The British journal of ophthalmology
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Methylmalonic acidemia (MMA) and propionic acidemia (PA) are rare hereditary disorders of protein metabolism, manifesting early in life with ketoacidosis and encephalopathy and often resulting in chronic complications. Optic neuropathy (ON) has been increasingly recognised in both conditions, mostly through isolated case reports or small cases series. We here report the clinical features and visual outcomes of a case series of paediatric patients with a diagnosis of MMA or PA. ⋯ Our study suggests that ON is under-reported in patients with MMA and PA. Clinical presentation can be acute or insidious, and episodes of acute metabolic decompensation appear to trigger visual loss. Photoreceptor involvement may coexist. Active clinical surveillance of affected patients is important as comorbidities and cognitive impairment may delay diagnosis.
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Retinal photography with a non-mydriatic camera is the method currently employed for diabetic retinography (DR) screening. We designed this study in order to evaluate the prevalence and severity of DR, and associated risk factors, in patients with type 2 diabetes (T2DM) screened in Catalan Primary Health Care. ⋯ The prevalence of any type of DR in patients with T2DM screened with retinal photography was lower when compared with earlier studies.
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To evaluate the role of achieving immediate target angles on the success of strabismus surgery. ⋯ Our results suggest that achieving the immediate target angle is the most significant factor in the success of strabismus surgery for exotropia. Adjustable suture surgery results in higher proportion of patients achieving this target angle.
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To evaluate the relationship between dry eye symptoms, non-ocular conditions and tear film parameters. ⋯ Dry eye symptoms more closely align to non-ocular pain, depression and PTSD than to tear film parameters.
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The changing profile of patients undergoing ophthalmic surgery, with an increase in prevalence of antiplatelet and anticoagulant drug use, predisposes to bleeding complications. This mandates an awareness of these agents, allowing optimal patient management. We review traditional and newer agents in the context of cataract, vitreoretinal, glaucoma and oculoplastic surgery. Recommendations are given for continuation, cessation and re-commencement of these agents in order to minimise the risk of bleeding and thrombotic/thromboembolic complications.