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Archives of Ophthalmology current issue

ABOUT THIS JOURNAL: About This Journal
Mon, 08 Dec 2008 00:00:00 -0000

CLINICAL TRIAL: Surgical Removal vs Observation for Idiopathic or Ocular Histoplasmosis Syndrome-Associated Subfoveal Choroidal Neovascularization: Vision Preference Value Scale Findings From the Randomized SST Group H Trial: SST Report No. 17
Submacular Surgery Trials Research Group Mon, 08 Dec 2008 00:00:00 -0000
Objective  To determine whether patients receiving observation vs surgery for subfoveal choroidal neovascularization that was idiopathic or associated with histoplasmosis differed in preference values assigned to their health and vision status. Methods  Before and after enrollment, patients rated their current vision on a scale from 0 (blind) to 100 (perfect vision) and rated blindness and perfect vision on a scale from 0 (dead) to 100 (perfect health and vision). Scores for current vision were converted to a preference value scale (0 represents death; 100, perfect health and vision). Results  In 170 patients, no significant difference existed between the observation and surgery arms in median vision preference values at baseline (74 vs 70) or at the 12- (74 vs 78) or 24-month follow-up (77 vs 73) (P > .05). Preference values did not differ between arms for subgroups defined by age, unilateral vs bilateral choroidal neovascularization, or good vs poor baseline visual acuity. Conclusions  Submacular surgery was no better than observation in the preference values patients assigned to their health status, despite previously reported improvements in vision-specific quality of life. Trial Registration  clinicaltrials.gov Identifier: NCT00000150 Clinical Relevance  Ophthalmologists should consider the effects on different measures of quality of life when determining treatment for patients similar to those in the Submacular Surgery Trials Group H Trial.
CALL FOR PAPERS: Surgeon's Corner
Mon, 08 Dec 2008 00:00:00 -0000

CLINICAL TRIAL: Patching vs Atropine to Treat Amblyopia in Children Aged 7 to 12 Years: A Randomized Trial
Pediatric Eye Disease Investigator Group Mon, 08 Dec 2008 00:00:00 -0000
Objective  To compare patching with atropine eyedrops in the treatment of moderate amblyopia (visual acuity, 20/40-20/100) in children aged 7 to 12 years. Methods  In a randomized, multicenter clinical trial, 193 children with amblyopia were assigned to receive weekend atropine or patching of the sound eye 2 hours per day. Main Outcome Measure  Masked assessment of visual acuity in the amblyopic eye using the electronic Early Treatment Diabetic Retinopathy Study testing protocol at 17 weeks. Results  At 17 weeks, visual acuity had improved from baseline by an average of 7.6 letters in the atropine group and 8.6 letters in the patching group. The mean difference between groups (patching – atropine) adjusted for baseline acuity was 1.2 letters (ends of complementary 1-sided 95% confidence intervals for noninferiority, –0.7, 3.1 letters). This difference met the prespecified definition for equivalence (confidence interval <5 letters). Visual acuity in the amblyopic eye was 20/25 or better in 15 participants in the atropine group (17%) and 20 in the patching group (24%; difference, 7%; 95% confidence interval, –3% to 17%). Conclusions  Treatment with atropine or patching led to similar degrees of improvement among 7- to 12-year-olds with moderate amblyopia. About 1 in 5 achieved visual acuity of 20/25 or better in the amblyopic eye. Clinical Relevance  Atropine and patching achieve similar results among older children with unilateral amblyopia. Trial Registration  clinicaltrials.gov Identifier: NCT00315328
CLINICAL SCIENCES: A Benign Syndrome of Transient Loss of Accommodation in Young Patients
Almog, Y. Mon, 08 Dec 2008 00:00:00 -0000
Objective  To describe a benign condition of transient, isolated accommodation paralysis in young patients as a specific entity. Design  Case series of children and young adults with transient loss of accommodation who were referred to the neuro-ophthalmology clinic at the Meir Medical Center from 1997 to 2006. Five young patients who complained of an inability to read had full neuro-ophthalmological examinations. Those who were found to have isolated accommodation paralysis without any other related ocular or systemic findings were prescribed reading glasses and followed up. Results  All 5 patients had isolated loss of accommodation. No one had other ocular, neurological, or systemic abnormalities that could be associated with accommodation paralysis; they all did well with near correction. Accommodation returned to normal within 3 to 14 months in all 5 patients. Conclusion  An isolated transient loss of accommodation unrelated to any other ocular or systemic manifestations may occur in children and young adults and may be considered a specific idiopathic entity.
CLINICAL SCIENCES: Confirmation of the Presence of Uveal Effusion in Asian Eyes With Primary Angle Closure Glaucoma: An Ultrasound Biomicroscopy Study
Kumar, R. S., Quek, D., Lee, K. Y., Oen, F. T., Sakai, H., Koh, V. T., MohanRam, L. S., Baskaran, M., Wong, T. T., Aung, T. Mon, 08 Dec 2008 00:00:00 -0000
Objective  To confirm the presence of uveal effusion in the eyes of Asian patients with primary angle closure glaucoma (PACG) using ultrasound biomicroscopy (UBM). Methods  In this observational case series, 70 patients with PACG (28 untreated patients with newly diagnosed PACG and 42 patients who had undergone previous laser iridotomy and were being monitored) and 12 patients with acute primary angle closure (APAC) were recruited. Eyes of patients with newly diagnosed PACG and APAC underwent UBM before and after laser iridotomy, whereas eyes of patients with treated PACG underwent UBM at enrollment. Uveal effusion was defined as a clear space between the choroid and sclera and was graded as follows: grade 0, none; grade 1, slitlike; grade 2, bandlike; and grade 3, obvious. Results  Overall, uveal effusion was found in 11 of 70 eyes with PACG (15.7%; 95% confidence interval, 8.8%-26.2%) and in 3 of 12 eyes with APAC (25%; 95% confidence interval, 8.0%-53.4%). For patients with newly diagnosed PACG, uveal effusion was found in 4 of 28 eyes (14.2%; 95% confidence interval, 5.1%-32.1%) before laser iridotomy; 2 eyes had effusion after laser iridotomy. When present, the effusion was grade 1 in PACG eyes and grade 2 or 3 in APAC eyes. Conclusions  Uveal effusion was present in a significant proportion of Asian eyes with PACG and APAC, confirming a recent report of this finding.

 
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Anterior Eye: A research-based journal covering all aspects of contact lens theory and practice.

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Electronic Journals: Journal listings in the subject of Optometry, Ophthalmology and Vision Science from UC Berkley Library.

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