This is the first documented case of macular edema secondary to vascular activity being associated with these rare lesions. When CSHRPE is found to have secondary vascular activity and associated macula edema, treatment of intravitreal bevacizumab may lead to improved visual and anatomical outcomes.
We read with interest the research article by Sandhouse et al titled "Effect of Osteopathic Cranial Manipulative Medicine on Visual Function." 1 The authors conducted this study to determine the effect of osteopathic cranial manipulative medicine (OCMM) on multiple functional visual parameters both before and after management of sphenobasilar synchondrosis (SBS) dysfunction. Few studies have been conducted in this area, especially with a blinded randomized prospective design, which is a strength of this study. However, we have concerns regarding the methods.
Purpose:
To analyze the efficacy of nasolacrimal duct probing conducted in the office for nasolacrimal duct obstruction.
Methods:
A retrospective chart review was conducted of 1,294 patients. Of those, 1,227 patients who underwent office-based nasolacrimal probings of the nasolacrimal duct at a single tertiary care center were included.
Results:
A total of 82 (6.7%) patients needed reprobing. Of the 82 patients who underwent a second procedure, 35 (43%) underwent a second in-office probing with a success rate of 77%. The 8 (22%) patients who failed the second in-office probing underwent probing and Crawford stent placement in the operating room and their symptoms resolved. For the 47 (57%) patients who failed the primary in-office probing and underwent operating room probing and stent placement, only 1 (2%) needed a second operating room probing and stent placement. Logistic regression analyses indicated an increased likelihood of needing a secondary procedure with increased age at the time of the first probing.
Conclusions:
This large, retrospective analysis of office-based probings demonstrated a success rate of 93.3% with increased likelihood of not needing a second procedure with probing at a younger age. This study demonstrates an excellent success rate for in-office probings for patients both younger and older than 12 months. This not only shows a high rate of efficacy, but is also highly cost efficient when compared to primary probing in the operating room.
[
J Pediatr Ophthalmol Strabismus
. 2019;56(1):50–54.]
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