All Posts tagged Health

Predictive Factors of Visual Outcome for Vitreomacular Traction Syndrome After Vitrectomy

Most patients of VMT gained significant functional and anatomical improvements after vitrectomy. Group 1 optical coherence tomography pattern, shorter symptom duration, and younger age are significant predictive factors of better visual outcome.

“Predictive Factors of Visual Outcome for Vitreomacular Traction Syndrome After Vitrectomy”

Retina 38:1533-1540, 2018
Chang-Sue Yang, MD, MHA; Ming-Hung Hsieh, MD; Yu-Fan Chang, MD; Chiao-Yu Wang, MD; Shih-Jen Chen, MD, PhD

Full Paper: Predictive Factors of Visual Outcome for Vitreomacular Traction Syndrome After Vitrectomy

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Methodological Insights for Randomized Clinical Trials of Retinitis Pigmentosa

There are no approved drug treatments for autosomal-dominant retinitis pigmentosa.
 
A study of oral Valproic acid (VPA) does not support the use of VPA in the treatment of autosomal-dominant retinitis pigmentosa.
 
The lessons learned from a trial of Valproic acid are:

  • Rigorous evaluation of drug treatment for retinitis pigmentosa is necessary.
  • FDA-approved drugs for other uses can have major adverse effects.
  • Patients vary greatly in their rates of progression of retinitis pigmentosa with identical gene mutations.

“Methodological Insights for Randomized Clinical Trials of Retinitis Pigmentosa”
Lessons Learned from a Trial of Valproic Acid

JAMA Ophthalmol 136:857-858, August 2018
Brian P. Brooks, MD, PhD; Brett Jeffrey, PhD

Full Paper: Methodological Insights for Randomized Clinical Trials of Retinitis Pigmentosa_08-13-18

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Retinal Subspecialist Re-referral

A patient who you are following that has had a retinal detachment repair or a vitrectomy for any reason is doing well. If the patient then develops any of the following signs or symptoms, it may justify a re-referral to a retinal subspecialist:

  • An intraocular pressure of below 6 mmHg.
  • An injected conjunctiva with associated pain.
  • A hazy cornea.
  • White, round-like deposits on the corneal endothelium.
  • Rubeosis on the iris.
  • Patient complains of seeing flashes of light or gnats in their eyes.
  • Vessel in-growth in the limbal area.
  • Patient complaining of seeing a shade or blurring in their field of vision.
  • Patient having difficulty seeing.
  • Intraocular pressure elevation above 30 mmHg.
  • Band keratopathy in eye with Silicone oil.
  • Patient complains of feeling like they have a lash in their eye.

A phone call to the retinal subspecialist may suffice or he/she may feel examining the patient is in order.

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Findings on OCT

You are following a patient with successful treatment of a subretinal neovascular membrane from any of the following disorders:

Or edema secondary to:

If this patient were to suddenly develop any of the following signs or symptoms or findings on OCT, this may justify a re-referral to the initial treating retinal subspecialist.

Signs and Symptoms

  • Decreased central visual acuity.
  • Complaints of blurred central vision.
  • Rubeosis on the iris.
  • Hazy vision of recent onset.
  • Patient states their vision is cloudy.
  • Hemorrhaging in the fovea on clinical retinal examination.

OCT Findings

  • An OCT finding of retinal thickening at or within 500 units of the center of the macula.
  • An OCT finding of hard exudate at or within 500 units of the center of the macula if associated with adjacent retinal thickening.
  • An OCT finding of a zone or zones of retinal thickening one disc-area in size, at least part of which is with one disc-diameter of the center of the macula.
  • Increased central retinal thickness on OCT.
  • Subretinal fluid over large contiguous drusen in the fovea on OCT.

A phone call to the retinal subspecialist may suffice or he/she may feel examining the patient is in order.

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Retinal Subspecialist

A patient who you are following that has had a retinal detachment repair or a vitrectomy for any reason is doing well. If the patient then develops any of the following signs or symptoms, it may justify a re-referral to a retinal subspecialist:

  • An intraocular pressure of below 6 mmHg.
  • An injected conjunctiva with associated pain.
  • A hazy cornea.
  • White, round-like deposits on the corneal endothelium.
  • Rubeosis on the iris.
  • Patient complains of seeing flashes of light or gnats in their eyes.
  • Vessel in-growth in the limbal area.
  • Patient complaining of seeing a shade or blurring in their field of vision.
  • Patient having difficulty seeing.
  • Intraocular pressure elevation above 30 mmHg.
  • Band keratopathy in eye with Silicone oil.
  • Patient complains of feeling like they have a lash in their eye.

A phone call to the retinal subspecialist may suffice or he/she may feel examining the patient is in order.

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Nutrition for the Well-Being of the Eye

Omega 3 fatty acids have been shown to increase the general sense of well-being and promote high health. They are present in fish and are highest in mackerel, white fish, tuna, and salmon.

Zinc has a specific role in the normal functioning of photoreceptors in the eye. Zinc is found in high protein foods such as beef, pork, and whole grain cereals.

Recently, it has been suggested that the carotenoids, Lutein (pronounced loo-teen) and Zeaxanthin (pronounced zee-uh-zan-thin) play an important role in eye health.

In the Eye Disease Case Control Study, medical researchers found that individuals experienced a significantly lower risk for developing age related macular degeneration when they had high amounts of Lutein and Zeaxanthin in their blood.

Sources of Lutein include yellow peppers, mango, blueberries, and green leafy vegetables such as kale, spinach, chard, and broccoli. Sources of Zeaxanthin include orange sweet peppers, broccoli, corn, lettuce, spinach, tangerines, oranges, and eggs.

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