简介:AIM:Todescribetheclinicalfeatures,systemicassociations,treatmentandvisualoutcomesinSaudipatientswithscleritis.·METHODS:AretrospectivechartreviewwasperformedforpatientswithscleritispresentingtotwotertiarycareeyehospitalsinRiyadh,SaudiArabia,from2001to2011.Datawerecollectedontheclinicalfeaturesofscleritis,subtypesofscleritis,associatedsystemicdisease,historyofpreviousocularsurgeryandmedicaltherapy,includingtheuseofimmunosuppressants.Treatmentoutcomeswereevaluatedbasedonbest-correctedvisualacuity(BCVA)andresponsetotreatment.·RESULTS:Ofthe52patientsincludedinthestudy,non-necrotizinganteriorscleritiswasthemostcommontypeofscleritisin22patients(42.3%),followedbyposteriorscleritisin14patients(26.9%).Themajorityofcases,31patients(59.6%),wereidiopathicinnature.Systemicassociationswerepresentin12patients(23.1%).Infectiousscleritiswasconfirmedin6patients(11.5%):3withbacterialscleritisafterpterygiumexcision,2patientswithscleritisrelatedtotuberculosisand1patientwithscleritisresultingfromherpessimplexinfection.Forthevarioussubtypesofscleritis,BCVAvaluesaftertreatmentandtimetoremissionsignificantlydiffered(P<0.05,allcases).Systemicimmunosuppressivetherapiesinadditiontosteroidswereadministeredto46.2%ofallpatients.TheT-signwaspresentonB-scanultrasonographyin9(64.3%)ofthe14posteriorscleritispatients.·CONCLUSION:Non-necrotizinganteriorscleritiswasthemostcommonsubtypeofscleritis.Finalvisualoutcomeandtimetoremissiondifferedamongthevariousscleritissubtypes.
简介:AIM:TodeterminethevisualoutcomesinadultpatientswhosustainedopenglobeinjuriesandtodeterminewhetherthevisualprognosisfollowinganeyeinjuryinanAfricansettingdiffersfromthepredictedoutcomesaccordingtotheOcularTraumaScore(OTS)study.AsecondaryaimwastoestablishtheeviscerationratefortheseinjuriesandassesshowthisformofinterventionaffectedoutcomesincomparisontotheOTS.·METHODS:Aprospectivecaseseriesofallpatientsadmittedwithopenglobeinjuriesoveratwo-year(July2009toJune2011)period.InjurieswerescoredusingtheOTSandthesurgicalinterventionwasrecorded.Thebestcorrectedvisualacuityatthreemonthswasregardedasvisualoutcome.·RESULTS:Therewere249openglobeinjuries,ofwhich169patients(169eyes)completedthe3-monthfollow-up.Allpatientsunderwentprimarysurgery,175(70.3%)repairs,61(24.5%)eviscerationsand13(5.2%)otherprocedures.GlobeeviscerationsweremainlydoneonOTSCategory1cases,butoutcomesinthiscategorywerenotfoundtobedifferentfromOTSoutcomes.OutcomesweresignificantlyworseinCategory2,butwhentheentiredistributionwastested,thedifferenceswerenotstatisticallysignificant.TheoverallassociationbetweenOTSoutcomesandthefinalvisualoutcomesinthisstudywasfoundtobeastrong(P<0.005).·CONCLUSION:Reliableinformationregardingtheexpectedoutcomesofeyeinjurieswillinfluencemanagementdecisionsandpatientexpectations.TheOTSisavaluabletool,theuseofwhichhasbeenvalidatedinmanypartsoftheworld-itmayalsobeavalidpredictorinanAfricansetting.
简介:AIM:Toinvestigatetheinfluencingfactorsofvisualfieldimprovementaftertrans-sphenoidalresectionofpituitarymacroadenomas.·METHODS:Thisretrospectivecohortstudyincluded201patients(366eyes)withvisualfielddefectinducedbypituitarymacroadenomas.Allofthemweretreatedwithtrans-sphenoidalsurgery.Ophthalmologicevaluation,best-correctedvisualacuity(BCVA),andvisualfieldexaminationwereperformedbeforeand3moaftersurgery.BCVA,visualfielddefectindexmeandeviation(MD),durationofsymptoms,age,sex,andvolumeoftumorswerecompared.Expressionofvascularendothelialgrowthfactor(VEGF)andKi-67oftumortissueweredetectedbyimmunohistochemicaltechnique.·RESULTS:Themeanageofpatientswas44.23±1.29y.Ninety-threepatientswerefemaleand108weremale.Themeantumorvolumewas14.36±6.23cm~3.Themeandurationofpreoperativesymptomswas11.50±0.88mo.MeanpreoperativeMDwas-17.50±0.82dB.MeanPreoperativevisualacuitywas0.64±0.04.Postoperativevisualfieldimprovedin270(73.77%)eyes,unchangedin96(26.23%)eyes.Multivariatelogisticregressiondisplayedthatthefactorsindependentlyinfluencingvisualfieldimprovementwereyoungage(OR=1.71,95%CI:1.325-2.387,P=0.013),lowpreoperativeMDabsolutevalue(OR=1.277,95%CI:1.205-1.355,P<0.001),smallvolumeoftumor(OR=1.458,95%CI:1.060-4.289,P<0.001),lowexpressionofVEGFintumortissue(OR=1.554,95%CI:1.089-2.457,P=0.022),andlowexpressionofKi-67intumortissue(OR=1.552,95%CI:1.161-2.847,P=0.026).·CONCLUSION:Afterpituitarymacroadenomastranssphenoidalresection,theindependentinfluencingfactorsofthevisualfieldsrecoverywerelowpreoperativeMDabsolutevalue,youngage,smallvolumeoftumor,andexpressionlevelsofVEGF/Ki-67.