| 1. |
- Teär Fahnerhjelm, Kristina, et al.
(författare)
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Belysning och utveckling av undersökningsrum : Multifunktionsrum i sjukvården
- 2012
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Employees in an eye hospital spend many hours in semidarkness or darkness performing visually demanding activities that can cause fatigue and eye strain. As preparation for the planning of a new eye hospital, this project was initiated in order to produce knowledge of how to improve lighting in examination rooms. Current light conditions at S:t Erik Eye Hospital were assessed including questionnaires to employees/patients, and measurements of luminance, space analyses and energy consumption. Visits to other prominent eye hospitals and a literature review were performed. The questionnaires revealed that eyestrain problems were common in eye care professionals, especially in women. Working in dark rooms increased the subjective feeling of fatigue. Many, but not all, lacked daylight. The general lighting system was often insufficient with poor light distribution, shadows, and a colour temperature that in general was too low. Improvements included possibilities to regulate inflow of daylight, installation of remote controls, and timing and level of adaptation to different light levels. These improvements have been tested in a real scale installation that used the latest technology in terms of artificial lighting, a lighting control systems and a novel solution to control daylight. Five different light scenarios were preinstalled and evaluated by professionals and patients. A majority reported an improvement compared with traditional solutions. Current and actual energy consumption was monitored. Simulations of future consumption points to a possible energy reduction by 50 %, using new lighting technology, daylight and optimal room design. With improved logistics, new buildings and new work organization, energy savings can be even higher, around 70 %.
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| 2. |
- Törnquist, Alba Lucia, et al.
(författare)
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Ocular manifestations and visual functions in patients with Fanconi anaemia
- 2014
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Ingår i: Acta Ophthalmologica. - : Wiley. - 1755-375X .- 1755-3768. ; 92:2, s. 171-178
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Fanconi anaemia (FA) is a multisystemic disorder with ocular implications. This study aims to describe visual function, ocular characteristics andvisual processing skills in patients with FA after haematopoietic stem cell transplantation. Methods: Ten patients with FA, ages 8-17years, underwent ophthalmological examinations, corneal, periocular and fundus photography, visual evoked potentials (VEPs), visual fields and ocular motor and visual processing information tests. Results: Best-corrected decimal visual acuity was ≥0.65 in all 20 eyes. Microcornea was present in 18 of 18 eyes, short axial lengths in six of six eyes, steep corneal curvatures in four of six eyes, ptosis in 14 of 16 eyes, short palpebral fissures in 15 of 16 eyes and hypotelorism in three of seven patients. Optic disc areas were smaller in patients with FA compared to controls (p=0.0003 right, p=0.0003 left eye). Visual fields were abnormal in 4 of 18 eyes, while VEP was abnormal in 1 of 20 eyes. Eight patients had ocular motor dysfunction, while nine of 10 patients showed delay in visual processing skills. Conclusion: Patients with FA can present with microcornea, microphthalmia, ptosis, steep corneal curvatures, small optic discs, ptosis and delay in visual processing skills. Detailed ophthalmological and visual processing skills assessments and developmental investigations are important to detect impairments and facilitate appropriate support.
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| 3. |
- Törnquist, Alba Lucia, et al.
(författare)
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Visual evoked potentials after hematopoietic allogeneic stem cell transplantation in childhood
- 2017
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Ingår i: Clinical Neurophysiology Practice. - : Elsevier. - 2467-981X. ; 2, s. 67-71
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study visual pathway pathology detected by visual evoked potentials (VEPs) in patients treated with hematopoietic stem cell transplantation (HSCT) in childhood and to determine the impact of adverse ocular findings, somatic diseases, and conditioning regimens on the VEP results.METHODS: Ophthalmological assessments including pattern VEPs were performed in 47 of 79 patients at a median age of 15 years (range 3-21 years) in median 6 years (1-17 years) after HSCT. Somatic data were extracted from medical records.RESULTS: Eight patients of 47 (17%) demonstrated pathological VEPs with prolonged latencies bilaterally (n = 3) or unilaterally (n = 5) at their latest VEP test at an age of 12-18 years. A subnormal visual acuity was present in 8/11 eyes with pathological VEPs: one eye had cataract, six eyes had cataract surgery where of two had developed secondary cataracts. One eye had residual retinopathy of prematurity. Pathological VEPs were associated with decreased visual acuity (p = 0.00019) but not linked to gender, malignant diagnosis or conditioning.CONCLUSION: VEP recordings showed an association with decreased visual acuity but no relationship with irradiation or chemotherapy in the present study.SIGNIFICANCE: VEP recordings might be of clinical value for children with an unexplained subnormal visual acuity undergoing HSCT.
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| 4. |
- Törnquist, Alba Lucia, et al.
(författare)
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Visual field results and optic disc morphology in patients treated with allogeneic stem-cell transplantation in childhood.
- 2010
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Ingår i: Acta ophthalmologica. - : Wiley. - 1755-3768 .- 1755-375X. ; 89:1, s. 62-69
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Tidskriftsartikel (refereegranskat)abstract
- Abstract. Purpose: This study aimed to describe the Rarebit (RB) visual field and optic nerve size/morphology in patients treated with allogeneic stem-cell transplantation (SCT) in childhood, and to determine the impact of ocular status and conditioning regimens such as total body irradiation (TBI), chemotherapy and/or immunosuppressive drugs on the RB visual field. Methods: Ocular fundi were evaluated in 79 patients. Digital analyses regarding optic disc area (DA), rim area (RA) and cup area (CA) were performed in 45 of 49 patients. RB visual field testing was performed in 53 of 79 patients. The mean hit rate (MHR) was compared to corneal status, cataract, diagnosis and pre and post-SCT treatment. Two groups of healthy children and young adults (RB = 51, disc analysis = 49) were used as controls. Results: The SCT patients, examined at a median age of 15.4 years, had a significantly lower MHR [median 91% (range 45-99) right eye and 91% (range 41-91) left eye] compared to controls [median 96% (range 78-100) right eye]. SCT patients treated surgically for cataract and with intraocular lenses (IOLs) had a significantly lower MHR compared to other SCT patients. The MHR was also significantly influenced by type of conditioning. Patients conditioned with chemotherapy other than busulfan had significantly better MHR compared to those who had received single-dose TBI. SCT patients had a significantly larger CA and smaller RA than the controls. Conclusion: Patients treated with SCT in childhood have a significantly lower MHR than controls when examined with RB. Also, patients surgically treated for cataract and with IOL implantation had a significantly lower MHR.
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| 5. |
- Törnquist, Alba Lucia
(författare)
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Visual outcome, ocular findings, and visual processing skills after allogeneic stem cell transplantation in children
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Stem cell transplantation (SCT) offers a chance of cure in children with leukaemia and other life-threatening haematological, immunological, and metabolic diseases that do not respond to conventional treatment. Pre and post SCT, these children receive irradiation, and/or chemotherapy and immunosuppressive agents which like the primary disease may adversely affect the eye, the central nervous system as well as the posterior visual pathways and potentially threaten vision. The most commonly described ocular problems after SCT in childhood are cataract, dry eye syndrome (DES), and conjunctival or corneal graft-versus-host-disease (GVHD). Aims: To determine the visual outcome, the frequency of ocular complications, visual fields, visual evoked potentials, and visual processing skills in a group of children/young adults who underwent SCT in childhood and to investigate the possible impact of the underlying disease, conditioning regimen, and treatment post SCT. Subjects and methods: An ocular examination, including best corrected visual acuity (BCVA), refraction, slit lamp and fundus examination, tear break-up time, Schirmer s test, intraocular pressure; digital fundus photography, Rarebit visual field perimetry, visual evoked potentials, and visual processing skill tests, were performed in 79 children (37 boys, 42 girls; age median 7 years range 2 18) during 2004 2007. Results: A best corrected visual acuity (BCVA) of 0.5 was achieved in 96% of the eyes. There was an increased risk of cataract and cataract surgery after conditioning including irradiation compared to chemotherapy (p < 0.001). There was an increased risk of developing cataract earlier if the child received single dose total body irradiation (TBI) compared to fractionated TBI (p < 0.01). Cataract development did not correlate with prolonged exposure to corticosteroids or chronic GVHD. Thirty-two percent of the patients showed objective signs of DES, defined as corneal staining with a short break-up time and/or pathological Schirmer. Malignant disease increased the risk of DES in girls. Frequent occasions of high cyclosporine A levels showed a significant association with DES. Single dose TBI and cataract surgery significantly correlated to a lower mean hit rate on visual field examination. Digital measurements of optic discs demonstrated significantly larger optic disc cup areas and smaller rim disc areas than reference material. Pathological visual evoked potentials (VEP) were observed in 15% of patients and were significantly associated with decreased BCVA. VEP may be of clinical use in patients with malignant diseases and/or patients conditioned with TBI. Four children with mucopolysaccharidosis I-Hurler showed a reduction of corneal opacities after early SCT but a decreased BCVA and high hyperopia were still present. In fanconi anaemia (FA) patients small optic discs were observed in six of ten eyes. Visual perceptual skills were subnormal in FA patients. Conclusion: Various ocular complications are common in children treated with SCT. Regardless of the prevalence of anterior and posterior abnormalities, the ultimate visual outcomes were excellent in the majority of the patients. The choice of conditioning regimen but also the character of the underlying disease had an impact on the prevalence of complications. Awareness of and systematic and close follow-up of these sometimes severe complications, as well as early intervention are necessary to preserve good visual perception in this continuously increasing group of patients.
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