Asynchronous teleophthalmology for monitoring glaucoma patients – a retrospective study (Preprint)

2021 ◽  
Author(s):  
Lukas Bisorca-Gassendorf ◽  
Simo Murovski ◽  
Henrike Julich-Härtel ◽  
Mariya Erokhina ◽  
Julie Szabo ◽  
...  
Keyword(s):  
Open Angle Glaucoma ◽  
Anterior Segment ◽  
Wide Field ◽  
Observational Period ◽  
Corrected Visual Acuity ◽  
Number Of Patients ◽  
The Mean ◽  
Lost To Follow Up ◽  
Observation Period

BACKGROUND COVID-19 created an escalating need for limiting in-person exams and potential viral exposure. Teleophthalmology allows ophthalmologists to continue providing care to patients while ensuring physician and patient safety. OBJECTIVE To assess patient care of an asynchronous teleconsultation for glaucoma patients in a rural German area. METHODS This retrospective, observational and monocentric study included 50 patients diagnosed with primary open angle glaucoma (n = 49) and ocular hypertension (n = 1), requiring medication for lowering intraocular pressure (IOP). Only patients with a well-regulated disease situation were included and a brief survey was analyzed. During each visit of every single patient IOP was measured, best-corrected visual acuity (BCVA), visual field test, a slit lamp photo of the anterior segment, as well as ultra-wide-field image of the fundus were taken. RESULTS Of the 50 patients included, the mean number of follow-up visits in this observation period was 4.4. No patients were lost to follow-up. Missed follow-up visits (but not lost to follow up) were nine in total. No patients required a change in their treatment regime during the observational period. Regarding patient focused assessment, the majority of patients were satisfied or very satisfied with the teleconsultation in general. CONCLUSIONS Asynchronous teleophthalmology is a promising option and effective way for monitoring glaucoma patients. The majority of patients are satisfied with the teleconsultation and adhered to the follow-up schedule. However, more prospective trails with a larger number of patients are needed. Further trials should focus also on the aspect of cost-effectiveness.

scholarly journals Combined Phacoemulsification and Goniosynechialysis under an Endoscope for Chronic Primary Angle-Closure Glaucoma

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Li Nie ◽  
Weihua Pan ◽  
Aiwu Fang ◽  
Zhangliang Li ◽  
Zhenbin Qian ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Anterior Segment ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Corrected Visual Acuity ◽  
Corneal Endothelial Cell Density ◽  
The Mean

Purpose. To investigate the clinical efficacy and safety of combined phacoemulsification with goniosynechialysis (GSL) under an ophthalmic endoscope for chronic primary angle-closure glaucoma and coexisting cataract. Methods. This is a retrospective study. The intraocular pressure (IOP), best-corrected visual acuity (BCVA), and number of glaucoma medications at baseline and each postoperative follow-up visit were recorded. Other measurements included supraciliochoroidal fluid measured by anterior segment optical coherence tomography, corneal endothelial cell density (ECD), and peripheral anterior synechia (PAS). All patients were followed for more than a year. Results. Thirty-eight eyes of 31 patients were included. The mean follow-up duration was 16.3 ± 3.9 months. The IOP decreased from 22.2 ± 9.3 mmHg at baseline to 15.4 ± 4.2 mmHg at the last follow-up (P<0.001). The mean number of glaucoma medications (0.1 ± 0.6) at the last follow-up was significantly lower than the preoperative number (2.3 ± 1.1) (P<0.001). All patients achieved improved or stable visual acuity after surgery. All patients achieved a complete opened angle after GSL. The postoperative complications included hyphema (7.9%), exudation (5.3%), transiently elevated IOP (55.3%), and supraciliochoroidal fluid (40%). Conclusions. Combined phacoemulsification and GSL under an endoscope can completely reopen PAS and is an effective and safe method for patients with chronic primary angle-closure glaucoma and coexisting cataract.

scholarly journals HIV care and treatment clinic performance following President’s Emergency Plan for AIDS Relief-funded infrastructure improvement in Tanzania

2018 ◽  
Vol 19 (1) ◽  
Author(s):  
Boniphace M. Idindili ◽  
Simon J. King ◽  
Kristen Stolka ◽  
Irene Mashasi ◽  
Philberth Bashosho ◽  
...  
Keyword(s):  
Retention In Care ◽  
Adult Patients ◽  
Hiv Care ◽  
Emergency Plan ◽  
Number Of Patients ◽  
The Mean ◽  
Care And Treatment ◽  
Patient Enrolment ◽  
Lost To Follow Up

Purpose: To assess how the infrastructure improvements supported by the US Centers for Disease Control and Prevention (CDC) and the United States President’s Emergency Plan for AIDS Relief (PEPFAR) contributed to facility-level quarterly and annual new patient enrolment in HIV care and treatment and antiretroviral therapy (ART) uptake and retention in care.Methods: Aggregate quarterly and annual facility-based HIV care and treatment data from the CDC-managed PEPFAR Reporting Online and Management Information System database collected between 2005 and 2012 were analysed for the 11 rural and 32 urban facilities that met the eligibility criteria. Infrastructure improvements, including both renovations and new construction, occurred on different dates for the facilities; therefore, data were adjusted such that pre- and post-infrastructure improvements were aligned and date-time was ignored. The analysis calculated the mean (95% confidence interval) number of patients per facility who were (1) newly enrolled in HIV care, (2) patients initiated on ART, (3) patients retained in care, defined as alive and on ART, and (4) reasons for attrition, defined as transferred out, lost to follow-up, deceased or stopped ART.Results: The overall mean number of adult patients newly enrolled in HIV care clinics per quarter declined from 187.7 (151.4–223.9) to 135.2 (117.4–152.9) after infrastructure improvements but was not statistically significant (p = 0.20). However, the mean number of patients who were alive and remained on ART increased from 193.2 (145.3–241.1) to 273.2 (219.0–327.3) after improvements in both rural and urban facilities, although not significantly (p = 0.59). A similar picture was observed for overall paediatric enrolment and retention in care. Health facility-specific case studies show variations in new patient enrolment and retention in care between health facilities depending on the catchment area, population HIV prevalence and coverage of ART facilities. Regarding attrition, the mean number of adult patients lost to follow-up changed from 76.6 (20.8–132.3) to 139.4 (79.6–199.1) (p = 0.65) among rural facilities, while the mean number of children lost to follow-up increased significantly from 3.4 (0.5–6.3) to 8.7 (5.0–12.3) (p = 0.02) after improvements.Conclusion: Patient retention in care improved in HIV care and treatment facilities with infrastructure improvements. However, the overall number of patients newly enrolled and initiated on ART declined and attrition increased in facilities after improvements.

scholarly journals Treatment Persistence and Real- World Effectiveness of Aripiprazole Once Monthly: A Four-Year Follow-Up

2021 ◽  
Author(s):  
Andrea Fagiolini ◽  
Eugenio Aguglia ◽  
Andrea Ballerini ◽  
Gaetano Callista ◽  
Bernardo Carpiniello ◽  
...  
Keyword(s):  
Real World ◽  
Treatment Persistence ◽  
Follow Up Study ◽  
The Poor ◽  
Number Of Patients ◽  
The Mean ◽  
Recorded Observation ◽  
Observation Period ◽  
Baseline Demographic

Abstract ObjectivesTreatment persistence refers to the act of continuing a treatment as prescribed and reflects the patient's or doctor's judgment about efficacy, tolerability, and acceptability. In patients with schizophrenia, antipsychotic persistence is often poor, because of issues such as lack or loss of efficacy, side effects, and poor adherence, which is often related to the degree to which patients find the medication and overall intervention to be helpful, tolerable, fair, reasonable, appropriate, and consistent with expectations of treatment. Despite the poor antipsychotic persistence that has been reported to date in patients with schizophrenia, we previously observed a relatively high (86%) 6-month persistence with aripiprazole once-monthly (AOM) in a group of patients with schizophrenia, treated in the real world Italian clinical practice. The present study explores the longer-term persistence with AOM, over a mean follow-up period of 48 months MethodsThis was an observational, multicenter, retrospective, non-interventional follow-up study, aimed at evaluating the longer-term persistence with AOM in a group of patients with schizophrenia who had already shown persistence over a period of at least 6 months. The study included 161 individuals who had participated in our previous study, where 86% of participating individuals had shown persistence with AOM for at least 6 months. Non-persistence was defined as discontinuing the medication for any reason. Baseline demographic and clinical characteristics of patients who continued AOM were then compared to those of patients who discontinued the medication ResultsStudy subjects were predominantly male (64.4%) and their mean age was 39.7 (SD: 12.24). Treatment persistence with AOM was 69.6% and 112 out of 161 patients were still receiving AOM treatment at the last follow-up visit. The mean duration of AOM treatment until the last recorded observation was 55.87 months (median 56.17, SD6.23) for the 112 persistent patients and 32.23 (median 28.68.SD 15.09) months for the 49 non-persistent individuals. The mean observation period for all patients (persistent and non-persistent) was 48.78 months (median 52.54, SD 14.64). For non-persistent subjects, the observation period ended with the discontinuation of AOM. Subjects treated with AOM at 400 mg presented a 69.6% lower risk of all-cause treatment discontinuation when compared with patients treated with 300 mg (HR: 0.314; 95% confidence interval [CI]: 0.162-0.608; P=0.001). The main reasons for discontinuation were lack of efficacy (30.6%), patient/caregiver choice (18.4%), physician’s choice (16.3%), non-adherence (12.2%) and inconvenience (6.1%). Only 3 patients (6.1%) discontinued AOM for tolerability issues. ConclusionsIn subjects with schizophrenia, who had already shown a 6-month persistence with AOM, a high number of patients (69.6%) continued to be persistent over a four-year follow-up period. This may reflect a favourable profile of efficacy, tolerability, and acceptability. Larger and prospective studies are warranted to confirm our observations.

scholarly journals The Recenter: an augmented Bankart. Results with a minimum follow-up of 2 years

2021 ◽  
Vol 9 (2_suppl) ◽  
pp. 2325967121S0000
Author(s):  
Kevin Picard ◽  
Jean-David Werthel ◽  
Bruno Toussaint ◽  
Thomas Bauer ◽  
Alexandre Hardy
Keyword(s):  
Surgical Technique ◽  
Clinical Results ◽  
Bankart Repair ◽  
Surgical Indications ◽  
Metal Implant ◽  
Number Of Patients ◽  
The Mean ◽  
Lost To Follow Up ◽  
New Surgical Technique

Objectives: The objective was to evaluate the clinical results of a new surgical technique to improve the Bankart repair by adding a prosthetic block called the Recenter. Methods: Thirty-two patients were retrospectively included in this multicenter study. Five patients were lost to follow-up. The surgical indications were similar to those for a standard Bankart repair. A metal implant called a Recenter was inserted in the anterior inferior glenoid and fixed with two TightRopes. A Bankart repair was then performed over the implant. All the patients had a follow-up CT scan and a clinical examination. The mean follow-up period was 37 months (29-47). The mean ISIS score was 2.42 (0-6). Results: Twenty-six patients aged 33.9 ± 10.2 (16-50) years were included. Patients presented with an average of 2.4 ± 3.2 (0-12) true dislocations prior to surgery and 6.1 ± 8.5 (0-30) subluxations. The time that had elapsed between the occurrence of the first symptoms and surgery was 6.8 ± 6.9 years. The last follow-up showed a residual VAS score of 1.3. The mean Walch-Duplay score was 78.9 ± 21.4 - SD (range 5-100), the mean ROWE score, 88.5 ± 15.9 - SD (30-100) and the mean SST score, 90.6 ± 14.5 - SD (41.6-100). 77.8% of the patients (n=21) had no apprehension, 11.1% (n=3) were apprehensive, 7.4% (n=2) were afraid of the possibility of luxation and 3.7% (n=1) had a recurrence. In terms of satisfaction, 59.3% were very satisfied, 33.3% satisfied and 7.4% dissatisfied with their operation. Concerning the CT study, we found no shifting of material or ballooning of the TightRope tunnels. Conclusion: The Recenter showed a recurrence rate of 4% (1 patient) with an average follow-up of 3 years. Despite a small number of patients, the Recenter appears to be a worthwhile addition to the arthroscopic Bankart technique.

HRA Model for Hypercholesterolemia Based on a Longitudinal Health Database

1998 ◽  
Vol 37 (02) ◽  
pp. 130-133
Author(s):  
T. Kishimoto ◽  
Y. Iida ◽  
K. Yoshida ◽  
M. Miyakawa ◽  
H. Sugimori ◽  
...  
Keyword(s):  
Total Cholesterol ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Model Analysis ◽  
Serum Total Cholesterol ◽  
Hazards Model ◽  
The Mean ◽  
Health Database ◽  
Observation Period

AbstractTo evaluate the risk factors for hypercholesterolemia, we examined 4,371 subjects (3,207 males and 1,164 females) who received medical checkups more than twice at an AMHTS in Tokyo during the period from 1976 through 1991; and whose serum total cholesterol was under 250 mg/dl. The mean follow-up duration was 6.6 years. A self-registering questionnaire was administered at the time of the health checkup. The endpoint of this study was the onset of hypercholesterolemia when the level of serum total cholesterol was 250 mg/dl and over. We compared two prognosis groups (normal and hypercholesterol) in terms of age, examination findings and lifestyle. After assessing each variable, we employed Cox's proportional hazards model analysis to determine the factors related to the occurrence of hypercholesterolemia. According to proportional hazards model analysis, total cholesterol, triglyceride and smoking at the beginning, and hypertension during the observation period were selected in males; and total cholesterol at the beginning and age were selected in females to determine the factors related to the occurrence of hypercholesterolemia.

scholarly journals Ophthalmic Screening in Patients with Coronavirus Disease 2019: A Prospective Cohort Study

2021 ◽  
Vol 10 (5) ◽  
pp. 896
Author(s):  
Anthia Papazoglou ◽  
Anna Conen ◽  
Sebastian Haubitz ◽  
Markus Tschopp ◽  
Viviane J. Guignard ◽  
...  
Keyword(s):  
Animal Studies ◽  
Clinical Course ◽  
Intraocular Inflammation ◽  
Ocular Motility ◽  
Corrected Visual Acuity ◽  
Published Evidence ◽  
Laboratory Results ◽  
Minimum Angle ◽  
Observation Period

Postmortem pathological examinations, animal studies, and anecdotal reports suggest that coronavirus disease 2019 (COVID-19) could potentially affect intraocular tissue. However, published evidence is scarce and conflicting. In our study, we screened 100 eyes of 50 patients hospitalized for COVID-19. Relevant medical and ophthalmological history was assessed as well as symptoms, laboratory results, specific treatments, clinical course, and outcome. Ophthalmic exams including assessment of best corrected visual acuity (BCVA), intraocular pressure (IOP), color perception, ocular motility, ophthalmoscopy as well as optical coherence tomography (OCT) of the macula and the optic disc was performed at hospital admission and 29 to 192 days later. Of the 50 patients included, 14 (28%) were female. Median age was 64.5 (range 29–90) years. COVID-19 severity was mild in 15 (30%), severe in 30 (60%), and critical in five cases (10%). At baseline, median BCVA was 0.1 (0–1.8) Logarithm of the Minimum Angle of Resolution (LogMAR) and median IOP was 16 (8–22) mmHg. At follow-up, no relevant changes in BCVA and IOP were documented. No signs of active intraocular inflammation or optic nerve affection were found and OCT findings were widely stable during the observation period. Our findings suggest that COVID-19 does not regularly affect intraocular tissue.

Management of optic disc pit-associated maculopathy: A case series from a tertiary referral center

2021 ◽  
pp. 112067212110237
Author(s):  
Ilkay Kilic Muftuoglu ◽  
Ecem Onder Tokuc ◽  
V Levent Karabas
Keyword(s):  
Optic Disc ◽  
Case Series ◽  
Internal Limiting Membrane ◽  
Maximum Height ◽  
Optic Disc Pit ◽  
Tertiary Referral Center ◽  
Number Of Patients ◽  
The Mean ◽  
Foveal Center

Purpose: To report outcomes of pars plana vitrectomy (PPV) combined with internal limiting membrane (ILM) stuffing technique in patients with optic disc pit associated maculopathy (ODP-M). Methods: Data including best-corrected visual acuity (BCVA), central macular thickness (CMT), foveal center point thickness (FCP), and maximum height of fluid (max_fluid) (intraretinal or subretinal) were collected from the medical records of the patients. Results: Six eyes of six patients with a mean age of 28.0 ± 17.68 years (range: 9–53 year) underwent PPV + ILM plug surgery. The mean follow-up duration was 25.62 ± 26.11 months (range: 11.80–78.00 month) duration. The mean BCVA increased from 1.25 ± 1.04 logMAR (20/355, Snellen equivalent) to 0.86 ± 1.09 logMAR (20/144, Snellen equivalent) at last follow-up ( p = 0.043). Compared to baseline, CMT, FCP, and max_fluid significantly decreased at all visits after the surgery ( p < 0.05 for all visits). At last follow-up, 66.6% of the eyes (four eyes) showed complete resolution of fluid at a mean of 5.25 ± 4.99 months (range: 1–12 months) after the surgery. Conclusion: PPV with ILM plug seemed to be an effective surgical technique in ODP-M. Studies with longer follow-up and higher number of patients are needed to confirm our results.

scholarly journals Use of Plasma Rich in Growth Factors and ReGeneraTing Agent Matrix for the Treatment of Corneal Diseases

Vision ◽  
2021 ◽  
Vol 5 (3) ◽  
pp. 34
Author(s):  
Ronald M. Sánchez-Ávila ◽  
Edmar Uribe-Badillo ◽  
Carlos Fernández-Vega González ◽  
Francisco Muruzabal ◽  
Borja de la Sen-Corcuera ◽  
...  
Keyword(s):  
Growth Factors ◽  
Corneal Ulcer ◽  
Disease Index ◽  
Eye Drops ◽  
Analog Scale ◽  
Ocular Surface Disease Index ◽  
Corneal Ulcers ◽  
Corrected Visual Acuity ◽  
The Mean

This study aimed to investigate the use of Plasma Rich in Growth Factors (PRGF) associated with tissue ReGeneraTing Agent (RGTA) drops for the treatment of noninfectious corneal ulcers. RGTA treatment was applied (one drop every two days); however, if ulcer closure was not achieved, PRGF eye drops treatment was added (four times/day). The time taken to reach the ulcer closure, the Best Corrected Visual Acuity (BCVA), intraocular pressure (IOP), Visual Analog Scale (VAS, in terms of frequency and severity of symptoms), and Ocular Surface Disease Index (OSDI) were evaluated. Seventy-four patients (79 eyes) were included, and the mean age was 56.8 ± 17.3 years. The neurotrophic corneal ulcer was the most frequent disorder (n = 27, 34.2%), mainly for herpes virus (n = 15, 19.0%). The time of PRGF eye drops treatment associated with the RGTA matrix was 4.2 ± 2.2 (1.5–9.0) months, and the follow-up period was 44.9 ± 31.5 months. The ulcer closure was achieved in 76 eyes (96.2%). BCVA, VAS and OSDI improved from the baseline (p < 0.001), and IOP remained unchanged (p = 0.665). RGTA and PRGF in noninfectious ulcers were effective and could be a therapeutic alternative for this type of corneal disease.

scholarly journals Morphological Changes in Lamellar Macular Holes According to SD-OCT Examination over a Long Observation Period

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1145
Author(s):  
Magdalena Kal ◽  
Izabela Chojnowska-Ćwiąkała ◽  
Mateusz Winiarczyk ◽  
Monika Jasielska ◽  
Jerzy Mackiewicz
Keyword(s):  
Retinal Thickness ◽  
Morphological Changes ◽  
Outer Diameter ◽  
Corrected Visual Acuity ◽  
Macular Holes ◽  
Kolmogorov Smirnov ◽  
Inner Diameter ◽  
Observation Period ◽  
Sd Oct

Background: The aim of this study was to evaluate the quantitative morphological changes in lamellar macular holes (LMHs) based on SD-OCT examinations and to assess the correlations among minimal retinal thickness (MRT), reading vision (RV), and best corrected visual acuity (BCVA) over a 36-month follow-up period. Methods: A group of 40 patients (44 eyes) with LMH was evaluated, with an average age of 69.87 (SD = 10.14). The quantitative parameters monitored in the follow-up period (at 0, 3, 6, 12, 18, 24, 30, and 36 months) were tested for normality of distribution by Shapiro–Wilk and Kolmogorov–Smirnov tests. Results: The RV and BCVA values were stable, and no significant changes were found at any of the check-ups during the 36-month follow-up period (BCVA p = 0.435 and RV p = 0.0999). The analysis of individual quantitative LMH parameters during the 36-month follow-up period did not demonstrate statistically significant differences: MRT (p = 0.461), Max RT temporal (p = 0.051), Max RT nasal (p = 0.364), inner diameter (ID) (p = 0.089), and outer diameter (OD) (p = 0.985). Conclusions: The observations at 0, 6, 12, 18, 24, 30, and 36 months revealed moderate and significant correlations between RV and MRT. No significant correlation between BCVA and MRT was observed.

Corneal densitometry in patients with keratoconus undergoing intrastromal Ferrara ring implantation

2021 ◽  
pp. 112067212110206
Author(s):  
Pablo Felipe Rodrigues ◽  
Bernardo Kaplan Moscovici ◽  
Guilherme Ferrara ◽  
Luciano Lamazales ◽  
Marcela Mara Silva Freitas ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Medical Records ◽  
Spherical Equivalent ◽  
Interventional Study ◽  
Data Comparison ◽  
Corneal Densitometry ◽  
Corrected Visual Acuity ◽  
Ring Segment ◽  
The Mean

Objective: Evaluation of central corneal densitometry changes following Ferrara corneal ring segment implantation in patients with keratoconus, especially the correlation between corneal densitometry and keratometry. Methods: Retrospective, non-comparative, interventional study based on the review of medical records of patients diagnosed with keratoconus who underwent Ferrara corneal ring segment implantation. Pre and post-operative corneal densitometry measurements obtained with Pentacam HR (Oculus, Wetzlar, Germany) were analyzed. The follow-up time was 3 months, and data comparison was made, using specific statistical analysis, with the data of 3 months postoperatively. Results: The study sample consisted of 43 eyes of 36 patients. The mean corrected visual acuity improved from 0.82 LogMAR preoperatively (SD ± 0.33) to 0.19 LogMAR (SD ± 0.13) postoperatively. The mean spherical equivalent varied from −4.63 (SD ± 3.94) preoperatively to −2.16 (SD ± 2.63) postoperatively. Asphericity varied from −0.69 (SD ± 0.32) preoperatively to −0.27 (SD ± 0.31) postoperatively. The mean maximum K was 54.01D (SD ± 3.38) preoperatively and 51.50D (SD ± 2.90) postoperatively. The mean anterior densitometric value was 18.26 (SD ± 2.03) preoperatively and 17.66 (SD ± 1.84) postoperatively. Conclusion: Corneal densitometry is an interesting technology that should be studied in keratoconus patients. Our results suggest that the corneal densitometry in the cornea’s anterior layer reduces after ICRS implantation and correlates with corneal keratometry. Further studies should be performed to increase the knowledge in this field.

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