RESUMO
PURPOSE. The fluorescein disappearance test (FDT) is reported to be an objective measure of lacrimal outflow in congenital non-canalisation of the nasolacrimal system. We introduced FDT into our evaluation of children with epiphora to investigate its sensitivity/specificity with regard to symptoms in a prospective study. We also examined the FDT against findings at syringing and probing (S&P) and persistence or resolution of symptoms on follow-up. METHODS. Over a period of 16 months, 88 consecutive children (median age 12 months; range 2.5-192) with epiphora were reviewed and FDT measured at 5 and 10 minutes; 66 FDT were evaluated for inter-observer variation in a masked fashion. S&P were scheduled on the basis of symptoms, abnormal FDT and age "1 year. Normal FDT prompted review. Younger children were observed for natural history and possible resolution with repeat FDT. Equivocal symptoms and normal FDT initiated discharge and telephone review. RESULTS. Inter-observer correlation coefficient = 0.86. Sensitivity/specificity of FDT was 76/76% at 5 minutes and 63/89% at 10 minutes, respectively. In patients under 1 year of age undergoing follow-up (29 patients; 38 eyes) FDT at 10 minutes correctly predicted persistence of symptoms in 65% and resolution in 66% of eyes (follow-up 3-14 months; mean 6); 23 patients (mean age 27 months; range 12-72) underwent S&P with positive surgical findings in 20 (87%). On review, symptoms had improved in 64% eyes (20/31). CONCLUSION. FDT at 5 minutes is an objective measure of symptoms with high inter-observer agreement and agreement with surgical findings. FDT read at 10 minutes may be useful to indicate the persistence or resolution of symptoms and guide patient management.
Assuntos
Exoftalmia/etiologia , Fibroma Ossificante/complicações , Neoplasias Maxilares/complicações , Criança , Exoftalmia/diagnóstico , Fibroma Ossificante/diagnóstico , Fibroma Ossificante/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Neoplasias Maxilares/diagnóstico , Neoplasias Maxilares/cirurgia , Tomografia Computadorizada por Raios XAssuntos
Endoftalmite/complicações , Leucemia Linfocítica Crônica de Células B/complicações , Fungos Mitospóricos/patogenicidade , Infecções Oportunistas/complicações , Idoso , Antineoplásicos/uso terapêutico , Endoftalmite/microbiologia , Humanos , Leucemia Linfocítica Crônica de Células B/terapia , Masculino , Fungos Mitospóricos/isolamento & purificação , Infecções Oportunistas/microbiologia , Vidarabina/análogos & derivados , Vidarabina/uso terapêuticoRESUMO
PURPOSE: To show the use of the polymerase chain reaction (PCR) in a granulomatous choroidal lesion to support a diagnosis of tuberculosis. DESIGN: Observational case report. TESTING: Nucleic acid target amplification of a choroidal specimen using PCR for detection of Mycobacterium tuberculosis was tested. MAIN OUTCOME MEASURES: Positive nucleic acid target amplification for M. tuberculosis in the ocular sample was measured. RESULTS: PCR was positive for M. tuberculosis with appropriate negative controls. CONCLUSIONS: PCR was thought to be a useful supportive technique in the diagnosis of choroidal tuberculosis.