| 1. |
- Andersson Grönlund, Marita, 1959-, et al.
(författare)
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Ophthalmological findings in children and young adults with genetically verified mitochondrial disease
- 2010
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Ingår i: British Journal of Ophthalmology. - : BMJ Publishing Group Ltd. - 0007-1161 .- 1468-2079. ; 94:1, s. 121-127
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe ophthalmological phenotypes in patients with mitochondrial disease and known genotypes.METHODS: A retrospective study was performed on 59 patients (29 male, 30 female) with a mean age of 11.8 years who had mitochondrial disease with known DNA mutations. Fifty-seven of the 59 subjects underwent a detailed ophthalmological examination including visual acuity (VA), eye motility, refraction, slit-lamp examination, ophthalmoscopy and, in almost one-half of the cases, a full-field electroretinogram (ERG).RESULTS: Forty-six (81%) of the patients had one or more ophthalmological findings such as ptosis (n = 16), reduced eye motility (n = 22) including severe external ophthalmoplegia (n = 9), strabismus (n = 4), nystagmus (n = 9), low VA (n = 21), refractive errors (n = 26), photophobia (n = 4), and partial or total optic atrophy (n = 25). Pigmentation in the macula and/or periphery was noted in 16 patients. In 10/27 investigated individuals with full field ERG, retinal dystrophy was recorded in six different genotypes representing Kearns-Sayre syndrome (n = 5), Leigh syndrome (n = 1), Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) (n = 1), Myoclonus epilepsy with red ragged fibres (MERRF) (n = 1), Leber hereditary optic neuropathy (n = 1) and mitochondrial myopathy (n = 1).CONCLUSION: The results show that a majority of patients with mitochondrial disorders have ophthalmological abnormalities. We recommend that an ophthalmological examination, including ERG, be performed on all children and adolescents who are suspected of having a mitochondrial disease.
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| 2. |
- Austeng, Dordi, et al.
(författare)
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Treatment for retinopathy of prematurity in infants born before 27 weeks of gestation in Sweden
- 2010
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Ingår i: British Journal of Ophthalmology. - : BMJ. - 0007-1161 .- 1468-2079. ; 94:9, s. 1136-1139
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To study various aspects of treatment for retinopathy of prematurity (ROP) in a Swedish population of extremely preterm infants born before 27 weeks of gestation. METHODS: A national, prospective and population-based study was performed in Sweden from April 1, 2004 to March 31, 2007. The criteria for treatment of ROP accorded with the recommendations of the Early Treatment for Retinopathy of Prematurity Cooperative Group. RESULTS: Twenty percent of the infants (99/506) were treated for ROP. The likelihood of reaching treatment criteria nearly doubled for each week of reduction in gestational age (GA) at birth. The first treatment was performed at an earlier postmenstrual age in the most immature infants. One third of the infants had more than one session of laser treatment. CONCLUSIONS: A high percentage of these extremely preterm infants required treatment for ROP. The likelihood of reaching treatment criteria increased with a decline in GA at birth. Although only a few infants progressed to ROP Stages 4 and 5, our findings indicate a potential for improvement of the treatment routines, both regarding timing and number of laser spots at the first treatment.
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| 3. |
- Azuara-Blanco, Augusto, et al.
(författare)
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European Glaucoma Society research priorities for glaucoma care
- 2024
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Ingår i: British Journal of Ophthalmology. - : BMJ Publishing Group Ltd. - 0007-1161 .- 1468-2079. ; 108:8, s. 1088-1093
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aims: The goal of health research is to improve patients care and outcomes. Thus, it is essential that research addresses questions that are important to patients and clinicians. The aim of this study was to develop a list of priorities for glaucoma research involving stakeholders from different countries in Europe.Methods: We used a three-phase method, including a two-round electronic Delphi survey and a workshop. The clinician and patient electronic surveys were conducted in parallel and independently. For phase I, the survey was distributed to patients from 27 European countries in 6 different languages, and to European Glaucoma Society members, ophthalmologists with expertise in glaucoma care, asking to name up to five research priorities. During phase II, participants were asked to rank the questions identified in phase I using a Likert scale. Phase III was a 1 day workshop with patients and clinicians. The purpose was to make decisions about the 10 most important research priorities using the top 20 priorities identified by patients and clinicians.Results: In phase I, 308 patients and 150 clinicians were involved. In phase II, the highest-ranking priority for both patients and clinicians was € treatments to restore vision'. In phase III, eight patients and four clinicians were involved. The top three priorities were € treatments to stop sight loss', € treatments to restore vision' and € improved detection of worsening glaucoma'.Conclusion: We have developed a list of priorities for glaucoma research involving clinicians and patients from different European countries that will help guide research efforts and investment.
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| 4. |
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| 5. |
- Beckman, Claes, 1962-, et al.
(författare)
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Confocal fundus imaging with a scanning laser ophthalmoscope in eyes with cataract.
- 1995
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Ingår i: British Journal of Ophthalmology. - : BMJ. - 0007-1161 .- 1468-2079. ; 79:10, s. 900-4
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Tidskriftsartikel (refereegranskat)abstract
- AIMS/BACKGROUND: The study aimed to determine the influence of increased intraocular light scatter on the contrast in scanning laser ophthalmoscope (SLO) images and to examine to what extent SLO images can visualise the fundus through media opacities due to cataract.METHODS: Intraocular light scatter was estimated from measurements of letter contrast sensitivity before and after cataract surgery in five eyes. SLO images were obtained before and after surgery using confocal apertures of 1, 2, 4, and 10 mm, at laser wavelengths of 633 and 780 nm. Visibility of the fundus was determined by measurements of retinal contrast. SLO images were compared with standard fundus photographs.RESULTS: SLO images obtained before surgery revealed details of the retina that were unresolvable in the fundus photographs because of light scattering. By using one of the three smallest apertures, image contrast was further improved. However, no simple relations between aperture size, estimated light scatter, and image contrast could be found.CONCLUSION: SLO imaging was found to be superior to fundus photography for viewing the retina in eyes with cataract. Owing to the inhomogeneous nature of cataracts, the optimal choice of confocal aperture and laser wavelength is not simple and must be individualised.
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| 6. |
- Botling Taube, Amelie, 1966-, et al.
(författare)
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Proteomic analysis of the aqueous humour in eyes with pseudoexfoliation syndrome
- 2019
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Ingår i: British Journal of Ophthalmology. - : BMJ PUBLISHING GROUP. - 0007-1161 .- 1468-2079. ; 103:8, s. 1190-1194
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Tidskriftsartikel (refereegranskat)abstract
- Background/aims Pseudoexfoliation syndrome (PEX) is characterised by the production and accumulation of extracellular fibrillar material in the anterior segment of the eye. The pathogenesis of PEX is multifactorial with genetic factors and ageing as contributing factors. Previously, an increased concentration of beta-crystalline B2 (CRYBB2) was observed in the aqueous humour (AH) in eyes with PEX in a pooled material. Here, the protein content was examined on individual basis. Methods During cataract surgery, AH was sampled from patients with and without PEX, 10 eyes in each group. The proteins were digested and labelled with isotopomeric dimethyl labels, separated with high-pressure liquid chromatography and analysed in an Orbitrap mass analyzer. Results The concentration of complement factor 3, kininogen-1, antithrombin III and vitamin D-binding protein was increased in all eyes with PEX. Retinol-binding protein 3, glutathione peroxidase, calsyntenin-1 and carboxypeptidase E were decreased in eyes with PEX. Beta-crystalline B1 and CRYBB2 and gamma-crystalline D were up to eightfold upregulated in 4 of 10 in eyes with PEX. Conclusion The results indicate that oxidative stress and inflammation are contributing factors in the formation of PEX. Knowledge about the proteome in PEX is relevant for understanding this condition.
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| 7. |
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| 8. |
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| 9. |
- Chauhan, B C, et al.
(författare)
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Practical Recommendations for Measuring Rates of Visual Field Change in Glaucoma
- 2008
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Ingår i: British Journal of Ophthalmology. - : BMJ. - 1468-2079 .- 0007-1161. ; 92, s. 569-573
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Tidskriftsartikel (refereegranskat)abstract
- Statement of Interest Assessment of visual field damage is the major index of the functional impact of glaucoma with direct relevance to quality of life measures. Visual field change was used as a primary endpoint for progression in the recent glaucoma trials and its measurement is the cornerstone of glaucoma management influencing therapeutic decisions. The objective of this perspective is to provide practical recommendations for measuring clinically relevant rates of glaucomatous visual field progression to help identify patients at risk for visual impairment. They focus on the frequency of examinations required for detecting various amounts and rates of visual field change.
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| 10. |
- Chen, Jialin, et al.
(författare)
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Mechanical stress potentiates the differentiation of periodontal ligament stem cells into keratocytes
- 2018
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Ingår i: British Journal of Ophthalmology. - : BMJ Publishing Group Ltd. - 0007-1161 .- 1468-2079. ; 102:4, s. 562-569
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Tidskriftsartikel (refereegranskat)abstract
- Aims To explore the role of corneal-shaped static mechanical strain on the differentiation of human periodontal ligament stem cells (PDLSCs) into keratocytes and the possible synergistic effects of mechanics and inducing medium. Methods PDLSCs were exposed to 3% static dome-shaped mechanical strain in a Flexcell Tension System for 3 days and 7 days. Keratocyte phenotype was determined by gene expression of keratocyte markers. Keratocyte differentiation (inducing) medium was introduced in the Flexcell system, either continuously or intermittently combined with mechanical stimulation. The synergistic effects of mechanics and inducing medium on keratocyte differentiation was evaluated by gene and protein expression of keratocyte markers. Finally, a multilamellar cell sheet was assembled by seeding PDLSCs on a collagen membrane and inducing keratocyte differentiation. The transparency of the cell sheet was assessed, and typical markers of native human corneal stroma were evaluated by immunofluorescence staining. Results Dome-shaped mechanical stimulation promoted PDLSCs to differentiate into keratocytes, as shown by the upregulation of ALDH3A1, CD34, LUM, COL I and COL V. The expression of integrins were also upregulated after mechanical stimulation, including integrin alpha 1, alpha 2, beta 1 and non-muscle myosin II B. A synergistic effect of mechanics and inducing medium was found on keratocyte differentiation. The cell sheets were assembled under the treatment of mechanics and inducing medium simultaneously. The cell sheets were transparent, multilamellar and expressed typical markers of corneal stroma. Conclusion Dome-shaped mechanical stimulation promotes differentiation of PDLSCs into keratocytes and has synergistic effects with inducing medium. Multilamellar cell sheets that resemble native human corneal stroma show potential for future clinical applications.
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| 11. |
- Chibani, Zohra, et al.
(författare)
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Autosomal recessive congenital hereditary corneal dystrophy associated with a novel SLC4A11 mutation in two consanguineous Tunisian families
- 2022
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Ingår i: British Journal of Ophthalmology. - : BMJ PUBLISHING GROUP. - 0007-1161 .- 1468-2079. ; 106:2, s. 281-287
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Tidskriftsartikel (refereegranskat)abstract
- Background Autosomal recessive congenital hereditary corneal dystrophy (CHED) is a rare isolated developmental anomaly of the eye characterised by diffuse bilateral corneal clouding that may lead to visual impairment requiring corneal transplantation. CHED is known to be caused by mutations in the solute carrier family 4 member 11 (SLC4A11) gene which encodes a membrane transporter protein (sodium bicarbonate transporter-like solute carrier family 4 member 11). Methods To identify SLC4A11 gene mutations associated with CHED (OMIM: #217700), genomic DNA was extracted from whole blood and sequenced for all exons and intron-exon boundaries in two large Tunisian families. Results A novel deletion SLC4A11 mutation (p. Leu479del; c.1434_1436del) is responsible for CHED in both analysed families. This non-frameshift mutation was found in a homozygous state in affected members and heterozygous in non-affected members. In silico analysis largely support the pathogenicity of this alteration that may leads to stromal oedema by disrupting the osmolarity balance. Being localised to a region of alpha-helical secondary structure, Leu479 deletion may induce protein-compromising structural rearrangements. Conclusion To the best of our knowledge, this is the first clinical and genetic study exploring CHED in Tunisia. The present work also expands the list of pathogenic genotypes in SLC4A11 gene and its associated clinical diagnosis giving more insights into genotype-phenotype correlations.
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| 12. |
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| 13. |
- Crossland, Michael, et al.
(författare)
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Electronic books as low vision aids
- 2010
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Ingår i: British Journal of Ophthalmology. - : BMJ. - 0007-1161 .- 1468-2079. ; 94:8, s. 1109-
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Tidskriftsartikel (refereegranskat)abstract
- Recently, several electronic book readers have become commercially available. These consist of a low glare electronic paper screen and internal memory, which can typically hold the full text of between 150 and 2000 full-length novels. Electronic paper has a wide viewing angle of almost 1808 but a slow refresh speed of about 250 ms. Amazon’s Kindle device has 300 000 books available in electronic format, and 11 000 are available through Waterstones in the UK for the Sony Reader. Table 1 shows the parameters of these and other popular electronic books. Here, we explore the utility of these two electronic books for use by the visually impaired.
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| 14. |
- Darlow, Brian A, et al.
(författare)
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International variations and trends in the treatment for retinopathy of prematurity
- 2017
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Ingår i: British Journal of Ophthalmology. - : BMJ Publishing Group Ltd. - 0007-1161 .- 1468-2079. ; 101:10, s. 1399-1404
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare the rates of retinopathy of prematurity (ROP) and treatment of ROP by laser or intravitreal anti-vascular endothelial growth factor among preterm neonates from high-income countries participating in the International Network for Evaluating Outcomes (iNeo) of neonates.METHODS: weeks' gestation who were admitted to neonatal units in Australia/New Zealand, Canada, Finland, Israel, Japan, Spain, Sweden, Switzerland, Tuscany (Italy) and the UK between 2007 and 2013. Pairwise comparisons of ROP treatment in survivors between countries were evaluated by Poisson and multivariable logistic regression analyses after adjustment for confounders. A composite outcome of death or ROP treatment was compared between countries using logistic regression and standardised ratios.RESULTS: Of 48 087 infants included in the analysis, 81.8% survived to 32 weeks postmenstrual age, and 95% of survivors were screened for ROP. Rates of any ROP ranged from 25.2% to 91.0% in Switzerland and Japan, respectively, among those examined. The overall rate of those receiving treatment was 24.9%, which varied from 4.3% to 30.4%. Adjusted risk ratios for ROP treatment were lower for Switzerland in all pairwise comparisons, whereas Japan displayed significantly higher ratios. Comparisons of the composite outcome between countries revealed similar, but less marked differences.CONCLUSIONS: Rates of any ROP and ROP treatment varied significantly between iNeo members, while an overall decline in ROP treatment was observed during the study period. It is unclear whether these variations represent differences in care practices, diagnosis and/or treatment thresholds.
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| 15. |
- Engqvist, Linn, et al.
(författare)
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Laser speckle contrast imaging enables perfusion monitoring of the anterior segment during strabismus surgery: a study on the horizontal rectus muscles
- 2023
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Ingår i: British Journal of Ophthalmology. - : BMJ. - 1468-2079 .- 0007-1161. ; 107, s. 1704-1708
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Tidskriftsartikel (refereegranskat)abstract
- Background A dreaded complication of strabismus surgery is anterior segment ischaemia (ASI), caused by damage to the anterior ciliary arteries. To avoid ASI, a maximum of two rectus muscles are operated on at a time. However, these surgical protocols are based on empirical observations of clinical outcome, rather than objective perfusion measurements. There is no method available for perioperative, real-time perfusion measurements during ocular muscle surgery. The aims of this study were to investigate whether laser speckle contrast imaging (LSCI) could be used for such measurements, and to monitor perfusion during strabismus surgery on one or two horizontal rectus muscles.Methods Forty-four eyes in 44 patients with horizontal strabismus underwent corrective surgery involving medial and/or lateral rectus muscle detachment. Perfusion in the adjacent paralimbal and iris tissue was monitored with LSCI.Results When the first horizontal rectus muscle was detached perfusion in the adjacent paralimbal tissue decreased by 23% (p<0.0001), and by 12% (p<0.0001) when the second muscle was detached. The iris perfusion decreased by 5% (p<0.05) when the first muscle was detached but showed no significant decrease as the second muscle was cut.Conclusion This is the first study showing that perfusion of the anterior segment can be monitored non-invasively with LSCI during strabismus surgery. In this cohort, two horizontal rectus muscles were detached with only a small decrease in the anterior segment circulation. Future studies are required for complete mapping of the effect of surgery on multiple ocular muscles on the anterior segment circulation.Data are available upon request.
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| 16. |
- Eriksson, L., et al.
(författare)
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WINROP can modify ROP screening praxis: a validation of WINROP in populations in Sormland and Vastmanland
- 2014
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Ingår i: British Journal of Ophthalmology. - : BMJ. - 0007-1161 .- 1468-2079. ; 98:7, s. 964-966
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Tidskriftsartikel (refereegranskat)abstract
- Background This study validates the newly developed WINROP algorithm aimed at detecting retinopathy of prematurity (ROP) requiring treatment at an early stage. The study was conducted at two middle-sized hospitals in Sweden, prospectively and retrospectively. Methods A total of 104 children participated in this study. Their mean gestational age at birth was 28.7 weeks (range, 23.6-32.1 weeks), and their mean birth weight was 1208 g (range, 477-2340 g). Weekly weight measurements were used in WINROP to calculate the risk of developing ROP. Results 80% of infants (83/104) had no ROP, 15% (16/104) had mild ROP (stage 1 or 2), 5% (5/104) had severe ROP, and 2% (2/104) were treated for ROP. The alarm was registered at an average of 2 weeks postnatal age (range 1-6 weeks). Conclusions WINROP identified all the infants at risk for developing stage 3 ROP (100% sensitivity) and had a 59% specificity. The alarm was registered several weeks before screening for ROP began. WINROP can be used to complement conventional ROP screening.
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| 17. |
- Eriksson, Urban, et al.
(författare)
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Macular thickness decreases with age in normal eyes : A study on the macular thickness map protocol in the Stratus OCT
- 2008
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Ingår i: British Journal of Ophthalmology. - : BMJ. - 0007-1161 .- 1468-2079. ; 93:11, s. 1148-1452
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND/AIM: Retinal and retinal nerve fibre layer (RNFL) thinning with age have been described in histological studies. In vivo techniques like optical coherence tomography (OCT), has shown thinning of optic nerve RNFL and the retina in specific areas. One would expect thinning of the total macula, but so far, a correlation with the quantitative OCT macular map tool and age has not been found. METHODS: Sixty-seven healthy individuals underwent three repeated scans in both eyes with the macular thickness map protocol in the Stratus OCT. That protocol divides the macula area in nine ETDRS fields.The RNFL was measured in one specific location close to the optic disc. Correlations between retinal, RNFL thickness, macular volume and age were determined. RESULTS: We found a statistically significant negative relationship between retinal thickness and age for all ETDRS areas, total macular volume and RNFL thickness. Retinal thickness decreased with 0,26-0,46 microm, the macula volume 0,01 mm(3) and RNFL with 0,09 microm per year. CONCLUSION: Retinal thickness within the area covered by the macular map significantly decreases with age. In the area examined in the papillomacular bundle, 20% of the retinal thinning is due to the RNFL and 80% due to thinning of other layers of the retina.
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| 18. |
- Fabian, ID, et al.
(författare)
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Travel burden and clinical presentation of retinoblastoma: analysis of 1024 patients from 43 African countries and 518 patients from 40 European countries
- 2021
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Ingår i: The British journal of ophthalmology. - : BMJ. - 1468-2079 .- 0007-1161. ; 105:10, s. 1435-1443
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Tidskriftsartikel (refereegranskat)abstract
- The travel distance from home to a treatment centre, which may impact the stage at diagnosis, has not been investigated for retinoblastoma, the most common childhood eye cancer. We aimed to investigate the travel burden and its impact on clinical presentation in a large sample of patients with retinoblastoma from Africa and Europe.MethodsA cross-sectional analysis including 518 treatment-naïve patients with retinoblastoma residing in 40 European countries and 1024 treatment-naïve patients with retinoblastoma residing in 43 African countries.ResultsCapture rate was 42.2% of expected patients from Africa and 108.8% from Europe. African patients were older (95% CI −12.4 to −5.4, p<0.001), had fewer cases of familial retinoblastoma (95% CI 2.0 to 5.3, p<0.001) and presented with more advanced disease (95% CI 6.0 to 9.8, p<0.001); 43.4% and 15.4% of Africans had extraocular retinoblastoma and distant metastasis at the time of diagnosis, respectively, compared to 2.9% and 1.0% of the Europeans. To reach a retinoblastoma centre, European patients travelled 421.8 km compared to Africans who travelled 185.7 km (p<0.001). On regression analysis, lower-national income level, African residence and older age (p<0.001), but not travel distance (p=0.19), were risk factors for advanced disease.ConclusionsFewer than half the expected number of patients with retinoblastoma presented to African referral centres in 2017, suggesting poor awareness or other barriers to access. Despite the relatively shorter distance travelled by African patients, they presented with later-stage disease. Health education about retinoblastoma is needed for carers and health workers in Africa in order to increase capture rate and promote early referral.
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| 19. |
- Farioli, Andrea, et al.
(författare)
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Vascular risk factors and rhegmatogenous retinal detachment : a follow-up of a national cohort of Swedish men
- 2016
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Ingår i: British Journal of Ophthalmology. - : BMJ. - 0007-1161 .- 1468-2079. ; 100:7, s. 907-913
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Tidskriftsartikel (refereegranskat)abstract
- Background We aimed to investigate the role of vascular risk factors in the genesis of rhegmatogenous retinal detachment (RRD) using data from a large cohort of Swedish conscripts. Methods We used data from a nationwide cohort of 49 321 Swedish men born during 1949-1951, conscripted for compulsory military service in 19691970 with nearly complete follow-up to 2009. Information on surgically treated RRD between 1973 and 2009 was collected from the National Patient Register. We fitted Cox regression models stratified on myopia degree and including blood pressure levels, body mass index and cigarette smoking. Population attributable fractions of RRD were estimated through maximum likelihood methods. Results We observed 262 cases of RRD in 1 725 770 person-years. At multivariate analysis, the number of cigarettes per day showed a reverse association with the risk of RRD (p for trend 0.01). Conscripts with obesity presented a higher risk compared with normal subjects (adjusted HR 2.51, 95% CI 1.02 to 6.13). We found weak evidence of an association between blood pressure and RRD (HR for men with hypertension compared with normotension 1.41, 95% CI 0.93 to 2.13). All the observed associations were stronger when the analysis was restricted to non-myopic conscripts. In particular, the HR for hypertension was 2.33 (95% CI 1.30 to 4.19) compared with normotension. If this association is causal, we estimated that 42.0% of RRD cases (95% CI 11.5% to 62.0%) occurring among non-myopics are attributable to elevated blood pressure. Conclusions Vascular risk factors may be important determinants of RRD, particularly among non-myopics. Further investigations on the role of hypertension and obesity are needed.
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| 20. |
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| 21. |
- Fili, M, et al.
(författare)
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Effect of plaque brachytherapy dose and dose rate on risk for disease-related mortality in 1238 patients with choroidal melanoma
- 2021
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Ingår i: The British journal of ophthalmology. - : BMJ. - 1468-2079 .- 0007-1161. ; 105:1, s. 57-62
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Tidskriftsartikel (refereegranskat)abstract
- Episcleral brachytherapy is the most common treatment for medium-sized choroidal melanomas. Although controversial, inadequate brachytherapy dose and dose rates have at least a hypothetical implication on patient survival.MethodsAll patients who received ruthenium-106 or iodine-125 brachytherapy for choroidal melanoma at St. Erik Eye Hospital 1996 to 2016 were included (n=1238). Cox regression hazard ratios for melanoma-related mortality across deciles, quartiles and individual integers of apex radiation doses (Gy) and dose rates (Gy/hour) were calculated, adjusted for tumour size and location.ResultsThe average radiation dose at the tumour apex ranged from 73.0 Gy in the first decile to 108.6 Gy in the tenth. Decreasing apex dose by 1 Gy increments or by decile or quartile group was not associated with melanoma-related mortality (p>0.2) The average radiation dose rate at the tumour apex ranged from 0.5 Gy/hour in the first decile to 2.8 Gy/hour in the tenth. Similarly, decreasing apex dose rate by 1 Gy/hour increments or by decile or quartile groups was not associated with melanoma-related mortality (p>0.5).ConclusionThere are no increased hazards for choroidal melanoma-related mortality after brachytherapy with decreasing doses between 108.6 and 73.0 Gy, or with decreasing dose rates between 2.8 and 0.5 Gy/hour.
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| 22. |
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| 23. |
- Fili, M, et al.
(författare)
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Ruthenium-106 versus iodine-125 plaque brachytherapy of 571 choroidal melanomas with a thickness of ≥5.5 mm
- 2020
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Ingår i: The British journal of ophthalmology. - : BMJ. - 1468-2079 .- 0007-1161. ; 104:1, s. 26-32
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Tidskriftsartikel (refereegranskat)abstract
- Episcleral brachytherapy is the most common eye-preserving treatment for medium-sized choroidal melanomas. γ-emitting iodine-125 (125I) and β-emitting ruthenium-106 (106Ru) are widely used. The latter is however generally reserved for thinner tumours (<6 mm). In this study, we compare ocular and patient survival in thicker tumours treated with the respective radioisotope.MethodsAll patients with ≥5.5 mm thick choroidal melanomas who were treated with plaque brachytherapy at a single institution between 1 November 1979 and 31 December 2015 were included (n=571). Size-controlled Cox regression HRs for postbrachytherapy enucleation, repeated brachytherapy and melanoma-related mortality were calculated, as well as Kaplan-Meier disease-specific survival and relative 10-year survival in matched subgroups.Results317 patients were treated with 106Ru and 254 with 125I. The rate of repeated brachytherapy was significantly higher among patients treated with 106Ru (8%) than with 125I (1%, p<0.001). Size-controlled Cox regression HRs for postbrachytherapy enucleation (125I vs 106Ru 0.7, p=0.083) and melanoma-related mortality were not significant (125I vs 106Ru 1.1, p=0.63). Similarly, Kaplan-Meier disease-specific and relative 10-year survival was comparable in matched groups of 5.5–7.4 mm (relative survival 106Ru 59%, 125I 56%) and ≥7.5 mm thick tumours (relative survival 106Ru 46%, 125I 44%).ConclusionsRates of repeated brachytherapy were significantly higher among patients treated with 106Ru versus 125I for thick choroidal melanomas. There were, however, no significant differences in rates of enucleation or patient survival.
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| 24. |
- Fries, Fabian N., et al.
(författare)
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Early ocular surface and tear film status in congenital aniridia indicates a supportive treatment window
- 2024
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Ingår i: British Journal of Ophthalmology. - : BMJ Publishing Group. - 0007-1161 .- 1468-2079. ; 108, s. 30-36
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Tidskriftsartikel (refereegranskat)abstract
- AimTo evaluate changes in the ocular surface and tear film with age and mutational status in congenital aniridia. Methods45 participants with congenital aniridia (89 eyes) in a prospective, cross-sectional study. Whole-exome sequencing identified the causative mutation. Examinations included slit-lamp biomicroscopy, in vivo confocal microscopy, Ocular Surface Disease Index (OSDI) score, blink rate, Schirmer I test, Oxford Staining Score (OSS), tear film break-up time (TFBUT) and Ocular Protection Index (OPI). ResultsThere were age-dependent increases in OSDI (beta=0.34, 95% CI 0.03 to 0.66; p=0.030), blink rate (beta=0.18, 95% CI 0.08 to 0.27; p<0.001) and OSS (beta=0.05, 95% CI 0.03 to 0.07; p<0.001) and age-dependent reductions in tear production (beta=-0.23, 95% CI -0.43 to 0.02; p=0.029) and TFBUT (beta=-0.10, 95% CI -0.17 to -0.04; p<0.001). Perturbed OSDI, OSS, blink rate, tear production and TFBUT were noted after the age of ten and OSDI, OSS, blink rate and TFBUT correlated with deficient corneal nerves and limbal stem cell function. OSDI, blink rate, Schirmer, OSS, TFBUT and OPI were not associated with type of PAX6 mutation, but OSDI, OSS and blink rate associated with grade of aniridia-associated keratopathy. ConclusionsOcular surface damage and dry eye signs appear in congenital aniridia regardless of mutation, appearing after 10 years of age and progressing thereafter. An early treatment window may exist for therapies to protect the ocular surface homoeostasis and limbal function, to possibly delay keratopathy development and progression.
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| 25. |
- Frisén, Lars, 1939
(författare)
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Photography of the retinal nerve fibre layer: an optimised procedure.
- 1980
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Ingår i: The British journal of ophthalmology. - 0007-1161. ; 64:9, s. 641-50
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Tidskriftsartikel (refereegranskat)abstract
- Normal and abnormal fundi were photographed at various magnifications in one and the same fundus camera, with and without 'red-free' filters and various types of black-and-white and colour films. Colour diapositive films were copied on various black-and-white negative films, with and without filters. The final negatives were evaluated under magnification with regard to resolution and contrast of detail in the nerve fibre layer. Complementary information was obtained by means of conventional resolution measurements at high and low contrast levels. The best overall results were obtained by copying colour slides obtained in unfiltered light on a new high-contrast black-and-white film (Kodak Technical Pan), with a Wratten No. 65 A filter. This simple technique produced negatives with a good definition of the nerve fibre layer, suitable as final records.
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| 26. |
- Frisén, Lars, 1939
(författare)
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Scope of super-resolution in central vision.
- 2010
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Ingår i: The British journal of ophthalmology. - : BMJ. - 1468-2079 .- 0007-1161. ; 94, s. 97-100
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Super-resolution refers to computational enhancement of detail in sets of similar images, particularly under-sampled images. Under-sampling is a key feature of visual disorders associated with neuro-retinal matrix damage. It is conceivable that a biological equivalent of super-resolution might be recruited in these settings. The need for sets of similar images might be satisfied by augmenting retinal image movements. METHODS: Monocular letter acuity thresholds were measured by computer graphics in normal subjects, with and without controlled test target movements. Various degrees of neuro-retinal matrix defects were simulated by superposing stationary masks on the test targets. RESULTS: Static acuity thresholds increased monotonically with increased mask densities. The addition of target movement partially counteracted the threshold increment. The effect was barely measurable at small mask densities and increased monotonically to a gain of approximately 2 lines on a decimal acuity scale with masks simulating loss of 90% of neural matrix elements. Similar results were obtained from a patient with an acquired neuro-retinal matrix defect, attesting to the validity of the mask experiments. CONCLUSION: Super-normal retinal image movements have subtle effects on visual resolution in normal eyes whereas eyes with neuro-retinal matrix defects may improve markedly. This finding may have implications for the development of aids for the visually handicapped.
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| 27. |
- Frisén, Lars, 1939, et al.
(författare)
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Spectrum of optic nerve hypoplasia.
- 1978
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Ingår i: The British journal of ophthalmology. - 0007-1161. ; 62:1, s. 7-15
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Tidskriftsartikel (refereegranskat)abstract
- Optic nerve hypoplasia is a non-progressive condition characterised by subnormal vision and a subnormal number of optic nerve axons. It may be unilateral or bilateral, isolated or combined with other defects. Analysis of fundus photographs from a series of 7 patients with a stationary abnormality of different degrees showed that the functional defects could be closely correlated with defects in the retinal nerve fibre layer. Our observations show that the condition has a wide range of both functional and anatomical defects and that a subnormal diameter of the optic disc is not a requisite for the diagnosis. Presumably, there is also a wide variety of causes, not only a primary failure of development of retinal ganglion cells. We suggest that optic nerve hypoplasia can be viewed as a non-specific manifestation of damage to the visual system, sustained any time before its full development.
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| 28. |
- Frisén, Lars, 1939
(författare)
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The Amsler grid in modern clothes.
- 2009
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Ingår i: The British journal of ophthalmology. - : BMJ. - 1468-2079 .- 0007-1161. ; 93:6, s. 714-6
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Amsler chart, a printed grid with a central fixation mark, is widely used to test for central/paracentral scotomata and metamorphopsias. Abnormal results are easily recognised but are not directly accessible to quantitative analysis. Negative results may be misleading, because it is never known how good an observer the subject is. METHODS: A new version was created in computer graphics. The grid was made to sweep the tested area in an optic flow manner. The sweeps provided seamless coverage, counteracted the Troxler fade-from-view effect, and encouraged stable fixation. Simulations of scotomata and metamorphopsias allowed quantitative evaluations of subject performance. RESULTS: Normal observers consistently detected absolute paracentral scotomata subtending > or =2 degrees . Grid deformation was consistently detected at 4' near fixation, whereas up to 20' was needed at the grid border. A patient with real metamorphopsia reproducibly nulled the apparent deformation of the grid in a manner closely matching his own renditions. CONCLUSIONS: The classical Amsler grid can be made to meet modern demands of quality control and quantitative measurements. The new "MacuFlow" test is freely accessible on the internet. Test results can easily be transmitted electronically for evaluation at distance.
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| 29. |
- Frisén, Lars, 1939
(författare)
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The lazy shadow: a monocular counterpart to the Pulfrich stereo phenomenon.
- 2007
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Ingår i: The British journal of ophthalmology. - : BMJ. - 0007-1161. ; 91:10, s. 1296-8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Pulfrich phenomenon is a dynamic stereo dysmetropsia attributed to an asymmetry of neural conduction between the eyes. The phenomenon may arise spontaneously with ocular and neurological disease and may be induced in normal subjects by placing a light-attenuating filter before one eye. By analogy, it is predicted that a localised variation of retinal illumination within one and the same eye should affect the perception of moving targets. METHODS: A rotating, nesting square display was generated by computer graphics. The inner square was painted bright white, the outer dim grey. Luminances, rates of rotation and angular sizes were varied. RESULTS: On rotation, the outer, dimmer square appeared to lag behind the inner, brighter one, as a "lazy shadow". The lag was measured quantitatively in normal observers by applying a compensatory lead to the lagging square. The magnitude of lag was found to depend on luminance, spin rate and visual angle. Lags exceeding 10 degrees were observed under optimum conditions. CONCLUSIONS: The experimental results confirm the existence of a monocular counterpart to the binocular Pulfrich phenomenon. Distortions of moving images are likely to occur spontaneously with monocular, localised visual field defects.
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| 30. |
- Friström, Björn, et al.
(författare)
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A double masked comparison of the intraocular pressure reducing effect of latanoprost 0.005% and 0.001% administered once daily in open angle glaucoma and ocular hypertension
- 1997
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Ingår i: British Journal of Ophthalmology. - : BMJ. - 0007-1161 .- 1468-2079. ; 81:10, s. 867-870
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Tidskriftsartikel (refereegranskat)abstract
- AIM To compare the intraocular pressure (IOP) reducing effect of latanoprost 0.005% and 0.001%.METHODS Twenty four patients with glaucoma or ocular hypertension were randomised into two groups. Twelve patients (group 1) were given latanoprost 0.005% once daily for 4 weeks and then latanoprost 0.001% once daily for the following 4 weeks. Twelve patients (group 2) were given latanoprost 0.001% once daily for 4 weeks and then latanoprost 0.005% for the following 4 weeks.RESULTS There was a significant IOP reduction from baseline in both groups on day 28 as well as on day 56. When the results from both groups were used for calculations, the mean IOP reduction from baseline after 4 weeks of treatment with latanoprost 0.005% (day 28 or 56) was 9.6 (SD 3.3) mm Hg (35.0%). After 4 weeks of treatment with latanoprost 0.001%, the IOP reduction (day 28 or 56) was 7.6 (3.4) mm Hg (27.7%). The difference in IOP reduction between the two concentrations was 2.0 (2.3) mm Hg (p<0.001).CONCLUSIONS Latanoprost 0.005% was more effective than latanoprost 0.001% in reducing IOP. Even the lower concentration was surprisingly effective, and potentially may be of importance for use in clinical practice. Furthermore, it is at present unknown whether the increase in iris pigmentation seen in certain patients treated with latanoprost 0.005% is dose dependent and might be less pronounced with latanoprost 0.001%. Long term studies with a larger number of patients are required in order to answer this question.
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| 31. |
- Garg, G, et al.
(författare)
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Patients presenting with metastases: stage IV uveal melanoma, an international study
- 2022
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Ingår i: The British journal of ophthalmology. - : BMJ. - 1468-2079 .- 0007-1161. ; 106:4, s. 510-517
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Tidskriftsartikel (refereegranskat)abstract
- To analyse ocular and systemic findings of patients presenting with systemic metastasis.Methods and analysisIt is an international, multicentre, internet-enabled, registry-based retrospective data analysis. Patients were diagnosed between 2001 and 2011. Data included: primary tumour dimensions, extrascleral extension, ciliary body involvement, American Joint Committee on Cancer (AJCC)-tumour, node, metastasis staging, characteristics of metastases.ResultsOf 3610 patients with uveal melanoma, 69 (1.9%; 95% CI 1.5 to 2.4) presented with clinical metastasis (stage IV). These melanomas originated in the iris, ciliary body and choroid in 4%, 16% and 80% of eyes, respectively. Using eighth edition AJCC, 8 (11%), 20 (29%), 24 (35%), and 17 (25%) belonged to AJCC T-categories T1–T4. Risk of synchronous metastases increased from 0.7% (T1) to 1.5% (T2), 2.6% (T3) and 7.9% (T4). Regional lymph node metastases (N1a) were detected in 9 (13%) patients of whom 6 (67%) had extrascleral extension. Stage of systemic metastases (known for 40 (59%) stage IV patients) revealed 14 (35%), 25 (63%) and 1 (2%) had small (M1a), medium-sized (M1b) and large-sized (M1c) metastases, respectively. Location of metastases in stage IV patients were liver (91%), lung (16%), bone (9%), brain (6%), subcutaneous tissue (4%) and others (5%). Multiple sites of metastases were noted in 24%. Compared with the 98.1% of patients who did not present with metastases, those with synchronous metastases had larger intraocular tumours, more frequent extrascleral extension, ciliary body involvement and thus a higher AJCC T-category.ConclusionsThough higher AJCC T-stage was associated with risk for metastases at diagnosis, even small T1 tumours were stage IV at initial presentation. The liver was the most common site of metastases; however, frequent multiorgan involvement supports initial whole-body staging.
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| 32. |
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| 33. |
- Grönlund, Marita Andersson, 1959, et al.
(författare)
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Ophthalmological findings in children and adolescents with Silver-Russell syndrome.
- 2011
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Ingår i: The British journal of ophthalmology. - : BMJ. - 1468-2079 .- 0007-1161. ; 95:5, s. 637-41
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Tidskriftsartikel (refereegranskat)abstract
- Aim To evaluate ophthalmological findings in children with Silver-Russell syndrome (SRS). Methods An ophthalmological evaluation including visual acuity (VA), refraction, strabismus, near point of convergence (NPC), slit-lamp examination, ophthalmoscopy, axial length measurements and full-field electroretinogram was performed on 18 children with SRS (8 girls, 10 boys; mean age 11.6 years). Fundus photographs were taken for digital image analysis. Data were compared with data on an age- and gender-matched reference group (ref) of school children (n=99). Results Seventeen out of 18 children with SRS had ophthalmological abnormalities. Best corrected VA of the best eye was <0.1 log of the minimal angle of resolution in 11 children (ref n=98) (p<0.0001), and 11 children had refractive errors (ref n=33) (p=0.05). Anisometropia (>/=1 dioptre) was noted in three of the children (ref n=3) (p=0.046). Subnormal stereo acuity and NPC were found in 2/16 (ref=0) (p=0.02). The total axial length in both eyes was shorter compared with that in controls (p<0.006 and p<0.001). Small optic discs were found in 3/16, large cup in 3/16 and increased tortuosity of retinal vessels in 4/13 children with SRS. Conclusion Children with SRS, who are severely intrauterine growth retarded, show significant ophthalmological abnormalities. Based on the present findings, ophthalmological examination is recommended in children with SRS.
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| 34. |
- Grönlund, Marita Andersson, 1959, et al.
(författare)
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Visual and ocular findings in children adopted from eastern Europe
- 2004
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Ingår i: Br J Ophthalmol. - : BMJ Publishing Group Ltd. ; 88:11, s. 1362-1267
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To evaluate ophthalmological findings in children adopted from eastern Europe. METHODS: A prospective study on 72/99 children, born 1990-5 and adopted from eastern Europe to western Sweden during 1993-7 was performed. The children (41 boys; mean age 7.5 years) were compared with an age and sex matched reference group ("ref") of Swedish children. RESULTS: 78% of the adopted children had abnormal ocular findings. 26% (ref 4%) had visual acuity (VA) of the better eye < or = 0.5 (> or = 0.3 logMAR) (p = 0.0001) and 8% (ref 0%) were visually impaired (p = 0.01). Amblyopia was found in 15% (ref 2%) (p = 0.005). 22% (ref 10%) were hyperopic (> or = 2.0 D SE) (NS) and 10% (ref 1%) were myopic (> or = 0.5 D SE) (p = 0.03). Astigmatism (> or = 0.75 D) was found in 51% (ref 23%) (p = 0.004). 32% (ref 2%) had strabismus (p<0.0001), mostly esotropia. Four cases had bilateral optic nerve hypoplasia, in three of whom a history of suspected prenatal alcohol exposure was documented. One child had congenital glaucoma. Signs of visuoperceptual problems were recorded in 37% (ref 1%) (p<0.0001). CONCLUSION: In this study, children adopted from eastern Europe had a high frequency of ophthalmological findings. Consequently, it is strongly recommended that an ophthalmological examination be performed in these children after arrival in their new home country.
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| 35. |
- Gyllencreutz, Emelie, et al.
(författare)
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Thinner retinal nerve fibre layer in young adults with foetal alcohol spectrum disorders
- 2021
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Ingår i: British Journal of Ophthalmology. - : BMJ Publishing Group Ltd. - 0007-1161 .- 1468-2079. ; 105:6, s. 850-855
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND/AIMS: Ophthalmological abnormalities such as ptosis, strabismus, refractive errors and optic nerve hypoplasia have been reported in foetal alcohol spectrum disorders (FASD). The purpose of this study was to investigate whether retinal thickness, retinal nerve fibre layer (RNFL) and optic disc area (ODA) differ between individuals with FASD and healthy controls.METHODS: Best-corrected visual acuity (BCVA) in terms of logarithm of the minimum angle of resolution (logMAR), refraction, and fundus variables measured by optical coherence tomography were obtained from 26 young adults with FASD (12 women, median age 23 years) and 27 controls (18 women, median age 25 years).RESULTS: The total thickness of the peripapillary RNFL was significantly lower in the FASD group than in controls; median (range) in the right/left eye was 96.5 (60-109)/96 (59-107) µm in the FASD group and 105 (95-117)/103 (91-120) µm among controls (p=0.001 and p=0.0001). Macular RNFL and retinal thickness measurements from the FASD group were also lower in most of the nine ETDRS areas, except for the central parts. Median (range) BCVA in the best eye was 0.00 (-0.1-0.3) logMAR in the FASD group and 0.00 (-0.2-0.0) logMAR in controls (p=0.001). No significant differences between the groups were found regarding ODA or refraction.CONCLUSION: Significant differences in peripapillary and macular RNFL, retinal thickness and BCVA were found in this group of young adults with FASD compared with healthy controls. However, there were no differences in the size of the optic disc.
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| 36. |
- Hellström, William, et al.
(författare)
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Low fraction of fetal haemoglobin is associated with retinopathy of prematurity in the very preterm infant
- 2022
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Ingår i: British Journal of Ophthalmology. - : BMJ. - 0007-1161 .- 1468-2079. ; 106, s. 970-974
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Tidskriftsartikel (refereegranskat)abstract
- Background: Blood loss and adult blood transfusions are common during the neonatal period in preterm infants. The objective of the study was to clarify if degree of loss of fetal haemoglobin (HbF) was associated with later retinopathy of prematurity (ROP). Methods: Retrospective observational cohort study. In total, 452 infants born <30 gestational weeks at a tertiary level neonatal intensive care unit in Sweden in 2009-2015 were included, 385 of whom had final ROP outcome. Mean fractions of HbF (%) during the first postnatal week were calculated from 11 861 arterial blood gas analyses. The relationship between fractions of HbF (%) and ROP was evaluated. Results: The mean (SD) gestational age (GA) at birth was 26.4 (1.8) weeks. In total, 104 (27 %) infants developed ROP. Higher fraction of HbF (%) was associated with a lower prevalence of ROP, OR by a 10% increase 0.83 (95% CI: 0.71 to 0.97; p=0.019), following adjustment for GA at birth, small for GA and sex. Infants with HbF (%) in the lowest quartile had OR of 22.0 (95% CI: 8.1 to 59.2; p<0.001) for ROP development compared with those in the highest quartile. The predictive ability (area under the curve) of HbF (%) in the full model during the first week was 0.849 for ROP. Conclusions: Early low fraction of HbF is independently associated with abnormal retinal neurovascular development in the very preterm infant. The potential benefit of minimising blood loss on development of ROP will be investigated in a multicenter randomised trial (NCT04239690). © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
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| 37. |
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| 38. |
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| 39. |
- Holmström, Gerd, et al.
(författare)
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Five years of treatment for retinopathy of prematurity in Sweden: results from SWEDROP, a national quality register
- 2016
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Ingår i: British Journal of Ophthalmology. - London, UK : BMJ. - 0007-1161 .- 1468-2079. ; 100:12, s. 1656-1661
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Tidskriftsartikel (refereegranskat)abstract
- Background/aims Retinopathy of prematurity (ROP) is a sight-threatening disease, requiring efficient screening and treatment. The present study aims to describe various aspects on treatment for ROP in Sweden. Methods Data on treatment for ROP in infants born in 2008-2012 were extracted from Swedish national register for retinopathy of prematurity, a web-based national register. Results During 2008-2012, 3488 infants with a gestational age (GA) at birth of <31 weeks had been screened for ROP in Sweden. Altogether, 30.3% (1057/3488) of the infants developed ROP and 5.2% (181/3488) were treated. Type 1 ROP was found in at least one eye in 83.2% (149/179) of the treated infants. One third of the eyes (32.2% right, 29.9% left eyes) were treated more than once. Laser was the only treatment in 90% of the eyes. Mean number of laser spots at first laser session was 1177 and 1386 in right and left eyes, respectively. Number of laser spots correlated negatively with GA at birth (p=0.01). There was no change in frequency of treatment or number of laser spots during the 5-year period. Anti-vascular endothelial growth factor injections were performed in 28 eyes, encircling band was used in five eyes and vitrectomies were performed in seven eyes. Twenty-six retinal surgeons performed 9.4 (range 1-37) treatment sessions in the 181 infants. Conclusions The present study reveals similar incidences of ROP and frequencies of treatment during the 5-year study period. Many surgeons were involved in treatment of a rather limited number of infants. The results call for national discussions on organisation of ROP treatment.
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| 40. |
- Holmström, Gerd, et al.
(författare)
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Genetic susceptibility to retinopathy of prematurity : the evidence from clinical and experimental animal studies
- 2007
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Ingår i: British Journal of Ophthalmology. - : BMJ. - 0007-1161 .- 1468-2079. ; 91:12, s. 1704-1708
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Forskningsöversikt (refereegranskat)abstract
- Despite advances in management and treatment, retinopathy of prematurity remains a major cause of childhood blindness. Evidence for a genetic basis for susceptibility to retinopathy of prematurity is examined, including the influences of sex, ethnicity, and ocular pigmentation. The role of polymorphisms is explored in the genes for vascular endothelial growth factor and insulin-like growth factor-1, and of mutations in the Norrie disease gene. Insights into the genetic basis of retinopathy of prematurity provided by the animal model of oxygen induced retinopathy are examined. Evidence for a genetic component for susceptibility to retinopathy of prematurity is strong, although the molecular identity of the gene or genes involved remains uncertain.
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| 41. |
- Holmström, Gerd, 1951-, et al.
(författare)
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New modifications of Swedish ROP guidelines based on 10-year data from the SWEDROP register
- 2020
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Ingår i: British Journal of Ophthalmology. - : BMJ. - 0007-1161 .- 1468-2079. ; 104:7, s. 943-949
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND/AIMS:During the last decade, improved neonatal care has resulted in increased survival of the most immature infants and improved health of more mature infants. We hypothesise that this has affected incidence and treatment of retinopathy of prematurity (ROP), enabling guidelines for screening to be modified.METHODS: In Sweden, all infants with gestational age (GA) at birth ≤30 weeks are screened for ROP. Results are registered in a web-based register, Swedish National ROP Register, with a coverage rate of 97%. Incidence of ROP and frequency of treatment, aspects on natural course of ROP and number of examinations, are calculated in relation to GA at birth in infants born during 2008-2017.RESULTS: Of 7249 infants, 31.9% (2310) had ROP and 6.1% (440) were treated. No infant with GA 30 weeks was treated. Incidence of ROP remained similar, but frequency of treatment increased (p=0.023). Over time, GA and birth weight were reduced in infants with ROP and with treated ROP. In the most immature infants, postmenstrual age was lower and postnatal age was higher when any ROP and stage 3 ROP were first detected (p<0.001). At treatment, postmenstrual but not postnatal age of the infant was associated with GA (p<0.001). During the 10-year period, 46 038 examinations were performed.CONCLUSION: Modification of Swedish guidelines is proposed, including only infants with a GA of <30 weeks and postponing the first examination with 1 week in infants with GA 26-29 weeks. This would spare many infants from stressful examinations and reduce eye examinations with at least 20%.
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| 42. |
- Jacobson, L, et al.
(författare)
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Nystagmus in periventricular leucomalacia
- 1998
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Ingår i: The British journal of ophthalmology. - : BMJ. - 0007-1161. ; 82:9, s. 1026-1032
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Tidskriftsartikel (refereegranskat)
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| 43. |
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| 44. |
- Jain, P, et al.
(författare)
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Conjunctival melanoma treatment outcomes in 288 patients: a multicentre international data-sharing study
- 2021
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Ingår i: The British journal of ophthalmology. - : BMJ. - 1468-2079 .- 0007-1161. ; 105:10, s. 1358-1364
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Tidskriftsartikel (refereegranskat)abstract
- To relate conjunctival melanoma characteristics to local control.MethodsRetrospective, registry-based interventional study with data gathered from 10 ophthalmic oncology centres from 9 countries on 4 continents. Conjunctival melanoma patients diagnosed between January 2001 and December 2013 were enrolled in the study. Primary treatments included local excision, excision with cryotherapy and exenteration. Adjuvant treatments included topical chemotherapy, brachytherapy, proton and external beam radiotherapy (EBRT). Cumulative 5-year and 10-year Kaplan-Meier local recurrence rates were related to clinical and pathological T-categories of the eighth edition of the American Joint Committee on Cancer (AJCC) staging system.Results288 patients had a mean initial age of 59.7±16.8 years. Clinical T-categories (cT) were cT1 (n=218,75.7%), cT2 (n=34, 11.8%), cT3 (n=15, 5.2%), cTx (n=21,7.3%) with no cT4. Primary treatment included local excision (n=161/288, 55.9%) followed by excision biopsy with cryotherapy (n=108/288, 37.5%) and exenteration (n=5/288, 1.7%). Adjuvant therapies included topical mitomycin (n=107/288, 37.1%), plaque-brachytherapy (n=55/288, 19.1%), proton-beam (n=36/288, 13.5%), topical interferon (n=20/288, 6.9%) and EBRT (n=15/288, 5.2%). Secondary exenteration was performed (n=11/283, 3.9%). Local recurrence was noted in 19.1% (median=3.6 years). Cumulative local recurrence was 5.4% (3.2–8.9%), 19.3% (14.4–25.5%) and 36.9% (26.5–49.9%) at 1, 5 and 10 years, respectively. cT3 and cT2 tumors were twice as likely to recur than cT1 tumours, but only cT3 had statistically significantly greater risk of local recurrence than T1 (p=0.013). Factors such as tumour ulceration, plica or caruncle involvement and tumour thickness were not significantly associated with an increased risk of local recurrence.ConclusionThis multicentre international study showed that eighth edition of AJCC tumour staging was related to the risk of local recurrence of conjunctival melanoma after treatment. The 10-year cumulative local recurrence remains high despite current management.
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| 45. |
- Johansson, Björn, et al.
(författare)
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Bilateral same day phacoemulsification : 220 Cases retrospectively reviewed
- 2003
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Ingår i: British Journal of Ophthalmology. - : BMJ. - 0007-1161 .- 1468-2079. ; 87:3, s. 285-290
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Tidskriftsartikel (refereegranskat)abstract
- Background/aims: The relative frequency, basic patient data, results, and complications of planned same day bilateral phacoemulsification were studied from April 1999 to May 2001 at the Department of Ophthalmology, Linköping University Hospital, Sweden. Methods: Retrospective study of patient records (n=220) regarding preoperative and postoperative visual acuity, applied indications, concurrent disease, preoperative, peroperative, and postoperative complications, and number of unplanned postoperative visits. The monthly rate of bilateral phacoemulsification to all cataract procedures was monitored. Results: Mean corrected preoperative visual acuity was 0.27 (worse eye) and 0.39 (better eye), and postoperatively (all eyes) 0.71. Visual acuity was 0.5 or better in 78% of eyes. Preoperative considerations included type of cataract, to avoid anisometropia, social circumstances, and concurrent eye disease. Reasons for unplanned postoperative visits included secondary cataract (n=10), iritis (n=6), corneal oedema (n=3), cortex in the anterior chamber (n=2), and unilateral endophthalmitis (n=2). During the study period, 10.5% of patients were operated upon bilaterally on the same day. Conclusions: Same day bilateral phacoemulsification was found to be a safe and cost effective way of rapidly rehabilitating selected cataract patients. The patient must be informed of the added potential risks as well as the benefits of the procedure.
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| 46. |
- Johansson, Björn
(författare)
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Clinical consequences of acrylic intraocular lens material and design: Nd:YAG-laser capsulotomy rates in 3 x 300 eyes 5 years after phacoemulsification
- 2010
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Ingår i: BRITISH JOURNAL OF OPHTHALMOLOGY. - : BMJ Publishing Group. - 0007-1161. ; 94:4, s. 450-455
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Tidskriftsartikel (refereegranskat)abstract
- Background/aims To investigate the incidence of Nd:YAG-laser treatment for posterior capsular opacification (PCO) over a period of 5 years from phacoemulsification in an unselected population, comparing outcomes for three acrylic intraocular lenses (IOLs). Methods Retrospective longitudinal cohort study comprising 900 eyes. Three subgroups of 300 eyes, receiving the AR40, AR40e (Abbott Medical Optics, Santa Ana, California), or BL27 (Bausch andamp; Lomb, Rochester, New York) IOL respectively, were compared. Data on patient age, gender, IOL type, dates of cataract surgery, Nd:YAG-laser treatment and/or death, and visual acuities before/after cataract surgery/Nd:YAG-laser treatment were collected from five sources: cataract operation register, patient administration system, quality control system for cataract operations, Nd:YAG-laser treatment register and clinical patient records. Results 216 eyes (24%) received Nd:YAG-laser treatment over a 5-year period. Statistically significant differences (pandlt;0.001, chi(2) test) were found between treatment rates for the three IOLs: AR40 73 eyes (24%), BL27 91 eyes (30%) and AR40e 52 eyes (17%). Eyes of patients who died during the follow-up period had fewer treatments (23/266, 8.6%) than eyes of patients living (193/634, 30%) at the end of the follow-up period. Conclusion In comparison with a hydrophobic acrylic IOL with sharp posterior optic edge, a hydrophilic acrylic IOL was associated with almost twice the number of Nd:YAG-laser treatments over the 5-year period. The results are useful for discussing the economic long-term consequences of choosing an IOL with a design that makes PCO development more or less likely. Caution is advised when applying data from post-mortem PCO studies on living populations.
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| 47. |
- Johansson, Kristina, et al.
(författare)
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Tailored vitrectomy and laser photocoagulation without scleral buckling for all primary rhegmatogenous retinal detachments.
- 2006
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Ingår i: British Journal of Ophthalmology. - : BMJ. - 1468-2079 .- 0007-1161. ; 90:10, s. 1286-1291
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To investigate the anatomical and functional results and the complications in eyes operated on using vitrectomy without scleral buckling for all forms of rhegmatogenous retinal detachment ( RRD). Methods: All cases of primary RRD at the University Hospital of Lund, Lund, Sweden, treated by one surgeon during a period of 3 years were retrospectively reviewed. In 131 ( 98%) of 134 consecutive cases, a final follow-up record of 3 - 14 months was obtained, and these eyes were included in the study. The surgical protocol was tailored for each case and consisted of vitrectomy, laser photocoagulation and tamponade. Preoperative and intraoperative variables were analyses for risk for redetachment and postoperative proliferative vitreoretinopathy ( PVR). Results: Complete reattachment was achieved in 87% of cases ( 114/131) after one operation and in 95% cases after >= 1 operation. A primary detachment of > 1 quadrant was the only significant risk factor for redetachment ( p < 0.05). The most common cause of redetachment was progressive PVR. Significant risk and factors for PVR postoperatively were a poor preoperative visual acuity and a high number of laser effects during surgery ( p < 0.05). The visual acuity for the total number of eyes, macula-off eyes, and pseudophakic as well as phakic eyes, improved significantly. The visual acuity for macula-on eyes did not change significantly. Six patients developed ocular hypertension and another 6 an epiretinal membrane. Three patients reported a visual field defect. Increased lens opacification was seen in 64 of the 94 ( 68%) phakic eyes. Conclusions: The tailored vitrectomy protocol is well suited to all types of RRD. Increased lens opacification in phakic eyes is common, but visual acuity is considerably improved in phakic as well as pseudophakic eyes. PVR development postoperatively is related to the extent of laser treatment, indicating that the protocol may be even further optimised in the future.
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| 48. |
|
|
| 49. |
|
|
| 50. |
|
|
