Objective: To investigate if IV immunoglobulin (IVIG)treatment in the acute ph ase of optic neuritis (ON) could improve visual outcome and reduce MRI disease a ctivity 6 months after onset of ON. Methods: Sixty-eight ...Objective: To investigate if IV immunoglobulin (IVIG)treatment in the acute ph ase of optic neuritis (ON) could improve visual outcome and reduce MRI disease a ctivity 6 months after onset of ON. Methods: Sixty-eight patients with ON were randomized within 4 weeks from onset of symptoms. Thirty-four pa tients were randomized to IVIG 0.4 g/kg body wt, and 34 patients were randomized to placebo. Infusions were given at days 0, 1, 2, 30, and 60. Contrast sensitiv ity, visual acuity, and color vision were measured at baseline and after 1 week, 1 month, and 6 months. Pattern reversal visual evoked potential studies and gad olinium-enhanced MRI were performed at baseline and after 1 and 6 months. Clini cal relapses during follow-up were recorded. Results: There was no difference i n the primary outcome, contrast sensitivity after 6 months, between patients ran domized to treatment with IVIG or placebo. In addition, there was no significant difference in the secondary outcome measures, improvement in the visual functio n measures and MRI, at any time during follow-up. At baseline, a significantly higher number of patients in the IVIG group had one or more enhancing lesions on MRI and IVIG-treated patients had a significantly higher number of enhancing l esions on MRI than patients treated with placebo. No difference was found in num ber of patients with one or more enhancing lesions or number of enhancing lesion s in subsequent scans between treatment groups. Number of relapses was equal in the two treatment groups during follow-up. Conclusions: There was no effect of IV immunoglobulin (IVIG) on long-term visual function following acute optic neu ritis, nor was there an effect of IVIG treatment in reducing latency on visual e voked potentials and thus preserving function of axons of the optic nerve.展开更多
To evaluatethe visual outcome of patients with myopic subfoveal choroidal neovascularization (CNV) given photodynamic therapy (PDT) in a clinical setting, and to identify potential relation between the visual outcome ...To evaluatethe visual outcome of patients with myopic subfoveal choroidal neovascularization (CNV) given photodynamic therapy (PDT) in a clinical setting, and to identify potential relation between the visual outcome and the age at treatment. Interventional case series. Retrospective comparative study. setting: Outpatient ophthalmology clinic. patients: Twenty- nine consecutive patients (30 eyes) with subfoveal CNV caused by pathologic myopia who were treated with verteporfin PDT from January 2000 to May 2003. intervention: All the patients received verteporfin PDT and were followed clinically and with fluorescein angiography (FA). Review of the medical records and angiograms was performed. Patients were divided into two groups by age, using the median age (60 years) as the cutoff. main outcome measures: Visual acuity (VA) at the end of follow- up in the older- patient group compared with the younger- patient group. The mean age was 63.1 years. Mean follow- up was 11.5 months. Patients received a mean of 3.48 treatments. Mean VA improved in the younger group from 0.63 to 0.39 logMAR (P=.02, paired t test) and deteriorated in the older group from 0.71 to 0.99 logMAR (P=.03, paired t test). In the whole cohort, 33% of eyes lost 3 or more lines of Snellen best- corrected VA; in the older age group, 50% of eyes lost 3 or more lines, whereas in the younger age group, only 8% of eyes did so (P=.024, Fisher’ s exact test). In our consecutive case series, visual prognosis of myopic CNV after PDT was found to be influenced by age at treatment.展开更多
Background: Several case series and a recent metaanalysis indicate that intra-arterial thrombolysis (IAT) is effective for the treatment of acute central retinal artery occlusion (CRAO). Methods: A total of 37 patient...Background: Several case series and a recent metaanalysis indicate that intra-arterial thrombolysis (IAT) is effective for the treatment of acute central retinal artery occlusion (CRAO). Methods: A total of 37 patients with acute monocular blindness because of unilateral thromboembolic CRAO were treated with IAT using urokinase within six hours of the onset of symptoms. Visual outcome was compared with a control group of 19 patients, also seen within six hours, who did not undergo thrombolytic treatment. In both groups some patients were treated by paracentesis and/or acetazolamide. Predictors of visual outcome were evaluated. Results: Visual improvement was more likely with IAT (P=0.01) as were the chances to regain visual acuity of > 0.6 significantly better (P=0.04): 8/37 patients (22% ) regained visual acuity of > 0.6 in the IAT group and none (0/19) in the control group. Younger patients were more likely to regain some vision with (P=0.012) or without IAT (P=0.026). Three patients had minor treatment related cerebral ischaemic events, two had transient ischaemic attacks and one a minor stroke. There were no haemorrhagic complications. Conclusions: This series of patients with CRAO demonstrated that IAT enhanced the chances of visual improvement compared with conventional treatment only. Furthermore, younger patients have a better chance to achieve some visual recovery.展开更多
文摘Objective: To investigate if IV immunoglobulin (IVIG)treatment in the acute ph ase of optic neuritis (ON) could improve visual outcome and reduce MRI disease a ctivity 6 months after onset of ON. Methods: Sixty-eight patients with ON were randomized within 4 weeks from onset of symptoms. Thirty-four pa tients were randomized to IVIG 0.4 g/kg body wt, and 34 patients were randomized to placebo. Infusions were given at days 0, 1, 2, 30, and 60. Contrast sensitiv ity, visual acuity, and color vision were measured at baseline and after 1 week, 1 month, and 6 months. Pattern reversal visual evoked potential studies and gad olinium-enhanced MRI were performed at baseline and after 1 and 6 months. Clini cal relapses during follow-up were recorded. Results: There was no difference i n the primary outcome, contrast sensitivity after 6 months, between patients ran domized to treatment with IVIG or placebo. In addition, there was no significant difference in the secondary outcome measures, improvement in the visual functio n measures and MRI, at any time during follow-up. At baseline, a significantly higher number of patients in the IVIG group had one or more enhancing lesions on MRI and IVIG-treated patients had a significantly higher number of enhancing l esions on MRI than patients treated with placebo. No difference was found in num ber of patients with one or more enhancing lesions or number of enhancing lesion s in subsequent scans between treatment groups. Number of relapses was equal in the two treatment groups during follow-up. Conclusions: There was no effect of IV immunoglobulin (IVIG) on long-term visual function following acute optic neu ritis, nor was there an effect of IVIG treatment in reducing latency on visual e voked potentials and thus preserving function of axons of the optic nerve.
文摘To evaluatethe visual outcome of patients with myopic subfoveal choroidal neovascularization (CNV) given photodynamic therapy (PDT) in a clinical setting, and to identify potential relation between the visual outcome and the age at treatment. Interventional case series. Retrospective comparative study. setting: Outpatient ophthalmology clinic. patients: Twenty- nine consecutive patients (30 eyes) with subfoveal CNV caused by pathologic myopia who were treated with verteporfin PDT from January 2000 to May 2003. intervention: All the patients received verteporfin PDT and were followed clinically and with fluorescein angiography (FA). Review of the medical records and angiograms was performed. Patients were divided into two groups by age, using the median age (60 years) as the cutoff. main outcome measures: Visual acuity (VA) at the end of follow- up in the older- patient group compared with the younger- patient group. The mean age was 63.1 years. Mean follow- up was 11.5 months. Patients received a mean of 3.48 treatments. Mean VA improved in the younger group from 0.63 to 0.39 logMAR (P=.02, paired t test) and deteriorated in the older group from 0.71 to 0.99 logMAR (P=.03, paired t test). In the whole cohort, 33% of eyes lost 3 or more lines of Snellen best- corrected VA; in the older age group, 50% of eyes lost 3 or more lines, whereas in the younger age group, only 8% of eyes did so (P=.024, Fisher’ s exact test). In our consecutive case series, visual prognosis of myopic CNV after PDT was found to be influenced by age at treatment.
文摘Background: Several case series and a recent metaanalysis indicate that intra-arterial thrombolysis (IAT) is effective for the treatment of acute central retinal artery occlusion (CRAO). Methods: A total of 37 patients with acute monocular blindness because of unilateral thromboembolic CRAO were treated with IAT using urokinase within six hours of the onset of symptoms. Visual outcome was compared with a control group of 19 patients, also seen within six hours, who did not undergo thrombolytic treatment. In both groups some patients were treated by paracentesis and/or acetazolamide. Predictors of visual outcome were evaluated. Results: Visual improvement was more likely with IAT (P=0.01) as were the chances to regain visual acuity of > 0.6 significantly better (P=0.04): 8/37 patients (22% ) regained visual acuity of > 0.6 in the IAT group and none (0/19) in the control group. Younger patients were more likely to regain some vision with (P=0.012) or without IAT (P=0.026). Three patients had minor treatment related cerebral ischaemic events, two had transient ischaemic attacks and one a minor stroke. There were no haemorrhagic complications. Conclusions: This series of patients with CRAO demonstrated that IAT enhanced the chances of visual improvement compared with conventional treatment only. Furthermore, younger patients have a better chance to achieve some visual recovery.
