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04) and duration of diabetes mellitus (P = 0.03) were predictors of central subfield thickness at 3 months.
External limiting membrane disruption and disorganization of retinal inner layers, as the spectral domain optical coherence tomography biomarkers of retinal hyperpermeability, can predict short-term outcomes in diabetic macular edema eyes treated with intravitreal bevacizumab.
External limiting membrane disruption and disorganization of retinal inner layers, as the spectral domain optical coherence tomography biomarkers of retinal hyperpermeability, can predict short-term outcomes in diabetic macular edema eyes treated with intravitreal bevacizumab.
To examine possible associations between subfoveal choroidal thickness (SCT), choroidal blood flow, aqueous flare value, and aqueous humor levels of multiple growth factors, cytokines, and other inflammatory mediators in patients with branch retinal vein occlusion and macular edema who received antivascular endothelial growth factor (anti-VEGF) therapy.
We recruited 65 patients with macular edema due to branch retinal vein occlusion who received intravitreal ranibizumab injection and measured aqueous levels of eight factors by the suspension array method. Furthermore, we evaluated choroidal blood flows by laser speckle flowgraphy and quantified them as the mean blur rate and measured aqueous flare values using a laser flare meter and SCT and central macular thickness by optical coherence tomography.
At 1 month after intravitreal ranibizumab injection, central macular thickness was significantly improved and SCT, choroidal mean blur rate, and aqueous flare value were significantly decreased. SCT was significantly correlated with vascular endothelial growth factor and placental growth factor, and the change in both SCT and central macular thickness was significantly correlated with the change in aqueous flare value. However, only SCT was significantly negatively correlated with the aqueous flare value.
Growth factors seem to play a role in SCT. In macular edema with branch retinal vein occlusion, antivascular endothelial growth factor agents may decrease SCT by reducing inflammation.
Growth factors seem to play a role in SCT. In macular edema with branch retinal vein occlusion, antivascular endothelial growth factor agents may decrease SCT by reducing inflammation.
To evaluate the anatomical and functional outcomes of internal limiting membrane (ILM) peeling and the inverted ILM flap technique for rhegmatogenous retinal detachment coexisting with macular hole.
This retrospective study evaluated the medical records of 79 eyes with concurrent rhegmatogenous retinal detachment and macular hole received vitrectomy and silicone oil tamponade, with ILM peeling on 56 eyes and the inverted ILM flap technique on 23 eyes.
The Type 1 closure rate was greater in the inverted ILM flap group than the ILM peeling group (82.6% vs. 55.4%, P = 0.038). Lines of improvement were 7.8 ± 5.3 in the ILM peeling group and 8.9 ± 5.6 in the inverted ILM flap group. Postoperative epiretinal membrane and retinal reattachment rates were similar in two surgical groups (16.1% vs. 21.7%, P = 0.535 and 94.6% vs. 95.7%, P = 0.999, respectively). Type 1 closure was significantly correlated with the inverted ILM flap technique (OR = 5.568, P = 0.023). The inverted ILM flap technique showed no significant association with the final logarithm of the minimum angle of resolution best-corrected visual acuity in multivariate model analysis.
The inverted ILM flap technique was more effective in restoring the macular structure in patients with rhegmatogenous retinal detachment and coexisting macular hole, but the functional outcomes of the two strategies were comparable.
The inverted ILM flap technique was more effective in restoring the macular structure in patients with rhegmatogenous retinal detachment and coexisting macular hole, but the functional outcomes of the two strategies were comparable.
To assess changes in myopic maculopathy based on the ATN classification system with optical coherence tomography angiography.
This was a cross-sectional study. The macular choroidal thickness (MCT) and the choriocapillaris flow (CC) were measured with optical coherence tomography angiography. The relationship of MCT and CC with different chorioretinal atrophy (A), myopic foveoschisis (T), and myopic neovascularization (N) grades was investigated.
One hundred and fifty-three participates (219 eyes) were included. MCT and CC had no significant correlation with different T grades (P > 0.05). Choriocapillaris flow had a significant decrease in eyes with lacquer cracks compared with those with no neovascular maculopathy (P < 0.05) and showed a significant increase in active choroidal neovascularization compared with those with lacquer cracks (P < 0.05). Macular choroidal thickness and CC had negative correlations with different A grades (P < 0.001). MCT showed the greatest decrease in the early stage of myopic atrophic maculopathy (P < 0.001), and CC showed the most significant reduction in the late stage (P < 0.001).
Choroidal changes in the highly myopic patients were detected by optical coherence tomography angiography. Progressive ischemia in the macula may play an important role in the development of myopic atrophic maculopathy. Active choroidal neovascularization may have manifested as compensation for the decrease in MCT and CC. On the contrary, myopic traction maculopathy had little correlation with choroidal changes.
Choroidal changes in the highly myopic patients were detected by optical coherence tomography angiography. Progressive ischemia in the macula may play an important role in the development of myopic atrophic maculopathy. Active choroidal neovascularization may have manifested as compensation for the decrease in MCT and CC. On the contrary, myopic traction maculopathy had little correlation with choroidal changes.
To investigate predictors of early displacement of submacular hemorrhage (SMH) by simple intravitreal SF6 gas injection.
This retrospective study included 16 eyes of 16 consecutive patients (age 74.5 ± 7.7 years; 15 men) with large SMH treated with simple intravitreal SF6 gas before inception of subretinal tissue plasminogen activator injection at our institution. The SMH displacement was graded at 1-week posttreatment as 0, 1, or 2. Central retinal thickness, central choroidal thickness, SMH height, SMH area, disease duration, use of anticoagulant or antiplatelet drugs, and contrast-to-noise ratio (CNR) of SMH on optical coherence tomography images were recorded. Correlations between displacement grading and baseline parameter were analyzed.
Univariable correlation analysis revealed association of the 1-week displacement grading with the CNR (P = 0.004; r = -0.68) and SMH height (P = 0.03; r = -0.55). The CNR was most strongly associated with 1-week displacement on multivariable correlation analysis (P = 0.01; β = -0.60).
Findings of the present study showed that the CNR of SMH was a useful predictor of early displacement of large SMH after simple intravitreal SF6 gas injection. When vitrectomy with subretinal injection of tissue plasminogen activator is difficult in patients with large SMH, with low CNR on optical coherence tomography, simple intravitreal SF6 gas injection may be a treatment option.
Findings of the present study showed that the CNR of SMH was a useful predictor of early displacement of large SMH after simple intravitreal SF6 gas injection. When vitrectomy with subretinal injection of tissue plasminogen activator is difficult in patients with large SMH, with low CNR on optical coherence tomography, simple intravitreal SF6 gas injection may be a treatment option.
To describe ophthalmological fundoscopic findings in patients with COVID-19 admitted to the intensive care unit of the largest third-level referral center for COVID-19 in Mexico City.
In this cross-sectional single-center study, consecutive patients admitted to the intensive care unit with a diagnosis of COVID-19 underwent fundus examination with an indirect ophthalmoscope. Clinical photographs were taken using a posterior-pole camera. We explored the association between ocular manifestations and demographic characteristics, inflammatory markers, hemodynamic factors, and comorbidities.
Of 117 patients examined, 74 were men; the median age was 54 years (range 45-63 years). Forty-two patients had ophthalmological manifestations (unilateral in 23 and bilateral in 19), and 10 of these patients had more than one ophthalmological manifestation. Ocular findings were papillitis (n = 13), cotton wool spots (n = 12), retinal hemorrhages (n = 5), retinal nerve fiber layer edema (n = 8), macular whitening (n = 5), retinal vascular tortuosity (n = 4), papillophlebitis (n = 3), central retinal vein occlusion (n = 1), and branch retinal vein occlusion (n = 1). Ocular fundus manifestations were not associated with demographic characteristics, inflammatory markers, hemodynamic factors, or comorbidities.
More than one-third of patients with severe COVID-19 had ophthalmological manifestations. The most frequent fundoscopic findings were optic nerve inflammation, microvasculature occlusion, and major vascular occlusions. We recommend long-term follow-up to prevent permanent ocular sequelae.
More than one-third of patients with severe COVID-19 had ophthalmological manifestations. The most frequent fundoscopic findings were optic nerve inflammation, microvasculature occlusion, and major vascular occlusions. We recommend long-term follow-up to prevent permanent ocular sequelae.
The ongoing COVID-19 pandemic will only exacerbate the rising mental health concerns among college students. However, stigma toward such concerns continues to hinder mental health care utilization among the students, requiring urgent evidence that can help guide college campuses in implementing effective antistigma interventions. We propose and provide evidence for an intervention based on findings from a 3-year-long antistigma intervention that was implemented on a Southeastern college campus in the United States. Unique random samples of college students, totaling N = 1727 across 3 years, were recruited as participants. Each year, participants completed a preintervention and postintervention survey comprising of questions related to demographics, stigma, and mental health care knowledge. Findings indicate that the stakeholder-led intervention decreased personal stigma and increased mental health care knowledge among students who were exposed to the intervention. Further research is needed to assess feasibre exposed to the intervention. Further research is needed to assess feasibility and efficacy of the proposed intervention framework on other campuses.
The aim of this study was to identify the accuracy of the McMurray test in the adolescent and pediatric population.
Retrospective case series.
Tertiary care, institutional.
Inclusion criteria included patients who presented with unilateral knee pain and were seen by pediatric sports medicine physicians. Patients were excluded if their knee pain was related to any underlying conditions. Three hundred patient charts were reviewed, and 183 patients (age range 8-18 years, mean 14 years; 74 male) met the inclusion criteria.
Symptoms at initial visit (knee pain).
Presence of a meniscal tear using the McMurray test.
Eighty-four percent (160/191) of patients had a McMurray test documented as performed by the physician, and 17% (27/160) elucidated a positive response. selleck compound Of 26 patients who had a positive McMurray and underwent magnetic resonance imaging (MRI), 16 (62%) showed a meniscal tear on their MRI. However, of the 87 patients who had a negative McMurray and still underwent MRI, 25 (29%) had a positive meniscal tear.
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