Purpose To identify changes in retinal function and structure in persons with proliferative diabetic retinopathy (PDR), including the effects of panretinal photocoagulation (PRP). Design Cross-sectional study Participants 30 adults who received PRP for PDR, 15 adults with untreated PDR, and 15 age-matched controls Methods Contrast sensitivity, frequency doubling perimetry (FDP), Humphrey visual fields, photostress recovery, and dark adaptation were assessed in all subjects. Fundus photography and macular spectral-domain optical coherence tomography (SD-OCT) were also obtained. SD-OCT scans were semi-automatically segmented to quantify retinal layer thicknesses. Main Outcome Measures Visual function test results were compared between patients with PDR and PRP, untreated patients with PDR, and controls. Mean retinal layer thicknesses were also compared between groups. Correlation analyses were performed to evaluate associations between visual function test results and retinal layer thicknesses. Results Patients with PDR exhibited significant reduction of FDP mean deviation (MD) in PRP-treated (MD ± SD: −8.20 ± 5.76 dB, p<0.0001) and untreated (−5.48 ± 4.48 dB, p<0.0001) patients relative to controls (1.07 ± 2.50 dB). Reduced log contrast sensitivity compared with controls (1.80 ± 0.14) was also observed in both PRP-treated (1.42 ± 0.17, p<0.0001) and untreated (1.56 ± 0.20, p= 0.001) patients with PDR. Compared to controls, patients treated with PRP demonstrated increased photostress recovery time (151.02 ± 104.43 sec vs 70.64 ± 47.14 sec, p=0.001) and dark adaptation speed (12.80 ± 5.15 min vs 9.74 ± 2.56 min, p=0.022) whereas untreated patients had no significant differences in photostress recovery time or dark adaptation speed relative to controls. PRP-treated patients had diffusely thickened nerve fiber layers (p=0.024) and diffusely thinned retinal pigment epithelial layers (RPE) (p=0.009) versus controls. Untreated patients with PDR also had diffusely thinned RPE layers (p=0.031) compared to controls. Conclusions Patients with untreated PDR exhibit inner retinal dysfunction, as evidenced by reduced contrast sensitivity and FDP performance, accompanied by alterations in inner and outer retinal structure. PRP-treated patients had more profound changes in outer retinal structure and function. Distinguishing the effects of PDR and PRP may guide the development of restorative vision therapies for patients with advanced diabetic retinopathy.
Alzheimer's disease (AD) and Parkinson's disease (PD) are the most common neurodegenerative diseases with age as the greatest risk factor. As the general population experiences extended life span, preparation for the prevention and treatment of these and other age-associated neurological diseases are warranted. Since epidemiological studies suggested that non-steroidal anti-inflammatory drug (NSAID) use decreased risk for AD and PD, increasing attention has been devoted to understanding the costs and benefits of the innate neuroinflammatory response to functional recovery following pathology onset. This review will provide a general overview on the role of neuroinflammation in these neurodegenerative diseases and an update on NSAID treatment in recent experimental animal models, epidemiological analyses, and clinical trials.
Corneal transplantation is one of the most common types of human transplant surgery. By removing a scarred or damaged host cornea and replacing it with a clear and healthy donor transplant, this procedure helps to restore vision in a variety of corneal diseases. The traditional technique for corneal transplantation, penetrating keratoplasty (PKP), involves transplantation of all corneal layers. Over the past decade though, there has been a trend away from PKP as surgeons have developed partial thickness transplant procedures, such as deep anterior lamellar keratoplasty and Descemet stripping automated endothelial keratoplasty. These partial thickness transplant procedures selectively replace diseased host corneal tissue, while conserving healthy and functioning tissue. This review describes current surgical techniques in the field of corneal transplantation, with special emphasis on indications for transplantation and postoperative outcomes.
Purpose of review Eyebank preparation of endothelial tissue for keratoplasty continues to evolve. While eye bank personnel have become comfortable and competent at Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) tissue preparation and tissue transport, optimization of preparation methods continues. Surgeons and eye bank personnel should be up to date on the research in the field. As surgeons transition to Descemet Membrane Endothelial Keratoplasty (DMEK), eye banks have risen to the challenge of preparing tissue. Eye banks are refining their DMEK preparation and transport techniques Recent findings This article covers refinements to DSAEK tissue preparation, innovations to prepare DMEK tissue, and nuances to improve donor cornea tissue quality. Summary As eye bank supplied corneal tissue is the main source of tissue for many corneal surgeons, it is critical to stay informed about tissue handling and preparation. Ultimately the surgeon is responsible for the transplantation, so involvement of clinicians in eye banking practices and advocacy for pursuing meaningful research in this area will benefit clinical patient outcomes.
Pre-HSCT initiation of LE 0.5% appears to be safe and may be as effective as CsA 0.5% for the treatment and prophylaxis of DES following HSCT.
Background The STOP-BANG is a simple obstructive sleep apnea (OSA) screening tool, part questionnaire (STOP) and part demographic or physical measures (BANG), developed for use in preoperative surgical clinics. This study assessed sensitivity and specificity of the instrument among patients referred to a sleep disorders laboratory, and also its performance characteristics when BANG physical measures are patient-reported rather than measured. Methods Adults referred for diagnostic polysomnography completed the STOP questions and answered four yes/no questions (BANG self-reported) about their body mass index (weight and height), age, neck circumference, and gender, which were also assessed by laboratory technologists (BANG-measured). Results Among N=219 subjects (mean age 46.3 ± 13.9 [s.d.] years; 98 [44.8%] males) the sensitivity of the STOP-BANG measured for an apnea/hypopnea index (AHI, events per hour of sleep) >5, >15, and >30 was 82, 93, and 97% respectively. Corresponding negative predictive values were 44, 87, and 96%. Specificities were comparatively low (48, 40, and 33%). The STOP-BANG measured and STOP-BANG self-reported scores showed essentially equivalent test characteristics against polysomnography. Conclusions The STOP-BANG appears to have limited utility in a referred, sleep laboratory setting. Negative results help to identify some individuals as unlikely to have moderate-to-severe apnea, and may thereby prove useful in identification of patients who would benefit more from laboratory studies than home studies. A STOP-BANG in which all information is self-reported may be as effective as the original version, and has potential to facilitate research or community screening where good negative predictive value is required for an effective screening tool.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.