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PURPOSE: To investigate the association of automated visual field (VF) reliability indices (false positive [FP], false negative [FN], and fixation loss [FL]) and sleep quality, VF experience, and age. METHODS: Prospective, cross-sectional study. Adult patients (age ≥ 18 years) completing automated VF testing were invited to participate. Baseline participant characteristics were obtained, and all participants were asked to complete the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Nonparametric Spearman correlations and logistical regression models were performed. RESULTS: 63 patients were enrolled. Lower PSQI score was correlated with higher percentage (%) FL in the right eye (p = 0.03). Fewer prior VF was significantly correlated with higher %FP in the right eye (p = 0.008). Older age was significantly correlated with higher %FN in the left eye (p = 0.01). Greater mean deviation (MD) and pattern standard deviation (PSD) were strongly correlated with higher %FN in the right (p = 0.02 and 0.002, resp.) and left eyes (p = 0.01 and 0.02, resp.). CONCLUSION: In this prospective, cross-sectional study, worse MD and PSD are strongly correlated with increased FN in both eyes. Increased FN in the left eye associated with older age might be attributable to test fatigue. Worse sleep quality is associated with decreased FL in the right eye.
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Frank-ter Haar syndrome (FTHS) is an autosomal recessive disorder characterized by abnormalities that affect the development of bone, heart, and eyes. We report a sibling pair with FTHS caused by a homozygous, novel mutation pLys133Glnfs*13 in the SH3PXD2B gene: one sibling had bilateral ocular hypertension and unilateral colobomas of iris, choroid and retina; the other, unilateral myelinated nerve fiber layer of the optic disk and papilledema due to idiopathic intracranial hypertension. Both children had refractive amblyopia and megalocornea.
Assuntos
Anormalidades Múltiplas/genética , Proteínas Adaptadoras de Transdução de Sinal/genética , Anormalidades Craniofaciais/genética , Anormalidades do Olho/genética , Cardiopatias Congênitas/genética , Mutação , Osteocondrodisplasias/congênito , Anormalidades Múltiplas/diagnóstico , Ambliopia/genética , Pré-Escolar , Corioide/anormalidades , Coloboma/genética , Análise Mutacional de DNA , Deficiências do Desenvolvimento/genética , Anormalidades do Olho/diagnóstico , Oftalmopatias Hereditárias/genética , Feminino , Doenças Genéticas Ligadas ao Cromossomo X/genética , Humanos , Iris/anormalidades , Masculino , Fibras Nervosas Mielinizadas/patologia , Hipertensão Ocular/genética , Disco Óptico/patologia , Osteocondrodisplasias/genética , IrmãosRESUMO
PURPOSE: To investigate the outcomes of childhood glaucoma suspects. DESIGN: Retrospective case series. METHODS: Records of childhood glaucoma suspects were identified using financial claims data; medical history, baseline biometric and exam findings were recorded. Conversion from suspect to glaucoma was determined based on the Childhood Glaucoma Research Network criteria. The study adheres to the tenets of the Declarations of Helsinki. RESULTS: 214 subjects were enrolled, with median age at initial presentation of 6.37 years (interquartertile range: Q1 = 2.46, Q3 = 8.90). 22 (10.2%) subjects developed glaucoma, 64 (29.9%) had ocular hypertension but no glaucoma, 9 (4.2%) had high-risk condition or syndrome without either ocular hypertension or glaucoma after a mean follow up of 39 +/- 34 months. Neither a family history of glaucoma nor patient gender was significantly different between the groups. 40.2% of subjects (86 of 214) had two or more episodes of intraocular pressure (IOP) > 21 mmHg, among which 25.6% (22 of 86) developed glaucoma after a mean duration of 32.8 +/- 33.5 months. CONCLUSIONS: Up to 25% of children with 2 or more episodes of elevated IOP may develop glaucoma. In 50% of suspects who converted to glaucoma, elevated IOP was not present at the initial evaluation. There is no significant difference in gender, family history, or baseline central corneal thickness between suspects who developed glaucoma compared to the rest. While suspects who converted to glaucoma had higher average, maximum and minimum IOP measurements, there is no clear cutoff between the groups.
Assuntos
Hipertensão Ocular/diagnóstico , Criança , Pré-Escolar , Feminino , Seguimentos , Glaucoma/diagnóstico , Glaucoma/fisiopatologia , Glaucoma/terapia , Humanos , Lactente , Pressão Intraocular , Masculino , Hipertensão Ocular/fisiopatologia , Hipertensão Ocular/terapia , Fatores de Tempo , Resultado do TratamentoRESUMO
A 31-year-old primagravid female at 27 weeks gestation presented to the emergency room with three weeks of progressive blurring of vision associated with intermittent headaches. Ocular examination revealed diminished visual acuity, decreased color discrimination, and constricted confrontation visual fields; optic nerve appearance was however normal. Magnetic resonance imaging of the brain and orbits revealed a large tuberculum meningioma compressing the optic chiasm and prechiasmatic optic nerves, as well as a small sphenoid wing meningioma. Given the risk of permanent vision loss, the patient underwent emergent tumor resection. Near total resection of the masses was achieved and the patient had complete resolution of her vision post-operatively. She gave birth via Caesarean section at 39 weeks. This case report describes the clinical presentations of intracranial meningiomas and discusses the challenges this condition poses in management during pregnancy.
