1,720,965 research outputs found
Evaluation of Retinal Morphology and Retinal Sensibility Before and After Macular Pucker Surgery
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Purpose:To analyze the role of both morphological and functional retinal assessment to better understand macular pucker surgery outcomes.
Methods:This prospective study included 23 eyes of 23 consecutive patients affected by macular pucker who underwent standard macular surgery. Morphological examinations and functional assessments were evaluated at baseline and at month 1, 3 and 6 after surgery. Morphological examination was performed by Spectral OCT (OTI, Toronto, Canada) evaluating type and thickness of macular edema. Functional assessment included visual acuity, retinal sensibility and fixation pattern using the microperimeter (MP1, Nidek Technologies, Padova, Italy).
Results:Presurgical morphological quantitative evaluation showed mean retinal thickness of 493.50±85.87 μm; after surgery, at day 30 we found 355.50±73.28 μm, at day 90 323.70±77.40 μm, at day 180 313.17±80.75 μm. Presurgical functional evaluation showed LogMAR mean visual acuity of 0.56±0.19 and retinal sensitivity of 11.14±3.30 dB; after surgery, at day 30 we found 0.40±0.19 and 11.73±3.33 dB, at day 90 0.41±0.17 and 12.06±4.14 dB, at day 180 0.32±0.17 and 12.18±2.44 dB. Overall macular thickness reduction and visual acuity increase resulted statistically significant (p<0.05) at each control during the follow up. Mean retinal sensibility increase resulted significant (p<0.05) between baseline and day 180. Fixation pattern improved significantly (p<0.05), showing a stable fixation in 12 of 23 patients (57%) at baseline, in 17 of 23 patients (74%) at day 30 and in 20 of 23 patients (87%) at day 180, suggesting a significative recovery on visual performances.
Conclusion: Our study, as already known in literature, shows macular thickness reduction significantly related to visual acuity increase. Moreover, functional evaluation we performed underlined the role of microperimetry (retinal sensibility and fixation pattern) to complete visual acuity examination for a better definition of the efficacy of surgical treatment. Overall, our study showed that morphological retinal analysis associated to functional assessment could best evaluate clinical effectiveness of the therapy applied
Retinal Morphology and Retinal Nerve Fibres Layer Changes After Intravitreal Ranibizumab for Exudative AMD: Nine Months-Prospective Study
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Purpose:To evaluate changes on visual acuity, retinal morphology and RNFL (Retinal Nerve Fiber Layer) thickness in patients receiving multiple intravitreal injections of ranibizumab for exudative AMD.
Methods:In this prospective study we included 21 eyes of 21 consecutive patients with active CNV for AMD. All patients were treated with a loading-dose of 3 intravitreal injections of ranibizumab (2,3 mg/0,23 ml) one every 30 days and then as needed according to visual acuity and OCT evaluations. We performed a complete ophthalmological examination, including visual acuity, OCT (macula and glaucoma protocol) and GDx-VCC examinations to analyze macular and RNFL thickness at baseline and during follow up at month 1, 3, 6 and 9.
Results:Mean LogMAR visual acuity at baseline was 0.418±0.169, at month 9 was 0.304±0.127. Mean central macular thickness at baseline was 379.33±148.06 μm; at month 9 we measured a mean decrease of-210±163.53μm (p0.05). Mean RNFL thickness obtained from GDx-VCC protocol at baseline was 61.18±6.18μm; at month 9 we measured a mean decrease of -5.657±4.194 μm (p>0.05).
Conclusions:Both OCT and GDx measurements showed a non statistical significative variation on retinal nerve fibre layer thickness during the follow up. This suggests that the frequent IOP fluctuations after intravitreal treatments as well as anti-VEGF properties of ranibizumab inhibiting neuroprotection do not cause adverse effects on retinal ganglion cells on one year follow up. Moreover, our study confirm the efficacy of ranibizumab to improve visual acuity modifying the worsening evolution of exudative AMD and restoring retinal layers thickness-morphology on treated patients
MP-1 Nidek vs. Spectral OCT/SLO OTI Microperimeter on the Evaluation of Retinal Sensibility in Different Macular Diseases
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Purpose:Prospective comparative observational study to measure diagnostic efficacy and availability of new OCT/SLO microperimetry OTI compared to MP1 NIDEK microperimeter.
Methods:40 eyes of 25 consecutive patients underwent a complete ophthalmologic examination with ETDRS BCVA and OCT evaluation. We classified eyes in 3 Groups according to the considered pathologies: 18 eyes with diabetic macular edema (different patterns: sponge like, diffuse, serous foveal detachment), 10 with idiopathic macular holes and 12 with macular pucker . Each eye was studied on both microperimetry instruments and a specified strategy was performed according to the pathological feature. Location and stability of fixation as well as depth and size of detected scotomata were compared on both instruments.
Results:The evaluation of macular fixation was not statistically different with both instruments in all Groups: a stable fixation was detected in 25 eyes in MP1 and 23 eyes in OTI. All over mean macular sensitivity was 12.3 dB with SLO and 13.3 dB with MP1. There was good concordance of results between the considered instruments in each specified Group, with 87.5% (35/40) eyes examined showing equal defects. Average number of stimuli was similar in both instruments on different studies applied (48.2 on MP1 and 45.7 on OTI); examination time was prolonged with MP1 (14.4 min on OTI - 18.5 min on MP1). Throughout all examinations, fundus visualization with the SLO was superior to standard MP1 (besides its optional fundus colour camera).
Conclusions:Our new OCT/SLO microperimetry instrument represents nowadays a valid and useful alternative to MP1, despite its less diffusion and less protocol standardization. This instrument has moreover the possibility to directly visualize the results of microperimetry overlapped on a OCT retinal thickness map, for an intuitive comprehension of the entity and extension of the pathology
Refraction and Strabismus Evaluation in Preterm Infants With and Without Retinopathy of Prematurity
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Purpose:To investigate cycloplegic refraction and ocular alignment in a population of preterm infants at one and six years old with regard to birth weight (BW) and gestational age (GA).
Methods:We considered 261 preterm infants with BW of 1500gr or less and/or GA of 32 weeks or less. We evaluated visual refraction and ocular alignment records on each patient at the age of one and six years. We considered retinopathy of prematurity (ROP) stage I and II as mild ROP and higher ROP stages as severe ROP. We identified three groups of patients: 217 infants (434 eyes) without evidence of ROP (Group 1: control group), 28 infants (56 eyes) with mild ROP (Group 2) and 16 infants (32 eyes) affected by severe ROP (Group 3). T Student test was performed at the end of the study to compare data.
Results:The incidence of visual refraction and ocular alignment at the age of one year old in Group 2 and 3 compared to control Group 1 was respectively: emmetropia 1.9% (Group 2) and 5% (Group 3) vs 4% (Group 1); myopia 17.3% (p=0.001) and 39% (p=0.002) vs 5%; hypermetropia 27.8% and 19% vs 37%; astigmatism 45% and 37% vs 54%; strabismus 11.5% (p=0.001) and 38% (p=0.002) vs 5.3%. The incidence of visual refraction and ocular alignment at the age of six years old was respectively: emmetropia 2% and 6% vs 4.5%; myopia 10.7% (p=0.003) and 25% (p=0.001) vs 5.5%; hypermetropia 46.4% and 40.6% vs 60.08%; astigmatism 39.2% and 28.1% vs 29% and strabismus 25% (p=0.003) and 56.25% (p=0.003) vs 11.5%.
Conclusions:Myopia and strabismus had a significative high incidence at one and six years follow up Groups 2 and 3 compared to control Group 1. The risk of these disorders increases significantly (p<0.05) with the severity of ROP (Group 2 and Group 3 vs Group 1). These data underline the importance of a correct diagnosis and follow up of myopia and strabismus to prevent amblyopia and visual impairment in adulthood. Our data confirm and better underline at six years follow up what we have already showed in our previous study (ARVO 2006, 5299-B714) at one year follow u
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