ABSTRACT
BACKGROUND: To assess the benefit of macular spectral-domain optical coherence tomography (SD-OCT) as a part of the routinary preoperative study of patients undergoing cataract surgery. METHODS: A prospective single-center study study was performed. Consecutive patients with normal biomicroscopic funduscopy, moderate cataract and no history of ophthalmological pathologies were enrolled. All patients underwent macular SD-OCT. The obtained images were analysed by a general ophthalmologist and two retina specialists. Incidence of macular pathology and its relation to age and comorbidities were assessed. RESULTS: Eight-hundred and thirty-six eyes of 419 patients were enrolled in this study. All images were analysed telematically by a general ophthalmologist. Forty-nine eyes were excluded due to insufficient quality of the obtained images. Abnormal images were observed in 156 eyes (18.6%), including age-related macular degeneration in 68 (8.2%), epiretinal membrane (ERM) in 67 (8.0%), cystoid macular edema in 3 eyes (0.4%), among others. Diagnostics with severe impact on patient visual prognosis were observed in 16 eyes (3.82%) from 12 patients. The relationship between incidence of macular pathologies and age or comorbidities was not statistically significant. To assess accuracy of the first observer, images were subsequently analysed by two retinologists. The kappa index of concordance was 0.80 and 0.85. CONCLUSIONS: Implementing a systematic macular SD-OCT as a preoperative test prior to cataract surgery would improve quality of postoperative visual prognosis information. A general ophthalmologist would be suitable to screen for pathology through macular OCT images.
Subject(s)
Cataract Extraction , Cataract , Epiretinal Membrane , Cataract/diagnosis , Epiretinal Membrane/diagnosis , Humans , Prospective Studies , Tomography, Optical Coherence/methodsABSTRACT
PURPOSE/METHODS: Subfoveal perfluorocarbon liquid (SPCL) causes vision loss and central scotoma. We present two clinical cases with this complication and we review the 5 clinical cases reported in the literature to analyse their potential prognostic factors. RESULTS/CONCLUSIONS: SPCL extraction involves an early visual acuity recovery and a central scotoma disappearance. The visual acuity recovery degree does not depend on the patient's age, the onset visual acuity or the evolution time when this last one is less than 3 months.
Subject(s)
Fluorocarbons/adverse effects , Fovea Centralis , Retinal Diseases/chemically induced , Aged , Humans , Male , Middle AgedABSTRACT
Objetivo/método: El perfluorocarbono líquidosubfoveal (PCLS) produce disminución de la visióny un escotoma central. Se presentan dos casos conesta complicación y se revisan los cinco casos descritosen la literatura mundial para valorar la existenciao no de factores pronóstico.Resultados/conclusiones: La extracción del(PCLS) comporta una pronta recuperación de laagudeza visual con la desaparición del escotomacentral. El grado de recuperación de la visión nodepende de la edad del paciente, de la agudezavisual inicial ni del tiempo de evolución cuandoeste es inferior a tres meses(AU)
Purpose/methods: Subfoveal perfluorocarbonliquid (SPCL) causes vision loss and central scotoma.We present two clinical cases with this complicationand we review the 5 clinical cases reported inthe literature to analyse their potential prognosticfactors.Results/conclusions: SPCL extraction involves anearly visual acuity recovery and a central scotomadisappearance. The visual acuity recovery degreedoes not depend on the patients age, the onsetvisual acuity or the evolution time when this lastone is less than 3 months(AU)
Subject(s)
Humans , Male , Adult , Middle Aged , Fluorocarbons , Fluorocarbons/adverse effects , Fluorocarbons/analysis , Vitrectomy , Scotoma , Vision, Low , Diabetes Mellitus , Diabetes Mellitus/diagnosis , Diabetes Mellitus/epidemiology , Diabetes Mellitus/therapyABSTRACT
PURPOSE: Long term assessment of the evolution of Idiopathic Polypoidal Choroidal Vasculopathy (IPCV) in symptomatic patients treated by laser photocoagulation. METHODS: We carried out a retrospective study involving seven eyes in six patients with visual impairment, affected by IPCV, confirmed by indocyanine green angiography. All were treated by laser photocoagulation and monitored during a period of at least one year. The controls were evaluated during the first, third, sixth and twelfth month, in order to assess whether it was necessary to repeat the treatment. RESULTS: Of the six patients with IPCV lesions, two were men and four were women (1:2) aged between 58 and 81 years (mean = 73 years), and monitored for a time interval of 18 and 75 months (mean = 39 months). The average initial visual acuity was 0.25, and the final was 0.15. All the patients had the other eye also affected: three had a macular disciform scar, secondary to the previous haemorrhagic episodes, two had asymptomatic polyps and in one patient we defined active bilateral IPCV which was treated by laser photocoagulation. In two eyes it appeared as a macular haemorrhage, in four eyes as a serosanguinous retinal pigment epithelial (RPE) detachment and in one eye as a serous RPE detachment. Three eyes suffered a relapse which required further laser photocoagulation treatment. CONCLUSIONS: Laser photocoagulation is a palliative treatment for IPCV. Final vision achieved is poor and relapse is frequent. Other procedures should be used to treat this disease.
Subject(s)
Choroid Diseases/surgery , Choroid/blood supply , Laser Coagulation , Vascular Diseases/surgery , Aged , Aged, 80 and over , Choroid/diagnostic imaging , Choroid Diseases/diagnostic imaging , Female , Follow-Up Studies , Humans , Male , Middle Aged , Radiography , Retrospective Studies , Time Factors , Vascular Diseases/diagnostic imagingABSTRACT
Objetivo: Valorar la evolución a largo plazo, de la vasculopatía coroidal polipoidea idiopática (VCPI) en pacientes sintomáticos, tratados mediante fotocoagulación (FCG) láser.Sujetos, material y métodos: Se ha realizado un estudio retrospectivo en siete ojos de seis pacientes con pérdida visual, afectos de VCPI, confirmada mediante angiografía con verde indocianina. Fueron tratados con FCG láser y con un seguimiento superior a un año. Se controlaron al primer, tercer, sexto y decimosegundo mes para valorar posibles retratamientos.Resultados: Los seis pacientes fueron dos hombres y cuatro mujeres (1:2) cuya edad oscilaba entre 58 y 81 años (x = 73). El seguimiento varió entre 18 y 75 meses ( x = 39). La agudeza visual inicial media fue de 0,25 mientras que la final fue de 0,15. El ojo contralateral se encontraba afectado en todos los pacientes: tres padecían cicatriz macular secundaria a la enfermedad, en otros dos pacientes se apreciaron pólipos asintomáticos y en un paciente se apreció la enfermedad activa bilateral por lo que fotocoagulamos ambos ojos. En dos ojos se presentó en forma de hemorragia macular. En cuatro como desprendimiento serohemorrágico del epitelio pigmentario (EP) y en un ojo como desprendimiento seroso del mismo. Tres ojos sufrieron recaídas por lo que precisaron nuevas FCG.Conclusiones: La FCG láser es un tratamiento paliativo para la VCPI. La agudeza visual final es mediocre y la recaída es frecuente. Deben intentarse otros procedimientos para el tratamiento de este padecimiento
Purpose: Long term assessment of the evolution of Idiopathic Polypoidal Choroidal Vasculopathy (IPCV) in symptomatic patients treated by laser photocoagulation.Methods: We carried out a retrospective study involving seven eyes in six patients with visual impairment, affected by IPCV, confirmed by indocyanine green angiography. All were treated by laser photocoagulation and monitored during a period of at least one year. The controls were evaluated during the first, third, sixth and twelfth month, in order to assess whether it was necessary to repeat the treatment.Results: Of the six patients with IPCV lesions, two were men and four were women (1:2) aged between 58 and 81 years (mean = 73 years), and monitored for a time interval of 18 and 75 months (mean = 39 months). The average initial visual acuity was 0.25, and the final was 0.15. All the patients had the other eye also affected: three had a macular disciform scar, secondary to the previous haemorrhagic episodes, two had asymptomatic polyps and in one patient we defined active bilateral IPCV which was treated by laser photocoagulation. In two eyes it appeared as a macular haemorrhage, in four eyes as a serosanguinous retinal pigment epithelial (RPE) detachment and in one eye as a serous RPE detachment. Three eyes suffered a relapse which required further laser photocoagulation treatment.Conclusions: Laser photocoagulation is a palliative treatment for IPCV. Final vision achieved is poor and relapse is frequent. Other procedures should be used to treat this disease
