1,720,978 research outputs found
Optical coherence tomography and biomicroscopical analysis inmacular holes
No full textPurpose To assess the usefulness of optical coherence tomography (OCT) for better
diff erential diagnosis of macular holes in comparison with biomicroscopical fundus
analysis.
Methods We reviewed the fi les of 25 eyes of 24 patients who were diagnosed as having
a macular hole on OCT examination and biomicroscopical fundus analysis. Each eye
underwent six radial 3-mm OCT scans centered on the macula, one 6-mm vertical and
one 6-mm horizontal scan. Retinal thickness was measured at the foveal center and 750
&m from the center, vertically, and horizontally. " e diameter of the macular contour
was also measured on vertical and horizontal scans.
Results On biomicroscopy only 8 eyes (32%) were diagnosed as having macular
hole, while in the remaining 17 eyes (68%) diagnosis of macular hole was possible only
performing an OCT examination.
Conclusion Optical coherence tomography is very useful in the diagnosis of macular
holes compared with classic biomicroscopical analysi
SELECTIVE LASER TRABECULOPLASTY: HYPOTENSIVE EFFICACY, ANTERIOR CHAMBER INFLAMMATION AND POSTOPERATIVE PAIN
No full textIntroduction
Argon laser trabeculoplasty (ALT) has been purposed for intraocular pressure (IOP) lowering in patients with glaucoma by Wise e Witter in 1979
1
and more recently, in 1995 a frequency-doubled,Qswitched, neodymium:yttrium aluminium garnet (Nd:YAG) laser was developed to lower IOP2
. It has the benefit of using 80-100 times less energy than ALT, preserving the trabecular meshwork architecture in animal models, and being potentially repeatible
3
. Selective laser trabeculoplasty (SLT) causes selective photothermolysis of pigmented trabecular cells without any collateral structural damage to
the trabecular meshwork (TM)
4
. SLT as an adjunctive or a primary therapy marks an advancement in the tratment of open angle glaucoma. The aim of our study was to evaluate the safety and efficay
of SLT to lower IOP in primary open angle glaucoma patients.
Methods
The patients already attending the glaucoma center at the Ophthalmology Unit of Unversity Hospital of Siena were included in a prospective clinical trial
if they had primary open angle glaucoma requiring therapy in addition to their current medications. The therapy was recomended when patients were
unable to reach their clinically determined target IOP while taking medications, were unable to tolarate the medications that were keeping IOP at an adeguate target level or were noncompliant with medication use. All of the patients had been fully informed about the procedure and informed consent was
obtained from all of them.
Patients underwent a full ophthalmologic examination that included Snellen visual acuity, applanation tonometry, slitlamp examination with gonioscopy,
pachimetry, evaluation of the optic disc and visual-field assessment (Humphrey 30-2 perimetry). The grade of pigmentation of the TM was assess before
treatment.
On the day of SLT the only pretreatment preparation was topical anaesthesia with benoxinate hydrochloride 0.4% (Novesina 0.4%, Novartis Farma) eye
drops. We used a new laser the Laser Solutis SLT laser (Quantel Medical, Clermont-Ferrand, France) a frequency doubled, Q-switched Nd:YAG laser emitting at 532 nm, with a pulse duration of 4 ns, a spot size of 400 μm and pulse Energy ranging from 0.2 to 2 mj, coupled to a Haag-Streit slit lamp (figg.
1-2). One Surgeon (PF) performed the laser procedure and the Latina SLT laser lent was used. Using a 400 μm spot the entire width of the trabecular
meshwork was irradiated with each pulse. The laser energy was initially set at 0.7 mj and a single pulse was delivered at the 12 o’clock position. If cavitation bubbles appeared, the energy was reduced by 0.1 mj increments until no bubble formations were observed and treatment continued at this energy level. If no cavitation bubbles occurred, the energy was increate by increments of 0.1 mj until bubble formation and then decreased as describe above. The
entir TM was treated with 100 non-overlapping spots. A drop of nonsteroidal anti-inflammatory agent was instilled after the SLT and the patients was advised to use the diclofenac sodium ophthalmic solution 0.1% (Voltaren Ofta, Novartis Farma) bid for 5 days. Treatment success for IOP control was defined
as at least a 20% reduction from baseline measurement. The IOP in the treated eye was assessed and recorded 1 day, 1 moonth and every 3 months after
treatment for one year (tab 1). Complete ophthalmic examination, gonioscopy, and visual field analysis were performed before, 6 months after and 1 year
after treatment.
Statistical analysis was performer using a paired t test for paired data for assessing change in intraocular pressure from baseline values.
Results
Selective laser trabeculoplasty was performed in 103 eyes of 103 primary open angle glaucoma patients, 41 (39.8%) men and 62 women (60.2%) with a
mean age of 70.3 years (range, 40-89 years) (tab.2). We esamine the safety and efficacy of the laser treatment to reduce IOP from its preoperative levels.
The mean IOP prior the treatment was 20.04 mmHg ± 3.3 SD range 12-28 mmHg, one day after the treatment IOP was 18.43 ± 3.1 SD, range 9-30 (P=
0.002), 1 month after the treatment IOP was 15.7 mmHg ± 2.9 SD, range 8-30 (P< 0.001), 3 months after the treatment IOP was 15.7 mmHg ± 2.3 SD,
range 10-22 mmHg (P< 0.001), after six months intraocular pressure was 15.5 mmHg ± 2.6 SD range 12-24 mmHg (P< 0.001), 9 months after the treatment IOP was 15.1 mmHg ± 2.8 SD range 9-20 mmHg (P< 0.001) and 1 year after the treatment IOP was 15.1 mmHg ± 2.7 SD range 10-21 mmHg (P<
0.001) (tab.3). Figure 3 graphically shows the IOPs over time for all treated eyes. Table 4 lists the mean change in IOPs and percent IOP reduction from
baseline for all treated eyes. The greatest drop in IOP occurs after 9 months (22.6%) and then again at 1 year after the procedure. An IOP reduction of
at least 20% after SLT was defined as a succesfull treatment and from 1 months after the treatment the averange percent IOP reduction from baseline for
all treated eyes was 21,82% (4.62 mmHg). The average number of SLT spots was 100 and the average energy per laser spot was 1.17 mj +/- 0.12 SD (range, 0.8-1.5 mj). The mean trabecular meshwork pigmentation was 1.48 (range, 0-3). There were not any kind of complications during the treatment and
after the treatments. One year follow up was not completed for 4 eyes for uncontrolled IOP or for visual fiel worsening (tab.5).
Anterior chamber reaction disappeared within 24 hours, 39 patients ( 37.8%) had a mild disconfort 1 day after the treatment and only 8 after 1 month.
One day after the treatment no eyes show any sings of anterior chambre inflammation (flare in anterior chambre (AC) and Cells in AC) (tab.6). During
follow up there were no change in visual acuity and no peripheral anterior sinechia were noted at gonioscopy 6 months and 1 year after SLT. In our study 95% of eyes treated had IOP reduction on 2 consecutive visits. As listed in table 7 before treatment the mean number of glaucoma medications for
the treated eyes was 2.7 ± 0.9 SD remained essentially unchanged throughout the trial with 2.3 ± 0.5 at 1 year of follow-up.
SELECTIVE LASER TRABECULOPLASTY:
HYPOTENSIVE EFFICACY, ANTERIOR CHAMBER
INFLAMMATION AND POSTOPERATIVE PAIN
P. Frezzotti, I. Motolese, S. Peruzzi, P. Mittica, V. Mittica, M. Fruschelli, E. Motolese
Department of Surgery, Ophthalmology Unit, University of Siena, Siena, Italy
Conclusions
SLT is a potentially usefull addition to the techniques available for glaucoma therapy. The main advantage of SLT over traditional argon laser tecniques is considered to be the selective tageting of
the pigmented trabecular meshwork cells, avoiding thermal damage to nonpigmented cells or
other local structures, such as the scleral beams of
meshwork tissue
5
. The results of our study show
that selective laser trabeculoplasty is a safe and effective method of lowering IOP in patients with
open-angle glaucoma. This is the first clinical trial
using Laser Solutis SLT laser (Quantel Medical,
Clermont-Ferrand, France) a frequency doubled,
Q-switched Nd:YAG laser emitting at 532 nm. In our patients we found an important and statistically significant (p<0.001) reduction of intraocular pressure during the follow-up period of month 1 to
12 after the selective laser trabeculoplasty. None of our patients show “cellular” reaction 1 day after treatment.
In conclusion, in our study we demontstrated an IOP decrease after SLT that was similar to those reported by other clinical studies, althoug there was a lower tendency for reduced IOP response with a
12 months follow-up. As there were notcomplications this treatment modality may be a good alternative to long-term medical therapy in primary open angle glaucoma patients
Caso clinico di un corpo estraneo corneale con diagnosi e management conservativo a lungo termine
No full textPurpose: To describe the diagnosis and
management of one case of a patient with a welltolerated
and long-standing retained intracorneal
brick foreign body.
Methods: Observational case report.
Results: A 42-years old man was admitted to our
clinic with an intracorneal brick foreign body well
demarcated in the posterior stroma of the right eye
(RE ) cornea in the correspondence of the inferior
quadrant at 6.30 o’ clock.
No signs of perforation were underlined at
slit-lamp-examination (SLE ) and fundus
biomicroscopy examination: the foreign body
stopped at 98 μ distance from corneal endothelium,
well tolerated and encapsulated, almost simulating
a sort of breach like a corneal tunnel.
Optical Coherence Tomography-Visante (Visante
1000, Carl Zeiss Meditec Inc, Dublin, CA , USA)
examination of the anterior segment of the RE
and color anterior segment photographs were
carried out to compare foreign body position and
corneal tissue reactions in the follow up visits”
Conclusion: Treatment options and classic
studies teach us that intracorneal foreign bodies
must be removed especially to avoid the danger
of the infections, but in some cases it is possible
obtain to a conservative management because
they can be well-tolerated by the eye without
sympthoms and preserving outcomes in visualacuity
Subthreshold micropulse photostimulation with true yellow 577nm diode laser for macular edema secondary to branch retinal vein occlusion
No full textPurpose: Subthreshold, or tissue sparing, Diode Micropulse (SDM)
Photostimulation is a recent retinal treatment used to produce a therapeutic
effect without inducing detectable intraretinal damage. Actually SDM
Photostimulation is available for diabetic macular edema (DME), central serous
chorioretinopathy (CSR) and macular edema secondary to branch retinal
vein occlusion (BRVO).
Methods: Three patients affected by cystoid macular edema (CME) secondary to non-ischemic BRVO, diagnosed by clinical and instrumental criteria,
Best Corrected Visual Acuity for distance (BCVA), Ocular Coherence
Tomography (OCT) and Fluorescein Angiography (FA) were submitted to
SDM Photostimulation using the IQ 577nm yellow laser system. Controls
were perfomed at 3 and 6 months after the treatment.
Results: Central Macular Thickness (CMT) decreased by an average of
179.76 microns, with a maximum of 89 and a minimum of 288. CME resolved
completely in one case and benefited of a great reduction in the other two
cases. Distance BCVA greatly improved in one case and showed a moderate
gain in reading snellen lines in the other cases.
Laser lesions were not clinically observed 3 and 6 months after the treatment.
Conclusions: SDM Photostimulation with the IQ 577 nm yellow laser has
been very effective in these three cases of CME after non-ischemic BRVO.
Visual recovery, anatomic resolution of edema and absence of iatrogenic retinal
damage may suggest us this treatment as an alternative to conventional
more invasive therapies
Use of amniotic membrane transplantation in isolated conjunctival Bowen disease: a case report
No full textPURPOSE: To report a case of isolated conjunctival Bowen disease treated with surgical resection and amniotic membrane transplantation.
METHODS: Interventional case report.
RESULTS: A 70-year-old man was admitted to our clinic with a large conjunctival verrucous plaque well-demarcated in the correspondence of the bulbar conjunctiva in the superior quadrant of the left eye with involved limbal and corneal surface. Ophthalmologic examination on slit-lamp examination and color fundus photographs were carried out before surgery and the results were evaluated.
CONCLUSIONS: Treatment options and treatment studies of Bowen disease are difficult because there are a variety of different protocols and the success of the management depends on several factors (body site, lesion size, number of lesions, and thickness). In the conjunctival localization of the lesion, amniotic membrane transplantation appears to be a useful therapeutic choice after surgical resection of the lesion used to reconstruct ocular and conjunctival surfac
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Retinal detachment and convexity intracranial meningioma: an uncommon association.
No full textCASE REPORT: A 70-years-old woman presented with a one week history of progressive loss of vision in the right eye (RE) diagnosed as retinal detachment from 7 to 1 o' clock with retinal break at the 10.30 o' clock associated. Gadolinium enhanced magnetic resonance imaging (MRI) scan of the brain and orbits with fat suppression showed a convexity meningioma. Scleral buckling with a segmental sponge, subretinal fluid drainage and cryopexy were performed with detachment repair. CONCLUSION: In our patient with retinal detachment and convexity meningioma without significant neurological symptoms, performing ocular surgery and close follow up care seemed to be the optimal treatment option
- …
