Background The purpose of the current study is to report the anatomical and functional results of off-label human amniotic membrane graft as primary intervention to repair large to giant macular holes and in reoperations when wide internal limiting membrane peeling was unsuccessful. Methods Retrospective chart review was carried out in five different centers to identify all cases that had undergone off-label human amniotic membrane graft for the treatment of large or failed macular holes (MH). Data collected included age, gender, other concomitant diagnosis, symptoms duration, lens status, number of previous surgeries, macular hole measurements (minimum and base linear diameters), mean post-operative follow-up (months), and pre- and post-operative best corrected visual acuity (BCVA). Main outcome measures were anatomical MH closure rates and final BCVA (in logMAR). Nonparametric Wilcoxon rank-sum test was used because the data was not normally distributed, a P values < 0.05 were considered statistically significant. Results Nineteen eyes of 19 patients were identified and included in the study. Mean age was 66.21 ± 14.96 years and predominantly females (84%). All eyes had successfully closed MH with a single intervention with no recurrences during a mean of 9 ± 3.87 months follow-up. The median BCVA in logMAR preoperative was 1.30 ± 0.44 (0.80–2.0), approximately 20/400 on Snellen chart and the median BCVA in logMAR postoperative was 1.0 ± 0.72 (0.4–3.0) approximately 20/200 (p < 0.0001) with median of three lines of visual improvement. Conclusion The use of human amniotic membrane graft seems to be a viable and effective alternative for the treatment of large and persistent macular holes. However, further larger prospective controlled studies are necessary to confirm our preliminary results of this new surgical technique.
A 34-year-old electronics technician with a macular hole caused by a Neodymium (Nd):YAG laser injury underwent follow up with optical coherence tomography for 1 year. Optical coherence tomography showed a defect in all retinal layers at the macula center, with rectified and perpendicularly orientated borders to the retinal pigment epithelium. One year postinjury, the hole dimensions increased, and optical coherence tomography disclosed less evident rectified borders. After 1 year of follow up, the optical coherence tomography characteristics of a traumatic Nd:YAG laser macular hole can change, looking similar to a senile idiopathic hole. [Ophthalmic Surg Lasers Imaging 2003:34:57-59]
RESUMOA miopia aguda pode ser desencadeada pelo uso de medicaç ões sistêmicas, dentre elas, o anticonvulsivante topiramato. Este trabalho descreve dois casos de pacientes jovens com quadro agudo bilateral de miopia induzida por terapia com topiramato para controle de síndrome depressiva, fazendo relação com casos semelhantes descritos na literatura e revisão bibliográfica pertinente.Descritores: Miopia/induzido quimicamente; Anticonvulsivantes/efeitos adversos; Relatos de casos Recebido para publicação em: 26/10/2009 -Aceito para publicação em 28/6/2011 ABSTRACT
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