ABSTRACT
PURPOSE: To evaluate the results of fundus autofluorescence and axial length as prognostic factors for surgical outcome of macular hole retinal detachment in high myopic patients. METHODS: This is a retrospective, interventional, nonrandomized study. Patients were treated with posterior vitrectomy, internal limiting membrane peeling, and silicone oil tamponade. Best-corrected visual acuity, axial length, fundus autofluorescence, and spectral domain optical coherence tomography images were obtained. RESULTS: Fifteen eyes from 15 patients (mean age, 69.4 years) were evaluated. The mean refractive error was -19 diopters, and the mean axial length was 29.9 mm. The mean best-corrected visual acuity (logMAR) improved from 2.17 to 1.42 (P = 0.02) after a mean follow-up of 19.3 months. Spectral domain optical coherence tomography scans showed retinal detachment resolution in 13 eyes (86.6%) and macular hole closure in 9 eyes (60%). Fundus autofluorescence showed macular hypoautofluorescence with foveal involvement (mean area of 9.7 mm2) in 10 eyes (66.6%). Postoperative best-corrected visual acuity was significantly worse in these eyes (P = 0.009). Axial length >30 mm was found in the 2 cases with recurrent retinal detachment and in 4 of the 6 cases without macular hole closure (66.6%). CONCLUSION: Macular hole retinal detachment in high myopic patients can be successfully treated with vitrectomy, internal limiting membrane peeling, and silicone oil. Axial length >30 mm and macular hypoautofluorescence with foveal involvement seem to be prognostic factors for a worse anatomical and visual outcome.
Subject(s)
Axial Length, Eye/pathology , Myopia, Degenerative/complications , Retinal Detachment/surgery , Retinal Perforations/surgery , Aged , Aged, 80 and over , Endotamponade , Epiretinal Membrane/surgery , Female , Fluorescein Angiography , Humans , Male , Middle Aged , Myopia, Degenerative/physiopathology , Prognosis , Retinal Detachment/diagnosis , Retinal Detachment/physiopathology , Retinal Perforations/diagnosis , Retinal Perforations/physiopathology , Retrospective Studies , Silicone Oils/administration & dosage , Tomography, Optical Coherence , Treatment Outcome , Visual Acuity/physiology , VitrectomyABSTRACT
Las enfermedades infecciosas de la cavidad oral tienen una elevada incidencia. Se realizó un estudio descriptivo prospectivo con el objetivo de caracterizar la utilización de antimicrobianos en las infecciones orales de los pacientes del Municipio de Aguada de Pasajeros, provincia de Cienfuegos, Cuba, durante el período comprendido entre agosto de 2005 a enero de 2006. El universo estuvo conformado por 300 pacientes y la muestra por 105 (35 por ciento del universo). Se midieron variables como: diagnóstico estomatológico; antimicrobianos indicados en la actual consulta; posología; combinacionesde antimicrobianos y evaluación de la prescripción de antimicrobianos realizada por el estomatólogo. Los datos se procesaron mediante el programa SPSS 11.0. Se encontró un predominio de los pacientes con edades entre 18-27 años (31,8 por ciento), del sexo femenino (53,3 por ciento). Los principales diagnósticos fueron el absceso dentoalveolar (63,8) y la celulitis facial (25,7 por ciento). 55 pacientes (52,3 por ciento) utilizaron antimicrobianos para el proceso infeccioso actual antes de acudir al estomatólogo y la tetraciclina (56,3 por ciento) fue el antimicrobiano más utilizado. Los médicos fueron los principales prescriptores (45,4 por ciento). El antimicrobiano más indicado por los estomatólogos fue la amoxicilina (36,2 por ciento) y la combinación más frecuente fue la de este fármaco con el metronidazol (6 para un 60 por ciento). El (73,3 por ciento) de los antimicrobianos se indicaron de forma adecuada con relación al diagnóstico estomatológico y no existieron dificultades importantes en cuanto a la posología. El 62,2 por ciento de las prescripciones realizadas fueron correctas. El estudio permite concluir que aún existen dificultades en el manejo de las infecciones orales en la atención primaria.
Infectious diseases of the oral cavity have a high incidence. A prospective, descriptive study was carried out aimed at characterizing the use of antimicrobial drugs in the treatment of oral diseases in patients from Aguada dePasajeros Municipality in Cienfuegos Province, Cuba in a six-month period which covers from August 2005 to January 2006. The universe was composed by 300 patients and the sample by 105 (35 percent of the universe). The variables under study were dental diagnosis, antimicrobial drugs as treatment in the present consultation, dosis, combination of antimicrobial drugs and assessment of their prescription by the dentist. Data was processed by SPSS 11.0 comp package. There was a high frequencyof female patients (53.3 percent) gathered in the age group 18-27 years of age. The principal diagnoses were dento alveolar abscess (63.8) and facial celullitis facial (25.7 percent). 55 Patients (52.3 percent) were medicated with antimicrobial drugs for their infectious process before consulting the dental specialist, and tetracicline (56.3 percent) was the antimicrobial drug most frequently used. Physicians were the main prescriptors of these drugs (45.4 percent). The most frequent antimicrobial drug prescribed by dentists was amoxiciline (36.2 percent) and the most frequent combination was its association to metrinidazol (6 which represents 60 percent). 73.3 percent of the antimicrobial drugs were properly prescribed in regards to the dental diagnosis and there were no significant difficulties in regards to dosis. 62.2 percent of the prescriptions were right. This students allows to conclude that there are still insufficiencies in the treatment of oral infections in primary health care in this municipality.
