PurposeThe present study aims to estimate the prevalence of non-compliance and improper drop administration technique among glaucoma patients and describe common obstacles to medication compliance.MethodsA hospital-based cross-sectional study, using standardized questionnaire and direct observation by study personnel was conducted among glaucoma patients aged 18 years and above at a tertiary care charitable eye hospital in North India. 151 consecutive glaucoma patients on medical therapy following up at the glaucoma clinics for at least 6 months were recruited. Non-compliance was defined as missing at-least one drop of medication per week and (or) the inability to accurately describe the medication regimen. Study personnel also assessed drop administration technique during application of eye drops by patients treating ophthalmologist-provided information, including measures of disease stability. Factors such as socioeconomic status, presence of caregiver, and number of medications with their effect on compliance were studied using chi-square statistics.ResultsAmong 151 patients interviewed, around 49% of patients reported problems in using glaucoma medications, with 16% of them reporting total non-compliance. 35% of patients demonstrated improper drop administration technique. Forgetfulness was cited as the main reason for being non-compliant and had a significant association with non-compliance (P = 0.00). Paying patients were more compliant as compared to subsidized patients (P = 0.05). Disease was more stable in compliant patients compared to non-compliant patients (P = 0.05). No other factor had significant association with compliance (P > 0.05).ConclusionsOver 50% of the patients surveyed were non-compliant, and 35% demonstrated improper administration technique. Glaucoma patients should be educated on the importance of compliance and aids that minimize forgetfulness, and delivery systems facilitating the delivery of medications to the eye could be considered to enhance patient adherence.
Purpose
To study the macular features in Eales disease patients observed with fundus fluorescein angiography (FA), optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA).
Methods
A cross-sectional study was done on treatment naïve 31 eyes (23 patients) with Eales disease. Baseline parameters such as Best-corrected visual acuity (BCVA), slit-lamp bio microscopy (SLB), indirect ophthalmoscopy, FA, spectral-domain OCT {quantitative (central macular thickness [CMT]) and qualitative analysis on SD-OCT} and OCTA were performed. Any media opacity precluding the above investigations was excluded.
Results
Macular findings comprised of- epiretinal membrane, macular exudation, full thickness macular hole, sub internal limiting membrane bleed, cystoid macular oedema, neurosensory detachment and retinal thickening. Sixteen (51.6%) of our patients had macular changes as seen on all modalities together. SLB and indirect ophthalmoscopy missed macular findings in 50% patients and FA in 18.8% patients. OCT and OCTA diagnosed all macular findings. On comparison of mean BCVA in patients with macular involvement on FA, OCT and OCTA, compared to those without macular involvement, patients with macular involvement had lower BCVA (p 0.000, 0.01 and 0.001 respectively). Thus, FA missed many patients who had significant macular involvement and hence less vision.
Conclusion
Eales disease though described in literature as classically being peripheral retina disease process, also has macular involvement. OCT and OCTA are useful guides to evaluation of macular involvement in these patients. The latter seems to be superior to FA in detecting macular abnormalities in this ailment. OCTA is non-invasive and shows deep capillary plexus changes which are not shown by any other modality.
Purpose:
To compare the axial length (AL) obtained by A-scan biometry (PAC SCAN 300AP; Sonomed Escalon, USA) and LENSTAR-LS 900 (Haag-Streit, Koeniz, Switzerland) in silicone oil (SiO)-filled eyes.
Methods:
AL measurements were taken in 50 SiO-filled eyes using A-scan and LENSTAR-LS 900 before SiO removal and 1 month following SiO removal. In the subset of patients requiring intraocular lens (IOL) insertion, the predicted refraction and the refraction obtained were compared. IOL power in these patients was calculated using SRK-T formula and the AL obtained by LENSTAR.
Results:
In SiO-filled eyes, a significant difference was noted between the AL values obtained using the two methods (P = 0.0002). No significant difference was noted after SiO removal (P = 0.634). In the subset of patients needing IOL insertion, no significant difference (P = 0.07) was seen between target refractive error and postoperative refractive error (mean deviation from the target being 0.176 diopter). AL of an SiO-filled eye is more accurately measured using optical low coherence reflectometry (OLCR)-based biometry (LENSTAR) than with conventional acoustic biometry (A-scan).
Conclusion:
We conclude that LENSTAR gives more accurate biometry in an SiO-filled eye. The AL obtained after SiO removal was comparable and showed no significant difference.
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