Randomized Control Trial Summary

Optical coherence tomography provides high-resolution imaging of the vitreoretinal interface, neurosensory retina, and subretinal space. Optical coherence tomography can be used to quantify retinal thickness, monitor macular edema, identify vitreomacular traction, and detect other forms of macular disease in patients with diabetic macular edema. 105,106 OCT helps in early diagnosis of macular oedema as it is more sensitive than clinically examination, in deciding the treatment options for DME and also

As humans, we don't always see with our eyes, but often with our imagination (Grunwald, 2016). Often times as people we never realize how useful our vision really is to us. You really don't think about something like that until it would actual happen to you. Throughout this essay, you will learn how the body is affected by Macular Degeneration (MD). Different signs and symptoms, as well as the etiology of MD, will be discussed. In the following, diagnosis tests and treatments may also be listed in order to help others who would like to know more about MD. Not to mention, you will learn the incidence and progression of MD. Furthermore, information though agencies and associations, as well as new research about MD will be given.

Prior to the subretinal injection of Luxturna, an ophthalmologist performs a vitrectomy to remove the vitreous gel within the eye. The AAV2 vector is then injected in close proximity to the retinal pigment epithelium at a very high concentration (Russell et al 849). Each eye is treated separately to monitor potential complications and prevent immune responses. The potential risks the vitrectomy procedure and injection include cataract formation, infection, retinal tears, and macular holes and macular tears (Russell et al 851). In addition, ophthalmologists require further subretinal injection training before performing this procedure.

Following epithelial debridement, Riboflavin 0.1%, suspended in a dextran T500 20% solution, is applied every 3–5 min for at least 20 min to allow sufficient stromal absorption prior to UVA exposure (Wollensak et al., 2003a). Intra-operative pachymetry is advocated by many surgeons to monitor corneal thickness prior to UVA exposure and apply hypotonic Riboflavin drops if it thins excessively during Riboflavin administration. The central 8–9 mm of the cornea is then irradiated with UVA, at 3 mW/cm2 for 30 min.

Glaucoma is a disease that damages the optic nerve because of extra fluid increasing pressure in the eye (Boyd). It is also the leading cause of blindness if left untreated in people over sixty Boyd states. Varieties of options are available for treatment regarding glaucoma and all are intended to lower the blood pressure and protect optic nerve (Radhakrishan and Iwach). Glaucoma can be treated with eye drops, pills, and surgery or a combination of these methods. (“Treating Glaucoma”). Right now eye drops are the first choice of treatment because they lower eye pressure, helping fluid drain better or decreasing fluid made by the eye (Radhakrishan and Iwach). As is states in the article “Treating Glaucoma” when eye drops cannot control the glaucoma,

Glaucoma can occur without much warning, whether its acute from a accident in which a trauma is issued on the eye, or if it is due to age and heredity. Glaucoma doesn 't discriminate, it is seen in all races and genders. It happens so slowly with age and heredity that you don 't even notice the loss of vision until it is too late, and with acute glaucoma it can be painful with pain that radiates over the face, a headache, nausea, vomiting and seeing colored halos around lights and even blurred vision can be a few symptoms (Ignatavicius & Workman, 2013). Once you start seeing halos, and lose peripheral vision, it may be an indicator that irreversible damage to the optic nerve has happened. In this paper we will discuss the pathophysiology of glaucoma, the types of glaucoma as well as the causes for them. the issues that glaucoma can cause someone, and the treatments and interventions. We will also have a education handout to help better understand how to administer the medication, and the effects it has on the eye.

Recommendation Statement “glaucoma affects approximately 2.5 million Americans and is a leading cause of impaired vision (loss of peripheral vision) and blindness” (Moyer). Glaucoma is a disease the damages the optic nerve in the eye. There are several different types of glaucoma including: Open-angle, normal-tension, closed-angle, and congenital glaucoma. Open-angle is the most common. Even though there is no treatment yet for glaucoma, a person can manage it. To help a person mange this disease there are two basic treatments that can be used: medicated eye drops or surgery.

As previously stated in the results section of this report, if there is a breakdown of the blood-ocular barrier, the amount of proteins present within the aqueous humour will tend to increase. When viewing the anterior chamber with a slit lamp, this increase in protein content will result in light being scattered. Flare is the term given to the presence of this scattered light. Flare is a common symptom seen in acute iritis and therefore would likely be seen in this patient with the use of a slit lamp.

Retinal vein occlusion is the second leading cause of vascular disorder after diabetic retinopathy.1 Retinal vein occlusions are classified into 3 categories depending on the location of the thrombus formation; branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO), and hemi retinal vein occlusion (Hemi-RVO). 7 BRVO is considered to be the most common among the retinal vein occlusions.6 BRVO occurs more often in men than women. Asians (5.7 per 1000) and Hispanics (6.9 per 1000) are at greater risk of developing BRVO than other ethnicities.6 The age range of patients diagnosed with retinal vein occlusion ranges from young as 14 years of age to old as 92 years of age, with 51% of patients being older than 65 years.3 Advancing age is an important risk factor for developing retinal vein occlusions. Prevalence of retinal vein occlusions in 40-49 years old is 1.57 per 1,000, 4.58 per 1,000 in 50-59 years old, 11.11 per 1,000 in 60-69 years old, 12.76 per 1,000 in 70-79 years old, and 10.32 per 1,000 in those older than 80 years.6

Preproliferative retinopathy indicates further destruction of retinal capillaries. Proliferative retinopathy is the severe form and the capillaries become occluded, and new blood vessels are formed to supply the retina with blood. It is caused by damage to the sensitive blood vessels in the eyes. Retinopathy can be worsened by severe hypertension because of the additional stress it places on the blood vessels. Diabetic patients should be referred to ophthalmolgists for annual eye examination (Baumann, Chang & Hoebeke 2002:191; Butterworth Medical Dictionary 1990:1467; Campbell, Pearson, Ratner & Wysham 1997:69; Long term Complications [sa]:36; Recognition [Sa]:31; Smeltzer & Bare

Donnelly, Winder, Kernohan and Stevenson used a Randomized control trial (RCT), to try and establish a difference between offloading and standard care in relation to the number and severity of pressure ulcers (PU’s) on the heel of patients who were admitted with fractured hips, while also examining the number and severity of PU’s that occurred in other areas of the body. This study took place in the fracture trauma unit of a major tertiary referral center in Belfast, with 119 patients being allocated the control group and 120 in the intervention group. The patients were aged 65 years and over and could not already have existing heel damage. The research design chosen, randomized control trail, allows for patients to be randomly allocated to

In a study done by Emadedin et al. in 2012, they injected MSC from each respective patients bone marrow, into six female volunteers with evidence of knee OA that was severe enough to require joint replacement surgery. The authors described a detailed, meticulous procedure in how they obtained the MSC from the patient’s bone marrow, and made it into the cells they needed for the procedure. They injected the patient’s affected knee joints with the stem cells and followed up with them in one year. At the one year mark, Emadedin et al. (2012) found that overall, the study was successful in decreasing pain and increasing the patients walking distance for the first 6 months. However, they discovered that 3 of the

Treatment of open-angle glaucoma usually begins with prescription eyedrops. These eyedrops lower pressure inside the eyeball, either by causing the eye to produce less fluid or by helping fluid to drain more. As an alternative to medication or when medication does not control glaucoma, laser surgery can be done. This surgery, also called laser trabeculoplasty, uses a laser to make the openings in the eye's drainage network larger. If medication and laser surgery are unsuccessful, conventional eye surgery may be necessary to make a new opening for fluid to leave the eye.

Randomized control trials are considered the “gold standard for evaluating medical interventions and there are numerous variations that can be applied to the study design. The cluster randomized crossover design is one such variation and has been gaining popularity in trial settings when individual randomization is not possible

Were all of the patients who entered the trial properly accounted for at its conclusions?