Eye最新文献

Introduction: Involutional ptosis repair is the signature procedure of Oculoplastic surgeons, with significant variation in approach. We aimed to assess the surgical approach currently used by BOPSS members for routine involutional ptosis repair.

Methods: A prospective 7-question survey was carried out of BOPSS members, assessing for prevalence of anterior- versus posterior-approach, bilateral simultaneous versus staged surgery, and approach to clinical photography.

Results: Of the respondents (n = 73), for routine involutional ptosis repair, 66% perform predominantly anterior-approach ptosis repair, 18% perform a mix of either anterior or posterior approach depending on the patient, and 16% perform predominantly posterior-approach ptosis repair. In bilateral ptosis, most respondents (84.9%) perform bilateral simultaneous surgery in one sitting, versus performing staged surgery (15.1%). Clinical photography is routinely obtained pre-operatively by most respondents (74%). Respondents varied in time post completion of training (CCT); the largest group (35.6%) had >15 years post certificate of (CCT) experience. Approach was not associated with experience.

Conclusions: Anterior-approach ptosis repair remains the most common approach to ptosis repair in this cohort, though posterior approach is increasing in popularity. Bilateral simultaneous surgery is most often performed, though not by all surgeons. Approach does not vary with experience level.

Background: Otitic hydrocephalus is increased intracranial pressure without ventricular dilation secondary to mastoiditis and cerebral venous sinus thrombosis (CVST). It is associated with significant visual morbidity, though more detailed data on visual outcomes is lacking. We sought to better characterize the management of increased intracranial pressure and visual outcomes in this population.

Methods: Retrospective chart review at a quaternary Children's Hospital of patients <18 years of age who were diagnosed with otitic hydrocephalus from January 2009 to July 2023. Data were collected on patient demographics, clinical course, imaging, and treatment outcomes.

Results: Fifteen patients were identified with mastoiditis complicated by otitic hydrocephalus. The average age was 5.7 years (range 2-15). Eight patients were male (53%). Six patients (40%) had cranial nerve VI palsy and 14 (93%) developed papilloedema. Eleven patients (73%) developed progressively worsening papilloedema despite improving infection, clot burden, and acetazolamide; of these, three required ventriculostomy catheters. Eight were started on corticosteroids. Six had resolution of papilloedema without the need for shunt placement. Two patients had evidence of optic atrophy from increased ICP and visual loss prior to corticosteroid initiation. Both had stabilization of their condition without further visual loss.

Conclusion: This study highlights the importance of systemic corticosteroids as part of the treatment paradigm for otitic hydrocephalus to prevent vision loss in patients otherwise unresponsive to medical management. It also identifies the risk of papilloedema progression and visual morbidity even after the initiation of appropriate medical therapy. Visual outcomes were significantly improved and invasive neurosurgical procedures were avoided with use of corticosteroids.

Background/objectives: The risk of depression in patients with non-arteritic anterior ischemic optic neuropathy (NAION) has yet to be thoroughly researched. This study aimed to investigate the association between NAION and the onset of depression using a large-scale nationwide cohort in South Korea.

Methods: This is a retrospective, nationwide cohort study involving 145,020 subjects without NAION and 29,004 individuals with a previous NAION diagnosis. Follow-up clinical data were collected until December 31, 2017. Multivariable adjustment models were employed to account for potential confounding factors.

Results: The incidence of new-onset depression was significantly higher among NAION patients (incidence, 38.09 per 1000 person-years) than among non-NAION individuals (incidence, 29.91 per 1000 person-years). After adjusting for demographic factors, socioeconomic status, and comorbid diseases, the association remained significant (aHR = 1.271; 95% CI = 1.226-1.317). Notably, a subgroup analysis highlighted a particularly pronounced risk of depression in NAION patients aged 40 to 64 compared to those aged 65 or older (aHR = 1.34 vs. 1.207; interaction P = 0.0038).

Conclusion: Our findings demonstrate a significant association between NAION and an increased risk of depression, especially in relatively younger patients aged 40 to 64 years. These results highlight the importance of regular monitoring and early intervention for depressive symptoms in patients with NAION.