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  1 / 29052 MEDLINE  
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PMID:29214788
Autor:Bae HW; Lee SY; Kim S; Park CK; Lee K; Kim CY; Seong GJ
Endereço:Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
Título:Asymmetry of Peak Thicknesses between the Superior and Inferior Retinal Nerve Fiber Layers for Early Glaucoma Detection: A Simple Screening Method.
Fonte:Yonsei Med J; 59(1):135-140, 2018 Jan.
ISSN:1976-2437
País de publicação:Korea (South)
Idioma:eng
Resumo:PURPOSE: To assess whether the asymmetry in the peripapillary retinal nerve fiber layer (pRNFL) thickness between superior and inferior hemispheres on optical coherence tomography (OCT) is useful for early detection of glaucoma. MATERIALS AND METHODS: The patient population consisted of Training set (a total of 60 subjects with early glaucoma and 59 normal subjects) and Validation set (30 subjects with early glaucoma and 30 normal subjects). Two kinds of ratios were employed to measure the asymmetry between the superior and inferior pRNFL thickness using OCT. One was the ratio of the superior to inferior peak thicknesses (peak pRNFL thickness ratio; PTR), and the other was the ratio of the superior to inferior average thickness (average pRNFL thickness ratio; ATR). The diagnostic abilities of the PTR and ATR were compared to the color code classification in OCT. Using the optimal cut-off values of the PTR and ATR obtained from the Training set, the two ratios were independently validated for diagnostic capability. RESULTS: For the Training set, the sensitivities/specificities of the PTR, ATR, quadrants color code classification, and clock-hour color code classification were 81.7%/93.2%, 71.7%/74.6%, 75.0%/93.2%, and 75.0%/79.7%, respectively. The PTR showed a better diagnostic performance for early glaucoma detection than the ATR and the clock-hour color code classification in terms of areas under the receiver operating characteristic curves (AUCs) (0.898, 0.765, and 0.773, respectively). For the Validation set, the PTR also showed the best sensitivity and AUC. CONCLUSION: The PTR is a simple method with considerable diagnostic ability for early glaucoma detection. It can, therefore, be widely used as a new screening method for early glaucoma.
Tipo de publicação: JOURNAL ARTICLE


  2 / 29052 MEDLINE  
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PMID:27772649
Autor:Raven ML; Burris CK; Potter HD
Endereço:Department of Ophthalmology and Visual Sciences, University of Wisconsin - Madison.
Título:Scleritis with Devastating Consequences.
Fonte:Ophthalmology; 123(11):2337, 2016 11.
ISSN:1549-4713
País de publicação:United States
Idioma:eng
Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE
Nome de substância:0 (Glucocorticoids)


  3 / 29052 MEDLINE  
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PMID:28449038
Autor:Cordeiro MF; Normando EM; Cardoso MJ; Miodragovic S; Jeylani S; Davis BM; Guo L; Ourselin S; A'Hern R; Bloom PA
Endereço:Glaucoma and Retinal Neurodegeneration Group, Department of Visual Neuroscience, UCL Institute of Ophthalmology, London EC1V 9EL, UK.
Título:Real-time imaging of single neuronal cell apoptosis in patients with glaucoma.
Fonte:Brain; 140(6):1757-1767, 2017 Jun 01.
ISSN:1460-2156
País de publicação:England
Idioma:eng
Tipo de publicação: CLINICAL TRIAL, PHASE I; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
Nome de substância:0 (Annexins); 0 (Fluorescent Dyes)


  4 / 29052 MEDLINE  
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PMID:29486746
Autor:Rosentreter A; Lappas A; Widder RA; Alnawaiseh M; Dietlein TS
Endereço:Department of Ophthalmology, University of Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany. andre.rosentreter@googlemail.com.
Título:Conjunctival repair after glaucoma drainage device exposure using collagen-glycosaminoglycane matrices.
Fonte:BMC Ophthalmol; 18(1):60, 2018 Feb 27.
ISSN:1471-2415
País de publicação:England
Idioma:eng
Resumo:BACKGROUND: To report the results of the repair of conjunctival erosions resulting from glaucoma drainage device surgery using collagen-glycosaminoglycane matrices (CGM). METHODS: Case series of 8 patients who underwent revision surgery due to conjunctival defects with exposed tubes through necrosis of the overlying scleral flap and conjunctiva after Baerveldt drainage device surgery. The defects were repaired by lateral displacement of the tube towards the sclera, with a slice of a CGM as a patch, covered by adjacent conjunctiva. RESULT: Successful, lasting closure (follow-up of 12 to 42 months) of the conjunctival defects was achieved without any side-effects or complications in all eight cases. CONCLUSIONS: Erosion of the drainage tube, creating buttonholes in the conjunctiva after implantation of glaucoma drainage devices, is a potentially serious problem. It can be managed successfully using a biodegradable CGM as a patch.
Tipo de publicação: JOURNAL ARTICLE
Nome de substância:0 (Glycosaminoglycans); 9007-34-5 (Collagen)


  5 / 29052 MEDLINE  
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PMID:29310612
Autor:Song YJ; Kim S; Yoon GJ
Endereço:Department of Ophthalmology, Chosun University College of Medicine, Gwangju, South Korea.
Título:Impending extrusion of Ex-PRESS shunt treated by shunt-position adjustment: a case report.
Fonte:BMC Ophthalmol; 18(1):4, 2018 Jan 08.
ISSN:1471-2415
País de publicação:England
Idioma:eng
Resumo:BACKGROUND: To report a case of impending extrusion of Ex-PRESS shunt treated by shunt-position adjustment. CASE PRESENTATION: A 56-year-old Asian woman presented with impending extrusion and malposition of Ex-PRESS shunt in her left eye. The bleb of the left eye was shallow and diffuse. In the past, the patient was treated by Ex-PRESS shunt implantation under the scleral flap in both eyes. There had been no Ex-PRESS shunt-related complication in her right eye, and she reported no history of left-eye trauma. Based on these findings, we hypothesized that the source of the left-eye problem was a loosely fixed Ex-PRESS shunt spur. It was thought, furthermore, that this inadequate scleral resistance during the Ex-PRESS shunt implantation was due to the low scleral rigidity resulting from high myopia and insufficient maintenance of the anterior chamber. We proceeded to make an incision in the area adjacent to the Ex-PRESS shunt using a super sharp blade. The shunt was then pushed into the anterior chamber with forceps, and the spur was fixed firmly. Pushing the shunt to the anterior chamber was found to have been sufficient to fix it firmly. In fact, when the sclera was palpated with a sponge, aqueous outflow was observed with no shunt displacement. Postoperative intraocular pressure (IOP) was managed well, and the bleb had formed with diffuse, prominent shapes. The Ex-PRESS shunt was well sustained with good positioning. CONCLUSIONS: When an Ex-PRESS shunt operation is performed on a patient who shows a tendency for low scleral rigidity, shunt implantation should be accomplished carefully and with force adequate for firm spur fixation.
Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE


  6 / 29052 MEDLINE  
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PMID:28449695
Autor:Ness T; Boehringer D; Heinzelmann S
Endereço:Eye Center, Medical Center, University of Freiburg, Faculty of Medicine, Killianstr. 5, 79106, Freiburg, Germany. thomas.ness@uniklinik-freiburg.de.
Título:Intermediate uveitis: pattern of etiology, complications, treatment and outcome in a tertiary academic center.
Fonte:Orphanet J Rare Dis; 12(1):81, 2017 Apr 27.
ISSN:1750-1172
País de publicação:England
Idioma:eng
Resumo:BACKGROUND: Patients with intermediate uveitis (IU) represent a heterogenous group characterized by a wide spectrum of etiologies and regional differences. Aim of the study was to analyze the characteristics of patients with IU examined in an academic center in Germany. METHODS: We conducted a retrospective analysis of the clinical records of all patients with intermediate uveitis referred to the Eye Center, University of Freiburg from 2007 to 2014. Diagnosis followed the Standardization in Uveitis Nomenclature (SUN) criteria. Data analysis included: etiology of IU, demographics, complications, treatment and visual acuity. RESULTS: We identified 159 patients with intermediate uveitis during that period. Mean age at diagnosis was 35 years. Most are female (64%), and the mean duration of IU was 6.1 years (range 1 month - 35 years). Etiology of IU was idiopathic in 59%. Multiple sclerosis (MS) (20%) and sarcoidosis (10%) were frequent systemic causes of IU. Other etiologies including infectious diseases (tuberculosis, borreliosis) or immune-mediated conditions (eg, after vaccination) were present in 11%. The pattern of complications included macular edema (CME) (36%), cataract (24%), secondary glaucoma (7%), and epiretinal membrane formation (19%). Periphlebitis and optic neuritis were more frequent in conjunction with MS. Treatment comprised local and systemic steroids, immunosuppressive agents, biologics, and surgery. Best corrected visual acuity was better than 20/25 in 60% of the eyes after more than 10 years of follow-up. CONCLUSIONS: In our German academic center, most IU cases were idiopathic or associated with MS or sarcoidosis. In contrast to other countries, infectious cases were rare. Patients' overall visual prognosis is favorable even when the duration of IU has been long and and despite numerous complications.
Tipo de publicação: JOURNAL ARTICLE
Nome de substância:0 (Immunosuppressive Agents); 0 (Steroids)


  7 / 29052 MEDLINE  
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PMID:29234807
Autor:Ting DSW; Cheung CY; Lim G; Tan GSW; Quang ND; Gan A; Hamzah H; Garcia-Franco R; San Yeo IY; Lee SY; Wong EYM; Sabanayagam C; Baskaran M; Ibrahim F; Tan NC; Finkelstein EA; Lamoureux EL; Wong IY; Bressler NM; Sivaprasad S; Varma R; Jonas JB; He MG; Cheng CY; Cheung GCM; Aung T; Hsu W; Lee ML; Wong TY
Endereço:Singapore Eye Research Institute, Singapore National Eye Center, Singapore.
Título:Development and Validation of a Deep Learning System for Diabetic Retinopathy and Related Eye Diseases Using Retinal Images From Multiethnic Populations With Diabetes.
Fonte:JAMA; 318(22):2211-2223, 2017 12 12.
ISSN:1538-3598
País de publicação:United States
Idioma:eng
Resumo:Importance: A deep learning system (DLS) is a machine learning technology with potential for screening diabetic retinopathy and related eye diseases. Objective: To evaluate the performance of a DLS in detecting referable diabetic retinopathy, vision-threatening diabetic retinopathy, possible glaucoma, and age-related macular degeneration (AMD) in community and clinic-based multiethnic populations with diabetes. Design, Setting, and Participants: Diagnostic performance of a DLS for diabetic retinopathy and related eye diseases was evaluated using 494 661 retinal images. A DLS was trained for detecting diabetic retinopathy (using 76 370 images), possible glaucoma (125 189 images), and AMD (72 610 images), and performance of DLS was evaluated for detecting diabetic retinopathy (using 112 648 images), possible glaucoma (71 896 images), and AMD (35 948 images). Training of the DLS was completed in May 2016, and validation of the DLS was completed in May 2017 for detection of referable diabetic retinopathy (moderate nonproliferative diabetic retinopathy or worse) and vision-threatening diabetic retinopathy (severe nonproliferative diabetic retinopathy or worse) using a primary validation data set in the Singapore National Diabetic Retinopathy Screening Program and 10 multiethnic cohorts with diabetes. Exposures: Use of a deep learning system. Main Outcomes and Measures: Area under the receiver operating characteristic curve (AUC) and sensitivity and specificity of the DLS with professional graders (retinal specialists, general ophthalmologists, trained graders, or optometrists) as the reference standard. Results: In the primary validation dataset (n = 14 880 patients; 71 896 images; mean [SD] age, 60.2 [2.2] years; 54.6% men), the prevalence of referable diabetic retinopathy was 3.0%; vision-threatening diabetic retinopathy, 0.6%; possible glaucoma, 0.1%; and AMD, 2.5%. The AUC of the DLS for referable diabetic retinopathy was 0.936 (95% CI, 0.925-0.943), sensitivity was 90.5% (95% CI, 87.3%-93.0%), and specificity was 91.6% (95% CI, 91.0%-92.2%). For vision-threatening diabetic retinopathy, AUC was 0.958 (95% CI, 0.956-0.961), sensitivity was 100% (95% CI, 94.1%-100.0%), and specificity was 91.1% (95% CI, 90.7%-91.4%). For possible glaucoma, AUC was 0.942 (95% CI, 0.929-0.954), sensitivity was 96.4% (95% CI, 81.7%-99.9%), and specificity was 87.2% (95% CI, 86.8%-87.5%). For AMD, AUC was 0.931 (95% CI, 0.928-0.935), sensitivity was 93.2% (95% CI, 91.1%-99.8%), and specificity was 88.7% (95% CI, 88.3%-89.0%). For referable diabetic retinopathy in the 10 additional datasets, AUC range was 0.889 to 0.983 (n = 40 752 images). Conclusions and Relevance: In this evaluation of retinal images from multiethnic cohorts of patients with diabetes, the DLS had high sensitivity and specificity for identifying diabetic retinopathy and related eye diseases. Further research is necessary to evaluate the applicability of the DLS in health care settings and the utility of the DLS to improve vision outcomes.
Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE; VALIDATION STUDIES


  8 / 29052 MEDLINE  
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PMID:29422751
Autor:Marco S; Damji KF; Nazarali S; Rudnisky CJ
Endereço:Department of Ophthalmology, University of Nairobi, Nairobi, Kenya.
Título:Cataract and Glaucoma Surgery: Endoscopic Cyclophotocoagulation versus Trabeculectomy.
Fonte:Middle East Afr J Ophthalmol; 24(4):177-182, 2017 Oct-Dec.
ISSN:0975-1599
País de publicação:India
Idioma:eng
Resumo:PURPOSE: To compare the efficacy and safety of endoscopic cyclophotocoagulation (ECP) versus trabeculectomy with mitomycin C (trab) in combination with cataract surgery. MATERIALS AND METHODS: We evaluated the 6-month results of patients undergoing phacoemulsification (phaco) with either ECP or trab. The primary outcome was mean intraocular pressure (IOP) at 6 months; secondary outcomes were change in glaucoma medications, visual acuity, intraocular inflammation, and postoperative complications. Complete success was a target IOP of <21 mmHg and >6 mmHg without glaucoma medications. Qualified success was target IOP achieved through glaucoma medications. RESULTS: We evaluated 53 eyes of 53 patients; 24 (45.3%) eyes were treated with ECP-phaco and 29 (54.7%) with trab-phaco. At 6 months, there was no significant difference in mean IOP of the two groups (ECP-phaco 14.2 ± 3.6 mmHg; trab-phaco 13.0 ± 2.5 mmHg; = 0.240). Six (25.0%) ECP-phaco eyes and 20 (69.0%) trab-phaco eyes achieved complete success ( = 0.002). Qualified success was achieved in 18 (75.0%) ECP-phaco eyes and 9 (31.0%) trab-phaco eyes ( = 0.002). The mean reduction of medication from baseline was significant (ECP-phaco 1.2 ± 1.1; trab-phaco 2.1 ± 1.5; = 0.020). ECP-phaco resulted in more IOP spikes on the 1 postoperative day ( = 0.040) and more anterior cellular reaction at 1 week and 1 month compared to trab-phaco ( < 0.05). The rate of postoperative complications was not significantly different between groups. CONCLUSION: At 6 months, ECP-phaco demonstrated similar improvements in IOP and visual acuity compared to trab-phaco. However, ECP-phaco patients had higher incidences of immediate postoperative IOP spikes and anterior chamber inflammation as well as requiring additional medications postoperatively.
Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE
Nome de substância:0 (Alkylating Agents); 50SG953SK6 (Mitomycin)


  9 / 29052 MEDLINE  
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PMID:29319544
Autor:Green W; Lind JT; Sheybani A
Endereço:Department of Ophthalmology and Visual Sciences, Washington University School of Medicine in Saint Louis, Saint Louis, Missouri, USA.
Título:Review of the Xen Gel Stent and InnFocus MicroShunt.
Fonte:Curr Opin Ophthalmol; 29(2):162-170, 2018 Mar.
ISSN:1531-7021
País de publicação:United States
Idioma:eng
Resumo:PURPOSE OF REVIEW: Two new translimbal glaucoma devices (Xen Gel Stent and InnFocus MicroShunt) have been developed with the goal of optimizing the predictability and safety for subconjunctival glaucoma surgery. RECENT FINDINGS: The new subconjunctival glaucoma implants are manufactured from nonsilicone, biocompatible materials, which may reduce the postoperative inflammatory and fibrotic reactions that can lead to failure. Early data suggests a favorable safety profile with significant reductions in intraocular pressure (IOP). The prevention of chronic hypotony has been a hallmark of the devices, which utilize an intrinsic flow-limiting design based on the tube length and internal lumen diameter. SUMMARY: Early data with the XEN Gel Stent and InnFocus MicroShunt show promising results. Prospective comparative studies comparing these devices with tube shunt and trabeculectomy will be needed.
Tipo de publicação: JOURNAL ARTICLE; REVIEW


  10 / 29052 MEDLINE  
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PMID:29305474
Autor:Montiani-Ferreira F
Endereço:Departamento de Medicina Veterinária, Universidade Federal do Paraná, Rua dos Funcionários, Brazil.
Título:Investigating the decision-making processes of vets: keratoconjuctivitis sicca and glaucoma.
Fonte:Vet Rec; 182(1):18-20, 2018 01 06.
ISSN:2042-7670
País de publicação:England
Idioma:eng
Tipo de publicação: JOURNAL ARTICLE; COMMENT



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