ABSTRACT
PURPOSE: To investigate the functional and structural outcomes after treatment with prednisolone eye drops in the following pachychoroid related diseases: chronic central serous chorioretinopathy (cCSC), pachychoroid pigment epitheliopathy (PPE) and peripapillary pachychoroid syndrome (PPS). METHODS: In this retrospective study, 54 eyes of 48 patients with pachychoroid related disease were treated with prednisolone acetate 1% eye drops for 3 times a day. Change in macular volume and retinal central subfield thickness on optical coherence tomography was measured. In addition, foveal or complete resolution of fluid and the change in visual acuity (VA) were studied. RESULTS: The follow-up visit was at a mean of 41.2 ± 14.5 days. In the 44 eyes with cCSC, a significant reduction in retinal central subfield thickness (p < 0.001) and macular volume (p < 0.001) was observed. Foveal intra- or subretinal fluid resolved completely in 22% of the eyes. In the 8 PPS eyes, a reduction in the nasal retinal thickness was observed (p = 0.025). One of the 2 PPE eyes showed structural improvement. No significant change in VA was observed in any of the pachychoroid spectrum diseases. CONCLUSIONS: In cCSC, PPS and PPE patients, anatomical improvement was observed after therapy with prednisolone eye drops. VA did not change significantly.
ABSTRACT
INTRODUCTION AND HYPOTHESIS: Patient-reported outcomes are relevant outcomes in studies on pelvic organ prolapse (POP) surgery, as anatomical recurrence alone does not have a significant correlation with perceived improvement. In the present study, the patient's impression of improvement after 1 year is studied after vaginal hysterectomy (VH) versus sacrospinous hysteropexy (SSH) in large cohorts from daily clinical practice. We hypothesize that there is no difference between the groups. METHODS: This is a secondary analysis on prospectively collected data in a multicenter cohort of patients who underwent VH or SSH for symptomatic POP. All patients had a POP-Q stage ≥ 2 in at least one compartment at baseline and were treated with VH or SSH between 2002 and 2019. The primary outcome was the patient-reported score on the patient global impression of improvement index (PGI-I) 1 year after surgery. The secondary outcome was a composite outcome of surgical success, defined as the absence of recurrent POP beyond the hymen with bothersome bulge symptoms and/or repeat surgery. RESULTS: A total of 378 women (196 VH and 182 SSH) were included. The median score on the PGI-I did not differ between VH and SSH. At 1 year post-operatively, 77 women after VH (73%) and 77 women after SSH (75%) considered their condition (very) much improved (p = 0.86). There was no difference in composite outcome of surgical success (126 out of 137 women [92%] after VH, 118 out of 125 women [94%] after SSH; p = 0.44). CONCLUSIONS: Our study shows that there was no difference in the type of surgery, VH or SSH, with regard to the patient's impression of improvement 1 year postoperatively in a large cohort from daily clinical practice.
