Romanian journal of ophthalmology最新文献

{"title":"Long-term outcomes of lacrimal canalicular trephination with viscoelastic-assisted monocanalicular stenting for canalicular obstructions","authors":"Manpreet Singh, Manpreet Kaur, Z. Zadeng, M. Sharma, Aditi Mehta, P. Gupta","doi":"10.22336/rjo.2022.10","DOIUrl":"https://doi.org/10.22336/rjo.2022.10","url":null,"abstract":"Purpose: To study the long-term outcomes of lacrimal canalicular trephination (LCT) with viscoelastic-assisted monocanalicular stenting (VAMS) for the treatment of epiphora secondary to lacrimal canalicular obstructions (LCO). Methods: Our study was a retrospective interventional work. All patients diagnosed with LCO, having morbid epiphora (Munk’s scale ≥ 2), were included. The LCO was divided as proximal (< 6mm from punctum) and distal (≥ 6mm from punctum). Sisler’s lacrimal trephine (21 gauge) was used to recanalize the LCO with monocanalicular stent (0.64mm diameter) insertion, which was kept for a minimum of 6 weeks and a post-stent removal follow-up of 12 months was ensured. Fluorescein dye disappearance test and lacrimal irrigation were used as functional and anatomical tests for evaluation, respectively. Results: We included 73 eyes of 52 patients having a mean age of 44.5 years. Of the total, the proximal LCO was seen in 38 eyes (52.1%) and distal in 35 eyes (47.9%). The preoperative Munk’s score of 5 was noted in the majority (n=57 eyes, 78.1%). The majority (n=32 eyes, 43.8%) had chronic blepharitis or meibomian gland disease as etiology. Monocanalicular stent was kept in place for a mean of 13.5 weeks. At a mean follow-up of 14.5 months, complete response was noted in 35.6% cases, while 50.7% had partial and 13.7% had a failure of the procedure. Conclusions: LCT (without DCR) is a minimally invasive, simple, and effective technique for the treatment of LCO in the long term. VAMS is a helpful innovation to facilitate the insertion of the flexible silicone stent.","PeriodicalId":21385,"journal":{"name":"Romanian journal of ophthalmology","volume":"72 1","pages":"41 - 48"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81959863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinal pigment epithelium atrophy after epiretinal membrane and internal limiting membrane peeling: case reports","authors":"Nicolás Rivera-Valdivia, Hiroshi Maeda-Yasunaga, Pablo Cabal-López, Carlos Salgado-Cerrate, Carlos Abdala-Caballero","doi":"10.22336/rjo.2022.16","DOIUrl":"https://doi.org/10.22336/rjo.2022.16","url":null,"abstract":"Objective: To describe the development of retinal pigment epithelium (RPE) atrophy after uncomplicated pars plana vitrectomy (PPV) with epiretinal membrane (ERM) and/or internal limiting membrane (ILM) peeling in 2 patients. Cases description: Case 1: A 79-years-old female with diagnosis of a full-thickness macular hole in her right eye (OD) with best corrected visual acuity (BCVA) of: 20/100 and left eye (OS): 20/70. After surgery she developed large RPE hyperplasia and presented hand movement that did not improve with pinhole. Case 2: A 69-years-old female patient who had ERM in her OS with BCVA of 20/30 in both eyes (OU). PPV was assisted with brilliant blue (BB) to better visualize the ILM. During follow-up visits we evidenced RPE atrophy in the zone where peeling was done. In the last control after 2-years, her visual acuity was 20/40 that did not improve with pinhole. Discussion: There are three possible mechanisms to explain this complication: toxic damage, mechanical trauma during the membrane removal with forceps, or a combination of both. In our cases, a combination of them is probably the cause of the presence of RPE atrophy. Conclusion: Vitrectomy with membrane removal is successful in most cases with low rate of complications. Because RPE atrophy is infrequent, our suggestion is to continue performing this technique and if possible, it should be done without dye staining to minimize risks. Abbreviations: ERM = epiretinal membrane, ILM = internal limiting membrane, MH = macular hole, RPE = Retinal pigment epithelium, OD = right eye, BCVA = Best corrected visual acuity, OS = left eye, OU = both eyes, IOL = intraocular lens, OCT = Optical coherence tomography, BB = Brilliant blue, TB = Trypan blue, ICG = indocyanine green","PeriodicalId":21385,"journal":{"name":"Romanian journal of ophthalmology","volume":"14 1","pages":"79 - 83"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88271009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The outcomes and usefulness of Intraoperative Optical Coherence Tomography in vitreoretinal surgery and its impact on surgical decision making","authors":"Rayyan Zakir, Kashif Iqbal, Muhammad Hassaan Ali, Umair Tariq Mirza, Khalid Mahmood, Sidrah Riaz, Nauman Hashmani","doi":"10.22336/rjo.2022.12","DOIUrl":"https://doi.org/10.22336/rjo.2022.12","url":null,"abstract":"Objective. To evaluate the utility of intraoperative OCT and its influence on the surgeon’s decision during vitreoretinal surgery. Methods. This was a pilot, prospective case series conducted at a tertiary care ophthalmology department in Lahore, Pakistan. Sixteen patients undergoing vitreoretinal surgeries were included using the Leica Enfocus microscope integrated intraoperative optical coherence tomography (IOCT). We also investigated the changes in surgical decision making based on the findings revealed by IOCT using a questionnaire. Results. 16 patients with a mean age of 40.6 ± 19.0 (range: 11-66) years, were included in the study; one case of acute postoperative endophthalmitis could not be imaged. The surgeon had to modify surgical decisions in four (26.7%) cases. IOCT clearly delineated various tissue planes for efficient and safe surgical dissection in pathologies such as posterior vitreous detachment, vitreomacular traction and epiretinal membranes. Furthermore, it also helped identifying perfluorocarbon-retina interface. Conclusions. The intraoperative OCT modality is a feasible and useful intraoperative imaging technique for various kinds of vitreoretinal disorders. The decision making of the surgeon was modified in a quarter of the cases after the use of this newer modality.","PeriodicalId":21385,"journal":{"name":"Romanian journal of ophthalmology","volume":"17 1","pages":"55 - 60"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78019673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Etiology of white pupillary reflex in pediatric age group","authors":"Muhammad Israr, Khalil Khan Zahir, Adnan Khattak, I. Khattak, N. Gul","doi":"10.22336/rjo.2022.8","DOIUrl":"https://doi.org/10.22336/rjo.2022.8","url":null,"abstract":"Background: Leukocoria means white pupil. Normal pupil appears black in children and adults. The typical red reflex is due to retro-illumination of choroidal vessels reflected via the retina, vitreous humor, crystalline lens, aqueous humor, pupil, and cornea. If there is interference in these structures, it would result in a changed red reflex, or leukocoria. Immediate family members are highly likely to detect the first indicator and the pediatrician or general ophthalmologist is usually the first to be visited. The aim of the study was to find out the prevalence of common causes of white pupillary reflex in children, to undertake early diagnosis and treatment, and to reduce morbidity and death. This study aimed to see how common it is for children to have a white pupillary reflex when they visit a pediatric ophthalmologist. Objective: Determine the incidence of conditions that cause a white pupillary reflex in children who visited Hayatabad Medical Complex Hospital in Peshawar. Materials and methods: This study was carried out in the Ophthalmology unit of HMC Hospital Peshawar, from January 2021 to December 2021. 168 patients were enrolled in the study. We included all patients of up to 10 years and both genders with the above findings. Workup for leukocoria was done to find the exact cause that included fundoscopy, B-Scan, MRI, and CT scans. Examination under anesthesia (EUA) was carried out for uncooperative children for detailed fundus examination. Patient data was recorded and a proforma was made to collect all the necessary information. Family history was taken in detail during this study. Results: The most common cause of aberrant pupillary reflex in children aged 1 to 10 years was cataract, 79.76 percent of patients having it. Retinoblastoma (12.5%), Coats disease (3.5%), retinal detachment (2.9%) and persistent hyperplastic vitreous (PHPV) (1.1%) were other notable causes found. Conclusion: Leukocoria is a critical clinical finding, and if parents or primary care physicians notice it, the patient requires a complete follow-up examination by a pediatric ophthalmologist to determine the etiology.","PeriodicalId":21385,"journal":{"name":"Romanian journal of ophthalmology","volume":"8 1","pages":"32 - 35"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76302902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survey of patient satisfaction after bilateral cataract surgery","authors":"Kozma Kinga, Horváth Karin Ursula","doi":"10.22336/rjo.2022.9","DOIUrl":"https://doi.org/10.22336/rjo.2022.9","url":null,"abstract":"Objective: Postoperative assessment of patients diagnosed with binocular cataract, who underwent two phacoemulsification treatments at different times, in terms of subjective experience of the two procedures. Material and method: The investigation is a prospective study based on patients of Ophthalmology Clinic of Mária Street in Budapest and the Ophthalmology Department in Târgu Mureş, between January 2020 and April 2021. After surgery, the patients were surveyed using questionnaires. A total of 53 responses from patients who had undergone cataract removal in both eyes were processed. Data was processed using Microsoft Office Excel and GraphPad Prism 8.0.1. Results: A statistically significant difference (p = 0.0008) in pain was found between the two interventions, with patients reporting greater pain after the second surgery compared to the first treatment. The subjective increase of visual acuity was significantly different (p=0.0156) between the two surgeries. After the first treatment, 37 patients affirmed that their visual acuity met their expectations, but, by the second operation, this had dropped to 31. There was also a statistically significant difference between the individually perceived duration of the two treatments (p=0.0013), with the most frequently reported duration of the first phacoemulsification treatment being 10 minutes (43.4%), and the second eye treatment being 20 minutes (37.7%). Assessing the asymptomaticity, a significant difference (p = 0.009) was registered between the two treatments, the asymptomatic reduction for the second operation being decreased by 28.1%. Conclusion: Patients treated for binocular cataract had significantly worse subjective symptoms during the second treatment.","PeriodicalId":21385,"journal":{"name":"Romanian journal of ophthalmology","volume":"58 1","pages":"36 - 40"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89748417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical approach in type II Peters anomaly – case report","authors":"C. Tătaru, C. Tătaru, Laura Denisa Preoteasa","doi":"10.22336/rjo.2022.20","DOIUrl":"https://doi.org/10.22336/rjo.2022.20","url":null,"abstract":"Objective: The aim of this report was to present a rare case of apparently unilateral Peters anomaly and describe the clinical characteristics, surgical approach, and visual prognosis. Methods: We presented the case of a 7-year-old female patient with posterior corneal defect due to kerato-lenticular adhesions along with anterior dislocation and opacification of the lens in the left eye and a history of post-traumatic evisceration of the right eye. Systemic associations included mental underdevelopment, left torticollis and scoliosis. No family history of acquired or inherited diseases were determined. We performed cataract extraction in the left eye and opted for aphakia. Results: Based on clinical findings, we considered unilateral Peters anomaly type II. Cataract surgery slightly improved the visual acuity from hand moving to 20/ 400 UCVA (uncorrected visual acuity) and 20/ 100 with +10.0 diopters at 1 month postoperative. No enlargement of the corneal opacity was observed. Conclusions: In this case, we were able to diagnose Peters anomaly only in one eye. The diagnosis required long follow-up with periodic measurement of intraocular pressure (IOP) to early detect glaucoma. The complexity and uniqueness of the case relied on the difficult approach made by the cloudy cornea and anterior lens dislocation. We applied a combination of techniques including adhesiolysis, cataract extraction and anterior vitrectomy. Further interventions such as secondary IOL (intraocular lens) implantation or PKP (penetrating keratoplasty) will be taken into consideration after six-month and one-year postoperative follow-up. Abbreviations: PA = Peters anomaly, DM = Descemet’s membrane, IOL = intraocular lens, VA = visual acuity, OVDs = ophthalmic viscosurgical devices, IOP = intraocular pression, PKP = penetrating keratoplasty, BCVA = best corrected visual acuity, UCVA = uncorrected visual acuity","PeriodicalId":21385,"journal":{"name":"Romanian journal of ophthalmology","volume":"97 1","pages":"101 - 108"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85270392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term and long-term results after intravitreal bevacizumab therapy for macular oedema in branch retinal vein occlusion","authors":"Ajla Pidro, Aida Pidro, Amra Nadarević-Vodenčarević, Meliha Halilbašić, O. Lepara, F. Nišić","doi":"10.22336/rjo.2022.6","DOIUrl":"https://doi.org/10.22336/rjo.2022.6","url":null,"abstract":"Objectives: The aim of this study was to determine the possible correlation between the short- and long-term effects of intravitreal bevacizumab on macular oedema after branch retinal vein occlusion (BRVO). Material and methods: This prospective clinical study included fifteen eyes of patients with macular oedema after BRVO. Corrected distance visual acuity (CDVA), recorded in LogMAR units, central foveal thickness (CFT) and maximum foveal thickness (MFT) were evaluated at one month after first application and at least every 2 months for one year. PRN treatment protocol was used for all patients. Statistical calculation was performed with SPSS for Windows and Microsoft Excel. Results: Mean CFT decreased significantly (p<0,0001) from baseline 471,2 ± 151,7 μm to 285,9 ± 79,82 μm at 12 months. CDVA improved significantly (p<0,0001) from baseline 0,58 ± 0,34 to 0,1 ± 0,25 at the end of follow up period. Change from baseline in the CDVA after one month was significantly positively correlated with the change in CDVA after 12 months (r=0,76, p=0,001). Change in CFT after one month had a strong positive correlation (r=0,78, p=0,001) with change after 12 months. There was no statistically significant correlation between the number of injections and the changes in CDVA, CFT, MFT after a single injection. Conclusions: Single injection effects of bevacizumab may indicate long-term results on macular oedema after BRVO, but further and larger studies are necessary. Abbreviations: BRVO = Branch retinal vein occlusion, RVO = Retinal vein occlusion, CFT = Central foveal thickness, MFT = Maximum foveal thickness, VEGF = Vascular endothelial growth factor, MO = Macular oedema, CDVA = Corrected distance visual acuity, PRN = Pro-re-Nata, SD-OCT = Special-domain optical coherence tomography, FT = Foveal thickness, LogMAR = Logarithm of the Minimum Angle of Resolution, WHO = World Health Organization, RPE = Retinal pigment epithelium","PeriodicalId":21385,"journal":{"name":"Romanian journal of ophthalmology","volume":"18 1","pages":"22 - 26"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74600263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"B-Hex, an ace up the sleeve for small pupil phacoemulsification","authors":"Rimsha Sarosh, Omar Rashid","doi":"10.22336/rjo.2022.13","DOIUrl":"https://doi.org/10.22336/rjo.2022.13","url":null,"abstract":"Objective: To analyze the utility and the nuances of implanting the B-HEX® Pupil Expander (Med Invent Devices, India) at various stages in small pupil phacoemulsification. Methods: This prospective interventional case series was undertaken to assess the utility of B-Hex in small pupil phacoemulsification under topical anesthesia. Our series comprised of 50 cataract cases with small pupils of various etiologies, operated by a single surgeon at our private practice, beginning February 2018. Cataract cases with pharmacological dilation of < 4 mm underwent phacoemulsification with B-Hex implantation. It was employed at the outset or interim, whenever the need arose. Results: The B-Hex ring is extremely handy and useful in small pupil phacoemulsification. The average age of our study cohort was 62 years. In 38 cases B-Hex was employed before making a capsulorhexis. Progressive pupillary constriction during nuclear disassembly warranted the utilization of the device in 9 cases, while the remaining 3 cases had a retained epi-nuclear plate or significant cortex and the ring was placed after nucleus removal. No significant complication was noted. Postoperatively, the pupil dimensions, notably the architecture, were maintained. No significant AC reaction was noted. Intraocular pressure was not high. Conclusion: Our experience showed that B-Hex is secure and easy to use under topical anesthesia. The learning curve is shallow and the technique is precise. B-Hex is truly an ace up the sleeve.","PeriodicalId":21385,"journal":{"name":"Romanian journal of ophthalmology","volume":"232 1","pages":"61 - 68"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80271711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The passing of the Romanian Torch","authors":"F. Balta","doi":"10.22336/rjo.2022.1","DOIUrl":"https://doi.org/10.22336/rjo.2022.1","url":null,"abstract":"I am deeply honored and truly grateful to have been appointed the current President of Romanian Society of Ophthalmology. After a rather challenging period, facing the COVID-19 pandemic as a major health crisis, we hope 2022 will be the year to “right the ship” for both ophthalmologists and patients.","PeriodicalId":21385,"journal":{"name":"Romanian journal of ophthalmology","volume":"101 1","pages":"1 - 1"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85808898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sympathetic Ophthalmia – case report","authors":"S. Macarie, Diana Huțu","doi":"10.22336/rjo.2022.17","DOIUrl":"https://doi.org/10.22336/rjo.2022.17","url":null,"abstract":"Purpose. To present the case of a 22-year-old man with a history of trauma on the right eye, followed by a sudden decrease of visual acuity on the left eye, but with a good recovery after surgical treatment. Material and methods. We reported a case of a 22-year-old patient with a sudden and painless decrease of visual acuity on the left eye, a month after a car accident, which led to the laceration of the right globe. At first, the patient received only medical treatment because he refused any surgical intervention. He had a favorable evolution during hospitalization, but he returned after a month with the same visual acuity as at his first admission. The patient accepted the medical treatment and the enucleation of the right eye, thus having a fast improvement in his visual acuity on the left eye. Conclusions. Although the enucleation was overdue, it had a strong favorable influence on the evolution of the disease. As a result of the surgery, the visual acuity has improved significantly in just a few days. Abbreviations: OCT = optical coherence tomography","PeriodicalId":21385,"journal":{"name":"Romanian journal of ophthalmology","volume":"2023 316","pages":"84 - 88"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91553423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}