2007/06/09

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Items 1 - 6 of 6
1: Ophthalmic Res. 2007 Jun 6;39(4):188-190 [Epub ahead of print]

Inhibiting Angiogenesis in Retinoblastoma.

Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Mo., USA.

PMID: 17556838 [PubMed - as supplied by publisher]

2: Br J Ophthalmol. 2007 Jun 7; [Epub ahead of print]

Cataract prevalence, cataract surgical coverage and barriers to uptake of cataract surgical services in Pakistan: The Pakistan National Blindness and Visual Impairment Survey.

Pakistan Institute of Community Ophthalmology, Kyber Institute of Ophthalmic Medical Sciences, Pakistan.

AIM: To estimate the prevalence of visual impairment and blindness due to cataract, the prevalence of aphakia/pseudophakia, the cataract surgical coverage (CSC), and to identify barriers to the uptake of cataract services among adults aged >/=30 years in Pakistan. METHODS: Probability proportional-to-size procedures were used to select a nationally representative sample of adults. Each subject underwent: interview, visual acuity measurement, autorefraction, biometry and ophthalmic examination. Those that saw < 6/12 in either eye underwent a more intensive examination procedure including: corrected visual acuity, slit lamp and dilated fundus examination. Cataract surgical coverage was calculated for different levels of visual loss by person and by eye. Individuals with <6/60 in the better eye due to cataract were interviewed regarding barriers. RESULTS: 16,507 adults were examined (95.5% response rate). The crude prevalence of blindness (presenting <3/60 in the better eye) due to bilateral cataract was 1.75% (95% CI: 1.55, 1.96%). 1,317 participants (633 men; 684 women) had undergone cataract surgery in one or both eyes giving a crude prevalence of 8.0% (95%CI: 7.6, 8.4%). The CSC (persons) at <3/60, <6/60 and <6/18 were 77.1%, 69.3% and 43.7% respectively. The CSC (eyes) at <3/60, <6/60 and <6/18 were 61.4%, 52.2% and 40.7% respectively. Cost of surgery (76.1%) was the main barrier to surgery. CONCLUSIONS: There are estimated to be approximately 570,000 adults who are blind (<3/60) from cataract in Pakistan, and 3,560,000 eyes with a visual acuity of < 6/60 due to cataract. Overall, the national coverage is good but underserved populations have been identified.

PMID: 17556430 [PubMed - as supplied by publisher]

3: Br J Ophthalmol. 2007 Jun 7; [Epub ahead of print]

Effect of pupillary dilation on glaucoma assessments using Optical Coherence Tomography.

Torbay Hospital, United Kingdom.

AIMS: To examine the effect of pupillary dilation on the reliability of retinal nerve fibre layer (RNFL) and optic nerve head (ONH) assessments using Stratus OCT in a glaucoma clinic. METHODS: Observational study involving 38 patients who attended a glaucoma clinic. The 'fast optic disc' and 'fast RNFL thickness' programmes on Stratus OCT were used to measure the RNFL thickness and ONH cup to disc ratio (CDR). Two scans were performed before dilation and 2 after dilation with tropicamide 1% drops. The mean values and reproducibility before and after dilation were compared, as was the quality of scans as indicated by the 'signal strength' score. RESULTS: In 9 patients (23.7%) no images were obtained undilated but after dilation examination was possible in all patients. Inability to obtain an undilated scan was associated with smaller pupil size and increasing cataract. The scan quality, as judged by the signal strength score, was higher dilated than undilated for both RNFL thickness (p=0.011) and ONH CDR (p=0.007). The reproducibility was higher with dilated scans for RNFL thickness but we found no difference for ONH CDR. There were significant differences between the dilated and undilated examinations for 3 of the 5 RNFL thickness variables and 2 of the 3 ONH CDR categories. CONCLUSIONS: In almost a quarter of patients, acquiring high quality OCT images was not possible without pupillary dilation. The dilated scans were more reproducible and of higher quality than the undilated scans. In addition the two methods of examination do not appear to be interchangeable, suggesting that follow up examinations should be performed with the pupil in the same condition as baseline. In view of these findings we recommend pupillary dilation prior to glaucoma assessments using Stratus OCT.

PMID: 17556429 [PubMed - as supplied by publisher]

4: Br J Ophthalmol. 2007 Jun 7; [Epub ahead of print]

Purtscher's retinopathy: epidemiology, clinical features and outcome.

Manchester Royal Eye Hospital, United Kingdom.

AIMS: To study the incidence, systemic associations, presenting features and natural history of Purtscher's retinopathy in the United Kingdom and Ireland. METHODS: Cases were collected prospectively by active surveillance through the British Ophthalmological Surveillance Unit. Clinical details were obtained using an incident questionnaire, with follow-up at 1 and 6 months. RESULTS: Clinical details were obtained for 15 cases in 1 year. These were associated with road traffic accident in 6 cases, chest compression in 6 cases and acute pancreatitis in 3 cases. All cases were symptomatic and presented with loss of visual acuity, visual field or a combination. Bilateral involvement was noted in 9 cases. The acute retinal signs of cotton wool spots, retinal haemorrhage and Purtscher flecken cleared within one month in 26% of eyes and within 6 months in all eyes. The most common chronic signs were optic disc pallor and atrophy of the retinal pigment epithelium. Without treatment, 50% of eyes improved by at least 2 Snellen lines at final follow-up and 23% improved by at least 4 Snellen lines. Only 1 of the 24 eyes had a final acuity worse than that recorded at presentation. CONCLUSION: Purtscher's retinopathy is a rare but sight threatening eye condition, most commonly seen in young or middle-aged males and after trauma. Spontaneous visual recovery of at least 2 Snellen lines is seen in half of the cases.

PMID: 17556428 [PubMed - as supplied by publisher]

5: Br J Ophthalmol. 2007 Jun 7; [Epub ahead of print]

Biologic Response Modifier Therapy for Refractory Childhood Uveitis.

MERSI, United States.

PURPOSE: To evaluate the use of biologic response modifiers (BRM's) in the treatment of refractory childhood uveitis. DESIGN: Retrospective non comparative case series of pediatric patients with uveitis treated with BRM's. PARTICIPANTS: 23 pediatric patients. METHODS: All children (18 years or younger) who received a BRM were assessed for visual changes, time to control inflammation, and any associated adverse side effects. Thirteen patients were treated with infliximab, five with adalimumab, and five with daclizumab. All patients had bilateral eye involvement. Diagnoses of the participants included juvenile idiopathic arthritis, keratouveitis, sarcoid panuveitis, Adamantiades- Behcets disease, and idiopathic panuveitis. MAIN OUTCOME MEASURES: Inflammation and visual acuity. RESULTS: In the infliximab group 16 of 26 (62%) eyes, and 10 of 13 (77%) patients demonstrated an improvement in visual acuity. Twenty of 26 (77%) patients demonstrated an improvement in the degree of inflammation. In the adalimumab group 4 of 10 (40%) eyes demonstrated an improvement in visual acuity with 5 of 10 (50%) patients demonstrating an improvement in inflammation. Four of 10 (40%) eyes in the daclizumab group demonstrated an improvement in vision with 8 of 10 (80%) patients demonstrating an improvement in inflammation. CONCLUSIONS: BRM's appear to be safe to use in children, and represent a useful therapeutic adjunctive drug group for treating recalcitrant childhood uveitides.

PMID: 17556427 [PubMed - as supplied by publisher]

6: Ophthalmology. 2007 Jun 5; [Epub ahead of print]

Functional Assessment of Two Different Accommodative Intraocular Lenses Compared with a Monofocal Intraocular Lens.

Ophthalmology Institute, University of Verona, Verona, Italy.

PURPOSE: To evaluate selected functional and physical properties of 2 models of accommodative intraocular lenses (IOLs) compared with those of a standard monofocal IOL. DESIGN: Prospective randomized comparative trial. PARTICIPANTS: Subjects were divided into 3 groups. In group 1, 30 eyes (19 subjects) received 1CU IOL implantation; in group 2, 29 eyes (19 subjects) received AT-45 IOL implantation; and in group 3, 21 eyes (21 subjects) were implanted with a monofocal IOL as a control. INTERVENTION: Cataract surgery with implantation of the 1CU and AT-45 accommodative IOL models in the study groups, and the ACR6D monofocal IOL in the control group. MAIN OUTCOME MEASURES: Far and near distance visual parameters were assessed at 1, 6, and 12 months after surgery in the accommodative IOL groups, and at 1 and 12 months in the control group. Anterior segment anatomy was investigated by ultrasound biomicroscopy, with and without visual accommodative stimulation. RESULTS: The accommodative IOL groups significantly differed from the controls in terms of lower near-distance refractive addition (NDRA) and better distance-corrected near visual acuity (DCNVA), with P<0.001 at 1 year. The anterior IOL displacement during accommodation (DeltaACD) was significantly larger in the study groups, and this correlated with DCNVA. Until 6 months, the DeltaACD correlated with the solicited sclerociliary process rotation only in the study groups. CONCLUSION: This 12-month study demonstrated that the accommodating IOLs achieved better clinical results than the monofocal IOL in terms of DCNVA and NDRA. These results support the hypothesis that accommodative IOLs proportionally react to ciliary body rotation, although this relationship became less evident at 12 months.

PMID: 17555820 [PubMed - as supplied by publisher]

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