Background/aim: Ultrasound biomicroscopy (UBM) is an important tool for assess ing anterior segment pathology. This study sought to evaluate UBM in the managem ent of anterior segment tumours. Methods: Retrospective a...Background/aim: Ultrasound biomicroscopy (UBM) is an important tool for assess ing anterior segment pathology. This study sought to evaluate UBM in the managem ent of anterior segment tumours. Methods: Retrospective analysis of medical reco rds of consecutive patients referred to the ocular oncology unit, University of California San Francisco (UCSF), for suspected anterior segment tumours from 199 9 to 2004. Results: 132 eyes from 130 patients were evaluated, including 55 uvea l melanomas (UM), 21 iris naevi, 30 iris cysts, and 26 remaining lesions. Of the melanomas, 45 were also evaluated with conventional A/B-scan. There was 29%co rrespondence between the anatomical structures invaded by melanoma as identified by B-scan v disease extent defined by UBM. Ciliary body and peripheral iris in volvement by melanomas was significantly more frequently observed by UBM than B -scan. Seven of 30 benign cysts were diagnosed as cystic before UBM evaluation. In three cases, neuroepithelial cysts were associated with intercurrent patholo gy including iris naevus (n=2) and ciliary body melanoma (n=1). Two ciliary body melanomas showed cavitation, including one patient with a pseudocyst. Histopath ological correlation was possible in six cases. Conclusion: UBM is an indispensa ble tool for the management of anterior segment tumours. This study demonstrates the superiority of UBM conventionalB-scan for the precise localisation of uvea l melanoma, especially involving the ciliary body and peripheral iris.展开更多
Purpose:To investigate complications associated with ganciclovir implants used to treat AIDS-related cytomegalovirus(CMV)retinitis,and to identify factors that predict poor outcomes.Design:Retrospective chart review.P...Purpose:To investigate complications associated with ganciclovir implants used to treat AIDS-related cytomegalovirus(CMV)retinitis,and to identify factors that predict poor outcomes.Design:Retrospective chart review.Participants:Consecutive patients with AIDS-related CMV retinitis from 3 clinical facilities who underwent implantation procedures during the period January 1,1995 through December 31,2001.Methods:Baseline for each patient was the date of the first implantation procedure performed during the study period by one of the facilities’surgeons(index implant).Medical and ophthalmological data were collected at baseline and at specific time points after baseline.The dates on which additional implantation procedures were performed and the dates on which complications or vision loss were identified were also recorded.Relationships between potential risk factors and outcomes were studied by Kaplan-Meier analyses and Cox proportional hazards regression models.Main Outcome Measures:Primary outcome measures included postoperative complications specifically related to or possibly related to ganciclovir implants.A secondary outcome measure was vision loss after implantation procedures.Results:The charts of 174 patients(one study eye per patient;279 implants)were reviewed.Median follow-up was 14.4 months(range,0-7 years).Complications specifically related to implants occurred throughout follow-up at a rate of 0.064 events per patient-year.Complications possibly related to implants occurred at an overall rate of 0.377 per patient-year,but seemed to be more common during the first 2 years after baseline.During the first 2 years of followup,retinal detachments occurred at a rate of 0.156 events per patient-year.The cumulative risk of vision loss(≥ 3 lines of Snellen visual acuity)at 7 years was 70%.Poor outcomes were associated with disease factors(size and activity of lesions),lack of highly active antiretroviral therapy(HAART),and lack of HAART-associated immune reconstitution,but not with surgical factors or implant-specific complications.Conclusions:Complications specifically associated with ganciclovir implants can occur many years after implantation procedures,but the incidence of such complications is low.Continued vision loss is not attributable directly to complications of implants in most cases.This information will help in planning of treatment strategies for CMV retinitis in long-term survivors of human immunodeficiency virus disease.展开更多
Background: Unsaturated fatty acids are important constituents of neuronal ce ll membranes and have neuroprotective, antioxidant, and anti- inflammatory prop erties. Objective: To determine if a high intake of unsatur...Background: Unsaturated fatty acids are important constituents of neuronal ce ll membranes and have neuroprotective, antioxidant, and anti- inflammatory prop erties. Objective: To determine if a high intake of unsaturated fatty acids migh t be associated with a lower risk of Parkinson disease (PD). Methods: In the Rot terdam Study, a prospective population- based cohort study of people ages ≥ 55 , the association between intake of unsaturated fatty acids and the risk of inci dent PD was evaluated among 5,289 subjects who were free of dementia and parkins onism and underwent complete dietary assessment at baseline. PD was assessed thr ough repeated in- person examination, and the cohort was continuously monitored by computer linkage to medical records. The data were analyzed using Cox propor tional hazards regression models. Results: After a mean follow- up of 6.0 years , 51 participants with incident PD were identified. Intakes of total fat, monoun saturated fatty acids (MUFAs), and polyunsatu rated fatty acids (PUFAs) were significantly associated with a lower risk of PD, with an adjusted hazard ratio per SD increase of energy- adjusted intake of 0.69 (95% CI 0.52 to 0.91) for total fat, of 0.68 (95% CI 0.50 to 0.94) for MUFAs, and 0.66 (95% CI 0.46 to 0.96) for PUFAs. No associations were found f or dietary saturated fat, cholesterol, or trans- fat. Conclusion: These finding s suggest that high intake of unsaturated fatty acids might protect against Park inson disease.展开更多
文摘Background/aim: Ultrasound biomicroscopy (UBM) is an important tool for assess ing anterior segment pathology. This study sought to evaluate UBM in the managem ent of anterior segment tumours. Methods: Retrospective analysis of medical reco rds of consecutive patients referred to the ocular oncology unit, University of California San Francisco (UCSF), for suspected anterior segment tumours from 199 9 to 2004. Results: 132 eyes from 130 patients were evaluated, including 55 uvea l melanomas (UM), 21 iris naevi, 30 iris cysts, and 26 remaining lesions. Of the melanomas, 45 were also evaluated with conventional A/B-scan. There was 29%co rrespondence between the anatomical structures invaded by melanoma as identified by B-scan v disease extent defined by UBM. Ciliary body and peripheral iris in volvement by melanomas was significantly more frequently observed by UBM than B -scan. Seven of 30 benign cysts were diagnosed as cystic before UBM evaluation. In three cases, neuroepithelial cysts were associated with intercurrent patholo gy including iris naevus (n=2) and ciliary body melanoma (n=1). Two ciliary body melanomas showed cavitation, including one patient with a pseudocyst. Histopath ological correlation was possible in six cases. Conclusion: UBM is an indispensa ble tool for the management of anterior segment tumours. This study demonstrates the superiority of UBM conventionalB-scan for the precise localisation of uvea l melanoma, especially involving the ciliary body and peripheral iris.
文摘Purpose:To investigate complications associated with ganciclovir implants used to treat AIDS-related cytomegalovirus(CMV)retinitis,and to identify factors that predict poor outcomes.Design:Retrospective chart review.Participants:Consecutive patients with AIDS-related CMV retinitis from 3 clinical facilities who underwent implantation procedures during the period January 1,1995 through December 31,2001.Methods:Baseline for each patient was the date of the first implantation procedure performed during the study period by one of the facilities’surgeons(index implant).Medical and ophthalmological data were collected at baseline and at specific time points after baseline.The dates on which additional implantation procedures were performed and the dates on which complications or vision loss were identified were also recorded.Relationships between potential risk factors and outcomes were studied by Kaplan-Meier analyses and Cox proportional hazards regression models.Main Outcome Measures:Primary outcome measures included postoperative complications specifically related to or possibly related to ganciclovir implants.A secondary outcome measure was vision loss after implantation procedures.Results:The charts of 174 patients(one study eye per patient;279 implants)were reviewed.Median follow-up was 14.4 months(range,0-7 years).Complications specifically related to implants occurred throughout follow-up at a rate of 0.064 events per patient-year.Complications possibly related to implants occurred at an overall rate of 0.377 per patient-year,but seemed to be more common during the first 2 years after baseline.During the first 2 years of followup,retinal detachments occurred at a rate of 0.156 events per patient-year.The cumulative risk of vision loss(≥ 3 lines of Snellen visual acuity)at 7 years was 70%.Poor outcomes were associated with disease factors(size and activity of lesions),lack of highly active antiretroviral therapy(HAART),and lack of HAART-associated immune reconstitution,but not with surgical factors or implant-specific complications.Conclusions:Complications specifically associated with ganciclovir implants can occur many years after implantation procedures,but the incidence of such complications is low.Continued vision loss is not attributable directly to complications of implants in most cases.This information will help in planning of treatment strategies for CMV retinitis in long-term survivors of human immunodeficiency virus disease.
文摘Background: Unsaturated fatty acids are important constituents of neuronal ce ll membranes and have neuroprotective, antioxidant, and anti- inflammatory prop erties. Objective: To determine if a high intake of unsaturated fatty acids migh t be associated with a lower risk of Parkinson disease (PD). Methods: In the Rot terdam Study, a prospective population- based cohort study of people ages ≥ 55 , the association between intake of unsaturated fatty acids and the risk of inci dent PD was evaluated among 5,289 subjects who were free of dementia and parkins onism and underwent complete dietary assessment at baseline. PD was assessed thr ough repeated in- person examination, and the cohort was continuously monitored by computer linkage to medical records. The data were analyzed using Cox propor tional hazards regression models. Results: After a mean follow- up of 6.0 years , 51 participants with incident PD were identified. Intakes of total fat, monoun saturated fatty acids (MUFAs), and polyunsatu rated fatty acids (PUFAs) were significantly associated with a lower risk of PD, with an adjusted hazard ratio per SD increase of energy- adjusted intake of 0.69 (95% CI 0.52 to 0.91) for total fat, of 0.68 (95% CI 0.50 to 0.94) for MUFAs, and 0.66 (95% CI 0.46 to 0.96) for PUFAs. No associations were found f or dietary saturated fat, cholesterol, or trans- fat. Conclusion: These finding s suggest that high intake of unsaturated fatty acids might protect against Park inson disease.
