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[PMID]:28471102
[Au] Autor:Yoo SG; Cho MJ; Kim US; Baek SH
[Ad] Endereço:Department of Ophthalmology, Kim's Eye Hospital, Seoul, Korea.
[Ti] Título:Cycloplegic Refraction in Hyperopic Children: Effectiveness of a 0.5% Tropicamide and 0.5% Phenylephrine Addition to 1% Cyclopentolate Regimen.
[So] Source:Korean J Ophthalmol;31(3):249-256, 2017 Jun.
[Is] ISSN:2092-9382
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To evaluate the effectiveness of a cycloplegic regimen using 0.5% tropicamide and 0.5% phenylephrine (Tropherine, Hanmi Pharm), in addition to 1% cyclopentolate, in hyperopic children. METHODS: The medical records of hyperopic patients below the age of 14 years who had undergone cycloplegic retinoscopy were retrospectively reviewed. Cycloplegic refractions were performed using one of two cycloplegic regimens. Regimen 1 was a Tropherine-added regimen comprising the administration of one drop of 1% cyclopentolate followed by two to three drops of Tropherine added at 15-minute intervals. Regimen 2 was a cyclopentolate-only regimen comprising the administration of three to four drops of 1% cyclopentolate at 15-minute intervals. The mean difference between noncycloplegic and cycloplegic refraction was compared between the two regimens. RESULTS: A total of 308 eyes of 308 hyperopic children were included. The mean difference (±standard deviation) in the spherical equivalent (SE) between cycloplegic and noncycloplegic refraction was significantly larger in regimen 2 than in regimen 1, with values of +1.70 ± 1.03 diopters (D) and +1.25 ± 0.89 D, respectively (p=0.001). The SE change after cycloplegia was significantly different between the two regimens only in patients aged 5 years or younger (p=0.001), particularly in those with high hyperopia with an SE ≥5 D (p=0.005) or fully accommodative esotropia (p=0.009). There was no significant difference between the two regimens in patients older than 5 years, regardless of the presence of high hyperopia or fully accommodative esotropia. CONCLUSIONS: The Tropherine-added regimen exerted a weaker cycloplegic effect than the cyclopentolate-only regimen, particularly in children under the age of 5 years with high hyperopia or fully accommodative esotropia. However, the difference in refraction between the two regimens was small. A Tropherine-added regimen can be effective in hyperopic children, with less associated discomfort than the instillation of cyclopentolate.
[Mh] Termos MeSH primário: Acomodação Ocular/efeitos dos fármacos
Ciclopentolato/administração & dosagem
Oftalmopatias Hereditárias/tratamento farmacológico
Hiperopia/tratamento farmacológico
Fenilefrina/administração & dosagem
Refração Ocular/efeitos dos fármacos
Tropicamida/administração & dosagem
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Quimioterapia Combinada
Oftalmopatias Hereditárias/fisiopatologia
Feminino
Seguimentos
Seres Humanos
Hiperopia/fisiopatologia
Lactente
Recém-Nascido
Masculino
Midriáticos/administração & dosagem
Soluções Oftálmicas/administração & dosagem
Estudos Retrospectivos
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Mydriatics); 0 (Ophthalmic Solutions); 1WS297W6MV (Phenylephrine); I76F4SHP7J (Cyclopentolate); N0A3Z5XTC6 (Tropicamide)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.3341/kjo.2016.0007


  2 / 2225 MEDLINE  
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[PMID]:29370195
[Au] Autor:Le Jeune C; Chebli F; Leon L; Anthoine E; Weber M; Péchereau A; Lebranchu P
[Ad] Endereço:Department of Ophthalmology, University Hospital of Nantes, Nantes, France.
[Ti] Título:Reliability and reproducibility of disc-foveal angle measurements by non-mydriatic fundus photography.
[So] Source:PLoS One;13(1):e0191007, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Abnormal torsion could be associated with cyclovertical strabismus, but torsion measurements are not reliable in children. To assess an objective fundus torsion evaluation in a paediatric population, we used Non-Mydriatic Fundus photography (NMFP) in healthy and cyclovertical strabismus patients to evaluate the disc-foveal angle over time and observers. METHODS: We used a retrospective set of NMFP including 24 A or V-pattern strabismus and 27 age-matched normal children (mean age 6.4 and 6.7 years respectively), taken during 2 distinct follow-up consultations (separated by 251 and 479 days respectively). Each disc-foveal angle measurement (from which the ocular torsion can be assessed) was performed by 5 different observers, using graphical software and based on reproducible fundus anatomical marks. Statistical analysis was performed with a multivariate ANOVA using group, time and observers as factors, in addition to intraclass coefficient correlation (ICC) to assess measurement reproducibility. RESULTS: A significant difference of disc-foveal angle measures was observed between groups (p<0,001): 18.73° (SD = 6.42), -3,25° (SD = 5.51) and 6,89° (SD = 4,41) respectively for V-pattern, A- pattern and normal subjects. Neither observers (F = 0,2028 p = 0,9369) nor time between 1st and 2nd NMFP (F = 0,6312 p = 0,4271) seem to influence the measure of disc-foveal angle. The evaluation of disc-foveal angle was very reproducible between observers (ICC>0,97). CONCLUSION: Abnormal amount of objective torsion could be associated with alphabet-pattern strabismus. Disc-foveal angle evaluation by NMFP in a children population appears as a non-invasive, reliable and reproducible method.
[Mh] Termos MeSH primário: Fundo de Olho
Fotografia
[Mh] Termos MeSH secundário: Estudos de Casos e Controles
Criança
Feminino
Seres Humanos
Masculino
Midriáticos/administração & dosagem
Reprodutibilidade dos Testes
Estudos Retrospectivos
Estrabismo/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Mydriatics)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191007


  3 / 2225 MEDLINE  
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[PMID]:29281690
[Au] Autor:Bawankar P; Shanbhag N; K SS; Dhawan B; Palsule A; Kumar D; Chandel S; Sood S
[Ad] Endereço:Sri Sankaradeva Nethralaya, Guwahati, India.
[Ti] Título:Sensitivity and specificity of automated analysis of single-field non-mydriatic fundus photographs by Bosch DR Algorithm-Comparison with mydriatic fundus photography (ETDRS) for screening in undiagnosed diabetic retinopathy.
[So] Source:PLoS One;12(12):e0189854, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Diabetic retinopathy (DR) is a leading cause of blindness among working-age adults. Early diagnosis through effective screening programs is likely to improve vision outcomes. The ETDRS seven-standard-field 35-mm stereoscopic color retinal imaging (ETDRS) of the dilated eye is elaborate and requires mydriasis, and is unsuitable for screening. We evaluated an image analysis application for the automated diagnosis of DR from non-mydriatic single-field images. Patients suffering from diabetes for at least 5 years were included if they were 18 years or older. Patients already diagnosed with DR were excluded. Physiologic mydriasis was achieved by placing the subjects in a dark room. Images were captured using a Bosch Mobile Eye Care fundus camera. The images were analyzed by the Retinal Imaging Bosch DR Algorithm for the diagnosis of DR. All subjects also subsequently underwent pharmacological mydriasis and ETDRS imaging. Non-mydriatic and mydriatic images were read by ophthalmologists. The ETDRS readings were used as the gold standard for calculating the sensitivity and specificity for the software. 564 consecutive subjects (1128 eyes) were recruited from six centers in India. Each subject was evaluated at a single outpatient visit. Forty-four of 1128 images (3.9%) could not be read by the algorithm, and were categorized as inconclusive. In four subjects, neither eye provided an acceptable image: these four subjects were excluded from the analysis. This left 560 subjects for analysis (1084 eyes). The algorithm correctly diagnosed 531 of 560 cases. The sensitivity, specificity, and positive and negative predictive values were 91%, 97%, 94%, and 95% respectively. The Bosch DR Algorithm shows favorable sensitivity and specificity in diagnosing DR from non-mydriatic images, and can greatly simplify screening for DR. This also has major implications for telemedicine in the use of screening for retinopathy in patients with diabetes mellitus.
[Mh] Termos MeSH primário: Algoritmos
Retinopatia Diabética/diagnóstico
Fundo de Olho
Midriáticos/administração & dosagem
Fotografia/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Automação
Retinopatia Diabética/fisiopatologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Mydriatics)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171228
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189854


  4 / 2225 MEDLINE  
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[PMID]:29233124
[Au] Autor:Lyu IJ; Park KA; Oh SY
[Ad] Endereço:Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
[Ti] Título:Increase in esodeviation under cycloplegia with 0.5% tropicamide and 0.5% phenylephrine mixed eye drops in patients with hyperopia and esotropia.
[So] Source:BMC Ophthalmol;17(1):247, 2017 Dec 12.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUD: To evaluate the manifestations of increased esodeviation under cycloplegia with 0.5% tropicamide and 0.5% phenylephrine in children with hyperopia and esotropia. METHODS: We reviewed the medical record of 34 children with hyperopia and esotropia who underwent a prism alternate cover test before and after instillation of mixed eye drops containing 0.5% tropicamide and 0.5% phenylephrine between November 2014 and October 2015. Increased angle of deviation was defined as 10 prism diopters (PD) or greater deviation after cycloplegia. The factors related to increased angle of deviation were evaluated using univariable and multivariable logistic regression analysis. RESULTS: The median age was 5.0 years (interquartile range, 3.75 to 5.0) and 12 patients (35.3%) were male. The median manifested refractive (MR) was +2.13 diopters (D) (+0.92 to +4.47) and cycloplegic refractive (CR) was +3.50 D (+1.72 to +5.66). The median difference between MR and CR was +0.88 D (+0.50 to +1.28). Thirteen patients (38.2%) showed increased esodeviation under cycloplegia and all had accommodative esotropia. A larger difference between MR and CR was the only significant factor affecting increased esodeviation in both univariable (OR = 4.72, P = 0.029) and multivariable (OR = 5.22, P = 0.047) analyses. CONCLUSION: Children with hyperopia and esotropia often showed an increased angle of deviation after instillation of 0.5% tropicamide and 0.5% phenylephrine. This phenomenon reminded the clinicians that cycloplegics can have a different effect on esodeviation and suggested that increased angle of esodeviation may help to reveal the latent deviation in some patients with hyperopia and esotropia.
[Mh] Termos MeSH primário: Esotropia/tratamento farmacológico
Hiperopia/tratamento farmacológico
Midriáticos/uso terapêutico
Fenilefrina/uso terapêutico
Refração Ocular/efeitos dos fármacos
Tropicamida/uso terapêutico
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Esotropia/fisiopatologia
Seres Humanos
Hiperopia/fisiopatologia
Modelos Logísticos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Mydriatics); 1WS297W6MV (Phenylephrine); N0A3Z5XTC6 (Tropicamide)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171220
[Lr] Data última revisão:
171220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-017-0644-7


  5 / 2225 MEDLINE  
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[PMID]:29202152
[Au] Autor:Nunn A; Sturek JM; Reuss JE; Rein MF; Heysell SK
[Ad] Endereço:Department of Pediatrics, Penn State Health Children's Hospital, Hershey, PA, USA.
[Ti] Título:Subacute loss of vision in one eye · rash on hands and feet · plaques with scaling on genitals · Dx?
[So] Source:J Fam Pract;66(12):E9-E11, 2017 Dec.
[Is] ISSN:1533-7294
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A 67-year-old man presented to the hospital with subacute loss of vision in his left eye. The visual changes began 2 weeks earlier, with a central area of visual loss that had since progressed to near complete vision loss in the left eye. Physical examination revealed patchy alopecia, a scaling and hyperkeratotic rash of his hands and feet, and blanching, erythematous plaques with associated scaling on the scrotum and glans penis. Ophthalmologic examination revealed 1/200 vision in his left eye with a large plaque occupying a substantial portion of the superior quadrant, smaller perifoveal plaques in both of his eyes, and a small infiltrate above the left optic nerve head. The patient also described fatigue, loss of taste, and an unintentional weight loss of 7 to 10 kg over the previous 6 months. He had seen his primary care provider 3 months prior for a burning sensation and scaling rash on his feet and hands, and was prescribed a topical steroid.
[Mh] Termos MeSH primário: Infecções por HIV/diagnóstico
Sífilis/diagnóstico
[Mh] Termos MeSH secundário: Idoso
Antibacterianos/uso terapêutico
Fármacos Anti-HIV/uso terapêutico
Biópsia
Coinfecção
Ciclopentolato/uso terapêutico
Diagnóstico Diferencial
Exantema/diagnóstico
Exantema/tratamento farmacológico
Glucocorticoides/uso terapêutico
Infecções por HIV/tratamento farmacológico
Seres Humanos
Masculino
Midriáticos/uso terapêutico
Penicilinas/uso terapêutico
Prednisolona/uso terapêutico
Sífilis/tratamento farmacológico
Transtornos da Visão/diagnóstico
Transtornos da Visão/tratamento farmacológico
[Pt] Tipo de publicação:CASE REPORTS
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Anti-HIV Agents); 0 (Glucocorticoids); 0 (Mydriatics); 0 (Penicillins); 9PHQ9Y1OLM (Prednisolone); I76F4SHP7J (Cyclopentolate)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171208
[Lr] Data última revisão:
171208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE


  6 / 2225 MEDLINE  
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[PMID]:28863141
[Au] Autor:Kimura S; Morizane Y; Shiode Y; Hirano M; Doi S; Toshima S; Fujiwara A; Shiraga F
[Ad] Endereço:Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
[Ti] Título:Assessment of tilt and decentration of crystalline lens and intraocular lens relative to the corneal topographic axis using anterior segment optical coherence tomography.
[So] Source:PLoS One;12(9):e0184066, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To investigate the tilt and decentration of the crystalline lens and the intraocular lens (IOL) relative to the corneal topographic axis using anterior segment ocular coherence tomography (AS-OCT). METHODS: A sample set of 100 eyes from 49 subjects (41 eyes with crystalline lenses and 59 eyes with IOLs) were imaged using second generation AS-OCT (CASIA2, TOMEY) in June and July 2016 at Okayama University. Both mydriatic and non-mydriatic images were obtained, and the tilt and decentration of the crystalline lens and the IOL were quantified. The effects of pupil dilation on measurements were also assessed. RESULTS: The crystalline lens showed an average tilt of 5.15° towards the inferotemporal direction relative to the corneal topographic axis under non-mydriatic conditions and 5.25° under mydriatic conditions. Additionally, an average decentration of 0.11 mm towards the temporal direction was observed under non-mydriatic conditions and 0.08 mm under mydriatic conditions. The average tilt for the IOL was 4.31° towards the inferotemporal direction relative to the corneal topographic axis under non-mydriatic conditions and 4.65° in the same direction under mydriatic conditions. The average decentration was 0.05 mm towards the temporal direction under non-mydriatic conditions and 0.08 mm in the same direction under mydriatic conditions. A strong correlation was found between the average tilt and decentration values of the crystalline lens and the IOL under both non-mydriatic and mydriatic conditions (all Spearman correlation coefficients, r ≥ 0.800; all P < 0.001). CONCLUSION: When measured using second generation AS-OCT, both the crystalline lens and the IOL showed an average tilt of 4-6° toward the inferotemporal direction relative to the corneal topographic axis and an average decentration of less than 0.12 mm towards the temporal direction. These results were not influenced by pupil dilation and they showed good repeatability.
[Mh] Termos MeSH primário: Cristalino/fisiologia
Lentes Intraoculares
Tomografia de Coerência Óptica
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Extração de Catarata/métodos
Córnea
Topografia da Córnea
Olho Artificial
Feminino
Seres Humanos
Implante de Lente Intraocular
Masculino
Registros Médicos
Meia-Idade
Midriáticos
Variações Dependentes do Observador
Facoemulsificação
Pupila/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Mydriatics)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170902
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0184066


  7 / 2225 MEDLINE  
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[PMID]:28774515
[Au] Autor:Liu JC; Green W; Van Stavern GP; Culican SM
[Ad] Endereço:Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO; Indiana University School of Medicine Transitional Residency Program, Indianapolis, IN.. Electronic address: jameschangliu@gmail.com.
[Ti] Título:Assessing the utility of 2.5% phenylephrine for diagnostic pupillary dilation.
[So] Source:Can J Ophthalmol;52(4):349-354, 2017 Aug.
[Is] ISSN:1715-3360
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate whether the addition of phenylephrine to tropicamide produces any clinically significant change in pupil size during diagnostic eye examination. METHODS: Twenty healthy adults at the Washington University School of Medicine Eye Clinic were enrolled in this prospective, nonrandomized, crossover trial. Each had 3 dilating eye drop regimens administered to the left eye on separate days. Tropicamide (T) + proparacaine (PP) + phenylephrine (PE) (T+PP+PE) was considered the standard therapy, to which tropicamide alone (T alone) and tropicamide + proparacaine (T+PP) were compared against. Main outcome measures were postdilation pupil size and proportion of pupils able to achieve adequate clinical pupil dilation of >7 mm. Comparisons were made using Wilcoxon signed-ranked tests and McNemar's test. RESULTS: Mean postdilation pupil size was 7.94 ± 0.78 mm, 7.64 ± 0.78 mm, and 7.48 ± 0.77 mm for T+PP+PE, T+PP, and T alone, respectively. T+PP+PE was statistically superior to T+PP (p = 0.004) and T alone (p < 0.001) with respect to postdilation pupil size. The proportion of pupils able to achieve adequate pupil dilation of >7 mm was 90%, 80%, and 70% for T+PP+PE, T+PP, and T alone, respectively. No statistical difference was observed in each regimen's ability to achieve adequate pupil dilation of >7 mm (T+PP+PE and T+PP: p = 0.47; T+PP+PE and T alone: p = 0.13). CONCLUSION: The addition of phenylephrine eye drops to tropicamide produced larger pupil dilation, but the magnitude of benefit was marginal and clinically insignificant in this young, healthy cohort. A single-dilating-agent regimen using tropicamide could be considered in routine clinical practice.
[Mh] Termos MeSH primário: Uso de Medicamentos
Oftalmopatias/diagnóstico
Fenilefrina/administração & dosagem
Pupila/efeitos dos fármacos
[Mh] Termos MeSH secundário: Adulto
Estudos Cross-Over
Relação Dose-Resposta a Droga
Feminino
Seguimentos
Voluntários Saudáveis
Seres Humanos
Masculino
Midriáticos/administração & dosagem
Soluções Oftálmicas
Estudos Prospectivos
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Mydriatics); 0 (Ophthalmic Solutions); 1WS297W6MV (Phenylephrine)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170805
[St] Status:MEDLINE


  8 / 2225 MEDLINE  
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[PMID]:28727614
[Au] Autor:Denion E; Charlot F; Béraud G
[Ad] Endereço:1Centre Ophtalmologique du Pays des Olonnes (COPO), Les Sables-d'Olonne, France 2Service d'Ophtalmologie, Polyclinique de la Baie, Saint-Martin-des-Champs, France 3Médecine Interne et Maladies Infectieuses, Poitiers, France 4Université Droit et Santé Lille 2, Lille, France 5Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt University, Hasselt, Belgium.
[Ti] Título:A 5-Minute Interval between Two Dilating Eye Drops Increases Their Effect.
[So] Source:Optom Vis Sci;94(8):838-844, 2017 Aug.
[Is] ISSN:1538-9235
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Patients are usually advised to wait 5 minutes between eye drops. This delay supposedly allows the first drop not to be washed out by the second one, thereby increasing the combined effect. However, in the only experimental study conducted in humans on the concurrent administration of two different eye drops, the authors concluded that a 10-minute time interval between eye drops did not increase their combined effect. Our study was designed to address this puzzling observation. METHODS: Using digital photographs shot in photopic conditions in 40 eyes of 20 healthy volunteers, we compared relative pupil surface (i.e., pupil to iris surface area ratios) before and after the administration of one drop of 10% phenylephrine and one drop of 0.5% tropicamide either immediately or after a 5-minute time interval. RESULTS: Waiting 5 minutes yielded a 5.6% relative pupil surface gain (observer 1: P = .003, observer 2: P = .005) indicating an additional combined effect with a 5-minute time interval. CONCLUSIONS: These results show a detectable additive effect that is probably the result of methodological refinements including the challenging of the mydriasis by photopic conditions and the use of pupil and iris surface areas, which may show differences that would be undetectable in terms of diameter.
[Mh] Termos MeSH primário: Fenilefrina/administração & dosagem
Pupila/efeitos dos fármacos
Tropicamida/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Esquema de Medicação
Feminino
Seres Humanos
Iris/efeitos dos fármacos
Masculino
Meia-Idade
Midriáticos/administração & dosagem
Soluções Oftálmicas
Projetos Piloto
Fatores de Tempo
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Mydriatics); 0 (Ophthalmic Solutions); 1WS297W6MV (Phenylephrine); N0A3Z5XTC6 (Tropicamide)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170913
[Lr] Data última revisão:
170913
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE
[do] DOI:10.1097/OPX.0000000000001104


  9 / 2225 MEDLINE  
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[PMID]:28724815
[Au] Autor:Ajay K; Saranya S; Sundaresh DD; Hithashree HR; Hemalatha BC; Krishnaswamy M; Shetty SB
[Ad] Endereço:Department of Ophthalmology, P. E. S. Institute of Medical Sciences and Research, Kuppam, Andhra Pradesh, India.
[Ti] Título:Efficacy and safety of intraoperative intracameral mydriasis in manual small incision cataract surgery - A randomized controlled trial.
[So] Source:Indian J Ophthalmol;65(7):584-588, 2017 Jul.
[Is] ISSN:1998-3689
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The purpose of this study is to assess the efficacy and safety of intracameral mydriatic solution, as compared to preoperative topical mydriatics, in patients undergoing manual small incision cataract surgery (MSICS) under peribulbar anesthesia. To assess the sustainability of intracameral mydriasis in MSICS by monitoring pupil size at specific junctures during the surgery. METHODS: This trial recruited 127 patients, who underwent MSICS under peribulbar block. Mydriasis in topical group was achieved with preoperative topical dilating drops while patients in intracameral group were taken up for surgery without dilation, and mydriasis was achieved intraoperatively with intracameral solution. Pupil sizes were measured serially, at six different junctures during surgery. Time duration of surgery, any intraoperative complications and first postoperative day visual acuity, corneal edema score, and anterior chamber inflammation score were noted in all patients. RESULTS: Mean pupil size just before peribulbar block was 7.3 mm in topical group and 3.3 mm in intracameral group (P < 0.001). Mean pupil size in intracameral group increased to 7.3 mm 30 s after injecting intracameral dilating solution. Mean pupil size in both groups progressively reduced, reaching 5.5 mm (topical group) and 6.2 mm (intracameral group) just before intraocular lens implantation (P = 0.001), and measured 5.1 mm and 5.5 mm, respectively, at the end of surgery (P = 0.048). On first postoperative day, there was no significant difference in distribution of corneal edema scores, AC inflammation scores, and in median logMAR visual acuity between the two groups. CONCLUSIONS: MSICS can be performed effectively and safely utilizing intracameral mydriatic solution, without the use of preoperative dilating drops. TRIAL REGISTRATION: CTRI/2016/06/007036.
[Mh] Termos MeSH primário: Extração de Catarata/métodos
Procedimentos Cirúrgicos Minimamente Invasivos/métodos
Midríase/induzido quimicamente
Midriáticos/administração & dosagem
Complicações Pós-Operatórias/prevenção & controle
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Câmara Anterior
Feminino
Seres Humanos
Injeções
Período Intraoperatório
Masculino
Meia-Idade
Soluções Oftálmicas
Pupila
Acuidade Visual
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Mydriatics); 0 (Ophthalmic Solutions)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE
[do] DOI:10.4103/ijo.IJO_262_17


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[PMID]:28675903
[Au] Autor:Davila JR; Sengupta SS; Niziol LM; Sindal MD; Besirli CG; Upadhyaya S; Woodward MA; Venkatesh R; Robin AL; Grubbs J; Newman-Casey PA
[Ad] Endereço:Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA.
[Ti] Título:Predictors of Photographic Quality with a Handheld Nonmydriatic Fundus Camera Used for Screening of Vision-Threatening Diabetic Retinopathy.
[So] Source:Ophthalmologica;238(1-2):89-99, 2017.
[Is] ISSN:1423-0267
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To analyze predictors of image quality for a handheld nonmydriatic fundus camera used for screening of vision-threatening diabetic retinopathy. METHODS: An ophthalmic photographer at an Aravind Eye Hospital obtained nonmydriatic and mydriatic fundus images from 3 fields in 275 eyes of 155 participants over 13 months using a Smartscope camera (Optomed, Oulu, Finland) and a Topcon tabletop fundus camera (Topcon, Tokyo, Japan). Two fellowship-trained retina specialists graded the images. Repeated-measures logistic regression assessed predictors of the main outcome measure: gradability of the fundus images. RESULTS: Of 2,475 images, 76.2% of the Smartscope nonmydriatic images, 90.1% of the Smartscope mydriatic images, and 92.0% of the Topcon mydriatic images were gradable. Eyes with vitreous hemorrhage (OR = 0.24, p < 0.0001) or advanced cataract (OR = 0.08, p < 0.0001) had decreased odds of image gradability. Excluding eyes with cataract or vitreous hemorrhage, nonmydriatic macular image gradability improved from 68.4% in the first set of 55 eyes to 94.6% in the final set of 55 eyes. CONCLUSION: With sufficient training, paraprofessional health care staff can obtain high-quality images with a portable nonmydriatic fundus camera, particularly in patients with clear lenses and clear ocular media.
[Mh] Termos MeSH primário: Retinopatia Diabética/diagnóstico
Diagnóstico por Computador/instrumentação
Técnicas de Diagnóstico Oftalmológico/instrumentação
Programas de Rastreamento/métodos
Fotografia/instrumentação
[Mh] Termos MeSH secundário: Desenho de Equipamento
Feminino
Seres Humanos
Masculino
Meia-Idade
Midriáticos
Reprodutibilidade dos Testes
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Mydriatics)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170929
[Lr] Data última revisão:
170929
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170705
[St] Status:MEDLINE
[do] DOI:10.1159/000475773



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