OBJECTIVE:To evaluate intraocular pressure in very low birth weight preterm infants and correlate it with postconceptional age.METHODS:The intraocular pressure in a prospective cohort of very low birth weight premature infants (defined as a birth weight ≤1,500 g and gestational age ≤32 weeks) admitted to Hospital de Clínicas de Porto Alegre, Brazil was evaluated weekly. The evaluated outcome was the variation in the intraocular pressure following changes in the postconceptional age (defined as the gestational age at birth plus the age in weeks at the time of examination) in the weeks following preterm birth. Mixed-effects models were used for the statistical analysis to determine the intraocular pressure variation according to postconceptional age, and means and 10th and 90th percentiles were calculated for the intraocular pressure values.RESULTS:Fifty preterm infants with a mean gestational age of 29.7±1.6 weeks and a mean birth weight of 1,127.7±222.7 g were evaluated. The mean intraocular pressure for the entire cohort considering both eyes was 14.9±4.5 mmHg, and 13.5% of all recorded intraocular pressure values were greater than 20 mmHg. The analysis revealed a mean reduction in the intraocular pressure of 0.29 mmHg for each increase in postconceptional age (p = 0.047; 95% CI: −0.58 to −0.0035). The mean intraocular pressure (P10–P90) decreased from 16.3 mmHg (10.52–22.16) at 26.3 weeks to 13.1 mmHg (7.28–18.92) at 37.6 weeks of postconceptional age.CONCLUSIONS:The mean intraocular pressure in very low birth weight preterm infants was 14.9±4.5 mmHg. This value decreased 0.29 mmHg per week as the postconceptional age increased.
Purpose: To evaluate differences in the thickness of the individual macular layers between early, moderate, and severe glaucomatous eyes and compare them with healthy controls. Patients and Methods: Subjects with glaucoma presenting typical optic nerve head findings, high intraocular pressure with or without visual field (VF) damage and normal controls were included. All participants underwent 24-2 perimetry and spectral-domain OCT. Patients were divided into three groups (early, moderate, and severe) based on the mean deviation of the VF and a healthy control group. The device segmented the layers automatically, and their measurements were plotted using the means of the sectors of the inner (3mm) and outer (6mm) circles of the ETDRS grid. Results: A total of 109 eyes qualified for the study: 14 in the control group and 52, 18 and 25 in the early, moderate and severe groups, respectively. Mean age was 66.13 (SD=12.38). The mean thickness of the circumpapillary retinal nerve fiber layer (RNFL), total macular thickness (TMT), macular RNFL, ganglion cell layer (GCL) and inner plexiform layer (IPL) were significantly different between the 4 groups, with progressive decrease in thickness. Significant overall difference was found for the inner nuclear layer (INL), and the severe glaucoma group presented thicker measurements than controls and early glaucoma. Outer nuclear layer (ONL) was thinner in severe glaucoma group compared with early glaucoma group. Conclusion: Individual macular layer measurement using the inner and outer circles of the ETDRS grid is useful to evaluate different stages of glaucoma. The INL thickening and ONL thinning in advanced glaucoma should be explored in the future studies.
20/200) and ocular surface stability were evaluated as main outcomes. Donor limbus was obtained from a sibling or a parent of the patient, after an appropriate Class I and II HLA match. RESULTS: One year after surgery, VA improved in 46.2%, ambulatory vision was achieved in 48.7% and a stable corneal surface was achieved in 84.6% of the eyes. At the final follow-up (mean, 48.7 ± 30.6 months), 66.6% of the eyes that had gained VA one year after surgery maintained an improved VA (p=0.28), 94.7% of eyes that had achieved ambulatory vision one year after surgery maintained 20/200 or better (p<0.001) and 93.9% still had a stable corneal surface (p=0.043) at the final follow-up. CONCLUSIONS: HLA-matched lr-CLAL can be an adequate method of treatment for bilateral ocular surface disorders, with a reasonable percentage of success of long-term results.]]>
Précis: Optic nerve head (ONH) changes were detected with sweptsource optical coherence tomography (SS-OCT) after intraocular pressure (IOP)-lowering glaucoma surgeries. Purpose:The aim of this study was to detect changes in the ONH with SS-OCT after IOP-lowering procedures.Patients and Methods: Patients with progressing glaucoma who were referred for IOP-lowering procedures were included. The participants underwent a 24-2 visual field test and SS-OCT (DRI OCT Triton Plus; Topcon). IOP and SS-OCT scans were obtained during the preoperative period and up to 7 days and 30-90 days postoperatively. ONH parameters were measured with a B-scan at the center of the optic disc and an average of 5 central B-scans. The hypotenuse of the ONH cup (HOC) was calculated using the Pythagorean theorem: hypotenuse 2 = leg1 2 + leg2 2 , considering the length and depth of the cup as the legs of a right triangle. We also evaluated changes in Bruch membrane opening (BMO)-to-BMO diameter. Statistical analysis was performed using generalized estimating equations.Results: A total of 15 eyes were included. The mean patient age was 70 (SD, 11.04) years. The mean circumpapillary retinal nerve fiber layer was 60.13 (SD, 23.21) µm and the visual field mean deviation was −13.29 (SD, 8.5) dB. The mean IOP at each visit was: 20.5 (SD, 4.99); 11 (SD, 4.95), and 15.7 (SD, 5.04), respectively. The mean HOC, the mean depth and length of the ONH cup, and the BMO-to-BMO diameter decreased significantly after the IOP-lowering procedures. Conclusions:The HOC evaluated with SS-OCT significantly decreased after IOP-lowering surgeries. This parameter was useful for evaluating short-term changes in the ONH.
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