L. Drolsum - Academia.edu (original) (raw)
Papers by L. Drolsum
BMC Medical Genetics, 2018
Background: Larsen syndrome is a hereditary disorder characterized by osteochondrodysplasia, cong... more Background: Larsen syndrome is a hereditary disorder characterized by osteochondrodysplasia, congenital large-joint dislocations, and craniofacial abnormalities. The autosomal dominant type is caused by mutations in the gene that encodes the connective tissue protein, filamin B (FLNB). Loeys-Dietz syndrome (LDS) is an autosomal dominant connective tissue disorder characterized by arterial aneurysms, dissections and tortuosity, and skeletal, including craniofacial, manifestations. Mutations in five genes involved in the transforming growth factor beta (TGF-β) signaling pathway cause five types of LDS. Stickler syndrome is a genetically heterogeneous arthro-ophthalmopathy caused by defects in collagen, exhibiting a wide specter of manifestations in connective tissue. A rare case is reported that was diagnosed with all these three hereditary connective tissue disorders. Case presentation: A 19 year-old, Norwegian male with a clinical diagnosis of Larsen syndrome and with healthy, nonconsanguineous parents attended a reference center for rare connective tissue disorders. Findings at birth were hypotonia, joint hypermobility, hyperextended knees, adductovarus of the feet, cervical kyphosis, craniofacial abnormalities, and an umbilical hernia. From toddlerhood, he required a hearing aid due to combined conductive and sensorineural hearing loss. Eye examination revealed hyperopia, astigmatism, and exotropia. At 10 years of age, he underwent emergency surgery for rupture of an ascending aortic aneurysm. At 19 years of age, a diagnostic re-evaluation was prompted by the findings of more distal aortic dilation, tortuosity of precerebral arteries, and skeletal findings. High throughput sequencing of 34 genes for hereditary connective tissue disorders did not identify any mutation in FLNB, but did identify a de novo missense mutation in TGFBR2 and a nonsense mutation in COL2A1 that was also present in his unaffected father. The diagnosis was revised to LDS Type 2. The patient also fulfills the proposed criteria for Stickler syndrome with bifid uvula, hearing loss, and a known mutation in COL2A1. Conclusion: LDS should be considered in patients with a clinical diagnosis of Larsen syndrome, in particular in the presence of arterial aneurysms or tortuosity. Due to genetic heterogeneity and extensive overlap of clinical manifestations, genetic high throughput sequencing analysis is particularly useful for the differential diagnosis of hereditary connective tissue disorders.
Journal of Cataract and Refractive Surgery, 2003
To evaluate the outcomes of conversion from trabeculectomy to deep sclerectomy with placement of ... more To evaluate the outcomes of conversion from trabeculectomy to deep sclerectomy with placement of a drainage implant.
Journal of Cataract and Refractive Surgery, 2003
To evaluate the long-term results of secondary implantation of modern flexible, open-loop, anteri... more To evaluate the long-term results of secondary implantation of modern flexible, open-loop, anterior chamber intraocular lenses (IOLs).
European Journal of Ophthalmology, 2012
Acta Ophthalmologica Scandinavica, 2006
To compare the longterm results in pseudoexfoliative glaucoma and primary open-angle glaucoma (PO... more To compare the longterm results in pseudoexfoliative glaucoma and primary open-angle glaucoma (POAG) following deep sclerectomy with implant. Methods: A total of 28 pseudoexfoliative glaucoma eyes and 27 POAG eyes were consecutively included in the study. Intraocular pressure (IOP) and number of glaucoma medications were compared before surgery and at every postoperative visit. Most patients included had very advanced glaucoma and were using multiple therapies (mean 3.3 and 3.6 in the pseudoexfoliative glaucoma and POAG groups, respectively) and the duration of the disease was more than 8 years in both groups. The definition of complete success was the achievement of IOP < < 19 mmHg without therapy. Results: After a mean follow-up time of 45 months in the pseudoexfoliative glaucoma group and 43 months in the POAG group, 50.0% of the pseudoexfoliative glaucoma group were considered to represent complete success compared with 33.3% of the POAG group (NS). In survival analyses controlling for covariates, it was found that patients with pseudoexfoliative glaucoma had a higher rate of success over time than POAG patients (p ¼ 0.014). Furthermore, the duration of glaucoma prior to surgery had a negative influence on the success rate (p ¼ 0.034). Four years after surgery, the mean IOP was 15.5 ± ± 5.3 mmHg in the pseudoexfoliative glaucoma group and 13.6 ± ± 3.5 mmHg in the POAG group (NS). The mean number of medications used by each group at that time was 1.7 ± ± 1.5 and 1.2 ± ± 1.1, respectively (NS). Conclusion: The present study suggests that deep sclerectomy is a safe procedure in pseudoexfoliative glaucoma. Half of the patients were regulated without therapy after 45 months.
Acta Ophthalmologica Scandinavica, 2006
We describe a case of iris microhaemangiomas (iris vascular tufts) causing spontaneous hyphaema a... more We describe a case of iris microhaemangiomas (iris vascular tufts) causing spontaneous hyphaema and where examination showed that the patient also had idiopathic juxtafoveolar retinal telangiectasis. A systematic search through PubMed, EMBASE and reference lists revealed a total of 90 reported cases of iris microhaemangiomas. To our knowledge, no previous reports have described concurrent findings of iris microhaemangiomas and idiopathic juxtafoveolar retinal telangiectasis in a patient. Both conditions are acquired vascular diseases, but their pathogenesis and aetiologies are unknown. Iris microhaemangiomas are important clinically because they are occasionally a cause of spontaneous hyphaema and may induce transient elevation of intraocular pressure.
Acta Ophthalmologica Scandinavica, 2007
Acta Ophthalmologica Scandinavica, 2003
.Purpose: To compare the results of deep sclerectomy in capsular glaucoma (CG) with those in pri... more .Purpose: To compare the results of deep sclerectomy in capsular glaucoma (CG) with those in primary open‐angle glaucoma (POAG). Methods: This consecutive, prospective study comprised 24 CG patients (28 eyes) and 25 POAG patients (29 eyes) who underwent deep sclerectomy. Two different implants were used: either an absorbable collagen implant (Aqua‐Flow®) or a non‐absorbable hydrophilic acrylic implant (T‐Flux®). The number of glaucoma medications, intraocular pressure (IOP) and complications were compared postoperatively. The definition of complete success was IOP below 19 mmHg without therapy. Results: After a mean follow‐up of 19.9 ± 10.9 months (range 6–36 months) in the CG group and 16.2 ± 10.0 months (range 6–36 months) in the POAG group, complete success was seen in 60.7% and in 37.9% of eyes, respectively (p = 0.085). After adjustments for disparities in baseline characteristics, survival analysis demonstrated that success rates were better over time in CG eyes than in POAG eyes (p = 0.038). At all time‐points, except at 24 months, the IOP was lower in the CG group than in the POAG group. This difference was statistically significant at 1 week (p = 0.050) and 3 months (p = 0.006). At 18 months, the mean decrease in number of medications was 77.3% in the CG group and 65.9% in the POAG group (not statistically significant). Levelled hyphema occurred more frequently in CG eyes (35.7%) than in POAG eyes (13.8%). Conclusion: Capsular glaucoma patients had significantly higher success rates over time than POAG patients following deep sclerectomy with implant.
Acta Ophthalmologica, 2014
ABSTRACT Purpose The objective of our study is to describe the clinical and imaging features of T... more ABSTRACT Purpose The objective of our study is to describe the clinical and imaging features of Terrien's marginal degeneration (TMD) and subsequently to define the clinical diagnostic criteria for TMD. Lastly we aim to detect the natural course of this disease.Methods Our study design is cross-sectional and includes TMD patients diagnosed in Helsinki University Eye Hospital, Aarhus University Hospital, Sahlgrenska University Hospital and Oslo University Hospital by corneal specialists. Analysis include gender distribution, age, symptoms, as well as clinical, topographical and imaging findings. The analysis is based on descriptive variables due the limited sample size.Results We present here clinical findings of Finnish TMD patients. All patients were asymptomatic and did not suffer from any systemic autoimmune diseases. Topographical analysis showed high astigmatism due to severe corneal thinning as evidenced by optical coherence tomography imaging.Conclusion TMD is a bilateral corneal disease. Patients are commonly asymptomatic and visit an ophthalmologist because of deteriorated vision due to increasing astigmatism. TMD is thus diagnosed by coincidence. TMD does not seem to be associated with any systemic autoimmune diseases and it is commonly non-progressing.
Acta Ophthalmologica, 2017
Acta Ophthalmologica, 2012
To compare posterior capsular opacification in patients with and without pseudoexfoliation syndro... more To compare posterior capsular opacification in patients with and without pseudoexfoliation syndrome 6-7 years following surgery. Forty-four eyes of 44 patients with pseudoexfoliation syndrome who underwent cataract surgery with phacoemulsification in 2001 and 2002 were available for follow-up in 2008. These patients were compared to 86 age- and gender-matched patients (86 eyes) without pseudoexfoliation syndrome who had surgery during the same time period. Posterior capsule opacification was assessed using digital retroillumination photography. The images were analysed with a software program (POCOman) to determine the extent and severity of the capsular opacification. Percentage and severity of posterior capsular opacification within the central 4.0 and 1.3 mm of the optical zone were compared in eyes with and without pseudoexfoliation syndrome. Neither of these results were statistically significant. Before the re-examination in 2008, neodymium:yttrium-aluminium-garnet laser posterior capsulotomy had been conducted in 16% (n = 7) of eyes with pseudoexfoliation syndrome, as well as in 16% (n = 14) of eyes without pseudoexfoliation syndrome. Our study indicates that, with phacoemulsification, development of long-term posterior capsular opacification is not increased in patients with pseudoexfoliation syndrome after uncomplicated cataract surgery.
Acta Ophthalmologica, 2009
Extracapsular cataract extraction with IOL implantation was performed in 32 consecutive cases of ... more Extracapsular cataract extraction with IOL implantation was performed in 32 consecutive cases of glaucomatous eyes which previously had undergone trabeculectomy (group A). The only complication seen during surgery was one tear in the posterior capsule. The mean IOP on postoperative day 1 was 17.7 * 7.9 mmHg. After extracapsular cataract extraction in 68 glaucomatous eyes with no previous surgery (group B) the corresponding mean IOP was 21.7 f 7.5 mmHg (p = 0.015). However, the mean preoperative IOP level was lower in group A (group A 14.3 f 4.0 mmHg, group B: 17.1 f 4.3 mmHg), so the increase in IOP was not significantly different in the two groups. In group A, 15.6% of the eyes had an IOP elevation exceeding 24 mmHg, compared to 30.9% of the eyes in group B. Four months postoperatively, the IOP was significantly reduced in group B and unchanged in group A (compared to preoperatively). Seventy-two percent of the eyes in group A and 79% of the eyes in group B achieved a visual acuity of 5/10 or better, respectively.
Acta Ophthalmologica, 2010
To assess the condition of the corneal endothelium an extended period after cataract surgery in e... more To assess the condition of the corneal endothelium an extended period after cataract surgery in eyes with and without pseudoexfoliation syndrome (PES). Forty-six patients with PES who underwent cataract surgery in the Eye Department, Oslo University Hospital, in 2001 and 2002 were enrolled and compared to 101 matched controls without PES who had surgery in the same period. They were re-examined 6-7 years following surgery with measurements taken of corneal endothelial cell density (ECD), pleomorphism, polymegathism and corneal thickness. Mean ECD was 2024 ± 371 cells/mm(2) in eyes with PES and 2144 ± 365 cells/mm(2) in eyes without PES. The difference was not statistically significant. No significant difference in polymegathism and pleomorphism was noted. Mean corneal thickness was 543 and 547 μm in eyes with and without PES, respectively (not statistically significant). The presence of glaucoma in pseudoexfoliative eyes was not associated with endothelial cell changes. Six to 7 years following cataract surgery, no statistically significant differences were established in ECD, pleomorphism, polymegathism and corneal thickness in eyes with and without PES. No clinical signs of corneal decompensation were noted amongst the participants.
Acta Ophthalmologica, 2009
Cataract extraction was performed in 1261 eyes. The relevant information was complete in 826 case... more Cataract extraction was performed in 1261 eyes. The relevant information was complete in 826 cases and thus only these were included in this study. Eleven variables describing clinical history, preoperative findings, operative problems and one variable representing visual acuity 4 months postoperatively were entered into a factor analysis model. Three factors were extracted by factor analysis, and these factors may be considered to be the underlying causes embracing the individual vanables. Factor 1: the maculopathy factor; explained 23.3% of the total variance. Sixteen percent of the variance was attributable to Factor 2: the miosis factor. Lastly, Factor 3: operative problems; was responsible for 13.4% of the variance. The maculopathy factor was significantly associated with postoperative visual acuity (p < 0.001). Slight significant association was also found between the factor for operative problems and visual outcome, whereas no association was seen between the miosis factor and the final vision. Key words: cataract extractionfactor analysismiosismaculopathyoperative complicationspostoperative visual acuity.
Acta Ophthalmologica, 2009
Postoperative results and complications in 136 eyes with pseudoexfoliation syndrome were compared... more Postoperative results and complications in 136 eyes with pseudoexfoliation syndrome were compared to 744 eyes without pseudoexfoliation syndrome in a consecutive study. The patients were followed for 4 months postoperatively. Excluding cases with glaucoma, 81.4% of the pseudoexfoliation eyes and 83.0% of the eyes without pseudoexfoliation achieved a corrected visual acuity of 5/8.5 or better. IOL malposition was rare in both groups (1.5% in the pseudoexfoliation group and 1.6% in the p u p without pseudoexfoliation). IOP elevation the first day postoperatively occurred most often in the pseudoexfoliation eyes. In the pseudoexfoliation eyes, postoperative intis and cellular precipitates were demonstrated in 16.2% and 11.0%, respectively, compared to 3.8% and 3.2% in the eyes without pseudoexfoliation (p < 0.001). The frequency of an inflammatory reaction was highly correlated to small pupil size during operation in both groups.
Acta Ophthalmologica, 2009
Secondary implantation of flexible, open loop anterior chamber IOLs was performed on 20 aphakic e... more Secondary implantation of flexible, open loop anterior chamber IOLs was performed on 20 aphakic eyes between January 1990 and May 1992. In 3 cases anterior vitrectomy was necessary. No other complications were encountered during surgery. The patients were followed up for 4 months postoperatively. Seventeen eyes achieved a corrected visual acuity of 5/5 or better. Fourteen eyes achieved the same visual acuity as preoperatively, and 5 ended with an improved visual outcome. In one case the visual acuity became worse than preoperatively due to cystoid macular edema. No other serious postoperative complications occurred. The postoperative refraction was within 1 diopter of emmetropia in 16 eyes compared to the estimated (biometry) 19 eyes. We conclude that implantation of flexible open loop anterior chamber 101,s is a safe procedure in properly selected cases. Key words: secondary 101. implantationaphakiaanterior chamber IOLrefraction.
Acta Ophthalmologica, 2009
Traditionally, IOL implantation in eyes with uveitis has not been recommended. In the present stu... more Traditionally, IOL implantation in eyes with uveitis has not been recommended. In the present study 31 eyes with uveitis which underwent extracapsular cataract extraction or phacoemulsification with IOL implantation, are compared to a reference group consisting of 930 eyes. There was increased postoperative inflammation in 29Yo in the uveitis group, compared to 5.9% in the reference group. The rate of per-and postoperative complications was slightly elevated in the group with uveitis. Corrected visual acuity of 5/85 or better was achieved in 58.1%. The major obstacle to good visual acuity postoperatively, was macular pathology.
Acta Ophthalmologica, 2009
The influence of age on 12 pre-, 1 intra-, and 2 postoperative patients' characteristics was inve... more The influence of age on 12 pre-, 1 intra-, and 2 postoperative patients' characteristics was investigated in 1261 consecutively performed extracapsular cataract extractions. The following characteristics were shown to be significantly associated with increasing age; cardiovascular disease (p < 0.0005), female gender (p < 0.0005), nuclear sclerosis (p < 0.0005), maculopathy (p < 0.0005), corneal guttatae (p = 0.008) and reducingvisual acuity in the fellow eye (p < 0.0005). Further, inadequate mydriasis at start of surgery was significantly associated with increasing age even after adjusting for glaucoma and pseudoexfoliation (p = 0.0007). After adjusting for pseudoexfoliation, a statistically significant relationship still existed between age and glaucoma (p = 0.0235). Even after controlling for relevant variables, i.e. maculopathy, a highly significant association was found between reducing visual acuity 4 months postoperatively and increasing age (p < 0.00005). Diabetes mellitus, the degree of cataract maturity, preoperative visual acuity of the operating eye, vitreous loss and postoperative inflammatory response were not significantly associated with increasing age. Key words: cataract extractionage influencepseudoexfoliationpupil sizemaculopathyvisual acuitycomplications.
Acta Ophthalmologica, 2009
Consecutive registration, rapid retrieval and relevant analysis of information about cataract pat... more Consecutive registration, rapid retrieval and relevant analysis of information about cataract patients were obtained by applying a data form. The form was designed to be used with a statistical computer program (SPSS/PC). Data describing cataract cases, operations and postoperative controls were recorded. The information is contained in 76 variables, each with up to 10 alternative answers. The main advantages are the opportunity for quality control and clinical research. As an example, an analysis of the pre-and postoperative visual acuity is presented. Originally, the material consisted of 969 eyes, and of these, 948 eyes were available for followup. The postoperative corrected visual acuity was 5/5 or better in 57.2% of the eyes. In 80.4% of the eyes a visual acuity better than 5/10 was achieved. The main cause of postoperative visual acuity less than 5B.5 was age-related macular degeneration (115 eyes). This maculopathy was recognized preoperatively in 76 eyes.
BMC Medical Genetics, 2018
Background: Larsen syndrome is a hereditary disorder characterized by osteochondrodysplasia, cong... more Background: Larsen syndrome is a hereditary disorder characterized by osteochondrodysplasia, congenital large-joint dislocations, and craniofacial abnormalities. The autosomal dominant type is caused by mutations in the gene that encodes the connective tissue protein, filamin B (FLNB). Loeys-Dietz syndrome (LDS) is an autosomal dominant connective tissue disorder characterized by arterial aneurysms, dissections and tortuosity, and skeletal, including craniofacial, manifestations. Mutations in five genes involved in the transforming growth factor beta (TGF-β) signaling pathway cause five types of LDS. Stickler syndrome is a genetically heterogeneous arthro-ophthalmopathy caused by defects in collagen, exhibiting a wide specter of manifestations in connective tissue. A rare case is reported that was diagnosed with all these three hereditary connective tissue disorders. Case presentation: A 19 year-old, Norwegian male with a clinical diagnosis of Larsen syndrome and with healthy, nonconsanguineous parents attended a reference center for rare connective tissue disorders. Findings at birth were hypotonia, joint hypermobility, hyperextended knees, adductovarus of the feet, cervical kyphosis, craniofacial abnormalities, and an umbilical hernia. From toddlerhood, he required a hearing aid due to combined conductive and sensorineural hearing loss. Eye examination revealed hyperopia, astigmatism, and exotropia. At 10 years of age, he underwent emergency surgery for rupture of an ascending aortic aneurysm. At 19 years of age, a diagnostic re-evaluation was prompted by the findings of more distal aortic dilation, tortuosity of precerebral arteries, and skeletal findings. High throughput sequencing of 34 genes for hereditary connective tissue disorders did not identify any mutation in FLNB, but did identify a de novo missense mutation in TGFBR2 and a nonsense mutation in COL2A1 that was also present in his unaffected father. The diagnosis was revised to LDS Type 2. The patient also fulfills the proposed criteria for Stickler syndrome with bifid uvula, hearing loss, and a known mutation in COL2A1. Conclusion: LDS should be considered in patients with a clinical diagnosis of Larsen syndrome, in particular in the presence of arterial aneurysms or tortuosity. Due to genetic heterogeneity and extensive overlap of clinical manifestations, genetic high throughput sequencing analysis is particularly useful for the differential diagnosis of hereditary connective tissue disorders.
Journal of Cataract and Refractive Surgery, 2003
To evaluate the outcomes of conversion from trabeculectomy to deep sclerectomy with placement of ... more To evaluate the outcomes of conversion from trabeculectomy to deep sclerectomy with placement of a drainage implant.
Journal of Cataract and Refractive Surgery, 2003
To evaluate the long-term results of secondary implantation of modern flexible, open-loop, anteri... more To evaluate the long-term results of secondary implantation of modern flexible, open-loop, anterior chamber intraocular lenses (IOLs).
European Journal of Ophthalmology, 2012
Acta Ophthalmologica Scandinavica, 2006
To compare the longterm results in pseudoexfoliative glaucoma and primary open-angle glaucoma (PO... more To compare the longterm results in pseudoexfoliative glaucoma and primary open-angle glaucoma (POAG) following deep sclerectomy with implant. Methods: A total of 28 pseudoexfoliative glaucoma eyes and 27 POAG eyes were consecutively included in the study. Intraocular pressure (IOP) and number of glaucoma medications were compared before surgery and at every postoperative visit. Most patients included had very advanced glaucoma and were using multiple therapies (mean 3.3 and 3.6 in the pseudoexfoliative glaucoma and POAG groups, respectively) and the duration of the disease was more than 8 years in both groups. The definition of complete success was the achievement of IOP < < 19 mmHg without therapy. Results: After a mean follow-up time of 45 months in the pseudoexfoliative glaucoma group and 43 months in the POAG group, 50.0% of the pseudoexfoliative glaucoma group were considered to represent complete success compared with 33.3% of the POAG group (NS). In survival analyses controlling for covariates, it was found that patients with pseudoexfoliative glaucoma had a higher rate of success over time than POAG patients (p ¼ 0.014). Furthermore, the duration of glaucoma prior to surgery had a negative influence on the success rate (p ¼ 0.034). Four years after surgery, the mean IOP was 15.5 ± ± 5.3 mmHg in the pseudoexfoliative glaucoma group and 13.6 ± ± 3.5 mmHg in the POAG group (NS). The mean number of medications used by each group at that time was 1.7 ± ± 1.5 and 1.2 ± ± 1.1, respectively (NS). Conclusion: The present study suggests that deep sclerectomy is a safe procedure in pseudoexfoliative glaucoma. Half of the patients were regulated without therapy after 45 months.
Acta Ophthalmologica Scandinavica, 2006
We describe a case of iris microhaemangiomas (iris vascular tufts) causing spontaneous hyphaema a... more We describe a case of iris microhaemangiomas (iris vascular tufts) causing spontaneous hyphaema and where examination showed that the patient also had idiopathic juxtafoveolar retinal telangiectasis. A systematic search through PubMed, EMBASE and reference lists revealed a total of 90 reported cases of iris microhaemangiomas. To our knowledge, no previous reports have described concurrent findings of iris microhaemangiomas and idiopathic juxtafoveolar retinal telangiectasis in a patient. Both conditions are acquired vascular diseases, but their pathogenesis and aetiologies are unknown. Iris microhaemangiomas are important clinically because they are occasionally a cause of spontaneous hyphaema and may induce transient elevation of intraocular pressure.
Acta Ophthalmologica Scandinavica, 2007
Acta Ophthalmologica Scandinavica, 2003
.Purpose: To compare the results of deep sclerectomy in capsular glaucoma (CG) with those in pri... more .Purpose: To compare the results of deep sclerectomy in capsular glaucoma (CG) with those in primary open‐angle glaucoma (POAG). Methods: This consecutive, prospective study comprised 24 CG patients (28 eyes) and 25 POAG patients (29 eyes) who underwent deep sclerectomy. Two different implants were used: either an absorbable collagen implant (Aqua‐Flow®) or a non‐absorbable hydrophilic acrylic implant (T‐Flux®). The number of glaucoma medications, intraocular pressure (IOP) and complications were compared postoperatively. The definition of complete success was IOP below 19 mmHg without therapy. Results: After a mean follow‐up of 19.9 ± 10.9 months (range 6–36 months) in the CG group and 16.2 ± 10.0 months (range 6–36 months) in the POAG group, complete success was seen in 60.7% and in 37.9% of eyes, respectively (p = 0.085). After adjustments for disparities in baseline characteristics, survival analysis demonstrated that success rates were better over time in CG eyes than in POAG eyes (p = 0.038). At all time‐points, except at 24 months, the IOP was lower in the CG group than in the POAG group. This difference was statistically significant at 1 week (p = 0.050) and 3 months (p = 0.006). At 18 months, the mean decrease in number of medications was 77.3% in the CG group and 65.9% in the POAG group (not statistically significant). Levelled hyphema occurred more frequently in CG eyes (35.7%) than in POAG eyes (13.8%). Conclusion: Capsular glaucoma patients had significantly higher success rates over time than POAG patients following deep sclerectomy with implant.
Acta Ophthalmologica, 2014
ABSTRACT Purpose The objective of our study is to describe the clinical and imaging features of T... more ABSTRACT Purpose The objective of our study is to describe the clinical and imaging features of Terrien's marginal degeneration (TMD) and subsequently to define the clinical diagnostic criteria for TMD. Lastly we aim to detect the natural course of this disease.Methods Our study design is cross-sectional and includes TMD patients diagnosed in Helsinki University Eye Hospital, Aarhus University Hospital, Sahlgrenska University Hospital and Oslo University Hospital by corneal specialists. Analysis include gender distribution, age, symptoms, as well as clinical, topographical and imaging findings. The analysis is based on descriptive variables due the limited sample size.Results We present here clinical findings of Finnish TMD patients. All patients were asymptomatic and did not suffer from any systemic autoimmune diseases. Topographical analysis showed high astigmatism due to severe corneal thinning as evidenced by optical coherence tomography imaging.Conclusion TMD is a bilateral corneal disease. Patients are commonly asymptomatic and visit an ophthalmologist because of deteriorated vision due to increasing astigmatism. TMD is thus diagnosed by coincidence. TMD does not seem to be associated with any systemic autoimmune diseases and it is commonly non-progressing.
Acta Ophthalmologica, 2017
Acta Ophthalmologica, 2012
To compare posterior capsular opacification in patients with and without pseudoexfoliation syndro... more To compare posterior capsular opacification in patients with and without pseudoexfoliation syndrome 6-7 years following surgery. Forty-four eyes of 44 patients with pseudoexfoliation syndrome who underwent cataract surgery with phacoemulsification in 2001 and 2002 were available for follow-up in 2008. These patients were compared to 86 age- and gender-matched patients (86 eyes) without pseudoexfoliation syndrome who had surgery during the same time period. Posterior capsule opacification was assessed using digital retroillumination photography. The images were analysed with a software program (POCOman) to determine the extent and severity of the capsular opacification. Percentage and severity of posterior capsular opacification within the central 4.0 and 1.3 mm of the optical zone were compared in eyes with and without pseudoexfoliation syndrome. Neither of these results were statistically significant. Before the re-examination in 2008, neodymium:yttrium-aluminium-garnet laser posterior capsulotomy had been conducted in 16% (n = 7) of eyes with pseudoexfoliation syndrome, as well as in 16% (n = 14) of eyes without pseudoexfoliation syndrome. Our study indicates that, with phacoemulsification, development of long-term posterior capsular opacification is not increased in patients with pseudoexfoliation syndrome after uncomplicated cataract surgery.
Acta Ophthalmologica, 2009
Extracapsular cataract extraction with IOL implantation was performed in 32 consecutive cases of ... more Extracapsular cataract extraction with IOL implantation was performed in 32 consecutive cases of glaucomatous eyes which previously had undergone trabeculectomy (group A). The only complication seen during surgery was one tear in the posterior capsule. The mean IOP on postoperative day 1 was 17.7 * 7.9 mmHg. After extracapsular cataract extraction in 68 glaucomatous eyes with no previous surgery (group B) the corresponding mean IOP was 21.7 f 7.5 mmHg (p = 0.015). However, the mean preoperative IOP level was lower in group A (group A 14.3 f 4.0 mmHg, group B: 17.1 f 4.3 mmHg), so the increase in IOP was not significantly different in the two groups. In group A, 15.6% of the eyes had an IOP elevation exceeding 24 mmHg, compared to 30.9% of the eyes in group B. Four months postoperatively, the IOP was significantly reduced in group B and unchanged in group A (compared to preoperatively). Seventy-two percent of the eyes in group A and 79% of the eyes in group B achieved a visual acuity of 5/10 or better, respectively.
Acta Ophthalmologica, 2010
To assess the condition of the corneal endothelium an extended period after cataract surgery in e... more To assess the condition of the corneal endothelium an extended period after cataract surgery in eyes with and without pseudoexfoliation syndrome (PES). Forty-six patients with PES who underwent cataract surgery in the Eye Department, Oslo University Hospital, in 2001 and 2002 were enrolled and compared to 101 matched controls without PES who had surgery in the same period. They were re-examined 6-7 years following surgery with measurements taken of corneal endothelial cell density (ECD), pleomorphism, polymegathism and corneal thickness. Mean ECD was 2024 ± 371 cells/mm(2) in eyes with PES and 2144 ± 365 cells/mm(2) in eyes without PES. The difference was not statistically significant. No significant difference in polymegathism and pleomorphism was noted. Mean corneal thickness was 543 and 547 μm in eyes with and without PES, respectively (not statistically significant). The presence of glaucoma in pseudoexfoliative eyes was not associated with endothelial cell changes. Six to 7 years following cataract surgery, no statistically significant differences were established in ECD, pleomorphism, polymegathism and corneal thickness in eyes with and without PES. No clinical signs of corneal decompensation were noted amongst the participants.
Acta Ophthalmologica, 2009
Cataract extraction was performed in 1261 eyes. The relevant information was complete in 826 case... more Cataract extraction was performed in 1261 eyes. The relevant information was complete in 826 cases and thus only these were included in this study. Eleven variables describing clinical history, preoperative findings, operative problems and one variable representing visual acuity 4 months postoperatively were entered into a factor analysis model. Three factors were extracted by factor analysis, and these factors may be considered to be the underlying causes embracing the individual vanables. Factor 1: the maculopathy factor; explained 23.3% of the total variance. Sixteen percent of the variance was attributable to Factor 2: the miosis factor. Lastly, Factor 3: operative problems; was responsible for 13.4% of the variance. The maculopathy factor was significantly associated with postoperative visual acuity (p < 0.001). Slight significant association was also found between the factor for operative problems and visual outcome, whereas no association was seen between the miosis factor and the final vision. Key words: cataract extractionfactor analysismiosismaculopathyoperative complicationspostoperative visual acuity.
Acta Ophthalmologica, 2009
Postoperative results and complications in 136 eyes with pseudoexfoliation syndrome were compared... more Postoperative results and complications in 136 eyes with pseudoexfoliation syndrome were compared to 744 eyes without pseudoexfoliation syndrome in a consecutive study. The patients were followed for 4 months postoperatively. Excluding cases with glaucoma, 81.4% of the pseudoexfoliation eyes and 83.0% of the eyes without pseudoexfoliation achieved a corrected visual acuity of 5/8.5 or better. IOL malposition was rare in both groups (1.5% in the pseudoexfoliation group and 1.6% in the p u p without pseudoexfoliation). IOP elevation the first day postoperatively occurred most often in the pseudoexfoliation eyes. In the pseudoexfoliation eyes, postoperative intis and cellular precipitates were demonstrated in 16.2% and 11.0%, respectively, compared to 3.8% and 3.2% in the eyes without pseudoexfoliation (p < 0.001). The frequency of an inflammatory reaction was highly correlated to small pupil size during operation in both groups.
Acta Ophthalmologica, 2009
Secondary implantation of flexible, open loop anterior chamber IOLs was performed on 20 aphakic e... more Secondary implantation of flexible, open loop anterior chamber IOLs was performed on 20 aphakic eyes between January 1990 and May 1992. In 3 cases anterior vitrectomy was necessary. No other complications were encountered during surgery. The patients were followed up for 4 months postoperatively. Seventeen eyes achieved a corrected visual acuity of 5/5 or better. Fourteen eyes achieved the same visual acuity as preoperatively, and 5 ended with an improved visual outcome. In one case the visual acuity became worse than preoperatively due to cystoid macular edema. No other serious postoperative complications occurred. The postoperative refraction was within 1 diopter of emmetropia in 16 eyes compared to the estimated (biometry) 19 eyes. We conclude that implantation of flexible open loop anterior chamber 101,s is a safe procedure in properly selected cases. Key words: secondary 101. implantationaphakiaanterior chamber IOLrefraction.
Acta Ophthalmologica, 2009
Traditionally, IOL implantation in eyes with uveitis has not been recommended. In the present stu... more Traditionally, IOL implantation in eyes with uveitis has not been recommended. In the present study 31 eyes with uveitis which underwent extracapsular cataract extraction or phacoemulsification with IOL implantation, are compared to a reference group consisting of 930 eyes. There was increased postoperative inflammation in 29Yo in the uveitis group, compared to 5.9% in the reference group. The rate of per-and postoperative complications was slightly elevated in the group with uveitis. Corrected visual acuity of 5/85 or better was achieved in 58.1%. The major obstacle to good visual acuity postoperatively, was macular pathology.
Acta Ophthalmologica, 2009
The influence of age on 12 pre-, 1 intra-, and 2 postoperative patients' characteristics was inve... more The influence of age on 12 pre-, 1 intra-, and 2 postoperative patients' characteristics was investigated in 1261 consecutively performed extracapsular cataract extractions. The following characteristics were shown to be significantly associated with increasing age; cardiovascular disease (p < 0.0005), female gender (p < 0.0005), nuclear sclerosis (p < 0.0005), maculopathy (p < 0.0005), corneal guttatae (p = 0.008) and reducingvisual acuity in the fellow eye (p < 0.0005). Further, inadequate mydriasis at start of surgery was significantly associated with increasing age even after adjusting for glaucoma and pseudoexfoliation (p = 0.0007). After adjusting for pseudoexfoliation, a statistically significant relationship still existed between age and glaucoma (p = 0.0235). Even after controlling for relevant variables, i.e. maculopathy, a highly significant association was found between reducing visual acuity 4 months postoperatively and increasing age (p < 0.00005). Diabetes mellitus, the degree of cataract maturity, preoperative visual acuity of the operating eye, vitreous loss and postoperative inflammatory response were not significantly associated with increasing age. Key words: cataract extractionage influencepseudoexfoliationpupil sizemaculopathyvisual acuitycomplications.
Acta Ophthalmologica, 2009
Consecutive registration, rapid retrieval and relevant analysis of information about cataract pat... more Consecutive registration, rapid retrieval and relevant analysis of information about cataract patients were obtained by applying a data form. The form was designed to be used with a statistical computer program (SPSS/PC). Data describing cataract cases, operations and postoperative controls were recorded. The information is contained in 76 variables, each with up to 10 alternative answers. The main advantages are the opportunity for quality control and clinical research. As an example, an analysis of the pre-and postoperative visual acuity is presented. Originally, the material consisted of 969 eyes, and of these, 948 eyes were available for followup. The postoperative corrected visual acuity was 5/5 or better in 57.2% of the eyes. In 80.4% of the eyes a visual acuity better than 5/10 was achieved. The main cause of postoperative visual acuity less than 5B.5 was age-related macular degeneration (115 eyes). This maculopathy was recognized preoperatively in 76 eyes.