RESUMEN
PURPOSE: To evaluate whether 23-gauge (23 G) pars plana vitrectomy is associated with earlier visual recovery compared with standard 20-gauge (20 G) pars plana vitrectomy. METHODS: Retrospective chart review of patients who underwent pars plana vitrectomy for various indications was performed. Thirty consecutive eyes in each group of 23-G and 20-G pars plana vitrectomy were analyzed. The mean decimal acuity of each patient was recorded at baseline, Day 1, and Weeks 1 and 6. The visual acuity on postoperative Day 1 and Week 1 was calculated as a proportion of the visual acuity at Week 6. The primary outcome measure was the rate of gain in visual acuity. The secondary outcome measures were intraocular pressure and surgical time. RESULTS: The baseline visual acuity between the two groups was similar. The mean visual acuity on Day 1 (0.05 ± 0.09 20 G versus 0.16 ± 0.18 23 G; Snellen equivalent 20/400 versus 20/125; P = 0.004) and Week 1 (0.12 ± 0.20 20 G versus 0.30 ± 0.27 23 G; Snellen equivalent 20/160 versus 20/63; P = 0.002) was significantly better in the 23-G pars plana vitrectomy group. There was no significant difference in best-corrected Snellen visual acuity at Week 6 between the 2 groups. Eighty-three percent of the mean final visual acuity was attained by Week 1 in the 23-G group compared with only 43% in the 20-G group. CONCLUSION: Twenty-three gauge pars plana vitrectomy is associated with faster visual recovery compared with 20-G pars plana vitrectomy.
Asunto(s)
Microcirugia/métodos , Recuperación de la Función/fisiología , Agudeza Visual/fisiología , Vitrectomía/métodos , Membrana Epirretinal/cirugía , Femenino , Humanos , Presión Intraocular/fisiología , Masculino , Persona de Mediana Edad , Desprendimiento de Retina/cirugía , Estudios Retrospectivos , Factores de Tiempo , Hemorragia Vítrea/cirugíaAsunto(s)
Infecciones Virales del Ojo/diagnóstico , Paperas/diagnóstico , Retinitis/diagnóstico , Atrofia , Niño , Ensayo de Inmunoadsorción Enzimática , Humanos , Inmunoglobulina G/sangre , Masculino , Virus de la Parotiditis/inmunología , Parotiditis/diagnóstico , Parotiditis/virología , Retina/patología , Retinitis/virología , Panencefalitis Esclerosante Subaguda/diagnóstico , Panencefalitis Esclerosante Subaguda/virologíaRESUMEN
PURPOSE: Genes involved in the complement cascade such as complement factor B (CFB) and complement component C2 have been implicated in age-related macular degeneration (AMD) worldwide. In continuation of the analysis of CFH and LOC387715/HTRA1, this study was conducted to gain understanding of the role of CFB and C2 in an Indian AMD cohort. METHODS: Single nucleotide polymorphisms in CFB and C2 were screened in a cohort of clinically well-characterized patients with AMD (n = 177) and unaffected normal control subjects (n = 175). Screening was accomplished by a combination of customized genotyping followed by validation through resequencing. In addition, genotyping of two CFB variants (rs12614 and rs641153) that were in close proximity had to be resolved by resequencing. Estimates of allele and genotype frequencies, odds ratios, Hardy-Weinberg equilibrium, linkage disequilibrium (LD), and haplotype frequencies were also performed. RESULTS: Three SNPs in C2 (rs547154 [IVS10]; P = 5.4 x 10(-11)) and CFB (rs641153 [R32Q], P = 2.2 x 10(-7) and rs2072633 [IVS17]; P = 2.0 x 10(-4)) were strongly associated with reduced risk of AMD. The rs547154 and rs641153 were in strong LD (D' = 0.90, 95% CI = 0.81-0.96) and a protective haplotype T-A was observed (OR = 0.10, 95% CI = 0.05-0.20). LD was moderate (D' = 0.77, 95% CI = 0.67-0.85) between the rs547154 and the rs2072633 SNPs, and the haplotype T-T generated with these SNPs was relatively less protective (OR = 0.28, 95% CI = 0.18-0.44). CONCLUSIONS: The results of the present study provide an independent validation of the association of rs547154 (C2) and rs641153 (CFB) SNPs with reduced risk of AMD in an Indian cohort.
Asunto(s)
Pueblo Asiatico/genética , Complemento C2/genética , Factor B del Complemento/genética , Degeneración Macular/genética , Polimorfismo de Nucleótido Simple , Alelos , Genotipo , Haplotipos , Humanos , India , Desequilibrio de Ligamiento , Oportunidad RelativaRESUMEN
PURPOSE: Single nucleotide polymorphisms (SNPs) in the LOC387715 (rs10490924), HTRA1 (rs11200638), and CFH (rs1061170) genes have been implicated in age-related macular degeneration (AMD). The present study was undertaken to determine the involvement of the LOC387715 and HTRA1 in an AMD cohort from India. METHODS: The coding region of LOC387715 (exon 1) and the promoter of HTRA1 were screened by resequencing in AMD cases and normal controls. Odds ratios were calculated to assess the risk of individual genotypes. Linkage disequilibrium (LD) and haplotype frequencies were estimated with Haploview software. Population attributable risk (PAR %) for the associated SNPs and their combined effects were calculated. RESULTS: Resequencing revealed seven different SNPs in these genes, of which significant associations were noted with the risk alleles of rs10490924 (T allele; P = 5.34 x 10(-12)) in LOC387715, and rs11200638 (A allele; P = 4.32 x 10(-12)) and rs2672598 (C allele; P = 3.39 x 10(-11)) in HTRA1 among the cases. Correspondingly, the homozygous risk genotypes TT, AA, and CC in these SNPs exhibited higher disease odds and PAR %. rs10490924 and rs11200638 were in tight LD (D', 0.90; 95% CI, 0.84-0.93). G-C-T-A-C was the risk haplotype (P = 8.04 x 10(-15)), whereas the G-C-G-G-T haplotype was protective (P = 2.01 x 10(-4)). The combined effect of the CFH (CC) and LOC387715 (TT) risk genotypes exhibited a PAR of 93.7% (OR, 73.89; 95% CI, 8.69-628.13). CONCLUSIONS: The present data provided an independent validation of the association of LOC387715 and HTRA1 SNPs, along with their risk estimates among Indian patients with AMD. These associations underscore their significant involvement in AMD susceptibility, which may be useful for predictive testing.
Asunto(s)
Cromosomas Humanos Par 10/genética , Degeneración Macular/genética , Polimorfismo de Nucleótido Simple , Proteínas/genética , Serina Endopeptidasas/genética , Anciano , Factor H de Complemento/genética , Exones/genética , Haplotipos , Serina Peptidasa A1 que Requiere Temperaturas Altas , Humanos , India , Desequilibrio de Ligamiento , Metaanálisis como Asunto , Persona de Mediana Edad , Familia de Multigenes , Oportunidad Relativa , Reacción en Cadena de la Polimerasa , Regiones Promotoras Genéticas/genética , Factores de RiesgoRESUMEN
PURPOSE: The occurrence of choroidal detachment (CD) in eyes with primary rhegmatogenous retinal detachment (RRD) is relatively uncommon (2%-4.5%). Recent reports suggest that primary vitrectomy yields better anatomic success than scleral buckling. However, for these inflamed eyes with low intraocular pressure, the influence of preoperative oral steroids on reattachment rates has not been elucidated yet. METHODS: Twenty eyes with combined RRD and CD that underwent primary vitrectomy were randomized to receive oral steroids (for 1 week) or no oral steroids before surgery. RESULTS: Preoperative clinical data such as mean age, lens status, Snellen visual acuity, duration of macular detachment, CD (size and extent), and retinal detachment characteristics (e.g., extent, number of retinal breaks, atrophic or tractional retinal break, size of retinal break, and location of retinal break) were similarly distributed in both groups. Single-operation anatomic success was 81.8% (9/11) among those patients who received preoperative oral steroids and was 66.7% (6/9) among those who did not receive preoperative oral steroids. After reoperation, anatomic success was 100% in both groups. The mean follow-up was 20.1 months. CONCLUSION: The results suggest that administration of oral steroids before primary vitrectomy in eyes with combined RRD and CD improves reattachment rates.