状体的患者。分别测量了远、中、近3种情况下的单眼和双眼视力,以及双眼介观视力,并测量了中、近两种情况下的低对比度双眼视力和阅读速度。完成患者满意度、眼镜独立性、视觉症状和功能视力问卷调查。结果:52名受试者的结果可供分析。从距离到33 cm的平均双眼无辅助视力为~0.1 logMAR(20/20), 81%的受试者在所有测试距离的视力为0.2 logMAR(20/25)或更好,92%的受试者报告在任何距离都不需要眼镜。在昏暗的光线下,40厘米处的平均阅读速度仅慢10个字/分钟(p = 0.03)。中视和低对比度视力良好。光晕是最常见和最烦人的视觉干扰,对夜间驾驶的影响最大。88%的受试者报告说,他们对自己的整体独立视觉“完全”或“大部分”满意。结论:该混合型人工晶状体可提供远至33 cm范围内的双眼视力,即使在昏暗光线下也具有良好的功能视力。应告知患者可能出现视觉障碍,特别是光晕。
{"title":"Visual Outcomes, Quality of Vision, Patient Satisfaction and Spectacle Independence After Bilateral Implantation of the Synergy™ Intraocular Lens.","authors":"Joaquin O De Rojas,&nbsp;Helga P Sandoval,&nbsp;Richard Potvin,&nbsp;Kerry D Solomon","doi":"10.2147/OPTH.S421185","DOIUrl":"https://doi.org/10.2147/OPTH.S421185","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate vision, visual quality, patient satisfaction and spectacle independence after bilateral implantation of the TECNIS Synergy™ intraocular lens.</p><p><strong>Setting: </strong>Two clinical practices in the USA.</p><p><strong>Design: </strong>Ambispective unmasked non-randomized clinical trial.</p><p><strong>Methods: </strong>Patients with a history of uneventful bilateral femtosecond laser assisted cataract surgery with the study IOL implanted, targeted for emmetropia, at least 3 months prior to the study visit were enrolled. Monocular and binocular visual acuity (VA) were measured at distance, intermediate and near, along with binocular mesopic VA. Low contrast binocular VA and reading speed in mesopic and photopic conditions were also measured. Patient satisfaction, spectacle independence, visual symptoms, and functional vision questionnaires were completed.</p><p><strong>Results: </strong>Results from 52 subjects were available for analysis. Mean binocular unaided visual acuity was ~0.1 logMAR (20/20) from distance to 33 cm, with 81% of subjects having 0.2 logMAR (20/25) vision or better at all test distances and 92% reporting never needing glasses at any distance. Average reading speed at 40 cm was only 10 words/minute slower in dim light (p = 0.03). Mesopic and low contrast acuity appeared good. Halos were the most frequent and bothersome visual disturbances, with the greatest effect on driving at night. Eighty-eight percent of subjects reported being \"completely\" or \"mostly\" satisfied with their overall unaided vision.</p><p><strong>Conclusion: </strong>This hybrid technology IOL provided a range of binocular visual acuity from distance to 33 cm and good functional vision, even in dim light. Patients should be advised of the likelihood of visual disturbances, particularly halos.</p>","PeriodicalId":10442,"journal":{"name":"Clinical ophthalmology","volume":"17 ","pages":"2277-2285"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c6/27/opth-17-2277.PMC10423583.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10358895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Magnification and Refocusing Comparison in Cataract Surgery Using a Heads-Up Three-Dimensional Visualization System versus Conventional Binocular Microscopy. 使用平视三维可视化系统与传统双目显微镜在白内障手术中的放大和再聚焦比较。
IF 2.2 Q3 OPHTHALMOLOGY Pub Date : 2023-01-01 DOI: 10.2147/OPTH.S423372
Mariana Ramírez Mejía, Leticia Arroyo Muñoz, Ana Beatriz Medina Perez, Cristina Mendoza Velasquez, Jimena Ceja Martínez, Azyadeh Camacho Ordonez, Oscar Guerrero-Berger
Purpose To compare magnification and refocusing during phacoemulsification with the NGENUITY® 3-D Visualization System (3-D) versus the conventional microscope (CM) OPMI LUMERA 700. Setting This study was performed in the Department of Anterior Segment of the Fundación Hospital Nuestra Señora de la Luz. Design Prospective, randomized, cross-sectional, multi-surgeon, and comparative study. Methods This study enrolled 100 patients (eyes) scheduled for phacoemulsification to measure the number of times changes in focusing and magnification were needed during cataract surgery. Results Our study included 100 patients. From the endpoints evaluated, “zoom-in” showed statistically significant differences for all of the four predefined cataract surgery steps (means: Step 1, 0.38 (CM) vs 0.08 (3-D); Step 2, 0.36 (CM) vs 0.06 (3-D); Step 3, 0.54 (CM) vs 0.22 (3-D); Step 4, 0.56 (CM) vs 0.24 (3-D); all comparisons, p <0.05). In Step 4, there was a statistically significant increased use of “focus-out” for the 3-D system (mean 0.16 (CM) vs 0.58 (3-D); p <0.05). “Focus-in” and “zoom-out” showed no group differences for all steps. The duration of surgery with the 3-D system was longer at each step and overall. The percentage of light intensity did not show a statistically significant difference between both systems, with a mean of 99.45 for CM vs 98.43% for the heads-up system. Conclusion The heads-up 3-D system is a safe option that offers excellent magnification for anterior segment visualization. The surgical time is longer, but adjusting settings like light intensity and brightness may facilitate some surgical steps early in the learning curve.
目的:比较NGENUITY® 3-D可视化系统(3-D)和传统显微镜(CM) OPMI LUMERA 700在超声乳化术中的放大和再聚焦效果。背景:本研究在Fundación Nuestra Señora de la Luz医院前段科进行。设计:前瞻性、随机、横断面、多外科医生、比较研究。方法:本研究纳入100例拟行超声乳化手术的患者(眼),测量白内障手术过程中需要改变聚焦和放大倍率的次数。结果:我们的研究纳入了100例患者。从评估的终点来看,“放大”在所有预定义的四个白内障手术步骤中显示出统计学上的显著差异(平均值:步骤1,0.38 (CM) vs 0.08 (3d);步骤2,0.36 (CM) vs 0.06 (3d);步骤3,0.54 (CM) vs 0.22 (3d);步骤4,0.56 (CM) vs 0.24 (3d);结论:平视三维系统是一种安全的选择,为前段可视化提供了良好的放大倍率。手术时间较长,但调整光线强度和亮度等设置可能有助于在学习曲线的早期进行一些手术步骤。
{"title":"Magnification and Refocusing Comparison in Cataract Surgery Using a Heads-Up Three-Dimensional Visualization System versus Conventional Binocular Microscopy.","authors":"Mariana Ramírez Mejía,&nbsp;Leticia Arroyo Muñoz,&nbsp;Ana Beatriz Medina Perez,&nbsp;Cristina Mendoza Velasquez,&nbsp;Jimena Ceja Martínez,&nbsp;Azyadeh Camacho Ordonez,&nbsp;Oscar Guerrero-Berger","doi":"10.2147/OPTH.S423372","DOIUrl":"https://doi.org/10.2147/OPTH.S423372","url":null,"abstract":"Purpose To compare magnification and refocusing during phacoemulsification with the NGENUITY® 3-D Visualization System (3-D) versus the conventional microscope (CM) OPMI LUMERA 700. Setting This study was performed in the Department of Anterior Segment of the Fundación Hospital Nuestra Señora de la Luz. Design Prospective, randomized, cross-sectional, multi-surgeon, and comparative study. Methods This study enrolled 100 patients (eyes) scheduled for phacoemulsification to measure the number of times changes in focusing and magnification were needed during cataract surgery. Results Our study included 100 patients. From the endpoints evaluated, “zoom-in” showed statistically significant differences for all of the four predefined cataract surgery steps (means: Step 1, 0.38 (CM) vs 0.08 (3-D); Step 2, 0.36 (CM) vs 0.06 (3-D); Step 3, 0.54 (CM) vs 0.22 (3-D); Step 4, 0.56 (CM) vs 0.24 (3-D); all comparisons, p <0.05). In Step 4, there was a statistically significant increased use of “focus-out” for the 3-D system (mean 0.16 (CM) vs 0.58 (3-D); p <0.05). “Focus-in” and “zoom-out” showed no group differences for all steps. The duration of surgery with the 3-D system was longer at each step and overall. The percentage of light intensity did not show a statistically significant difference between both systems, with a mean of 99.45 for CM vs 98.43% for the heads-up system. Conclusion The heads-up 3-D system is a safe option that offers excellent magnification for anterior segment visualization. The surgical time is longer, but adjusting settings like light intensity and brightness may facilitate some surgical steps early in the learning curve.","PeriodicalId":10442,"journal":{"name":"Clinical ophthalmology","volume":"17 ","pages":"2333-2339"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/67/0b/opth-17-2333.PMC10439775.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10405105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of Short and Long-Tunnel Needle Track for Ahmed Glaucoma Valve Implantation in a Private Eye Center in the Philippines: A Retrospective Study. 菲律宾一家私人眼科中心艾哈迈德青光眼瓣膜植入术的短、长隧道针径比较:回顾性研究。
IF 2.2 Q3 OPHTHALMOLOGY Pub Date : 2023-01-01 DOI: 10.2147/OPTH.S405924
Marie Jeremy B San Pedro, James Paul S Gomez, Edgar U Leuenberger

Purpose: This study aimed to compare the success and complication rates among patients implanted with Ahmed Glaucoma Valve (AGV) using the short and long tunnel technique through retrospective chart review.

Patients and methods: We reviewed 54 charts of adult patients who underwent AGV implantation using a Short-Needle Track (SNT) or Long-Needle Track (LNT) technique. Intraocular pressures (IOP), Best Corrected Visual Acuity (BCVA) and number of medications were recorded pre-operatively, and at Day 1, 3, 7, Month 1, 3, 6 post-operatively. Treatment success, occurrence of Hypertensive Phase (HP), complication and procedures done after AGV implantation were compared between the two groups using one-tailed Z-test of proportions.

Results: A total of 20 (LNT) and 21 (SNT) charts were included in the study. There was no significant difference between the median postoperative IOP, BCVA, and number of anti-glaucoma medications between the two groups at each time interval. The comparison between the occurrence of HP (P = 0.435) and success rates (P = 0.476) between the two groups yielded no significant difference. Flat/shallow anterior chamber (AC) was seen exclusively in three eyes (14%) in the SNT group (P = 0.039). There was one occurrence of plate exposure in the LNT group (P = 0.149).

Conclusion: The LNT technique of AGV Implantation may be used as an alternative to the traditional SNT (with autologous graft). The long needle track offers the advantage reducing the risk of complications arising from shallow anterior chamber post-operatively.

目的:通过回顾性图表分析,比较短隧道技术和长隧道技术青光眼瓣膜(AGV)植入术的成功率和并发症发生率。患者和方法:我们回顾了54例使用短针径(SNT)或长针径(LNT)技术进行AGV植入的成人患者的病历。分别于术前、术后第1天、第3天、第7个月、第1个月、第3个月、第6个月记录眼内压(IOP)、最佳矫正视力(BCVA)及用药次数。采用单尾比例z检验比较两组患者的治疗成功率、高血压期(HP)发生率、并发症及AGV植入后的手术情况。结果:共纳入LNT图20张,SNT图21张。两组各时间间隔的术后中位IOP、BCVA、抗青光眼药物数量无显著差异。两组HP发生率(P = 0.435)和成功率(P = 0.476)比较,差异无统计学意义。SNT组仅有3只眼(14%)出现扁平/浅前房(AC) (P = 0.039)。LNT组出现1例钢板暴露(P = 0.149)。结论:AGV移植的LNT技术可作为传统SNT(自体移植)的替代技术。长针径的优点是减少了术后浅前房并发症的风险。
{"title":"Comparison of Short and Long-Tunnel Needle Track for Ahmed Glaucoma Valve Implantation in a Private Eye Center in the Philippines: A Retrospective Study.","authors":"Marie Jeremy B San Pedro,&nbsp;James Paul S Gomez,&nbsp;Edgar U Leuenberger","doi":"10.2147/OPTH.S405924","DOIUrl":"https://doi.org/10.2147/OPTH.S405924","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare the success and complication rates among patients implanted with Ahmed Glaucoma Valve (AGV) using the short and long tunnel technique through retrospective chart review.</p><p><strong>Patients and methods: </strong>We reviewed 54 charts of adult patients who underwent AGV implantation using a Short-Needle Track (SNT) or Long-Needle Track (LNT) technique. Intraocular pressures (IOP), Best Corrected Visual Acuity (BCVA) and number of medications were recorded pre-operatively, and at Day 1, 3, 7, Month 1, 3, 6 post-operatively. Treatment success, occurrence of Hypertensive Phase (HP), complication and procedures done after AGV implantation were compared between the two groups using one-tailed Z-test of proportions.</p><p><strong>Results: </strong>A total of 20 (LNT) and 21 (SNT) charts were included in the study. There was no significant difference between the median postoperative IOP, BCVA, and number of anti-glaucoma medications between the two groups at each time interval. The comparison between the occurrence of HP (P = 0.435) and success rates (P = 0.476) between the two groups yielded no significant difference. Flat/shallow anterior chamber (AC) was seen exclusively in three eyes (14%) in the SNT group (P = 0.039). There was one occurrence of plate exposure in the LNT group (P = 0.149).</p><p><strong>Conclusion: </strong>The LNT technique of AGV Implantation may be used as an alternative to the traditional SNT (with autologous graft). The long needle track offers the advantage reducing the risk of complications arising from shallow anterior chamber post-operatively.</p>","PeriodicalId":10442,"journal":{"name":"Clinical ophthalmology","volume":"17 ","pages":"1691-1699"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/35/7f/opth-17-1691.PMC10290859.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10095449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of Color Fundus Photography and Multicolor Fundus Imaging for Detection of Lesions in Diabetic Retinopathy and Retinal Vein Occlusion. 彩色眼底摄影与彩色眼底成像对糖尿病视网膜病变及视网膜静脉阻塞病变检测的比较。
IF 2.2 Q3 OPHTHALMOLOGY Pub Date : 2023-01-01 DOI: 10.2147/OPTH.S414603
Catarina Castro, João Heitor Marques, Nisa Silva, Ana Carolina Abreu, Maria João Furtado, Miguel Lume

Purpose: To evaluate the agreement between conventional fundus photography (CFP) and multicolor fundus imaging (MFI) for the detection of lesions of diabetic retinopathy (DR) and retinal vein occlusion (RVO).

Methods: Cross-sectional analysis of eyes with DR or RVO who underwent CFP and MFI. All images were independently analyzed by two observers (O1 and O2), and the evaluated lesions were classified as "present" or "absent". Then, a paired comparison between both exams of the same eye was performed, to assess which made it easier to detect the lesions.

Results: Considering DR, the agreement was substantial for cotton wool spots and photocoagulation scars for both observers (O1: κ=0.75 and κ=0.67; O2: κ=0.71 and κ=0.64, respectively) and for hard exudates for O1 (κ=0.80). These lesions were detected more frequently on MFI. Regarding RVO, the agreement was considered substantial for venous sheathing by O1 (κ=0.64) and moderate for optociliary shunts by O2 (κ=0.60). Optociliary shunts were detected more frequently in CPF by both observers and venous sheathing on MFI by O1. For microaneurysms, retinal hemorrhages, retinal neovascularization, and proliferative membranes, in DR, and retinal hemorrhages, venous engorgement, and retinal neovascularization in RVO, the agreement was almost perfect (κ>0.82). In the paired analysis, both observers considered that, in DR, microaneurysms and retinal hemorrhages were easier to detect on CFP and that retinal neovascularization, cotton wool spots, and photocoagulation scars were easier to identify on MFI. Regarding RVO, optocilliary shunts were easier to identify on CFP and venous engorgement on MFI.

Conclusion: The agreement of MFI and CFP was substantial to almost perfect for most lesions. MFI seems better to detect cotton wool spots and photocoagulations scars in DR and venous sheathing in RVO. Optocilliary shunts seem easier to detect on CFP.

目的:评价常规眼底摄影(CFP)与多色眼底成像(MFI)在糖尿病视网膜病变(DR)和视网膜静脉闭塞(RVO)病变检测中的一致性。方法:对行CFP和MFI的DR或RVO眼进行横断面分析。所有图像由两位观察者(O1和O2)独立分析,并将评估的病变分类为“存在”或“不存在”。然后,对同一只眼睛的两种检查进行配对比较,以评估哪种检查更容易发现病变。结果:考虑DR,观察双方对棉絮斑和光凝疤痕的一致性是显著的(O1: κ=0.75和κ=0.67;O2: κ=0.71, κ=0.64),硬渗出物为O1 (κ=0.80)。MFI更常发现这些病变。在RVO方面,O1对静脉鞘的一致性是显著的(κ=0.64), O2对光睫状体分流的一致性是中等的(κ=0.60)。光睫状体分流在CPF中被观察者和MFI静脉鞘检测的频率更高。对于微动脉瘤、视网膜出血、视网膜新生血管和增殖膜,DR和RVO的视网膜出血、静脉充血和视网膜新生血管,两者的一致性几乎是完美的(κ>0.82)。在配对分析中,两位观察者都认为在DR中,CFP上更容易发现微动脉瘤和视网膜出血,而MFI上更容易发现视网膜新生血管、棉絮斑和光凝疤痕。对于RVO, CFP更容易识别光睫状体分流,MFI更容易识别静脉充血。结论:MFI和CFP在大多数病变中基本一致,几乎完全一致。MFI似乎可以更好地检测DR中的棉絮斑点和光凝疤痕和RVO中的静脉鞘。光睫状体分流似乎更容易在CFP上发现。
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引用次数: 0
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Clinical ophthalmology
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