ABSTRACT
Aim: To evaluate the management outcomes amongst various treatment modalities for submacular hemorrhage (SMH) in Indian subjects. Settings and Design: Retrospective, single-center study. Materials and Methods: Patients presenting with SMH between 1999 and 2006 were included. Treatment modalities included: vitrectomy with subretinal recombinant tissue plasminogen activator (r-tPA) assisted SMH evacuation (group 1, n = 14); pneumatic displacement with intravitreal r-tPA and gas (group 2, n = 25); and pneumatic displacement with intraocular gas (group 3, n = 7). Favorable anatomical outcome was defined as complete displacement of SMH from fovea and favorable functional outcome was defined as a gain of >2 Snellen lines from the baseline. Kruskal–Wallis, analysis of variance (ANOVA), and Chi-square tests were used to compare the three groups, while Mann–Whitney and independent t-test were used to evaluate the influence of duration and size of SMH on outcomes. Results: There was no difference amongst groups in terms of favorable anatomical (P = 0.121) or functional outcomes (P = 0.611). Eyes with median duration of SMH less than 7.5 days had a significantly higher probability of achieving favorable anatomical outcome compared to eyes with SMH >14.5 days (P = 0.042). However, duration of SMH did not influence functional outcome (P = 0.595). Similarly, size of SMH did not affect anatomical (P = 0.578) or functional (P = 0.381) outcome. Median follow-up was 31.5, 6.5, and 2.5 months in the three groups, respectively. Conclusions: Co- existing posterior segment conditions and duration of SMH may influence the choice of treatment modality and treatment outcomes. Pneumatic displacement with r-tPA and r-tPA assisted vitrectomy appear to be favorable options for the management of SMH.
Subject(s)
Aneurysm/etiology , Chi-Square Distribution , Choroid Diseases , Humans , Macular Degeneration/complications , Retinal Hemorrhage/epidemiology , Retinal Hemorrhage/surgery , Retinal Hemorrhage/therapy , Tissue Plasminogen Activator , Vitrectomy/methodsABSTRACT
OBJECTIVE: To describe radiographic findings in physically abused children. MATERIAL AND METHOD: The physically abused children diagnosed in King Chulalongkorn Memorial Hospital from 1998 to 2002 were retrospectively reviewed of medical records and radiographic imaging. RESULT: Eighteen of 30 physically abused children had positive radiographic findings and 15 of 18 were related to head injury. Subdural hematomas and skull fractures were the two most common findings found in 11 cases and 9 cases respectively. Seven of 11 cases of head injury had retinal hemorrhage. Fractures other than the skull were detected in 6 patients, located at the long bones, ribs and spines. The abused children with positive radiographic findings were more commonly found in younger infants and mucocutaneous lesions might be absent. CONCLUSION: Inflicted head injury was the most common radiographic findings in the present series. Shaking-impact mechanism was likely to play a significant role in this group of patients.
Subject(s)
Child Abuse/diagnosis , Craniocerebral Trauma/diagnostic imaging , Female , Humans , Infant , Infant, Newborn , Male , Retinal Hemorrhage/epidemiology , Retrospective Studies , Rib Fractures/epidemiology , Skull Fractures/epidemiology , Spinal Fractures/epidemiology , Subarachnoid Hemorrhage/epidemiology , ThailandABSTRACT
Se estudiaron prospectivamente 374 recién nacidos de término, en el Hospital San Juan de Dios, Santiago, Chile, se realizó un examen de fondo de ojo, antes de las 48 horas de vida, con oftalmoscopía directa, previamente dilatados con Tropicamida al 0,5 por ciento, en busca de hemorragias retinales (H.R.) de polo posterior (fundamentalmente papila y mácula). Las H.R. son más frecuentes en primíparas y tienen una frecuencia de 23,5 por ciento. Se controlaron prospectivamente los pacientes con Fondo de Ojo, estudio sensorio motor y agudeza visual hasta los 4 años de edad, para restablecer si existe relación con tropía y/o ambliopía. No hay relación entre la presencia de H.R. de polo posterior al nacer en el grupo estudiado y el desarrollo de tropía y/o ambliopía. El seguimiento es difícil por la no asistencia a los controles de los pacientes
Subject(s)
Humans , Infant, Newborn , Male , Female , Retinal Hemorrhage/epidemiology , Amblyopia/etiology , Fundus Oculi , Obstetric Labor Complications , Ophthalmoscopy , Strabismus/etiology , Tropicamide/administration & dosageABSTRACT
Se examinaron 600 R.N., productos de embarazos normales terminados por vía vaginal o cesárea. Analizándose factores importantes en el desencadenamiento de las hemorragias retinianas como: peso y condiciones del R.N., período expulsivo, vía de terminación del embarazo