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Rohan W Essex

Publications and source records attributed to Rohan W Essex.

7 recordsLinked to original sources
PubMed2005

Two-year results of laser treatment for retinopathy of prematurity at a single neonatal intensive care unit.

PURPOSE: To present the 2-year results of all patients receiving laser treatment for retinopathy of prematurity (ROP) at a single institution over a 9.5-year period. To establish the frequency of threshold ROP. METHODS: Consecutive case series. All patients who had laser treatment for ROP at The Royal Women's Hospital, Melbourne, Australia, between January 1992 and July 2001 were prospectively recorded in a database. Their medical charts were retrospectively reviewed. Baseline birthweight, gestational age at birth, timing of treatment, and ROP severity at treatment were recorded. The main outcome measures were visual acuity (significantly reduced or not), anatomic outcome and refractive error at 2 years of age (corrected for the degree of prematurity). RESULTS: A total of 107 eyes of 57 babies were treated with laser photocoagulation. Four children did not survive for follow-up, and 2-year follow-up data were available for 38 children (67%, 71 treated eyes). Average duration of follow-up was 26 months. Two-year visual acuity was significantly reduced in 12/71 (17%) treated eyes, and 3/38 children (8%) had significantly reduced vision in both eyes. An anatomical outcome of macular fold or worse was observed in 8/71 eyes (11%). Mean 2-year spherical equivalent refractive outcome was only minimally myopic (-0.6 D). CONCLUSION: Visual, anatomic and refractive outcomes after laser treatment for ROP were favourable, confirming that laser photocoagulation is an effective treatment for severe ROP.

Birth Weight↗
PubMed2004

Post-traumatic endophthalmitis.

OBJECTIVE: To establish risk factors for the occurrence of post-traumatic endophthalmitis, to observe the efficacy of prophylaxis, and to describe the clinical features of post-traumatic endophthalmitis. DESIGN: Partially prospective consecutive case-control study. PARTICIPANTS: A total of 250 consecutive patients admitted to a single ophthalmic hospital with open globe injuries during a 3-year period were included. METHODS: Patients with post-traumatic endophthalmitis were identified prospectively and added to an endophthalmitis database. All open globe injuries during the same time period were identified through a retrospective search of inpatient admissions, and their charts were reviewed. Information collected from all patient files included patient age; gender; injury setting (indoor/outdoor); wound contamination; nature of injury (site on eye, lens involvement, retained intraocular foreign body); mechanism of injury (penetration/perforation/rupture/ruptured surgical wound); prophylactic antibiotic administration, including route and timing; timing of primary repair; lensectomy at the time of primary repair; and depot corticosteroid at the time of primary repair. Any association between these parameters and the subsequent development of endophthalmitis was investigated. Any association between endophthalmitis and final visual acuity (VA) and also enucleation was evaluated. MAIN OUTCOME MEASURE: Development of endophthalmitis. RESULTS: The frequency of endophthalmitis after open globe injury was 6.8%. The following factors were associated with the subsequent development of endophthalmitis by univariate analysis: dirty wound (14.3% vs. 4.1%, P = 0.01), retained intraocular foreign body (13.0% vs. 4.4%, P = 0.02), lens capsule breach (12.8% vs. 3.2%, P = 0.01), delayed primary repair (> or =12 hours) (11.3% vs. 2.9%, P = 0.02), and rural address (10.1% vs. 4.3%, P = 0.07). Risk factors identified after multivariate analysis were dirty injury (odds ratio [OR], 5.3; 95% confidence interval [CI)], 1.5-18.7), breach of lens capsule (OR, 4.4; 95% CI, 1.2-15.6), and delay in primary repair (per hour: OR, 1.013; 95% CI, 1.002-1.024). None of the following factors was found to be associated with post-traumatic endophthalmitis: patient age, gender, injury setting, site of injury on eye, mechanism of injury, antibiotic administration, lensectomy at the time of primary repair, and depot corticosteroid at the time of primary repair. Final VA tended to be worse in eyes with endophthalmitis (P = 0.08). Endophthalmitis did not significantly influence the frequency of enucleation/evisceration (5.9% vs. 4.3%, P = 0.55). CONCLUSIONS: Delay in primary repair, ruptured lens capsule, and dirty wound were each independently associated with the development of post-traumatic endophthalmitis. Patients with > or =2 of these 3 risk factors had a particularly high frequency of infection.

Adolescent↗
PubMed2004

Are Duane syndrome and infantile esotropia allelic?

PURPOSE: To evaluate the clinical overlap of families with Duane syndrome and infantile esotropia to determine whether the identification of genes for Duane syndrome may explain some cases of infantile esotropia. METHODS: Three separate groups of patients were evaluated. 1) Families with features of infantile esotropia were identified through the Strabismus Inheritance Study Tasmania (SIST). Clinical details of participants and their families were reviewed for any cases of Duane syndrome. 2) Cases of Duane syndrome were identified through the clinical diagnostic database at the Royal Children's Hospital, Melbourne, and private ophthalmology clinics in Melbourne and Tasmania. Previous medical notes were reviewed and family history of strabismus noted. All affected individuals were invited for re-examination in cases where a positive family history of strabismus was reported; siblings, parents, and other family members, where appropriate, were invited to be examined for signs of Duane syndrome or infantile esotropia. 3) Cases of mosaic trisomy 8, which has been associated with Duane syndrome and infantile esotropia, were reviewed for signs of strabismus. RESULTS: A total of 133 families from the SIST were reviewed, but no 'pure' families of Duane syndrome were identified. Two families with infantile esotropia had several members affected with Duane syndrome. Of the 40 index cases with Duane syndrome whose families agreed to be involved in the study, 21 had a family history of ocular motility disorders, but only two of these families had multiple cases of Duane syndrome. From 24 cases with mosaic trisomy 8, one individual case had Duane syndrome and another had mild congenital cataracts and infantile esotropia. CONCLUSIONS: There is clinical overlap in families with Duane syndrome and infantile esotropia. We confirmed the previous association of mosaic trisomy 8 with both Duane syndrome and infantile esotropia. These data suggest that the two conditions may be allelic and may be due to a gene on chromosome 8.

Alleles↗
PubMed2004

Three cases of post-traumatic endophthalmitis caused by unusual bacteria.

Three cases of post-traumatic endophthalmitis caused by unusual bacteria are presented. The pathogens identified were: (i) Bacillus cereus and Citrobacter freundii; (ii) Pseudomonas fluorescens; and (iii) Chryseobacterium meningosepticum and Stenotrophomonas maltophilia. Two of these pathogens have not previously been reported to cause endophthalmitis. The available literature regarding the individual cases is summarized and a brief discussion of post-traumatic endophthalmitis is presented, with reference to a recently published large series at the authors' institution.

Adult↗
PubMed2004

Amniotic membrane grafting in the surgical management of primary pterygium.

BACKGROUND: To evaluate the efficacy of amniotic membrane transplantation in primary pterygium surgery. METHODS: Patients presenting to the outpatient clinic of the Royal Victorian Eye and Ear Hospital with primary pterygium requiring surgical management were included in this study. The pterygia were excised to bare sclera and the conjunctival defects were closed with amniotic membrane grafts. The primary outcome was pterygium recurrence. RESULTS: Twenty-eight pterygia of 26 patients were included. Twenty-three patients (88%, 25 eyes) completed 12 months follow up. By 12 months postoperatively 16 of these eyes (64%) had developed corneal recurrence and a further two had developed a limbal recurrence (9%). Five required repeat surgery during the 12 month follow-up period. No association was found between pterygium recurrence and pterygium size (P = 0.33), amniotic membrane graft dimension (P = 0.12), patient age (P = 0.53) or patient sex (P = 0.63). CONCLUSION: Amniotic membrane grafting for primary pterygium was associated with an unacceptably high recurrence rate in this population.

Adult↗
PubMed2003

Photodynamic therapy in practice: a review of the results of the first 12 months experience with verteporfin at the Royal Victorian Eye and Ear Hospital.

PURPOSE: To review the 12-month results of the first 136 eyes treated with photodynamic therapy (PDT) with verteporfin at a single institution, and to determine if this treatment when used in the broader community could reproduce the results achieved in the Treatment of Age-related Macular Degeneration (AMD) with PDT (TAP) study. METHODS: A record of all patients who first received PDT with verteporfin at The Royal Victorian Eye and Ear Hospital between the time of its introduction in February 2000 and February 2001 was prospectively maintained. The medical charts of these cases were reviewed and fluorescein angiograms were graded. Eyes with AMD were classified into three groups: TAP comparable if they had predominantly classic subfoveal choroidal neovascularization (CNV) and visual acuity between 6/12 and 6/60; VIP comparable if they had occult but no classic subfoveal CNV and visual acuity better than 6/36; and PDT ineligible if they fell outside recommended eligibility guidelines of the TAP/VIP studies. The main outcome measure was visual acuity change, with total number of treatments a secondary outcome variable. RESULTS: A total of 136 eyes of 130 patients began PDT during this period. The baseline angiogram and clinical data were available for 123 eyes (90%), and these were reviewed. Fourteen eyes had non-AMD related CNV, while 109 eyes of 105 patients had AMD. Of the 109 AMD related lesions, 72 (66%) were TAP comparable, six (5.5%) were VIP comparable and 31 (28%) were PDT ineligible. At the 12-month visit the proportion of TAP comparable eyes with same or better vision was 36/72 (50%), compared to 13/31 (42%) of the PDT ineligible eyes (P = 0.45). Only 30/72 (42%) of the TAP comparable eyes were still undergoing regular angiographic and clinical assessment (similar to the TAP protocol) at the time of the 12 month visit. The number of these who had same or better vision at 12 months was 17/30 (57%) compared to 19/42 (44%) TAP comparable eyes without regular angiographic follow up to 12 months (P = 0.37). CONCLUSDIONS; When used according to the guidelines established by the TAP study, the visual acuity results with PDT approached those achieved in the TAP study. When eyes were either enrolled outside the TAP study eligibility guidelines, or were not actively followed up over the 12-month period as per TAP study guidelines, the visual outcome was similar to natural history of CNV secondary to AMD.

Aged↗