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| 3. |
- Ayala, Marcelo, 1965
(författare)
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Former smoking as a risk factor for visual field progression in exfoliation glaucoma patients in Sweden
- 2024
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Ingår i: European Journal of Ophthalmology. - 1120-6721 .- 1724-6016.
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The present study aimed to identify whether former smoking was a risk factor for visual field progression in exfoliation glaucoma patients. Methods: Prospective nonrandomised cohort study. The study included patients diagnosed with exfoliation glaucoma. All included patients were followed for three years (± three months) with reliable visual fields. At least five reliable visual fields needed to be included in the study. Exfoliation glaucoma was defined using the European Glaucoma Society Guidelines. The visual fields were tested using the 24–2 test strategy of the Humphrey Field Analyzer. Smoking was assessed through questionnaires. Outcomes: Visual field progression. Three different approaches were used: difference in mean deviation (MD), rate of progression (ROP), and guided progression analysis (GPA). Results: In total, n = 113 patients were included; among them, n = 57 were smokers. Smoking was a significant predictor for visual field progression in the three models (MD/ROP/GPA) studied (p = 0.01/p = 0.001/p ≤ 0.001), even adjusting for intraocular pressure (IOP). Other predictors were included in the MD model: IOP at diagnosis (p = 0.04) and selective laser trabeculoplasty (SLT) treatment (p = 0.01). Other predictors were in the ROP model: Visual field index (p = 0.005), number of medications (p = 0.001) and SLT treatment (p = 0.001). The number of medications was another predictor in the GPA model (p = 0.002). Conclusions: Former smoking induced visual field deterioration in all models studied. Smoking status should be considered when establishing the glaucoma diagnosis. Increased glaucoma care should be provided to former smokers to slow the progression of the disease.
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| 4. |
- Brautaset, R, et al.
(författare)
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Reproducibility of disc and macula optical coherence tomography using the Canon OCT-HS100 as compared with the Zeiss Cirrus HD-OCT
- 2014
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Ingår i: European journal of ophthalmology. - : SAGE Publications. - 1724-6016 .- 1120-6721. ; 24:5, s. 722-727
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Tidskriftsartikel (refereegranskat)abstract
- In a clinical setting, the usefulness of optical coherence tomography (OCT) is strongly dependent on reproducibility of the measurement. The aim of the present study was to evaluate macula and optic disc measurement reproducibility with the new spectral-domain OCT (SD-OCT) from Canon (Canon OCT-HS100) and to compare reproducibility and obtained measurements with the Zeiss Cirrus HD-OCT. Methods Macula and optic disc parameters from the right eyes of 31 subjects were obtained twice with both instruments. Interoperator reproducibility was evaluated by use of the coefficient of repeatability (CR), and the obtained measurements were compared between the instruments. Results No difference in interoperator reproducibility could be found when comparing the 2 instruments and reproducibility ranged from 3.94% to 12.77% for optic disc parameters and from 1.19% to 3.54% for macula parameters. The lowest reproducibility was found for cup volume and vertical cup/disc ratio with both instruments. For all macula and retinal nerve fiber layer (RNFL) thickness measurements, there was a statistical difference when comparing the 2 instruments, except for RFNL measurements of the superior quadrant, with the Canon OCT-HS100 always evaluating the thickness to be thicker; however, the 2 instruments correlated well. Conclusions The Canon OCT-HS100 is a reproducible instrument that matches the Zeiss Cirrus HD-OCT well. It remains to be evaluated how sensitive the Canon OCT-HS100 is to detect small subtle changes in optic disc parameters and macular nerve fiber layer thickness. Furthermore, due to the differences in thickness estimation, it is important to emphasize that SD-OCTs are not interchangeable.
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| 5. |
- Bro, Tomas, et al.
(författare)
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Worth changing? Clinical effects of switching treatment in neovascular age-related macular degeneration from intravitreal ranibizumab and aflibercept to bevacizumab in a region in southern Sweden
- 2021
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Ingår i: European Journal of Ophthalmology. - : SAGE PUBLICATIONS LTD. - 1120-6721 .- 1724-6016. ; 31:1, s. 144-148
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To examine the clinical effects of switching intravitreal drug treatment from the approved vascular endothelial growth factor inhibitors, ranibizumab and aflibercept, to off label use of bevacizumab in patients with wet age-related macular degeneration. Methods: This retrospective study scrutinized medical records of patients with wet age-related macular degeneration who switched therapy to bevacizumab due to a policy decision. Best corrected visual acuity, central retinal thickness, and number of injections before and 1 year after the switch was compared. The non-inferiority margin of best corrected visual acuity was five Early Treatment Diabetic Retinopathy Study letters. Results: A switch from ranibizumab was evaluable in 93 eyes and from aflibercept in 19 eyes. Neither of the groups had a significant non-inferior visual acuity 16 month after the switch. Mean best corrected visual acuity in Early Treatment Diabetic Retinopathy Study letters was 63.8 (95% confidence interval: 61.3-66.4) before and 62.2 (95% confidence interval: 59.3-65.1) after in the ranibizumab group and 68.2 (95% confidence interval: 63.3-73.1) before and 67.7 (95% confidence interval: 62.8-72.6) after in the aflibercept group. Mean central retinal thickness in micrometers decreased from 254 (95% confidence interval: 247-261) to 250 (95% confidence interval: 225-275) in the ranibizumab group and from 265 (95% confidence interval: 255-276) to 262 (95% confidence interval: 251-273) in the aflibercept group. The treatment was changed again after the switch in 18% of the patients in the ranibizumab group and 19% in the aflibercept group and these subjects were excluded from the analyses. Conclusion: In patients with neovascular age-related macular degeneration, a switch from ranibizumab or aflibercept to bevacizumab seems possible without a significant decrease in visual acuity in most patients.
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| 6. |
- Chang, A, et al.
(författare)
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Comparison of phacoemulsification cataract surgery with low versus standard fluidic settings and the impact on postoperative parameters
- 2017
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Ingår i: European journal of ophthalmology. - : SAGE Publications. - 1724-6016 .- 1120-6721. ; 27:1, s. 39-44
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Tidskriftsartikel (refereegranskat)abstract
- To compare complications after cataract surgery using 2 different phacoemulsification fluidic settings. Methods One cataract surgeon (M.K.) performed phacoemulsification cataract surgery in one eye of 43 patients in this randomized prospective clinical study conducted at St. Erik Eye Hospital, Stockholm, Sweden. The patients were randomized to phacoemulsification with low fluidic settings in one group and standard fluidic settings in the other group. Corrected distance visual acuity (CDVA), central corneal thickness (CCT), endothelial cell density (ECD), anterior chamber flare, intraocular pressure (IOP), and macular thickness were measured preoperatively and postoperatively, with a final evaluation at 3 months. Surgical time, ultrasound energy, and amount of balanced saline solution used intraoperatively were recorded. Results Twenty-one patients were included in the group with standard settings and 22 patients were in the group with low settings. There were no significant differences between the groups in CDVA, CCT, flare, IOP, macular thickness, or ECD at 1 day, 3 weeks, or 3 months postoperatively. The surgical time was significantly (p = 0.009) longer and cumulative dissipated energy was significantly (p<0.001) higher in the group with low fluidic settings. Conclusions Although the surgical time and ECD were significantly higher in the group with low fluidic settings, there were no differences in the CCT, ECD, macular thickness, or inflammation postoperatively between the low and standard fluidic settings during phacoemulsification.
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| 7. |
- Chang, A, et al.
(författare)
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Posterior capsule opacification 9 years after phacoemulsification with a hydrophobic and a hydrophilic intraocular lens
- 2017
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Ingår i: European journal of ophthalmology. - : SAGE Publications. - 1724-6016 .- 1120-6721. ; 27:2, s. 164-168
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Tidskriftsartikel (refereegranskat)abstract
- To compare the development of posterior capsule opacification (PCO) and survival rate without capsulotomy after implantation of a hydrophobic or hydrophilic acrylic intraocular lens (IOL) at the 9-year postoperative follow-up. Methods One of 3 experienced cataract surgeons performed standard phacoemulsification in one eye of 120 patients with cataract. The patients were randomized to implantation of either a hydrophobic acrylic IOL or a hydrophilic acrylic IOL. Both IOLs had sharp posterior edges. Retroillumination images of PCO were obtained with a fundus camera 9 years postoperatively and analyzed semiobjectively using POCOman computer software. Results Seventy-eight of the 120 patients completed the 9-year follow-up examination. Patients implanted with the hydrophilic IOL had significantly (p<0.001) more and denser PCO. The survival rate without Nd:YAG capsulotomy was significantly higher (p<0.001) in eyes with the hydrophobic IOL. Conclusions After 9 years, more and denser PCO developed in eyes with the hydrophilic IOL than the hydrophobic IOL. The survival rate without the need for capsulotomy was higher in eyes with the hydrophobic IOL.
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| 10. |
- Hedman, Katarina, et al.
(författare)
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A pooled data analysis of three randomised, double-masked six-month clinical studies comparing the intraocular pressure reducing effect of latanoprost and timolol
- 2000
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Ingår i: European Journal of Ophthalmology. - 1120-6721 .- 1724-6016. ; 10:2, s. 95-104
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE:To compare the intraocular pressure (IOP) reduction by latanoprost and timolol, and to study factors of prognostic value for assessing this reduction.METHODS:We analyzed 829 patients included in three phase 111 studies comparing six months' treatment with 0.005% latanoprost once daily and 0.5% timolol twice daily in patients with open-angle glaucoma or ocular hypertension. Analysis of covariance controlled for differences in baseline IOP and sex was used to assess the IOP reduction.RESULTS:Latanoprost reduced diurnal IOP (average of morning, noon and afternoon assessments) by 7.7 mmHg (31%) and timolol by 6.5 mmHg (26%) after six months of treatment. Thus the diurnal IOP was reduced 1.2 mmHg (18%) more with latanoprost than with timolol (p<0.001). Latanoprost-treated patients showed a further decrease in morning IOP of 0.7 mmHg (9%, p<0.001) from the initial morning IOP reduction obtained at two weeks. No such further decrease in IOP was seen with timolol. Higher baseline diurnal IOP resulted in a larger diurnal reduction during treatment with both drugs (p<0.001). Diurnal IOP in women was reduced 0.7 mmHg (11%) less than males with both drugs (p<0.001).CONCLUSIONS:Latanoprost was more effective than timolol in reducing mean diurnal IOP. The effect after two weeks was maintained for timolol while with latanoprost there was a further, significant IOP reduction from two weeks to six months. Baseline IOP was the only factor of clinical importance found to be of prognostic value for assessing the IOP reduction.
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| 11. |
- Hollo, G, et al.
(författare)
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Referral for first glaucoma surgery in Europe, the ReF-GS study
- 2019
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Ingår i: European journal of ophthalmology. - : SAGE Publications. - 1724-6016 .- 1120-6721. ; 29:4, s. 406-416
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Tidskriftsartikel (refereegranskat)abstract
- To analyze the appropriateness of referrals for incisional glaucoma-surgery in Europe. Methods: Referrals for the first open-angle glaucoma surgery between January and October 2017 were analyzed in 18 countries: 8 “old” European Union, 7 “new” European Union and 3 non-European Union European countries. Results: Most eyes had primary open-angle or exfoliative glaucoma. The average mean deviation was −13.8 dB with split fixation in 44.3%. No structural progression analysis was made before the referrals. The most common medications were the combination of a prostaglandin analog, timolol and a carbonic anhydrase inhibitor (30.0%), and all other combinations comprising ⩾ 3 molecules (33.8%). Laser trabeculoplasty was reported in only 18.4%. Of the 294 referrals, 41.5% were appropriate and timely, 35.0% appropriate but later than optimal, and 17.6% appropriate but too late (minimal vision maintained). The treatment period was significantly longer (median: 7 years) in the “old” European Union countries than in the other groups (3 and 2 years, respectively). No between-group differences were seen in intraocular pressure and mean deviation, but the non-European Union group referred the patients at significantly lower cup/disk ratio and eye drop usage than the other groups. Split fixation was significantly more common in the “old” (60.6%) than the “new” European Union countries (38.7%), and in both EU country-groups than in the non-European Union countries (13.6%). Conclusions: Of 294 European open-angle glaucoma referrals for first glaucoma-surgery, 41.5% were completely satisfactory. The damage was typically advanced, and the care varied considerably among the countries. This suggests that further efforts are necessary to improve glaucoma care in Europe.
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| 12. |
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| 13. |
- Kulik, U, et al.
(författare)
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Long-term results after primary intraocular lens implantation in children with juvenile idiopathic arthritis-associated uveitis
- 2019
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Ingår i: European journal of ophthalmology. - : SAGE Publications. - 1724-6016 .- 1120-6721. ; 29:5, s. 494-498
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Tidskriftsartikel (refereegranskat)abstract
- To evaluate the long-term outcome after cataract surgery with primary intraocular lens implantation in children with juvenile idiopathic arthritis–associated uveitis. Methods: The medical records of all 24 children (34 eyes) with chronic juvenile idiopathic arthritis–associated uveitis who underwent cataract surgery between 1990 and 2013 were reviewed retrospectively. Primary intraocular lens implantation was performed in all patients. Results: Median age at diagnosis of uveitis in the first eye was 5.3 years (range: 2.7–9.4 years) and median age at the time of cataract surgery in the first eye was 9.7 years (range: 4.1–16.9 years). Postoperative follow-up time ranged from 1 to 23.1 years, with a median of 10.9 years. Best corrected visual acuity at the last follow-up was good (⩾20/40) in 65% of the eyes. Postoperatively, glaucoma developed in 8 eyes (24%), posterior capsular opacification and secondary membrane formation requiring surgery in 15 eyes (44%), macular oedema in 5 eyes (15%) and phthisis in 2 eyes (6%). Conclusion: This study shows a favourable visual outcome in most of the cases. Primary intraocular lens implantation may be considered in juvenile idiopathic arthritis–associated uveitis complicated by cataract in patients with well-controlled inflammation.
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| 16. |
- Lundqvist, Oskar, et al.
(författare)
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Gender differences in refractive prediction in refractive lens exchange surgery
- 2015
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Ingår i: European Journal of Ophthalmology. - : Wichtig Publishing. - 1120-6721 .- 1724-6016. ; 25:2, s. 108-111
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare the refractive outcomes after refractive lens exchange (RLE) surgery with regards to gender and intraocular lens (IOL) power calculation formula. Methods: A cohort of consecutive patients operated with bilateral same-day RLE surgery at a private eye clinic (n = 512) was studied. Target refraction was emmetropia in all cases and Haigis formula was used for all IOL power calculations. One month after surgery, subjective refraction was assessed and the absolute refractive prediction error (RPEAbs), as well as the refractive prediction error with correct signs (RPESign), was calculated, as were the refractive outcomes with the SRK/T formula. Results: For the whole cohort, the Haigis formula rendered a significantly smaller RPEAbs than the SRK/T formula (0.16 +/- 0.26 D vs 0.32 +/- 0.30 D; p<0.001). No gender difference in RPEAbs was seen. A slight myopic error was seen with the SRK/T formula in women, and a slight hyperopic error in men (-0.06 +/- 0.47 D vs + 0.16 +/- 0.39 D; p<0.001). No similar gender difference was seen with the Haigis formula (+ 0.05 +/- 0.29 D vs + 0.05 +/- 0.31 D; p = NS). Axial length, anterior chamber depth, and corneal steepness differed significantly between the sexes. Conclusions: The Haigis formula generally performed better in this RLE cohort. The SRK/T formula generates a small myopic error in women and a hyperopic error in men, associated with flatter corneas, longer axial lengths, and deeper anterior chambers in the latter.
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| 17. |
- Malm, Eva, et al.
(författare)
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Alteration of rod and cone function in children with Usher syndrome
- 2011
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Ingår i: European Journal of Ophthalmology. - Milan, Italy : Wichtig Editore Srl. - 1120-6721 .- 1724-6016. ; 21:1, s. 30-38
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate the retinal function, with emphasis on phenotype and rate of progression, in infants and children with different genotypes of Usher syndrome.Methods: Fourteen children (2-10 years of age) with retinitis pigmentosa and hearing impairment were examined with full-field electroretinography (ERG) during general anesthesia, ophthalmologic examination, and genetic analysis. Five children were repeatedly examined (follow-up 5-10 years) with full-field ERG under local anesthesia and in 2 children multifocal ERG and optical coherence tomography (OCT) were performed. These results were compared to full-field ERG data from 58 children without retinal eye disorder.Results: Six children were genotyped as Usher 1B, 2A, and 3A. Full-field ERG demonstrated early alterations corresponding to a rod-cone dystrophy in all children. A remaining rod function could be verified in the majority of the children up to 4 years of age. After 4 years of age, there was a further deterioration of the rod function; the progress was severe in Usher types 1 and 2 and moderate in Usher type 3. In all children, the cone function was moderately reduced, in a few cases almost normal. The results from the 58 children without retinal disorder confirm that full-field ERG during general anesthesia is reliable. Multifocal ERG confirmed a preserved central cone function and in OCT there were discrete structural alterations.Conclusions: Full-field ERG during general anesthesia in children with Usher syndrome demonstrates variable phenotypes and different degrees in rate of progression during childhood.
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| 18. |
- Mascialino, Barbara, et al.
(författare)
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Meta-analysis of the prevalence of Leber hereditary optic neuropathy mtDNA mutations in Europe
- 2012
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Ingår i: European Journal of Ophthalmology. - : SAGE Publications. - 1120-6721 .- 1724-6016. ; 22:3, s. 461-465
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE. A meta-analysis was conducted to estimate the prevalence of patients with molecularly confirmed Leber hereditary optic neuropathy (LHON) carrying any of the 3 primary mtDNA mutations (m.11778G > A, m.14484T > C, m.3460G > A) which cause this inherited form of blindness. METHODS. A literature search was conducted to identify primary reports with LHON prevalence data reported for Europe. The overall prevalence of LHON with molecularly confirmed diagnosis was evaluated by weighting the prevalence estimates of the individual studies by the inverse of their variance. RESULTS. Based on this meta-analysis of 5 European studies providing appropriate information, the estimated prevalence of LHON disease associated with the combined m.11778G > A, m.14484T > C, m.3460G > A mutations was similar to 1:45,000 (2.23x10(-5); 95% confidence interval [CI] 2.01-2.44x10(-5)). Patients with LHON carrying either the m.11778G > A or the m.3460G > A mutation have a more severe clinical presentation and a much lower chance of spontaneous recovery from vision loss compared to patients with the m.14484T > C mutation. The estimated prevalence for patients with LHON in Europe carrying either of these severe mutations (m.11778G > A or m.3460G > A) was similar to 1:65,000 (1.54x10(-5); 95% CI 1.33-1.74x10(-5)). CONCLUSIONS. Although this meta-analysis summarizes the existing prevalence data for the primary, disease-causing mitochondrial DNA mutations of LHON in Europe, there is still a clear lack of reliable primary epidemiologic data for this devastating ophthalmologic disease.
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| 19. |
- Merkoudis, Nikolaos, et al.
(författare)
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Treatment of macular edema associated with retinal vein occlusion using sustained-release dexamethasone implants in a clinical setting
- 2013
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Ingår i: European Journal of Ophthalmology. - : SAGE Publications. - 1120-6721 .- 1724-6016. ; 23:4, s. 558-563
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate the clinical effect, safety, and administration procedure of slow-release dexamethasone implants (Ozurdex (R)) for macular edema secondary to retinal vein occlusion in clinical praxis. Methods: Data from 11 patients (4 eyes with central vein occlusion and 7 eyes with branch vein occlusion) were reviewed. Data were compiled and analyzed with respect to best-corrected visual acuity (BCVA), central macular thickness (CMT), intraocular pressure (IOP), and adverse events. Follow-up was 10 months. Changes in BCVA >= logMAR 0.2, IOP >= 5 mm Hg, and CMT >= 100 mu m were considered clinically relevant. Results: Two months after the first dexamethasone implant, BCVA improved from logMAR 0.65 +/- 0.2 to logMAR 0.34 +/- 0.1. All patients demonstrated a decrease in CMT from an initial average value of 632 +/- 178 mu m to 229 +/- 34 mu m. However, in 10 out of 11 eyes, macular edema recurred by month 4 through 5 and a second dexamethasone implant was administered. Two and 4 months after the second implant, BCVA was logMAR 0.36 +/- 0.2 and logMAR 0.40 +/- 0.2 and the CMT was 254 +/- 61 mu m and 357 +/- 81 mu m, respectively. The IOP increased 5.1 +/- 1.5 mm Hg 1 month after the first implant compared to baseline. In eyes with an IOP above 25 mm Hg (4 out of 11), pressure-lowering eyedrops were administered. Conclusions: Administration of dexamethasone implants induced a clinically relevant increase in visual acuity and a decrease in central macular thickness. In 91% of patients, macular edema recurred within 5 months and a second implant was administered. Adverse events, primarily increased IOP, were manageable. The injection procedure was relatively simple and uncomplicated.
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| 20. |
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| 22. |
- Querat, L, et al.
(författare)
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iCare® Home vs Goldmann applanation tonometry: Agreement of methods and comparison of inter-observer variation at a tertiary eye centre
- 2023
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Ingår i: European journal of ophthalmology. - : SAGE Publications. - 1724-6016 .- 1120-6721. ; 33:1, s. 312-318
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To investigate whether the inter-observer variation is similar between the Goldmann applanation tonometer used by healthcare staff and the iCare® Home tonometer used by glaucoma patients, volunteers and healthcare staff. Methods: Sixty-one participants were recruited to the study, including 24 glaucoma patients. Seven participants were excluded. For each participant, intraocular pressure (IOP) was measured on the same occasion by two different healthcare staff using GAT as well as by a healthcare staff and the participant using the iCare® Home tonometer. Results: Seventy-two per cent of iCare® measurements were within 3 mmHg of the GAT measurements. There was a statistically significant difference between the trainers’ measurements made with iCare® Home and those made with GAT ( p < 0.001), as well as between the GAT measurements made by trainers and those made by extra personnel ( p = 0.017). The strongest correlation was between iCare® Home participants’ and trainers’ measurements (0.934). The correlation between different users with GAT was lower (0.769). The inter-user agreement was excellent for iCare® Home users (95% CI 0.93, ranging from 0.880 to 0.959) and moderate for GAT users (95% CI 0.741, ranging from 0.558 to 0.849). Conclusion: Our study found that tonometry with iCare® Home has similar or less inter-user variation compared with GAT.
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| 23. |
- Samadi, Behrad, et al.
(författare)
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Improving patient-assessed outcomes after cataract surgery
- 2017
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Ingår i: European Journal of Ophthalmology. - : SAGE Publications. - 1120-6721 .- 1724-6016. ; 27:4, s. 454-459
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To identify and evaluate possible causes of poor patient-reported visual function after cataract surgery. Methods: We obtained retrospective data from the Swedish National Cataract Register on patient self-assessed visual function before and after cataract surgery based on the Catquest-9SF questionnaire. We identified patients who self-reported similar or more difficulties postoperatively than preoperatively, and looked at possible causative variables such as sex, age, preoperative and postoperative corrected distance visual acuity (CDVA) and refractive errors, and ocular comorbidity. Results: Nearly 75% of the 119 patients identified had a better postoperative CDVA; the mean CDVA increased by over 0.2 logarithm of the minimum angle of resolution visual acuity. Patients with low or high preoperative CDVA had poor self-assessed outcomes postoperatively. Younger patients (52-68 years) had a lower self-assessed outcome than more elderly patients. Surgical complications and poor near vision yielded lower outcomes. Anisometropia, ocular comorbidity, and sex did not significantly affect the outcome in this specific group. Conclusions: Patients content with their visual function despite the presence of a cataract should defer surgery. This may also include patients younger than 68 years with good visual function. Detailed information given to the patients about their ophthalmic condition, the surgical procedure and risks, and the eventual need for reading glasses postoperatively may result in higher self-assessed visual function outcomes among patients.
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| 24. |
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| 25. |
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| 26. |
- Sharif, Ali, 1986-, et al.
(författare)
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Inter-observer Reliability of Counting Retinal Microaneurysms and Haemorrhages in Elderly with Diabetes
- 2023
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Ingår i: European Journal of Ophthalmology. - : Sage Publications. - 1120-6721 .- 1724-6016. ; 33:1 Suppl., s. 20-20
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- DESIGN: Cross-sectional retrospective cohort study.PURPOSE: To investigate if quantifying retinal microvascular lesions is a reliable outcome measure in elderly.METHODS: Fundus photographs from all patients with type 2 diabetes, age ≥80 years, visiting the screening program 2008 in Region Värmland Sweden, n = 668, were reviewed. Inclusion criteria were mild/moderate diabetic retinopathy (DR) according to the International Diabetic Retinopathy Severity Scale. Exclusion criteria were hard exudates within two disc-diameters, and microaneurysms or haemorrhages within one-disc diameter, from the centre of the macula. Two observers counted microaneurysms and haemorrhages independently. Outcome measures were the total sum of microaneurysms and the total sum of haemorrhages per patient. Correlation, agreement and reliability between the counts of the observers was assessed. Analyses microaneurysm counts utilized all included patients while analyses of haemorrhages those with at least moderate DR in one eye.RESULTS: In total 101 patients met the inclusion/exclusion criteria, median age 82 years and 50.5% were of female sex. Moderate DR in at least one eye was present in 59 patients. In all patients the number of microaneurysms ranged from 1-82, and among patients with at least moderate DR the haemorrhages ranged from 1–29. For microaneurysm count the Pearson correlation coefficient was 0.896 p < 0.001 and intraclass correlation coefficient (ICC) was 0.944 (95% CI 0.917–0.962) between the two observers. For haemorrhage count the Pearson correlation coefficient was 0.897 p < 0.001 and ICC was 0.94 (95% CI: 0.893–0.965) between the two observers.CONCLUSIONS: Retinal microaneurysm count and haemorrhage count was assessed with excellent reliability. The results suggests that retinal microvascular lesions in elderly with diabetes can be manually quantified but the usefulness of such measures needs further evaluation.
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| 27. |
- Stalmans, Ingeborg, et al.
(författare)
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Preservative-free treatment in glaucoma: who, when, and why?
- 2013
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Ingår i: European Journal of Ophthalmology. - : SAGE Publications. - 1120-6721 .- 1724-6016. ; 23:4, s. 518-525
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To review and summarize the available literature on the effect of preservatives on the eye, to provide practical guidance for the clinical assessment of the ocular surface in glaucoma patients, and to define patient populations that might benefit from preservative-free topical intraocular pressure (IOP)-lowering agents. Methods: This manuscript is based on a combination of a literature review on preservatives and the eye and expert opinion from glaucoma specialists with an interest in ocular surface disease. Results: There is an increasingly recognized association between eyedrop preservatives and ocular surface disease. Preservative-free therapy is now available for a wide range of active compounds, although there are still some misconceptions regarding their appropriate use. For patients treated topically for glaucoma or ocular hypertension, a rough estimate could be that 20% may need treatment with topical IOP-reducing agents that are free from preservatives. Conclusions: This review provides an up-to-date account of the literature regarding preservatives and the eye, as well as suggestions and recommendations on to when to use preservative-free antiglaucoma treatment.
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| 28. |
- Villani, Edoardo, et al.
(författare)
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Dry eye and cataract surgery: Narrative review and recommendations for management
- 2023
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Ingår i: European Journal of Ophthalmology. - : SAGE PUBLICATIONS LTD. - 1120-6721 .- 1724-6016.
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Forskningsöversikt (refereegranskat)abstract
- Cataract surgery is the most frequently performed surgical procedure in the elderly in Western countries and patients expectations for postoperative outcomes are very high. Dry eye disease (DED) is a common multifactorial symptomatic disease of the ocular surface with a complex etiopathogenesis and a prevalence significantly increasing with age. Cataract surgery and DED have a complex relationship, which needs to be acknowledged, understood, and properly managed, as suggested by daily clinical experience and growing scientific evidence. The surgical procedure can have a relevant impact on the tear film and the ocular surface, and it can, usually transiently, induce or exacerbate DED symptoms. Moreover, preoperative DED can affect surgical refractive outcomes, while postoperative DED symptoms can significantly worsen patients reported outcomes and satisfaction. At the end of this narrative review summarizing the evidence on this topic, the "Dry Eye and Cataract Surgery" subcommittee of the DROPS workshop formulated some recommendations for ocular surface and DED management pre-, intra-, and post-cataract surgery.
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| 29. |
- Wittström, Elisabeth, et al.
(författare)
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Clinical and electrophysiologic outcome in patients with neovascular glaucoma treated with and without bevacizumab.
- 2012
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Ingår i: European Journal of Ophthalmology. - : SAGE Publications. - 1120-6721 .- 1724-6016. ; 22:4, s. 563-574
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Tidskriftsartikel (refereegranskat)abstract
- Purpose. To investigate the clinical and electrophysiologic effect of a single intravitreal injection of bevacizumab for neovascular glaucoma (NVG) after ischemic central retinal vein occlusion (iCRVO). Methods. Nineteen eyes from 19 patients with NVG secondary to iCRVO were randomly allocated to either an intravitreal bevacizumab injection and panretinal photocoagulation (PRP) (10 eyes) or PRP alone (9 eyes). The primary outcome measure was the change in the total retinal function 6 months after treatment, demonstrated by full-field electroretinography (ERG). Secondary outcomes included visual acuity, intraocular pressure (IOP), glaucoma medication, additional IOP-lowering treatment, and the presence of ocular neovascularization before treatment, and 1 week, 2 months, and 6 months after treatment. Results. The regression of ocular neovascularization in the bevacizumab/PRP group was confirmed 1 week after injection. Patients in both study groups had very poor visual acuity at baseline. This remained unchanged. There was no significant difference in the mean IOP between the groups at any point in time. The a-wave amplitudes of combined rod-cone response were significantly decreased after 6 months in the bevacizumab/PRP group (p=0.028), compared with the baseline values. The a- and b-wave amplitudes of combined rod-cone response and the b-wave amplitudes of the 30-Hz flicker response were also markedly reduced compared with the PRP group (-60%, -43%, -47% vs +23%, -36%, -16%, respectively). Conclusions. This study suggests that intravitreal injection of bevacizumab is valuable in the treatment of NVG by hastening the resolution of neovascularization, while the full-field ERG results indicate that bevacizumab may reduce the photoreceptor function in NVG patients.
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- Wändell, Per, et al.
(författare)
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Incident cases of vision impairment and blindness among adult foreign-born and Swedish-born individuals : A national Swedish study
- 2022
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Ingår i: European Journal of Ophthalmology. - : SAGE Publications. - 1120-6721 .- 1724-6016. ; 32:4, s. 1915-1923
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To analyse risk of vision impairment (VI) and blindness in adult foreign-born individuals and Swedish-born individuals. Methods: A nationwide study of individuals 18 years of age and older (N = 6,042,891; 2,902,918 men and 3,139,973 women) in Sweden. VI (in general) and blindness was defined as at least one registered diagnosis in the National Patient Register between January 1, 1998 and December 31, 2015. Cox regression analysis was used to estimate the relative risk (hazard ratios (HR) with 95% confidence intervals (CI)) of incident VI in foreign-born compared to Swedish-born individuals. The Cox regression models were stratified by sex and adjusted for age, co-morbidities, and for sociodemographic status. Results: A total of 14,597 cases (6433 men and 8164 women) of VI were registered, with an age-standardized incidence per 100,000 person-years of 10.37 in men and 11.03 in women. VI (in general) was more common in immigrants, fully adjusted HRs (95% CI) were for immigrant men 1.38 (95% CI, 1.29–1.48) and women 1.24 (95% CI, 1.16–1.32), with significantly higher HRs among men and women from Eastern Europe, Africa, Latin America and Asia. Higher risks of blindness were also seen for immigrant men, HR 1.75 (95% CI 1.36–2.25), as well as for the other degrees of VI among immigrant men, HR 1.36 (95% CI 1.26–1.47), and immigrant women, HR 1.26 (95% CI 1.18–1.35). Conclusions: We observed a generally higher risk of VI among foreign-born men and women, especially from some regions.
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