RESUMEN
OBJECTIVES: The study aimed to investigate the relationship between subjective oral frailty and adverse health outcomes or medical and dental expenditures in the latter-stage older adult through a 6-year longitudinal study. METHODS: The participants enrolled in the cross-sectional study were 3564 Tokushima City residents aged 75, 80, 85, and 90 years old who received oral health examinations and who responded to a questionnaire on oral conditions and health behavior at baseline. The data for the occurrence of disability or mortality, and the monthly medical expenditures, dental expenditures, and total medical expenditure of each participant were obtained from the National Health Insurance Database. RESULTS: The total medical expenditure showed significant differences in participants who had difficulties in eating tough foods, difficulties in swallowing tea or soup, and dry mouth when compared to that of healthy participants, in addition to the current medical treatment against the general disease. The 6-year longitudinal study revealed that participants with subjective oral frailty symptoms, including difficulties in eating tough foods and difficulties in swallowing tea or soup at baseline, had significantly higher medical, dental, and total expenditures among 538 participants without certified nursing care. In addition, those with subjective oral frailty or with less than 19 teeth present were shown to have a higher possibility for the occurrence of disability or mortality by the cox proportional hazard analysis. Furthermore, it was found that medical and total expenditures in older adults with adverse health outcomes were higher than that of healthy participants. CONCLUSION: These results suggest that subjective oral frailty in the latter-stage older adult is related to subsequent adverse health outcomes and an increase in medical and dental expenditures.
Asunto(s)
Fragilidad , Humanos , Anciano , Estudios Longitudinales , Gastos en Salud , Estudios Transversales , Evaluación de Resultado en la Atención de Salud , TéRESUMEN
SYNOPSIS/PRECIS: We investigated the relationship between contrast sensitivity (CS) and vision-related quality of life (VR-QOL) in patients with central retinal vein occlusion following ranibizumab intravitreal injection; CS showed a stronger association with VR-QOL than visual acuity. BACKGROUND/AIMS: To investigate the relationship between CS, VR-QOL and optical coherence tomography (OCT) findings in patients with cystoid macular oedema secondary to central retinal vein occlusion (CRVO-CMO) following intravitreal injection of ranibizumab. METHODS: This was a multicentre, open-label, single-arm, prospective study. The study included 23 patients with CRVO-CMO who were followed up for 12 months after treatment. The best-corrected visual acuity (BCVA), letter contrast sensitivity (LCS) and OCT images were obtained every month. For VR-QOL assessment, the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) was administered to the patients before treatment and at 3, 6 and 12 months following treatment. RESULTS: The LCS and VFQ-25 composite score improved significantly from baseline to 12 months following treatment. The multiple regression analysis revealed that the LCS of the affected eye and BCVA of the fellow eye were related to the VFQ-25 composite score following treatment. The LCS improvement showed a significant correlation with the improvement in the VFQ-25 composite score, whereas the BCVA improvement was not correlated with the improvement in the VFQ-25 composite score. Stepwise multiple regression analyses revealed that, at the time of macular oedema resolution, the distance between the external limiting membrane and retinal pigment epithelium (ELM-RPE) and average ganglion cell-inner plexiform layer (GCIPL) thickness were associated with LCS. CONCLUSION: CS had a stronger association with VR-QOL than with BCVA in patients with CRVO-CMO. With the resolution of macular oedema, CS was associated with ELM-RPE thickness and average GCIPL thickness.
Asunto(s)
Edema Macular , Oclusión de la Vena Retiniana , Humanos , Sensibilidad de Contraste , Inyecciones Intravítreas , Edema Macular/diagnóstico , Edema Macular/tratamiento farmacológico , Edema Macular/etiología , Estudios Prospectivos , Calidad de Vida , Ranibizumab/uso terapéutico , Oclusión de la Vena Retiniana/complicaciones , Oclusión de la Vena Retiniana/diagnóstico , Oclusión de la Vena Retiniana/tratamiento farmacológico , Tomografía de Coherencia ÓpticaRESUMEN
The aim of the present study was to investigate changes in metamorphopsia in patients with diabetic macular edema (DME) following intravitreal aflibercept injection (IVA) with the treat and extend (TAE) regimen for a year. We performed a post hoc analysis of a multicenter, open-label, single-arm, prospective study. The study included 20 patients with DME. All eyes received 3 monthly loading injections of 2 mg aflibercept, followed by a TAE regimen. Every visit, the severity of metamorphopsia and the best-corrected visual acuity (BCVA) were evaluated, and optical coherence tomography (OCT) images were obtained. The severity of metamorphopsia was measured using M-CHARTS. The metamorphopsia scores before treatment and at 1, 2, 3, 6 and 12 months following treatment were 0.25 ± 0.23, 0.21 ± 0.15, 0.19 ± 0.23, 0.14 ± 0.16, 0.17 ± 0.20 and 0.10 ± 0.17, respectively, with significant improvement from before treatment to 3 and 12 months following treatment (p < 0.05 and p < 0.005, respectively). At the time of macular edema resolution, the presence of an epiretinal membrane (ERM) was associated with the metamorphopsia score (p < 0.05). In conclusion, the metamorphopsia score in patients with DME improved following IVA with the TAE regimen for one year. The presence of ERM was associated with the metamorphopsia score.
Asunto(s)
Diabetes Mellitus , Retinopatía Diabética , Membrana Epirretinal , Edema Macular , Receptores de Factores de Crecimiento Endotelial Vascular , Humanos , Inhibidores de la Angiogénesis/efectos adversos , Diabetes Mellitus/tratamiento farmacológico , Retinopatía Diabética/complicaciones , Retinopatía Diabética/tratamiento farmacológico , Membrana Epirretinal/complicaciones , Inyecciones Intravítreas , Edema Macular/complicaciones , Estudios Prospectivos , Receptores de Factores de Crecimiento Endotelial Vascular/uso terapéutico , Proteínas Recombinantes de Fusión/efectos adversos , Tomografía de Coherencia Óptica , Resultado del Tratamiento , Trastornos de la Visión , Agudeza VisualRESUMEN
To evaluate the vision-related quality of life (VR-QOL) treated by intravitreal ranibizumab (IVR) in patients with branch retinal vein occlusion (BRVO) and to assess subscale items of the VR-QOL. This was prospective, multicenter, open-label, observational study including 38 patients with unilateral BRVO who underwent IVR treatment and 28 age-matched healthy subjects. VR-QOL using the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) and best-corrected visual acuity (BCVA) were examined before and at 3, 6, and 12 months after treatment. The VFQ-25 composite score and BCVA significantly improved from 3 to 12 months after IVR treatment (P < 0.05), such that there was no significant difference between the BRVO and control groups at 12 months. All subscales of the VFQ-25, except "general health", significantly improved after treatment, while "near vision" and "mental health" were worse than those in healthy subjects (P < 0.05). Patients with superior BRVO had a lower "near vision" score than healthy subjects after treatment (P < 0.05). BCVA in the treated eye and fellow eye had no significant relationship with the VFQ-25 composite score before and after treatment. The VR-QOL of patients with BRVO improved with IVR treatment and was comparable to that of healthy subjects after 12 months. Superior BRVO particularly affected near vision for a low level.
Asunto(s)
Ranibizumab , Oclusión de la Vena Retiniana , Inhibidores de la Angiogénesis/uso terapéutico , Humanos , Inyecciones Intravítreas , Estudios Prospectivos , Calidad de Vida , Ranibizumab/uso terapéutico , Agudeza VisualRESUMEN
Visual functions that affect vision-related quality of life (VR-QoL) before and after intravitreal injection of ranibizumab in patients with cystoid macular edema secondary to central retinal vein occlusion (CRVO-CME) are poorly understood. This multicenter, open-label, single-arm prospective study included 23 treatment-naïve patients with CRVO-CME. The best-corrected visual acuity (BCVA), letter contrast sensitivity (LCS), severity of metamorphopsia (M-CHARTS), amount of aniseikonia (New Aniseikonia Test), and stereopsis (Titmus Stereo Test and TNO stereotest) were examined every month from before treatment to 12 months after treatment. For VR-QoL assessment, the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) was provided to the patients before treatment and at 3, 6, and 12 months after treatment. Stepwise multiple regression analysis revealed that the BCVA of the fellow eye was related to the VFQ-25 composite score before treatment, and that the BCVA of the fellow eye and TNO values were related to the VFQ-25 composite score 12 months after treatment. Changes in LCS were significantly correlated with changes in the VFQ-25 composite score. In patients with CRVO-CME, visual acuity of the fellow eye had the strongest impact on VR-QoL. The contrast sensitivity of the affected eye and stereopsis were also associated with VR-QoL.
RESUMEN
Background: To investigate the relationship between stereopsis and vision-related quality of life (VR-QOL) in patients with branch retinal vein occlusion (BRVO) before and after treatment with intravitreal ranibizumab (IVR). Methods: This prospective multicentred observational study included 37 patients undergoing IVR treatment for unilateral BRVO and 24 age-matched healthy controls.Stereopsis was evaluated using the TNO stereo test (TNO) and Titmus stereo test (TST) every month, and the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) was administered at baseline, then at 3, 6 and 12 months after treatment. Results: Time course of the changes in stereopsis and VR-QOL. IVR treatment significantly reduced central fovea thickness and improved both the TNO and the TST from 2 to 12 months (both p<0.05). Stereopsis before and after IVR injection in the eyes with BRVO were significantly worse than those in control subjects (TNO, p<0.001; TST, p<0.001). The VFQ-25 composite score significantly improved from 3 to 12 months after IVR treatment (p<0.05). Univariate analysis showed that the TNO score at baseline was significantly correlated with the VFQ-25 composite score at baseline and after treatment (p<0.05, p<0.05, respectively). TST score was not associated with the VFQ-25 composite score at baseline or after treatment. Conclusions: Treatment with IVR for BRVO improved cystoid macular oedema, which was correlated to improved stereopsis, although not to the control level. The TNO score at baseline was associated with VR-QOL in patients with BRVO.
Asunto(s)
Oclusión de la Vena Retiniana , Inhibidores de la Angiogénesis/uso terapéutico , Preescolar , Percepción de Profundidad , Humanos , Estudios Prospectivos , Calidad de Vida , Ranibizumab/uso terapéutico , Oclusión de la Vena Retiniana/tratamiento farmacológico , Agudeza VisualRESUMEN
The influence of dry eye disease (DED) on ocular biometric measurements is unclear. We aimed to investigate the effect of DED on the repeatability of ocular biometric measurements in cataract patients. Overall, 114 eyes scheduled for cataract surgery were enrolled. Before surgery, DED parameters including tear film break-up time (BUT), corneal and conjunctival staining scores, and subjective symptoms were examined. Corneal curvature radius and axial length were assessed twice on the same day using IOLMaster-500 (Carl Zeiss Meditec), and the absolute difference between the two measurements was calculated and used as an index of measurement repeatability. The measurement repeatability of the steep meridian of corneal curvature radius was significantly worse in eyes with DED than in those without DED (p = 0.044) and was significantly associated with BUT (r = -0.206, p = 0.031). The measurement repeatability of axial length was negatively correlated with BUT (r = -0.199, p = 0.041) and positively correlated with the corneal staining score (r = 0.253, p = 0.009). In conclusion, the measurement repeatability of corneal curvature radius declined in eyes with DED. Shortened BUTs were associated with a deterioration in the measurement repeatability of corneal curvature radius and axial length.
RESUMEN
PURPOSE: To compare laser photocoagulation and intravitreal injection of bevacizumab (IVB) treatment for retinopathy of prematurity (ROP). METHODS: The study included 52 eyes of 26 patients after ROP treatment who were observed up to 5 years of age. Twenty-eight eyes received laser photocoagulation as the initial treatment (laser group), and twenty-four eyes underwent IVB (IVB group). We collected data on gestational age, birth weight, 1- and 5-min Apgar scores, zone and stage at the time of treatment, recurrence of ROP and best-corrected visual acuity (BCVA) (logMAR), equivalent spherical value (SE), ocular complications, and developmental delay at the age of 5. RESULTS: More zone I low-stage eyes were treated with IVB than laser. There was no difference in BCVA (p = 0.836). Although the mean SE was not different between the groups (p = 0.280), the prevalence of myopia was significantly higher in the laser group (p = 0.020). Developmental delay was observed in 3 of 14 and 3 of 12 cases in the laser and IVB groups, respectively (p = 0.596). Retinal holes were observed in 2 eyes in the IVB group, with 1 developing localized retinal detachment. There were no significant differences between the groups in the other factors. CONCLUSIONS: Compared to laser for ROP, IVB was not inferior in neurodevelopment or visual outcome and was superior in refractive error. As cases in the IVB group showed retinal holes, long-term follow-up with fundus examination is recommended after IVB.
Asunto(s)
Retinopatía de la Prematuridad , Inhibidores de la Angiogénesis/uso terapéutico , Bevacizumab/uso terapéutico , Edad Gestacional , Humanos , Recién Nacido , Inyecciones Intravítreas , Coagulación con Láser , Rayos Láser , Retinopatía de la Prematuridad/diagnóstico , Retinopatía de la Prematuridad/tratamiento farmacológico , Retinopatía de la Prematuridad/cirugía , Estudios Retrospectivos , Resultado del Tratamiento , Factor A de Crecimiento Endotelial VascularAsunto(s)
Lesiones Oculares Penetrantes/fisiopatología , Percepción/fisiología , Agudeza Visual/fisiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Niño , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Adulto JovenRESUMEN
Oral health status is known to be associated with lifestyle-related diseases such as diabetes and chronic kidney disease. In Japan, around 40% of hemodialysis cases are patients with diabetic nephropathy. The aim of this study was to clarify the association between oral health status and diabetic nephropathy-related indices in Japanese middle-aged men. Sixty-six men (age range: 55-64 years) with ≥20 remaining teeth and who received public medical checkups and oral examinations were enrolled. We examined correlations of age, body mass index, HbA1c, HDL-C, LDL-C, neutral fat, serum creatinine, and the estimated glomerular filtration rate (eGFR) with the number of remaining teeth or the community periodontal index (CPI) score (periodontal pocket < 4 mm: 0, 4-6 mm: 1, ≥6 mm: 2). A positive correlation between the CPI score and serum creatinine and a negative correlation between CPI score and eGFR (Spearman's rank correlation coefficient, r = 0.459, p < 0.01, and r = -0.460, p < 0.01, respectively) were observed. The mean eGFR in the CPI score 0 group was significantly higher than that in the CPI score 1/2 group (82.6 vs. 70.7, Student's t-test, p < 0.01). Logistic regression analysis using eGFR as a dependent variable and age, CPI score, body mass index, HbA1c, and neutral fat as independent variables suggested that low eGFR (<60) could be attributed to CPI score (OR = 3.169, 95% CI: 1.031-9.742, p = 0.044). These results suggest a possible association between periodontal status and renal function in Japanese middle-aged men. Periodontal condition is controlled by oral prophylaxis, and periodontal disease and chronic kidney disease have some common risk factors. Thus, periodontal management can contribute to the prevention of severe chronic kidney disease.
Asunto(s)
Creatinina/metabolismo , Diabetes Mellitus/metabolismo , Nefropatías Diabéticas/metabolismo , Tasa de Filtración Glomerular , Índice Periodontal , Insuficiencia Renal Crónica/metabolismo , Índice de Masa Corporal , HDL-Colesterol/metabolismo , LDL-Colesterol/metabolismo , Diabetes Mellitus/epidemiología , Nefropatías Diabéticas/epidemiología , Hemoglobina Glucada/metabolismo , Humanos , Japón/epidemiología , Pruebas de Función Renal , Modelos Logísticos , Masculino , Persona de Mediana Edad , Salud Bucal , Bolsa Periodontal , Insuficiencia Renal Crónica/epidemiologíaRESUMEN
PURPOSE: To investigate the clinical characteristics and visual outcomes of patients with work-related open globe injuries (OGIs) and compare them with patients with non-work-related OGIs. DESIGN: Retrospective, observational, multicentre, case-control study. METHODS: A total of 374 patients with work-related OGIs and 170 patients with non-work-related OGIs who presented to hospitals that belong to the Japan-Clinical Research of Study group from 2005 to 2015 were included in this study. Clinical data including age, sex, initial and final visual acuity, type of open globe injury, lens status, zone of injury, wound length, and presence of proliferative vitreoretinopathy, retinal detachment, expulsive haemorrhage, and endophthalmitis were recorded. MAIN OUTCOME MEASURES: Visual acuity. Results Work-related OGIs were associated with younger age, male sex, better initial and final visual acuity, more laceration, smaller wounds, presence of retinal detachment, and expulsive haemorrhage, compared with non-work-related OGIs. Multiple regression analysis revealed that final visual acuity is significantly associated with initial visual acuity, wound length, and the presence of proliferative vitreoretinopathy in work-related OGIs. CONCLUSIONS: Work-related OGIs showed better visual outcomes than other OGIs. Initial visual acuity, wound length, and the presence of proliferative vitreoretinopathy are predictors of visual outcomes in patients with work-related OGIs.
Asunto(s)
Lesiones Accidentales/patología , Lesiones Oculares Penetrantes/patología , Traumatismos Ocupacionales/patología , Lesiones Accidentales/complicaciones , Lesiones Accidentales/terapia , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Niño , Preescolar , Lesiones Oculares Penetrantes/complicaciones , Lesiones Oculares Penetrantes/terapia , Femenino , Estudios de Seguimiento , Humanos , Japón , Masculino , Persona de Mediana Edad , Traumatismos Ocupacionales/complicaciones , Traumatismos Ocupacionales/terapia , Estudios Retrospectivos , Resultado del Tratamiento , Agudeza Visual , Vitreorretinopatía Proliferativa/etiología , Heridas y Lesiones/patología , Adulto JovenRESUMEN
This study investigated the changes in the severity of aniseikonia after surgery for macula-off retinal detachment (RD), and the relationship between aniseikonia and retinal microstructures. The study included 26 eyes of 26 patients undergoing RD surgery. Visual acuity was measured preoperatively, and at 3, 6, and 12 months postoperatively. Degree of aniseikonia and OCT images were obtained at 3, 6, and 12 months postoperatively. The aniseikonia values (mean ± standard deviation) at 3, 6, and 12 months postoperatively were -5.3 ± 4.2%, -4.4 ± 4.4%, and -3.1 ± 3.2%, respectively. Significant improvement was observed from 3 to 12 months postoperatively (P = 0.001). Twelve months postoperatively, 14 eyes had micropsia, 1 eye had macropsia, and 11 eyes were free of aniseikonia. Stepwise multiple regression analyses revealed that the severity of aniseikonia at 12 months postoperatively was significantly associated with postoperative development of cystoid macular edema (CME) and epiretinal membrane (ERM), as well as area of preoperative RD. In conclusion, although aniseikonia was gradually relieved after RD surgery during a 1-year follow-up period, approximately half of patients had aniseikonia and almost all of them had micropsia. Aniseikonia was associated with presence of postoperative CME, ERM, and area of preoperative RD.
Asunto(s)
Aniseiconia/fisiopatología , Mácula Lútea/cirugía , Desprendimiento de Retina/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Aniseiconia/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Agudeza Visual , Adulto JovenRESUMEN
PURPOSE: To evaluate the short-term changes in intraocular pressure (IOP) after intravitreal injection of bevacizumab (IVB) in premature infants with retinopathy of prematurity (ROP). STUDY DESIGN: Prospective cohort study. METHODS: Twenty-two eyes of 11 premature infants with ROP were evaluated. The control eyes were from adults who received an intravitreal injection of antivascular endothelial growth factor agent. The patients received a 0.025 mL (0.625 mg) IVB for the ROP. The IOP was measured with a rebound tonometer at baseline, immediately after the injection, and at 5, 10, 15, 20, and 30 minutes after the injection. The clinical data were collected. The main outcome measures were the IOP values at baseline, immediately after the injection, and at 5, 10, 15, 20, and 30 minutes after the injection. RESULTS: The mean IOP values at baseline, immediately after the injection, and at 5, 10, 15, 20, and 30 minutes after the injection were 12.3 ± 3.0, 40.1 ± 10.7, 20.8 ± 5.1, 15.1 ± 4.8, 11.9 ± 3.2, 9.9 ± 2.6, and 8.8 ± 2.1 mmHg, respectively. The IOP was significantly higher at 5 minutes after the injection (P < .01); however, the pressure in all the eyes normalized (< 21 mmHg) within 15 minutes. None of the clinical parameters, including axial length, was correlated with a high IOP after IVB. CONCLUSION: In premature infants with ROP, IVB is tolerable in terms of the short-term elevation in IOP, which returned to a safe range (< 21 mmHg) within 15 minutes of the injection in all the patients. Consecutive IOP measurement might not be necessary after IVB in premature infants with ROP.
Asunto(s)
Bevacizumab/administración & dosificación , Presión Intraocular/fisiología , Retinopatía de la Prematuridad/tratamiento farmacológico , Agudeza Visual , Inhibidores de la Angiogénesis/administración & dosificación , Femenino , Estudios de Seguimiento , Edad Gestacional , Humanos , Recién Nacido , Presión Intraocular/efectos de los fármacos , Inyecciones Intravítreas , Masculino , Estudios Prospectivos , Receptores de Factores de Crecimiento Endotelial Vascular/antagonistas & inhibidores , Retinopatía de la Prematuridad/fisiopatología , Factores de Tiempo , Resultado del TratamientoRESUMEN
PURPOSE: To describe the epidemiology and clinical outcomes of open globe injuries (OGIs) in Japan over 10 years, and examine preoperative factors influencing the visual prognosis after surgery. STUDY DESIGN: Retrospective, observational, multicenter case-series study. METHODS: Patients' data were entered into a computerized database for review and statistical analyses. The following parameters were assessed; age, gender, initial and final visual acuity, duration between onset and surgery, presence of lens in the eye, characteristics of injury, presence of ocular complications, and number of surgeries. RESULTS: The records of 374 eyes with OGI were enrolled. The average age of the patients was 56.8 ± 22.1 years, and the majority of patients were men (73.5%). Compared to the overall cohort, work-related OGI was the most common, associated with significantly better final visual acuity, whereas patients with fall-down OGI showed significantly worse final visual acuity (P < 0.05). Among the types of injury, both the initial and final visual acuity were significantly worse in the rupture group than in the laceration group. Multiple liner regression analyses revealed that the final visual acuity was significantly associated with initial visual acuity, type of injury (rupture), retinal detachment, and proliferative vitreoretinopathy. CONCLUSION: To predict the visual outcome in patients with OGI, ophthalmologists need to pay attention not only to the initial visual acuity but also to initial ocular conditions, such as the presence of ocular complications.
Asunto(s)
Lesiones Oculares/epidemiología , Agudeza Visual , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Lesiones Oculares/clasificación , Lesiones Oculares/diagnóstico , Femenino , Humanos , Incidencia , Japón/epidemiología , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Distribución por Sexo , Índices de Gravedad del Trauma , Adulto JovenRESUMEN
PURPOSE: To evaluate the clinical characteristics and visual outcomes of patients with traffic accident-related open globe injuries, and to examine preoperative factors influencing the visual prognosis after pars plana vitrectomy, as compared with common open globe injuries. METHODS: Patients with open globe injuries, who underwent pars plana vitrectomy, were identified. Patients' demographic and clinical data were entered into a computerized database for review and analysis; data included age, sex, initial visual acuity, duration between onset of injury and surgery, information about the type and cause of injury, wound location and length, presence of ocular complications, and final visual acuity. RESULTS: Of the 355 open globe injuries, 14 were sustained during a traffic-related accident; the average age was 50.4 years (range: 20-85) and most (78.6%) were men. Of these 14 patients, 9 (64.3%) presented with rupture and 5 (35.7%) with laceration. Injuries were caused while driving (6 eyes; 42.9%), riding a bicycle (5 eyes; 35.7%), involved in car accident while walking (2 eyes; 14.3%), and riding a motorbike (1 eye; 7.1%). Initial visual acuity was significantly related to final visual acuity (P = 0.003, R = 0.80). The final visual acuity in patients with traffic accident-related open globe injuries was significantly better than that of the total group (P = 0.01). CONCLUSION: Traffic accident-related open globe injuries had better visual outcomes than common open globe injuries. Visual outcomes in patients with traffic accident-related open globe injuries were related to the initial visual acuity. No eyes developed endophthalmitis in patients with traffic accident-related open globe injuries.
Asunto(s)
Accidentes de Tránsito/estadística & datos numéricos , Lesiones Oculares Penetrantes/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Conducción de Automóvil , Ciclismo/lesiones , Lesiones Oculares Penetrantes/fisiopatología , Lesiones Oculares Penetrantes/cirugía , Femenino , Humanos , Japón/epidemiología , Laceraciones/epidemiología , Laceraciones/fisiopatología , Laceraciones/cirugía , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Rotura/epidemiología , Rotura/fisiopatología , Rotura/cirugía , Agudeza Visual/fisiología , Vitrectomía , Adulto JovenRESUMEN
PURPOSE: A surgical technique is described that facilitates membrane peeling in patients with macular diseases by using small amounts of perfluorocarbon liquid (PFCL) and brilliant blue G (BBG) dye. STUDY DESIGN: Retrospective cohort study. METHODS: After placing about 1.0-1.5 cc PFCL on the macular area, BBG was applied with a 27-gauge blunt needle at the interface of PFCL and retina. The membrane peeling was performed under PFCL. RESULTS: The amount of BBG dye with PFCL-assisted staining technique has the potential to be smaller than in conventional staining method. Since the displacement angle of the membrane during peeling procedures is considerably increased by PFCL, combined with its high specific gravity and interfacial tension, the risk of tearing the membrane during manipulation is reduced to a great extent. The postoperative visual function in patients with PFCL-assisted peeling was comparable to that of patients without PFCL-assisted peeling. CONCLUSION: The PFCL-assisted technique enables sufficient membrane staining with minimal amounts of BBG dye, with tearing of the epiretinal membrane or internal limiting membrane being less likely than with the conventional method.
Asunto(s)
Membrana Basal/cirugía , Colorantes/farmacología , Membrana Epirretinal/cirugía , Fluorocarburos/administración & dosificación , Perforaciones de la Retina/cirugía , Coloración y Etiquetado/métodos , Vitrectomía/métodos , Anciano , Anciano de 80 o más Años , Membrana Basal/diagnóstico por imagen , Membrana Epirretinal/diagnóstico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Perforaciones de la Retina/diagnóstico , Estudios Retrospectivos , Agudeza VisualRESUMEN
PURPOSE: To investigate the clinical characteristics and visual outcomes in patients with fall-related open globe injuries and to evaluate differences between fall-related and non-fall-related open globe injuries in Japan. METHODS: A retrospective review of patients with open globe injury who presented to Japan-Clinical Research of Study (J-CREST) hospitals between 2005 and 2015 was enrolled. Clinical information including age, sex, initial visual acuity, final visual acuity, type of injury, status of the crystalline lens, zone of injury, wound length, presence of retinal detachment, proliferative vitreoretinopathy, expulsive hemorrhage, and endophthalmitis was recorded. RESULTS: A total of 374 eyes were enrolled, of which 120 (32.1%) suffered from fall-related injury with average age of 73.7 ± 15.9 years (range, 11-101 years). A majority of patients were female (55.8%). Of 120 patients with fall-related injury, 109 (90.8%) presented with rupture and 11 (9.2%) with laceration. A multiple regression analysis revealed that final visual acuity was significantly associated with initial visual acuity (r = 0.99, P < 0.001). Compared to non-fall-related open globe injuries, fall-related open globe injuries were associated with elderly age, female sex, poorer initial and final visual acuity, rupture, absence of the lens, larger wound size, retinal detachment, expulsive hemorrhage, and absence of endophthalmitis (P < 0.01). CONCLUSIONS: Fall-related open globe injuries were more frequent in elderly female and accompanied by larger wound lengths and severer ocular complications. Visual outcomes in patients with fall-related open globe injuries were related to initial visual acuity.
Asunto(s)
Accidentes por Caídas/estadística & datos numéricos , Lesiones Oculares Penetrantes/etiología , Medición de Riesgo/métodos , Agudeza Visual , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Lesiones Oculares Penetrantes/diagnóstico , Lesiones Oculares Penetrantes/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Japón/epidemiología , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Rotura , Distribución por Sexo , Índices de Gravedad del Trauma , Adulto JovenAsunto(s)
Traumatismos en Atletas/epidemiología , Lesiones Oculares Penetrantes , Agudeza Visual , Adulto , Traumatismos en Atletas/complicaciones , Lesiones Oculares Penetrantes/diagnóstico , Lesiones Oculares Penetrantes/etiología , Lesiones Oculares Penetrantes/fisiopatología , Femenino , Salud Global , Humanos , Incidencia , Masculino , Persona de Mediana Edad , PronósticoRESUMEN
PURPOSE: To evaluate the effects of intravitreal ranibizumab injection (IVR) on metamorphopsia in patients with branch retinal vein occlusion (BRVO) and to assess the relationship between retinal microstructure and metamorphopsia. METHODS: Subjects were 39 eyes of 39 patients with branch retinal vein occlusion. The severity of metamorphopsia was quantified using the M-CHARTS before and 1, 2, 3, 4, 5, and 6 months after treatment. Based on optical coherence tomography (OCT) images, we assessed central retinal thickness (CRT) and status of the external limiting membrane (ELM) and ellipsoid zone (EZ). The association between retinal microstructure and metamorphopsia was analyzed in 24 eyes with treatment-naïve branch retinal vein occlusion. RESULTS: Intravitreal ranibizumab injection treatment significantly improved best-corrected visual acuity (BCVA) and central retinal thickness (P < 0.0001, P < 0.0001, respectively), but metamorphopsia did not improve by treatment. Posttreatment metamorphopsia scores showed a significant correlation with duration of symptoms (P < 0.05) and pretreatment metamorphopsia scores (P < 0.01). Posttreatment metamorphopsia score was significantly worse in patients with disruption of external limiting membrane (P < 0.05). CONCLUSIONS: In patients with branch retinal vein occlusion, intravitreal ranibizumab injection treatment significantly improved best-corrected visual acuity and central retinal thickness, but not metamorphopsia. The severity of posttreatment metamorphopsia was significantly associated with duration of symptoms, degree of pretreatment metamorphopsia, and posttreatment integrity of external limiting membrane.
Asunto(s)
Inhibidores de la Angiogénesis/uso terapéutico , Ranibizumab/uso terapéutico , Oclusión de la Vena Retiniana/tratamiento farmacológico , Trastornos de la Visión/tratamiento farmacológico , Adulto , Anciano , Femenino , Humanos , Inyecciones Intravítreas , Masculino , Persona de Mediana Edad , Retina/patología , Oclusión de la Vena Retiniana/patología , Tomografía de Coherencia Óptica , Trastornos de la Visión/patologíaRESUMEN
PURPOSE: To investigate changes in metamorphopsia after rhegmatogenous retinal detachment surgery and to evaluate the relationship between metamorphopsia and retinal microstructures assessed with optical coherence tomography. METHODS: The study included 47 eyes of 47 patients undergoing retinal detachment surgery. We examined the severity of metamorphopsia using M-CHARTS, best-corrected visual acuity, and optical coherence tomography images. All data were recorded before and 3, 6, and 12 months after surgery, except for M-CHARTS which were recorded only postoperatively. RESULTS: Metamorphopsia scores at 3, 6, and 12 months postoperatively were 0.46 ± 0.51, 0.41 ± 0.44, and 0.28 ± 0.37, respectively, with significant improvement from 3 months to 12 months after surgery. Significant metamorphopsia (score ≥0.2) was present in 49% of patients at 12 months postoperatively. Multiple regression analysis revealed that metamorphopsia score at 12 months was significantly related to the status of macula and interdigitation zone. In patients with macula-off retinal detachment, improvement of metamorphopsia scores was associated with an increase in thickness of external limiting membrane-retinal pigment epithelium. CONCLUSION: After successful retinal detachment surgery, metamorphopsia gradually improved, but nearly half of the patients still exhibited metamorphopsia at 12 months postoperatively. Disruption of interdigitation zone and external limiting membrane-retinal pigment epithelium thickness was related to metamorphopsia.