Search PubMed⌕ Search

Biomedical subjects

A M Hamilton

Publications and source records attributed to A M Hamilton.

At least 91 records · Page 5Linked to original sources
PubMed1978

Diabetic retinopathy and pregnancy.

Diabetic retinopathy was found to be present in 12 out of a group of 67 diabetic patients supervised by us during 92 pregnancies, and 3 further pregnant diabetics were referred to us because of retinopathy. The mean duration of diabetes was 13 years (range 3--25 years). Nine patients had minimal retinopathy, 2 had background retinopathy, and the remaining 4 proliferative retinopathy. The cases with minimal retinopathy showed no progression during pregnancy. In 1 patient with background retinopathy there was deterioration. Of the 4 patients with proliferative retinopathy 1 showed regression during the pregnancy, 2 showed advance and were treated with photocoagulation (these 2 patients now have normal vision), while the patient with extensive retinitis proliferans, with retinal detachment in both eyes and previous photocoagulation remained unchanged. The prognosis during pregnancy for patients with diabetic retinopathy is reasonable and has been improved by the advent of photocoagulation.

Adolescent↗
PubMed1978

Placoid pigment epitheliopathy and Harada's disease.

Twenty-six patients are described who suffered from acute bilateral multifocal pigment epithelial disease. In 7 the pattern of disease was indistinguishable from acute posterior multifocal placoid pigment epitheliopathy, while in 8 it was indistinguishable from Harada's disease. In a further 9 cases the pigment epithelial disease was associated with serious detachment of the retina simulating Harada's disease but without systemic symptoms; spontaneous resolution occurred within a few days, and there was no recurrence. One additional case had short-lived disease with detachment initially, but this was followed by severe recurrence, and the last patient had serious detachment in 1 eye but not the other. When seen as a whole these patients appeared to represent a continuous spectrum of disease making it difficult to define boundaries between one condition and another. The difficulties in distinguishing diseases according to morphology alone are emphasised.

Diagnosis, Differential↗
PubMed1978

Photocoagulation in diabetic retinopathy: II. Methodology.

There is now evidence from clinical trials that patients with diabetic retinopathy have their visual lives prolonged by photocoagulation. However, the exact indications for treatment have not yet been established and are undergoing continuous reevaluation. For many years, the presence of fibrous tissue either on the optic disc or the retina was considered to be a contraindication to treatment. However, recently treatment has been possible using gentle photocoagulation. It is hoped that over the next few years the exact indications for treatment will be established. It may be found in the future that the treatment of patients with maculopathy by panretinal photocoagulation and focal treatment and similarly patients with a few peripheral new vessels, by panretinal photocoagulation may prevent further progression and remove the necessity for treatment. It is important to limit as much as possible the number of visits to the opththalmologist that the patient must make. It is therefore important to establish a technique that requires as few treatment sessions as possible. Ultimately, follow up should be done by the well trained physician. The difficulty with the development of this type of technique is that diabetic retinopathy is a progressive disease and therefore new abnormal areas may well develop in patients who have had seemingly adequate treatment. Also, relatively mild background retinopathy or maculopathy may progress ultimately to proliferative retinopathy. However, with improvements in technique and establishment of safe treatment regimens, the goal of single treatment may be achieved.

Diabetic Retinopathy↗
PubMed1978

Photocoagulation in diabetic retinopathy: III. Complications.

We have reviewed the unwanted effects that follow the treatment of diabetic retinopathy with photocoagulation. Complications are uncommon, and those side effects that occur regularly are acceptable in relation to the benefits to be gained from treatment.

Diabetic Retinopathy↗
PubMed1977

Management of diabetic retinopathy.

There is now evidence from clinical trials that patients with diabetic retinopathy treated by photocoagulation may have their visual life extended, so that they may lead socially, professionally, and economically independent lives. The establishment of treatment centres for photocoagulation is now urgently required. The exact indications and techniques are not clearly defined.

Diabetic Retinopathy↗
PubMed1976

Streptokinase in central retinal vein occlusion: a controlled clinical trial.

Forty patients with central retinal vein occlusion were allocated at random either to a treatment group given streptokinase followed by anticoagulatns or to a control group given no specific treatment. The two groups, which were each of 20 patients, were broadly similar in respect of clinical and laboratory values and similar in their initial visual acuity. At follow-up ("final" vision) the visual acuity in the treated group was significantly better than in the untreated group. Only one treated patient developed thrombotic glaucoma compared with four controls. Streptokinase may, however, have been responsible for vitreous haemorrhage (and permanent loss of vision) in three patients and hence probably has only a limited role in the treatment of central retinal vein occlusion.

Adult↗
PubMed1976

Florid diabetic retinopathy and its response to treatment by photocoagulation or pituitary ablation.

A group of 34 patients with florid diabetic retinopathy are reported. Nine of these had at least one eye untreated and of these only two maintained vision at one year-the others were blind. Ten patients had 11 florid eyes treated by photocoagulation. At one year six were blind and five had good vision. At two years only three could still see. Of 20 pituitary-ablated patients with 29 florid eyes, only three were blind at one year. Even at five years, 12 of 17 eyes could see and only two patients were blind. The one- and two-year visual acuities were significantly better in the pituitary ablated eyes than in the untreated and photocoagulated ones (p = 0.01-0.03). It is suggested that for this rare form of retinopathy pituitary ablation remains the treatment of choice if vision is to be maintained.

Adult↗
PubMed1975

The retinal blood flow in diabetes.

Retinal blood flow was studied in 9 normal volunteers and 36 diabetic patients. The method used was based on the measurement of the mean transit time of flourescein in the superior temporal quandrant of the retina and on estimation of the vascular volume by measuring vessels diameters. The results showed that patients with mild or no retinopathy had significantly increased volume flow compared with normals, those with moderate retinopathy had a slight but not significant increase and those with severe retinopathy had blood flow similar to that found in normals. The mean transit time was reduced significantly in those with mild or no retinopathy, but was similar to normals in those with moderate and severe retinopathy. Following succesful pituitary ablation and photocoagulation retinal blood flow was reduced compared with pre-treatment studies.

Adult↗
PubMed1975

Histopathology of ruby and argon laser lesions in monkey and human retina. A comparative study.

Suprathreshold fundus lesions produced by ruby and argon laser photocoagulation were studied within 24 hours by light and electron microscopy. It was shown that damage was maximal in the outer retina in all ruby laser lesions and extramacular argon laser lesions. In both monkey and human, inner retinal damage occurred independently of outer retinal damage in macular lesions produced by the argon laser. In lesions produced by equal energy, inner retinal damage was more severe in humans than in monkeys. In both species outer retinal damage was less severe in the foveal than the parafoveal region and this disparity was greater in humans than in monkeys. These findings are important to the therapeutic use of argon laser energy for mascular disease. In particular, absortion of energy in the inner retina reduces the energy available in the treatment of subretinal lesions in the foveal area, and causes unwanted neuroretinal damage. The higher sensitivity to argon laser irradiation of the human fovea compared with the monkey fovea, has not been appreciated when defining laser safety limits.

Animals↗
PubMed1975

Retinal macroaneurysms.

Twenty patients with retinal macroaneurysms were examined and observed for at least 9 months. All these patients were elderly and had evidence of hypertension or systemic vascular disease. Nineteen patients presented with loss of central vision and one patient was asymptomatic. Visual loss was due to macular haemorrhage in 13 patients and macular oedema in 6. Whereas the visual prognosis in patients with haemorrhage was good it was considerably poorer in the patients with macular oedema.

Age Factors↗
PubMed1975

Visual loss due to posterior segment disease in scleritis.

Exudative retinal detachment and oedema of the posterior retina are well-recognized clinical entities for which a cause is rarely found. Scleritis may cause both these clinical syndromes by a spread of inflammation from the sclera into the uveal tract. Although treatment may result in a rapid resolution of scleritis, retinal detachment and macular oedema persist and prove extremely resistant, even to high doses of systemic steroids. Recovery may be incomplete and may occur only after weeks or months of treatment.

Adrenal Cortex Hormones↗