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  • 1.
    Aström, Siv
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Lindén, Christina
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Incidence and prevalence of pseudoexfoliation and open-angle glaucoma in northern Sweden: I. Baseline report.2007In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 85, no 8, p. 828-831Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To evaluate the prevalence of pseudoexfoliation (PEX) syndrome and open-angle glaucoma (OAG) among 66-year-old people in the municipality of Skellefteå in northern Sweden.

    METHODS: A population-based study comprising 339 individuals, representing 40% of the age group and 87% of those randomly selected. The examination included tonometry, dilated slit-lamp biomicroscopy, optic disc evaluation and a visual field analysis if glaucoma was suspected.

    RESULTS: The overall prevalence of PEX syndrome was 23%[95% confidence interval (CI): 20-26%], 29% (CI: 24-34%) in women and 15% (CI: 10-19%) in men (P < 0.01). The intraocular pressure (IOP) in PEX eyes was higher (17.3 mmHg, SD 4.5 mmHg) than in eyes without PEX [15.7 mmHg, SD 3.7 mmHg; P < 0.001]. IOP exceeded 22 mmHg in 17% (CI: 11-23%) of the PEX eyes and in 3.0% (CI: 1.9-4.1%) of the non-PEX eyes. Seven individuals (2.1%) had OAG. Six were associated with PEX, i.e. 7.7% of the PEX individuals.

    CONCLUSION: PEX syndrome is common in northern Sweden, affecting every fourth individual reaching the age of 66 years. The prevalence in women is twice that in men. Elevated IOP is roughly six times more frequent in eyes with PEX than in eyes without PEX syndrome. The prevalence of OAG is 2.1%.

  • 2.
    Behndig, Anders
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    A case of unilateral acid burn.2003In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 81, no 5, p. 526-529Article in journal (Refereed)
  • 3.
    Behndig, Anders
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Results with a modified method for scleral suturing of intraocular lenses.2002In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 80, no 1, p. 16-18Article in journal (Refereed)
    Abstract [en]

    PURPOSE / METHODS: The long-term results obtained by a modified method of scleral suturing of posterior chamber lenses (PCLs) (Behndig & Otto 1997) were retrospectively registered and evaluated. Forty-four patients with insufficient capsular support for ordinary PCL implantation were included. Mean follow-up time was 13.1 +/- 6.4 months and registered parameters included visual acuity, deviation from planned refractive outcome, induced astigmatism, and complications. RESULTS / CONCLUSIONS: The results were comparable to those reported earlier for this type of surgery. It has previously been stated that scleral suturing of posterior chamber lenses is a safe procedure with good long-term results. This modified method produces comparable results while being more surgically simple and reproducible.

  • 4.
    Behndig, Anders
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Eriksson, Anders
    Medocular/Strandvägskliniken, Grevgatan 5, Stockholm, Sweden.
    Evaluation of surgical performance with intracameral mydriatics in phacoemulsification surgery.2004In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 82, no 2, p. 144-147Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To evaluate surgical performance using intracameral mydriatics (ICM) in phacoemulsification surgery in a series of consecutive cases. METHODS: In a series of 198 consecutive procedures 50-200 microl of cyclopentolate 0.1%, phenylephrine 1.5% and lidocaine 1% was given intracamerally for mydriasis and anaesthesia. The previous 198 cases, dilated with topical mydriatics, were studied for comparison. Several pre- intra- and postoperative parameters were registered, and the subjective surgical performance was graded after each procedure. In 41 consecutive cases, the change in pulse and oxygen saturation induced by the ICM injection was registered. RESULTS: No increase in operation time or complication rates was seen with ICM, compared to when standard topical mydriatics were used. The subjective surgical performance was ranked as equally good for both groups. CONCLUSION: From this clinical evaluation, our impression is that ICM performs well in routine phacoemulsification surgery.

  • 5.
    Bäckström, Gunnie
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Behndig, Anders
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Redilatation with intracameral mydriatics in phacoemulsification surgery.2006In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 84, no 1, p. 100-104Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To determine whether intracameral mydriatics can redilate pupils that contract during phacoemulsification cataract surgery. METHODS: A total of 80 patients were included in this prospective, randomized, double-blind study performed at Ornsköldsviks Hospital Eye Clinic. Of these, 60 patients had 0.6 microg/ml of epinephrine added to the balanced salt solution (BSS) used for irrigation and 20 patients did not. The patients in each group were randomized and given either an intracameral mydriatics (ICM) solution or placebo intracamerally after phacoemulsification and cortex cleaning. The pupil size was registered preoperatively, after cortex cleaning, 30 seconds after study injection, 2 mins after study injection and the day after surgery. RESULTS: No clinically relevant differences were found preoperatively. In the epinephrine material a significantly longer operation time (p = 0.023) and more procedures requiring Vision Blue and Kelman-type tip in the placebo group might indicate diversity in the grade of cataract. There was a greater degree of contraction in the absence of epinephrine in the irrigation solution (2.3 +/- 1.0 mm in the ICM group and 3.2 +/- 0.7 mm in the placebo group) compared to in the presence of epinephrine. With no epinephrine ICM significantly redilated the pupils at 30 seconds (p < or = 0.001) as well as at 2 mins (p = 0.015). CONCLUSION: We have shown that in cases with an intraoperative pupil contraction, ICM is effective in redilating the pupil. Insufficient adrenergic stimulation of the pupil dilator appears to be a major factor causing intraoperative pupil contraction during phacoemulsification cataract surgery.

  • 6.
    Jonsson, Asa C
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Burstedt, Marie S I
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Golovleva, Irina
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Medical and Clinical Genetics.
    Sandgren, Ola
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Tinted contact lenses in Bothnia dystrophy.2007In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 85, no 5, p. 534-539Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To determine whether tinted contact lenses can improve visual function in patients with Bothnia dystrophy (BD), a genetically defined retinal dystrophy with prolonged dark adaptation. METHODS: Twelve patients with BD were fitted with the same type of soft contact lenses tinted dark brown. Visual acuity (VA), contrast vision, near vision and visual fields were tested before and 1 month after contact lens fitting. The patients completed a visual function questionnaire. The physical properties of the contact lenses were tested using spectrophotometry. RESULTS: The patients with the lowest VA described the most obvious improvement in visual function. This group of patients preferred darker contact lenses and continued wearing their contact lenses after the study ended. The patients with the best VA preferred lighter contact lenses and a few patients in this group discontinued contact lens wear upon completion of the study. CONCLUSIONS: Visual function in BD patients was improved by dark tinted contact lenses. The optimal colour for lenses varies, depending on the season and the individual. Other patient groups with retinal dystrophies associated with prolonged dark adaptation or dysfunction of the cone system, such as cone dystrophies or achromatopsia, may also benefit from this type of contact lens.

  • 7.
    Jonsson, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Markström, Klas
    Umeå University, Faculty of Science and Technology, Department of Mathematics and Mathematical Statistics.
    Behndig, Anders
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Slit-scan tomography evaluation of the anterior chamber and corneal configurations at different ages.2006In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 84, no 1, p. 116-120Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To evaluate the aqueous humour and corneal volumes, their correlations to age, sex and refractive status, and their changes with age. METHODS: A total of 153 eyes of 153 healthy volunteers and 58 eyes of 58 patients planned for cataract surgery were examined with Orbscan II slit-scan tomography and the autorefractometer-keratometer. In 16 eyes of 16 volunteers, the same examinations were performed twice with a 4-year interval. Anterior chamber volumes were calculated with a 3-dimensional mapping method, corneal volumes were calculated, and multiple refraction and corneal/anterior chamber configuration variables were registered. RESULTS: The aqueous humour volume is inversely correlated to the age of the individual (r = - 0.22, p = 0.001), with an average decrease of 1.4 +/- 2.6 microl per year on longitudinal follow-up (p = 0.042). Specifically, the posterior part of the anterior chamber undergoes a pronounced reduction in volume with time, whereas the volume of the anterior part increases slightly with time. Increasing steepness and peripheral thinning of the cornea (p = 0.034), and a reduction in corneal volume (p = 0.037) were also seen with increasing age. Males had less steeply curved corneas and higher aqueous humour volumes than females. CONCLUSION: The anterior segment of the eye undergoes continuous alterations with age, which differ significantly between the genders. These normal differences and alterations may be of importance in the planning of refractive procedures, and in the evaluation of disease processes.

  • 8.
    Jóhannesson, Gauti
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Gudmundsdóttir, Gudrún J
    Rejykjavik, Island.
    Lindén, Christina
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Can the prevalence of open-angle glaucoma be estimated from a retrospective clinical material? A study on the west coast of Iceland.2005In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 83, no 5, p. 549-553Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To explore the possibility of estimating the prevalence of open-angle glaucoma (OAG) on the west coast of Iceland using a clinical retrospective material, and to compare that estimate with the results from a recent prospective Icelandic study.

    METHODS: The compulsory ophthalmological examination for the prescription of eye glasses in combination with information obtained from Statistics Iceland were used to establish the prevalence of glaucoma in Akranes and to estimate the minimum prevalence for the greater west coast area. A recent prospective study from Iceland was used as reference.

    RESULTS: In all, 79% of 1443 Akranes inhabitants aged 50 years or more had visited the eye clinic at least once between 1996 and 2001. The prevalence of OAG was 4.8% (95% CI 3.6-6.1). The minimum prevalence for the west coast was 3.8% (95% CI 3.2-4.4). The prevalence increased with age (p < 0.001). The overall prevalence was similar to that of recently published prospective data but the prevalence of normal tension glaucoma (NTG) was lower.

    CONCLUSION: The results from the two studies are similar in many respects, which indicates that retrospective data may supply meaningful information on glaucoma prevalence. Important sources of error are the selection and attendance of patients, screening methods and diagnostic criteria. If routine examination does not include fundus photography and/or perimetry, the prevalence of NTG will be underestimated.

  • 9.
    Jóhannesson, Gauti
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Hallberg, Per
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Eklund, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Lindén, Christina
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Introduction and clinical evaluation of servo-controlled applanation resonance tonometry2012In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 90, no 7, p. 677-682Article in journal (Refereed)
    Abstract [en]

    Purpose:  In recent years, Applanation Resonance Tonometry (ART) has been suggested for intraocular pressure (IOP) measurements. The manual version of ART (ARTmanual) has been further developed, and to improve usability, an automatic servo-controlled prototype (ARTservo) has been proposed. The aim of this study was to assess the limits of agreement (LoA) of ARTmanual and ARTservo as compared with the reference method, Goldmann Applanation Tonometry (GAT).

    Methods:  This was a prospective single-centre study on 152 eyes from 77 subjects. It was designed according to International Standard Organization’s (ISO) requirements for tonometers (ISO 2001). Intraocular pressure was measured six times/method in a standardized order. The ART technique has two available analysis procedures: a dynamic one that measures IOP during the indentation phase and a static one that causes a Goldmann-like measurement during two seconds of full applanation. The 95% LoA was defined as ±1.96 × standard deviation of difference against GAT.

    Results:  Mean IOP for GAT was 19.1 mmHg (range: 10–37 mmHg). The 95% LoA of ARTmanual was ±4.5 mmHg for both dynamic and static analyses. The 95% LoA of ARTservo was ±5.7 mmHg for dynamic and ±4.9 mmHg for static analyses.

    Conclusions:  This study confirms that the ART methodology is feasible. The further developed ARTmanual fulfilled the ISO standard with both the dynamic and the static analysis techniques. ARTservo with static analysis was close to fulfilling the standard but failed to do so in the highest IOP range. ARTservo has the potential to greatly improve usability if further development is completed.

  • 10.
    Kobelt, Gisela
    et al.
    European Health Economics, Spéracèdes, France.
    Jonsson, Björn
    Bergström, Anders
    Chen, Enping
    Karolinska institutet, S:t Eriks ögonsjukhus.
    Lindén, Christina
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Alm, Albert
    Uppsala universitet, medicinska fakulteten.
    Cost-effectiveness analysis in glaucoma: what drives utility? Results from a pilot study in Sweden.2006In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 84, no 3, p. 363-71Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To investigate the effect of different levels of visual field defect in glaucoma on utilities and to test if utilities could be assessed using a general questionnaire such as the EQ-5D. METHODS: A cross-sectional study in 199 patients with ocular hypertension or open-angle glaucoma grouped into 5 severity stages according to visual field defects was performed in 4 specialized ophthalmic centres. Descriptive analysis was performed for the sample and by stage, and the effect of vision loss on utility was investigated with multiple step-wise regression analysis. RESULTS: The mean age of the sample was 70 and the mean MD in the worse eye was -13.1 dB (SD 10.2). Visual acuity (VA) was 0.63 and 0.87 in the worse and better eye, respectively, and the mean utility was 0.80 (SD 0.23). Utility decreased with increasing glaucomatous damage, ranging from 0.84 for mild disease to 0.72 for severe damage (MD -2.5 to -28.1), but the difference between the groups was not statistically significant when controlling for co-morbidity, except for the most severe stage (p < 0.01). In multiple regression analysis, visual field in the better eye was significantly correlated with utility, and there was an indirect correlation between visual field in the worse eye and utility: the effect of total VA on utility was significant, and MD in the worse eye was correlated with total VA. CONCLUSIONS: Utility is strongly correlated with overall vision. Our results suggest a relationship between glaucomatous damage and utility, and patients with severe damage have a significantly lower utility. However, this should be further investigated in larger samples that include more patients with moderate-severe bilateral damage.

  • 11.
    Linden, Christina
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Aspects on prostanoid and cholinergic effects on aqueous humour dynamics in human eyes1999In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 77, no 6, p. 725-726Article in journal (Refereed)
  • 12.
    Lundberg, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Behndig, Anders
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Intracameral mydriatics in phacoemulsification surgery obviate the need for epinephrine irrigation.2007In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 85, no 5, p. 546-550Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To evaluate the possibility of removing epinephrine from the irrigating solution in phacoemulsification surgery when using intracameral mydriatics (ICMs). METHODS: We carried out a prospective, randomized, double-blinded study of 140 patients with age-related cataracts, scheduled for unilateral phacoemulsification. The first part of the study involved 90 patients divided into two groups. Patients in both groups were given 150 microl ICMs at the beginning of the procedure. In group 1, 0.6 microg/ml epinephrine was added to the irrigating balanced salt solution. No epinephrine was added to the irrigation solution used in group 2. The second part of the study involved 50 patients, all of whom were given topical mydriatics (TMs) and then similarly divided into two groups and treated as in the first study setting. RESULTS: With ICMs, pupil sizes generally increased during the procedures. Remarkably, this increase was significantly greater without epinephrine (13 +/- 19% versus 4 +/- 14%; p = 0.02). In the TMs setting, pupil sizes decreased intraoperatively in both groups; significantly more without epinephrine (- 5 +/- 4% versus - 12 +/- 7%; p < 0.001). CONCLUSIONS: An irrigating solution without epinephrine can safely be used with ICMs. The increase in pupil size during the procedure is greater without epinephrine. This study also confirms earlier findings that epinephrine is beneficial when using TMs.

  • 13.
    Lundqvist, Britta
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Mönestam, Eva
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Gender-related differences in cataract surgery outcome: a 5-year follow-up2008In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 86, no 5, p. 543-548Article in journal (Refereed)
    Abstract [en]

    PURPOSE: A prospective, longitudinal, population-based cohort study was performed to analyse gender-related differences in subjective and objective visual function 5 years after cataract surgery.

    METHODS: All patients (n = 810) who underwent cataract surgery during a 1-year period (1997-98) at Norrlands University Hospital in Umeå, Sweden, were studied with visual acuity (VA) data and questionnaires (VF-14) before and after surgery, as well as 5 years later. Five hundred and thirty patients (177 men, 353 women) answered the questionnaire, constituting 90% (530/590) of the survivors. Four hundred and sixty-seven (156 men, 311 women) also underwent an eye examination.

    RESULTS: The women were significantly older (P = 0.009) and were more often operated on both eyes (P = 0.005). Before surgery and postoperatively, the women had a significantly lower age- and VA-adjusted VF-14 score (P = 0.000 and P = 0.036, respectively). This difference was not significant 5 years after surgery (P = 0.16). Five years after surgery, a significantly larger proportion of women had a decline of more than 0.1 logarithm of the minimum angle of resolution of the better-seeing eye (P = 0.013). There were no significant gender-related differences in the operated eye.

    CONCLUSION: Female cataract surgery patients assess their visual function worse than males after adjustment for age and VA preoperatively and postoperatively. These differences were not significant 5 years after surgery although the men had better best-corrected visual acuity (BCVA) of their better eye. It is important to be aware of gender-related differences in perception when performing questionnaire-based outcome studies.

  • 14.
    Lundström, Anna-Lena
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Wang, Ling
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Wachtmeister, Lillemor
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Neuronal adaptation in the human retina: a study of the single oscillatory response in dark adaptation and mesopic background illumination.2007In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 85, no 7, p. 756-763Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The single oscillatory response in complete dark adaptation (DA) and the effect of mesopic illumination were studied in order to investigate the behaviour of the neuronal adaptation system as reflected in the oscillatory potentials (OPs) of the electroretinogram (ERG). METHODS: The rapid oscillatory and slow components (a- and b-waves) of single ERGs were simultaneously recorded in nine healthy, young subjects in response to first flash after both DA of 45 mins and light adaptation to a steady background light (BGL) of low mesopic intensity. RESULTS: Two low-amplitude oscillatory peaks were present in the single response to the first flash recorded in DA. There was no increase in the summed amplitudes of the OPs (SOP) when recorded in the single response to the first flash in mesopic BGL. However, the morphology of the oscillatory response altered. The first OP was reduced and a third oscillatory peak appeared. CONCLUSIONS: We conclude that early, scotopically related OPs may indeed be activated in the single response to the first flash in DA (i.e. without using conditioning flashes). Secondly, on its own, adaptation to mesopic BGL does not seem to trigger enhancement of the overall oscillatory response. The altered single oscillatory response to the first flash apparent in the mesopic BGL comprises a third cone-associated OP and seems to reflect a reorganization of the retinal microcircuitry from a predominantly rod-activated system to one of mixed rod/cone neuronal activity in the inner part of the retina at the level at which individual OPs have their respective origins.

  • 15.
    Lundström, Mats
    et al.
    EyeNet Sweden, Blekinge Hospital, Karlskrona.
    Behndig, Anders
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Kugelberg, M
    EyeNet Sweden, Blekinge Hospital, Karlskrona.
    Montan, P
    EyeNet Sweden, Blekinge Hospital, Karlskrona.
    Stenevi, Ulf
    Sektionen för oftalmologi, Sahlgrenska universitetssjukhuset/Mölndal.
    Pesudovs, K
    The outcome of cataract surgery measured with the Catquest-9SF2011In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 89, no 8, p. 718-723Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this study was to use the Catquest-9SF to measure cataract surgery outcomes, and to use Rasch analysis to test the psychometric properties of this questionnaire, including its validity and responsiveness. Methods: Patients were recruited as consecutive cataract surgery patients during 1 month at six surgical units in Sweden (via the National Cataract Register). The patients completed the questionnaire before surgery and 3 months after. The Catquest-9SF data were assessed for fit to the Rasch model using version 3.63.2 of the WINSTEPS software (Winsteps.com, Beaverton, OR, USA). Both preoperative and postoperative questionnaires were included in the analysis. The responsiveness to cataract surgery was calculated as the effect size. Results: Completed questionnaires before and after surgery were received from 846 patients. The Rasch analysis showed that the category thresholds were ordered. All items fit a single overall construct (infit range 0.79-1.40; outfit range 0.74-1.40). The ability to discriminate different strata of person ability was good, with a real patient separation of 2.58 and patient separation reliability of 0.87. The questionnaire showed unidimensionality and was largely free from differential item functioning. The item difficulty was reasonably well targeted to both preoperative and postoperative patient ability. The Catquest-9SF Rasch score correlated significantly with visual acuity, and cataract surgery resulted in a significant improvement with an effect size of 1.8. Conclusion: The Catquest-9SF shows excellent psychometric properties, as demonstrated by Rasch analysis. It is highly responsive to cataract surgery, and its brevity (nine items) makes it well suited for use in daily clinical practice

  • 16. Åsman, Peter
    et al.
    Lindén, Christina
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Internet-based assessment of medical students' ophthalmoscopy skills2010In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 88, no 8, p. 854-857Article in journal (Refereed)
    Abstract [en]

    Purpose: Ophthalmoscopy is an important skill in undergraduate medical education. The use and outcome of a novel Internet-based method for assessing motor skills-related aspects of ophthalmoscopy skills in medical students are described. Methods: A total of 139 students in Malmö and 255 students in Umeå were assessed during four consecutive semesters. An optic disc photograph was obtained in each student. At assessment each student was asked to examine the eye of a fellow student. Fifteen disc photographs were displayed on a computer screen. One of the photographs was from the fellow student. The remaining images had been randomly selected. The student was asked to identify the optic disc of the fellow student from the 15 photographs on the screen. In one semester, the time spent on this by each student was recorded. Results: All students completed the task. The average pass ratio was 96.4% (ranging from 94.0% to 98.0%). Median student times were 5.53 mins in Malmö and 6.36 mins in Umeå. Conclusions: This is the first automated, Internet-based assessment of an ophthalmic motor skill performed in co-operation between universities. The method used bears more similarities to real-life ophthalmoscopy than methods that use model eyes. Time investments and infrastructure demands were comparatively low. The method was designed for stand-alone assessment of ophthalmoscopy or as an objective structured clinical examination station, but it may also be used during the learning process. The collaboration between universities was easily transformed into routine practice and similar projects should be encouraged to increase the standardization of assessment

  • 17.
    Åström, Siv
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Lindén, Christina
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Incidence and prevalence of pseudoexfoliations and open-angle glaucoma in northern Sweden: II. Results after 21 years of follow-up.2007In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 85, no 8, p. 832-837Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To prospectively evaluate the prevalence and incidence of pseudoexfoliation (PEX) syndrome and open-angle glaucoma (OAG) with and without PEX and to evaluate PEX as a risk factor for glaucoma in a population born in 1915 and living in the municipality of Skellefteå in northern Sweden.

    METHODS: A randomized population study comprising 339 individuals. The cohort was followed for 21 years at 7 year intervals. The examination included tonometry, dilated slit-lamp biomicroscopy, optic disc evaluation and, if glaucoma was suspected, a visual field analysis.

    RESULTS: The prevalence of PEX increased from 23%[95% confidence interval (CI): 20-26] at 66 years of age to 61% (CI 50-71) at 87 years. The annual incidence of PEX was 1.8% (CI 1.3-2.4). In the group of subjects with unilateral PEX, 55% converted to bilateral PEX during follow-up. The prevalence of OAG was 2.1% (CI 0.8-4.3%) at 66 years of age and 25% (CI 16-35) at 87 years. Of the glaucoma cases, 59% had PEX. There was no difference in incidence between the sexes. The annual incidence of PEX and OAG did not increase with time. The overall annual incidence of OAG was 0.9% (CI 0.6-1.3%) [0.5% (CI 0.2-0.9) without PEX and 2.1% (CI 1.2-3.3) with PEX]. PEX increased the risk of glaucoma four fold in both sexes. There was no significant difference in mortality between individuals with or without PEX.

    CONCLUSION: PEX syndrome and OAG are common in the north of Sweden. Prevalences increase with age. PEX increases the risk of glaucoma four fold. The consequences of this situation demand guidelines for handling patients with PEX, with or without other risk factors. In order to issue guidelines, more information is needed on the impact of the disease on the general health in the ageing population.

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