BACKGROUND AND OBJECTIVE: To describe the clinical manifestations,diagnoses,treatments,and outcomes of orbital mass lesions at a tertiary care referral center. PATIENTS AND METHODS: All cases of newly diagnosed or ref...BACKGROUND AND OBJECTIVE: To describe the clinical manifestations,diagnoses,treatments,and outcomes of orbital mass lesions at a tertiary care referral center. PATIENTS AND METHODS: All cases of newly diagnosed or referred orbital tumors at the Jules Stein Eye Institute from 1999 to 2003 were reviewed retrospectively. Demographic and clinical data were extracted from the electronic oculoplastics registry of the Division of Orbital and Ophthalmic Plastic Surgery. RESULTS: Three hundred sixty-nine cases of orbital mass lesions were evaluated (167 males and 202 females; mean age=48 years). The most common presenting symptoms were mass/proptosis,pain,swelling,inflammation,and diplopia. The most common categories of diagnosis were cystic or structural lesions,benign tumors,inflammatory processes,neuronal processes,and fibrous processes. Increasing age was associated with an increased incidence of primary and metastatic malignant tumors. Half of all cases required surgical intervention consisting of excision,debulking,or exenteration; 20% to 30% of cases were managed conservatively. CONCLUSIONS: The differential diagnosis of orbital mass lesions differs across age groups. No clinical sign or symptom is specific for the underlying diagnosis and the biological behavior of the abnormal process may be misleading. Therefore,a careful diagnostic approach that considers the benefit of imaging studies must be undertaken. Almost 50% of these mass lesions can be managed with nonsurgical intervention.展开更多
BACKGROUND AND OBJECTIVE: To describe a series of patients with decreased vision secondary to stage 1 macular hole confirmed by optical coherence tomography (OCT) that failed to spontaneously resolve with observation....BACKGROUND AND OBJECTIVE: To describe a series of patients with decreased vision secondary to stage 1 macular hole confirmed by optical coherence tomography (OCT) that failed to spontaneously resolve with observation. To determine whether current surgical techniques can prevent progression to a full-thickness macular hole and lead to improved visual acuity. PATIENTSANDMETHODS: Retrospective,comparative case series presenting patient demographics,duration of symptoms,timing of surgery,preoperative and postoperative vision,and clinical outcome based on examination and OCT. RESULTS: Five eyes of five patients with stage 1 macular holes identified on OCT required surgical repair. All eyes showed anatomic closure and lack of progression to a full-thickness hole confirmed by OCT after one procedure. Mean preoperative visual acuity was 20/102 (range,20/50 to 20/200) and mean postoperative visual acuity was 20/52 (range,20/25 to 20/200). Average improvement for all five eyes was 3 Snellen lines,with four of the five (80% ) improving 5 lines each. CONCLUSION: In symptomatic eyes with stage 1 macular holes that fail to spontaneously resolve with observation,vitrectomy with intraocular gas tamponade may prevent progression to a full-thickness hole and lead to improved visual acuity.展开更多
A 62-year-old woman with neovascular glaucoma underwent filtering surgery with the Ahmed glaucoma valve (New World Medical,Inc.,Rancho Cucamonga,CA). Intraoperative hypotony secondary to a defective valve was noted an...A 62-year-old woman with neovascular glaucoma underwent filtering surgery with the Ahmed glaucoma valve (New World Medical,Inc.,Rancho Cucamonga,CA). Intraoperative hypotony secondary to a defective valve was noted and managed by excising the valve mechanism. The implant was then treated as if it was non-valved by placement of an obturator suture. The postoperative course was unremarkable for a non-valved implant. This case demonstrates how intraoperative hypotony secondary to overfiltration of an Ahmed glaucoma valve implant can be successfully managed by converting to a non-valved implant.展开更多
Background: Uveitis is a frequent and potentially vision-threatening manifestation of juvenile idiopathic arthritis (JIA). There are only a few population-based studies providing data on the frequency and severity of ...Background: Uveitis is a frequent and potentially vision-threatening manifestation of juvenile idiopathic arthritis (JIA). There are only a few population-based studies providing data on the frequency and severity of uveitis. Methods: Documentation of patients with JIA was collected in a national database. An analysis of the paediatric rheumatologic and ophthalmologic data collected from all patients that were included in 2002 was performed. Results: Uveitis was documented in 12%of a total of 3271JIA patients: extended oligoarthritis (25%), persistent oligoarthritis (16%), seronegative polyarthritis (4%), seropositive polyarthritis (2%), psoriatic arthritis (10%), enthesitis-related arthritis (ERA) (7%), Systemic arthritis(1%), other arthritis forms (11%) Opthalmologic data were available from 115 uveitis patients (28%). Mean age at onset of uveitis was 5.2 (SD 3.2) years. JIA patients with uveitis were significantly younger at onset of arthritis (3.8 vs. 7.0 years), and were more often girls (74 vs. 63%) or ANA-positive (86 vs. 42%) than the patients without uveitis. Uveitis complications were present in 45%at initial presentation of uveitis. After a mean duration of 5.6 years, complications were noted in 56%, and included band keratopathy (29%), posterior synechiae (27%), cataract (26%), glaucoma (8%), and macula oedema (6%). Final visual acuity was less than 20/50 in 31%and less than 20/200 in 12%of eyes. In patients with uveitis, immunosuppressive or immunomodulatory drugs were used significantly more often than in patients without uveitis (75%vs. 43%). Conclusions: The nationwide data documents the spectrum of uveitis in patients with JIA, the complications and the therapy for uveitis. The high rate of uveitis complications at the time of diagnosis points out the need for early ophthalmologic screening and therapy, and for a close collaboration between ophthalmologist and paediatric rheumatologist.展开更多
PURPOSE: To describe the treatment of juxtapapillary capillary angioma by pars plana vitrectomy (PPV) and tumor excision. DESIGN: Interventional case report. METHODS:A6-year-old girl with symptomatic juxtapapillary ca...PURPOSE: To describe the treatment of juxtapapillary capillary angioma by pars plana vitrectomy (PPV) and tumor excision. DESIGN: Interventional case report. METHODS:A6-year-old girl with symptomatic juxtapapillary capillary retinal angioma with associated epiretinal membrane (ERM) underwent PPV and extraction of the tumor and ERM. A clinical and molecular genetic workup for the presence of von Hippel-Lindau disease (VHL) was performed. RESULTS: A favorable functional result without tumor recurrence was achieved. Capillary retinal angioma was confirmed by histology of the surgical specimen,and familial VHL was revealed. CONCLUSIONS: PPV and extraction of the tumor is applicable in juxtapapillary capillary retinal angioma with associated ERM. A workup for the presence of VHL is pertinent in patients presenting with this tumor entity.展开更多
PURPOSE: To determine the prevalence of full-thickness macular holes in the elderly Chinese population. DESIGN: Population-based,cross-sectional cohort study. METHODS: The Beijing Eye Study included 4439 subjects out ...PURPOSE: To determine the prevalence of full-thickness macular holes in the elderly Chinese population. DESIGN: Population-based,cross-sectional cohort study. METHODS: The Beijing Eye Study included 4439 subjects out of 5324 subjects invited to participate (response rate 83.4% ) aged 40 years or older. The present investigation consisted of 8653 (97.9% ) eyes of 4346 subjects for whom readable fundus photographs were available. RESULTS: Full-thickness macular holes were found in eight (0.092% ) eyes of seven (0.16% )-patients (six women). Prevalence was 0.09± 3.04% 95% confidence interval (CI): 0.03,0.16% . CONCLUSIONS: Fullthickness macular holes may be present in approximately 1.6 out of 1000 elderly Chinese in Northern China. Calculated for the entire population in China,the figure would be approximately 750,000 patients with unilateral full-thickness macular holes 650,000 (95% CI: 217,000 to 1,156,000) or bilateral full-thickness macular holes 100,000 (95% CI: 33,000 to 178,000).展开更多
PURPOSE: To investigate the influence of test reliability on the screening performance of frequency-doubling perimetry (FDT). DESIGN: Cross-sectional study. METHODS: FDT sensitivity and specificity were calculated thr...PURPOSE: To investigate the influence of test reliability on the screening performance of frequency-doubling perimetry (FDT). DESIGN: Cross-sectional study. METHODS: FDT sensitivity and specificity were calculated three times using three different strategies for handling unreliable (that is,>0 reliability indices outside normal limits) and unfeasible (that is,could not be completed) tests in 452 glaucoma patients from our outpatient department and 237 healthy subjects recruited outside the hospital. RESULTS: Unreliable (P=.01) and unfeasible (P < .001) tests occurred more frequently in glaucoma patients when compared with healthy subjects. Best screening performance was obtained by interpreting unreliable tests as if they were reliable and considering unfeasible tests as positive. With this strategy,sensitivity was 0.90 (95% confidence interval 0.87-0.93) and specificity 0.81 (95% confidence interval 0.76-0.86). CONCLUSIONS: Unreliable and unfeasible FDT tests appear to contain useful information.展开更多
PURPOSE: To estimate the prevalence and distribution of blindness and low vision in Northern China. DESIGN: Population-based cohort study. METHODS: The Beijing Eye Study included 4438 subjects with an age of 40+ years...PURPOSE: To estimate the prevalence and distribution of blindness and low vision in Northern China. DESIGN: Population-based cohort study. METHODS: The Beijing Eye Study included 4438 subjects with an age of 40+ years. Mean age was 56.2± 10.6 years (range,40 to 101 years). RESULTS: Fortythree (1.0% ) individuals had low vision (< 20/60 and ≥ 20/400 best-corrected vision),and 17 (0.4% ) individuals were blind (best-corrected visual acuity in the better-seeing eye < 20/400). Low vision/blindness were significantly associated with age (P < .001),myopic refractive error (P < .001),and level of educational background (P=.035). It was not associated with gender (P=.76) and rural vs urban area (P=.88). CONCLUSIONS: Blindness or low vision affects approximately one in 100 Chinese older than 40 years. An estimated 4.1 million Chinese older than 40 years have low vision,and an estimated 1.6 million Chinese older than 40 years are blind.展开更多
BACKGROUND AND OBJECTIVE: To present a series of 3 patients with the dry form of age-related macular degeneration (AMD) in whom choroidal neovascularization (CNV) was observed following neodymium: yttrium-aluminum-gar...BACKGROUND AND OBJECTIVE: To present a series of 3 patients with the dry form of age-related macular degeneration (AMD) in whom choroidal neovascularization (CNV) was observed following neodymium: yttrium-aluminum-garnet (Nd:YAG) capsulotomy. PATIENTS AND METHODS: Three consecutive patients aged 80 to 87 years (average=83.7 years) with hard drusen or retinal pigment epithelial changes underwent uneventful cataract extraction between 6 months and 20 years before undergoing Nd:YAG capsulotomy for posterior capsule opacity. The patients were examined for retinal changes before laser treatment and at regular intervals after treatment. RESULTS: All patients developed CNV between 12 days and 1 month after capsulotomy that caused a decrease in the visual acuity from 20/20-20/40 to 20/200-counting fingers at 4 feet. The fellow eye did not show a substantial change in AMD over a year of follow-up. Two of the fellow eyes had disci form scar due to CNV before the cataract surgery,and these patients remained legally blind. CONCLUSIONS: The development of CNV after Nd:YAG capsulotomy suggests a temporal association between the two and calls for further study. Because posterior capsule opacity may mask CNV,patients with dry AMD and posterior capsule opacity who experience decreased visual acuity or glare may undergo indocyanine green angiography before it is decided to perform Nd:YAG capsulotomy.展开更多
BACKGROUND AND OBJECTIVE: To report the results of trabeculectomy with adjunctive intraoperative mitomycin C in Chinese patients with glaucoma. PATIENTS AND METHODS: The medical records of Chinese patients who receive...BACKGROUND AND OBJECTIVE: To report the results of trabeculectomy with adjunctive intraoperative mitomycin C in Chinese patients with glaucoma. PATIENTS AND METHODS: The medical records of Chinese patients who received trabeculectomy with intraoperative mitomycin C from 1992 to 1998 were retrospectively reviewed. A “ successful” trabeculectomy was defined as one after which the intraocular pressure (IOP) could be controlled to between 5 and 21 mm Hg,inclusive,with no more than 3 glaucoma medications. RESULTS: One hundred fourteen trabeculectomies in 105 eyes of 90 patients were retrospectively reviewed. Mean age ± standard deviation was 48.1 ± 21.9 years. Primary open-angle glaucoma (43.0% ) and angle-closure glaucoma (27.2% ) were the most common diagnoses leading to trabeculectomy. The mean follow-up ± standard deviation was 29.6 ± 18.6 mo-nths (range,6 to 92 months). The overall success rate at the last followup was 73.7% (84 of 114 trabeculectomies). CONCLUSIONS: Trabeculectomy with mitomycinC is a safe and effective procedure for the control of IOP in Chinese patients with glaucoma.展开更多
The effects of poor anterior segment compensation on scanning laser polarimetry measurements of the retinal nerve fiber layer (RNFL) were systematically explored. A prototype scanning laser polarimeter with an adjusta...The effects of poor anterior segment compensation on scanning laser polarimetry measurements of the retinal nerve fiber layer (RNFL) were systematically explored. A prototype scanning laser polarimeter with an adjustable compensator to neutralize anterior segment birefringence was used. By systematically varying the magnitude and axis of anterior segment compensation in a healthy and a glaucomatous eye,marked changes were observed in RNFL appearance: the healthy eye could appear to have glaucomatous damage,whereas the glaucomatous eye could appear to have a thicker and healthier RNFL. Even small amounts of uncompensated corneal birefringence,which may occur in routine clinical use,resulted in apparent changes in RNFL morphology. Knowledge of this effect is important for clinicians when using scanning laser polarimetry in clinical practice.展开更多
Optic disc melanocytoma is a well-known clinical entity occurring as a deeply pigmented lesion on the optic nerve head. A 40-year-old man with a pigmented lesion overlying the left optic disc was evaluated with optica...Optic disc melanocytoma is a well-known clinical entity occurring as a deeply pigmented lesion on the optic nerve head. A 40-year-old man with a pigmented lesion overlying the left optic disc was evaluated with optical coherence tomography. The single high reflectance band from the anterior edge of the disc lesion with optical back shadowing behind on optical coherence tomography helped to pinpoint the diagnosis of the lesion as optic disc melanocytoma. Quantitative assessment of the mass with optical coherence tomography for its growth did not show any increase in size horizontally or vertically after 6 months. Optical coherence tomography is useful for obtaining the exact measurements of the mass lesion and may be used as a tool to follow the progress and growth pattern of the lesion.展开更多
文摘BACKGROUND AND OBJECTIVE: To describe the clinical manifestations,diagnoses,treatments,and outcomes of orbital mass lesions at a tertiary care referral center. PATIENTS AND METHODS: All cases of newly diagnosed or referred orbital tumors at the Jules Stein Eye Institute from 1999 to 2003 were reviewed retrospectively. Demographic and clinical data were extracted from the electronic oculoplastics registry of the Division of Orbital and Ophthalmic Plastic Surgery. RESULTS: Three hundred sixty-nine cases of orbital mass lesions were evaluated (167 males and 202 females; mean age=48 years). The most common presenting symptoms were mass/proptosis,pain,swelling,inflammation,and diplopia. The most common categories of diagnosis were cystic or structural lesions,benign tumors,inflammatory processes,neuronal processes,and fibrous processes. Increasing age was associated with an increased incidence of primary and metastatic malignant tumors. Half of all cases required surgical intervention consisting of excision,debulking,or exenteration; 20% to 30% of cases were managed conservatively. CONCLUSIONS: The differential diagnosis of orbital mass lesions differs across age groups. No clinical sign or symptom is specific for the underlying diagnosis and the biological behavior of the abnormal process may be misleading. Therefore,a careful diagnostic approach that considers the benefit of imaging studies must be undertaken. Almost 50% of these mass lesions can be managed with nonsurgical intervention.
文摘BACKGROUND AND OBJECTIVE: To describe a series of patients with decreased vision secondary to stage 1 macular hole confirmed by optical coherence tomography (OCT) that failed to spontaneously resolve with observation. To determine whether current surgical techniques can prevent progression to a full-thickness macular hole and lead to improved visual acuity. PATIENTSANDMETHODS: Retrospective,comparative case series presenting patient demographics,duration of symptoms,timing of surgery,preoperative and postoperative vision,and clinical outcome based on examination and OCT. RESULTS: Five eyes of five patients with stage 1 macular holes identified on OCT required surgical repair. All eyes showed anatomic closure and lack of progression to a full-thickness hole confirmed by OCT after one procedure. Mean preoperative visual acuity was 20/102 (range,20/50 to 20/200) and mean postoperative visual acuity was 20/52 (range,20/25 to 20/200). Average improvement for all five eyes was 3 Snellen lines,with four of the five (80% ) improving 5 lines each. CONCLUSION: In symptomatic eyes with stage 1 macular holes that fail to spontaneously resolve with observation,vitrectomy with intraocular gas tamponade may prevent progression to a full-thickness hole and lead to improved visual acuity.
文摘A 62-year-old woman with neovascular glaucoma underwent filtering surgery with the Ahmed glaucoma valve (New World Medical,Inc.,Rancho Cucamonga,CA). Intraoperative hypotony secondary to a defective valve was noted and managed by excising the valve mechanism. The implant was then treated as if it was non-valved by placement of an obturator suture. The postoperative course was unremarkable for a non-valved implant. This case demonstrates how intraoperative hypotony secondary to overfiltration of an Ahmed glaucoma valve implant can be successfully managed by converting to a non-valved implant.
文摘Background: Uveitis is a frequent and potentially vision-threatening manifestation of juvenile idiopathic arthritis (JIA). There are only a few population-based studies providing data on the frequency and severity of uveitis. Methods: Documentation of patients with JIA was collected in a national database. An analysis of the paediatric rheumatologic and ophthalmologic data collected from all patients that were included in 2002 was performed. Results: Uveitis was documented in 12%of a total of 3271JIA patients: extended oligoarthritis (25%), persistent oligoarthritis (16%), seronegative polyarthritis (4%), seropositive polyarthritis (2%), psoriatic arthritis (10%), enthesitis-related arthritis (ERA) (7%), Systemic arthritis(1%), other arthritis forms (11%) Opthalmologic data were available from 115 uveitis patients (28%). Mean age at onset of uveitis was 5.2 (SD 3.2) years. JIA patients with uveitis were significantly younger at onset of arthritis (3.8 vs. 7.0 years), and were more often girls (74 vs. 63%) or ANA-positive (86 vs. 42%) than the patients without uveitis. Uveitis complications were present in 45%at initial presentation of uveitis. After a mean duration of 5.6 years, complications were noted in 56%, and included band keratopathy (29%), posterior synechiae (27%), cataract (26%), glaucoma (8%), and macula oedema (6%). Final visual acuity was less than 20/50 in 31%and less than 20/200 in 12%of eyes. In patients with uveitis, immunosuppressive or immunomodulatory drugs were used significantly more often than in patients without uveitis (75%vs. 43%). Conclusions: The nationwide data documents the spectrum of uveitis in patients with JIA, the complications and the therapy for uveitis. The high rate of uveitis complications at the time of diagnosis points out the need for early ophthalmologic screening and therapy, and for a close collaboration between ophthalmologist and paediatric rheumatologist.
文摘PURPOSE: To describe the treatment of juxtapapillary capillary angioma by pars plana vitrectomy (PPV) and tumor excision. DESIGN: Interventional case report. METHODS:A6-year-old girl with symptomatic juxtapapillary capillary retinal angioma with associated epiretinal membrane (ERM) underwent PPV and extraction of the tumor and ERM. A clinical and molecular genetic workup for the presence of von Hippel-Lindau disease (VHL) was performed. RESULTS: A favorable functional result without tumor recurrence was achieved. Capillary retinal angioma was confirmed by histology of the surgical specimen,and familial VHL was revealed. CONCLUSIONS: PPV and extraction of the tumor is applicable in juxtapapillary capillary retinal angioma with associated ERM. A workup for the presence of VHL is pertinent in patients presenting with this tumor entity.
文摘PURPOSE: To determine the prevalence of full-thickness macular holes in the elderly Chinese population. DESIGN: Population-based,cross-sectional cohort study. METHODS: The Beijing Eye Study included 4439 subjects out of 5324 subjects invited to participate (response rate 83.4% ) aged 40 years or older. The present investigation consisted of 8653 (97.9% ) eyes of 4346 subjects for whom readable fundus photographs were available. RESULTS: Full-thickness macular holes were found in eight (0.092% ) eyes of seven (0.16% )-patients (six women). Prevalence was 0.09± 3.04% 95% confidence interval (CI): 0.03,0.16% . CONCLUSIONS: Fullthickness macular holes may be present in approximately 1.6 out of 1000 elderly Chinese in Northern China. Calculated for the entire population in China,the figure would be approximately 750,000 patients with unilateral full-thickness macular holes 650,000 (95% CI: 217,000 to 1,156,000) or bilateral full-thickness macular holes 100,000 (95% CI: 33,000 to 178,000).
文摘PURPOSE: To investigate the influence of test reliability on the screening performance of frequency-doubling perimetry (FDT). DESIGN: Cross-sectional study. METHODS: FDT sensitivity and specificity were calculated three times using three different strategies for handling unreliable (that is,>0 reliability indices outside normal limits) and unfeasible (that is,could not be completed) tests in 452 glaucoma patients from our outpatient department and 237 healthy subjects recruited outside the hospital. RESULTS: Unreliable (P=.01) and unfeasible (P < .001) tests occurred more frequently in glaucoma patients when compared with healthy subjects. Best screening performance was obtained by interpreting unreliable tests as if they were reliable and considering unfeasible tests as positive. With this strategy,sensitivity was 0.90 (95% confidence interval 0.87-0.93) and specificity 0.81 (95% confidence interval 0.76-0.86). CONCLUSIONS: Unreliable and unfeasible FDT tests appear to contain useful information.
文摘PURPOSE: To estimate the prevalence and distribution of blindness and low vision in Northern China. DESIGN: Population-based cohort study. METHODS: The Beijing Eye Study included 4438 subjects with an age of 40+ years. Mean age was 56.2± 10.6 years (range,40 to 101 years). RESULTS: Fortythree (1.0% ) individuals had low vision (< 20/60 and ≥ 20/400 best-corrected vision),and 17 (0.4% ) individuals were blind (best-corrected visual acuity in the better-seeing eye < 20/400). Low vision/blindness were significantly associated with age (P < .001),myopic refractive error (P < .001),and level of educational background (P=.035). It was not associated with gender (P=.76) and rural vs urban area (P=.88). CONCLUSIONS: Blindness or low vision affects approximately one in 100 Chinese older than 40 years. An estimated 4.1 million Chinese older than 40 years have low vision,and an estimated 1.6 million Chinese older than 40 years are blind.
文摘BACKGROUND AND OBJECTIVE: To present a series of 3 patients with the dry form of age-related macular degeneration (AMD) in whom choroidal neovascularization (CNV) was observed following neodymium: yttrium-aluminum-garnet (Nd:YAG) capsulotomy. PATIENTS AND METHODS: Three consecutive patients aged 80 to 87 years (average=83.7 years) with hard drusen or retinal pigment epithelial changes underwent uneventful cataract extraction between 6 months and 20 years before undergoing Nd:YAG capsulotomy for posterior capsule opacity. The patients were examined for retinal changes before laser treatment and at regular intervals after treatment. RESULTS: All patients developed CNV between 12 days and 1 month after capsulotomy that caused a decrease in the visual acuity from 20/20-20/40 to 20/200-counting fingers at 4 feet. The fellow eye did not show a substantial change in AMD over a year of follow-up. Two of the fellow eyes had disci form scar due to CNV before the cataract surgery,and these patients remained legally blind. CONCLUSIONS: The development of CNV after Nd:YAG capsulotomy suggests a temporal association between the two and calls for further study. Because posterior capsule opacity may mask CNV,patients with dry AMD and posterior capsule opacity who experience decreased visual acuity or glare may undergo indocyanine green angiography before it is decided to perform Nd:YAG capsulotomy.
文摘BACKGROUND AND OBJECTIVE: To report the results of trabeculectomy with adjunctive intraoperative mitomycin C in Chinese patients with glaucoma. PATIENTS AND METHODS: The medical records of Chinese patients who received trabeculectomy with intraoperative mitomycin C from 1992 to 1998 were retrospectively reviewed. A “ successful” trabeculectomy was defined as one after which the intraocular pressure (IOP) could be controlled to between 5 and 21 mm Hg,inclusive,with no more than 3 glaucoma medications. RESULTS: One hundred fourteen trabeculectomies in 105 eyes of 90 patients were retrospectively reviewed. Mean age ± standard deviation was 48.1 ± 21.9 years. Primary open-angle glaucoma (43.0% ) and angle-closure glaucoma (27.2% ) were the most common diagnoses leading to trabeculectomy. The mean follow-up ± standard deviation was 29.6 ± 18.6 mo-nths (range,6 to 92 months). The overall success rate at the last followup was 73.7% (84 of 114 trabeculectomies). CONCLUSIONS: Trabeculectomy with mitomycinC is a safe and effective procedure for the control of IOP in Chinese patients with glaucoma.
文摘The effects of poor anterior segment compensation on scanning laser polarimetry measurements of the retinal nerve fiber layer (RNFL) were systematically explored. A prototype scanning laser polarimeter with an adjustable compensator to neutralize anterior segment birefringence was used. By systematically varying the magnitude and axis of anterior segment compensation in a healthy and a glaucomatous eye,marked changes were observed in RNFL appearance: the healthy eye could appear to have glaucomatous damage,whereas the glaucomatous eye could appear to have a thicker and healthier RNFL. Even small amounts of uncompensated corneal birefringence,which may occur in routine clinical use,resulted in apparent changes in RNFL morphology. Knowledge of this effect is important for clinicians when using scanning laser polarimetry in clinical practice.
文摘Optic disc melanocytoma is a well-known clinical entity occurring as a deeply pigmented lesion on the optic nerve head. A 40-year-old man with a pigmented lesion overlying the left optic disc was evaluated with optical coherence tomography. The single high reflectance band from the anterior edge of the disc lesion with optical back shadowing behind on optical coherence tomography helped to pinpoint the diagnosis of the lesion as optic disc melanocytoma. Quantitative assessment of the mass with optical coherence tomography for its growth did not show any increase in size horizontally or vertically after 6 months. Optical coherence tomography is useful for obtaining the exact measurements of the mass lesion and may be used as a tool to follow the progress and growth pattern of the lesion.
