Long-term visual field changes in diabetic papillopathy

Is to evaluate the fundus and central visual field changes in patients with diabetic papillopathy after long term follow up. Twelve patients [14 eyes] with diabetic papillopathy were followed up for at least 3 years. Full clinical ophthalmological evaluation, colour fundus photography, fluorescein angiography and central automated perimetry were repeatedly performed initially and at specific intervals. All eyes presented with hyperemic optic' disc edema and minimal or no evidence of optic nerve dysfunction. Within 3-12 months, the optic disc edema completely resolved. At 1 year and later on, pallor and hypofluorescence of the optic disc and peripapillary choroidal atrophy were observed in 12 eyes. In central perimetry, enlarged blind spot only or in association with scattered scotomata was initially seen in most eyes. At 1 year, recovery of the previously detected field defects was seen in most eyes, but persistent minor defects were seen in few eyes. At 2 year and later on, inferior altitudinal and superior arcuate field defects with marked depression of the retinal sensitivity were more commonly seen. Inferior arcuate defect and superior scattered scotomata with moderate reduction of the retinal sensitivity were less commonly noticed. In all eyes, the central 5-100° were preserved. These visual field defects were not associated with corresponding retinal or significant tonometric changes. -Diabetic papillopathy may not be as benign as described before, and an ischemic factor may play a role in its pathogenesis

visual outcome and the influencing prognostic factors after extraction of posterior segment foreign bodies

To identify the prognostic factors and visual outcomes in eyes with retained posterior segment intraocular foreign bodies managed by pars plana vitrectomy. Patients and Twenty-three consecutive patients with retained posterior segment intraocular foreign bodies underwent extraction of the foreign body through pars plana vitrectomy were included in this study. Prognostic factors were studied for better and poor visual outcome. These factors included: the initial visual acuity, mechanism of injury, type, site and size of the foreign body, presence of hyphaema, cataract and vitreous haemorrhage, the site and extent of the wound, the time between injury to admission and the time between admission and surgical removal, the presence of retinal detachment and the prolapse of the uveal tissue; After a follow-up of 5.63 months [ +/- 1.19], three patients [13.1%] achieved excellent vision [6/18], ten patients [43.5%] had fair vision [1/60 to 6/24] and ten patients [43.5%] had poor vision [less than 1/60]. The causes of poor visual acuity are corneal scarring, macular pucker and retinal ischaemia with consecutive optic atrophy. The predictors for poor prognosis are poor initial visual acuity, Type of the foreign body as pellets or BB, and large sized wound [P < 0.05]. The prolapse of uveal tissue and the time between injury and reference, although affects the visual outcome, they were not statistically significant [P > 0.05]. The initial visual acuity was the strongest predictor of final visual outcome. Other additional predictive factors included the type of foreign body and size of wound which reflect the severity of the primary injury to the ocular tissues