Transactions of the American Ophthalmological Society
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Trans Am Ophthalmol Soc · Jan 2007
Macular holes and macular pucker: the role of vitreoschisis as imaged by optical coherence tomography/scanning laser ophthalmoscopy.
The pathogenesis of macular pucker and macular holes is poorly understood. Anomalous posterior vitreous detachment (PVD) and vitreoschisis have been proposed as possible mechanisms. This study used clinical imaging to seek vitreoschisis and study the topographic features of macular pucker and macular holes. ⋯ Vitreoschisis was detected in about half of all eyes with macular hole and macular pucker. The topographic and structural features in eyes with macular hole with retinal contraction differed in comparison to eyes with macular pucker alone, suggesting that although each condition may begin with anomalous PVD, differences in subsequent cell migration and proliferation probably result in the different clinical appearances detected in this study.
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Trans Am Ophthalmol Soc · Jan 2007
The goal of value-based medicine analyses: comparability. The case for neovascular macular degeneration.
To evaluate the comparability of articles in the peer-reviewed literature assessing the (1) patient value and (2) cost-utility (cost-effectiveness) associated with interventions for neovascular age-related macular degeneration (ARMD). ⋯ The majority of cost-utility studies performed on interventions for neovascular macular degeneration are value-based medicine studies and thus are comparable. Value-based analyses of neovascular ARMD monotherapies demonstrate the power of value-based medicine to improve quality of care and concurrently maximize the efficacy of healthcare resource use in public policy. The comparability of value-based medicine cost-utility analyses has important implications for overall practice standards and public policy. The adoption of value-based medicine standards can greatly facilitate the goal of higher-quality care and maximize the best use of healthcare funds.
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Trans Am Ophthalmol Soc · Jan 2006
Long-term visual outcomes in extremely low-birth-weight children (an American Ophthalmological Society thesis).
The goal is to analyze the long-term visual outcome of extremely low-birth-weight children. ⋯ Long-term visual development in extremely low-birth-weight infants is problematic and associated with a high risk of subnormal acuity. Early acuity testing is useful in identifying children at greatest risk for long-term visual abnormalities. Gestational age at birth of
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Trans Am Ophthalmol Soc · Jan 2005
Retinopathy of prematurity: involution, factors predisposing to retinal detachment, and expected utility of preemptive surgical reintervention.
To characterize involution of retinopathy of prematurity (ROP) following treatment at threshold, to identify findings during involution that portend development of retinal detachment, and to assess the potential utility of preemptive vitrectomy for eyes with high-risk features. ⋯ Acute-phase ROP involuted quickly in most eyes. Vitreous organization and vitreous hemorrhage were predictive of eyes that developed a retinal detachment. Decision analysis suggests that preemptive vitrectomy for eyes with vitreous organization meeting specific criteria is not likely to be worse than deferred vitrectomy, and it could be advantageous in some scenarios.
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Trans Am Ophthalmol Soc · Jan 2005
Comparative StudyA comparison of implant extrusion rates and postoperative pain after evisceration with immediate or delayed implants and after enucleation with implants.
To examine implant extrusion rates after evisceration with immediate or delayed implants in patients with culture-proven endophthalmitis. To compare postevisceration and postenucleation pain. ⋯ Both immediate and delayed implant techniques appear safe in patients with endophthalmitis, with the former being simpler, more cost-effective, and perhaps less painful. Prolonged antibiotic therapy and smaller implants may render a false sense of security against implant extrusion; good surgical technique and meticulous postoperative wound care are essential. Postenucleation pain appears more severe than postevisceration pain.