PPV

PPV
  • 文章类型: Journal Article
    分析初级玻璃体视网膜外科医生进行的原发性孔源性视网膜脱离(RRD)修复的单次手术解剖学成功(SOAS),并由经验丰富的指导者玻璃体视网膜外科医生进行术前个例选择。
    回顾性,单一研究所,观察性研究,纳入2021年11月至2022年12月接受标准平坦部玻璃体切除术(PPV)或联合环绕束带(CB)和PPV以及气体填塞治疗RRD的所有患者.术前选择的手术决定,是否通过高级外科医生进行标准PPV或组合CB和PPV;根据RRD的位置和扩展,视网膜撕裂(RT)和晶状体状态的数量。我们排除了牵引性视网膜脱离的患者,RD伴增生性玻璃体视网膜病变C期,巨大的眼泪,创伤,以前的巩膜带扣,schisisRD和RD需要硅油。主要结果指标是评估单次手术解剖成功(SOAS)。次要结果指标评估了两种程序之间是否存在统计学上的显着差异。
    82只眼被纳入研究。选择45只眼用于CB和PPV的组合,37只眼用于标准PPV。联合组40眼(88.8%)和标准PPV组35眼(94.5%)均达到SOAS。两种手术的成功率无统计学差异,p=0.65。
    根据RD的复杂程度对标准化手术技术进行结构化的术前选择,加上严密的监督,使接受培训的初级玻璃体视网膜外科医生在两种类型的手术中的再附着率都超过80%。
    UNASSIGNED: To analyse single-operation anatomical success (SOAS) of primary rhegmatogenous retinal detachment (RRD) repair by junior vitreoretinal surgeons guided by preoperative individual case selection by an experienced mentor vitreoretinal surgeon.
    UNASSIGNED: Retrospective, single institute, observational study, included all patients who underwent standard pars plana vitrectomy (PPV) or combined encircling band (CB) and PPV and gas tamponade in the treatment of RRD from November 2021 to December 2022 were included. Preoperative selection for the surgery decision, whether standard PPV or combined CB & PPV was undertaken through the senior surgeon; according to the location and extensions of the RRD, number of retinal tears (RT) and lens status. We excluded patients with tractional retinal detachment, RD with proliferative vitreoretinopathy stage C, giant tears, trauma, previous scleral buckle, schisis RD and RD requiring silicone oil. The primary outcome measure was to evaluate the single-operation anatomic success (SOAS). Secondary outcome measures evaluated whether there was a statistical significant difference between both procedures.
    UNASSIGNED: Eighty-two eyes were included in the study. Forty-five eyes were selected for combined CB&PPV and 37 eyes for standard PPV. SOAS was achieved in 40 eyes (88.8%) in combined group and 35 eyes (94.5%) in standard PPV group. There was no statistically significant difference in the success rate between both operations, p = 0.65.
    UNASSIGNED: Structured preoperative selection of standardized surgical techniques according to the degree of complexity of RD together with close supervision enables junior vitreoretinal surgeons in training to achieve re-attachment rates of more than 80% with both types of surgeries.
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  • 文章类型: Journal Article
    目的:评估子宫内膜癌病例发现算法的阳性预测值(PPV),该算法使用来自美国保险索赔的国际疾病分类第10次修订临床修改(ICD-10-CM)诊断代码,以在计划的上市后安全性研究中实施。评估了两种算法变体。
    方法:从2016年到2020年,在≥50岁的女性中发现了临时发生的子宫内膜癌病例。一种算法变体使用了子宫部位恶性肿瘤的诊断代码(C54。x),排除C54.2(子宫肌层恶性肿瘤);另一个仅使用C54.1(子宫内膜恶性肿瘤)。要求对近期事件临时病例(2018-2020年)的病历进行随机抽样裁定。确诊病例显示子宫内膜癌的活检证据,癌症分期的文献,或诊断后子宫切除术。我们用95%置信区间(CI)估计了变异体的PPV,不包括信息不足的病例。
    结果:在裁定的294起临时案件中,85%来自门诊(n=249)。诊断时的平均年龄为69.3岁。在294起判决的案件中(用更广泛的算法变体确定),通过两种算法变体确认了同样的223例子宫内膜癌病例.更广泛的算法变体的PPV(95%CI)为84.2%(79.2%和88.3%),对于仅使用C54.1的变体,为85.8%(80.9%和89.8%)。
    结论:我们开发并验证了一种使用ICD-10-CM诊断代码的算法,以识别具有足够高PPV的健康保险索赔中的子宫内膜癌病例,用于计划的上市后安全性研究。
    To evaluate the positive predictive value (PPV) of an endometrial cancer case finding algorithm using International Classification of Disease 10th revision Clinical Modification (ICD-10-CM) diagnosis codes from US insurance claims for implementation in a planned post-marketing safety study. Two algorithm variants were evaluated.
    Provisional incident endometrial cancer cases were identified from 2016 through 2020 among women aged ≥50 years. One algorithm variant used diagnosis codes for malignant neoplasms of uterine sites (C54.x), excluding C54.2 (malignant neoplasm of myometrium); the other used only C54.1 (malignant neoplasm of endometrium). A random sample of medical records of recent incident provisional cases (2018-2020) was requested for adjudication. Confirmed cases showed biopsy evidence of endometrial cancer, documentation of cancer staging, or hysterectomy following diagnosis. We estimated the PPV of the variants with 95% confidence intervals (CI) excluding cases that had insufficient information.
    Of 294 provisional cases adjudicated, 85% were from outpatient settings (n = 249). Mean age at diagnosis was 69.3 years. Among the 294 adjudicated cases (identified with the broader algorithm variant), the same 223 were confirmed endometrial cancer cases by both algorithm variants. The PPV (95% CI) for the broader algorithm variant was 84.2% (79.2% and 88.3%), and for the variant using only C54.1 was 85.8% (80.9% and 89.8%).
    We developed and validated an algorithm using ICD-10-CM diagnosis codes to identify endometrial cancer cases in health insurance claims with a sufficiently high PPV to use in a planned post-marketing safety study.
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  • 文章类型: Journal Article
    目的:糖尿病性黄斑水肿(DME),糖尿病相关视力障碍的最常见原因,可能发生在平坦部玻璃体切除术(PPV)治疗增生性糖尿病视网膜病变并发症后。这项回顾性单中心病例系列评估了使用定制的针头将4mg/0.1ml曲安奈德注入脉络膜上腔以治疗PPV后DME的疗效和安全性。
    方法:使用光谱域光学相干断层扫描和基线(注射前)最佳矫正视力(通过Snellen图)有关中央黄斑厚度(CMT)的数据,并在注射后1、4和8周进行分析,随着眼内压(IOP),白内障进展,和眼睛安全。
    结果:10例患者的11只眼接受了11次脉络膜上注射。注意到视力改善(基线时0.75log最小分辨率角(MAR)至治疗后0.40logMAR)。CMT从基线的456.45±113.42μm显著降低至注射后8周的247.63±53.40μm。IOP没有上升,或在单个治疗的有晶状体眼发生白内障,在8周的随访中观察到。
    结论:使用定制的针头在脉络膜上注射曲安奈德治疗PPV后DME显示了有希望的结果,安全性可接受。对于卫生保健资源有限的国家,需要进行长期随访的大型临床试验来评估这种治疗方案。
    OBJECTIVE: Diabetic macular edema (DME), the most common cause of diabetes-related visual impairment, may occur following pars plana vitrectomy (PPV) to manage proliferative diabetic retinopathy complications. This retrospective single-centre case series evaluated the efficacy and safety of injecting 4 mg/0.1 ml triamcinolone into the suprachoroidal space using a custom-made needle to treat DME post PPV.
    METHODS: Data regarding central macular thickness (CMT) using spectral domain-optical coherence tomography and best-corrected visual acuity (by Snellen chart) at baseline (pre-injection), and at 1, 4, and 8 weeks following injection were analysed, along with intraocular pressure (IOP), cataract progression, and ocular safety.
    RESULTS: Eleven eyes in 10 patients received 11 suprachoroidal injections. Vision improvement was noted (0.75 log minimum angle of resolution (MAR) at baseline to 0.40 log MAR after treatment). CMT reduced significantly from 456.45 ± 113.42 μm at baseline to 247.63 ± 53.40 μm at 8 weeks following injection. No rise in IOP, or cataract development in the single treated phakic eye, was observed during 8 weeks of follow-up.
    CONCLUSIONS: Suprachoroidal injection of triamcinolone using a custom-made needle to treat DME post PPV shows promising results with acceptable safety outcomes. Large clinical trials with longer follow-up are needed to evaluate this treatment option for countries with limited health-care resources.
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  • 文章类型: Case Reports
    目的:报道一例罕见的新型后房型人工晶状体延迟脱位进入玻璃体腔,通过改良技术成功治疗。
    方法:一名29岁女性接受了Ejinn有晶状体难治性晶状体(EPRL)植入术以矫正其高度近视。术后26个月发生自发性脱位进入玻璃体腔,无外伤史。进行平坦部玻璃体切除术并将EPRL切成两片,以去除脱位的EPRL。
    结论:我们的改良技术可以成功且轻松地去除EPRL玻璃体腔内的脱位。术前关注小带相关并发症,术中,术后必须在EPRL植入的实践中提高。
    OBJECTIVE: To report a rare case of delayed dislocation of a novel posterior chamber phakic intraocular lens into the vitreous cavity, which was successfully treated by a reformed technique.
    METHODS: A 29-year-old female received Ejinn phakic refractory lens (EPRL) implantation to correct her high myopia. Spontaneous dislocation into the vitreous cavity occurred 26-months post-operatively without traumatic history. Pars plana vitrectomy combined with cutting the EPRL into two equal pieces was performed to remove the dislocated EPRL.
    CONCLUSIONS: Dislocation into the vitreous cavity of EPRL can be successfully and easily removed by our reformed technique. Concerns about zonules-related complications pre-operatively, intraoperatively, and post-operatively must be raised in the practice of EPRL implantation.
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  • 文章类型: Journal Article
    报告视盘凹陷相关性黄斑病变(ODP-M)患者平面玻璃体切除术(PPV)联合内界膜(ILM)填充技术的结果。
    包括最佳矫正视力(BCVA)在内的数据,黄斑中心厚度(CMT),中央凹中心点厚度(FCP),从患者的医疗记录中收集最大液体高度(max_fluid)(视网膜内或视网膜下)。
    6例平均年龄28.0±17.68岁(范围:9-53岁)的患者的6只眼睛接受了PPV+ILM栓塞手术。平均随访时间为25.62±26.11个月(范围:11.80-78.00个月)。在最后一次随访时,平均BCVA从1.25±1.04logMAR(20/355,Snellen等效)增加到0.86±1.09logMAR(20/144,Snellen等效)(p=0.043)。与基线相比,CMT,FCP,手术后所有就诊时,max_fluid均显着降低(所有就诊均p<0.05)。在最后的随访中,66.6%的眼睛(四只眼睛)在手术后平均5.25±4.99个月(范围:1-12个月)显示出完全的液体消退。
    带有ILM插头的PPV似乎是ODP-M的有效手术技术需要更长的随访时间和更多患者的研究来证实我们的结果。
    UNASSIGNED: To report outcomes of pars plana vitrectomy (PPV) combined with internal limiting membrane (ILM) stuffing technique in patients with optic disc pit associated maculopathy (ODP-M).
    UNASSIGNED: Data including best-corrected visual acuity (BCVA), central macular thickness (CMT), foveal center point thickness (FCP), and maximum height of fluid (max_fluid) (intraretinal or subretinal) were collected from the medical records of the patients.
    UNASSIGNED: Six eyes of six patients with a mean age of 28.0 ± 17.68 years (range: 9-53 year) underwent PPV + ILM plug surgery. The mean follow-up duration was 25.62 ± 26.11 months (range: 11.80-78.00 month) duration. The mean BCVA increased from 1.25 ± 1.04 logMAR (20/355, Snellen equivalent) to 0.86 ± 1.09 logMAR (20/144, Snellen equivalent) at last follow-up (p = 0.043). Compared to baseline, CMT, FCP, and max_fluid significantly decreased at all visits after the surgery (p < 0.05 for all visits). At last follow-up, 66.6% of the eyes (four eyes) showed complete resolution of fluid at a mean of 5.25 ± 4.99 months (range: 1-12 months) after the surgery.
    UNASSIGNED: PPV with ILM plug seemed to be an effective surgical technique in ODP-M. Studies with longer follow-up and higher number of patients are needed to confirm our results.
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