Ophthalmology
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To investigate whether nasal peripapillary retinal nerve fiber layer (RNFL) attenuation is associated with visual field loss attributed to the anti-epileptic drug vigabatrin. ⋯ Vigabatrin-attributed visual field loss is associated with a characteristic pattern of RNFL attenuation: nasal quadrant thinning and normal temporal quadrant thickness with, or without, superior or inferior quadrant involvement. Nasal attenuation may precede visual field loss. Ocular coherence tomography of the peripapillary RNFL should be considered in patients previously exposed to vigabatrin. It should also be considered at baseline and follow-up in those commencing vigabatrin for treatment of epilepsy or in trials for anti-addiction therapy. The pattern of RNFL thinning seems to be a useful biomarker to identify vigabatrin toxicity.
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Multicenter Study
Prevalence of diabetic retinopathy in rural China: the Handan Eye Study.
To describe the age- and gender-specific prevalence, characteristics, and severity of diabetic retinopathy (DR) in a rural population in northern China. ⋯ Our study reports a high prevalence of DR among adults 30 years and older with diabetes in rural China. On the basis of estimates obtained from our study, we projected that in rural China, 21.1 million persons aged 30+ years have diabetes and 9.2 million have DR, including 1.3 million with vision-threatening DR. There is a pressing need for appropriate screening and management of diabetes and its complications in rural China.
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Multicenter Study
Facial nerve injury during external dacryocystorhinostomy.
To describe weakness of the orbicularis oculi muscle after external dacryocystorhinostomy (DCR) and propose an anatomic explanation for the complication. ⋯ Damage to peripheral fibers of the zygomatic and buccal branches of the facial nerve as they course through the medial canthal area to innervate the upper eyelid orbicularis oculi muscle may occur during external DCR surgery. Such injury may be responsible for orbicularis oculi muscle weakness manifesting as postoperative abnormal eyelid closure and lagophthalmos. In our cohort of patients, these findings were temporary and typically resolved in several months.
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To determine the risk factors for intraoperative complications in resident-performed phacoemulsification surgery and the effect of complications on postoperative visual acuity. ⋯ Residents performing phacoemulsification surgery achieved a low overall rate of major complications. However, specific features of cataracts, such as mature nuclei and zonular pathology, carried increased intraoperative risk. Anticipating risk may help to decrease surgical complications further and to counsel patients appropriately.