1,720,964 research outputs found
Yellow micropulse laser in diabetic macular edema: a short-term pilot study.
No full textAbstract
PURPOSE:
To evaluate the effects of yellow micropulse laser in eyes with diabetic macular edema (DME).
METHODS:
In this retrospective interventional case series, 22 eyes of 17 patients with visual impairment secondary to persistent DME received one single session of yellow micropulse laser. Patients were divided into 2 groups: group 1, naive eyes; and group 2, previously treated eyes. Main outcome measures included changes in central retinal thickness (CRT) and best-corrected visual acuity (BCVA). Possible atrophic changes of the retinal pigment epithelium as a result of yellow micropulse laser application were evaluated with fundus autofluorescence.
RESULTS:
At baseline, the mean logMAR BCVA was 0.39 ± 0.18 and the mean CRT was 361.8 ± 70.95. The mean BCVA improved to 0.31 ± 0.19 (p = 0.0091) and 0.31 ± 0.19 (p = 0.0078) at 3 and 6 months of follow-up, respectively. The mean CRT improved to 331.3 ± 48.46 (p<0.0001) and 328.1 ± 53.25 (p<0.0001) at 3 and 6 months of follow-up. Subgroup analysis showed that only in naive eyes was there a beneficial effect on visual acuity and central macular thickness.
CONCLUSIONS:
In eyes with DME, yellow micropulse laser produces a statistically significant improvement in BCVA and CRT in the short term
Subthreshold laser grid photocoagulation for the treatment of diabetic macular edema
No full textAbstract Purpose : o evaluate the efficacy and safety of subthreshold laser grid photocoagulation (SLGP) in patients affected by diabetic macular edema (DME). Methods : or the past decades, laser photocoagulation has been the mainstay of treatment for patients with DME; however, although effective in preserving vision, this form of therapy is of limited effect in restoring lost vision. Recently, anti vascular endothelial growth factor agents and corticosteroids have been approved for the treatment of DME but there are still some questions regarding safety, dose frequency and costs for both the patients and the national health system. Retrospective analysis of the I-maculaweb database selecting patients with DME treated with SLGP. The patients for this study were selected according to the following characteristics: not being able to receive either anti-VEGF agents, due to medical reasons, or corticosteroids being phakic or cortisone responders or among those who did not show any improvement after anti-VEGF injections. 21 eyes of 14 caucasian patients were treated with SLGP using 10 ms, 100 μm single spot, 50% end point management. Initial energy was 100 mW, increases of 25 mW were utilised as needed.Patients were retreated after a minimum time of 3 months when either the central retinal thickness (CRT) didn’t show any sign of decrease or best corrected visual acuity (BCVA) didn’t increase more than 5 letter. Mean number of SLGP was 1.4±0.75.Glycosilated Haemoglobin levels were monitored before the treatment and did not differ significantly during the follow-up. Results : ean age was 68 years±16.85. Mean CRT at baseline and last follow-up visit was 327.49μ ±27.40 and 312.07 μ ±32.06 respectively (p=0.0045; paired t test). Mean number of ETDRS letter score at baseline and last follow-up visit was 67.43±9.93 and 71.38±10.95 (p=0,0075; paired t test) respectively. Mean follow-up was 11.52 months ±9.02.No visual and systemic adverse events were experienced after the SLGP. Conclusions : LGP might be a safe and useful option in those patients who cannot receive either anti-vegf agents or corticosteroids. This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016
Chorioretinal folds: a proposed diagnostic algorithm
No full textPurpose: To create a diagnostic algorithm for the management of chorioretinal folds. Methods: We reviewed the existing literature about chorioretinal folds focusing our attention on three specific conditions and created a diagnostic algorithm in order to otpimize the choice and the number of investigations. Results: Chorioretinal folds are visible striations of the fundus usually arranged in parallel lines and disposed horizontally. They may be either unilateral or bilateral, symptomatic or asymptomatic and are often associated with different possible ocular and extra ocular pathologies, including systemic diseases like autoimmune disorders and intracranial hypertension. They are named idiopathic when no apparent cause for their development is detectable. However, with improved diagnostic testing, the patients with idiopathic choroidal folds are likely to represent only a smaller portion of the total. Conclusions: Since choroidal folds be the sole sign of an underlying disease possibly requiring a multidisciplinary approach, an appropriate work-up varying according to the specific clinical features of each case is needed to define the etiology and the treatment. A diagnosting algorithm may be useful in order to optimize the diagnostic approach and management
Assessing Descemet's Stripping Automated Endothelial Keratoplasty in complex cases followed up with Optical Coherence Tomography
No full textAbstract Purpose : to assess the predictive value of early Anterior Segment Optical Coherence Tomography (AS-OCT) findings on graft adherence after Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK) performed in complex eyes. Methods : hirty-seven consecutive DSAEK in complex eyes, performed by a single surgeon (C.E.T.), were analyzed. The main inclusion criterion was a history of one or more surgical procedures, i.e. trabeculectomy, glaucoma drainage device (GDD, Baerveldt®) implantation, penetrating keratoplasty (PK), aphakia with anterior chamber intraocular lens (AC-IOL) implantation, AC-IOL + GDD, PK + GDD, PK + AC-IOL + GDD, respectively. Complexity included severe corneal edema. Uncomplicated cataract extraction with posterior chamber IOL implantation was not a selection criterion. Graft adherence/detachment was assessed using AS-OCT on day 1 (early AS-OCT) and week 1 postoperatively and again at 1, 3 and 6 months. Grading was: complete attachment, one sector peripheral detachment (1S.P.D.), more than one sector peripheral detachment (>1S.P.D.). Results :f the 37 consecutive complex eyes analyzed, thirty eyes (81%) had severe corneal edema preoperatively. At day 1, 7 grafts (19%) were completely attached in the AS-OCT scan and 30 (81%) showed some degree of peripheral detachment. Nineteen (63%) of the partially detached cases presented 1S.P.D. and 11 (37%) had >1S.P.D. At 6 months, completely attached grafts were stable. Seventeen eyes with 1S.P.D. (90%) showed improved graft adhesion; 2 (10%) were unchanged. Of the 11 cases with >1S.P.D.: 8 (72%) were stable, 2 (18%) detached completely while and 1 (9%) improved. Conclusions :S-OCT is a non-invasive imaging technique and therefore suited to monitor DSAEK graft adhesion in complex eyes. Findings at day 1 yielded a good predictive value of graft adherence at 6 months. Therefore, early AS-OCT scans do, indeed, facilitate decision-making with regards to further surgical procedures in complex eyes. This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016
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
Half-Fluence Versus Half-Dose Photodynamic Therapy in Chronic Central Serous Chorioretinopathy
No full textPURPOSE:
To compare the efficacy and safety of half-fluence vs half-dose photodynamic therapy (PDT) in chronic central serous chorioretinopathy (CSC).
DESIGN:
Multicenter retrospective comparison study.
METHODS:
Retrospective review of 56 patients affected by chronic CSC, including 28 patients (31 eyes) who received half-fluence PDT and 28 patients (29 eyes) who received half-dose PDT. Best-corrected visual acuity (BCVA), central foveal thickness (CFT), and resolution of subretinal fluid on optical coherence tomography at 1 and 12 months were assessed.
RESULTS:
The mean logMAR BCVA improved significantly (P < .001), both in the half-fluence group (from 0.187 [± 0.187] to 0.083 [± 0.164]) and in the half-dose group (from 0.126 [± 0.091] to 0.068 [± 0.091]), at 12 months, without significant difference between the 2 groups. At 1 month a complete resolution of subretinal fluid was observed in 19 half-fluence-treated eyes (61.3%) and in 25 half-dose-treated eyes (86.2%) (P = .04). At 12 months, a complete resolution of subretinal fluid was achieved in 26 half-fluence-treated eyes (83.9%) and 29 half-dose-treated eyes (100%) (P = .0529). Nine eyes (29%) in the half-fluence group and 5 eyes (17.2%) in the half-dose group had at least 1 recurrence of subretinal fluid during the follow-up. Overall there were 15 and 5 recurrences in the half-fluence PDT and half-dose PDT groups, respectively (P = .07). In no eye of either groups was atrophy of the retinal pigment epithelium observed in the area of treatment.
CONCLUSION:
Half-dose PDT induced a more rapid reabsorption of the fluid, a more lasting effect, and equal safety with respect to half-fluence PDT
The multifaceted presentation of syphilitic chorioretinitis examined by multimodal imaging: A case series
No full textOcular syphilis is also known as the 'great masquerader' for the wide variety of clinical features associated with this infection. Although chorioretinitis represents the most frequent manifestation in the posterior pole, other clinical entities can be described, including retinal vasculitis, optic disc disorders, necrotizing vasculitis and acute syphilitic posterior placoid chorioretinopathy (ASPPC).
This latter is an infrequent ocular manifestation of syphilis, whose pathophysiology remains still unknown; however, multimodal imaging, including optical coherence tomography angiography (OCTA), has enabled us to better describe its pathophysiology and clinical course.
In this study we report a case series of 3 different patients with syphilis-related chorioretinopathies; in this regard, the role of multimodal imaging has emerged has an extremely useful approach in order to better understand the pathophysiology of syphilitic chorioretinopathies. This could help clinicians (both ophthalmologist and infectious disease specialists) to early treat and prevent the severe ocular complications related to this fearsome disease
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
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