Purpose Our study aims to assess peripapillary retinal nerve fiber layer (RNFL) thickness, macular thickness and volume, and optic nerve head (ONH) measurements in patients affected by schizophrenia Methods 30 schizophrenic patients (mean age 44.5 +/‐ 10.9 years) were enrolled. They were compared with 30 age‐matched controls. In all subjects, peripapillary RNFL thickness, ONH measurements, macular thickness and volume were measured by optical coherence tomography (OCT). The eye studied was the right eye Results Schizophrenic patients showed an statistically significant reduction of the overall peripapillary RNFL thickness (95.1+/‐ 13.4 µm) compared with those values observed in control eyes (103.3+/‐9.0 µm) (p=0.008, Student t test). We also observed reduced peripapillary RNFL thickness in superior quadrant in schizophrenic patients (114.7+/‐18.0 µm) when compared with controls (127.3+/‐ 14.4 µm) (p=0.004, Student t test). Cup/disk area ratio (cases: 0.45 +/‐ 0.31; controls: 0.26 +/‐ 0.27 p=0.002, Mann‐Whitney U test), cup/disk horizontal ratio (cases: 0.67 +/‐ 0.22; controls: 0.48 +/‐ 0.23 p=0.003, Student t test), cup/disk vertical ratio (cases: 0.60 +/‐ 0.24; controls: 0.44 +/‐ 0.23 p=0.003, Mann‐Whitney U test) and cup area (cases: 1.32 +/‐ 1.09; controls: 0.73 +/‐ 0.82 p=0.001, Mann‐Whitney U test) were statistically increased in schizophrenic patients. Conclusion Schizophrenia patients showed a reduction in peripapillary RNFL thickness evaluated by OCT and an increase in some measurements of ONH. These findings suggest that as previously observed in neurodegenerative disorders, neuronal degeneration could be present in the
PurposeOrbital cellulitis and preseptal cellulitis are the major infections of the ocular adnexal and orbital tissues. Orbital cellulitis is an infection of the soft tissues of the orbit, posterior to the orbital septum.The purpose of this text is to point out sickle‐cell disease as an important risk factor in a 2‐year‐old boy with sinusitis.MethodsWe evaluated a 2‐year‐old boy with sickle‐cell disease and sinusitis treated with oral amoxicillin (80 mg/kg/day). He presented a remarkable proptosis, intense ophthalmoplegia and conjunctival chemosis, with a temperature of 39°C and leukocytosis with left shift. We treated him with clindamycin 30 mg/kg, cefotaxime 200 mg/kg and prednisolone IV.ResultsAxial image CT scan demonstrated sinusitis of the left ethmoid sinus. Furthermore, there was a left sided subperiosteal abscess between the medial wall of the left orbit and the left medial rectus muscle. Due to the bad evolution and the CT scan image, the sinus was drainage in a surgical procedure under general anesthesia. Appropriate patient evolution was achieved without the need for additional therapy.ConclusionsPatients with sickle‐cell anemia show anincreased risk of severe bacterial infections due to loss of functioning spleen tissue. Daily penicillin prophylaxis is the most commonly used treatment during childhood. Orbital cellulitis can result in orbital and intracranial complications. Blindness may occur secondary to elevated intraorbital pressure. This is the reason we must control the patient at least daily and evaluate the antibiogram. Finally, when medical treatment is not working and there is an elevated intraorbital pressure with involvement of the eyeball, the surgery cannot be postponed.
Purpose To evaluate the anterior chamber variations after‐iridotomy with Nd: Yag laser in eyes with narrow angle. Methods Twenty one patients with shalow anterior chamber were studied. Spectral domain OCT (Heidelberg, Germany) was performed before and seven days after laser peripheral iridotomy treatment in all cases. Spetial attention was taken to evaluate angle changes. Main measures were: anterior chamber volumen, central anterior chamber depth and temporal angle wide. Results Thirty two eyes of twenty one patients , 15 females and 6 males, age average 66.28 years old were measured. The preoperative angle wide at the temporal angle was 25.9 ± 4,8 degrees and postoperative was 27.1 ± 10 degrees. Morphological changes were evident with a deeper chamber and disruption in iris parenchyma. Conclusion Spectral domain OCT is a potential tool to evaluate changes in anterior chamber in narrow angle someted to iridotomy with Nd: Yag laser. The procedure is effective to increase anterior chamber volumen, central anterior chamber depth and angle wide in all cases.
Purpose Angiomas are common vascular tumors in children. Only 10‐15% should be treated by any vital consequences, functional or aesthetic complications. Classically, oral corticosteroids were the preferred treatment for this type of injury. We present the results obtained after treatment of an eyelid angioma in an infant with oral propranolol. Methods Infant 6 months old, was referred to our clinic for purple injury which had gradually increased in size, in the right lower eyelid. Underwent imaging studies (MRI), which together with the clinical features led to the diagnosis of eyelid hemangioma without intraorbital extension, so it was decided to start treatment, under pediatric control with 2 mg / kg / day of oral propranolol suspension in two doses. Results Three months after starting treatment we found a partial regression of the lesion. Complete resolution occurred after 8 months. During this period there were no adverse reactions or complications to treatment with propanolol. Conclusion Treatment with oral propranolol is currently an effective and safe alternative in the management of infantile hemangiomas.
Purpose To assess the reproducibility intraoperative macular thickness measurements using optical coherence tomography, spectral domain (spectralis, Heidelberg Engineering, Germany) in patients with wet AMD and to evaluate differences in reproducibility with optical coherence tomography (Stratus, Carl Zeiss Meditect Inc, USA). Methods prospective observational study and cross‐sectional study included 30 eyes of 30 patients with exudative AMD. All of them were dealt with macular status by fast‐track protocol posterior pole with spectral domain OCT (Spectralis OCT) and time domain OCT (Stratus OCT). Each patient underwent 3 consecutive scans each of the scanners and performed by the same observer to compare the reproducibility of both devices. We evaluated the central macular thickness in macular different areas described in the ETDRS (Early Treatment Diabetic Retinopathy Study).Statistics was performed descriptive analysis of variance and calculated the intraclass coefficient of correlation (ICC) and coefficients of variation Results The thickness of the retina was highly reproducible for all ETDRS areas with OCT Spectralis with values of ICC and VOC better than the Stratus OCT. VOCs spectralis were obtained with less than 5% indicating a high reproducibility and the ICC greater than 0.9. Conclusion Reproducibility of retinal thickness measurements with optical coherence tomography spectral domain is almost perfect, there are few differences in intraobserver assessments. The values are higher than getting with time‐domain OCT .Fourier domain OCT is a valid and highly reliable device for diagnosis and monitoring of retinal diseases such as wet AMD.
Purpose Bilateral cataract surgery is not part of the regular practice of all centers.It´s indicated only for those cases in which the patient's general condition is very poor Methods We conducted a retrospective study of 106 patients in which visual acuity was assessed before and after surgery, complications, pre, intra and postoperative, the reason for simultaneous intervention, as well as the rate of total bilateral phacoemulsification interventions between 2007‐2011 Results The best corrected visual acuity was 0.4 preoperatively half while mean postoperative visual acuity was 0.8. The rate of simultaneous bilateral phacoemulsification in that period was 0.83%. Conclusion Our results show that simultaneous bilateral surgery is a safe and economical way to quickly rehabilitate certain patients with bilateral cataract.
Purpose The Spectralis® Anterior Segment Module that offers Spectral‐Domain Optical Coherence Tomography (SD‐OCT) Heidelberg Engineering, is a sign of the revolution who are suffering OCT teams nowadays. The aim of our study is to analyze the usefulness of optical coherence tomography of anterior segment in the diagnosis and monitoring of different corneal diseases. Methods Some ophthalmologists explored their patients from department of cornea and ocular superfie under slit lamp and later with the OCT Anterior Segment Module. The Spectralis SD‐OCT offers high quality images of cornea and anterior segment, without any contact and comfort for the patient. Because it is installed on a slit lamp is very intuitive and easy to use, so no special training is required. Results We present several cases where we used optical coherence tomography of anterior segment in the diagnosis of different corneal diseases: degeneration, infections, dystrophies... and also in following various surgical procedures such as intrastromal corneal rings, keratoplasty, lamellar corneal graft and amniotic membrane coatings. Conclusion We believe it is a useful diagnostic tool in every department of cornea, refractive surgery and ocular surface diseases to document, make measurements and studies of evolution and, especially, to evaluate the surgical results.
Purpose To assess the variation of the chamber angle in glaucoma patients postphacotrabeculectomy primary open angle. Methods Was measured by optical coherence tomography Fourier domain (Spectralis, Heidelberg Germany) the chamber angle in 30 patients diagnosed with primary open‐angle glaucoma with cataract surgery combined before and postoperatively, performed with the same protocol and evaluated the difference of the angle pre‐and postoperatively. Results We observed a statistically significant increase in the chamber angle in patients undergoing phacotrabeculectomy Conclusion The phacotrabeculectomy is a safe and effective procedure with minimal complications and good results of intraocular pressure and visual acuity postoperatively.
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