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Biomedical subjects

C E Margo

Publications and source records attributed to C E Margo.

At least 37 records · Page 2Linked to original sources
PubMed1998

Wound complications following cataract surgery. A case-control study.

OBJECTIVE: To determine whether selected preoperative medical, social, or behavioral factors predict the occurrence of cataract wound complications. PATIENTS AND METHODS: Patients who underwent cataract surgery at a Veterans Administration hospital were used in a case-control study. Cases were defined by the occurrence of any postoperative cataract wound gape with or without iris prolapse within 12 weeks of surgery and requiring repair in the operating room. Controls were patients who had no postoperative complications. Two controls were selected for each case patient and matched for surgeon. RESULTS: Thirty-one patients with postoperative wound complications occurred after 2041 cataract extractions (1.5%). Occurrence of wound complications was predicted by previous hematologic disorder (odds ratio, 2.9; 95% confidence interval, 1.1-8.1). Phacoemulsification surgery had a protective effect against wound complication (odds ratio, 0.2; 95% confidence interval, 0.09-0.64). There was no difference in final visual acuity and refractive indexes in patients with and without wound complications (P = .6 by Student t test). CONCLUSIONS: Most medical social and behavioral preoperative factors have limited discriminatory power in predicting who will have postoperative cataract wound complications. The association of previous hematologic disorders to predict the occurrence of wound complications varied with the level of alcohol use. Although this study was not primarily designed to assess the role of surgical technique, phacoemulsification cataract extraction had a statistically significant protective effect against wound complications. Visual outcome in patients with postoperative wound complications is generally very good.

Aged↗
PubMed1998

Patterns of emergency department visits for disorders of the eye and ocular adnexa.

OBJECTIVE: To characterize the magnitude and patterns of visits to the emergency department (ED) for problems related to the eye and ocular adnexa. METHODS: The National Hospital Ambulatory Medical Care Survey was used to obtain information on ED visits in the United States for conditions of the eye and ocular adnexa in 1993. Patients were identified by International Classification of Diseases, Ninth Revision, Clinical Modification, codes. National projections were based on a staged probability design. RESULTS: There were 2.32 million projected ED visits for problems of the eye and ocular adnexa in 1993. Forty-nine percent of visits were for injuries, two thirds of which occurred in males. Thirty-five percent of injuries occurred in the home and 18% occurred in the workplace. Only 3% of patients required hospitalization. Most patients had private insurance, but substantial variations in coverage existed for patients who used the ED for injury- vs non-injury-related care. CONCLUSIONS: Emergency departments in the United States provide a large amount of eye care, much of which is for conditions other than trauma. Differences in insurance coverage for injury- and non-injury-related eye care indicate that factors other than medical urgency are involved in the decision to use ED services. Further studies are needed to determine the cost-effectiveness and quality of ocular-related ED visits.

Adolescent↗
PubMed1998

Cystoid macular edema associated with latanoprost in aphakic and pseudophakic eyes.

PURPOSE: To describe four patients who developed cystoid macular edema shortly after onset of treatment with latanoprost. METHOD: Retrospective review of medical records of patients with open-angle glaucoma who developed cystoid macular edema shortly after starting latanoprost. RESULTS: The use of topical latanoprost was temporally related to the development of cystoid macular edema in four patients (six eyes; two aphakic eyes and four pseudophakic eyes). Cystoid macular edema resolved in all patients after latanoprost was discontinued. CONCLUSIONS: Cystoid macular edema is a potential complication of latanoprost therapy. Further observations are needed to determine if the risk of cystoid macular edema is limited to or greatest in patients who are pseudophakic or aphakic.

Aged↗
PubMed1998

Malignant tumors of the orbit. Analysis of the Florida Cancer Registry.

PURPOSE: The purpose of the study is to determine the relative frequency and incidence of primary malignant tumors of the orbit occurring in Florida. METHODS: Cases of primary orbital malignancy were identified in the Florida Cancer Data System registry from 1981 through 1993. Analysis was restricted to persons who reside within the state. RESULTS: Three hundred fourteen primary orbital malignancies were reported; 55% of malignant orbital tumors were lymphoma. The average annual incidence for all malignancies was 2 cases per million. There was a steady increase in the annual incidence of orbital malignancy during the 13 years of the study. Lymphoma showed the greatest rise in annual incidence. The average annual incidence of lymphoma increased 166% the last 6 years of the study compared to the first 6 years. CONCLUSIONS: A large increase in orbital lymphoma was documented in the Florida cancer registry from 1981 through 1993. The increase in incidence cannot be explained by improved compliance in reporting or by the small increase in incidence of systemic lymphoma during the survey period. Additional studies are needed to determine whether the observed increase in incidence in orbital lymphoma is genuine or spurious.

Adolescent↗
PubMed1998

Incidence of surgically treated uveal melanoma by race and ethnicity.

OBJECTIVE: The purpose of the study was to determine the race- and ethnicity-specific incidence of histologically confirmed uveal melanoma. DESIGN: The study design was a retrospective study of histologically confirmed cases of primary uveal melanoma submitted to the Florida Cancer Data System (FCDS). MAIN OUTCOME MEASURES: Race-, gender-, and Hispanic-specific incidence rates of uveal melanoma were measured. Calculations are based on Florida census data and Hispanic population estimates from the University of Florida Bureau of Economic and Business Research. RESULTS: From 1981 through 1993, 873 histologically confirmed uveal melanomas were reported to the FCDS. Four melanomas occurred in black non-Hispanics, 47 in white Hispanics, and none in black Hispanics. The relative risk of uveal melanoma for blacks compared to non-Hispanic whites was 0.03 (95% confidence interval, 0.01-0.08). Non-Hispanic white men had 72 times the risk of uveal melanoma compared to black men; non-Hispanic white women experienced a 22-fold risk compared to black women. White Hispanics were less likely to develop uveal melanoma than white non-Hispanics (relative risk, 0.36; 95% confidence interval, 0.27-0.48). CONCLUSION: The risk of uveal melanoma in blacks is exceptionally low. The reason for lower risk of uveal melanoma in white Hispanics than in white non-Hispanics is not known but could be related to the protective effects associated with dark skin pigmentation or may be because of unknown cultural-environmental exposures or socioeconomic factors.

Adolescent↗
PubMed1998

Postural vision loss in giant cell arteritis.

Two patients with biopsy-proven giant cell arteritis experienced bilateral transient vision loss after bending over and after getting up from a supine position. One patient had no demonstrable signs of carotid, ophthalmic, or anterior ciliary vascular disease, suggesting that his episodes of transient vision loss were due to vertebrobasilar insufficiency. The other patient experienced bilateral postural vision loss in the context of impending bilateral anterior ischemic optic neuropathy. Bilateral transient postural vision loss is an uncommon manifestation of giant cell arteritis that could reflect either severe bilateral vascular compromise of the anterior circulation or severe vertebrobasilar insufficiency. In either situation, prompt evaluation and treatment is indicated to prevent the irreversible sequelae of the disease.

Aged↗
PubMed1998

Microscopic examination of surgical margins of intraocular tumors excised en bloc.

Microscopic examination of the surgical margins of an en bloc resection of an intraocular tumor is difficult because of the small size of the specimen. A technique to study the surgical margins of en bloc resections is described that minimizes gross handling of the tissue in the laboratory. Step sections at 1/8-mm intervals along the anteroposterior axis of the eye provide sufficient sampling to detect involvement of the surgical margin. They also allow easy anatomic reconstruction of the tumor with glass slides.

Ciliary Body↗
PubMed1997

Cystic epithelial downgrowth following clear-corneal cataract extraction.

Epithelial downgrowth is a serious complication of intraocular surgery. It is characterized by the diffuse or cystic proliferation of surface epithelium inside the eye. Advances in microsurgical technique that result in smaller surgical wounds and permit greater precision in wound closure should reduce the incidence of this complication. We report a case of epithelial downgrowth presenting 3 years after an uncomplicated clear-corneal cataract extraction with insertion of a posterior chamber silicone lens. The epithelial down-growth was amenable to surgical correction because the well-defined cyst could be excised en bloc.

Aged↗
PubMed1997

Acquired capillary hemangioma of the eyelid in an adult.

PURPOSE: To report a case of an acquired capillary hemangioma of the eyelid in an adult. METHODS: A 38-year-old man developed a discrete blue nodular mass in the lower eyelid. The lesion grew slowly for 6 months and then remained stable in size. Excisional biopsy was performed. RESULTS: Histopathologic examination of an excisional biopsy specimen of the nodular mass disclosed a capillary hemangioma. CONCLUSIONS: Capillary hemangioma of the eyelid can occur in adults but should be distinguished from other acquired vascular lesions, including angiosarcoma.

Adult↗
PubMed1997

Bilateral subinternal limiting membrane hemorrhage with Terson syndrome.

PURPOSE: To report the anatomic location of bilateral dome-shaped posterior pole hemorrhages in a patient with Terson syndrome. METHODS: Case report. We performed bilateral vitrectomy for vitreous hemorrhage in a patient with Terson syndrome. After removal of vitreous hemorrhage, the tissue overlying a large discrete hemorrhage in the posterior pole was removed, and the tissue from one eye was examined histologically. RESULT: The discrete dome-shaped hemorrhage in the posterior pole was confined to the retina anteriorly by the internal limiting membrane. CONCLUSION: Large dome-shaped retinal hemorrhages with Terson syndrome can be located beneath the internal limiting membrane of the retina.

Basement Membrane↗
PubMed1997

Lack of p53 protein immunoreactivity in bilateral diffuse uveal melanocytic proliferation.

BACKGROUND: Bilateral diffuse uveal melanocytic proliferation is a poorly understood disorder characterized by the progressive proliferation of uveal melanocytes associated with a systemic nonocular malignancy. Overexpression of p53 protein plays a role in the loss of regulatory control of normal cell proliferation, and p53 is the most commonly identified oncogenic protein in human malignancies. We tested the hypothesis that the aberrant cellular activity in bilateral diffuse uveal melanocytic proliferation involves the overexpression of p53 protein. METHODS: Eight eyes from four patients with bilateral diffuse uveal melanocytic proliferation were tested for p53 protein using an immunoperoxidase technique with an anti-p53 protein monoclonal antibody sensitive for normal and mutant p53 protein. RESULTS: The p53 protein could not be detected in any of the eight eyes. CONCLUSIONS: The proliferation of uveal melanocytes in bilateral diffuse uveal melanocytic proliferation does not depend on the overexpression of p53 protein. The loss of cellular regulatory control in bilateral diffuse uveal melanocytic proliferation is probably mediated through another mechanism.

Antibodies, Monoclonal↗
PubMed1997

Positive vitreous cultures from eyes without signs of infectious endophthalmitis.

BACKGROUND AND OBJECTIVE: There is little information on the rate of false-positive vitreous cultures, because cultures from presumably sterile vitreous are not routinely taken in clinical practice. The objective of this study was to determine the rate of positive vitreous cultures from patients who have no signs of endophthalmitis. PATIENTS AND METHODS: Aerobic cultures from vitreous biopsies were taken from 36 consecutive eyes in which there was no clinical evidence of endophthalmitis. Effluent collected in cassettes during pars plana vitrectomies was processed and cultured in a standard manner. Balanced salt solution was processed intraoperatively through the vitrector and cultured as a negative control. RESULTS: Positive cultures were obtained in 8 of 36 eyes (22.2%). Coagulase-negative Staphylococcus and Corynebacteria accounted for 7 of the 9 identified organisms. No organism was grown in more than one medium. None of the patients were treated for endophthalmitis after surgery, and none had signs of intraocular infection. CONCLUSIONS: A substantial number of vitrectomy cultures from effluent specimens grow low-virulence organisms in the absence of clinical signs of endophthalmitis. The absence of inflammation at the time of surgery suggests that these positive cultures are contaminants.

Aspergillus niger↗
PubMed1997

Complex retinal detachment treated with silicone oil or sulfur hexafluoride gas: a randomized clinical trial.

BACKGROUND AND OBJECTIVE: To determine if either silicone oil or sulfur hexafluoride gas (SF6) is superior to the other in the treatment of complex retinal detachment after previously failed vitreous surgery. PATIENTS AND METHODS: In this randomized clinical trial, 18 patients received treatment with silicone oil and 16 patients received SF6. The primary outcome was defined as successful anatomic attachment of the retina. Secondary outcomes included the time to retinal detachment, visual acuity, anatomic macular attachment, and any complications of surgery. RESULTS: The odds of successful reattachment with silicone oil were 50% greater than they were with SF6, but this difference was not statistically significant. There were no differences between the two groups in any of the secondary outcomes. CONCLUSIONS: This study did not have enough statistical power to detect a small but clinically important difference between the two treatment groups. Physicians must use their clinical judgment to select a vitreal substitute for complex retinal detachment when clinical trials are inconclusive. Data pooling is one method of overcoming the limitation of clinical trials with small sample sizes.

Adolescent↗