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Biomedical subjects

C L Trempe

Publications and source records attributed to C L Trempe.

At least 91 records · Page 5Linked to original sources
PubMed1987

Asteroid hyalosis: posterior vitreous detachment and diabetic retinopathy.

The vitreoretinal relationship in 59 eyes with asteroid bodies was studied by biomicroscopy with the El Bayadi-Kajiura lens. Complete posterior vitreous detachment (PVD) occurred less often in eyes with asteroid bodies than in control eyes (P less than .05), and partial PVD occurred more often than in control eyes (P less than .01). In eyes with asteroid bodies after the age of 70 years, the prevalence of PVD, either complete or partial, was lower than in age-matched control eyes (P less than .01), and the prevalence of liquefaction (19%) was lower than has been reported in controls. Of eight eyes with proliferative diabetic retinopathy and asteroid bodies, only one showed partial PVD. Patients who were diabetic and who had asteroid bodies were significantly younger than patients without diabetes with asteroid hyalosis (P less than .01). Our data suggest that the presence of asteroid bodies may arrest the process of vitreous collapse or contraction and that diabetes might influence the development of asteroid hyalosis.

Adult↗
PubMed1986

Role of the vitreous in idiopathic preretinal macular fibrosis.

Of 250 eyes with idiopathic preretinal macular fibrosis, 56 had no posterior vitreous detachment (Group 1), ten had partial posterior vitreous detachments without vitreous traction to the macula (Group 2), 29 had partial posterior vitreous detachments with vitreous traction to the macula (Group 3), and 155 had complete posterior vitreous detachments (Group 4). There were significantly more eyes with visual acuities of 20/60 or worse, cystoid macular changes, or macular fluorescein leakage in Group 3 than in Group 1 or Group 4. Thus, the presence of vitreous traction to the macula was associated with worse anatomic and functional findings.

Adolescent↗
PubMed1986

Fellow eyes in cases of macular hole. Biomicroscopic study of the vitreous.

One hundred thirty eyes of 126 patients with idiopathic macular holes were studied by means of indirect ophthalmoscopy, biomicroscopy, color fundus photography, and fluorescein angiography. Posterior vitreous detachment was absent in 61% of these eyes; opacities interpreted as opercula were found in 78 eyes (60%). Forty-nine fellow eyes were followed up for a mean period of 47 months. Eight of 28 fellow eyes without posterior vitreous detachment and none of 21 fellow eyes with posterior vitreous detachment developed macular holes, suggesting that vitreous attachment to the macula is closely related to the development of macular holes. The difference between the incidences of macular hole development in eyes with and without posterior vitreous detachment is statistically significant.

Adult↗
PubMed1986

Role of the vitreous in diabetic retinopathy. II. Active and inactive vitreous changes.

The course of the vitreoretinal relationship in 272 eyes with diabetic retinopathy was studied retrospectively in an attempt to identify the prognostic role of the vitreous. In eyes with initial nonproliferative diabetic retinopathy, the development of neovascularization had a positive correlation with eventual partial posterior vitreous detachment (PVD) and a negative correlation with complete PVD. In eyes with initial proliferative diabetic retinopathy, those with active vitreous changes had a poor prognosis and those with inactive vitreous changes, an apparently good prognosis. Photocoagulation for retinal neovascularization was successful in most eyes with stable no-PVD but less successful in eyes that progressed to partial PVD. Therefore, considering the diabetic vitreous changes from a prognostic standpoint, the data suggest that if early proliferative changes are observed, photocoagulation before partial PVD develops might be considered.

Age Factors↗
PubMed1986

Role of the vitreous in diabetic retinopathy. I. Vitreous changes in diabetic retinopathy and in physiologic aging.

The vitreoretinal relationships in 1021 eyes of 570 patients with diabetic retinopathy and in 857 normal eyes were studied retrospectively in an attempt to identify the vitreous changes specifically related to diabetes. Complete posterior vitreous detachment (PVD) occurred in diabetic patients largely as part of the aging process, but proliferation interfered with its development. Complete PVD with nonproliferative diabetic retinopathy in the younger age groups was more prevalent in eyes treated by panretinal photocoagulation (PRP) than in untreated eyes and thus might have an association with PRP treatment. Partial PVD, seen mainly in proliferative diabetic retinopathy, had no correlation with aging. In the eyes of patients who were younger when diabetes was diagnosed, the development of partial PVD had a close correlation with the duration of diabetes. The data suggest the need for a clinical trial of early photocoagulation, before partial PVD develops, in younger-onset diabetic patients showing early proliferative changes.

Adolescent↗
PubMed1985

Vitreous changes in peripheral uveitis.

The vitreous in 76 eyes with peripheral uveitis was examined and compared with the vitreous in 77 eyes of age- and sex-matched controls. The vitreous findings in peripheral uveitis were inflammatory and cotton ball-like opacities, gel shrinkage, and posterior vitreous detachment. The prevalence of partial and complete vitreous detachment was significantly higher in the peripheral uveitis group than in the control group. The prevalence of partial vitreous detachment was significantly higher in eyes with macular change than in eyes without macular change, whereas the prevalence of complete vitreous detachment was significantly higher in eyes without macular change than in eyes with macular change. We also found a significantly higher prevalence of complete vitreous detachment in eyes with visual acuity of 20/50 or better than in those with an acuity of 20/60 or worse. The prevalence of partial vitreous detachment was significantly higher in eyes with a visual acuity of 20/60 or worse than in those with an acuity of 20/50 or better.

Adolescent↗
PubMed1985

A case of pulmonary tuberculosis presenting with a choroidal tuberculoma.

A 17-year-old woman was referred because of a choroidal mass, with marked decrease in vision, in her left eye. Her medical history was negative. However, preliminary examination revealed a positive skin tuberculin test (PPD) and a chest x-ray picture of pulmonary tuberculosis. Bronchoscopy documented the diagnosis. Findings of other systemic investigations were negative. Fluorescein angiographic findings were compatible with the clinical diagnosis of a choroidal tuberculoma. A regimen of antituberculous medications was started, and both the choroidal and the pulmonary lesions gradually subsided. To our knowledge this is the first reported case of nonmiliary tuberculosis that presented solely with a choroidal lesion.

Adolescent↗
PubMed1985

Examination of the vitreous. A comparison of biomicroscopy using the Goldmann and El Bayadi-Kajiura lenses.

Vitreous examinations using the three-mirror Goldmann and the preset El Bayadi-Kajiura lenses were performed on 222 eyes. The presence of posterior vitreous detachment, vitreous traction, liquefaction, lacunae, and cells was noted. Clinical findings using the two lenses differed in 10% of the variables studied. The accuracy of the El Bayadi-Kajiura technique was confirmed by clinical and histological examination of 20 animal eyes with experimentally altered vitreous. The Goldmann lens afforded examination of peripheral vitreous and better identification of cells in the vitreous, whereas the El Bayadi-Kajiura lens permitted better visualization of complex vitreoretinal relationships.

Eye Diseases↗
PubMed1985

Photofield mapping in the evaluation and management of subretinal neovascularization.

Photofield mapping is a useful method for classifying subretinal neovascularization based on its area and location. Careful central field mapping is performed to delineate scotomata during evaluation of patients with subretinal new vessels. A photofield map is then constructed by projecting 35 mm fundus photographs and angiograms onto an appropriately-oriented central visual field map. The composite map (photofield) documents the location and relationship of scotomata, subretinal neovascularization, foveal avascular zone, and retinal blood vessels. The areas of subretinal neovascularization and scotomata are measured in square millimeters with a planimeter. The distance between their closest edge and the center of the foveal avascular zone is measured in millimeters. This method permits quantitative comparison of results with different photocoagulation protocols and instrumentation. Such comparative analysis may help improve the technique and instrumentation used in laser photocoagulation of subretinal neovascularization.

Adult↗
PubMed1985

Biomicroscopic study of the vitreous in eyes with macular pucker after retinal detachment surgery.

The posterior vitreous condition of 43 eyes with macular pucker following retinal detachment surgery was studied using the El Bayadi-Kajiura preset lens mounted on a slit lamp. The posterior vitreous was found to be attached in one eye (2%), completely detached in 29 eyes (68%), and partially detached with residual vitreoretinal adhesion to the macular area in 13 eyes (30%). Macular pucker with partial posterior vitreous detachment was significantly more frequent (P less than .05) in eyes with refractive errors of -4 diopters or less. That condition was also accompanied by a higher incidence of dye leakage in the macular area by fluorescein angiography, a shorter time lapse between retinal detachment surgery and development of macular pucker, and a worse visual outcome than was found in eyes with complete posterior vitreous detachment.

Adult↗
PubMed1985

Central visual field in patients with retinal branch vein occlusion.

We studied the central visual fields in 11 eyes with retinal branch vein occlusion that presented extensive areas of capillary nonperfusion by fluorescein angiography. Relative scotomata corresponding to the areas of capillary nonperfusion were seen in seven eyes where the venous occlusion was of recent onset (average, 11 months). In the remaining four eyes with long-standing venous occlusion (average, 24 months), capillary occlusion was associated with absolute scotomata.

Aged↗
PubMed1984

Manifestations of Whipple's disease in the posterior segment of the eye.

Ocular manifestations of Whipple's disease result from CNS involvement, direct intraocular involvement, or both. Ocular signs caused by CNS involvement occurred in 30 of the 34 patients with ocular manifestations described in the literature. In only four of the 34 cases were ocular manifestations due solely to intraocular involvement. Two cases reported herein had unique intraocular involvement, manifested as diffuse chorioretinal inflammation. Fluorescein angiography showed diffuse vasculitis, with hemorrhages, exudates, retinal capillary occlusion in the perifoveal and midperipheral areas, capillary dilation at the optic disc, and choroidal folds. Proper antibiotic treatment resulted in ocular and systemic recovery. Follow-up is mandatory because of possible recurrences, which may start with intraocular signs, followed by systemic manifestations. Some cases progress to fetal CNS involvement. Therefore, when intraocular signs recur in treated patients, antibiotic therapy should be restarted or dose should be increased.

Adult↗
PubMed1984

Immersion A- and B-scan ultrasonography. Its use in preoperative evaluation of diabetic vitreous hemorrhage.

Immersion A- and B-scan ultrasonography was performed before vitreous surgery in 256 eyes with diabetic vitreous hemorrhage. Of 32 eyes with vitreous hemorrhage without vitreous traction (group 1), 28 (88%) showed useful postoperative vision. Of 87 eyes with vitreous traction without tractional retinal detachment (group 2), 69 (79%) had useful postoperative vision. Eyes with tractional retinal detachments were classified as follows: X-shaped detachment with narrow vitreoretinal adhesions (group 3, 75 eyes), and H-shaped detachment with broad vitreoretinal adhesions (group 4, 62 eyes). Useful postoperative vision returned in 43 eyes in group 3 (57%) and in only 14 eyes in group 4 (23%), a statistically significant difference. Visual improvement was greater in groups 1 and 2 than in groups 3 and 4. Postoperative functional results were worse when the macular area was the site of vitreoretinal adhesion and traction.

Adolescent↗
PubMed1984

Effect of vitreous detachment on vitreous fluorophotometry.

Twenty eyes of 17 normal subjects with or without posterior vitreous detachment (PVD) were examined to investigate the influence of various types of PVD on vitreous fluorophotometric readings. Biomicroscopic examinations of the vitreous body were performed with an El Bayadi - Kajiura preset lens, and the findings were classified according to the extent of vitreous detachment and the position of the posterior hyaloid membrane when the eye was stationary. Equivalent fluorescein concentration profiles along various directions in the vitreous cavity were obtained with vitreous fluorophotometry. The degree of PVD significantly affected the measurements. Close to the retina, fluorescein concentrations were significantly higher when the subhyaloid space was sampled than when the vitreous gel was sampled. Our findings have implications for vitreous fluorophotometric assessment of the permeability of the blood-retinal barrier.

Aged↗
PubMed1984

Surgical treatments of proliferative vitreoretinopathy.

Four hundred ten eyes with retinal detachment and proliferative vitreoretinopathy underwent closed vitrectomy with membrane peeling, scleral buckling, and intraocular air injection. The retina was reattached in 243 eyes (59.3%). Useful vision was attained in 223 eyes. The preoperative proliferative vitreoretinopathy was clinically graded in six groups of increasing severity (C-1, C-2, C-3, D-1, D-2, D-3). From grades C-2 to D-3, a significant trend related a decreased rate of retinal reattachment with increased severity. However, grade C-1 showed a significantly lower success rate than did grade C-2. Scleral buckling alone may be the treatment of choice in grade C-1 eyes. Grade D-3 eyes had the worst anatomic and functional results. Preoperatively, there was a significant relationship between increasing severity of proliferative vitreoretinopathy and frequency of aphakia, and aphakic eyes showed a significantly lower rate of retinal reattachment than did phakic eyes.

Adult↗
PubMed1984

Role of the vitreous in cystoid macular edema.

Eyes suffering from various conditions, such as aphakia, diabetic retinopathy, peripheral uveitis, branch vein occlusion, or retinitis pigmentosa, are predisposed to vitreous detachment. When vitreous detachment occurs, the vitreous can remain attached to the macula due to a firm vitreomacular adhesion. This partial posterior vitreous detachment associated with continuous vitreous traction to the macular area can lead to the development of cystoid macular edema. Two types of vitreous traction have been observed: traction with narrow vitreous strand and traction with broad vitreoretinal adhesion. It has been postulated that the posterior vitreous can cause cystoid macular edema by vitreous contraction without vitreous detachment, producing tractional forces at sites of firm vitreoretinal adhesions that are located at the optic disc and macula. Cystoid macular edema is often accompanied by leakage from dilated retinal capillaries at the optic disc.

Adult↗