An international collaborative evaluation of central serous chorioretinopathy: different therapeutic approaches and review of literature. The European Vitreoretinal Society central serous chorioretinopathy study

Purpose: To study and compare the efficacy of different therapeutic options for the treatment of central serous chorioretinopathy (CSCR). Methods: This is a nonrandomized, international multicentre study on 1719 patients (1861 eyes) diagnosed with CSCR, from 63 centres (24 countries). Reported data included different methods of treatment and both results of diagnostic examinations [fluorescein angiography and/or optical coherent tomography (OCT)] and best-corrected visual acuity (BCVA) before and after therapy. The duration of observation had a mean of 11 months but was extended in a minority of cases up to 7 years. The aim of this study is to evaluate the efficacy of the different therapeutic options of CSCR in terms of both visual (BCVA) and anatomic (OCT) improvement. Results: One thousand seven hundred nineteen patients (1861 eyes) diagnosed with CSCR were included. Treatments performed were nonsteroidal anti-inflammatory eye drops, laser photocoagulation, micropulse diode laser photocoagulation, photodynamic therapy (PDT; Standard PDT, Reduced-dose PDT, Reduced-fluence PDT), intravitreal (IVT) antivascular endothelial growth factor injection (VEGF), observation and other treatments. The list of the OTHERS included both combinations of the main proposed treatments or a variety of other treatments such as eplerenone, spironolactone, acetazolamide, beta-blockers, anti-anxiety drugs, aspirin, folic acid, methotrexate, statins, vitis vinifera extract medication and pars plana vitrectomy. The majority of the patients were men with a prevalence of 77%. The odds ratio (OR) showed a partial or complete resolution of fluid on OCT with any treatment as compared with observation. In univariate analysis, the anatomical result (improvement in subretinal fluid using OCT at 1 month) was favoured by age <60 years (p < 0.005), no previous observation (p < 0.0002), duration less than 3 months (p < 0.0001), absence of CSCR in the fellow eye (p = 0.04), leakage outside of the arcade (p = 0.05) and fluid height >500 \u3bcm (p = 0.03). The OR for obtaining partial or complete resolution showed that anti-VEGF and eyedrops were not statistically significant; whereas PDT (8.5), thermal laser (11.3) and micropulse laser (8.9) lead to better anatomical results with less variability. In univariate analysis, the functional result at 1 month was favoured by first episode (p = 0.04), height of subretinal fluid >500 \u3bcm (p < 0.0001) and short duration of observation (p = 0.02). Finally, there was no statistically significant difference among the treatments at 12 months. Conclusion: Spontaneous resolution has been described in a high percentage of patients. Laser (micropulse and thermal) and PDT seem to lead to significant early anatomical improvement; however, there is little change beyond the first month of treatment. The real visual benefit needs further clarification

Conversion of grip strength scores between Jamar dynamometer and a modified sphygmomanometer in patients with rheumatoid arthritis

BACKGROUND: Jamar dynamometer and modified sphygmomanometer (SphM) are used to evaluate grip strength (GS) in patients with rheumatoid arthritis (RA). However, their scores are not interchangeable

Age- and gender-specific normative data of pinch strengths in a healthy Turkish population

WOS: 000304664200011PubMed ID: 22117012It has been demonstrated that normative data of pinch strengths (PSs) vary among healthy populations. Data from 838 participants (420 women and 418 men) aged 15-96 years were analyzed to develop normative data of PSs for a healthy Turkish population and to analyze changes in the means according to the physical demands of participants' jobs. Lateral, palmar, and tip-to-tip pinch strengths were measured in standard manners. Occupations were classified based on the descriptions in the Dictionary of Occupational Titles. Mean PSs peaked between the ages of 30-50 years in general and increased a small amount in parallel with the increasing strength ratings of the occupations. PS changes followed a curvilinear relationship to age. The differences between our findings and those of similar studies in this field emphasize the importance of using normative data specific to a particular population

Conversion of grip strength scores between Jamar dynamometer and a modified sphygmomanometer in patients with rheumatoid arthritis

WOS: 000324990900001BACKGROUND: Jamar dynamometer and modified sphygmomanometer (SphM) are used to evaluate grip strength (GS) in patients with rheumatoid arthritis (RA). However, their scores are not interchangeable. OBJECTIVES: The aim of this study was to describe the intertrial reliability of grip strength measures obtained with Jamar dynamometer and an SphM, and delineate the relationship of the measures obtained with these two instruments when they were used in patients with RA. METHODS: Patients were eligible volunteers among 74 consecutive patients with definite diagnosis of RA. The data from 61 patients were analyzed. Student's t test was used to compare GS means of the male and female patients. Intertrial reliability was examined using one-way repeated measures ANOVA and intraclass correlation coefficients. The relationship between the measures was established using Pearson correlation coefficients and inverse regression analysis. The latter allowed the generation of conversion tables. RESULTS: GS means were not significantly different between the genders. Both instruments demonstrated excellent intertrial reliabilities. No significant difference was observed among the trials with each instrument. There was a strong relationship between the instruments' scores. This relationship was proven to be linear. Conversion equations were calculated based on the instruments' scores. CONCLUSION: Clinicians now have a table to convert hand strength scores between Jamar dynamometer and an SphM, and can determine the deviation from the normal in patients with RA