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Biomedical subjects

A F Cruess

Publications and source records attributed to A F Cruess.

28 records · Page 2Linked to original sources
PubMed1988

Argon green and krypton red laser treatment of diabetic macular edema.

We treated 69 eyes of 44 patients who had clinically significant macular edema with argon or krypton laser photocoagulation or both. The mean initial visual acuity was 20/40. Patients were followed for 6 to 63 (mean 19.7 +/- 11.0) months. There was a mean loss of three letters in acuity, but the difference between initial and final acuity was not statistically significant. In 43 eyes the acuity remained within two lines of the initial acuity, in 17 there was a loss of two lines or more, and in 9 the acuity improved by two lines or more. The initial acuity correlated highly to the final acuity (p less than 0.0001). Multiple linear regression showed that pretreatment existence of macular ischemia or diffuse macular edema or both, when adjusted for initial acuity, age, insulin dependence and duration of diabetes mellitus, was predictive of poorer final acuity than in patients without ischemia or diffuse edema. The results support a consensus that macular edema should be treated early. In view of the conflicting experimental and clinical studies of grid techniques of photocoagulation and the role of the krypton laser, further clinical studies of the treatment of diabetic macular edema are warranted.

Adult↗
PubMed1986

Peripheral circumferential retinal scatter photocoagulation for the treatment of proliferative sickle retinopathy. An update.

Forty-four patients (70 eyes, 220 sea fans) with proliferative sickle retinopathy (PSR) received peripheral circumferential retinal scatter photocoagulation (PCRP) to the peripheral zones of retinal capillary nonperfusion. With an average follow-up of 3.3 years, 33% of preexisting sea fans regressed completely, 46% regressed partially, 19% remained stable, and 2% showed progression. De novo neovascularization developed after treatment in only one eye (1.4%). Ninety-five percent of patients treated had a final visual acuity of 20/30 or better and only one patient (2%) developed a nonresolving vitreous hemorrhage requiring vitrectomy surgery. These results confirm the authors' previous report and continue to compare favorably to the natural history of PSR in which de novo lesions developed in 58%, and 12% of eyes ended with a visual acuity of 20/200 or less. PCRP seems preferable to other techniques in reducing the risk of nonresolving vitreous hemorrhage and/or traction retinal detachment, although randomized controlled studies are needed to conclusively assess the safety and efficacy of this strategy in treating PSR.

Adolescent↗
PubMed1985

Chloroquine retinopathy. Is fluorescein angiography necessary?

Color fundus photographs and corresponding fluorescein angiograms from 83 patients suspected of having chloroquine retinopathy were reviewed in a retrospective masked study to determine the relative sensitivity of these two photographic methods in the diagnosis of retinal toxicity. We identified retinal toxicity on both color photographs and fluorescein angiograms in 7.6% of cases, on the color photographs but not on the corresponding angiograms in 6.1% of cases, and on the fluorescein angiograms but not on the color photographs in 1.5% of cases. Fluorescein angiography may not be as sensitive as color fundus photography (or ophthalmoscopy) in the diagnosis of chloroquine retinopathy.

Chloroquine↗
PubMed1984

Regression of posterior uveal melanomas following cobalt-60 plaque radiotherapy.

A method has been devised for evaluating the rate and extent of regression of the first 100 consecutive patients with a posterior uveal melanoma that we had managed by Cobalt-60 plaque radiotherapy at Wills Eye Hospital. It was found that the "average" posterior uveal melanoma in the series did not regress rapidly to a flat, depigmented scar but shrank slowly and persisted as a residual mass approximately 50% of the thickness of the original tumor at 54 months following Cobalt-60 plaque radiotherapy. We also found that the rate and extent of regression of the tumors in patients who subsequently developed metastatic melanoma were not appreciably different than the rate and extent of regression of the tumors in patients who remained well systemically. These observations indicate that the rate and extent of regression of posterior uveal melanomas following Cobalt-60 plaque radiotherapy are poor indicators of the prognosis of the affected patients for subsequent development of clinical metastatic disease.

Brachytherapy↗
PubMed1984

Visual results following cobalt plaque radiotherapy for posterior uveal melanomas.

Visual results of cobalt plaque radiotherapy on the eyes of 77 patients with posterior uveal melanoma in one eye and pretreatment visual acuity of 20/25 or better in both eyes were analyzed using actuarial methods. The study demonstrated that eyes receiving a radiation dose in excess of 5,000 rad to the fovea and/or optic disc commonly lose a substantial amount of vision within 2 to 3 years. It also showed that eyes treated by cobalt plaque radiotherapy for a large posterior uveal melanoma are more likely to suffer profound visual loss than those treated for a medium or small melanoma. The predominant cause of severe visual loss in these patients appeared to be foveal radiation retinopathy.

Adult↗
PubMed1983

Peripheral circumferential retinal scatter photocoagulation for treatment of proliferative sickle retinopathy.

Twenty-nine patients (40 eyes) with proliferative sickle retinopathy (PSR) were treated with circumferential argon laser scatter photocoagulation to zones of peripheral retinal capillary nonperfusion. Each eye was examined in a prospective fashion, with a mean follow-up of 1.4 years. Following scatter treatment, 26% of the pre-existing sea fans regressed completely, 57% regressed partially, 17% remained stable, and none showed progression. In only one eye did de novo neovascularization develop. The results compare favorably with the natural history of PSR (Condon et al, 1980), in which de novo lesions occurred in 58%, and the visual acuity was decreased to less than 20/200 in 12% of affected eyes. Severe iatrogenic complications reported following direct focal treatment of sea fans, such as vitreous hemorrhage, progressive traction retinal detachment, retinal breaks, and choroidal-retinal-vitreal neovascularization were virtually eliminated.

Adolescent↗
PubMed1982

Anterior segment necrosis following cyclocryotherapy.

A 74-year-old woman with secondary glaucoma underwent cyclocryotherapy. Ten weeks later anterior segment necrosis and dehiscence in the area of the cryotherapy lesions resulted in an expulsive choroidal hemorrhage. Anterior segment ischemia following cyclocryotherapy has previously been described, but this is the first reported case of anterior segment necrosis as a complication of this procedure.

Aged↗
PubMed1981

Corneal epithelial dysplasia and carcinoma in situ.

Corneal epithelial dysplasia and carcinoma in situ have not been emphasized as distinct clinical conditions in the literature. Seven cases are presented with their clinicopathological correlation. Six of the patients presented primarily with corneal signs and symptoms consisting of notable visual blurring or foreign body sensations, or both. Biomicroscopic examination revealed a geographic, diffuse, greyish-white haze involving the corneal epithelium, often with; subtle thickening and irregularity of the involved areas and overlying superficial punctate keratitis. Histologic examination showed all degree of corneal epithelial dysplasia up to carcinoma in situ. The diagnosis, course and management of these conditions is discussed.

Adult↗
PubMedDate not supplied

Ophthalmomyiasis treated by argon-laser photocoagulation.

A live, subretinal fly larva was observed in a 16-year-old Caucasian female. Argon-laser photocoagulation killed the larva without a destructive inflammatory response. The patient's vision improved from 20/200 to 20/20 as the eye recovered. Clinical photographs demonstrate the larva and the acute and later healed pathopneumonic subretinal tracks. The laser photocoagulation technique is described.

Adolescent↗