Precis: Although this sample with glaucoma had preserved central vision, they presented worse reading performance compared with similarly aged controls. Objective: To determine whether patients with glaucoma with preserved central vision have impaired reading performance compared with healthy controls. Methods: A cross-sectional study of 35 patients with glaucoma and 32 similarly aged controls with visual acuity better than 0.4 logMAR in both eyes. Each participant had a detailed ophthalmological examination followed by a 5-chart reading performance test using a Portuguese version of the Minnesota Low Vision Reading Test (MNREAD). Correlation between reading performance (reading speed) and ocular parameters was investigated. Results: Participants had an average age of 63.0±12.6 years. In the glaucoma group, mean deviation in the better and worse eyes was −6.29±6.36 and −11.08±0.23 dB, respectively. There was no significant difference in age, sex, rage, education, visual acuity, or systemic comorbidities between groups. Participants with glaucoma had significantly slower reading speeds, with an average of 83.2±25.12 compared with 102.29±29.57 words per minute in controls (P=0.006). Reading speed was slower for all 5 charts. Odds of glaucoma increased by 1.29 (95% confidence interval, 1.07-1.56; P=0.009) for each 10 words per minute decrease in average reading speed, with this relationship maintained after accounting for age, schooling, and visual acuity. Conclusions: Patients with mild to moderate glaucoma had worse reading performance compared with similarly aged controls, despite both having preserved central vision.
To evaluate the clinical course and management of infectious interface keratitis after Descemet membrane endothelial keratoplasty. Methods: A total of 352 cases that had undergone Descemet membrane endothelial keratoplasty were retrospectively reviewed. Patients with infectious interface keratitis during follow-up were analyzed. The microbiological analyses, time to infection onset, clinical findings, follow-up duration, treatment, and post-treatment corrected distance visual acuity were recorded. Results: IIK was detected in eight eyes of eight cases. Three fungal and three bacterial pathogens were identified in all cases. All patients received medical treatment according to culture sensitivity. Antifungal treatment was initiated in two cases with no growth on culture, with a preliminary diagnosis of fungal interface keratitis. Intrastromal antifungal injections were performed in all patients with fungal infections. The median time to infection onset was 164 days (range: 2-282 days). The postoperative infectious interface keratitis developed in the early period in two cases. The mean follow-up duration was 13.4 ± 6.2 months (range: 6-26 months). Re-Descemet membrane endothelial keratoplasty was performed in two patients (25%) and therapeutic penetrating keratoplasty in four patients (50%) who did not recover with medical treatment. The final corrected distance visual acuity was 20/40 or better in five patients (62.5%). Conclusions: The diagnosis and treatment of infectious interface keratitis following Descemet membrane endothelial keratoplasty are challenging. Early surgical intervention should be preferred in the absence of response to medical treatment. Better graft survival and visual acuity can be achieved with therapeutic penetrating keratoplasty and re-Descemet membrane endothelial keratoplasty in patients with infectious interface keratitis.
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