scholarly journals The Correlation between Corneal Findings and Disease Severity in Keratoconus per Scheimpflug Corneal Tomography

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Ahmed E. M. Shehata ◽  
James W. Foster ◽  
Albert S. Jun ◽  
Uri S. Soiberman
Keyword(s):  
Visual Acuity ◽  
Disease Severity ◽  
Clinical Signs ◽  
Case Series ◽  
Final Analysis ◽  
Atopic Disease ◽  
Senior Author ◽  
Treatment Naïve ◽  
One Year ◽  
Corneal Tomography

Purpose. This study aims to correlate the clinical signs of keratoconus (KC) which include superficial apical scarring, Fleischer rings, and Vogt striae with best spectacle-corrected visual acuity (BSCVA) and corneal tomography findings. Patients and methods. A retrospective observational study. 72 consecutive KC patients seen by the senior author over the course of one year were included in this case series. Eyes with pellucid marginal degeneration, postrefractive ectasia, history of a corneal graft, prior corneal collagen cross-linking, intracorneal ring segments or hydrops were excluded from analysis. Subsequently, the final analysis included only treatment-naïve KC eyes with varying degrees of disease severity. Results. BSCVA with manifest refraction was 0.5 logMAR higher in eyes with apical scarring (p<0.001). Eyes with apical scarring had worse vision than eyes with Fleischer rings alone (0.43 logMAR higher in the former, p<0.009). Eyes with apical scarring had higher keratometry readings (K2 = 64.56 ± 12.89 D versus 49.07 ± 6.61 D, p<0.001); this was also true for eyes with Fleischer rings compared with ring-free eyes (K2 = 56.23 ± 11.52 D versus 48.91 ± 7.79 D, p<0.001) and eyes with Vogt striae (K2 = 56.19 ± 10.27 D versus 50.68 ± 9.21 D, p=0.01). Atopic disease was a risk factor for scarring: odds ratio (OR) = 2.87 (p=0.03). The OR of observing Fleischer rings in KC eyes was 12% per year (p=0.001). Additionally, each mm of corneal apex displacement from the pupillary center led to a 0.76 logMAR increase in visual acuity (p=0.001). Conclusion. The presence of apical scarring and Fleischer rings on biomicroscopy can aid the clinician in making the distinction between severe or long-standing disease (respectively). Apical scarring is a sign of advanced disease and is associated with worse BSCVA and tomography findings. Fleischer rings are markers of intermediate disease and their presence correlates with disease duration.

scholarly journals One-year outcomes of fixed-dosing Aflibercept therapy for pre treated and naive polypoidal choroidal vasculopathy patient

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hun Gu Choo ◽  
Jin Hae Lee ◽  
Hyun Sub Oh ◽  
Soon Hyun Kim ◽  
Yong Sung You ◽  
...  
Keyword(s):  
Polypoidal Choroidal Vasculopathy ◽  
Vision Loss ◽  
Case Series ◽  
Age Related Macular Degeneration ◽  
Research Information ◽  
Age Related ◽  
Case Series Study ◽  
Treatment Naïve ◽  
One Year ◽  
Choroidal Vasculopathy

Abstract Background Polypoidal choroidal vasculopathy (PCV) is a type of age-related macular degeneration that can cause permanent vision loss. The purpose of this paper was to report the one-year outcomes of fixed-dosing aflibercept therapy for the treatment of PCV. Methods This was a prospective, single-arm, interventional case series study of 25 PCV patients; 12 pre-treated and 13 treatment-naïve patients. The patients were treated and monitored for 12 months. Each patient was administered with an aflibercept (2.0 mg) injection every month for the first 3 months (the loading phase), and thereafter, once every 2 months. At every follow-up visit, best-corrected visual acuity (BCVA) test, fundus examination, and optical coherence tomography for measuring the central subfield macular thickness (CSMT) were performed. Fluorescein and indocyanine green angiography were conducted at baseline and at 4 and 12 months. Results After 12 months of aflibercept therapy, the mean BCVA of the patients significantly improved from 65.48 letters at baseline to 69.91 letters (p=0.001), and the CSMT significantly decreased from 406.92 um at baseline to 276.12 um (p< 0.001). Additionally, ten patients (40%) showed complete polyp regression. The treatment-naïve patients showed a statistically significant improvement in BCVA from 66.58 letters at baseline to 76.36 letters at 12 months, and a significant decrease in CSMT, from 462 to 243 um. In the pre-treated group, there was no change in BCVA (64.46 letters), and the decrease in CSMT from 356.08 to 303.69 um was not statistically significant. Conclusions The fixed-dosing aflibercept regimen is effective for treating patients with PCV and is more effective in treatment-naïve patients than in pre-treated patients. Trial registration Clinical Research Information Service (CRiS), Republic of Korea. Identifer: KCT0005798, Registered: Jan 20, 2021. Retrospectively registered, URL: https://cris.nih.go.kr/cris/en/search/search_result_st01.jsp?seq=18546

scholarly journals PHACOEMULSIFICATION

2016 ◽  
Vol 23 (11) ◽  
pp. 1422-1428
Author(s):  
Faheem Ahmad ◽  
Syeda Iqra Iqbal
Keyword(s):  
Visual Acuity ◽  
Case Series ◽  
Visual Outcome ◽  
University Hospital ◽  
Complication Rates ◽  
Basic Training ◽  
Ophthalmic Surgery ◽  
Counting Finger ◽  
Good Visual Outcome ◽  
One Year

Introduction: Any opacity in crystalline clear lens that may or maynot impaired vision is called cataract. According to maturity of cataract it may beimmature, mature or hypermature. When a patient develop cataract than there isno significant medical treatment for cataract. Surgery is the treatment of choice forcataract. Phacoemulsification (phaco), a modification of ECCE, has found worldwidepopularity in last two decades. Objectives: To find out visual acuity and complicationsof phacoemulsification in patients operated by senior surgeon during learning curve.Study Design: Descriptive case series. Settings: Department of OphthalmologyIndependent University Hospital, Faisalabad. Period: One year from 01-04-2014to 31-03-2015. Data Collection Methods: Patients coming through the OPD ofthe eye department who fulfilled the inclusion criteria were enrolled and informedconsent was taken from all patients. Results: In this study 100 eyes had undergonePhacoemulsification with IOL under Local anesthesia during study period. The meanage of patients was 57.50 years (range 30-85 years). Regarding the visual acuity inoperated eyes, 80 eyes ( 80 %) had a BCVA of 6/6-6/12, 12 eyes (12 %) had a BCVA of6/18 to 6/36 and 6 eyes (6 %) had a BCVA of 6/60 to CF. While only 2 percent Patienthad visual acuity less than Counting finger(CF). Discussion: During phaco training,the author was taught in stepwise about various stages of phaco and then authorpractice single part every stage of phaco multiple times to be master in every step ofphaco under supervision of an experienced ophthalmologist. Due to learning of phacostep-by-step leads to good surgical outcomes and least complication rates. Afterlearning the phaco basic training, the author started to perform phacoemulsification inIndependent University Hospital Faisal Abad under the supervision of an experiencedophthalmologist followed by independently performing phacoemulsification.Conclusion: Surgeon experienced in ophthalmic surgery along with adequatephacoemulsification training leads to a good visual outcome with minimum peroperativeand post-operative complications.

scholarly journals Safety and effectiveness of intrastromal corneal ring segment implantation at Al-Dharan Eye Specialist Hospital, Al-Dharan, Saudi Arabia

2019 ◽  
Vol 6 (4) ◽  
pp. 1295
Author(s):  
Abdulaziz Alaqsam ◽  
Mohanna AL-Jindan ◽  
Ammar Almahmod ◽  
Ibrahim Gosadi
Keyword(s):  
Visual Acuity ◽  
Saudi Arabia ◽  
Case Series ◽  
Applanation Tonometry ◽  
Retrospective Case ◽  
Intrastromal Corneal Ring ◽  
Case Series Study ◽  
Ring Segment ◽  
The Mean ◽  
One Year

Background: Intrastromal corneal ring segment (ICRS) implantation is one of the treatment options of keratoconus. This study is aiming to evaluate safety and effectivness of ICRS implantation at Al-Dharan Eye Specialist Hospital.Methods: This study is a descriptive retrospective case series study. The target population of this study is patients diagnosed with corneal ectasia who underwent ICRS implantation in Al-Dharan Eye Specialist Hospital, Al-Dharan, Saudi Arabia. Preoperative and postoperative data about uncorrected visual acuity (UCVA), best spectacle–corrected visual acuity (BSCVA), manifest refraction, keratometry, applanation tonometry, corneal topography, and slit-lamp biomicroscopy and indirect ophthalmoscopy were retrieved from medical records of department of Medical Archive. Paired students t-test was used to compare preoperative and postoperative means of study variables.Results: The total number of recruited patients in this study was 57 patients where 62% of them were males. Sixty-six treated eyes were included in this study where no intra-operative complications were recorded. Upon comparing the mean preoperative data to the mean postoperative data at three months, six months and one year intervals, an overall improvement in the measured outcomes was witnessed. UCVA, BSCVA, and keratometric readings exhibited a statistically significant improvement when comparing preoperative with one-year postoperative findings (p<0.001).Conclusions: The findings of this study indicate that ICRS implantation is a safe and effective treatment for keratoconus.

scholarly journals Aflibercept for Vascularised Serous Pigment Epithelial Detachment: One-Year Anatomical and Functional Results

2020 ◽  
Vol 76 (2) ◽  
pp. 88-93
Author(s):  
Jaroslav Románek ◽  
Hana Palyzová ◽  
Jan Grygar ◽  
Jan Ernest
Keyword(s):  
Visual Acuity ◽  
Functional Results ◽  
University Hospital ◽  
Pigment Epithelial Detachment ◽  
Intravitreal Therapy ◽  
Pigment Epithelial ◽  
Department Of Ophthalmology ◽  
Treatment Naïve ◽  
One Year ◽  
The Military

Purpose: To assess the effect of intravitreal aflibercept on pigment epithelial detachment (PED) secondary to occult choroidal neovascularization (CNV) in treatment-naive patients. Patients and methods: Retrospective analysis of thirty-six patients (thirty-eight eyes) with mean age 77 (SD ± 7), who were treated with aflibercept 2.0 mg (Eylea, Bayer) at the Department of Ophthalmology of 1st Faculty of Medicine of the Charles University and the Military University Hospital Prague. All patients were treated in fixed regimen, which means 3 loading doases 1 month apart, followed by further 2-monthly doses over total 12-month period. Best corrected visual acuity (BCVA) was evaluated on Early Treatment Diabetic Retinopathy Study (ETDRS) charts. Diameters as PED height, width and central retinal thickness (CRT) were assesed using spectral-domain optical coherence tomography. All previously mentioned were analyzed et the baseline and than at every visit. Therapy complications were also evaluated. Results: Borderline significant improvement in the mean of BCVA score of 3.2 letters (SD ± 11.6, p = 0.05) at the end of follow-up period was observed. Mean PED height at 12 months significantly decreased by 140 µm (SD ± 238, p < 0.01). Reductions in PED height were correlated with reductions in central macular thickness (R = 0.94, p < 0.001) simultaneously with PED width (R = 0.45, p < 0.01). There was no significant correlation between PED height decrease and visual acuity. PED rupture was observed in 3 eyes (8 %). Conclusion: Aflibercept intravitreal therapy in fixed regimen in patients with PED secondary to occult CNV shows great anatomical effect. However, correlation between PED diameters and visual acuity was not observed.

scholarly journals One Year Outcomes and Stability of a Novel Scleral Anchored Intraocular Lens

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Edoardo Abed ◽  
Matteo Forlini ◽  
Edlira Bendo ◽  
Aurelio Imburgia ◽  
Alessandro Mularoni ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Anterior Segment ◽  
Case Series ◽  
Specular Microscopy ◽  
Iop Measurement ◽  
Prospective Case Series ◽  
One Year

Purpose. To assess one year results and stability of the implantation of a scleral anchored intraocular lens (IOL). Design. Interventional prospective case series. Methods. Sixty eyes of 60 patients affected by either aphakia or IOL dislocation were included in this study. Patients underwent vitrectomy, scleral fixation of the IOL, and, if present, dislocated IOL removal. Patients were evaluated preoperatively and at 1, 3, 6, and 12 months after surgery by best-corrected distance visual acuity (BCVA) assessment, intraocular pressure (IOP) measurement, corneal specular microscopy, and optical coherence tomography (OCT) of both the macula and anterior segment. Results. At twelve months, mean BCVA significantly improved ( p < 0.0001 ), and none of the patients experienced a decrease of visual acuity. A 10% decrease of endothelial cell count occurred after surgery. Cystoid macular edema occurred in three patients (5%). A transient increase of intraocular pressure was noted in 7 cases (12%). At one month, horizontal and vertical IOL tilt was 1.04 ± 0.87 and 0.74 ± 0.71 degrees, respectively, and did not significantly change in the follow-up ( p > 0.05 ). None of the patients had decentration or dislocation of scleral-fixated IOL during the follow-up. Conclusion. Implantations of scleral plug fixated IOL provide good visual results, low complication rate, and excellent stability of the lens until one-year follow-up.

scholarly journals Optical Coherence Tomography Prognostic Factors in AMD Patients with Peripapillary Choroidal Neovascularization

2021 ◽  
Author(s):  
Gilad Rabina ◽  
Anfisa Ayalon ◽  
Michael Mimouni ◽  
Nir Stanescu ◽  
Elad Moisseiev ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Choroidal Neovascularization ◽  
Pigment Epithelium ◽  
Case Series ◽  
Age Related Macular Degeneration ◽  
Optical Coherence ◽  
Foveal Thickness ◽  
Age Related ◽  
One Year

Purpose: To investigate the correlation between optical coherence tomography (OCT) findings and visual acuity outcomes after treatment with intravitreal bevacizumab (IVB) injections for age related macular degeneration (AMD) patients with peripapillary choroidal neovascularization (PPCNV). METHODS: A retrospective case series of consecutive patients diagnosed with PPCNV secondary to AMD. All patients were treated with IVB injections with a follow-up time of one year. Data collected included best corrected visual acuity (BCVA), automated and manually measured OCT parameters. RESULTS: A total of 68 eyes were diagnosed with PPMV. Of them, 30 eyes of 30 patients aged 84.3±6.9 years of which 63.3% female gender were included. Baseline BCVA was 0.46±0.62 logMAR (Snellen 20/57), average choroidal thickness was 193.2±22 µm and mean number of IVB injections was 7.2±1.9. After one year BCVA was 0.56±0.78 logMAR (Snellen 20/72) (p=0.28). Eyes with greater central retinal thickness (r=-0.36, p=0.05), greater subretinal hyperreflective material (SHRM) area (r=-0.37, p=0.05) and greater sub retinal fluid (SRF) area (r=-0.73, p<0.001) had a significantly smaller improvement in BCVA. Eyes with pigment epithelium detachment (PED) (0.68±0.90 versus 0.21±0.12, p=0.03) had a significantly worse BCVA. CONCLUSIONS: Our data suggests that AMD related PPCNV with greater foveal thickness, PED size, SHRM and SRF areas have worse final BCVA prognosis.

Reduced fluence corneal cross-linking in mild to moderate keratoconus: One year-follow-up

2020 ◽  
pp. 112067212096656
Author(s):  
Seyed Reza Ghaffari ◽  
Saeed Khaheshi ◽  
Fateme Alipour ◽  
Somayye Mashhadi Farahani ◽  
Amir-Hooshang Beheshtnejad ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Eligible Patient ◽  
Case Series ◽  
Control Group ◽  
Data Analyst ◽  
Cell Counts ◽  
Group 2 ◽  
One Year ◽  
And Control

Purpose: To evaluate the safety and efficacy of reduced fluence CXL (lower dose of UV-A irradiation) in mild to moderate keratoconus. Setting: Farabi Eye Hospital, Tehran, Iran. Design: Non-randomized prospective comparative interventional case series. Every eligible patient included in the study (mild to moderate progressive keratoconus) was randomly allocated to case (reduced fluence) and control (standard) groups, except for bilateral patients. In these patients the eye with more advanced disease was allocated to control group and the other eye was randomly assigned in either case or control group. Operators performing refraction and images and the data analyst were masked, but patients and physicians were not. Methods: Forty-six eyes of 38 patients were recruited. Group 1 received 7 min (fluence of 3.8 J/cm2), while group 2 received 10 min of 9 mW/cm2 UV-A (fluence of 5.4 J/cm2). Visual, keratometric and biomechanical outcomes were compared between groups. Results: At last follow-up (mean12 months, range 6–24 months), there were no statistically significant differences in changes in uncorrected visual acuity, best corrected distance visual acuity, Kmax, Kmean, corneal hysteresis, corneal resistance factor, endothelial cell counts, demarcation line depth, and intraoperative pain scores between groups (all p-values < 0.05). Conclusion: The results of this study show comparable one-year outcomes between 3.8 and 5.4 J/cm2 accelerated CXL in mild to moderate keratoconus. Should the results of this study be confirmed in longer follow-ups, using a reduced fluence setting could be considered as an alternative to standard treatment in these patients.

scholarly journals One-year results and safety of femtosecond arcuate incisions for high post-keratoplasty astigmatism treatment: time to rethink the procedure?

2021 ◽  
Author(s):  
Sergio Kwitko ◽  
Bruno Schneider de Araujo ◽  
Felipe Pigozzi Cabral ◽  
Nessana Neubauer
Keyword(s):  
Visual Acuity ◽  
Complication Rate ◽  
Treatment Time ◽  
Treatment Options ◽  
Case Series ◽  
Limiting Factor ◽  
Visual Rehabilitation ◽  
Astigmatism Correction ◽  
One Year ◽  
High Degree

Abstract Background/Aims High astigmatism after keratoplasty is the main limiting factor for visual rehabilitation. Among its treatment options the arcuate keratotomy (AK) with the femtosecond laser stands out for its perfection and versatility of the incision making. We designed a study to evaluate the results and safety of femtosecond arcuate keratotomy (femto-AK) in the treatment of high astigmatism after keratoplasty.Methods A prospective interventional cohort study. We enrolled 17 eyes with high degree of irregular astigmatism, scheduled for Femto-AK. IntraLase FS was used to perform arcuate incisions 1.00 mm inside the graft. Patients’ uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BDCVA), and astigmatic change were recorded and followed up to one year after surgery.Results Despite overall improvement in corneal cylinder and visual acuity in one-year follow-up, there was a 52.9% complication rate. Cylinder overcorrection occurred in 6 cases (35.3%) that was managed with compressive sutures; microperforation occurred in two cases (11.7%); and endothelial rejection in one case (5.9%).Conclusion The predictability of astigmatism correction was variable in reducing postkeratoplasty astigmatism and high complication rate was found in our case series. New nomograms and improvements in technique need to be developed in order to reduce the incidence of overcorrections.

scholarly journals VISUAL OUTCOME OF TRAUMATIC CATARACT: ONE YEAR REVIEW

1969 ◽  
Vol 6 (2) ◽  
pp. 827-831
Author(s):  
ARSHAD IQBAL ◽  
SHER AKBAR KHAN ◽  
TARIQ MOHAMMAD SAEED ◽  
HAROON RASHID
Keyword(s):  
Visual Acuity ◽  
Case Series ◽  
Visual Outcome ◽  
Teaching Hospitals ◽  
Traumatic Cataract ◽  
Young Males ◽  
Co Morbidity ◽  
Open Globe ◽  
Corneal Scar ◽  
One Year

BACKGROUND: Traumatic cataract is a very common ocular emergency encountered byophthalmologists worldwide. There is a long list of co-morbidities associated with traumatic cataract.Visual outcome is unpredictable after surgical management of the traumatic cataract.OBJECTIVES: To study the presentation and surgical outcome of traumatic cataract following openand closed globe injury.MATERIAL & METHODS: It is a prospective interventional case series. The study was carried out atDepartment of Ophthalmology, Saidu Group of Teaching Hospitals, Swat from 1st July 2015 to 30th June2016 on the patients with traumatic cataract.RESULTS: In this study we evaluated 40 eyes of 40 patients who presented with traumatic cataract andwere admitted to our unit during the study period. There were 72.5% male and 27.5% female. Stick andwooden splinter was the most common traumatic agent responsible for traumatic cataract in 40%followed by stone in 22.5% cases. Preoperative visual acuity was perception of light (PL) to handmovements (HM) in 45%, counting fingers to 6/60 in 50% patients. 50% patients had postoperativevisual acuity of less than 6/60, while 50% had visual acuity of 6/60 and above. Extracapsular cataractextraction (ECCE) with intraocular lens (IOL) was performed in 55% cases, while ECCE without IOLwas done in 7.5% cases. The most common co-morbidity was corneal scar in 12.5%, 27.5% patients hadcombined co-morbidities while 25% had no co-morbidity.CONCLUSION: Majority of the patients with traumatic cataract were young males. Postoperativevisual acuity was better in those cases which were not associated with other co-morbidities. Surgicalintervention was required in all cases and conventional ECCE with IOL implantation was the mostcommonly adopted surgical procedure. Trauma with stick and wooden splinter was the most commoncause of traumatic cataract.KEY WORDS: Traumatic cataract, Closed globe injury (CGI), Open globe injury (OGI), visual acuity(VA).

scholarly journals Surgical outcomes of minimally invasive vitrectomy surgery in Eales’ disease

2013 ◽  
Vol 5 (2) ◽  
pp. 182-189
Author(s):  
S Khanduja ◽  
S Gupta ◽  
S Sinha ◽  
Pradeep Venkatesh ◽  
R Vohra ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Surgical Outcomes ◽  
Case Series ◽  
Vitreous Hemorrhage ◽  
Neovascular Glaucoma ◽  
Retinal Breaks ◽  
Eales Disease ◽  
23 Gauge ◽  
One Year

Introduction: The results of surgical outcomes of 20 gauge pars plana vitrectomy in Eales’ disease are available in the scientific literature. However, all these studies have been done using the 20 gauge vitrectomy systems and most studies have been conducted in a retrospective manner. Objective: To evaluate the outcomes and safety of 23 gauge vitrectomy in complications of Eales’ disease. Materials and methods: Study design: Consecutive interventional case series. Participants: Seventy-six eyes of 72 nonconsecutive patients undergoing 23-gauge vitrectomy for complications of Eales’ disease were enrolled. The participants were followed up for a minimum of one year. Intervention: The participants underwent a complete demographic, medical and ophthalmic evaluation. A 23-gauge vitrectomy was performed. Endotamponade was used when necessary. Perioperative and postoperative events were recorded. Primary outcome measures were visual acuity and complications arising due to surgery. Results: Indication for surgery was non-clearing vitreous hemorrhage in 89.4% (68/76) and secondary retinal detachment in 10.6% (8). Visual acuity improved from Log Mar 1.80 ± 0.19 units preoperatively to Log Mar 0.47±0.59. Best-corrected visual acuity equivalent to Snellen 6/9 was achieved in 77. 6% of eyes. . Surgical failure was seen in 6.5% cases. Four cases were lost due to progression to neovascular glaucoma and 1 case was lost to severe residual retinal detachment. Iatrogenic portside retinal breaks occurred in 3.9% (3), post-vitrectomy retinal detachment 2.6% ( 2), hypotony 1.3% (1) and cataract in 38.1% (28) cases. Conclusion: 23-gauge sutureless vitrectomy in patients with Eales’ disease is a safe and effective technique with acceptable level of risk and complications. Nepal J Ophthalmol 2013; 5(10): 182-189 DOI: http://dx.doi.org/10.3126/nepjoph.v5i2.8710

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