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A Gandorfer

Publications and source records attributed to A Gandorfer.

30 records · Page 2Linked to original sources
PubMed2000

[Pars plana vitrectomy in diabetic retinopathy. From pathogenetic principle to surgical strategy].

Diabetic retinopathy is the most important manifestation of diabetic eye disease. There are retinopathy, maculopathy, pathology of the vitreoretinal interface, and tractional retinal detachment. The development of surgical approaches based on pathogenetic ideas are shown. The beneficial effect of pars plana vitrectomy for persisting and recurrent vitreous hemorrhage, epiretinal fibrovascular proliferation, and retinal detachment is discussed. The surgical skills and experiences in diabetic eyes are stressed.

Diabetic Retinopathy↗
PubMed2000

[Expansion of intraocular gas due to reduced atmospheric pressure. Case report and review of the literature].

Since the advent of vitrectomy and the increased use of intraocular gases, there had been concern voiced about the safety of air travel for patients with intraocular gas. Anecdotal reports and experimental models verify the danger of acute glaucoma and central retinal artery occlusion following depressurization and expansion of intraocular gas. However, the amount of gas, that can be compensated for, is a matter of controversy. CASE REPORT I: A 58-year old man underwent vitrectomy with intraocular air tamponade as a primary procedure for retinal detachment. The patient went home by airplane with a residual gas volume of less than 30% of the volume of the eye. Before takeoff at 530 m (1739 ft) above sea level, the intraocular pressure was 12 mmHg. During the ascent, severe ocular pain and loss of vision occurred. CASE REPORT II: A 38-year old woman underwent vitrectomy for primary repair of retinal detachment. The eye was injected with a 15% mixture of perfluoroethan (C2F6). When traveling home to Italy by car, the eye contained a residual gas volume of 50% of the volume of the globe. Intraocular pressure was 17 mmHg. During the ascent to the "Brennerpass", 1375 m (4511 ft) above sea level, the eye became severely painful and vision was lost for approximately three minutes. Descending to a lower altitude relieved the symptoms. CONCLUSION: The expansion of intraocular gases depends on the atmospheric pressure and the mechanisms for compensation. Small volumes of intraocular gas or moderate traveling altitudes can cause a symptomatic rise in intraocular pressure.

Adult↗
PubMed2000

[Imaging of vitreoretinal adhesions in the partner eye of patients with penetrating macular foramina in optical coherence tomography].

BACKGROUND: Vitreoretinal adhesions play a crucial role in the development of a macular hole. To visualize vitreoretinal adhesion we used optical coherence tomography to investigate fellow eyes of patients with macular holes. METHODS: In a prospective study we scanned the retina in 188 patients with a macular hole stage III or IV (Gass classification). The foveal shape and vitreous were classified into grades. RESULTS: Of the 188 patients 45% showed no vitreous reflex, 45% a partial vitreous detachment with foveolar adhesions, and 10% a vitreous detachment with complete separation from the fovea. While eyes with normal foveolar shape displayed partial vitreous detachment in 33%, this figure rose to 66% in eyes with a macular hole stage I. CONCLUSION: Diffuse thickening of the fovea is followed by an intraretinal split and formation of a cyst. The shape of the foveolar adhesion suggests that continuing anteroposterior vitreal traction leads to a retinal break and formation of a full-thickness macular hole.

Aged↗
PubMed2000

Humoral response in a patient with cutaneous nocardiosis.

The clinical appearance of infection due to Nocardia spp. varies widely. The low sensitivity of direct microscopy and the slow growth of the organism challenge the laboratory diagnosis. We present the case of a skin abscess in an immunocompetent man caused by Nocardia brasiliensis. Diagnosis was made by cultivation and 16S rRNA sequencing. Using indirect immunofluorescence and Western blot, a strong antibody response to the N. brasiliensis isolate could be demonstrated. Serological tests might therefore be useful for the diagnosis and management of nocardial infections.

Antibodies, Bacterial↗
PubMed2000

Silicone oil removal strategies.

Although it is widely accepted to use silicone oil in the treatment of very complex retinal detachments, there is no definite agreement on when and why silicone oil should be removed. Frequently found is a statement on the necessity of silicone oil removal after a certain period of time. However, the rate of retinal redetachment after silicone oil removal varies widely and appears to correlate with the underlying disease process and its severity. The literature on strategies of silicone oil removal, the rate of complications, and, thus, the risk-benefit ratio is scant. Therefore, for the discussion of silicone oil removal we rely on personal experience and the rather rare studies on silicone oil removal. Regarding the data given in the literature, the rate of vitreoretinal complications after silicone oil removal, even in cases with a clinically stable-appearing retinal situation, is rather high in severe proliferative vitreoretinopathy (PVR) and lower in most advanced cases of severe proliferative diabetic retinopathy (PDR) requiring silicone oil tamponade. The benefits of silicone oil removal are better in cases of cytomegalovirus retinitis or other situations without a PVR component. Silicone oil removal has to be considered a procedure of ill-defined risks, especially if silicone oil is really used as a last therapeutic resort in most severe cases of complicated retinal detachment. Further, exact criteria for the timing and safe removal of silicone oil in these complex vitreoretinal disorders still needs to be defined. A strategy for the removal of silicone oil is discussed.

Humans↗
PubMed2000

Resolution of diabetic macular edema after surgical removal of the posterior hyaloid and the inner limiting membrane.

PURPOSE: To evaluate the surgical results of pars plana vitrectomy with peeling of the inner limiting membrane (ILM) in a preliminary series of 12 eyes with diffuse diabetic macular edema. PATIENTS AND METHODS: Pars plana vitrectomy with peeling of the ILM was performed in 12 eyes with diffuse diabetic macular edema. In 10 eyes, the posterior hyaloid was attached and thickened. Six eyes had undergone macular photocoagulation previously, and two other eyes had been vitrectomized previously. Light and electron microscopy of the specimens obtained during vitrectomy was performed. Visual acuity and retinal thickening were monitored. RESULTS: Intraoperatively, the posterior hyaloid was found to be thickened and completely attached to the macula in 10 eyes. Two previously vitrectomized eyes showed a glistening reflex of the vitreoretinal interface but no premacular membrane. The posterior hyaloid and the ILM were removed from the macula. Postoperatively, retinal thickening resolved or decreased in all eyes. Visual acuity improved by at least two lines in 11 eyes. Best-corrected postoperative visual acuity developed within 4 to 12 weeks. No recurrence or deterioration of macular edema or epiretinal membrane formation were observed during the entire period of review (mean, 16 months; range, 8-31 months). Light and electron microscopy showed the presence of the ILM associated with sparse and mostly single-layered fibrous astrocytes. CONCLUSION: Vitrectomy including removal of the ILM leads to expedited resolution of diffuse diabetic macular edema and improvement of visual acuity without subsequent epiretinal membrane formation. Complete release of tractional forces and inhibition of reproliferation of fibrous astrocytes seem to be prudent in the eyes of patients with diabetes and advanced vitreoretinal interface disease of the macula.

Adult↗
PubMed1998

[Recurrent choroid neovascularization in age-related macular degeneration. Fluorescein angiographic morphology after surgical membranectomy].

UNLABELLED: The surgical removal of choroidal neovascularization (CNV) in age-related macular degeneration (AMD) causes a retinal pigment epithelial defect (RPED) corresponding to the area of diffuse RPE damage. We describe angiographic features of recurrent CNV in AMD after surgical membranectomy in order to elucidate the nature of persistence and recurrence. METHODS: After digitalization of the pre- and postoperative fluorescein angiographic images of eight patients with recurrent CNV in AMD we determined the morphology (well or ill-defined) and the area of the CNV and of the subretinal hemorrhage preoperatively and of the recurrent CNV and of the RPE defect postoperatively. RESULTS: The nature of recurrences showed differences between preoperatively well- and ill-defined CNV. Four preoperatively well-defined CNV with surrounding subretinal hemorrhage showed recurrences in the entire area of the preoperative CNV excluding the retinotomy 8-9 weeks postoperatively. Four preoperatively ill-defined CNV with subretinal hemorrhage developed marginal recurrences at the rim of the RPED. There was no background fluorescence in the area of the RPED. CONCLUSION: The nature of recurrences extending over the entire area of the preoperatively well-defined CNV without loss of background fluorescence only a few weeks after surgical removal of well-defined CNV suggests partial persistence. The removal of the subretinal well-defined CNV could leave sub-RPE parts in locations that preoperatively cannot be visualized angiographically. The marginal recurrence of preoperatively ill-defined CNV weeks to months postoperatively shows angiographic similarities to recurrent CNV after laser coagulation.

Aged↗
PubMed1993

The influence of variations of the coracoacromial arch on the development of rotator cuff tears.

In order to define the geometry of the coracoacromial arch in both its bony and soft parts and to bring it into relationship with rotator cuff tears, 54 cadaver shoulders (from subjects aged 47-90 years) were dissected and X-rayed (anteroposterior projection and supraspinatus outlet view). Partial rotator cuff tears were assessed additionally by transillumination and polarized microscopy. After transfixation of the coracoacromial arch with a polyurethane mould, sections were made along the coracoacromial ligament. The morphology of the acromion was described following the classification of Bigliani et al. [5]. Amongst other parameters, measurements were taken between the long axis of the scapula, the spina, and the acromion. In 19 of 22 cases, a traction osteophyte was associated with rotator cuff tears. In incomplete tears, spurs were completely encased within the ligament and did not impair the subacromial space. The number of rotator cuff tears was significantly increased in shoulders with "curved" acromia, flat acromial slope, and increased angle between the scapular plane and the spina (intact, mean 58 degrees; tears, mean 47 degrees). The morphology of the subacromial space was secondarily determined by this angle. In contrast to Bigliani et al. we were unable to find a "hooked" acromion. These results indicate that the combination of a flat and curved acromion or a position of the acromioclavicular joint above the cranial pole of the glenoid must be regarded as considerable risks for the development of rotator cuff tears. The concept of anterior acromioplasty is supported by our results.

Acromioclavicular Joint↗