Biomedical subjects

Isaac Avni

Publications and source records attributed to Isaac Avni.

21 records · Page 2Linked to original sources

PubMed2003

Methotrexate as a first-line corticosteroid-sparing therapy in a cohort of uveitis and scleritis.

PURPOSE: To evaluate the clinical experience with methotrexate as a first-line corticosteroid-sparing drug in patients with resistant ocular inflammation. METHODS: We retrospectively studied 39 consecutive patients with uveitis (n = 36) or scleritis (n = 3) who were treated with methotrexate following inadequate control with corticosteroids lasting five years. Criteria for initiating treatment with methotrexate and defining outcome were strictly defined. RESULTS: The cohort included 21 females and 18 males, all Caucasians, with a mean age of 26.6 years (range: 3-73 years). Patients were followed up for 21.5 +/- 12.6 months. Treatment was discontinued due to side effects in 10 patients (26%). Of the remaining 29 patients, full or partial control of inflammation was achieved in 23 (79%). Response to treatment was observed after a mean of 2.4 +/- 0.8 months. Ten patients were fully controlled and discontinued methotrexate therapy after a mean of 20.9 +/- 9.2 months, with no recurrence of inflammation. Use of topical and systemic corticosteroids was markedly reduced in responsive patients. CONCLUSIONS: Methotrexate is recommended as a first-line adjunct to or replacement of systemic corticosteroids in the treatment of ocular inflammation.

Adolescent↗

PubMed2003

Scleral contact lenses may help where other modalities fail.

PURPOSE: To describe the vision-correcting and therapeutic benefits of gas-permeable scleral contact lenses (GP-ScCL) in the management of irregular corneal surface disorders and ocular surface diseases. METHODS: The charts of 48 consecutive patients (66 eyes) whose management included the use of GP-ScCL were reviewed. RESULTS: The most common indication for fitting the lenses was keratoconus in patients who had to stop wearing other types of corneal lenses (44 eyes, 74.6%). Other indications included extreme corneal irregularity after penetrating keratoplasty, nonhealing corneal ulcer, postoperative dry eye syndrome following laser in situ keratomileusis (LASIK), severe exposure keratitis and acid burn. Mean follow-up was 17 months (range, 2-96). Mean wearing time of the GP-ScCL was 16.2 hours per day (range, 3-18). Visual acuity of 20/40 or better was achieved in 90.9% of keratoconus patients and in 81.8% of postkeratoplasty patients. A gain of two or more Snellen lines was observed in 94.5% of eyes treated for improving vision. Marked subjective improvement in quality of life was reported by 86% of the patients, mainly as a result of improvement in their visual function and reduction in discomfort. Five patients (seven eyes) failed to wear GP-ScCL. CONCLUSION: GP-ScCL can provide successful and safe visual and therapeutic solutions for ocular conditions when conventional contact lenses and medical treatment have failed and where surgery is undesirable or contraindicated.

Adolescent↗

PubMed2002

Correlation between reading skills and different measurements of convergence amplitude.

PURPOSE: To find correlations between convergence amplitude and reading ability, as assessed in various methods. METHODS: Convergence of 66 children aged 8-10 years was evaluated using 1) Non-accommodative target at near and distance; 2) A near computerized stereogram; and 3) Measurement of near point of convergence (NPC). Reading ability was examined by: 1) a reading comprehension test and 2) the Developmental Eye Movement Test (DEM), which evaluates saccadic speed and accuracy. RESULTS: Convergence amplitudes on a distant target and on a near stereogram were correlated with the DEM score (P = 0.005/0.02, r = -0.38/-0.32 and P < 0.001/0.002, r = -0.53/-0.53 for break/recovery respectively), while NPC and convergence on a near non-accommodative target did not. Reading comprehension test score was not correlated with any of the convergence measurements. CONCLUSIONS: Convergence amplitude measured while accommodation is controlled was correlated with the DEM score, which evaluates saccadic speed and accuracy. Further study to evaluate whether improvement in vergence control improves DEM scores is needed.

Accommodation, Ocular↗