Search Results - "International Ophthalmology"

1573-2630

contact Nd:YAG laser ; ocular structure ; incision ; coagulation

Springer Online Journal Archives 1860-2000

Medicine

Abstract We evaluated the effects of Nd:YAG laser energy directly applied to ocular tissue through a fiberoptic and a sapphire tip. All ocular tissue could be easily cut with the maximum 4 watts of energy. The coagulated borders extended 20 to 200 μ into the healthy tissue depending on the speed with which the cutting was performed.

Electronic Resource

1573-2630

Nd.YAG-laser ; retinal function ; Umazume-Ohta test ; visual acuity ; visual field defects

Springer Online Journal Archives 1860-2000

Medicine

Abstract The purpose of this study was to evaluate the effect of Nd.YAG-laser treatment on retinal function. All the patients treated showed a temporary decrease of visual acuity immediately after treatment. The ERG and EOG recordings were identical before and after treatment. The Umazume-Ohta test showed temporary central or paracentral relative field defects in all cases investigated.

Electronic Resource

1573-2630

central scotoma ; glucagonoma syndrome ; dacarbazine

Springer Online Journal Archives 1860-2000

Medicine

Abstract A 63-year-old man with a metastasising pancreatic glucagonoma is described, who presented with progressive deterioration of vision and bilateral central scotomata as the first symptom. This patient was treated with dacarbazine (DTIC) 250 mg/m2 IV daily for five consecutive days at 4-week intervals. The vision returned completely to normal, in a clinical and biochemical remission. Although there is no wide experience in treatment, the literature seems to indicate that DTIC should be the drug of choice in treating metastatic glucagonoma. Central scotomata may be a new ‘paraneoplastic’ symptom and a key to the earlier diagnosis of the glucagonoma syndrome by ophthalmologists, just as necrolytic migratory erythema has been for the dermatologists.

Electronic Resource

1573-2630

retinal detachment ; macular hole ; vitrectomy ; gas

Springer Online Journal Archives 1860-2000

Medicine

Summary We report on17 consecutive cases of retinal detachment due to macular hole surgically treated by one of the authors (S.B) between the fall of1982 and 1985. Thestandard method used was pars plana vitrectomy and intraocular air tamponade. In cases of subsequent reaccumulation of subretinal fluid, the macular hole was cautiouslycoagulated. With repeated redetachment and as a last resort,silicone oil was injected into the vitreous cavity. After a follow-up period ranging from 5 to 42 months,13 of the 17 eyes were cured; in 2 aphakic eyes treatment remained unsuccessful; in 2 eyes a small central detachment with some accumulation of subretinal fluid persisted but did not progress. Vitrectomy and gas tamponade alone, without coagulation, constitute the safest and most sparing treatment of this type of retinal detachment. Unfortunately, approximately one half of these cases require subsequentadditional photocoagulation because of renewed accumulation of subretinal fluid. In about one fourth of macular hole retinal detachments, however, lasting reattachment is achieved only bysilicone oil tamponade following initial vitrectomy and air/gas tamponade.

Electronic Resource

1573-2630

Springer Online Journal Archives 1860-2000

Medicine

Abstract A 17-year-old male suffered superficial and deep facial burns after coming into contact with a high tension electrical cable with his head and right side of the face. The right eye sustained severe thermal coagulative injuries and subsequently was enucleated. Histopathological examination showed that the retinal neuropile was relatively intact although the retinal and choroidal circulations were severely compromised. The left eye was less affected but a dense cataract developed and required lensectomy. Visual acuity remained poor in the left eye due to retinal atrophy, retinal vascular attenuation and optic nerve degeneration. Electroretinographic tests and pseudo-random binary stimulus visually evoked responses were useful in predicting the visual outcome.

Electronic Resource

1573-2630

peripheral proliferative retinopathy causes

Springer Online Journal Archives 1860-2000

Medicine

Abstract The cases of 100 consecutive persons (156 eyes) seen with peripheral proliferative retinopathy were reviewed in a retrospective fashion. Associated systemic and ocular diseases included sickling hemoglobinopathies (49%), branch retinal vein obstruction (20%), diabetes mellitus (9%), sarcoidosis (4%), intravenous drug abuse (4%), the ocular ischemic syndrome (1%), pars planitis (1%), Coats' disease (1%) and retinitis pigmentosa/retinal detachment (1%). In ten (10%) patients no obvious cause for the development of new blood vessel growth could be ascertained.

Electronic Resource

1573-2630

iris-ciliary body-choroidal tumor ; contact Nd: YAG laser ; sapphire probe

Springer Online Journal Archives 1860-2000

Medicine

Abstract We used a contact Nd: YAG laser fit with a 0.2-mm diameter sapphire tip to excise a large (5 1/2 clock hour) iris ciliary body-choroidal tumor and a large (15×8×3 mm) choroidal tumor. The cutting and coagulation action of the laser helped to minimize intraoperative and postoperative hemorrhage.

Electronic Resource

1573-2630

congenital colour vision defects ; road traffic security ; vehicle lights ; traffic lights

Springer Online Journal Archives 1860-2000

Medicine

Abstract New extentive experiments demonstrated that: (a) protan observers are more deficient than deutan ones with regard to perception distances of some traffic panels, of vehicle red stop lights, of vehicle red rear-position lights and of white, yellow and red reflectors. Contrarily, deutan observers are more deficient than protan ones for the distinction of differently coloured traffic lights and vehicle rear lights; (b) protan and deutan drivers are nevertheless not responsible for more traffic accidents than drivers with normal colour vision; (c) this apparent contradiction is due to psychological compensation mechanisms. The practical conclusions are: (a) that persons with defective colour vision need not to be excluded from non professional road traffic; (b) that it is nevertheless useful that they should be aware of their handicap; (c) that the red traffic signal has to be larger than the other ones; and (d) that the stop and red position lights of vehicles must be sufficiently intense and that the filters transmitting only pure red should be avoided in them.

Electronic Resource

1573-2630

Springer Online Journal Archives 1860-2000

Medicine

Electronic Resource

1573-2630

arterial occlusion ; preretinal arterial loops ; retinal hemorrhage ; vitreous hemorrhage

Springer Online Journal Archives 1860-2000

Medicine

Abstract Three cases with preretinal arterial loops complicated by obstructive accidents of various intensities are reported. The range of the complication varied from arterial spasm to transient retinal hemorrhages and arterial branch occlusion with permanent field defect, followed by extensive recurrent vitreous hemorrhages. These results lend further support to the assumption that the spiral arterial loops have an inherent tendency to twist and produce occlusive episodes.

Electronic Resource

1573-2630

external drainage ; subretinal fluid ; Nd:YAG laser ; sapphire tip

Springer Online Journal Archives 1860-2000

Medicine

Abstract We used a Nd:YAg laser fit with a fiberoptic cord and sapphire tip to drain subretinal fluid externally in patients with rhegmatogenous retinal detachment. The direct contact between the laser and the choroid allowed for controlled cutting and coagulation of the intervening choroidal vasculature. The drainage was successfully achieved with no complication.

Electronic Resource

1573-2630

Springer Online Journal Archives 1860-2000

Medicine

Electronic Resource

1573-2630

secondary glaucoma ; vitreo-retinal surgery ; silicone oil injection

Springer Online Journal Archives 1860-2000

Medicine

Abstract Purpose: To evaluate the prevalence of glaucoma after pars plana vitrectomy with silicone oil injection and to determine the different clinical forms. Methods: Authors have carried out a retrospective longitudinal study on patients who underwent pars plana vitrectomy with silicone oil injection from 1981 to 1995. The examined population consists of 301 patients (301 eyes), with an age ranging from 8 to 85 years, affected by retinal detachment and proliferative vitreoretinopathy. Results: The prevalence of the secondary glaucoma has been 18.5%. In all cases glaucoma was caused by trabecular meshwork obstruction due to silicone oil emulsification. The glaucoma has been more frequent after surgery for recurrent rhegmatogenous retinal detachment with fibrous PVR (52.86%) and for particular forms of rhegmatogenous retinal detachment (giant tears, multiple breaks, pseudophakia) with incipient PVR (30%). Conclusion: Glaucoma after intravitreal silicone oil injection for complicated retinal detachments is a relatively frequent complication mostly when surgery needs endophotocoagulation, endodiatermy and lensectomy.

Electronic Resource

1573-2630

cyclophotocoagulation ; diode laser ; glaucoma ; Mitomycin-C ; rabbit eye

Springer Online Journal Archives 1860-2000

Medicine

Abstract Both filtering surgery with Mitomycin-C and diode laser cyclophotocoagulation have proved to be effective alternatives in cases of glaucoma with poor surgical prognosis. The right eyes of 40 pigmented rabbits were randomly divided into 2 groups: Mitomycin-C group underwent filtering surgery with application of 0.4 mg/ml of Mitomycin-C whereas the diode laser (DL) group received 15 applications of 1.8 J (1800 mW. 1000 ms) distributed in 270°. Mean IOP showed statistical differences in two periods between days 3–13 and 45–60 — Mann-Whitney U test — with a higher IOP lowering in the DL group. The comparison of IOP survival curves (Log-Rank test) was not significant p = 0.070809. Ocular hypertension, hyphema and inflammatory signs were higher in the DL group, both in short and long term, but in terms of statistical significance only ocular hypertension showed differences p = 0.00011717 - Fisher exact test. Microscopic examination revealed patent sclerostomies in 60% of the MMC group eyes with different grades of fibroblastic proliferation. In the DL group we observed necrosis of the sclieral stroma and of the pigmented and unpigmented ciliary epithelium, with signs of thermal coagulation of the ciliary stroma and of the stromal vasculature. We must point out that the treatment with laser has proved to be more effective although both treatments showed very acceptable IOP lowering until 2 months after the surgery.

Electronic Resource

1573-2630

Springer Online Journal Archives 1860-2000

Medicine

Abstract Purpose: We evaluated the ability of optic disc parameters and nerve fiber analysis with the Glaucoma-scope to distinguish glaucoma from normal or hypertensive eyes. Methods: Glaucoma-scope examination was performed on 68 eyes of 44 patients split into following groups based on Humphrey 24-2 visual field and clinical criteria of glaucoma: normal eyes (n = 17), ocular hypertension (n = 19), early glaucoma (n = 17), moderately advanced glaucoma (n = 15). The contour of the juxta papillary nerve fiber layers was measured in the four groups. We also evaluated a global index as the mean disc depth corrected for the disc size by dividing by the disc area (MP/D). Results: We found a statistical difference (p 〈 0.001) between the four groups with the global index MP/D: normal eyes MP/D = − 17.42, hypertensive eyes MP/D = − 26.34, early glaucoma MP/D = − 82.33, moderately advanced glaucoma MP/D = − 99.69. We also found a statistical difference between the first two groups (normal visual field) compared to the two glaucoma groups for the mean fiber layer height in the superior and the inferior quadrant. Conclusion: Nerve fiber analysis and optic nerve head index calculated with the Glaucoma-scope could prove to be an interesting tool for glaucoma diagnosis and follow-up.

Electronic Resource

1573-2630

glaucoma ; silicone oil ; trabecular meshwork ; ultrastructure

Springer Online Journal Archives 1860-2000

Medicine

Abstract Purpose: We analyzed morphological changes in trabecular meshwork in glaucoma developing after intravitreal silicone oil injection with transmission electron microscopy (TEM). Methods: Specimens obtained from 2 patients after surgical trabeculectomy were fixed in Mc Dowell fixative in one patient and in buffered formaldehyde in the other, dehydrated and embedded in Epon. Ultrathin sections were made and stained with lead citrate and uranyl acetate for TEM. Results: In specimens mainly connective tissue sheets with disorganized and narrowed intertrabecular spaces were observed. At higher magnification the collagen sheets were composed of interstitial collagen and some of them were covered by amorphous basal membrane structures resembling material. Cellular remnants were present along the intertrabecular spaces. No other cells or clearly evident silicone oil were noted. Conclusion: Changes such as decrease in cell content, fibrosis and build-up of basement membrane-like material have been described by other authors. They are not specific and can be seen in many secondary glaucomas. No macrophages and foreign-body granulomas in response to silicone oil were present. The pathological changes in angle structures are probably caused by other mechanisms and are not induced by silicone oil itself.

Electronic Resource

1573-2630

glaucoma ; conjunctiva ; antiglaucoma medication

Springer Online Journal Archives 1860-2000

Medicine

Abstract Purpose: The effect of antiglaucomatous agents on conjunctiva used for various durations evaluated histopatho-logically. Methods: Conjunctiva biopsies were taken in 19 Mayis University Faculty of Medicine Ophthalmology Department from 31 eyes of 30 patients who underwent filtration surgery after a period of antiglaucomatous agent use and examined under light microscope. The results were compared with the results of conjunctival biopsies from 10 similar aged patients undergoing retinal detachment of cataract surgery and with no other ocular pathology. Results: Five of the cases were using antiglaucomatous treatment for two months (Group A), four cases for two to 12 months (Group B) and 22 cases for more than 12 months (Group C) before the surgery. Four cases were using a beta blocker only, eight cases beta blocker + sympathomimetic or beta blocker + myotic and the remaining 19 cases were using a combination of beta blocker + sympathomimetic + myotic. Histopathologic evaluation with light microscope showed no pathologic change in group A, but, subepithelial increase of lymphocytes, mast cells, macrophages and fibroblasts in group C. Conclusion: It was detected that subconjunctival inflammatory reaction increases as the number of antiglaucomatous agents and the treatment duration increase. These changes might be considered as risk factors that decrease the success rate of filtration surgery.

Electronic Resource

1573-2630

blood flow ; glaucoma ; Heidelberg Retina Flowmeter ; myopia ; peripapillary atrophy ; scanning laser ; Doppler flowmetry

Springer Online Journal Archives 1860-2000

Medicine

Abstract In order to study peripapillary perfusion, one randomly selected eye of 34 healthy volunteers and 40 glaucoma patients (27 suffering from primary open-angle glaucoma (POAG) 10 from normal pressure glaucoma (NPG) and three from other types of glaucoma) was studied with a Heidelberg Retina Flowmeter. Temporal flow adjacent to the disc edge was significantly higher than the nasal flow (p 〈 0.01). It was reduced significantly in myopia both in controls (p 〈 0.05) and in glaucoma patients (p 〈 0.001). However, there was no difference between either controls and glaucoma patients or between POAG and NPG patients. It was independent of treatment type in glaucoma. Within the temporal peripapillary area extremely high flow values (values higher than the mean + 2 SD of the corresponding individual retinal flow) seemed to represent deep peripapillary vascular rings. They were significantly more frequent in glaucoma (72%) than in healthy volunteers (44%, p 〈 0.05). Their frequency was 83% in myopic and 23% in non-myopic eyes in the control group (p 〈 0.001). However, in glaucoma patients they were common both in myopic eyes (71%) and in non-myopic ones (75%). The results suggest that capillary perfusion adjacent to the temporal edge of the disc is significantly reduced in myopia. Deep peripapillary vascular structures can be measured on images focused on the surface of the retina, especially if the retina is thinner than normal (healthy myopic eyes and glaucomatous eyes independently of the refraction). This may mask a deficient function of the retinal capillary bed.

Electronic Resource

1573-2630

glaucoma ; filtering surgery ; trabeculectomy ; Mitomycin-C

Springer Online Journal Archives 1860-2000

Medicine

Abstract The purpose of this study is to evaluate the effect of trephination with free scleral auto-implant plug exposed to Mitomycin-C out of the eye, in surgical treatment of primary open-angle glaucoma (POAG), in comparison with efficacy of trabeculectomy with MMC (32 eyes with POAG of patients, younger than 55 years — group 1). Trephination with scleral auto-implant plug with MMC was done on 35 eyes of patients, younger than 55 years, with POAG (group 2). The postoperative follow-up was 28.52 ± 8.78 months. Surgical procedure: A limbal 1.0 mm diameter trephination is made beneath the limbus-based conjunctival flap, a small iridectomy is performed. From the external layers of the trephine button one third of the corneoscleral thickness, in the form of a thin disc, is excised. The scleral disc, a free auto-implant, is dipped into liquid containing MMC with concentration 0.2 mg/ml for 5 minutes, outside the eye. Afterwards the scleral disc soaked with MMC is carefully irrigated with 150 ml of BSS and placed in the external part of the trephine fistula in primary position and stabilized with two interrupted 10-0 nylon sutures. The operation is ended as a typical trabeculectomy. The final success rate in terms of IOP (IOP 〈 14 mmHg) was 100%, without or with antiglaucoma medication, in both groups, but the number of postoperative complications was significantly lower in group 2. Trephination with free scleral auto-implant plug soaked with MMC may represent a viable alternative to trabeculectomy with MMC; the scleral plug may be taken out of the eye and exposed to antimetabolite outside the eye to minimize toxicity.

Electronic Resource

1573-2630

Mitomycin C ; trabeculectomy ; bleb failure ; subconjunctival injection ; needle revision ; glaucoma (surgery) ; intraocular pressure

Springer Online Journal Archives 1860-2000

Medicine

Abstract Purpose: To evaluate the safety and efficacy of a low-dose Mitomycin C injected subconjunctivally after a guarded filtration operation in humans. Methods: Fourteen patients with failing filters received an injection of 0.01 mg Mitomycin C (0.25 ml of 0.04 mg/ml solution) into the filtering bleb. Eyes with end stage glaucoma of patients with healthy or successfully operated fellow eye were selected for the treatment. In 6 of the cases 2 to 5 days later a needle revision of the bleb was performed. Results: In 12 of the treated eyes (86%) we found a lowering of the IOP with a mean of 8.08 mmHg (range, 4 to 13 mmHg) and a development of a typical wide, pale, avascular filtering bleb. Complications, such as conjunctival, scierai or corneal necrosis, wound dehiscence, bleb leaks, hypotony or any clinically detectable signs of toxic damage of the anterior segment of the eye were not observed. Conclusion: Subconjunctival injection of low-dose Mitomycin C in the early postoperative period may offer a useful option for improving the outcome in some cases of failing trabeculectomies. This alternative method of application seems to enhance the effect of a subsequent needle revision. With the concentration used we did not find any undesirable complications after a follow-up of 1 to 9 months.

Electronic Resource