Search Results - "International Ophthalmology"

1573-2630

age-related macular degeneration ; drusen ; fluorescein angiography ; indocyanine green angiography ; occult choroidal neovascularization

Springer Online Journal Archives 1860-2000

Medicine

Abstract Purpose: To determine the role of indocyanine green angiogaphy (ICGA) in the prediction of the development of choroidal neovascularization (CNV). Methods: We reviewed the ICG angiograms of 124 patients with newly diagnosed unilateral occult CNV secondary to age-related macular degeneration (AMD) in whom the fellow eye had only drusen by biomicroscopy and fluorescein angiography. Follow-up data of at least 12 months were obtained in all eyes. Results: 113 fellow eyes had a normal ICG study, while 11 fellow eyes revealed plaque-like late hyperfluorescence. During an average follow-up time of 18.2 months exudative AMD developed in 7 of 11 eyes with late hyperfluorescence on ICGA and in 6 of 113 with a normal ICGA study. Conclusion: ICGA may help to predict which fellow eyes are at higher risk of developing future exudative changes.

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1573-2630

cross-linked gelatin plug ; intraocular gas ; macular hole ; vitrectomy

Springer Online Journal Archives 1860-2000

Medicine

Abstract Background: The surgical management of macular holes has been a subject of controversy in recent years. Various techniques such as vitrectomy, membrane peeling, and gas tamponade with or without transforming growth factor-beta 2, and recently the use of autologous platelets have produced closure rates from 58% to 96%, depending on the stage of the hole. Methods: The authors present preliminary results in a study of 19 consecutive patients with stage 3 or stage 4 macular hole who underwent vitrectomy followed by placement of an absorbable partially cross-linked gelatin plug in the macular hole. The vitreous cavity was filled with a nonexpanding gas or air alone; the patient was instructed to maintain prone positioning for 2–3 days. Results: Anatomic attachment of the edges of the macular hole was achieved in 19 out of 19 patients with a minimum follow-up period of 6 months (average 11.5 months). Conclusions: A cross-linked gelatin plug can effectively reattach the edges of macular holes of stages 3 and 4. Its use is recommended only in macular holes in high myopes with posterior staphyloma or recurrent macular hole.

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1573-2630

endemic typhus ; murine typhus ; retina ; retinitis ; Rickettsia typhi

Springer Online Journal Archives 1860-2000

Medicine

Abstract Purpose: To report the ocular manifestations of acute serologically confirmed murine typhus. Methods: A retrospective analysis of the clinical history, photography and fluorescein angiography of two patients with acute murine typhus with ocular involvement was conducted. Results: A 38 year old male and a 49 year old female were included in the study. Both complained of fever, headache, rash, night sweats and pulmonary symptoms. They had noted the recent onset of diminished visual acuity and floaters. Examination of the posterior pole revealed mild optic nerve head edema (in one patient), intraretinal hemorrhages and small localized areas of retinal whitening. The history confirmed that both patients had been exposed to fleas and the serologic testing was positive for Rickettsia typhi. The systemic and ocular findings resolved after the use of systemic antibiotics. Conclusion: Rickettsial diseases such as murine typhus should be included in the differential diagnosis of otherwise healthy individuals who present with an acute systemic febrile illness and retinitis or neuroretinitis. Summary Statement: The clinical features of two patients with serologically proven acute murine typhus with ocular involvement are presented. Both patients presented with a retinal whitening that resolved after treatment.

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1573-2630

ultrasonography ; optic nerve ; optic neuritis ; AION

Springer Online Journal Archives 1860-2000

Medicine

Abstract Purpose: There is considerable overlap in the clinical profile of patients with idiopathic optic neuritis(ON) and anterior ischemic optic neuropathy (AION). We tested the hypothesis that the retrobulbar diameter of the optic nerve may be a criterion for the differential diagnosis between ON and AION. Methods: The diameter of the optic nerve was measured by B-scan ultrasonography with the eye in an abducted position. Only patients with a unilateral optic neuropathy were included, 16 ON patients (mean age 24years, 5 with and 11 without disc swelling) and 9patients with AION (mean age 72 years). As controls for the ON patients 10 young normal subjects (mean age25 years) and as controls for the AION patients 10elderly subjects with eye problems not related to the optic nerve (mean age 76 years) were examined. Results: In the ON patients with disc swelling the diameter of the optic nerve was 5.4 ± 0.5 mm in the affected and 3.0 ± 0.3 mm in the unaffected side. This difference was significant (Wilcoxon-test, p = 0.043). In the ON patients without disc swelling the diameter of the optic nerve was 4.4 ± 0.4 mm in the affected and 3.0 ± 0.3 mm in the unaffected side. This difference was significant (Wilcoxon-test, p = 0.003). In the AION patients the diameter of the optic nerve was 3.0 ± 0.3 mm on the affected and2.8 ± 0.4 mm on the unaffected side. This difference was not significant (Wilcoxon-test, p =0.093). Comparing the optic nerves with ON and AION to those of the controls, the diameter was significantly enlarged in the nerves with ON and normal in the nerves with AION (one factor repeated ANOVA). Conclusion: The diameter of the optic nerve is increased in ON without disc swelling and even more so in ON with disc swelling. The enlargement is probably due to edema of the nerve itself, not the surrounding subarachnoidal space. In AION, the diameter of the optic nerve is normal. Measuring the diameter of the optic nerve by B-scan ultrasonography is particularly useful in the differential diagnosis between ON with disc swelling and AION.

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1573-2630

Springer Online Journal Archives 1860-2000

Medicine

Abstract Purpose: To assess the level of awareness among UK ophthalmic surgeons of the potential risks from starch powdered surgical gloves during ophthalmic surgery and to show by electron microscopy that starch granule contamination can occur during ophthalmic surgery. Setting: A sample (N = 46) of UK ophthalmologists from the North of England, UK. Methods: Type of glove usage and awareness of the possible risks from starch powdered surgical gloves were assessed by means of a questionnaire sent to ophthalmic surgeons in the North of England. The surface of a polymethylmethacrylate (PMMA) intraocular lens (IOL) handled with a starch powdered surgical glove was examined by electron microscopy for evidence of starch contamination. Results: Of the sampled ophthalmic surgeons (46), 89.1% considered it important to use starch free surgical gloves and the 84.8% already did so. Starch granule contamination was seen by electron microscopy on the surface of a PMMA IOL which had been handled with starch powdered surgical gloves. Conclusions: Although there has been sporadic attention in the ophthalmic literature to the risks associated with starch powdered surgical gloves in ophthalmology, up to 15% of UK ophthalmic surgeons may still be using starch powdered gloves. The authors show that starch powder contamination of ophthalmic materials can actually occur and remind ophthalmologists that this has been reported in the literature as a possible cause of sterile intra and extraocular inflammation.

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1573-2630

5-fluorouracil ; perfluoroperhydrophenanthrene ; proliferative vitreoretinopathy ; silicone oil ; vitrectomy

Springer Online Journal Archives 1860-2000

Medicine

Abstract Purpose: To evaluate the toxicity and efficacy of 5-fluorouracil (5-FU) in combination with perfluoroperhydrophenanthrene (Vitreon), silicone oil, or a combination of silicone oil and Vitreon in a ratio of 3:2 in the management of experimental proliferative vitreoretinopathy (PVR). Methods: Toxicity study. Seventy rabbit eyes underwent vitrectomy followed by intravitreal injection of 5-FU in doses of 800, 400, or 200 μg: Group 1, 5-FU alone; Group 2, 5-FU plus 1 mL Vitreon; Group 3, 5-FU plus 1 mL silicone oil; Group 4, 5-FU plus 0.6 mL silicone oil and 0.4 mL Vitreon; Group 5, 0.6 mL silicone oil plus 0.4 mL Vitreon. Electroretinography was performed preoperatively and 8 weeks postoperatively before the animals were sacrificed. Efficacy study. Seventy-two rabbit eyes underwent vitrectomy and were injected intravitreally with 100,000–200,000 retinal pigment epithelial cells to induce PVR. Groups were injected with 200 μg 5-FU alone or with 1 mL silicone oil, 1 mL Vitreon, or a combination of 0.6 mL silicone oil and 0.4 mL Vitreon. Others were given only 1 mL Vitreon or 1 mL silicone oil. The animals were followed for 8–12 weeks; PVR was graded using Fastenberg's system. Results: Toxicity study. Eyes given 200 μg 5-FU, silicone, and Vitreon showed mild inflammation and vitritis which resolved in 1 week; the dose was nontoxic by electroretinography and histopathology. Doses of 400 and 800 μg 5-FU were toxic. Efficacy study. Clinical severity of PVR was less in the groups which received 5-FU plus vitreous substitutes when compared to the control groups at all time points. The lowest incidences were in groups given 5-FU plus Vitreon or 5-FU plus Vitreon and silicone oil: 33.33% and 11.11%, respectively. Conclusions: A dose of 200 μg 5-FU with silicone oil and Vitreon combined was nontoxic to the rabbit retina. The combination of 5-FU, Vitreon, and silicone oil showed significant efficacy in the prevention of experimental PVR.

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1573-2630

intraocular pressure ; trabeculectomy ; Crozafon-De Laage punch ; chronic open-angle glaucoma

Springer Online Journal Archives 1860-2000

Medicine

Abstract Purpose: To evaluate the effectiveness of punch trabeculectomy in controlling intraocular pressure (IOP) in patients with uncontrolled chronic open-angle glaucoma (COAG) undergoing medical treatment. Methods: This prospective study included 22 patients (27 eyes) with uncontrolled COAC on medical treatment undergoing punch trabeculectomy through a scleral tunnel. The tunnel was created with a 3.5 mm keratome, the tunnel mouth was not sutured but the conjunctival flap was sutured by 8/0 vicryl. The mean surgical time from opening the conjunctiva to closing the conjunctiva was 8 m 59 s. IOP and other parameters were checked on day 1 and subsequently at intervals appropriate to the individual. Results: After a mean period of 22.2 months follow-up the mean IOP was 13.3 mmHg (SD 5.2). There were few transient early post-operative complications; two eyes had a shallow anterior chamber (AC) due to excess drainage, five had IOP above 21 mmHg, which responded to ocular massage, ten eyes had hyphaema less than 1.5 mm and two eyes had no filtration bleb. Conclusions: Punch trabeculectomy is a rapid and effective method of controlling IOP. The complication rate is moderate and mainly transient.

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1573-2630

Solitary fibrous tumour ; orbit ; proptosis

Springer Online Journal Archives 1860-2000

Medicine

Abstract Purpose: Solitary fibrous tumour (SFT) of the orbit is a very rare lesion that may be misdiagnosed as fibrous histiocytoma, haemangiopericytoma, or other orbital tumour. We studied a case of SFT of the orbit in a 35-year-old woman. Methods: The patient, with a 1-year history, reported a ‘pressure’ sensation behind her right eye, but no pain, vision changes, or other associated symptoms. Ocular examination was normal. Magnetic resonance imaging (MRI) showed a well-circumscribed medial mass in the right orbit. The tumour was excised. Results: The tumour was a cellular spindle-cell neoplasm with a storiform pattern. The tumour cells were spindle-shaped with bland nuclei and rare mitoses. Immunostaining was positive for vimentin and CD34, but negative for cytokeratin (AE1–AE3), EMA, desmin, smooth muscle actin, S-100, CD31, CD45 and bcl-2. Conclusion: SFT can infrequently involve the orbit. The tumour must be removed entirely to avoid recurrences. Careful and continued follow-up is important because orbital recurrence may occur several years after the excision of the primary tumour.

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1573-2630

blindness ; visual impairment ; cataract ; glaucoma ; ocular trauma ; Nigeria

Springer Online Journal Archives 1860-2000

Medicine

Abstract Objectives: To determine the common eye diseases as well as the prevalence and causes of blindness and visual impairment in young adult residents of rural areas of Anambra State, Nigeria. Materials and methods: Three rural villages in Anambra State, Nigeria were selected by simple random sampling. A structured questionnaire on demographic characteristics, symptoms and attitude to eye diseases was administered to residents aged 18–49 years. Ocular examination included visual acuity estimation, colour vision test, tonometry, refraction and ophthalmoscopy. Skin-snip was examined for microfilaria. Results: The common ocular problems in the 510 young adults examined were presbyopia (33.3%), refractive errors (41.1%), allergic conjunctivitis (8.2%), pterygium (8.2%), pingueculum (5.9%) and colour vision defect (2.4%). Bilateral blindness occurredin 1.2%, uniocular blindness in 0.8% and 1.7% had visual impairment in their better eyes. Glaucoma and sequelae of congenital cataract caused bilateral blindness while visual impairment was due to refractive errors, cataract, corneal opacities and uveitis. Trauma predisposed to uniocular blindness and visual impairment. Conclusions: Eyeglasses alone would alleviate visual impairment and ensure good near vision in more than 47% of the subjects. The prevalence of blindness could be reduced through early detection of glaucoma, congenital cataract and ocular trauma.

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1573-2630

children ; epidemiology ; eye ; injuries

Springer Online Journal Archives 1860-2000

Medicine

Abstract Aims: To provide epidemiological data on serious eye injuries among children that can be utilized in planning health education and safety strategies for preventing such injuries. Materials and Methods: Records were reviewed of 116 children who sustained serious eye injuries which required admission to Princess Basma Teaching Hospital between October 1995 and November 1998. The material was analyzed retrospectively with respect to various epidemiological features. Results: 71.5% of the injured children were male and 28.5% were female. There was a marked preponderance of injuries in the age group 6–10 years. The majority of injuries occurred during play and sport (74.1%). Stones and sharp objects were the most common causes accounting for 18.1% and 17.2% respectively. Most of the sharp objects were household instruments. Perforating injuries were more common than non-perforating injuries. 56% of injured eyes had a low vision with visual acuity between 6/24 and 3/60, and 13% had a blinding outcome with visual acuity less than 3/60. Conclusion: The major causes of serious eye injuries among these children were unnecessary risks during play, the use of dangerous objects and insufficient supervision by adults, especially at home. Health education should be directed towards prevention of such serious injuries.

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1573-2630

intermediate uveitis ; familial type ; cytogenetic analysis ; pedigree analysis

Springer Online Journal Archives 1860-2000

Medicine

Abstract The occurrence of intermediate uveitis in monozygotic twins has rarely been reported in literature. We report the occurrence of this disease condition in identical twins. Twin sisters presented with typical features of intermediate uveitis, which appeared three years earlier in one of the sisters. They were treated with posterior subtenon injection of triamcinolone acetonide and recovered well. Systemic evaluation and laboratory investigations did not reveal any etiology. Cytogenetic high-resolution analysis did not reveal any chromosomal abnormalities. Pedigree analysis revealed no specific transmission pattern. No other family members in three generations had similar ocular disease. Our report indicates that a detailed family history should be taken in intermediate uveitis and examination of other siblings of patients with intermediate uveitis should be performed.

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1573-2630

lenticular electrolytes ; radiation ; rat ; verapamil

Springer Online Journal Archives 1860-2000

Medicine

Abstract Purpose: To investigate the effect of verapamilon lenticular calcium, magnesium, iron and on radiation-induced cataract in rats. Methods: Thirty-seven, female, Wistar Albino rats, weighing 180–230 g were randomly grouped as follows: control group (10 rats), radiation group (13 rats) and radiation-verapamil group (14 rats). Both radiation and radiation-verapamil groups received 5 Gy radiation to the whole body in a single dose, including both eyes within the irradiation volume; in addition the verapamil group received daily subcutaneous injections of 8 mg/kg verapamil starting on the first day of radiation. At the end of an 8-week experimental period, the animals were killed by decapitation. Lenticular calcium, magnesium, and iron levels were studied. Results: The mean lens calcium level for the radiation group was significantly higher than that for the control and radiation-verapamil groups and, there was no significant difference between the control and radiation-verapamil groups. The mean lens magnesium value for the radiation group was significantly higher than that for the control group. In the radiation-verapamil group the mean lens magnesium content was significantly lower than that for the radiation group. The iron level in the radiation group was significantly higher than that for the radiation-verapamil group. Conclusions: The lens calcium, magnesium and iron contents increased after radiation exposure. Verapamil treatment significantly reduced the increase in the lenticular content of calcium, magnesium and iron, indicating a probable protective effect of verapamilin radiation-induced cataract formation.

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1573-2630

multiple gestation ; retinopathy of prematurity ; risk factors ; ROP ; twins

Springer Online Journal Archives 1860-2000

Medicine

Abstract Objectives: The purpose of this study was to determine what risk factors play a role in the development of retinopathy of prematurity (ROP). Study design: Data were collected on 157 infants born and cared for in one institution between January 1991 and July 1994. Initially we evaluated all children enrolled in the study to determine potential risk factors for the development of ROP. We subsequently compared multiple variables for ROP positive singletons with ROP positive twins to determine ROP risk factors for each group and to determine if one group was more susceptible to a given risk factor. Results: Of the 157 infants examined, 72 infants (46%) developed ROP. Infants who developed ROP had a lower gestational age, a lower birth weight, a higher number of days on oxygen/ventilator. more days in the intensive care unit (ICU), a greater need for steroids and a higher incidence of sepsis when compared to infants who did not develop ROP. There was no significant difference noted between singleton and twin gestation infants that developed ROP when comparing gestational age, weight, ventilator time or length of ICU stay. Total number of days on oxygen therapy was higher in the singleton group and this difference did reach statistical significance. Conclusions: Several risk factors are associated with a higher incidence of ROP. These variables may not be independent risk factors but may be a sign of the increased severity of illness associated with those infants who are born earlier with a lower birth weight. Multiple gestational births do not appear to increase the risk of developing ROP when compared to a similar group of singleton birth infants.

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1573-2630

Springer Online Journal Archives 1860-2000

Medicine

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1573-2630

cataracts ; aspirin ; diabetes ; lens ; arthritis

Springer Online Journal Archives 1860-2000

Medicine

Abstract The prevalence of cataracts is significanly lower in patients with rheumatoid arthritis receiving aspirin (mean of 2,700 mgs daily for an average of 10.4 years) as compared to a matched population not receiving aspirin. Similarly, fewer cataracts were found among a population with diabetes and rheumatoid arthritis receiving aspirin (mean of 2,340 mgs daily for an average of 8.8 years) as compared to a matched population on no aspirin. The effects of aspirin on cataract formation may result from 1) lowering of plasma tryptophan levels and increased excretion of tryptophan metabolites, 2) inhibition of aldose reductase and sorbitol formation in the diabetic lens, 3) inhibition of tryptophan or kynurenine binding to lens protein.

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1573-2630

Springer Online Journal Archives 1860-2000

Medicine

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1573-2630

Springer Online Journal Archives 1860-2000

Medicine

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1573-2630

retinitis pigmentosa ; retina ; electroretinogram ; genetics ; vitamin A

Springer Online Journal Archives 1860-2000

Medicine

Abstract Electroretinograms (ERGs) have provided criteria for establishing the diagnosis of retinitis pigmentosa in early life even at a time when fundus abnormalities visible with the ophthalmoscope are minimal or absent. Patients with widespread progressive forms of retinitis pigmentosa have shown not only reduced amplitudes but also delays in cone or rod b-wave implicit times, or both, while patients with self-limited sector retinitis pigmentosa or stationary forms of night blindness have had reduced amplitudes with normal b-wave implicit times. In families with retinitis pigmentosa ERGs can be used not only to identify which patients are affected but also to establish which patients are normal as those patients, age 6 and over, with normal cone and rod amplitudes and normal cone and rod b-wave implicit times have not been observed to develop primary retinitis pigmentosa at a later time. ERGs from patients with retinitis pigmentosa and allied night blinding disorders are presented to show their usefulness in genetic typing, documenting natural histories, and defining possible pathogenetic mechanisms. The potential application of the ERG in evaluating the efficacy of therapeutic trials is also considered.

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1573-2630

gyrate atrophy ; ornithine ; prenatal diagnosis

Springer Online Journal Archives 1860-2000

Medicine

Abstract We report two methods for potential prenatal diagnosis of gyrate atrophy of the retina and choroid caused by an inborn error of ornithine aminotransferase activity. A high pressure liquid chromatography assay measures ornithine aminotransferase accurately and directly in cultured amniotic fluid cells. The differential incorporation of 14C-ornithine and 3H-leucine into cell protein measures OAT directly but rapidly and simply.

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1573-2630

vitreous fluorophotometry ; retinitis pigmentosa ; blood-retinal barrier ; electroretinogram ; carrier

Springer Online Journal Archives 1860-2000

Medicine

Abstract The blood-retinal barrier was assessed by vitreous fluorophotometry in nine carriers of X-linked recessive retinitis pigmentosa. A breakdown of the blood-retinal barrier was apparent in all patients. In one carrier, the barrier was compromised even when abnormalities were not apparent in the retina ophthalmoscopically or by electroretinogram testing. The degree of abnormality of the blood-retinal barrier tended to parallel the extent of abnormalities noted on ophthalmoscopy, visual field examination, and electroretinogram testing.

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