S. Adams

Short-term response of macular oedema to intravitreal bevacizumab

Background/aims: Bevacizumab has been shown to be an effective treatment of macular oedema. This study assesses the response of macular oedema to bevacizumab with specific focus on the first 24 h postinjection. Methods: Subjects with diabetic macular oedema (DMO) or exudative age-related macular degeneration (ARMD) received intravitreal bevacizumab injections. Early Treatment of Diabetic Retinopathy Study (ETDRS) visual acuity and OCT macular thickness measurements were obtained at baseline, 1, 3, 6, 24 and 48 h, 1 week and 1 month postinjection. Results: The average baseline OCT was 452.91 µm (SD 182.96, range 249.00 to 784.00). After injection, there was a statistically significant decrease in OCT thickness within 2 h with a plateau phase out to 24 h, followed by a significant drop between 24 and 48 h, and a return towards baseline between 1 week and 1 month. Average changes in ETDRS visual acuity were not statistically significant, though many patients experienced a positive outcome. Conclusion: While there is an immediate pressure-related effect, it appears that the anti-VEGF effects of bevacizumab require approximately 24 h to become active and persist for 2–3 weeks. These results suggest that injections at 2–3-week intervals might provide improved clinical outcomes, compared with the currently typical 4–6-week interval of injections.

An examination of a proposed scoring procedure for the clock drawing test: Reliability and predictive validity of the clock scoring system (CSS)

The clock drawing test (CDT) is usedfor a variety of diagnostic purposes, including screening for dementia. Individuals have relied on subjective judgments in distinguishing between normal and abnormal clocks. This studyproposesaformal, objective scoring procedure called the Clock Scoring System (CSS). The CDTwas administered to 23 dementia patients and 27 normal, elderly controls. The inter-rater reliability estimates of the CSS rangedfrom 82 to .98 across diagnostic groups. Scores discriminated between the patient and comparison groups, even after controlling for age and education. A discussion of the usefulness of this measure as well as ftture research directions is presented.

Sociodemographic factors in health psychology research: 12 years in review.

The article provides a 12-year review of health psychology research through a content analysis of the journal Health Psychology. Empirical studies of adults (n = 490) and children (n = 103) published between 1985-1996 were assessed with respect to information reported on race, income, education level, gender, and age characteristics of study participants. Although gender and age were usually reported, several studies did not provide race, income, or education information. However, time-trend analyses revealed significant improvements over the past few years in reporting of race, education, and age in articles on adults and in race reporting in articles on children.

Alternative technique for implantation of a scleral-fixated intraocular lens

We describe an alternative method of implanting a scleral-fixated intraocular lens (IOL) that facilitates passage of the suture and improves control of suture placement. An ab externo approach introduces a loop of polypropylene (Prolene) through the sclera in a single 27-gauge puncture. The loop is used to secure the IOL haptic in a cow-hitch fashion, which minimizes the risk for the knot to unravel and the IOL to dislocate. After the IOL is placed in the eye, it is secured with the externalized curved suture needle. Knots are covered with a scleral flap. This technique improves efficiency and control in placing an IOL near the normal anatomical location of the crystalline lens when the absence of capsule support precludes nontethered placement of an IOL in the sulcus or capsular bag.

Clinical differentiation of the Rey Auditory-Verbal Learning Test

The Rey Auditory-Verbal Learning Test (RAVLT) was used to assess memory and learning in dementia, psychiatric, general medicine, and head injury patients. Subjects were 127 older male veterans who received the RAVLT as part of a routine assessment. The dementia group recalled fewer total words than the psychiatric and general medicine groups. While all men demonstrated a positive learning curve, learning patterns varied among the four groups. Recency effects were seen in all groups. Primacy effects were not seen in the dementia group. Specific trials of the RAVLT appear to distinguish groups better than the total score. Additionally, sequential organization of information may influence memory and learning in these groups.