BACKGROUND Anterior visual pathway lesions can cause severe visual loss.Optical coherence tomography(OCT)can detect ganglion cell complex(GCC)thinning,even with normal retinal nerve fiber layer(RNFL)thickness and subt...BACKGROUND Anterior visual pathway lesions can cause severe visual loss.Optical coherence tomography(OCT)can detect ganglion cell complex(GCC)thinning,even with normal retinal nerve fiber layer(RNFL)thickness and subtle visual field changes.AIM To determine the proportion of eyes with RNFL and GCC thinning and their association with visual parameters in patients with brain tumors undergoing surgery.METHODS A prospective study was conducted on 37 patients(69 eyes)with peri-chiasmatic and chiasmatic brain tumors undergoing surgical decompression between February 2019 and June 2020 at a tertiary care institute.A comprehensive neuroophthalmological work-up,demographic and clinical profile documentation,and six-month postoperative follow-up weredone.Statistical analysis was significant at P<0.05.RESULTS Mean age was 35.14±11.98 years.The best and worst visual outcomes were associated with the craniopharyngioma and meningioma groups,respectively(P=0.008).There was an increase in the proportion of eyes with RNFL damage in the inferior quadrant(P=0.02).Maximum GCC thickness thinning was associated with severe visual impairment.The odds of having blindness in eyes with RNFL(inferior)and GCC loss were 0.96(P=0.003)and 0.95(P=0.03),respectively.GCC thickness showed a clinically positive correlation with visual acuity(r=-0.48,P<0.001)and field defect(r=-0.27,P=0.04)at six months postoperatively.The preoperative GCC thickness and the final postoperative visual outcome were plotted in an empirical ROC curve with area under the curve=0.754.The cut-off value of RNFL(inferior)and GCC,beyond which blindness could be prevented,was 73μm and 58μm,respectively.CONCLUSION In chiasmal compression,RNFL and GCC thickness measurements using OCT can be a useful prognostic indicator for assessing visual recovery.An eye with structural damage,with significant RNFL and GCC loss,is a predictive factor of blindness.A minimum preoperative RNFL and GCC thickness of 73μm and 58μm,respectively,can preserve vision after surgery.展开更多
BACKGROUND Glaucoma is the leading cause of irreversible blindness worldwide,with 60.5 million affected individuals,of whom 11 million are from India.Due to its asymptomatic nature,the disease largely remains underdia...BACKGROUND Glaucoma is the leading cause of irreversible blindness worldwide,with 60.5 million affected individuals,of whom 11 million are from India.Due to its asymptomatic nature,the disease largely remains underdiagnosed or diagnosed in advanced stages,where little can be done to salvage functional vision.The literature suggests that a lack of knowledge is one of the reasons for its grave consequences.Assessment of awareness is the first step in planning management.Several studies have been conducted in the Indian community,but data from healthcare providers,who play a significant role in educating the masses directly or indirectly,are limited.AIM To identify awareness,knowledge,and attitudes about glaucoma among healthcare workers in a tertiary center in India.METHODS This cross-sectional study was conducted at a tertiary care institute in Eastern India.Data were collected from 423 participants by systematic stratified sampling after Institutional Ethics Committee approval via a pretested,self-designed,semistructured,validated questionnaire.Statistical analyses were performed using the Statistical Package for Social Sciences Software v22.0.Continuous variables are expressed as the means±SD for parametric values and medians with interquartile ranges for nonparametric values.The associations between the variables were studied via multivariate linear and logistic regression.P<0.05 was considered statistically significant.RESULTS Most respondents were 20–30 years old(n=345,81.6%).The knowledge regarding glaucoma was good,and almost 56.3%of the participants gained knowledge from their medical training.The majority were aware that it has a familial predisposition and is secondary to high intraocular pressure,leading to irreversible peripheral vision loss.Only 42%knew about the life-long requirements of treatment.The resident group scored highest on knowledgeand attitude-based questions,whereas the faculty group scored highest on practice-based questions.Although 62%of the nursing staff had good attitude scores,their knowledge and practice scores were lower.The occupation group response difference was statistically significant(P<0.05)for all the knowledge-based questions.CONCLUSION Although the majority of healthcare providers are aware of glaucoma,there is a dearth of knowledge about treatment modalities.Education via seminars and media can improve their knowledge,attitudes,and practices.展开更多
文摘BACKGROUND Anterior visual pathway lesions can cause severe visual loss.Optical coherence tomography(OCT)can detect ganglion cell complex(GCC)thinning,even with normal retinal nerve fiber layer(RNFL)thickness and subtle visual field changes.AIM To determine the proportion of eyes with RNFL and GCC thinning and their association with visual parameters in patients with brain tumors undergoing surgery.METHODS A prospective study was conducted on 37 patients(69 eyes)with peri-chiasmatic and chiasmatic brain tumors undergoing surgical decompression between February 2019 and June 2020 at a tertiary care institute.A comprehensive neuroophthalmological work-up,demographic and clinical profile documentation,and six-month postoperative follow-up weredone.Statistical analysis was significant at P<0.05.RESULTS Mean age was 35.14±11.98 years.The best and worst visual outcomes were associated with the craniopharyngioma and meningioma groups,respectively(P=0.008).There was an increase in the proportion of eyes with RNFL damage in the inferior quadrant(P=0.02).Maximum GCC thickness thinning was associated with severe visual impairment.The odds of having blindness in eyes with RNFL(inferior)and GCC loss were 0.96(P=0.003)and 0.95(P=0.03),respectively.GCC thickness showed a clinically positive correlation with visual acuity(r=-0.48,P<0.001)and field defect(r=-0.27,P=0.04)at six months postoperatively.The preoperative GCC thickness and the final postoperative visual outcome were plotted in an empirical ROC curve with area under the curve=0.754.The cut-off value of RNFL(inferior)and GCC,beyond which blindness could be prevented,was 73μm and 58μm,respectively.CONCLUSION In chiasmal compression,RNFL and GCC thickness measurements using OCT can be a useful prognostic indicator for assessing visual recovery.An eye with structural damage,with significant RNFL and GCC loss,is a predictive factor of blindness.A minimum preoperative RNFL and GCC thickness of 73μm and 58μm,respectively,can preserve vision after surgery.
文摘BACKGROUND Glaucoma is the leading cause of irreversible blindness worldwide,with 60.5 million affected individuals,of whom 11 million are from India.Due to its asymptomatic nature,the disease largely remains underdiagnosed or diagnosed in advanced stages,where little can be done to salvage functional vision.The literature suggests that a lack of knowledge is one of the reasons for its grave consequences.Assessment of awareness is the first step in planning management.Several studies have been conducted in the Indian community,but data from healthcare providers,who play a significant role in educating the masses directly or indirectly,are limited.AIM To identify awareness,knowledge,and attitudes about glaucoma among healthcare workers in a tertiary center in India.METHODS This cross-sectional study was conducted at a tertiary care institute in Eastern India.Data were collected from 423 participants by systematic stratified sampling after Institutional Ethics Committee approval via a pretested,self-designed,semistructured,validated questionnaire.Statistical analyses were performed using the Statistical Package for Social Sciences Software v22.0.Continuous variables are expressed as the means±SD for parametric values and medians with interquartile ranges for nonparametric values.The associations between the variables were studied via multivariate linear and logistic regression.P<0.05 was considered statistically significant.RESULTS Most respondents were 20–30 years old(n=345,81.6%).The knowledge regarding glaucoma was good,and almost 56.3%of the participants gained knowledge from their medical training.The majority were aware that it has a familial predisposition and is secondary to high intraocular pressure,leading to irreversible peripheral vision loss.Only 42%knew about the life-long requirements of treatment.The resident group scored highest on knowledgeand attitude-based questions,whereas the faculty group scored highest on practice-based questions.Although 62%of the nursing staff had good attitude scores,their knowledge and practice scores were lower.The occupation group response difference was statistically significant(P<0.05)for all the knowledge-based questions.CONCLUSION Although the majority of healthcare providers are aware of glaucoma,there is a dearth of knowledge about treatment modalities.Education via seminars and media can improve their knowledge,attitudes,and practices.
