No author has a financial or proprietary interest in any material or method mentioned.
No author has a financial or proprietary interest in any material or method mentioned.
Aim-To analyse the formation and disappearance rates of individual microaneurysms in mild background retinopathy. Methods-Three fluorescein angiograms were taken at 1 year intervals during a 2 year follow up from 24 type 1 diabetics with mild background retinopathy. Microaneurysms were identified and localised twice from each angiogram using a computerised system for retrieval of the coordinates for each microaneurysm. Microaneurysms identified similarly in both sessions were then processed further to obtain rates of microaneurysm formation and disappearance, and microaneurysm count changes. Although some studies have reported the disappearance of these lesions,3 5 the fate of individual microaneurysms has not been studied much, in spite of their importance in the pathogenesis of diabetic retinopathy. We report here the fate of individual microaneurysms during a 2 year follow up in a group of diabetic patients with mild background retinopathy. Materials and methodsWe studied 43 eyes of 24 patients with insulin dependent diabetes. Five eyes were excluded because of the bad quality of the angiograms. The patients ranged in age from 23 to 69 years, the median age being 39. The mean duration of diabetes was 18-3 (range 9 to 34) years. Of the patients, 10 were female and 14 male. All of the patients had mild background retinopathy and none of them developed proliferative or preproliferative retinopathy during follow up.The patients gave their informed consent to the study, which was also approved by the institutional review committee of the Department of Ophthalmology, Helsinki University Hospital. The tenets of the Helsinki Declaration were followed.Three fluorescein angiograms of each fundus were taken at 1 year intervals. The angiograms were taken with a Canon CF 60 camera, using Kodak T-Max 400 film with Exciter SE 40 and Barrier SB 50 filters after an intravenous injection of 12 mg/kg sodium fluorescein (Fluorescite, Alcon, Fort Worth, TX, USA).In this study, we used central 600 images centred on the fovea and taken at the late arterial phase (generally 12-15 seconds after the injection). A rectangular area of 4X6 disc diameters extending from 1 DD nasal of the optic disc to 5 DD temporal of the disc was analysed. The criterion for classifying a lesion as a microaneurysm in the fluorescein angiograms was a distinctly round hyperfluorescent lesion >20 ,um and <125 ,um in diameter. Saccular capillary ends were considered to be microaneurysms. The microaneurysms were localised and identified as described previously. 6 In brief, the photographs were projected on a magnetic digitising table, and two anatomical points were selected as reference points. The lesions to be analysed were then marked using a mouse equipped with a crosshair ring and their coordinates in relation to the reference points were recorded and stored in a computer. We used a program that mathematically forms a small circle around each lesion. The diameter of this circle corresponded to 33 ,um at the retina. All coordinates within this circ...
PURPOSE: To assess the safety and efficacy of Intacs inserts for the treatment of mild to moderate keratoconus. METHODS: In a nonrandomized prospective clinical trial, 50 eyes of 37 patients with mild to moderate keratoconus were implanted with asymmetrical pairs of Intacs segments. Patients were interviewed and observed preoperative^ and 24 hours, 1 week, 1,3,6, and 12 months postoperatively. Main outcome measures were uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), refraction, satisfaction with vision and trouble with vision, Visual Function-7 score, and surgically induced change in corneal astigmatism. RESULTS: Of the 50 operations performed, 92% were successful. Mean follow-up was 6.3 ±3.2 months. In 4 (8%) eyes, both Intacs segments were removed. In addition, 7 refractive adjustments in 7 eyes were performed successfully to improve visual and surgical outcome. Both BSCVA and UCVA improved throughout follow-up. Visual functioning index improved from 61.6 ±21.1 to 80. 8 ±22.5, and the percentage of satisfaction with vision improved from 24.3% to 87.5% at 12 months. Vector analysis of astigmatism correction showed that the mean change in corneal astigmatism was 2.9 ±2.9 D at 6 months postoperatively. By selecting patients in whom astigmatism correction was best (index of success > 0.5), an analysis was performed to determine individual factors important in successful surgery. Preoperative Iy these 11 (22%) eyes did not differ significantly from the remaining eyes and the only significant value was low K readings in the flat axis. CONCLUSIONS: Asymmetric Intacs placement improves BSCVA and UCVA and reduces astigmatism in patients with mild to moderate keratoconus. The procedure of Intacs placement is safe and effective. The change in astigmatism correction is unpredictable. [J Refract Surg. 2005;21:236-246.]
Although MAs in FAG and red spots in colour or red-free photographs all reflect the degree of retinopathy, about half of the red dots in photographs do not represent open MAs in FAGs.
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