Telefon: 38 66 66 37. På øjenafdelingen i Glostrup har vi for nylig fået publiceret en undersøgelse, der viser, at en ukompliceret grå stær operation generelt øger risikoen for nethindeløsning 4 gange i forhold til, hvis man ikke blev opereret. This validation showed that the NPR had less than 3% wrong coding, meaning that 97% of the data must be assumed to be correct. When an entire country is a cohort, Epidemiology. The NPR also contains information about which eye has been operated which is useful when looking at the risk of detachment on the fellow eye (Paper I). - Sidst i juni ringede jeg til vagtlægen og fortalte, hvad der var galt. nethindeløsning så sent, er det desværre de færreste, som genvinder evnen til at læse efter en operation. Klag digitalt. Så kryds gerne fingrene eller pindene! Ph.d. Javad Nouri Hajari fra Øjenafdelingen på Glostrup Hospital forsker i nethindeløsning. This is based on the status of the lens (Heimann et al. Previous studies have found a crude incidence of RRD of 6.9–17.9 cases per 100.000 citizens per year (Tornquist et al. Og . The central 1.85 mm in diameter of the macula is called the fovea or macula lutea as it contains a large amount of the yellow pigment lutein. Øjenklinikken Rasmus Pold. Departments have different approaches regarding surgery for RRD. En efterstær kan nemt fjernes ved hjælp af laser. The risk of fellow eye involvement is of interest to patients and physicians alike. Inventor of the surgical treatment for retinal detachment, Assessment of accuracy and precision of quantification of ultra-widefield images, Epidemiologic characteristics of rhegmatogenous retinal detachment in Kumamoto, Japan, Quantitative estimations of foveal and extra-foveal retinal circuitry in humans, Results of primary retinal reattachment surgery: a prospective audit, National audit of the outcome of primary surgery for rhegmatogenous retinal detachment. Use of the rate of reoperations to measure the quality of care requires at the very least that one knows how much of the risk of a reoperation for RRD that can be attributed to the primary intervention, and how much can be attributed to the eye itself. BLEGDAMSVEJ 9, 2100 KBH Ø | VALDEMAR HANSENS VEJ 1-23, 2600 GLOSTRUP. operation for grå stær. Having indicators for surgical outcome that can be assessed within a short time frame would be preferred, as they would result in faster optimization of a procedure and improving patient morbidity. Cibis died prematurely and the treatment of difficult RRD cases was continued by the British surgeon J. Scott who used open sky vitrectomy for difficult cases. 4,7 millioner i støtte Projektet støttes med 4,7 millioner kr. Øjenlæger Herlev - øjeninfektioner, infektioner i øjet, øjensygdomme, grøn stær, speciallæger, bygningsfejl, laserbehandling, øjenallergi, hornhindeskader . Vores ansatte i USA koster ca 150000DKK om året i sundhedsforsikring for en familie. Kl. Spørgsmål. Amotio Retinae - firmaer, adresser, telefonnumre. We know from Paper I how many patients have been treated for RRD in Denmark, but the question remains whether these patients are treated correctly. Establishing the risk of RRD in the fellow eye is of interest both for the patient and for the ophthalmologist. The advantage of the OCT is that it provides a more precise demarcation of the detachment, and as we were more interested in the risk of a posterior RRD that advances towards the fovea, the OCT is still more useful than the OPTOS™. The risk of a detachment on the fellow eye was used to define when an operation for RRD was a reoperation and thereby caused by poor surgery. 12.15 - 13.00 Frokost. We know that a RRD results in alterations in the microstructure of the retina (Abouzeid & Wolfensberger 2006), and achieving anatomical success by performing as few surgeries as possible would therefore be beneficial. 2013). Middle-aged male patients should be monitored closely and be made aware of the large risk of bilateral RRD. After the first couple of years, a regular check-up on the operated eye is not more reasonable than it would be on the fellow eye. However, over time the fellow eye is at risk of being affected. We therefore evaluated the intra- and interobserver variability of these distance measurements and found a minor intra-observer variation (standard deviation 42 microns) which has to be accounted for. The risk of RRD on the initially operated eye and the fellow eye of the same patient is similar after one year. år, og den tilsvarende øgning af nærsynetheden omkring 0,5 dioptrier pr. The detachment begins in the periphery of the retina and works its way towards the fovea. Kastevind er Alberte Windings fine erindringsglimt fra barndommen. Vælg kommune for at se selvbetjening og information, der gælder dig. (2010) presented nationwide data from a two-year period. 2014). . 2007). Most patients with flashes and floaters do not have retinal tears or a detachment and screening patients with symptoms to find the ones that have a condition that needs treatment is time-consuming as all patients have to be seen by an ophthalmologist. Han havde fået nethindeløsning igen - bare i det andet øje. The aim of this thesis is to create knowledge on how treatment and care of RRD patients can be optimized. The connections between RPE cells and the ELM seal the subretinal space preventing any passive transport to this compartment. ikke i . They tend to progress more rapidly, and therefore, special concern should be made regarding this group. 15 år. In these two distinct search algorithms, patients were excluded if they had any of the exclusion criteria mentioned above. However, the literature still lacks information on whether a redetachment does result in poorer vision compared to a successful first operation. Nethindeløsning betragtes som en akut øjensygdom, der kræver akut behandling. Ulrik C. Christensen Department of Ophthalmology Glostrup Hospital DK ‐ Glostrup Denmark Tel: +45 4312 4811 Fax: +45 4323 4669 Email: ulrikchristensen@dadlnet.dk A recent prospective study in UK by Mitry et al. and you may need to create a new Wiley Online Library account. The validation was conducted at two different departments as mentioned in Paper I and Paper II. With the inventions of the direct ophthalmoscope in 1850 by H. Helmholtz and indirect ophthalmoscope in 1852 by Th. Svær nærsynethed er forbundet med alvorlige følgetilstande, der i værste fald kan medføre blindhed. Hereafter, all public activity regarding each Danish citizen has been recorded via the CRN which is unique for each Danish citizen. Many of these studies are single-centre studies which increases the risk of bias. Øjenklinikken, som er beliggende på Østerbro, er moderne og betjener sig af det nyeste udstyr. 2002; Polkinghorne & Craig 2004; Mitry et al. This knowledge can be used in the management of the follow-up period for patients. Under operationen efterlades en lille tynd membran bag linsen, kaldet linsekapslen. The only risk factor for progression towards the fovea was pseudophakia. 2018-11-17T19:02. Rigshospitalet - Glostrup. Den gennemsnitlige længdevækst af øjet hos nærsynede danske børn i alderen 8-14 år er omkring 0,3 mm pr. Using the results given in this thesis, a more optimal treatment and follow-up algorithms could be attained. Strict bed rest is difficult to maintain for a prolonged period, and this could be the explanation for the overall progression that was observed. To answer this question, a quality indicator is needed that can be used in both measuring and monitoring the surgical outcome in retinal surgical centres. We found that the risk of a macula on RRD progressing to affect the fovea is small if the patient is postured appropriately. This subgroup of detachments seems to progress differently than shallow detachments as the bullous detachments – of which we only had a few in this study – did not regress as well as the other type of detachments when the patient was on bed rest. Operationen forløb godt. Den venstre del af modellen er forstørret 850 gange og den højre del 3800 gange i forhold til øjets væv i en voksen person. Accordingly, a national audit on RRD from United Kingdom notes that redetachment rate should be <15% (Comer et al. The indicator presented in the paper is based on redetachment rates. This time window has not yet been fully established. Hvem får nethindeløsning? Nethindeløsning betragtes som en akut øjensygdom, der kræver akut behandling. Disse pletter forsvinder oftest helt. Hereafter, the significant advances of the surgical procedure over the last 100 years have enabled a reattachment rate of around 97% (Sullivan et al. Du kan dog i særlige tilfælde være fritaget herfra, fx hvis du pga. Retinal detachment (RD) is an acute and severe eye disease that potentially can cause complete visual loss in the affected eye. er smerter, der opleves, som om de k ommer fra det manglende øje, og hvor årsagen ikke kan påvises. I sidste uge skrev Ekstra Bladet, at Karsten Ree var blevet hasteindlagt og opereret for en nethindeløsning på Glostrup Hospital, efter han havde ignoreret synsforstyrrelser i en længere periode. In RRD surgery, reoperation for redetachment is a clearly identifiable event. Ruete, accurate and reliable clinical diagnoses were made possible revolutionizing the understanding and treatment of RD and other retinal diseases. 1999; Comer et al. The second paper also shows that the risk of redetachment is low one year after surgery, and actually lower than the risk of detachment on the second eye. The concept has been used in many fields, especially the more large disease entities as coronary artery disease and diabetes. They would regress and then progress if kept on bed rest for more than one day, but they would only progress to the arcades again and never beyond. The subjects raised in this thesis show ways that surgery for RRD can be optimized. The groups are arranged according to the volume of the departments. It is apparent that no single technique is superior for all detachments. En behandling som øger bindehindens indhold af collagen må således antages at bremse udviklingen af nærsynethed. Ndr. Written descriptions of RD – at this time perceived as the Gutta Senera – dates back to the beginning of the 18th century before it was possible to visualize the posterior structure of the eye, and therefore, little was known of the pathology of the disease at this time. A fremsatte allerede under opholdet på destinationen et . Vi undersøger og vejleder dig - uden ventetid. The first part of the thesis is register-based (Paper I and Paper II) and the other part is a prospective observational study (Paper III). Transport of fluid and ions in and out of the subretinal space is only possible via the RPE cells. The centre of the fovea is also characterized by not having any retinal blood vessels – the foveal avascular zone, and therefore, this region is solely dependent on oxygenation from the underlying choroid. A claim was raised by a patient that due to late surgery, the patient had suffered permanent injury to the vision. Good visual outcome is critically dependent on the anatomical success of the primary intervention, but the preoperative visual acuity – and thereby the status of the macula – is also an important factor (Abouzeid & Wolfensberger 2006). This gives better opportunity for organizing the surgical programme in an optimal way. The Scottish study was large and had a high quality of prospective follow-up time, but does not provide an exact risk time. Denne linsekapsel vil hos 30-40 % af alle der opereres for grå stær blive uklar i løbet af nogle . sygdom ikke kan bruge en computer eller har sproglige vanskeligheder. Having an opportunity to postpone surgery without risking the outcome for the patient allows a more optimal surgery. However, are all redetachments a result of poor surgery, or did the redetachment occur because of new tears that are not related to the prior surgery? Gennem studier i 20 år har han fundet frem til, at et stof, 7-methylxanthin, udvundet af kakao, kan nedsætte børns nærsynethed. Ringvej 57, 2600 Glostrup) på telefonnummer: 38 63 47 36. Although it is surgically possible to achieve anatomical success in nearly 100% of cases of RRD, some patients have to undergo additional surgery to accomplish anatomical success. During the development of this region, inner retinal neurons migrate peripherally, whereby a central depression appears (the foveal pit) with a surrounding slope. Ideally the best approach would, however, be to prevent RRD. 2006; Wykoff et al. The first photoreceptor cells that develop are the central cone photoreceptors. 5.00 Jeg er tidligt oppe hjemme i Charlottenlund for at cykle til Glostrup. A hypothesis of the paper was also that men have an increased risk of RRD on both the first and second eyes. Patients who had been operated for an RRD were found by one of two search algorithms listed in Table 1. 39 16 10 12. Dette kaldes efterstær (eller sekundær katarakt). Our experience is that posturing patients who have RRDs with more peripheral detachments do not pose a threat to the fovea overnight. Grå stær - en folkesygdom. Lastly, we found that departments have different approaches in their choice of technique, answering the last hypothesis of the paper. Formålet med denne afhandling er at skabe viden om, hvordan behandling og pleje af patienter med nethindeløsning kan optimeres. The disadvantage is that the image provided is magnified and thereby, measurements are not reliable for exact estimations (Oishi et al. Det eneste hun er klar over, er, at hun har brug for støtte og nogen at læne sig op af i denne udfordrende og livsomvæltende situation. 2010; Ehrlich et al. We chose to set the length of the scans to 3000 microns allowing us to find any RRDs that encroaches the fovea inside the vessels arcades. We also conducted OCT on patients with a split fovea. Jeg har medvirket til adskillige artikler, såvel som udgivelse af brochurer og været mødeltager ved snesevis af foredrag om emnet, ligesom jeg har deltaget i optagelsen af video om glaslegemesammenfald og nethindeløsning udsendt af dk4 og nu placeret på Øjenforeningens hjemmeside. The vitreous is a clear substance inside the eye that fills the space between the lens and the retina. For at sikre at patienter med en nethindeløsning bliver behandlet mest optimalt, er man nødt til at have en indikator, som kan fortælle noget om kvaliteten af behandlingen. Having a redetachment can result in poor visual outcome due to increased risk of structural changes in the retina (Abouzeid & Wolfensberger 2006). Hele modellen vejer 1,1 kg og måler 25 x 23 x 18,5 cm. A redetachment is a good indicator for this purpose as it is a clearly defined entity than can easily be compared between surgical centres. In both studies, we wanted to find patients which had a primary RRD and without a previous history of ocular diseases. The y-axis shows the distance from foveola in microns, and the x-axis shows the amount of hours the patient was admitted to the hospital. 1999; Lynge et al. Hertil kommer modeller som er mere avancerede og viser muskulaturen omkring øjet evt. 2012). Scanning the eyes of the patients is objective with limited observer influence on the scan. Øjenvagt, Glostrup Hospital (Ndr. These studies have been chart based or have relied on the progression measurement obtained from retinal drawings by the examining ophthalmologist. Age- and gender-specific number of surgeries for RRD in the second eye. Adjacent to the pit is the foveal slope that contains the neuroretinal layers that have migrated during development. Using data from the NPR, we estimated that the risk of a RRD occurring on the fellow eye is 100 times larger than on the first eye and that middle aged men have the highest risk. Det generøse menneske er en overrumplende og tankevækkende rundrejse i nye erkendelser inden for biologi, psykologi, økonomi og antropologi. It seems that the neuroretina is more strongly bound to the RPE at the arcades. The full text of this article hosted at iucr.org is unavailable due to technical difficulties. Forundersøgelsen giver dig svar på den bedste løsning baseret på din anatomi og dine ønsker, samt at du selv er oplyst og velinformeret om det forventede resultat. We found that the risk of progression to macula off is less than 0.7% if delaying surgery for up to 72 hours. Written consent was collected from all patients prior to inclusion in the study. 7 begynder vi at se de patienter, som er kommet siden i går eftermiddags, så vi kan planlægge dagens operationer. Find vej. This adhesion is mediated by several factors: compression from the vitreous body, the intraocular pressure, RPE water transport out of the subretinal space, interphotoreceptor matrix (IPM) bonding properties – dependent on hydration and local ionic environment that are controlled by RPE and RPE microvilli adhesion to cone outer segments. jeg har læst hvad Glostrup hospital ( hvor Dan ligger) skriver om nethindeløsning før, under og efter operationen. 70 år. 600 tilfælde af nethindeløsning, som hvert år forekommer i Danmark, ville skønsmæssigt 300 kunne forhindres, hvis nærsynethed over -3 dioptrier kunne forebygges. 2010, 2011). The downside is that wrong registration could be made, and therefore, using the registry would give a misleading result. Post. Ny behandling skal bremse nærsynethed hos børn. Højesteret stadfæstede den 6. maj 2021 Østre Landsrets dom af 6. februar 2019, hvorved Højesteret har sat punktum i et sagskompleks, der har varet mere end 12 år. Describe the epidemiology of RRD with emphasis on the risk of the fellow eye, and the effect of increased cataract surgery on the incidence of RRD. Så kan vi gå i gang med at operere omkring kl. 1981; Folk & Burton 1982; Gonzales et al. The central part of the retina is called the macula. The surgical procedures for RRD have been refined since then, and there are now three main types of surgical treatment for RRD: pneumatic retinopexy (PR), scleral buckling (SB) and pars plana vitrectomy (PPV). Du forsøger muligvis at få adgang til dette websted fra en sikret browser på serveren. Although modern cataract surgery is a lesser trauma to the eye, surgery on the lens should be well indicated. If patients were admitted for more than one night, the scans were repeated every morning until surgery. To find patients who were operated for a primary RRD, we used an algorithm to sort the data. This region is delineated by the vessel arcades at the top and bottom, the optic disc is the nasal limit, but no anatomical structure limits the temporal part. At present time, we have basically two different surgical approaches to treat cases of RRD. 2002; Koch et al. Velkommen til Øjenklinikkens hjemmeside. To exclude patients with a previous history of ocular diseases, vitreoretinal surgery, trauma surgery and diagnosis codes for trauma, a four-year period from 1 January 1996 to 31 December 1999, was studied. There is no anatomical connection between the ELM and the RPE, but nevertheless there is a strong adhesion between the two layers. It is widely accepted that RRD is an acute disease but when should surgery be performed to attain the most optimal result? The prognosis for good visual outcome in an eye affected by RRD is – apart from a successful anatomical reattachment – dependent on the preoperative status of the macula (Abouzeid & Wolfensberger 2006). NÃ¥r man opereres for grÃ¥ stær (katarakt), fjernes ens egen uklare linse, og der lægges en kunstig plast-linse ind i øjet. Age- and gender-specific incidence rates of surgery for RRD in the first eye. Siden har Yousif Subhis forskning været centreret omkring Rigshospitalets Øjenafdeling i Glostrup. 1987; Rowe et al. Øjenlæge i København. Søvnforstyrrelser Op mod 100.000 danskere er ramt af nethindesygdomme som nethindeløsning, forkalkning af nethinden, diabetesforandringer på nethinden, grøn stær og synsnerve-svind og -betændelse. This important question still needs to be answered. The posterior vitreous is in contact with the retina but with ageing the vitreous liquefies and will in many cases separate from the retina and contract. When is an operation for a redetachment no longer a reoperation for a failed primary intervention, but an operation for a recurrence of the disease? This patient had at admission a bullous superior detachment. During the study, we did some observations that are not presented in the paper. at øjet kun skal behandles én enkelt gang. Bestil tid til undersøgelse - grøn stær, grå stær, synstest mm. The algorithm was created by combining surgical and diagnosis codes (Table 1). øje, som man ikke længere . In the third paper, we evaluated the progression of posterior RRD with an optical coherence tomography to make an objective assessment of the movement.

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