In this case-control study, we compared the optic nerves (ONs) by clinical examination and scanning laser ophthalmoscopy (SLO) of 40 patients with Alzheimer disease (AD) and 50 controls. There was a reduction in the number of ON fibers in patients with AD, with a threefold greater odds ratio for a larger optic cup-to-disc ratio in patients with AD.
Abstract Aim: To assess New Zealand's research productivity in the area of ophthalmology and vision science over the decade 1993–2002. Methods: New Zealand‐based researchers involved in ophthalmology or vision science research, including ophthalmologists, optometrists and vision scientists were identified via professional colleges, universities and electronic databases. Peer‐reviewed publications by these authors were identified by both searching electronic databases (MEDLINE/Pubmed) and personal communication with individual researchers. Results: Eighty‐five New Zealand‐based researchers involved in ophthalmology or vision science research published 446 articles in 84 scientific journals during the 10‐year period. The cohort consisted of 59 ophthalmologists and 26 other researchers based in a diverse range of ophthalmology, optometry and university departments. Significant collaboration was observed between groups within New Zealand and with international institutions. Comparing ophthalmologists and ‘other’ researchers, ophthalmologists produced 69% of all ophthalmology and vision science research publications and those classified as ‘active ophthalmologist researchers’ published an average of 11 (range 5–55) papers each during this decade, compared to eight (range 5–25) for the group ‘other active researchers’. This was also reflected in the high productivity rate by ophthalmologists of 277 publications per 1000. Publications were identified in a wide range of journals with the majority in top 20‐ranked ophthalmology journals. The trend over the decade highlighted an increase in number of scientific publications, from 43 per annum in 1993, to 68 per annum in 2002. Conclusions: Despite a relatively small and geographically isolated population, New Zealand ophthalmology and vision science research is highly active and collaborative, with significantly increased research productivity during the period 1993–2002. The present study is the first to document these trends and provides strong evidence to justify continued support for ophthalmology and vision science research in New Zealand.
To evaluate the effectiveness of full-thickness skin graft adhesion using fibrin tissue glue (TISSEEL) in cicatricial ectropion repair of the lower eyelid.This study was a prospective case series. Nine eyes of 8 consecutive patients with cicatricial ectropion were included. All patients underwent a conjunctival approach lower eyelid retractor plication, lateral tarsal strip, and insertion of a full-thickness skin graft secured with TISSEEL. Symptoms of epiphora, eye and eyelid irritation, discharge, and graft size were recorded pre- and postoperatively.All of the patients were satisfied with their postoperative appearance, and the symptoms of eye and eyelid irritation, discharge, and visual disturbance were eliminated. Fifty-five percent of patients had complained of watering some or all of the time preoperatively, whereas only 33% admitted to occasional watering postoperatively. The average size of the graft reduced by 18% at 1 week, 39% at 1 month, and 40% at 3 months from the initial size.Fibrin tissue glue used to attach a full-thickness skin graft during cicatricial ectropion repair is an effective technique and may offer additional benefits over sutured graft fixation. Most of the reduction in graft size occurred in the first postoperative month, which indicates that the time window for modulation of the graft is in the first few weeks after surgery. The vertical graft length was affected to a greater extent than the horizontal length.
sequel to 40-1, 42, 47 see also 1641 depositions Communist Party of Kampuchea (CPK) 264-6 comparative history 6, 10, 71, 259-60 compensation claims 43, 143, 178, 186-8 'Concerning Ireland' memorandum 105 Condé, Prince of see Bourbon, Louis de, Prince of Condé conferences (Catholic/Protestant) 211-13
Cicatricial ectropion repair is effective and has a low complication rate.To evaluate the effectiveness and long-term functional outcomes of surgical repair of lower lid cicatricial ectropion.Prospective consecutive case series.Forty-four consecutive operations for cicatricial ectropion repair.Consecutive cases of cicatricial ectropion repair completed during 2007-2011 in Waikato Hospital and Hamilton Eye Clinic, New Zealand, were enrolled in the study following formal ethics approval. Ectropion repair was completed using inferior retractor repositioning, horizontal lid tightening and full-thickness skin grafting.Patient-reported symptoms and satisfaction, ectropion recurrence and punctal ectropion.Forty-four eyes of 40 patients (30 males and 10 female) were included in the study. The average age at surgery was 75 years. Watering and poor appearance were the most common presenting symptoms. Postoperative follow-up was 1-6 years (mean = 4 years). There were no major perioperative complications, one patient developed trichiasis postoperatively. There were five reoperations (11%) during the study period. Two patients underwent medial spindle procedures for symptomatic medial ectropion and three patients required additional horizontal lid tightening. Seventy percent of patients reported satisfaction with their long-term results despite the partial recurrence of symptoms in 45%. Ectropion recurrence in <1 year occurred in three patients.In this series, satisfactory appearance and symptom control were reported by 68% of patients at long-term follow-up. Preoperative marked ectropion with marked lid laxity is associated with early treatment failure and may be regarded as a relative contraindication to surgical correction with this technique. Punctal ectropion is an unreliable indicator of functional success.
A bstract Background: To describe self‐reported patterns of care for glaucoma of ophthalmologists in Australia and New Zealand and summarize current practice styles and patterns associated with glaucoma management. Methods: A questionnaire of glaucoma management practices was mailed to all ophthalmologists registered with the Royal Australian and New Zealand College of Ophthalmologists in June 2003. The questionnaire assessed practice preferences for medical management, examination techniques and indications for surgery. The results were cross‐tabulated by age, country and subspecialty training in glaucoma. Results: Fifty‐one per cent of 761 surveys were returned, 14% being from glaucoma specialists. New Zealand ophthalmologists proceeded to surgical management of glaucoma earlier than did their Australian colleagues. Australian ophthalmologists tended to use argon laser trabeculoplasty more frequently. Ninety‐six per cent of ophthalmologists routinely use gonioscopy in diagnosing glaucoma. Disc drawings and recording cup:disc ratios were the most commonly used methods of documenting disc morphology; glaucoma specialists were more likely to use imaging technologies. SITA‐Standard 24‐2 was the most commonly used modality of perimetry, and was favoured by glaucoma specialists. Conclusions: This survey represents the first Australian and New Zealand effort to identify glaucoma management practices. Although a substantial consensus was found in most areas of treatment, a few areas showed diversity. The information gathered will enable ophthalmologists to compare their own practices with those of their colleagues. In addition, this survey provides a baseline allowing future trends in management to be determined.
purpose. To evaluate the relationship between abnormalities detected by the multifocal visual-evoked potential (mfVEP) compared with those detected by static achromatic automated perimetry in patients with compressive optic neuropathy. methods. Fifteen patients of mean age 50.8 years, with known compressive optic neuropathy from chiasmal lesions, underwent monocular mfVEP and 24-2 SITA-standard Humphrey visual field (HVF; Carl Zeiss Meditec, Dublin CA) testing in each eye. Visual field spatial agreement and extent of involvement were analyzed by assigning a severity score to each quadrant, based on pattern deviation and amplitude deviation probability plots. results. HVF mean deviation (MD) was −6.54 ± 7.43 dB (mean), and the mfVEP mean AccuMap Severity Index (ASI; ObjectiVision Pty. Ltd., Sydney, Australia) score was 81 ± 74. MD and ASI correlated significantly (r = −0.55, P = 0.024). Although both mfVEP and HVF reported approximately the same proportion of visual fields as abnormal (70%, 21/30, and 87%, 26/30, respectively), 19% (5/26) with abnormal HVF were labeled normal or borderline by mfVEP. The agreement for field quadrants between instruments was 69% (κ = 0.33). mfVEP severity scores for quadrants and hemifields were higher than scores for HVF in the same eyes. The superotemporal quadrant showed the strongest correlation between techniques (r = 0.73, P = 0.002). conclusions. In the first study to compare mfVEP to HVF in patients with compressive optic neuropathy, there was good qualitative and quantitative agreement between tests, though findings were in only modest agreement in some areas. The injury caused by compressive optic neuropathy may be usefully identified by mfVEP. Improved methods of analysis may increase the diagnostic utility of the method.
A bstract Giant cell arteritis (GCA) is an immune‐mediated vasculitis, affecting medium‐ to large‐sized arteries, in individuals over the age of 50 years. Visual loss is a frequent complication of GCA, and once it occurs it tends to be both permanent and profound. Although major advances have been made in recent years in genetics, molecular biology and the description of the vessel wall morphology, the aetiology and pathogenesis of GCA are still incompletely understood. Over the years there has been much debate over whether polymyalgia rheumatica and GCA are separate or linked entities. Recent investigations support that polymyalgia rheumatica and GCA are two different expressions of the same underlying vasculitic disorder. A single cause or aetiological agent has not as yet been identified. Except for the histopathology of the arterial wall, there are no laboratory findings specific for GCA, and no particular signs or symptoms specific for the diagnosis. GCA typically causes vasculitis of the extracranial branches of the aorta and spares intracranial vessels. Transmural inflammation of the arteries induces luminal occlusion through intimal hyperplasia. Clinical symptoms reflect end‐organ ischaemia. Branches of the external and internal carotid arteries are particularly susceptible. Corticosteroids remain the only proven treatment for GCA, the regimen initially involving high doses followed by a slow taper. However, early detection and treatment with high‐dose corticosteroids is effective in preventing visual deterioration in most patients.
A bstract Purpose: To summarize current practice styles and patterns associated with glaucoma management in ophthalmologists of Australia and New Zealand as derived from a survey. Method: A questionnaire was sent to all Australian and New Zealand ophthalmologists, which anonymously assessed demographic characteristics and prescribing patterns for each major class of glaucoma medication. Results: A total of 761 questionnaires were sent with a response rate of 51%. Of respondents 14% were glaucoma subspecialists. In 69%, the first‐line drug‐class of choice was a prostaglandin analogue. New Zealand ophthalmologists favoured beta‐blockers as their first‐line agent because of cost, government restrictions and familiarity. Most respondents stated ‘hypotensive efficacy’ as the most important factor in class choice. Alpha‐2‐agonists, carbonic anhydrase inhibitors and miotics were considered second‐line agents, because of side‐effects and lack of hypotensive potency. Conclusions: The choice of first‐line agent for the treatment of glaucoma differed between Australian and New Zealand ophthalmologists, in part as the result of government restriction of prostaglandin‐class drugs. Practice patterns seen in Australasia parallel the current evidence base reported in peer‐reviewed literature.
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