ABSTRACT
PURPOSE: To describe the use of the second-generation QuantiFERON-TB Gold (QFT-G) test in a series of patients in an ophthalmic practice. METHODS: The charts of all patients who had QFT-G tests ordered by Mayo Clinic ophthalmologists in the past 3 years were reviewed. RESULTS: A total of 27 QFT-G tests were ordered. Thirteen (48%) tests were negative, six (22%) were indeterminate, two (7%) tests were re-ordered after a lab accident or an improper cancellation, four (15%) were positive and represented infection, and two (7%) were positive but negative when re-tested. Of the four truly positive cases, three were treated for tuberculosis (TB): one had tuberculous iritis, one had retinal vasculitis and haemorrhage, and one had asymptomatic TB but was on immunosuppressive therapy. The fourth patient had previously been treated for latent infection. CONCLUSIONS: In a series of selected patients with uveitis, the QFT-G test was able to detect TB infection in 15% of the patients, though it does not differentiate between active and latent TB infection. QFT-G should be considered in place of purified protein derivative testing in those with uveitis that have had prior BCG vaccination and in immunocompromised patients. Patients with a positive QFT-G, but who have little risk for TB infection and a negative systemic work-up, should be re-tested.
Subject(s)
Interferon-gamma/blood , Tuberculosis/diagnosis , Tuberculosis/immunology , Uveitis/microbiology , Adult , Antitubercular Agents/therapeutic use , Enzyme-Linked Immunosorbent Assay/methods , Glucocorticoids/therapeutic use , Gold , Humans , Male , Middle Aged , Mycobacterium tuberculosis/immunology , Treatment Outcome , Tuberculosis/drug therapy , Visual Acuity , Young AdultABSTRACT
PURPOSE: To report the use of commercially available preservative-free intravitreal triamcinolone acetonide for the treatment of macular oedema due to retinal vascular diseases. DESIGN: Retrospective interventional case series. METHODS: Charts of eyes that received 4 mg preservative-free intravitreal triamcinolone acetonide for the treatment of persistent macular oedema due to retinal vascular diseases were reviewed. Patients were included if they had a follow-up of at least 3 months. Visual acuity, intraocular pressure, presence of an anterior chamber reaction, and mean macular thickness on optical coherence tomography (OCT) were recorded. RESULTS: A total of 10 eyes of 10 patients were identified. Visual acuity improved by a mean of 1.1 Snellen lines at 1 month and 1.3 lines at 3 months. Macular thickness on OCT decreased by a mean of 183.5 microm at 1 month (P<0.0001). Intraocular pressure increased from a mean of 13.5 mmHg at baseline to 15.3 at 1 month, and 14.5 at 3 months. Only the 1-month change in intraocular pressure was statistically significant (P=0.0274). There were no cases of endophthalmitis, anterior chamber reaction, or retinal detachment. CONCLUSION: In this small retrospective, noncomparative series, commercially available preservative-free intravitreal triamcinolone acetonide had no adverse outcomes. Macular oedema was noted to decrease following treatment.
Subject(s)
Anti-Inflammatory Agents/administration & dosage , Macular Edema/drug therapy , Triamcinolone Acetonide/administration & dosage , Anti-Inflammatory Agents/therapeutic use , Follow-Up Studies , Humans , Injections , Intraocular Pressure , Macula Lutea/pathology , Macular Edema/etiology , Macular Edema/pathology , Pilot Projects , Retinal Vein Occlusion/complications , Retinal Vein Occlusion/drug therapy , Retinal Vein Occlusion/pathology , Retrospective Studies , Tomography, Optical Coherence , Treatment Outcome , Triamcinolone Acetonide/therapeutic use , Visual Acuity , Vitreous BodyABSTRACT
Traumatic brain injury can cause an assortment of visual problems for the patient. These problems, unless resolved, can hinder a patient's rehabilitative progress. This article discusses the characteristic visual deficits found after traumatic brain injury. It also explains how minor modifications made to a routine comprehensive optometric examination can tailor an examination to the head trauma patient.
Subject(s)
Brain Injuries/complications , Optometry , Vision Disorders/etiology , Cerebrovascular Disorders/complications , Hospitalization , Humans , Vision Disorders/diagnosis , Vision TestsABSTRACT
This article describes a perceptual testing battery useful in the evaluation of the traumatic-brain-injury patient. Areas of visual perceptual deficits significant in this population are discussed. Key tests, familiar to optometrists, are indicated for the evaluation of these areas. A differential diagnosis based on the results of these tests can be made. This allows for an effective visual rehabilitation program to be developed for these patients.
Subject(s)
Brain Injuries/complications , Vision Disorders/diagnosis , Vision Tests , Diagnosis, Differential , Humans , Ocular Motility Disorders/diagnosisABSTRACT
This article discusses the role of optometric visual therapy in the rehabilitation of left head trauma patients. It overviews the functions of the left hemisphere and the consequences of traumatic brain injury. A patient who was helped by this perceptual therapy is presented. An overview of the therapy approach used for this patient is discussed.
