Search Results - "International Ophthalmology"

1573-2630

Trauma ; Vitrectomy ; Retinal detachment

Springer Online Journal Archives 1860-2000

Medicine

Abstract The principles and guidelines in the management of penetrating ocular injury are detailed. In the absence of definitive clinical trial or an experimental model, the rationale for pars plana vitrectomy has been presented. In addition, our recommendations as to the appropriate role and timing of pars plana vitrectomy are included.

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1573-2630

Visual resolution ; deyelinating diseases ; interference acuity measurement

Springer Online Journal Archives 1860-2000

Medicine

Abstract An interferometric acuity device (Takata) has been used to study visual resolution in individuals with possible demyelinating disease. The instrument employed provides a large field with a continuous range of grid or fringe frequencies and a relatively intense (105 mean photopic trolands) stimulus. After a brief period of time with eyes closed, resolution thresholds of patients are repeatedly determined during a five minute period. In all individuals suspected of having a demyelinating disease tested to date, a fall off in resolution capability has been found in time when using this intense stimulus display. This occurs whether eye signs have been present, are present or have not yet been observed. Normal observers do not exhibit comparable decrements. The fall off in resolution capability may or may not occur at lower stimulus levels, and is often not revealed when testing routine Snellen acuity. Outer and inner retinal pathology (division based on vascular support) do not cause a comparable fall off in resolution in time. The interferometric acuity test is a non-invasive, easily applied test.

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1573-2630

Springer Online Journal Archives 1860-2000

Medicine

Electronic Resource

1573-2630

Photocoagulation ; Non-linear effects ; Physics ; Morphology ; Nd glass Q-switched laser ; Scanning electron microscopy ; Chamber angle ; Monkey

Springer Online Journal Archives 1860-2000

Medicine

Abstract Working at a power density above optical breakdown threshold, irradiation effects upon the angle of the anterior chamber of the Macaca speciosa monkey by a Nd glass Q-switched laser, have been analysed with scanning electron microscopy. Two different damage effects can be identified: openings of Schlemm's canal and the creation of a cyclodialysis, that is opening the uveoscleral outflow routes; the latter may be a more effective one than the former. Also a third mechanism, namely a structural alteration of the trabecular meshwork, at the molecular level by laser action, has been inferred. The physical effects leading to optically induced mechanical damage are discussed. Applicability of such effects upon the morphological findings described here, is limited and to a greater part speculative. A better definition of the physical parameters, required for optimal therapeutical damage effects in the treatment of the wide angle glaucoma may be obtained by trial and error methods, which are guided by the results of electron microscopical analyses of samples obtained from in vivo and in vitro experiments.

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1573-2630

corneal endothelium ; corneal haze ; glaucoma ; pilocarpine gel

Springer Online Journal Archives 1860-2000

Medicine

Abstract Corneal thickness measurements and endothelial cell counts were carried out in 34 patients undergoing treatment for glaucoma with 4% pilocarpine gel between 18 to 78 months after initiation of therapy. The corneal thickness and endothelial cell population were found to be within normal limits in all cases except two, one patient with increased corneal thickness who had recently undergone cataract and glaucoma filtering surgery and another patient with decreased cell count who had an old endothelial scar sustained prior to pilocarpine gel therapy. There was a very close correlation for both of these parameters noticed in patients treated with pilocarpine gel and in age-matched control group of patients with glaucoma. The present study has shown that there are no adverse corneal effects with pilocarpine gel therapy.

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1573-2630

Sodium cromoglycate (SCG) ; vernal conjunctivitis ; chronic allergic conjunctivitis

Springer Online Journal Archives 1860-2000

Medicine

Abstract This study was planned to find out whether there is any beneficial effect in adding the SCG drops in the treatment of patients with vernal or chronic allergic conjunctivitis. Fifty-eight patients, 12 with vernal and 46 with chronic allergic conjunctivitis, who had used basal solutions, local steroids and peroral antihistamines to manage their symptoms were given SCG drops four times daily in addition to the previous treatment. Fifty-three patients became symptomfree and stayed so when local steroids were tapered off. All but three of these 53 patients have been able to discontinue SCG drops after varying treatment periods, but some 10 to 15 patients probably will need medication during the next pollen season. SCG is not the first choice of local treatment in chronic allergic reactions, because many patients' symptoms can be managed with basal solutions and occasional local steroids if the patients are taught the importance of avoidance of allergens and irritating agents. SCG is indicated whenever the allergic symptoms bother the patient continuously and either the causative factor cannot be identified or it cannot be avoided. In vernal conjunctivitis the effect of SCG drops was so marked in every patient that SCG can be recommended as the basic medication of vernal conjunctivitis. Among ophthalmologists both vernal and chronic allergic conjunctivitis are usually considered to be local problems and the general management of allergic reactions gets too little attention. For permanent results the patient has to learn how to manage both the prevention and the treatment of symptoms and in both these aspects SCG was found helpful.

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1573-2630

glaucoma ; operation results ; intra-ocular pressure ; visual field ; visual acuity ; cataract

Springer Online Journal Archives 1860-2000

Medicine

Abstract This paper presents the four-year follow-up results of a prospective study on the results of the Double Flap Scheie. The study was started in 1971 and the pre- and post-operative evaluation was carried out according to carefully selected criteria. Admitted were only open angle glaucoma patients. Diurnal IOP-curves, static perimetry, evaluation of lens and optic disc in mydriasis were included in the complete pre- and post-operative examination. In the Double Flap Scheie a conjunctival and scleral flap are made followed by a cornea-scleral cauterization and incision after which a peripheral iridectomy is made. 51 eyes of 48 patients were operated. After 4 years 42 eyes of 37 patients could still be examined. The mean IOP was reduced from 33.0 to 17.3 mm without additional therapy. This is a mean percentage reduction of 48.5%. 75% of the mean IOP was under 21 mm; with additional therapie 91% was under 21 mm. Diurnal variation decreased from 7 to 4 mm. 48% of the eyes showed a decreased visual acuity of which 38% was caused by cataract. 52% showed visual field deterioration of which one third was attributed to cataract. In 24% the visual field deterioration was considered clinically important. There was no clear relation between IOP level and visual field deterioration.

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1573-2630

macroaneurysms of the retinal arteries ; retinal exudates ; retinal heamorrhages ; fluorescein angiography ; laserphotocoagulation

Springer Online Journal Archives 1860-2000

Medicine

Abstract Acquired macroaneurysms of the retinal arteries are rather frequent. Four new cases are reported. Aetiology, clinical features, fluorescein angiographic aspects, complications, prognosis, pathogenesis, differential diagnosis and treatment by photocoagulation are discussed.

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1573-2630

intraocular pressure ; hypotony ; retinal detachment ; scleral buckling operation

Springer Online Journal Archives 1860-2000

Medicine

Abstract Relative hypotony in the affected eye was present in 40% of patients with uncomplicated unilateral retinal detachments. The average pressure asymmetry was only 1.3 mm Hg, but in one out of every four patients the difference was 3 mm Hg or more. In a control group, such a difference occured in only one out of every twenty patients. Relative hypotony persisted for longer than six months after scleral buckling operation, occuring even in patients that did not exhibit hypotony preoperatively.

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1573-2630

macula ; hereditary macular degeneration ; vitelliform dystrophy

Springer Online Journal Archives 1860-2000

Medicine

Abstract Seven of eight siblings of asymptomatic non-consanguineous parents were investigated. Two of them had atrophic cystoid macular degeneration and flat or subnormal electro-oculograms suggesting the diagnosis of vitelliform dystrophy. In one eye the central cystoid lesion was surrounded by atypical small whitish hyperfluorescent flecks resembling fundus flavimaculatus. In the other eye of this patient cystoid macular degeneration progressed to shallow non-rhegmatogenous detachment of the retina. One of the asymptomatic siblings had a mild colour vision defect of tritan-type and some fleckish hyperfluorescence around the macula and another sister showed abnormal EOG responses. These patients are probably carriers of the pathological gene responsible for the disease.

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1573-2630

corneal endothelial permeability ; aqueous humor dynamics ; fluorophotometry ; normal pressure glaucoma ; tonography

Springer Online Journal Archives 1860-2000

Medicine

Abstract Corneal endothelial permeability and aqueous humor dynamics were studied in 17 non-treated normal pressure glaucoma patients in order to analyse the relevance of these parameters in the pathophysiology of this disease. Corneal endothelial permeability and aqueous humor flow were measured by fluorophotometry and aqueous outflow facility was determined by tonography. The results were compared with those of 17 healthy controls of similar age. The mean corneal endothelial permeability values and the aqueous flow and outflow facility values of the patients did not differ significantly from those of the healthy controls (P=0.8, P=0.2 and P=0.5, respectively). Normal pressure glaucoma does not affect the corneal endothelial permeability. The aqueous humor dynamics are not primarily involved in the pathophysiology of normal pressure glaucoma.

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1573-2630

evaluation ; outcomes ; quality of life ; questionnaire ; visual functioning

Springer Online Journal Archives 1860-2000

Medicine

Abstract This article discusses the importance of self-reported visual function and quality of life (QOL) assessment in evaluating the effectiveness of eye care and prevention of blindness interventions. Traditional clinical measurements do not provide an adequate characterization of the burden of visual disability faced by the patient in day-to-day activities. The validity, reliability and responsiveness of QOL questionnaires should be demonstrated before general use of such instruments is advocated. A visual function questionnaire currently undergoing psychometric evaluation as part of a clinical study of cataract surgery in India is presented.

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1573-2630

retinal detachment ; retinopathy of prematurity ; hard exudate

Springer Online Journal Archives 1860-2000

Medicine

Abstract The cases of 11 patients with a unilateral, retinal detachment associated with hard exudate and other late sequelae of retinopathy of prematurity are described. The abnormality was first noted in the second to fourth decades of life. Ten of the patients were women and one was a man. The source of the hard exudate was thought to be telangiectatic retinal vascular abnormalities. Among the ten treated eyes, four demonstrated an improvement in visual acuity. In two cases a mass lesion was also noted in the fundus.

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1573-2630

cataract surgery ; fibrin ; tissue plasminogen activator

Springer Online Journal Archives 1860-2000

Medicine

Abstract In a prospective study performed between June 1992 and March 1994 19 eyes of 19 patients with dense fibrinous pupillary membranes following cataract surgery were treated with intracameral injections of 25μg recombinant tissue plasminogen activator (r-tPA). Injections were performed between the second and twenty-third postoperative day (mean 5.6±6.9 days). Complete fibrinolysis within one to 4 hours (mean: 3.3±0.89 hours) was observed in 18 (94.7%) eyes. In one (5.3%) eye fibrinolysis was incomplete despite a second injection. In 2 (10.5%) eyes recurrence of a distinct fibrinous membrane was noted which then cleared spontaneously with topical treatment. A small hyphema developed in 2 (10.5%) eyes and intraocular pressure exceeded 25 mm Hg in 2 (10.5%) eyes. No increase of keratopathy nor any toxic intraocular side effect of 25μg intracameral r-tPA was observed throughout the study. The intracameral injection of r-tPA clinically proved to safely accelerate the resorption of dense fibrinous membranes following cataract surgery and thus enhance visual recovery minimizing subsequent complications and systemic or subconjunctival anti-inflammatory treatment.

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1573-2630

aqueous humour ; Fuchs' heterochromic cyclitis ; immunology ; iris

Springer Online Journal Archives 1860-2000

Medicine

Abstract Over a 10 year period, a large number of immunological investigations were performed on the peripheral blood, iris and aqueous humour of patients with Fuchs' heterochromic cyclitis (FHC). Many immunological aberrations were detected, but it was felt these may indicate a response to a variety of initiating or unrelated factors rather than reflecting a disease of true immunological origin.

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1573-2630

epidemiology ; exfoliation syndrome ; geriatrics ; glaucoma ; intraocular pressure ; prevalence of glaucoma

Springer Online Journal Archives 1860-2000

Medicine

Abstract The distribution of intraocular pressure (IOP) and the prevalence of glaucoma and their correlates were studied in a population-based study of inhabitants aged 70 years or older of three communities in the county of Oulu, Finland. 500 of the 560 eligible subjects (89%) were examined. IOP was measured using applanation tonometry. The diagnosis of glaucoma (or suspected glaucoma) was based on previous history and/or characteristic optic disc changes assessed first by ophthalmoscopy and later by photographic evaluation. No correlation existed between IOP level and age, but IOP was higher in women than in men. Glaucoma occurred in 12% of the participants (60 of 500 persons). In 42 of the 60 persons (8% of the participants) glaucoma had been diagnosed before this survey: non-exfoliative open-angle glaucoma in 15 persons (3.0%), bilateral or unilateral exfoliative open-angle glaucoma in 19 persons (3.8%), and congestive glaucoma in 8 persons (1.6%). In another 18 persons (4% of the participants) new open-angle glaucoma was detected, one third of these were exfoliative. In addition, 6% of the study population had suspected glaucomatous disc changes. In all new glaucoma cases and in all suspected cases the IOP was lower than 25 mmHg. Ocular hypertension (〉25 mmHg) without disc changes was found in 2%.

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1573-2630

cyclitic membrane ; immunohistochemistry ; proliferative vitreoretinopathy ; ringschwiele ; subretinal strand ; trauma

Springer Online Journal Archives 1860-2000

Medicine

Abstract To further characterize the content and nature of cyclitic membranes (n=4), ringschwielen (n=3) and a subretinal strand on sections of complete globes with long-standing retinal detachment after trauma (n=7) or retinal reattachment surgery (n=1), we applied a panel of cellular and extracellular antibodies using the APAAP (alkaline phosphatase and monoclonal anti-alkaline phosphatase) technique. Only one cyclitic membrane from an eye that was enucleated two months after trauma was positive for glial fibrillary acidic protein, demonstrating the presence of glial cells. All cyclitic membranes contained macrophages and expressed intracellular contractile proteins. Ringschwielen stained consistently for cells of epithelial origin (RPE) with cytokeratin and for macrophages. The subretinal strand stained for cytokeratin, macrophages andα-smooth muscle actin, supporting cellular contraction in the genesis of this form of proliferative vitreoretinopathy.

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1573-2630

choroidal neovascularization ; laser surgery ; macular degeneration ; myopia

Springer Online Journal Archives 1860-2000

Medicine

Abstract Direct laser photocoagulation of macular choroidal neovascularization (CNV) in pathologic myopia is still controversial. However, previous studies have reported encouraging results. One-hundred and thirty-three consecutively treated eyes were followed, in a prospective manner, for at least 12 months (108 of these were followed for 24 months, 84 for 36 months, 63 for 48 months, and 47 for 60 months) to evaluate the potential benefits and complications of laser treatment of extra-foveal macular CNV in pathologically myopic eyes. Pre-treatment mean visual acuity was 0.36. Post-treatment mean visual acuity was 0.33 at 1-year examination, 0.31 at 2 years, 0.32 at 3 years, 0.34 at 4 years, and 0.33 at 5 years. During the total follow-up period mean visual acuity did not change. Neovascular recurrences occurred in 58% of treated eyes by the end of the five-year follow-up. At final examination, complete destruction of CNV was achieved in 100 eyes (75%). These findings suggest that laser photocoagulation of macular choroidal neovascularization in pathologic myopia may be effective in preventing or limiting severe and irreversible loss of vision.

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1573-2630

sport-related ocular injuries ; bungee jumping

Springer Online Journal Archives 1860-2000

Medicine

Abstract Bungee jumping is becoming a popular sport in the Western world with some cases of ophthalmic complications being reported in recent literature. The authors reported a case of a 23-year-old healthy female who presented retinal complications following a bungee jumping. Her fundi showed superficial retinal hemorrhages in the right eye and a sub-internal limiting membrane hemorrhage affecting the left eye. A general examination, including a full neurological examination, was normal and laboratorial investigations were all within normal values. More studies are necessary to identify risk factors and the true incidence of related ocular lesions, but until then, we think this sport activity should be desencouraged, especially to those that are not psychological and physically fit.

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1573-2630

Springer Online Journal Archives 1860-2000

Medicine

Electronic Resource