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Visual disturbance or visual failure due to toxicity of an ingested substance or a severe nutritional deficiency can present significant challenges for diagnosis and management, for instance, where an adverse reaction to a prescribed medicine is suspected. Objective assessment of visual function is important, particularly where structural changes in the retina or optic nerve have not yet occurred, as there may be a window of opportunity to mitigate or reverse visual loss. AT7867 This paper reviews a number of clinical presentations where visual electrophysiological assessment has an important role in early diagnosis or management alongside clinical assessment and ocular imaging modalities. We highlight the importance of vitamin A deficiency as an easily detected marker for severe combined micronutrient deficiency.
Retinopathy of prematurity (ROP) is a potentially blinding disease of immature retinal vasculature. ROP regresses in majority of the cases and very few go on to develop ROP needing treatment. Fundus fluorescein angiography (FFA) is the gold standard technique to study retinal vasculature. The present study was undertaken with the objective to identify the FFA findings associated with the progression of ROP.
Prospective single centre study in a tertiary care hospital of 99 eyes of 50 preterm babies. Fundus fluorescein angiography (FFA) was performed in all babies using RetCam 3 at the first detection of ROP. The babies were followed up for the progression of ROP. The FFA predictors for the progression of ROP were evaluated using the Mann-Whitney U test and Fisher's test.
Thirty-eight eyes were Type 1 ROP at initial presentation and were lasered. Amongst the rest, 24 eyes showed features of stage 3 ROP with intense leakage on FFA and were designated as FFA-treatable ROP and were also lasered. Amongst the rest of the 37 eyes, the disease progression was seen in 13 eyes and the disease regression was seen in 24 eyes. The baseline FFA findings associated with the progression of ROP were delayed retinal arterial perfusion (p = 0.037) and popcorn lesions (p = 0.042). The post hoc analysis was done using a validated FFA scoring system.
FFA may be added in the classification of ROP and delayed retinal arterial perfusion and popcorn lesions on FFA may predict the progression of ROP.
FFA may be added in the classification of ROP and delayed retinal arterial perfusion and popcorn lesions on FFA may predict the progression of ROP.
To analyse the changes in reported frequency of retinal detachment admissions and vitreo-retinal surgery procedures performed between 2000 and 2018 in England. To obtain information useful to contribute towards the planning of service delivery.
Analysis of England's Hospital Episode Statistics from the Health and Social Care Information Centre and population data from the United Kingdom's Office for National Statistics.
Episodes of 'retinal detachments with breaks' increased year on year from 3447 (7.0/100 M) in 2000 to 10,971 (19.7/100 M) in 2018 (p < 0.001), whereas records of 'tractional retinal detachment' increased from 290 (0.6/100 M) to 910 (1.6/100 M) in the same period (p < 0.0001). The number of reported pars plana vitrectomies irrespective of indication increased over fourfold from 5761 to 26,900 (p < 0.0001), while the number of scleral buckling records decreased by two thirds from 2897 to 780 (p < 0.0001). During the same period, the population of England increased from 49.2 to g rates of myopia) as well as repeat surgery in cases of recurrent retinal detachment. Other factors which may play a role include improvements in patient access, increased public awareness and improved local coding and reporting practice.
To evaluate the effect of cataract surgery on vision-related quality of life (VR-QOL) in cataract patients with high myopia (HM).
In this prospective study, 90 patients with bilateral HM (HM group, mean [SD] age, 62.9 [9.7] years) and 90 age-matched patients with normal axial lengths (ALs) (control group) who underwent phacoemulsification surgery were consecutively included. The VR-QOL was evaluated using the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) preoperatively and 6 months postoperatively. During the same periods, the best-corrected visual acuity (BCVA) was recorded.
Postoperatively, the BCVA improved significantly in the HM group, with 78 patients (86.7%) achieving improvements ≥0.2 logMAR units, higher than that in the control group (61.1%, P < 0.001). Although the preoperative NEI-VFQ-25 composite score was lower in the HM group than in the control group (65.8 ± 4.7 [95% CI] versus 77.3 ± 3.8, P < 0.001), the postoperative composite score was not significantly different between the two groups (87.5 ± 2.6 versus 90.4 ± 1.6, P = 0.126); changes in composite score and scores of 7 subscales were greater in the HM group than in the control group (P < 0.05 for all). In the HM group, but not in the control group (r = -0.019, P = 0.860), patient age was negatively associated with the change in composite score (r = -0.235, P = 0.026). Preoperative BCVA (logMAR) was positively associated with changes in composite score for both groups (r = 0.796 and 0.714, respectively, P < 0.001 for both).
VR-QOL is significantly impaired in cataract patients with HM and is remarkably improved by cataract surgery. The improvement is greater than that in normal AL cases.
VR-QOL is significantly impaired in cataract patients with HM and is remarkably improved by cataract surgery. The improvement is greater than that in normal AL cases.
To audit the structural and functional outcomes of surgery for acute tractional retinal detachment due to retinopathy or prematurity between 2004 and 2014 in Oxford UK.
Consecutive operations were identified from a surgical log. Clinical data including demography, perioperative data, and retinal outcomes were extracted into a spreadsheet and compared against two international data sets referenced in the method section. Nonparametric tests (Fisher's exact, and the Mann-Whitney U-tests) were used for statistical analysis with a p-value < 0.05 considered significant.
Twenty-nine eyes of 19 babies underwent surgery. The mean age (SD) at final follow-up was 6.4 (3.7) years of age and comparable to the reference data sets. The mean birth weight and gestational age of babies matched the ETROP data set referenced in the method section. Anatomical success was obtained in 16/29 (55.2%) of eyes and more likely with stage 4 ROP than stage 5 disease (p < 0.05). Thirteen of 29 eyes (44.8%) obtained form vision post-operatively.
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