Macular thickness changes evaluated with spectral domain optical coherence tomography after uncomplicated phacoemulsification.

PURPOSE: To determine macular thickness changes after uncomplicated cataract surgery using spectral domain optical coherence tomography (OCT). METHODS: This was a prospective non-randomized, clinical study. Data were analysed for 40 healthy patients undergoing uneventful phacoemulsification. OCT measurements were performed before surgery and postoperatively at day 1, week 1 and 2, and month 1, 2, 3, and 6. The retinal map was divided into central point thickness (CPT), central 1-mm subfield (CSF), and two peripheral ring areas with diameters of 3 and 6 m. Fellow eyes were used as controls. Retinal thickness change between the operated and fellow eyes were compared using unpaired t-test. Correlations were analysed using the Spearman or the Pearson analysis. RESULTS: There was a progressive significant increase in retinal thickness of the operated eyes compared with the fellow eyes, with a peak at 1 month (P<0.0001) for the 3- and 6-mm areas and a peak at 2 months for CPT and CSF (P=0.01 and P<0.0001, respectively). At 6 months, retinal thickness was still significantly increased only in the peripheral areas (P<0.0001). There was no significant correlation between macular thickness changes and preoperative factors (age, axial length, anterior chamber depth, posterior vitreous detachment, best-corrected visual acuity), intraoperative factors (length of surgery, effective phaco time, phaco energy) or BCVA change. CONCLUSIONS: The present study demonstrated a significant increase in macular thickness up to 6 months after uncomplicated cataract surgery. The most important finding was the regional pattern of retinal thickening with an early involvement of the parafoveal area.

Montelparo study: risk factors for age-related macular degeneration in a little rural community in Italy.

PURPOSE: To evaluate the prevalence of age-related maculopathy (ARM) and age-related macular degeneration (AMD) lesions. Secondary outcome includes to examine 16 potential risk factors and their prevalence for attribution of risk for ARM and AMD in Montelparo, a small, rural and homogeneous population in central Italy. MATERIALS AND METHODS: A population aged 65 years old and over underwent a detailed interview about demographic notices and possible main risk factors for ARM and AMD. The following information were assessed as medical variables with bivariate analysis: demographic variables such as age and gender, dietary intake (meat, alcohol, fresh and cooked vegetables, fruit and fish), lifestyle factors (smoking, time of sunlight exposure, physical activity), medical history (cataract, hypertension, glaucoma, drug intake and body-mass index). Clinical examination included visual acuity measurement, anterior and posterior segment examination, fundus photography grading using The International Classification and Grading System. Any image was further classified according to the Clinical Age-Related Maculopathy Staging (CARMS) system. RESULTS: 210 patients (79%) of a farmer community participated the study. Prevalence of ARM resulted in 38.5%, drusen larger than 125 micron were found in 14.81%, AMD was 4.28%. The attributable risk estimate, reveal that age (p = 0.014), prior cataract surgery (p = 0.00) and hypertension history (p = 0.005), have the greatest impact on the prevalence of ARM in the community. A vegetable based diet, seems to prevent such effect (p = 0,007). CONCLUSIONS: This study show age as the only dominant invariable factor. Prior cataract surgery and hypertension seems to play an effective role in increasing the risk of maculopathy. Our results provides further evidence that a diet poor in alcohol, rich in vegetables and in polyunsaturated fat could reduce risk of AMD.

Predisposing factors, clinical and microbiological aspects of bacterial keratitis: a clinical study.

PURPOSE: To identify predisposing factors and to evaluate clinical and microbiological characteristics of bacterial keratitis. MATERIALS AND METHODS: A retrospective analysis was performed on the charts of patients hospitalized for microbial keratitis and treated at the Department of Ophthalmology of the Policlinico Umberto I Hospital, Rome, Italy. The study was performed during a 42-month period. Risk factors, clinical and microbiological data were collected. RESULTS: A total of 65 patients with bacterial keratitis were documented. Contact lens wear was the most common risk factor (46.1%). Trauma or a history of keratopathy was found in 18.5% and 15.4% of cases, respectively. An organism was identified in 62% of cases. 74% of all positive cultures involved gram negative bacteria. The most frequently cultured organism was Pseudomonas aeruginosa alone (72.2%) or in combination with other microorganisms (16.7%). Fifty-eight per cent of patients had visual acuity better than the level at admission, and 12% had very poor visual outcome. CONCLUSIONS: Contact lens wear is the most important risk factor. The role of initial therapy for microbial keratitis remains important.