Search Results - "International Ophthalmology"

1573-2630

injury ; foreign body ; vitrectomy ; size ; prognosis

Springer Online Journal Archives 1860-2000

Medicine

Abstract In a study of 95 patients with intraocular foreign body injuries presenting in the eight year period from 1978–1986 we found the overall visual results to be good with 62% of patients achieving a final visual acuity of 6/18 or better. The factors leading to a poor visual result were a large intraocular foreign body, poor presenting visual acuity and the presence of posterior vitreo-retinal complications. We support the removal of dense vitreous haemorrhage to reduce the risk of retinal traction.

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1573-2630

tilted disc syndrome ; choroidal neovascularization

Springer Online Journal Archives 1860-2000

Medicine

Abstract In the paper the authors describe two cases of tilted disc syndrome associated with choroidal neovascularization. The presumed causes of development of this neovascularization and factors that can influence the location of neovascular membrane are discussed.

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1573-2630

lens epithelium ; extracapsular cataract extraction ; posterior capsule opacification ; daunomycin

Springer Online Journal Archives 1860-2000

Medicine

Abstract Posterior capsule opacification is the major complication of extracapsular cataract extraction (ECCE). Lens epithelial cells derived from the periphery of the lens are thought to migrate posteriorly and contribute significantly to the postoperative proliferations at the posterior pole. We have evaluated the effects of the antiproliferative drug daunomycin on cultured porcine lens epithelial cell viability and proliferation. We observed that the mitotic activity of the cells is suppressed by a single short time treatment with daunomycin at a concentration as low as 2.5 mg/l. Long term effects on the reproductive capacity of the lens epithelial cells may not be as pronounced as the inhibition of other cells examined before e.g. retinal pigment epithelium and fibroblasts. Our results indicate that daunomycin may be useful for the pharmacologic prevention of postoperative proliferations in patients treated by ECCE.

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1573-2630

Springer Online Journal Archives 1860-2000

Medicine

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1573-2630

bacterial adhesion ; heparin ; heparin-surface-modification ; intraocular lens ; Staphylococcus epidermidis

Springer Online Journal Archives 1860-2000

Medicine

Abstract Bacterial adherence to intraocular lenses (IOLs) could be the cause of endophthalmitis following cataract surgery and lens implantation. The majority of cases of postoperative endophthalmitis are caused by microflora that reside on or near the eye of the patient. Staphylococcus epidermidis commonly colonizes the eyelid margin and conjunctiva and is the most common organism causing postoperative endophthalmitis. In this study, the in vitro adherence of S. epidermidis to regular poly-methyl methacrylate (PMMA) IOLs and to heparin-surface-modified (HSM) PMMA IOLs was investigated. The effects of heparin and antibiotics in solution on the adherence of bacteria to regular PMMA IOLs were evaluated. Adhesion of bacterial cells to IOLs was determined by counting the viable cells attached to the lenses. Significantly, fewer S. epidermidis attached to HSM-PMMA IOLs and to regular PMMA IOLs treated with heparin than to PMMA IOLs (p 〈 0.001). Furthermore, bacteria attached in significantly lower numbers to regular PMMA IOLs treated with heparin than to HSM-PMMA IOLs (p = 0.0031). Antibiotics in solution had no significant effect on bacterial adherence to PMMA IOLs. These data indicate that the use of HSM-PMMA IOLs and treatment of PMMA IOLs with heparin could diminish the incidence of postoperative endophthalmitis and intraocular inflammation associated with IOL implantation.

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1573-2630

Springer Online Journal Archives 1860-2000

Medicine

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1573-2630

argon laser photocoagulation ; non-rhegmatogenous detachment ; panretinal photocoagulation ; temporal retinal vessels ; vitreous strands ; Neodymium Yag laser

Springer Online Journal Archives 1860-2000

Medicine

Abstract Purpose: To treat patients with traction detachment of the central retina by laser in order to avoid vitrectomy. Methods: Focal treatment of and around the flat detached retinal area with the argon laser. Results: Seven patients were treated for macular-threatening traction detachment of the retina. The non-rhegmatogenous traction detachment was flat and circumscribed. Panretinal photocoagulation (PRP) with the argon laser was performed prior to treatment of the traction in three of the cases, in four it was carried out in addition to PRP. In each of the seven patients partial or complete reattachment and stabilization for many years was achieved, rendering vitrectomy unnecessary (mean follow-up after therapy: 40.1 months). In no case was a laser-induced hole produced, and in no patient did the visual acuity decrease. Conclusion: The favourable results following photocoagulation can be explained by the tight retinal/choroidal scar formation (laserpexy). Laserpexy is only recommended for eyes with slight initial detachment.

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1573-2630

cataract ; Fuchs‘ heterochromic iridocyclitis ; posterior chamber intraocular lens ; uveitis

Springer Online Journal Archives 1860-2000

Medicine

Abstract Background: To determine the inflammatory course and level of visual rehabilitation after cataract extraction and posterior chamber lens implantation in patients withFuchs‘ heterochromic iridocyclitis complicated by cataract. Methods: In a clinical trial, 32 eyes (visual acuity of 20/160 or worse) of 30 patients underwent extracapsular cataract extraction (19 eyes) or lensectomy(13 eyes) accompanied by posterior chamber intraocular lens implantation. Indirect ophthalmoscopy was performed intraoperatively prior to intraocular lens implantation and the extent of vitreous haze was assessed. If vitreous haziness was 3+ or more, core vitrectomy (two eyes) or three-port pars plana deep vitrectomy (four eyes) was performed. Results: After an average follow up of14.4 months (6 to 24 months), there was no statistically significant increase in cell and flare in the anterior chamber and vitreous or in keratic precipitates compared with the preoperative status of the eyes. However, 12%of the eyes developed synechiae (anterior and/or posterior) in comparison to preoperative condition (p〈 0.05). Eighty-seven percent of the eyes gained visual acuity of 20/40 or better (P 〈 0.005). Using the logistic regression model, a higher level of preoperative inflammation was associated with reduced likelihood of gaining visual acuity of 20/25 or more (OR = 0.25, 95%CI 0.049, 1.255). The complications of surgery were synechiae, 12%; opaque posterior capsule, 12%; vitreous loss, 3%; chronic glaucoma, 3%; and retinal detachment,3%. Conclusions: Implantation of a posterior chamber intraocular lens can be well tolerated in patients with Fuchs‘ heterochromic iridocyclitis. Vitrectomy, whenever indicated in addition to cataract extraction, improves visual rehabilitation.

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1573-2630

diabetic retinopathy ; argon laser ; panretinal photocoagulation ; automated perimetry ; retinal light sensitivity ; visual field

Springer Online Journal Archives 1860-2000

Medicine

Abstract Purpose: The aim of the present study was to prospectively examine the effect of two styles of PRP, full- and mild-scatter on central and peripheral visual field in diabetic patients. Methods: 40 eyes with preproliferative or early proliferative diabetic retinopathy of 32 patients underwent visual field testing on the C 30-1 and P 30/60-1 program of the Humphrey field analyser before and after argon laser panretinal photocoagulation (PRP). 21 eyes received full- and 19 mild-scatter PRP. Results: Laser treatment had caused significant reduction of central retinal sensitivity in all eyes with no difference between full- and mild-scatter PRP. Peripheral visual field sensitivity was significantly improved after mild-scatter PRP and was significantly depressed after full-scatter PRP. Conclusion: Our results suggest, that two treatment produced essentially equal effects on central and different on peripheral visual field.

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1573-2630

utility analysis ; bilateral visual loss

Springer Online Journal Archives 1860-2000

Medicine

Abstract Purpose: To ascertain whether patients with unilateral visual loss to a specific level are able to approximate the degree of impairment of quality-of-life experienced by patients with bilateral visual loss to the same level. Methods: One hundred thirty-three study group patients with (1) visual loss to 20/40 or worse in at least one eye, and (2) a marked difference between the visual acuities in their two eyes, were polled using the time tradeoff method of utility value measurement. All patients were asked to assume that the visual acuity in both of their eyes was as poor as the visual acuity in their worst seeing eye. These utility values were then compared to those obtained from a control group of 173 patients with known utility values who had similar bilateral visual loss. Both the study and control groups were stratified into 4 levels of visualloss (20/40 to 20/50, 20/60 to 20/100, 20/200 to 20/400, and counting fingers to light perception). Results: Mean utility values for the study group ranged from 0.47 to 0.71. Patients with unilateral visual loss, given the assumption of bilateral visual loss to the same degree, routinely demonstrated no significant difference in utility preferences as compared to patients with true bilateral visual loss to the samelevel. Conclusions: Patients with unilateral visual loss can very accurately estimate the degree of impairment of quality-of-life that would result if visual loss to a similar degree occurred in the remaining eye with better vision.

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1573-2630

epithelial cyst ; strabismus surgery ; subconjunctival cyst

Springer Online Journal Archives 1860-2000

Medicine

Abstract A fourteen year old girl who had developed a large subconjunctival mass extending into the orbit is presented. The mass had appeared after a strabismus operation, and it caused a consecutive exotropia and decreased adduction in the affected eye. She had had this cyst for six years. A cranial CT scan confirmed the presence of a massive orbital cyst. This cyst was removed surgically. Postoperatively, exotropia and adduction limitation improved. The pathological report stated that it was an epithelial cyst. This cyst and its differential diagnosis is the subject of this paper.

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1573-2630

CD4+ T lymphocytopenia ; immunodeficiency ; measles-retinopathy ; MMR-vaccination

Springer Online Journal Archives 1860-2000

Medicine

Abstract We describe a 4-year-old girl with subnormal visual acuity due to a bilateral retinopathy. The child had a history of encephalitis following MMR vaccination. Temporary retinopathy associated with measles, mumps, and rubella (MMR) vaccination has been described [1]. Recently an idiopathic CD4+ T lymphocytopenia in the child was diagnosed. This cellular immunodeficiency supports our hypothesis of measles retinopathy after vaccination of an immuno-deficient child.

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1573-2630

antiphospholipid antibodies ; antiphospholipid syndrome ; retinal vein occlusion ; retinal artery occlusion

Springer Online Journal Archives 1860-2000

Medicine

Abstract The purpose of this study is to evaluate the ocular findings in patients with the primary antiphospholipid syndrome (APS). Patients and methods: Twenty-two patients (44 eyes) with primary APS (17 women, 5 men) were examined. All patients were younger than 50 years (median age; 37.5 years). In 18 patients, fundus flourescein angiography was performed in addition to the ophthalmologic examination. Results: Sixteen patients (72.7%) described visual symptoms. Anterior segment was normal in 19 patients (86.4%). Posterior segment abnormalities were observed in 15 patients (68.2%). Venous dilatation and tortuosity were the most common ocular findings. Retinal vascular occlusive disease was detected in 5 patients (22.7%). Flourescein angiography abnormalities were noted in 14 of the 18 patients (77.8%). The most common angiographic finding was pigment epithelial window defects. Conclusions: Our results indicate that posterior eye segment involvement is relatively common in the primary APS. It also seems that the screening for APS is important in young patients with retinal vascular occlusion, especially in those without conventional risk factors.

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1573-2630

high-pressure ; paint gun ; injection injury ; orbit ; adnexa ; botulinum toxin

Springer Online Journal Archives 1860-2000

Medicine

Abstract High-pressure injection injury to the orbit and adnexa is a rare but potentially blinding type of trauma. Few cases of such injury have been reported in the literature. A 27-year-old Indian man accidentallyi njected paint material from a high-pressure nozzle gun into his left eye. Radiological investigation revealed the presence of paint material in the orbital tissues and the ethmoidal sinuses. The patient underwent two orbital surgeries to remove the paint material. He later developed signs suggestive of limbal stem cell failure and was treated with limbal stem cell autografting. He also has ophthalmoplegia with a compensatory anomalous head posture that was managed conservatively. We report the clinical course and outcome of this unfortunate patient to highlight the complexity of such an injury and the need for a multidisciplinary approach in its management.

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1573-2630

Springer Online Journal Archives 1860-2000

Medicine

Abstract Objective: To report changes in retinal arterial and venous blood flow pattern in two patients with tumors involving the entire optic nerve. Methods: Retrospective review of one patient with clinical and neuroimaging characteristics typical of bilateral optic nerve gliomas and one patient with a probable meningioma of the left optic nerve sheath. Results: The optic nerve glioma patient had reduced peak systolic velocity of central retinal arteries bilaterally, while the patient with an optic nerve sheath meningioma had relatively low central retinal artery flow velocity and intermittent blood flow in the central retinal vein on the affected side. Conclusions: Reduced retinal arterial flowvelocities in the setting of optic nerve gliomas may correlate with thepresence of optic nerve disease. Phasic blood flow in the central retinalvein with optic nerve sheath meningioma may be the reason that somepatients with this tumor develop retinal choroidal venous anastomoses.

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1573-2630

blood flow ; calcium channel blocker ; color Doppler imaging ; normal-tension glaucoma ; optic nerve head ; scanning laser Doppler flowmetry

Springer Online Journal Archives 1860-2000

Medicine

Abstract Background: Because calcium channel blockers reduce vascularresistance, they may have a clinical application in the treatment ofnormal-tension glaucoma (NTG). This study investigates changes inboth the optic disc blood flow and the hemodynamics of retrobulbarvessels in NTG patients after the systemic administration of a calcium channel blocker. Methods: Twelve eyes of 12 NTG patients (meanage 57 6 ± 15.3 years) were examined before and after a 4-weektreatment with 2 mg b.i.d. oral nilvadipine, an L-typc calcium channel blocker. By scanning laser-Doppler flowmetry (SLDF), we obtained the velocity, flow, and volume from within a 10 × 10 pixel windowplaced on the temporal rim region of the optic disc perfusion map. Byultrasound color Doppler imaging (CDI), we measured the peak systolicvelocity (PSV) and the end diastolic velocity (EDV) of the ophthalmicartery (OA), central retinal artery (CRA), nasal posterior ciliary artery (NPCA), and temporal posterior ciliary artery (TPCA). We then calculated a resistance index (RI) for each vessel. Results: After treatment, the flow and velocity of the optic disc blood flow significantly increased (P 〈 0.05).Nilvadipine also significantly reduced RIs of the CRA, NPCA, and TPCA(P 〈0 .05), and increased both the PSV of the NPCA and the EDVs of the CRA, NPCA, and TPCA. The percent change in velocity correlated significantly with the percent changes of the CRA RI and NPCA RI. Conclusions: Oral nilvadipine appears to reduce orbital vascular resistance, which consequentlyincreases the optic disc blood flow. Abbreviations.BP – blood pressure;CRA – central retinal artery;CDI – ultrasound color Doppler imaging;EDV – end diastolic velocity;NPCA – short posterior ciliary arteries located nasal to optic nerve;NTG – normal-tension glaucoma;OA – ophthalmic artery;PP – perfusion pressure;PSV – peak systolic velocity;RI – resistance index;SLDF scanning laser-Doppler flowmetry;TPCA – short posterior ciliary arteries locatedtemporal to optic nerve.

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1573-2630

semi-fluorinated alkanes ; vitreous substitutes ; electroretinography ; retinal vessels ; vitrectomy

Springer Online Journal Archives 1860-2000

Medicine

Abstract Background: Perfluorocarbon liquids are established tools for intraoperative hydrokinetic retinal manipulation. Because of their high specific gravity, however,they may well cause mechanical damage to the retina whenapplied as a long-term vitreous substitute.Perfluorohexyloctane, a semi-fluorinated liquid fluorocarbon of low specific gravity (1.35 g/cm3), was developed as a long-term vitreous substitute. The current study was performed to investigate intraocular tolerance to perfluorohexyloctane as a long-term vitreous substitute in the experimental animal. Methods: 34 vitrectomised eyes of pigmented rabbits underwent intravitreal injection of 1.0–1.2 ml perfluorohexyloctane or balanced salt solution. In 5 eyes the anterior chamber was filled. During the follow-up period of 3 months, the eyes were examined by slit lamp biomicroscopy, by fluorescein angiography and by electroretinography. The eyes were then enucleated and processed for light- and electron microscopy. Results: Perfluorohexyloctane depicted dispersion beginning between the first and third week. Over a period of 9 weeks no toxic effect on retina, lens and cornea was noticed. At 14 weeks ERG showed a slight decrease in amplitude and early morphological changes in the retina.Conclusion: Our findings suggest that perfluorohexyloctane is tolerated in the rabbit eye for 9 weeks. Since avascular rabbit retina is more susceptible to mechanical and toxic damage than vascularized primate retina, we suggest proceeding from here, and investigating tolerance and quality of tamponade of perfluorohexyl octane in man for up to 9 weeks.

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1573-2630

corneal pachometry ; keratopathy ; silicone oil ; specular microscopy

Springer Online Journal Archives 1860-2000

Medicine

Abstract Purpose: To assess acute corneal decompensation after silicone oil removal in some aphakic eyes with clear corneas whose anterior chambers were completely filled with silicone oil for a considerable period of time. Methods: Eight eyes of 8 patients who underwent vitrectomy and intraocular silicone oil injection were studied. All the eyes were aphakic and anterior chambers were completely filled with silicone oil. In all eyes, corneas were clear and no corneal finding indicating keratopathy was detected by slit-lamp microscopy before silicone oil removal. The mean silicone oil removal time was 4 months (range 2–7 months). A specular microscope was used for the evaluation of corneal endothelial changes and corneal pachometry was performed to observe corneal changes before and after the silicone oil removal in 5 eyes besides slit-lamp microscopy. The follow up period after silicone oil removal was 2–12 months (mean 6 months).Results: In all eyes severe corneal stromal edema and clouding was detected in the first day following silicone oil removal. Increased corneal thickness was seen in all eyes. Decreased (at or below critical levels) corneal cell density was detected by specular microscopy before and after silicone oil removal. No significant improvement was observed during the follow up period. Conclusion: Eyes whose anterior chambers completely filled with silicone oil could be evaluated as clear corneas by slit lamp microscopy despite severe endothelial damage. We recommend that eyes with silicone oil in the anterior chambers should be monitored by a combination of slit-lamp microscopic examination and specular microscopy to determine the relative corneal endothelial tolerance to the silicone oil and endothelial damage. Early removal of the silicone oil can be considered when the retinal adhesion allows.

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1573-2630

glaucoma ; venous tone ; betaxolol ; timolol

Springer Online Journal Archives 1860-2000

Medicine

Abstract The aim of this study was the assessment of physiological venous reflexes in 40 glaucoma patients treated with topically applied timolol maleate 0.50% and betaxolol HCL 0.50%. They were divided into two groups of twenty each; one group being given timolol and the other betaxolol. The assessment of the venous tone was performed by testing venous reflexes. We found no statistically significant difference between timolol and betaxolol; however, when the influence of circulating catecholamines and the other vasoactive substances was excluded by suprasphygmatic insufflation of a pediatric cuff, a significant difference was found in the Valsalva's maneuver (125.5 ± 8.1 vs 85.0 ± 34.3 venoconstrictive units VCUs, p = 0.03). The IOP was significantly decreased in both treatment group, although the pressure reduction effect was more pronounced in the timolol group.Our study suggests that timolol and betaxolol have a slightly different mode of action on the venous side of circulation under topical medications. It is possible that the use of betaxolol topically may reducea systemic venoconstriction.

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1573-2630

brain stem ; neoplasms ; strabismus

Springer Online Journal Archives 1860-2000

Medicine

Abstract We encountered a 5-year-old girl with acute onset of alternating, comitant esotropia in the absence of diplopia and other neurologic findings. She did not have any refractive error and seen bilateral papilledemas in fundus examination, magnetic resonance imaging (MRI) of the head was performed. A large cerebellar astrocytoma and moderate hydrocephalus was identified and successfully resected. The onset of comitant esotropia in a child can be the first sign of a cerebellar tumor without any other neurologic signs and symptoms.

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