Purpose. To describe the ocular findings in subjects with congenital heart disease (CHD). Methods. In a prospective study, the same observer examined 240 consecutive patients with CHD admitted to the medical centre. T...Purpose. To describe the ocular findings in subjects with congenital heart disease (CHD). Methods. In a prospective study, the same observer examined 240 consecutive patients with CHD admitted to the medical centre. Two independent geneticists performed identification of syndromes. Results. The commonest anatomic cardiac anomalies were ventricular or atrial septal defects (62), tetralogy of Fallot (39), pulmonary stenosis (25), and transposition of the great arteries (24). The heart lesions were divided physiologically into volume overload (90), cyanotic (87), and obstructive (63). In all, 105 syndromic subjects included the velocardiofacial syndrome (18), Down’ s syndrome (17), CHARGE association (6), DiGeorge syndrome (5), Williams syndrome (3), Edwards syndrome (3), Noonan syndrome (3), VACTERL association (2), and Patau syndrome (trisomy 13) (2). The paediatric team recognized 51 patients as syndromic. Two independent geneticists recognized additional 54 patients as syndromic. Positive eye findings were present in 55% (132) and included retinal vascular tortuosity (46), optic disc hypoplasia (30), trichomegaly (15), congenital ptosis (12), strabismus (11), retinal haemorrhages (8), prominent eyes (7), and congenital cataract (6). There was a strong correlation between the retinal vascular tortuosity and both a low haematocrit (P=0.000) and a low arterial oxygen saturation (P=0.002). Conclusions. Patients with CHD are at a high risk for ocular pathology and need screening for various ocular abnormalities.展开更多
Purpose. To ascertain the therapeutic effect of periocular corticosteroids in diabetic papillopathy. Methods. Prospec-tively, five consecutive adult-onset diabetic patients with symptomatic diabetic papillopathy under...Purpose. To ascertain the therapeutic effect of periocular corticosteroids in diabetic papillopathy. Methods. Prospec-tively, five consecutive adult-onset diabetic patients with symptomatic diabetic papillopathy underwent visual fields and fluorescein angiography before and after superonasal subtenon injection of corticosteroids. Results. The median duration of papillopathy was 2.5 weeks by ophthalmoscopy and 3 weeks by fluorescein angiography. The median recovery time of best-spectacle-corrected visual acuity was 2 weeks. Two patients developed sequential diabetic papillopathy, and both reported faster visual recovery and better subjective vision in treated eyes. In these two patients, the final best-spectacle-corrected visual acuity and visual evoked responses were comparable between the two eyes, while automated visual fields were less constricted in treated eyes. Complications included ocular hypertension, mild progression of cataract, and mild ptosis in one patient each. Conclusions. Periocular corticosteroids shortened the duration of diabetic papillopathy from a reported median of 5 months to 3 weeks in the present uncontrolled observational study, partly by their angiostatic and antioedema effects at the level of the anterior optic nerve. Intraocular pressure needs to be monitored in eyes receiving periocular corticosteroids.展开更多
Purpose:To ascertain factors associated with anterior ischaemic optic neuropathy(AION)following coronary artery bypass graft(CABG)in a Lebanese population.Methods:A retrospective chart review of consecutive CABG perfo...Purpose:To ascertain factors associated with anterior ischaemic optic neuropathy(AION)following coronary artery bypass graft(CABG)in a Lebanese population.Methods:A retrospective chart review of consecutive CABG performed over a 5-year period(1995-1999)in one medical centre.A comparison of clinical characteristics was carried out between AION cases and subjects free from AION.The variables analysed included history of diabetes as well as preoperative,intraoperative,or postoperative values of haematocrit,blood sugar,oxygen saturation,and arterial blood pressure.Results:A total of 1594 persons were included.Three subjects experienced acute visual loss from AION following CABG,all had diabetes mellitus,and two suffered from severe postoperative anaemia.Among diabetics(n=484),the risk of AION was significantly higher in subjects with postoperative haematocrit falling below 22(28.6%)than the rest(0.21%)(P=0.001).Blood transfusion was given in two subjects with prompt visual recovery.Conclusions:Severe anaemia in patients undergoing CABG appears to be a risk factor for AION,especially in diabetics,and needs prompt correction to prevent or reverse the ischaemic ocular events.展开更多
文摘Purpose. To describe the ocular findings in subjects with congenital heart disease (CHD). Methods. In a prospective study, the same observer examined 240 consecutive patients with CHD admitted to the medical centre. Two independent geneticists performed identification of syndromes. Results. The commonest anatomic cardiac anomalies were ventricular or atrial septal defects (62), tetralogy of Fallot (39), pulmonary stenosis (25), and transposition of the great arteries (24). The heart lesions were divided physiologically into volume overload (90), cyanotic (87), and obstructive (63). In all, 105 syndromic subjects included the velocardiofacial syndrome (18), Down’ s syndrome (17), CHARGE association (6), DiGeorge syndrome (5), Williams syndrome (3), Edwards syndrome (3), Noonan syndrome (3), VACTERL association (2), and Patau syndrome (trisomy 13) (2). The paediatric team recognized 51 patients as syndromic. Two independent geneticists recognized additional 54 patients as syndromic. Positive eye findings were present in 55% (132) and included retinal vascular tortuosity (46), optic disc hypoplasia (30), trichomegaly (15), congenital ptosis (12), strabismus (11), retinal haemorrhages (8), prominent eyes (7), and congenital cataract (6). There was a strong correlation between the retinal vascular tortuosity and both a low haematocrit (P=0.000) and a low arterial oxygen saturation (P=0.002). Conclusions. Patients with CHD are at a high risk for ocular pathology and need screening for various ocular abnormalities.
文摘Purpose. To ascertain the therapeutic effect of periocular corticosteroids in diabetic papillopathy. Methods. Prospec-tively, five consecutive adult-onset diabetic patients with symptomatic diabetic papillopathy underwent visual fields and fluorescein angiography before and after superonasal subtenon injection of corticosteroids. Results. The median duration of papillopathy was 2.5 weeks by ophthalmoscopy and 3 weeks by fluorescein angiography. The median recovery time of best-spectacle-corrected visual acuity was 2 weeks. Two patients developed sequential diabetic papillopathy, and both reported faster visual recovery and better subjective vision in treated eyes. In these two patients, the final best-spectacle-corrected visual acuity and visual evoked responses were comparable between the two eyes, while automated visual fields were less constricted in treated eyes. Complications included ocular hypertension, mild progression of cataract, and mild ptosis in one patient each. Conclusions. Periocular corticosteroids shortened the duration of diabetic papillopathy from a reported median of 5 months to 3 weeks in the present uncontrolled observational study, partly by their angiostatic and antioedema effects at the level of the anterior optic nerve. Intraocular pressure needs to be monitored in eyes receiving periocular corticosteroids.
文摘Purpose:To ascertain factors associated with anterior ischaemic optic neuropathy(AION)following coronary artery bypass graft(CABG)in a Lebanese population.Methods:A retrospective chart review of consecutive CABG performed over a 5-year period(1995-1999)in one medical centre.A comparison of clinical characteristics was carried out between AION cases and subjects free from AION.The variables analysed included history of diabetes as well as preoperative,intraoperative,or postoperative values of haematocrit,blood sugar,oxygen saturation,and arterial blood pressure.Results:A total of 1594 persons were included.Three subjects experienced acute visual loss from AION following CABG,all had diabetes mellitus,and two suffered from severe postoperative anaemia.Among diabetics(n=484),the risk of AION was significantly higher in subjects with postoperative haematocrit falling below 22(28.6%)than the rest(0.21%)(P=0.001).Blood transfusion was given in two subjects with prompt visual recovery.Conclusions:Severe anaemia in patients undergoing CABG appears to be a risk factor for AION,especially in diabetics,and needs prompt correction to prevent or reverse the ischaemic ocular events.
