ABSTRACT
PURPOSE: To analyse the influence of renal function on the outcomes of vitrectomy for tractional-related complications in cases of severe proliferative diabetic retinopathy (PDR). METHODS: Retrospective consecutive case series of 109 eyes that underwent vitreoretinal interventions for traction-related complications of severe PDR from 2014 to 2017. Data collected included patient demographics, best-corrected visual acuity (BCVA), surgical complications, and systemic markers including HbA1c and estimated glomerular filtration rate (eGFR). Renal function categories were defined as low (eGFR < 30 mL/min/1.73 m2), medium (eGFR 30-60 mL/min/1.73 m2), and normal (eGFR > 60 mL/min/1.73m 2). RESULTS: A total of 109 eyes (56% (n = 61) female) were included in the study. Overall, mean baseline BCVA improved from 1.33 logMAR to 0.91 logMAR (p < 0.001) postoperatively. Patients with low eGFR had significantly worse baseline BCVA (p = 0.039) and demonstrated greater improvement in mean BCVA (p = 0.059). Multivariate regression analysis indicated that seven predictors explained 65.5% of the variance (R2 = 0.655, F(11,97) = 16.7, p < 0.01). CONCLUSIONS: Reduced renal function does not adversely affect visual outcomes of vitrectomy for traction-related complications of PDR.
Subject(s)
Diabetic Retinopathy/surgery , Visual Acuity , Vitrectomy/methods , Vitreoretinopathy, Proliferative/surgery , Adult , Aged , Diabetic Retinopathy/complications , Diabetic Retinopathy/diagnosis , Female , Follow-Up Studies , Humans , Male , Middle Aged , Retrospective Studies , Treatment Outcome , Vitreoretinopathy, Proliferative/diagnosis , Vitreoretinopathy, Proliferative/etiology , Young AdultABSTRACT
CASO CLÍNICO: Niña de 6 años con artritis psoriásica juvenil (APJ) y uveítis anterior bilateral complicada, presentó múltiples complicaciones que requirieron 5 procedimientos quirúrgicos. Pese al curso agresivo de la inflamación ocular, conservó una buena agudeza visual. La artritis (necesaria para el diagnóstico de APJ) apareció años después de los síntomas oculares y mostró buena respuesta inicial al adalimumab. DISCUSIÓN: El diagnóstico definitivo de APJ fue realizado años después del inicio de los síntomas. Además, la paciente conservó buena agudeza visual a pesar de su complicada evolución. Finalmente, mostró una respuesta clínica satisfactoria a la terapia con inhibidores del factor de necrosis tumoral
CASE REPORT: A 6 year-old girl with juvenile psoriatic arthritis (JPsA) and bilateral complicated anterior uveitis developed several ocular complications that required 5 surgical procedures. Despite the aggressive course of ocular inflammation, her visual acuity remained good. Arthritis (main criterion for the diagnosis of JPsA) appeared years after ocular involvement. She showed a good anti-tumour necrosis factor initial response. DISCUSSION: The definitive diagnosis of JPsA was established years after the onset of symptoms. In addition, the patient maintained a good visual acuity, despite its complicated disease course. Finally, she showed a good clinical response to adalimumab
Subject(s)
Humans , Female , Child , Uveitis, Anterior/complications , Uveitis, Anterior/diagnosis , Uveitis, Anterior/therapy , Arthritis, Juvenile/complications , Arthritis, Juvenile/diagnosis , Arthritis, Juvenile/therapy , Uveitis, Anterior/classification , Uveitis, Anterior/etiology , Arthritis, Juvenile/classification , Arthritis, Juvenile/prevention & controlABSTRACT
CASE REPORT: A 6 year-old girl with juvenile psoriatic arthritis (JPsA) and bilateral complicated anterior uveitis developed several ocular complications that required 5 surgical procedures. Despite the aggressive course of ocular inflammation, her visual acuity remained good. Arthritis (main criterion for the diagnosis of JPsA) appeared years after ocular involvement. She showed a good anti-tumour necrosis factor initial response. DISCUSSION: The definitive diagnosis of JPsA was established years after the onset of symptoms. In addition, the patient maintained a good visual acuity, despite its complicated disease course. Finally, she showed a good clinical response to adalimumab.
Subject(s)
Arthritis, Psoriatic/complications , Tumor Necrosis Factor-alpha/therapeutic use , Uveitis, Anterior/etiology , Arthritis, Juvenile , Child , Female , Humans , Uveitis, Anterior/drug therapyABSTRACT
CASO CLÍNICO: Una niña de 4 años ingresa por politraumatismo grave por arrollamiento. Durante la evolución se le diagnostica de parálisis completa del tercer par del ojo derecho y retinopatía de Purtscher en ojo izquierdo. DISCUSIÓN: La retinopatía de Purtscher es poco frecuente. El diagnóstico es clínico y su tratamiento no está estandarizado aunque los corticoides sistémicos podrían mejorar el pronóstico visual. Las parálisis deL tercer par traumáticas tienen baja tendencia a la recuperación espontánea. El uso de toxina botulínica en niños podría mejorar la tasa de recuperación total y podría ser útil para acelerar la resolución y así permitir binocularidad y evitar la ambliopía
CASE REPORT: A 4 year-old girl was referred to our hospital after have suffered a severe accident. The patient was diagnosed with complete third nerve palsy in her right eye and Purtscher retinopathy in her left eye. DISCUSSION: Purtscher retinopathy is a rare condition. The diagnosis is made on clinical ground and its treatment is not well defined although it is believed that systemic steroids could improve the visual outcome. Traumatic third nerve palsy has a poor spontaneous recovery. The use of botulinum toxin might be useful in children to improve the recovery rate, maintaining binocularity, and avoiding amblyopia in other cases
Subject(s)
Child, Preschool , Female , Humans , Oculomotor Nerve Diseases/diagnosis , Craniocerebral Trauma/complications , Botulinum Toxins/therapeutic use , Multiple Trauma/complicationsABSTRACT
CASE REPORT: A 4 year-old girl was referred to our hospital after have suffered a severe accident. The patient was diagnosed with complete third nerve palsy in her right eye and Purtscher retinopathy in her left eye. DISCUSSION: Purtscher retinopathy is a rare condition. The diagnosis is made on clinical ground and its treatment is not well defined although it is believed that systemic steroids could improve the visual outcome. Traumatic third nerve palsy has a poor spontaneous recovery. The use of botulinum toxin might be useful in children to improve the recovery rate, maintaining binocularity, and avoiding amblyopia in other cases.
