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.
Purpose
To translate, adapt and validate the Endometriosis Health Profile-5 (EHP-5) in Croatian population.
Methods
This validation study is a part of a prospective, observational study (EHP-5 CRO) ...with aim of implementation of EHP-5 and to provide better insight in quality of life consideration of women with endometriosis in Croatian clinical practice. A 150 consecutive patients with surgically proven endometriosis were enrolled. The translation to Croatian followed standardized procedure. Cronbach's Alpha was calculated to calculate internal consistency reliability of EHP-5. The test–retest reliability was calculated using intraclass correlation coefficient (ICC). The
t
test for independent samples was used to assess known-groups validity.
Results
Both EHP-5 core and EHP-5 modular parts of the questionnaire had good internal consistency, assessed by the Cronbach’s Alpha coefficient (
α
= 0.793 and
α
= 0.842, respectively). Obtained results indicate very good reliability for core as well as for modular part of EHP-5 questionnaire (ICC = 0.896 and 0.936, respectively). The independent
t
test showed that women who reported their pain with VAS scale 7 or more had significantly higher results (
p
< 0.001) on EHP-5 (
M
= 50.63) compared with women who reported their pain 6 or less (
M
= 26.91). Furthermore, we found statistically significant difference between women who are infertile with women who are fertile (
p
< 0.001), whereby infertile women had higher average result on EHP-5 (
M
= 49.55) compared with fertile women (
M
= 34.36).
Conclusions
The Croatian version of the EHP-5 have very good psychometric characteristics and can be used as a reliable tool for assessing patients with endometriosis in everyday clinical practice.
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.
Conventional Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK) is a corneal transplantation procedure where the patient's inner dysfunctional layer is replaced with donor lamella. The ...data currently present in the literature about the correlation between lamellar thickness and visual acuity is sometimes contradictory and lacks clarity.
Study included 55 eyes that underwent the conventional DSAEK procedure. Patients had no other comorbidities that could affect visual acuity. Data about lamellar thickness and visual acuity were measured six months after surgery with anterior segment optical coherent tomography (A5-OCT).
The results show that visual acuity before surgery improved from 0.82 to 0.25 logMAR after surgery. Better visual acuity of 0.20 logMAR was achieved with postoperative lamellas thinner than 124 μm, while statistically significantly lower visual acuity of 0.29 logMAR was gained with postoperative lamellas thicker than 124 μm.
Our results suggest that the goal after conventional DSAEK is to have postoperative lamellas thinner than 124 μm in the eye, as this will result in better postoperative visual acuity. This value represents the optimal thickness for conventional DSAEK surgery that could minimize tissue loss for eye banks and surgeons may experience fewer problems during surgery, while obtaining good final visual acuity.
Introduction
Lacrimal gland prolapse (LGP) is a term used to describe a benign, anterior displacement of the lacrimal gland. If this condition is not properly addressed during upper blepharoplasty, ...the aesthetic and functional results are less than optimal. This study aimed to report the surgical outcomes of upper blepharoplasty combined with dacryoadenopexy in patients with LGP.
Methods
We reported an unusual case of severe LGP in a young patient. In addition, we performed a systematic review of the English literature on surgical cases of LGP published between 1973 and 2023. Eligible articles were analyzed for individual patient data (IPD) and aggregate patient data (APD). The primary predictor variable was the surgical technique used for lacrimal gland repositioning/suspension. The primary outcome variable was relapse rate.
Results
The bibliographic search retrieved 488 surgical cases of LGP: 12 in IPD, and 476 in APD datasets. The relapse rates in the IPD and APD cohorts were 8.3% (1/12) and 1.2% (6/476), respectively. Within the APD dataset, no significant difference in the relapse rates between dacryoadenopexy via suture suspension and Whitnall’s ligament suspension (5/409 and 1/20, respectively;
P
> 0.05) was observed. Light cauterization of the lacrimal gland capsule and surrounding soft tissues was performed in mild LGP cases (< 4 mm prolapse), with a relapse rate of 0% (0/47).
Conclusion
Upper blepharoplasty combined with dacryoadenopexy proved to be a safe surgical procedure with very satisfactory aesthetic outcome and minimal relapse rate.
Level of Evidence III
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors
www.springer.com/00266
.
Purpose
This study aimed to evaluate the level of treatment adherence and identify predictors of adherence in glaucoma patients during the coronavirus disease 2019 (COVID-19) pandemic in Zagreb, ...Croatia.
Methods
The cross-sectional study was conducted among primary open-angle glaucoma (POAG) patients at the Department of Ophthalmology, University Hospital Centre Zagreb, between 1st April 2020 and 1st April 2021. The sociodemographic data, clinical, and drug information were recorded. The treatment adherence was assessed through a self-administered questionnaire, the Culig Adherence Scale (CAS). Statistical analyses were performed using TIBCO Statistica™ 14.0.0.
Results
113 POAG patients (48M/65F) with a mean age of 65.89 ± 8.53 years were included in this study. According to the CAS, only 39.8% of patients adhered to topical glaucoma treatment. Educational level was positively related to adherence to treatment (p = 0.022). The main predictors for adherence were the patients' positive attitude towards the drug's effect, family support, and good relationship with the healthcare providers (p < 0.05, respectively). The majority of patients stated forgetfulness as the main reason for skipping drug dosing.
Conclusions
Non-adherence to treatment was prevalent among patients with POAG during the COVID-19 pandemic in Zagreb, Croatia. Personal beliefs and attitudes towards treatment, family support, and patient-healthcare provider relationship were significant predictors of adherence. Special consideration should be given to the whole health system-level strategies targeting the adherence to treatment, especially in crises, in order to achieve positive therapeutic outcomes.
The study protocol was registered in the DRKS - German Clinical Trials Register, DRKS-ID: DRKS00022081.
We present a patient with concurrent pigmentary glaucoma, bilateral central serous chorioretinopathy and unilateral optic disc pit, and propose a possible association of these conditions. ...Comprehensive ophthalmic examination of a 36-year-old man who was complaining of blurry vision and pain in the eyes showed reduced visual acuity on the left eye, elevated intraocular pressure in the right eye, bilateral signs of pigment dispersion syndrome, and bilateral central serous chorioretinopathy, combined with optic disc pit in the left eye. Visual field and optical coherence tomography findings demonstrated functional and structural glaucoma changes. Choroidal circulation abnormalities were observed by angiographic methods. Genetic and developmental anomalies of the external layer of the optic disc cup that gives rise to many anterior and posterior eye segment structures suggest a possible association of a clinical condition characterized by the combination of pigmentary glaucoma, central serous chorioretinopathy and optic disc pit. Future research would enable to determine proper diagnostic protocols, treatment and follow-up procedures for this chronic-progressive disorder.
- The purpose of this study was to evaluate postoperative deturgescence of lamellar donor graft after conventional Descemet's stripping automated endothelial keratoplasty (DSAEK). It was a ...prospective study that included 55 eyes of patients (mean age 70.9±9.4 years; female 61.8%, male 38.2%). Preoperative thickness of lamella was compared with postoperative thickness six months after surgery. Central lamellar graft thickness decreased from 142±27 µm preoperatively to 124±20 µm 6 months postoperatively (p<0.01). After performing conventional DSAEK corneal transplantation, surgeons should expect deturgescence of corneal graft and reduction in thickness of lamellae by about 12% of initial thickness according to our results. We found this information important for better planning of surgical procedures and knowing what to expect after surgery, as well as for better cooperation with eye banks when ordering pre-cut corneal tissue.
Background: The COVID-19 epidemic and earthquakes in Croatia during 2020 suddenly disrupted everyday life and caused
psychological disturbances in population. The purpose of the present study was to ...assess the prevalence of anxiety symptoms and the
level of treatment adherence in glaucoma patients during the pandemic. The paper also aimed to evaluate the correlation between
anxiety symptoms, treatment adherence and treatment outcomes in the studied cohort.
Subjects and methods: This cross-sectional study was conducted among primary open-angle glaucoma (POAG) patients at the
Department of Ophthalmology, Zagreb University Hospital Center, during one year. The Beck Anxiety Inventory (BAI) was used to
measure the level of anxiety symptoms. Treatment adherence was estimated by the Culig adherence scale (CAS). Glaucoma damage
was determined for each patient from the level of structural and functional impairment of the worse eye, by retinal nerve fiber layer
(RNFL) thickness and mean defect (MD), respectively. Statistical analyses were performed, with a P value of less than 0.05
considered being statistically significant.
Results: This study included 113 POAG patients, with a mean age of 65.89 years. The median of the BAI total score in all
patients was 10. According to the CAS, 60.2% of patients were non-adherent to glaucoma treatment during the COVID-19 outbreak.
The BAI total score was significantly negatively related to adherence to local glaucoma treatment (p<0.001). A significant negative
association was also observed between adherence and MD (p=0.017), while no correlation was found between adherence and RNFL
thickness (p=0.228).
Conclusion: Considerable proportion of patients with glaucoma have shown non-adherence to treatment during the COVID-19
pandemic. Anxiety severity was associated with lower adherence, thus indirectly influencing therapeutics outcomes. Special
consideration should be given to the strategies promoting mental health and interventions focusing on treatment adherence in
glaucoma patients in a time of emergencies.
Central vision loss, photopsia, floaters, and macular edema in a highly myopic patient can easily be misinterpreted as high myopia complications. In atypical cases, detailed examination and a ...thorough diagnostic workup are required to establish the proper diagnosis, which is often beyond the scope of diagnoses initially considered.
Careful examination of the patient by an experienced ophthalmologist, together with the use of adequate diagnostic protocols, results in accurate diagnoses and initiation of proper therapy, with the ultimate aim to preserve vision in the patient.
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