Purpose The aim was to compare the impact of rigid gas‐permeable (RGP) contact lenses on vision‐related quality of life (VR‐QOL) in keratoconic patients with different grades of severity. Methods This comparative study was conducted from December 2012 to September 2013 on 46 patients with bilateral keratoconus. Patients were divided into three groups according to the average of the steep keratometry (K) readings in the two eyes of each patient. Main outcome measures included binocular visual acuity (VA), lens wearing time, the 25‐item National Eye Institute Visual Function Questionnaire (NEI‐VFQ‐25), foreign body (FB) sensation, comfort and overall satisfaction. Results Patients with severe keratoconus showed significantly reduced wearing time compared with the other two groups (4.8 ± 2.5 hours per day). Regarding the subjective criteria, there was no significant difference on NEI‐VFQ‐25 scores, foreign body sensation, comfort and overall satisfaction between mild and moderate keratoconus groups but scores in the group with severe keratoconus were significantly lower than the other two groups. Binocular VA strongly correlated with NEI‐VFQ‐25 scores; however, NEI‐VFQ‐25 scores had no significant correlations with different disease severities. Conclusions Appropriate correction with RGP lenses contributes to good VR‐QOL for keratoconic patients; however, as the disease progresses to a steep keratometric value of more than 52 dioptres (6.50 mm), RGP lenses did not guarantee a relatively good VR‐QOL. Other lens options with new designs might bring better life quality for these patients with severe keratoconus.
Although drug-based treatment is the primary intervention for malaria control and elimination, optimal use of targeted treatments remains unclear. From 2008 to 2016, three targeted programs on treatment were undertaken in Kachin Special Region II (KR2), Myanmar. Program I (2008–2011) treated all confirmed, clinical and suspected cases; program II (2012–2013) treated confirmed and clinical cases; and program III (2014–2016) targeted confirmed cases only. This study aims to evaluate the impacts of the three programs on malaria burden individually based on the annual parasite incidence (API), slide positivity rate (SPR) and their relative values. The API is calculated from original collected data and the incidence rate ratio (IRR) for each year is calculated by using the first-year API as a reference in each program phase across the KR2. Same method is applied to calculate SPR and risk ratio (RR) at the sentinel hospital too. During program I (2008–2011), malaria burden was reduced by 61% (95%CI: 58%-74%) and the actual API decreased from 9.8 (95%CI: 9.6–10.1) per 100 person-years in 2008 to 3.8 (3.6–4.1) per 100 person-years in 2011. Amid program II (2012–2013), the malaria burden increased by 33% (95%CI: 22%-46%) and the actual API increased from 2.1(95%CI: 2.0–2.3) per 100 person-years in 2012 to 2.8 (95%CI: 2.7–2.9) per 100 person-years in 2013. During program III (2014–2016) the malaria burden increased furtherly by 60% (95%CI: 51% - 69%) and the actual API increased from 3.2(95%CI: 3.0–3.3) per 100 person-years in 2014 to 5.1 (95%CI: 4.9–5.2) per 100 person-years in 2016. Results of the slide positivity of the sentinel hospital also confirm these results. Resurgence of malaria was mainly due to Plasmodium vivax during program II and III. This study indicates that strategy adopted in program I (2008–2011) should be more appropriate for the KR2. Quality-assured treatment of all confirmed, clinical and suspected malaria cases may be helpful for the reduction of malaria burden.
Purpose. To evaluate the efficacy of intravitreal conbercept (IVC) plus modified grid laser photocoagulation (MGP) versus IVC alone for treatment of diffuse diabetic macular edema (DDME). Methods. In this retrospective study, 51 DDME patients were treated with either IVC alone (IVC group) or IVC plus MGP (combined group) with 12 months of follow-up. The clinical records of those patients were reviewed. Results. 26 patients (31 eyes) received IVC alone and 25 patients (30 eyes) received combined therapy. At month 12, the mean best-corrected visual acuity (BCVA) letter score improvement was 9.1 ± 4.5 and 7.5 ± 4.2 in the IVC group and the combined group and the mean central retinal thickness (CRT) reduction was 145.1 ± 69.9 μm and 168.5 ± 53.6 μm, respectively. There was no statistically significant difference of improvement in BCVA (P = 0.164) and decrease in CRT (P = 0.149) between the two groups. The mean number of injections delivered was significantly higher (P < 0.001) in the IVC group (5.6 ± 0.8 per eye) than in the combined group (3.3 ± 1.2 per eye). Conclusions. IVC alone or combined with MGP appeared to be effective for treatment of DDME, achieving the similar clinical efficacy. Moreover, MGP helps to reduce the number of injections.
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