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Biomedical subjects

Randa S Haddad

Publications and source records attributed to Randa S Haddad.

4 recordsLinked to original sources

Intravitreal triamcinolone for the management of macular edema due to nonischemic central retinal vein occlusion.

OBJECTIVE: To evaluate the efficacy of intravitreal triamcinolone acetonide in the management of persistent macular edema secondary to nonischemic central retinal vein occlusion (CRVO). METHODS: Twenty consecutive patients were selected with a 3- to 4-month history of nonischemic CRVO and persistent macular edema. These patients received a single intravitreal injection of 4 mg of triamcinolone acetonide (40 mg/mL). The follow-up period ranged from 10 to 12 months. The amount of macular edema was assessed by the amount of retinal thickening on clinical examination using the Goldmann contact lens and by the area and intensity of staining on fluorescein angiography. Treated patients were compared with a retrospectively matched group of patients who were managed with observation only. MAIN OUTCOME MEASURES: Changes in visual acuity and amount of macular edema were assessed in the treated patients and compared with the observation group. RESULTS: The mean baseline visual acuity in the treatment group was 20/132 vs 20/123 for the observation group (P =.57). After 1 week, the treated group had a mean visual acuity of 20/51. At final follow-up, the treated group had a mean visual acuity of 20/37 while the observation group had a mean visual acuity of 20/110 (P =.001). Sixty percent of treated patients had a final visual acuity of 20/40 or better vs only 20% in the observation group (P =.01). Forty percent of the untreated patients had a final visual acuity worse than 20/200 while none of the treated patients did (P<.001). At final follow-up, 75% of treated patients had complete resolution of macular edema on clinical examination vs only 20% of the untreated patients (P<.001). Two of the treated patients had recurrence of macular edema at 6 months, and 3 had elevated intraocular pressure. CONCLUSION: This study shows a treatment benefit from intravitreal triamcinolone in terms of visual acuity and macular edema for nonischemic CRVO.

Aged↗

Intravitreal tissue plasminogen activator in the management of central retinal vein occlusion.

PURPOSE: To evaluate the role of intravitreal tissue plasminogen activator (tPA) in the management of central retinal vein occlusion (CRVO) in patients with symptoms for <3 days. METHODS: We evaluated the visual outcome of a consecutive series of patients with CRVO following intravitreal tPA injection. All patients presented with visual acuity worse than 20/50 within 3 days from the onset of symptoms. Main outcome measures included percentage of patients whose final vision improved to 20/50 or better and change in percentage of patients with vision of 20/200 or worse before and after treatment. RESULTS: Twelve patients received intravitreal tPA for CRVO. Nine patients (75%) had best-corrected visual acuity of 20/200 or worse at presentation compared with 4 patients (33%) at the last follow-up after treatment. Five (55%) of these 9 patients had final visual acuity that improved to 20/50 or better. The remaining four patients did not have improvement or their vision continued to worsen. All 4 patients had fluorescein angiographic evidence of >10 disk areas of capillary nonperfusion at presentation. Overall, 8 (67%) of 12 patients had final visual acuity of 20/50 or better. No side effects related to tPA injection were observed. CONCLUSION: Our data suggest that intravitreal tPA injection may have a beneficial role in the management of CRVO when used within a few days of the onset of symptoms in patients with no angiographic evidence of severe capillary nonperfusion even if initial visual acuity is 20/200 or worse.

Adult↗

Corneal topography after ocular rubbing.

PURPOSE: To examine the immediate effect of ocular rubbing on corneal topography. METHODS: Corneal topography and analysis were performed before, immediately after, and 5 minutes after eyelid rubbing in 29 volunteers without ocular disease. RESULTS: The surface regularity index increased from a baseline of 0.24 to 0.91 ( p< 0.0001) immediately after rubbing and returned to baseline after 5 minutes. The surface asymmetry index increased from 0.27 to 0.89 ( p= 0.0018) immediately after rubbing. There was a small amount of astigmatism induced immediately by rubbing (0.5 diopter) ( p= 0.01). CONCLUSIONS: Ocular rubbing should be avoided prior to standard corneal topography. The increased surface regularity index may reflect the alterations of the tear film and/or the molding of the corneal surface.

Adult↗

Vernal keratoconjunctivitis presenting unilaterally.

A 7-year-old boy had itching, foreign body sensation, and redness in his right eye. Unilateral cobblestone papillae and a shield ulcer were found. Topical antihistamines, mast cell stabilizers, and steroids led to marked improvement. Unilateral vernal keratoconjunctivitis should be included in the differential diagnosis of unilateral giant papillary conjunctivitis.

Child↗