The assessment of disability related to vision performance-based measure in diabetic retinopathy.

PURPOSE: To validate a third-generation performance-based measure of visual function titled Assessment of Disability Related to Vision (ADREV) in a study population of patients with diabetic retinopathy. DESIGN: Prospective, cross-sectional study. METHODS: Patients with nonproliferative or proliferative diabetic retinopathy, free from ocular comorbidity, were recruited from a single institute and completed the ADREV, the 25-Item National Eye Institute Visual Functioning Questionnaire (VFQ-25), and a clinical ophthalmic examination. Correlation, regression, and bootstrap analysis were conducted to determine the relationship between ADREV scoring and each of the study\u27s clinical and self-report measures of visual ability, while controlling for potential confounders. RESULTS: Ninety-one patients with diabetic retinopathy completed the study and analysis showed that the ADREV total and subscale scores shared a stronger relationship with the clinical measures of visual function than did the VFQ total and subscale scores. Regression analysis revealed that binocular visual acuity, contrast sensitivity, and better eye visual field were the best predictors of ADREV performance. CONCLUSIONS: The ADREV performance measure is a valid instrument for the assessment of disability related to vision in patients with diabetic retinopathy. Furthermore, the assessments provided by ADREV were more related to traditional clinical indicators of visual impairment than were the results of the self-report measure, specifically the VFQ-25

Pericardium patch graft (Tutoplast) for bleb repair and bleb remodelling after nonpenetrating filtering surgery: 6-month outcomes

Purpose: The purpose of this study was to evaluate the outcome of pericardium patch graft (Tutoplast) as an adjuvant to either bleb repair or bleb reduction after nonpenetrating filtering surgery. Methods: Retrospective study, at a tertiary glaucoma center. Bleb revision with Tutoplast positioning was performed either for bleb repair to treat early leaks or hypotony with maculopathy, either for bleb reduction to improve ocular pain, discomfort, burning, foreign body sensation, tearing, and fluctuations of visual acuity. Intraocular pressure (IOP), best corrected visual acuity, number of antiglaucoma medications, and postoperative complications were analyzed postoperatively at 1 week, 1, 3, 6 months, and compared with the preoperative baseline. Surgical success was defined as achieving an IOP between 8 and 16 mm Hg. Results: Six-month data were available from 15 eyes of 15 patients; mean patient age was 69.6 +/- 11.7 (66.7% male). Bleb revision was necessary for 10 patients due to bleb dysesthesia (bleb reduction), and in 5 patients due to leaking filtering bleb (bleb repair). The success rate was 73.3% at 6 months, with a significant IOP increase from 4.9 +/- 2.2 mm Hg preoperatively to 12.7 +/- 3.5 mm Hg at 6 months (P=0.0001), and a concomitant rise of best corrected visual acuity from 0.5 +/- 0.3 to 0.6 +/- 0.3 (P=0.2871). To control IOP, antiglaucoma medications were needed for 3 patients (20%) at 6 months. Overall, 3 patients (20%) required additional bleb revision for persistent hypotony, and 1 patient underwent a subsequent glaucoma surgery (transscleral cyclodestruction). Conclusion: Pericardium patch graft (Tutoplast) is a safe and effective adjuvant for bleb revision due to bleb dysesthesia of leaking filtering bleb after nonpenetrating filtering surgery