Subject(s)
Humans , Female , Adult , Gastrointestinal Hemorrhage/etiology , Endometriosis/complications , Endometriosis/diagnosisABSTRACT
We report the case of a 37-year old woman with a history of ovarian endometriosis who was referred for cyclical episodes of hematochezia during her menstrual period. Colonoscopy and Computed Tomography were performed with a final diagnosis of appendiceal endometriosis. She was operated, evolving favorably.
ABSTRACT
PURPOSE: To estimate the prevalence and causes of bilateral blindness and visual impairment in an urban institutionalized population aged 65 years and older. METHODS: A total of 392 nursing home residents completed a standardized eye examination, including measurement of visual acuity (VA), intraocular pressure, lens opacity grading, indirect ophthalmoscopy, and photography of the macular area. The major causes of vision loss identified for all participants were blindness and visual impairment. RESULTS: The average subject age was 82 years (65-97); women outnumbered men 263 to 129. The prevalence of bilateral blindness (VA > or =1.0 logarithm of the minimum angle of resolution [logMAR]) was 14.9% (43/288); the prevalence of visual impairment (VA > or =0.5 and 1.0 logMAR) was 31.9% (92/288). Blindness and visual impairment increased significantly with age (p<0.05), odds ratio (OR) 1.047 and 1.088, respectively. Cataract was the most common cause of bilateral blindness and visual impairment (27.9% and 44.6%, respectively) followed by pathologic myopia (23.3%) and age-related macular degeneration (AMD) (20.9%) for blindness, and by AMD (27.2%) and pathologic myopia (12%) for visual impairment. Fifty percent of subjects with visual loss had the potential for improved vision with medical or surgical intervention. CONCLUSIONS: Although the prevalences were high, these data are important since it is difficult for epidemiologic studies to include aged, institutionalized individuals, although their numbers are increasing. Recognition of the predominant causes of visual loss dependent on age is fundamental for early diagnosis and treatment of ocular diseases. Many cases of low vision can be treated with appropriate ophthalmologic care.
Subject(s)
Blindness/epidemiology , Cataract/complications , Institutionalization , Macular Degeneration/complications , Myopia/complications , Vision, Low/epidemiology , Aged , Aged, 80 and over , Blindness/etiology , Cataract/epidemiology , Female , Humans , Incidence , Macular Degeneration/epidemiology , Male , Myopia/epidemiology , Prevalence , Risk Factors , Spain/epidemiology , Vision, Low/etiology , Visual AcuityABSTRACT
PURPOSE: To evaluate the role of optical coherence tomography (OCT) in determining choroidal neovascularization (CNV) activity before and after photodynamic therapy (PDT) in patients with age-related macular degeneration (ARMD). DESIGN: Prospective observational case series. SETTING: Institutional study. patient population: Fifty-three patients (62 eyes) with ARMD. OBSERVATION PROCEDURE: Prospective observational case study. MAIN OUTCOME MEASURES: Presence or absence of leakage on fluorescein angiography, presence of intraretinal or sub-retinal fluid on OCT, and macular and choroidal neovascular complex thickness on OCT. RESULTS: The macular thickness decreased significantly after PDT (P = .001). However, no significant changes in CNV thickness were measured after PDT (P = .567). Once the diagnosis of ARMD was established before treatment, OCT had a sensitivity of 96.77% for detecting CNV activity. After treatment, OCT had a good sensitivity (95.65%) and a moderate specificity (59.01%) in determining CNV activity, which resulted in a diagnostic efficiency (proportion of correct results) of 82.95%. CONCLUSIONS: OCT appears to be useful for indicating CNV activity. Therefore, it may serve as a complementary technique for deciding the need for PDT and re-treatment in patients with ARMD.
