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      Agreement between optical coherence tomography and fundus fluorescein angiography in post-cataract surgery cystoid macular edema Translated title: Concordância entre tomografia de coerência óptica e angiofluoresceinografia no edema macular cistóide secundário a cirurgia de catarata

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          Abstract

          PURPOSE: To evaluate the agreement between optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) regarding the detection of cystoid macular edema (CME) following cataract surgery. METHODS: Retrospective comparative observational series of 25 eyes with suspected CME. Patients with low visual acuity and alterations in fundus biomicroscopy after cataract surgery underwent OCT scanning followed by FFA on the same visit. The diagnosis of CME was established considering fluorescein leakage on FFA and retinal thickness and/or cystoid spaces and/or subretinal fluid on OCT. RESULTS: Twenty-five eyes of 25 patients were enrolled. Twenty-two eyes had similar results on both OCT and FFA, of which 15 eyes had CME and 7 eyes had no CME. Two eyes had CME detected only by FFA and one eye only by OCT. The agreement between the two examinations was good (Kappa = 0.7331; p=0.0001) with no tendency to have neither more positive nor negative findings (p=1.0). CONCLUSION: According to these preliminary data, OCT seems to be as effective as FFA to detect CME with a good agreement between the two techniques.

          Translated abstract

          OBJETIVO: Avaliar a concordância entre tomografia de coerência óptica (OCT) e angiofluoresceinografia (AF) no diagnóstico do edema macular cistóide (EMC) secundário a cirurgia de catarata. MÉTODOS: Estudo retrospectivo observacional comparativo de 25 olhos com provável EMC. Pacientes com baixa de acuidade visual e alterações na biomicroscopia de fundo após cirurgia de catarata foram submetidos aos exames de OCT e AF na mesma visita. O diagnóstico do EMC foi realizado considerando a presença de vazamento de fluoresceína na angiografia e o espessamento retiniano e/ou espaços cistóides e/ou líquido subretiniano pela OCT. RESULTADOS: Vinte e cinco olhos de 25 pacientes foram avaliados. Vinte e dois olhos mostraram resultados semelhantes no OCT e AF, sendo que 15 olhos apresentaram EMC e 7 olhos não apresentaram EMC. Dois olhos com EMC foram diagnosticados apenas pela AF e um olho apenas pelo OCT. A concordância entre os exames foi boa (Kappa = 0,7331; p=0,0001) sem tendência para achados positivos ou negativos (p=1,0). CONCLUSÃO: Conforme este estudo preliminar, OCT parece ser tão efetiva quanto a AF na detecção do EMC com boa concordância entre os dois métodos.

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          Fluorescein angiography complication survey.

          This is a report on the results of a national survey designed to study the nature and frequency of moderate and severe complications of intravenous fluorescein angiography. In this survey, 2434 responding ophthalmologists reported on 221,781 fluorescein angiograms performed in the year 1984. Adverse reactions were classified as mild, moderate, severe, and death, depending on the duration of the effect, the necessity for medical intervention, the time required for its resolution, and the final outcome. The frequency rate for a moderate reaction was (1:63), for a severe reaction (1:1900), and for death (1:222,000). A review of previous studies on adverse reactions to the drug, a compilation of suggested methods for the amelioration and prevention of the complications, and a comparison of the responses of the general ophthalmic public to the members of The Macula Society are also reported.
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            Comparison between optical coherence tomography and fundus fluorescein angiography for the detection of cystoid macular edema in patients with uveitis.

            To compare optical coherence tomography (OCT) with fundus fluorescein angiography (FFA) for the detection of cystoid macular edema (CME) in patients with uveitis. Prospective comparative observational series. One hundred twenty-one eyes of 58 patients with uveitis of varied causes (seven patients were studied twice). Patients with suspected CME underwent OCT scanning followed by FFA at the same visit. Detection and distribution of macular edema. One hundred eight eyes had similar results on both OCT and FFA in that 67 eyes had CME and 41 eyes had no CME. In 10 eyes subretinal fluid was detected on OCT but not FFA. Five of these eyes had CME on FFA but not OCT. Three other eyes had CME that was detected by FFA but not by OCT. Compared with FFA, the OCT sensitivity for detecting CME was 96% (including the eyes with subretinal fluid), and the OCT specificity was 100%. OCT is as effective at detecting CME as is FFA but is superior in demonstrating axial distribution of fluid.
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              Ketorolac versus prednisolone versus combination therapy in the treatment of acute pseudophakic cystoid macular edema.

              To evaluate the efficacy of ketorolac tromethamine 0.5% ophthalmic solution, prednisolone acetate 1.0% ophthalmic solution, and ketorolac and prednisolone combination therapy in the treatment of acute, visually significant, cystoid macular edema (CME) occurring after cataract extraction surgery. Randomized, double-masked, prospective trial. Twenty-eight patients who had undergone cataract extraction and in whom clinical CME developed within 21 to 90 days after cataract surgery. Patients were randomized to topical therapy with ketorolac (group K), prednisolone (group P), or ketorolac and prednisolone combination therapy (group C) four times daily. Treatment was continued until CME resolved or for 3 months, whichever occurred first. Treatment was then tapered over 3 weeks. Examinations were monthly and included Snellen visual acuity, contrast sensitivity, Amsler grid, slit-lamp examination, dilated fundus examination, and fluorescein angiography. Twenty-six of 28 patients completed the study. Patients were enrolled an average of 48 days after surgery. The average improvements in Snellen visual acuity were as follows: 1.6 lines in group K, 1.1 lines in group P, and 3.8 lines in group C. This reached statistical significance for all visits when group C was compared with group P, and for visits 4 and 5 when group C was compared with group K. Group C reached a mean change of two lines or more by visit 2; at no time did either group K or P reach a mean two-line improvement. At no time was a significant difference detected between group K and P with regard to visual acuity or change from baseline. A two-line or more improvement in Snellen acuity was achieved in 16 of 26 patients (61%). Analysis by group revealed four of eight patients (50%) in group P, six of nine patients (67%) in group K, and eight of nine patients (89%) in group C who had achieved a two-line or more improvement. In patients who did improve two lines or more, improvement occurred an average of 2.75 months after initiating therapy in group P, 1.43 months in group K, and 1.33 months in group C. Improvements in contrast sensitivity and leakage on fluorescein angiography tended to mirror improvements in Snellen acuity. Treatment of acute, visually significant pseudophakic CME with ketorolac and prednisolone combination therapy appears to offer benefits over monotherapy with either agent alone. Patients were more likely to experience recovery of two lines or more of visual acuity. Patients treated with combination therapy or ketorolac monotherapy responded more quickly than did patients treated with prednisolone alone.
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                Author and article information

                Journal
                abo
                Arquivos Brasileiros de Oftalmologia
                Arq. Bras. Oftalmol.
                Conselho Brasileiro de Oftalmologia (São Paulo, SP, Brazil )
                0004-2749
                1678-2925
                December 2003
                : 66
                : 6
                : 771-774
                Affiliations
                [01] orgnameUniversidade Federal de São Paulo orgdiv1Pronto Socorro de Oftalmologia
                [02] orgnameUniversidade Federal de São Paulo orgdiv1Setor de Glaucoma
                [03] orgnameUniversidade Federal de São Paulo orgdiv1Setor de Catarata
                [05] orgnameUniversidade Federal de São Paulo
                [06] orgnameUniversidade Federal de São Paulo orgdiv1Setor de Trauma Ocular e Pronto Socorro de Oftalmologia
                [04] orgnameUniversidade Federal de São Paulo orgdiv1Setor de Documentação Fotográfica
                Article
                S0004-27492003000700007 S0004-2749(03)06600607
                10.1590/S0004-27492003000700007
                4eef2619-c883-4c27-a376-de990c14d3b3

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 20 June 2003
                : 16 September 2003
                : 20 May 2002
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 12, Pages: 4
                Product

                SciELO Brazil


                Macular edema, cystoid,Cataract extraction,Fluorescein angiography,Tomography,Comparative study,Edema macular cistóide,Extração de catarata,Angiofluoresceinografia,Tomografia,Estudo comparativo

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