Purpose: To determine the feasibility of non-invasive tear break-up time (NIBUT) assessment using the Handheld tear lipid layer thickness assessment instrument and compare it with the standard tear ...break-up time (TBUT) test and other dry eye tests.
Subjects and methods: 108 subjects were enrolled, 56 with and 52 without dry eye symptoms. Schein questionnaire was used to determine the severity of dry eye symptoms. Ocular signs were assessed by NIBUT, TBUT, lipid layer thickness (LLT), lid-parallel conjunctival folds (LIPCOF), conjunctival hyperemia, and corneal staining.
Results: Median NIBUT and TBUT, and other clinical test values significantly differed among the dry eye symptoms group and control group. NIBUT yielded the most significant difference between the groups (NIBUT: 7 sec vs. 17.5 sec, p < .001, Z = 5.94; TBUT: 5 sec vs. 10 sec, p < .001, Z = 4.38; LLT: p = .007; LIPCOF: p < .001, conjunctival hyperemia: p < .047, corneal staining: p < .010). Spearman's test showed a significant correlation between NIBUT and TBUT (p < .001), NIBUT and LLT (p = .001), NIBUT and LIPCOF (p = .019), NIBUT and conjunctival hyperemia (p = .002), and NIBUT and corneal staining (p = .012) in the dry eye symptoms group. NIBUT did not significantly differ among the three measurements in both groups of patients (p = .061, p = .096), while TBUT values did in the control group (p < .001). Short NIBUT values were the main predictors and indicators of dry eye complaints (AOR = 0.87, p < .001), superior to TBUT (AOR = 0.88, p = .008) and other tests even after adjustment for age and gender.
Conclusion: NIBUT measured by Handheld instrument is a simple, accessible, practical, and, most of all, reproducible and objective method that might allow NIBUT assessment on a regular basis.
To compare the incidence and intensity of posterior capsule opacification (PCO) between two intraocular lenses (IOLs) over three years.
Eighty-three patients underwent cataract surgery with ...implantation of Acreos Adapt AO or Acrysof SA60AT. PCO values were assessed using a photographic image analysis system (EPCO 2000) and the amount of PCO at the slit lamp.
Mean PCO score was 2.78 ± 1.55 for the Acreos Adapt AO and 2.32 ± 1.20 for the Acrysof SA60AT (P=.229). There were no significant differences in the median EPCO values in the entire IOL optics area (0.60 ± 0.26 vs 0.58 ± 0.23; P=.745) and in the central 3-mm zone (0.28 ± 0.13 vs 0.27 ± 0.12; P=.638). Neodymium:YAG capsulotomy was performed in 28% of eyes with Acreos Adapt AO and 23.33% with Acrysof SA60AT (P=.692).
Both IOLs had comparable PCO and Nd:YAG rates three years postoperatively.
Purpose
The purpose of the study was to translate, adapt and validate the Croatian version of the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) in participants with visual ...impairment. This study also aims at evaluating the relationship between visual impairment and health-related quality of life (HRQoL).
Methods
The prospective observational study was conducted at the University Hospital Centre Zagreb, Department of Ophthalmology. The sample consisted of 175 patients with four chronic ocular diseases: cataract, glaucoma, diabetic retinopathy and age-related macular degeneration. The translation of the NEI VFQ-25 to Croatian was conducted following the standardised procedure. All participants underwent an ophthalmological examination and completed the NEI VFQ-25 and the Medical Outcomes Study Short Form-36 Questionnaire (SF-36). In order to assess the psychometric properties of the NEI VFQ-25, we calculated Cronbach’s α coefficient, intraclass correlation coefficient (ICC), convergent and discriminant validity, as well as criterion and concurrent validity.
Results
Results show high internal consistency (Cronbach
α
range 0.739–0.932) and high test–retest reliability (ICC 0.876–0.975) for all subscales. None of the items had failed either convergent or discriminant validity. Moderate to high Spearman’s rho coefficients of correlations were found between best corrected visual acuity and eight subscales in the NEI VFQ-25 (0.430 <
ρ
< 0.631). Moderate correlations were found between comparable domains in the NEI VFQ-25 and in the SF-36 questionnaire (
p
< 0.01).
Conclusion
The Croatian version of the NEI VFQ-25 has very good psychometric properties and can be a useful instrument for assessing vision-related quality of life in Croatian population with chronic ophthalmic diseases.
A lot of pathological conditions could provoke damaging of the innervations of the cornea and lead to persistent epithelial defect (PED). AMX is lyophilized preparation of amniotic membrane (AM), ...which contains biological components and efficacy of AM for treatment of the corneal surface defects. In processing all the substances essential for biological effects of AM are preserved (growth factors, neutrophins, interleukins, receptors, fibronectins and different types of collagen). A patient can apply AMX as eye drops by himself in his home, thus avoiding surgical procedure. We presented two patients with PED; we treated them with eye drops of AMX, 2 drops every hour during day time. There was observed healing effect by reducing epithelial defect. Almost after a second day of application, and after 1-2 week period PED that persisted for weeks healed completely.
Cloninger's psychobiosocial model of personality proposes that consistent patterns of health behavior are determined by the complex interaction of different neurobiological processes of the patient's ...temperament and character dimensions. Poor medication adherence is a pervasive problem among glaucoma patients and can lead to increased morbidity and disability. The objective of the present study was to investigate the association between Cloninger's personality dimensions and medication adherence among glaucoma patients.
The cross-sectional study was conducted among 113 primary open-angle glaucoma (POAG) patients. The treatment adherence was assessed through a valid and reliable self-administered questionnaire, the Culig Adherence Scale (CAS). Personality dimensions were evaluated using the abbreviated version of the Temperament and Character Inventory-Revised (TCI-140). Statistical analyses were performed using TIBCO Statistica 14.0.1. The study protocol was registered in the DRKS - German Clinical Trials Register; (DRKS-ID: DRKS00022081).
According to CAS, only 39.8% of patients were adherent to glaucoma treatment. Adherence was significantly negatively related only to the character dimension of Self-Transcendence (
< 0.05). No other TCI-140 dimension was significantly associated with medication adherence (
> 0.05).
The results suggest that POAG patients with higher scores on the Self-Transcendent personality dimension are more likely to experience difficulties adhering to medication regimen. The study highlights the importance of a holistic approach to glaucoma treatment, which takes into account not only the biological aspects of disease but also the psychosocial factors that influence patient behavior. Healthcare providers may need to consider glaucoma patients' personality dimensions, beliefs and values when developing treatment plans and strategies to improve medication adherence.
The aim was to determine feasibility and reliability of noninvasive tear break-up time (NIBUT) assessment using handheld lipid layer examination instrument, and to compare it with standard tear ...break-up time (TBUT) test. Fifty patients were enrolled, 31 with and 19 without dry eye symptoms. Schein questionnaire was used to assess dry eye symptoms. During examination, three NIBUT measurements were performed on each eye using handheld instrument, followed by three TBUT measurements. Receiver operating characteristic curves, sensitivity, specificity and logistic regression analysis were generated. Median NIBUT values were significantly shorter in dry eye symptom group than in control group in all three measurements (9, 8 and 8 s
. 21, 22 and 21 s; p<0.001). TBUT values showed no significant difference between the groups in the first measurement (p=0.053), but the values were significantly shorter in dry eye symptom group in second and third measurements (p=0.020). The cutoff value to distinguish patients with symptoms of dry eye from control group was 12 seconds for NIBUT and 8 seconds for TBUT, with NIBUT having significantly higher sensitivity, specificity, area under the receiver operating characteristic curve and positive predictive value. NIBUT, measured by handheld lipid layer examination instrument, was superior to TBUT in detecting dry eye.
: To determine the 6-month effect of conventional (CXL30) and accelerated cross-linking with a UVA intensity of 9 mW/cm
(CXL10) on corneal stability and to investigate whether there was a difference ...in ABCD grading system parameters regarding the two different procedures.
: Twenty-eight eyes of 28 patients with a documented keratoconus (KN) progression were included. Patients were selected to undergo either epi off CXL30 or CXL10. At the baseline and the follow-up visits after one (V1), three (V2), and six months (V3), the patients underwent complete ophthalmic examination and corneal tomography.
: In the CXL30 group, all the parameters from the ABCD grading system significantly changed from baseline to V3; parameter A decreased (
= 0.048), B and C increased (
= 0.010,
< 0.001), and D decreased (
< 0.001). In the CXL10 group, there were no changes in parameters A (
= 0.247) and B (
= 0.933), though parameter C increased (
= 0.001) and D decreased (
< 0.001). After an initial decline after one month, visual acuity (VA) recovered on V2 and V3 (
< 0.001), and median maximal keratometry (Kmax) decreased in both groups (
= 0.001,
= 0.035). In the CXL30 group, there were significant changes in other parameters; average pachymetric progression index (
< 0.001), Ambrósio relational thickness maximum (ARTmax) (
= 0.008), front and back mean keratometry (
< 0.001), pachymetry apex (PA) (
< 0.001), and front elevation (
= 0.042). However, in the CXL10 group, there were significant changes only in ARTmax (
= 0.019) and PA (
< 0.001).
: Both epi-off CXL protocols showed similar short-term efficacy in improving VA and Kmax, halting the progression of KN, and both similarly changed tomographic parameters. However, the conventional protocol modified the cornea more significantly.
Purpose: To evaluate the effect of switching from preserved prostaglandin analog-timolol fixed combinations (PG-timolol FCs) to preservative-free latanoprost-timolol FC (PF-LT) on intraocular ...pressure (IOP), ocular surface health, and tolerability in glaucoma and ocular hypertension (OH) patients with the concurrent ocular surface disease (OSD). Methods: This was a longitudinal, prospective, interventional, real-life study among 42 patients. Up to 3 visits were planned, at baseline, 30, and 90 days to assess efficacy on IOP decrease and local tolerance. The severity of OSD symptoms Ocular Surface Disease Index (OSDI) questionnaire, subjective drug tolerability visual analog scale (VAS), conjunctival hyperemia (McMonnies scale), and tear break-up time (TBUT) were the main parameters assessed. Results: Data from 36 patients were available for statistical analysis. IOP was significantly reduced at day 30 and day 90 compared to baseline (16 vs 14 vs 14 mmHg, p < 0.001). Significant improvement was demonstrated in OSD symptoms, signs, and VAS scores from the baseline to the second and third visits. Median OSDI (27.1 vs 9.6 vs 4.2, p < 0.001), conjunctival hyperemia (2 vs 1 vs 1, p < 0.001), corneal surface staining (p < 0.001), and conjunctival staining scores (p < 0.001), and the percentage of patients with eyelid and periocular hyperemia (61.1 vs 12.5 vs 2.8%, p < 0.001), significantly decreased. TBUT (4 vs 5 vs 6 s, p < 0.001) and VAS score regarding tolerability (5 vs 2 vs 1, p < 0.001) significantly increased. Conclusion: A switch from preserved PG-timolol FCs to PF-LT improved tolerability and optimized IOP control, providing better adherence with greater chances of treatment success. Keywords: glaucoma, prostaglandin analogs, preservative, benzalkonium chloride, preservative-free, fixed combinations
The aim of this paper was to assess soft contact lens replacement habits of patients of Contact Lens Clinic, Zagreb University Hospital Department of Ophthalmology, Zagreb, Croatia. During spring of ...2010, a survey was conducted in Contact Lens Laboratory, Zagreb University Hospital Department of Ophthalmology, Zagreb, Croatia. 47 completed surveys were collected and analyzed. The results of the survey have shown that the majority of soft contact lens wearers wear them longer than recommended by the manufacturer. It also showed that they eventually replace the lenses in regular intervals, indicating that they base their lens replacement on constant criteria. The main reasons for the eventual lens replacement were increased blur or discomfort while wearing lenses. Since it is obviously impossible to convince all lens wearers to replace their lenses as recommended by the manufacturer, it is up to the contact lens practitioners to find the way to reduce the risks of lens overwear. It may be achieved by introducing a method that will enable each soft contact lens wearer to choose an optimal lens replacement regimen without risking their eye health.
Tear film status in glaucoma patients Jandroković, Sonja; Suić, Smiljka Popović; Kordić, Rajko ...
Collegium antropologicum
37 Suppl 1
Journal Article
Peer reviewed
The purpose of this study was to determine the prevalence of ocular surface disease symptoms and the state of the tear film among patients with glaucoma who are receiving topical intraocular pressure ...lowering monotherapy. 62 responders were divided in 2 groups: 32 glaucoma patients and 30 healthy individuals. Tear film break-up time (TBUT), Schirmer 1 testing and ocular surface disease questionnaire were performed in both groups. 50% glaucoma patients and 25% control group participants had dry eye symptoms. Advanced disorder in TBUT was found in seven 21.9% glaucoma patients and was not found in the control group. Basal tear secretion measured by Schirmer 1 testing was found reduced in 87% of glaucoma patients and in 16.7% control group patients. Glaucoma patients on topical intraocular pressure lowering monotherapy showed a significantly higher prevalence of ocular surface disease symptoms, significantly reduced basal tear secretion and destabilisation of tear film in comparison with healthy volunteers.
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