Choroidal blood flow in AMD.
Explore the source record for details and available documents.
Blood Flow Velocity↗
Biomedical subjects
C W Spraul
Publications and source records attributed to C W Spraul.
Müllerian mixed tumor metastatic to the iris and ciliary body.
Explore the source record for details and available documents.
Aged↗
Characteristics of Drusen and Bruch's membrane in postmortem eyes with age-related macular degeneration.
We performed a histopathologic study to compare eyes with different stages of age-related macular degeneration (AMD) with age-matched eyes to identify characteristics associated with exudative vs nonexudative AMD. We analyzed 51 eyes, which were obtained from an eye bank, from 40 donors with different stages of AMD and compared them with 40 age-matched control eyes. The eyes were processed for light microscopy, and the degree of calcification of Bruch's membrane, fragmentation of Bruch's membrane, the number of different types of drusen, and the presence of basal laminar (linear) deposit were assessed in the macular and extramacular regions. In the macular area, a statistically significant difference was observed for the degree of calcification (P = .02) and fragmentation (P = .03) of Bruch's membrane in eyes with exudative AMD (1.6 and 5 per eye, respectively) compared with eyes with nonexudative AMD (0.8 and 1 per eye, respectively) and control eyes (0.8 and 0 per eye, respectively). Eyes with AMD displayed notably softer, more confluent, and larger drusen and basal laminar (linear) deposit in the macular area compared with control eyes. Calcification and fragmentation of Bruch's membrane, soft, confluent, and large drusen, and basal laminar (linear) deposit but not hard drusen correlate with the histological presence of AMD. The degree of calcification and fragmentation of Bruch's membrane is greater in eyes with exudative compared with nonexudative AMD.
Aged↗
[Central serous chorioretinopathy in systemic therapy with corticosteroids].
PURPOSE: To describe retinal pigment epithelial changes associated with systemic corticosteroid treatment. METHODS: We report on five patients who developed maculopathy during treatment with systemic corticosteroids. A thorough ophthalmologic examination including perimetry, fundus photography, and fluorescein angiography was performed. RESULTS: Three patients displayed focal and two patients showed diffuse retinal pigment epithelial changes comparable to the acute and chronic form of central serous chorioretinopathy, respectively. Four of five patients had a complete visual recovery after decrease or cessation of treatment with corticosteroids. CONCLUSION: These five patients provide further evidence that systemic treatment with corticosteroids may damage the posterior blood-retinal barrier, leading to central serous chorioretinopathy. Visual acuity may increase after reduction of the dosage or cessation of treatment with corticosteroids. Patients on systemic corticosteroid treatment should be informed about possible symptoms of central serous chorioretinopathy in order to prevent irreversible visual loss.
Adrenal Cortex Hormones↗
[Granular cell tumor of the eyelid].
A 54-year-old woman was evaluated for a right lower eyelid lesion that had been present for four months. Examination showed a firm, yellow to brown mass with associated loss of eyelashes. A complete resection of the lesion was performed and the lid was reconstructed with the Hughes procedure. Histologic features of the excised mass were consistent with a granular cell tumor. Immunohistochemical stains were positive for S-100 protein, neuron specific enolase, laminin, and various myelin proteins in the tumor cells. Ultrastructural examination displayed that tumor cells were distended by autophagic granules and some cells contained angulated bodies (Bangle bodies). Granular cell tumors probably origin from Schwann cells and rarely involve the eyelids.
Biomarkers, Tumor↗
[Idiopathic conjunctival lymphangiectasia].
PATIENT: A 41-year-old male was evaluated for multiple yellowish cysts on the temporal bulbar conjunctiva of his right eye. These cysts have spontaneously developed over a period of one week, have been punctuated, and recurred one week later in an even greater number. The patient's ophthalmologic and medical history were normal. Complete excision of the largest cysts and marsupialization of the smaller cysts were performed. Histologic features of the excised cysts were consistent with lymphangiectasia and displayed dilated lymphatic channels. CONCLUSION: Conjunctival lymphangiectasia is a benign condition of unknown etiology. It has been observed with many underlying diseases as well as spontaneously and the dilated lymphatic channels can secondarily become hemorrhagic (Hemorrhagic lymphangiectasia of the conjunctiva). Simple excision and/or marsupialization are therapeutic options.
Adult↗
[Idiopathic polypoid choroid vasculopathy].
BACKGROUND: The idiopathic polypoidal choroidal vasculopathy, also known as "posterior uveal bleeding syndrome" or "multiple recurrent serosanguineous retinal pigment epithelial detachments in black women" is a rare disease entity. A clincopathologic correlation of a patient with this disease is presented. CASE REPORT: A 47-year-old black woman was evaluated for a decrease of visual acuity in her right eye which had occurred over the last 3 months. Ophthalmic examination of her right eye revealed sub-RPE hemorrhage associated with a reddish-orange subretinal vascular-like lesion. In addition, both eyes displayed a few choroidal vascular-like bulbous structures in the superior temporal peripapillary region. The patient developed an extensive choroidal hemorrhage that led eventually to the enucleation of the eye. CONCLUSION: Choroidal neovascular membranes (CNV) secondary to idiopathic polypoidal choroidal vasculopathy differs in many aspects from other entities associated with CNV including clinical and fluorescein angiographic features, clinical course, and prognosis.
Bruch Membrane↗
[Reparative giant cell granuloma with orbital involvement].
A 54-year-old woman was evaluated for a left orbital mass that had been present for one year. Examination showed mild superolateral displacement of the normal left eye and a firm medical orbital mass. A complete resection of the lesion was accomplished via a combined neurosurgical, otolaryngologic and ophthalmologic superior orbital approach. Histologic features of the mass were consistent with giant-cell (reparative) granuloma. However, it has to be pointed out that fibroosseous lesions with giant-cells display similar histologic features and require clinicopathologic correlation including radiographic studies for final diagnosis.
Diagnosis, Differential↗
[Risk factors for retinal occlusive diseases].
Retinal vascular occlusions are the second most common retinal vascular diseases following diabetic retinopathy. Central retinal artery occlusion and branch retinal artery occlusion are most often caused by emboli. The mean age of patients with retinal artery occlusion and branch retinal artery occlusion is 62 and 58 years, respectively. The most common risk factors are arterial hypertension (65%), diabetes mellitus (25%), valvular diseases of the heart (25%), and carotid artery stenosis or plaques (45%). Rare causes are arteritis and vascular spasm. The pathogenesis of retinal branch vein occlusion and central retinal vein occlusion remains speculative. Two different mechanisms have been postulated, i.e. thrombosis in the vein due to a compression by atherosclerotic changes in the adjacent artery and a local alteration of the blood flow due to unfavourable physiologic factors. Retinal vein occlusion manifests at a mean age of 65 years. The most common risk factors are arterial hypertension in 34-75% and primary open angle glaucoma in 2.1-82%. In 5.6% of the patients with retinal branch vein occlusion retinal vasculitis is present.
Humans↗
[Histological characterization and classification of surgically excised choroid neovascular membranes].
PURPOSE: This study was undertaken in order to histologically characterize surgically-excised choroidal neovascular membranes and to correlate theses histologic findings with the fundus and fluorescein angiographic appearance. MATERIAL AND METHODS: Surgically-excised subfoveal choroidal neovascular membranes submitted in the time period from November 1994 to July 1996 were included in this study. The membranes were processed and evaluated by light and transmission electron microscopy. Some membranes were oriented by the surgeon and marked on their inner surface with India ink and the configurations of these membranes were recorded and correlated with the fundus and fluorescein angiographic features. RESULTS: Sixty-two choroidal neovascular membranes were available for this study. In 74% age-related macular degeneration was the underlying disease. Retinal pigment epithelium and endothelial lined vascular channels were present in over 87.5% of cases. Basal laminar (linear) deposit was only present in membranes excised from patients with age-related macular degeneration. In six cases with Gass Type II choroidal neovascular membranes the histologic-clinical-fluorescein angiographic correlation showed well-defined (classic) neovascular membranes according to the criteria of the Macular Photocoagulation Study. Two membranes were not surrounded by retinal pigment epithelium and were classified as Type IIa membranes. Four membranes were surrounded by retinal pigment epithelium and classified as Type IIb membranes. CONCLUSIONS: Choroidal neovascular membranes represent a stereotypic, non-specific wound repair response to a specific stimulus. Retinal pigment epithelium may proliferate around and attempt to wall off choroidal neovascular membranes. We propose a new classification of surgically-excised choroidal neovascular membranes as Types I, IIa, and IIb.
Adult↗
[Bilateral adult periocular xanthogranuloma].
PATIENT: A 62-year-old woman was evaluated for a bilateral subconjunctival mass that had been present for 6 months. With magnetic resonance imaging the lesion could not be delineated form the lacrimal glands. A biopsy was performed and histologic examination exhibited a xanthogranulomatous lesion with multiple giant-cells of the Touton type. The differential diagnosis of the adult xanthogranuloma is Erdheim-Chester disease, necrobiotic granuloma, xanthoma, Langerhans histiocytosis, and Rosai-Dorfman syndrome. CONCLUSION: Hyperlipemia should be excluded, in addition, in the presence of necrobiosis, paraproteinemia.
Conjunctiva↗
[Congenital retinal macrovessel].
PATIENT: A 18-year-old male was evaluated for vitreous floaters. Examination exhibited a large, aberrant retinal venule in the inferiortemporal macula. The venule crossed the horizontal raphe. Only slight retinal pigment epithelial changes were present. Fluorescein angiography transiting revealed no early filling and no evidence of arteriovenous anastomoses. The diagnosis of a congenital retinal macrovessel was made. CONCLUSION: This condition is a rare, usually unilateral retinal vascular anomaly which may be associated with arteriovenous anastomoses. Areas of capillary nonperfusion, foveal cysts, and associated vitreous hemorrhage have been described. The condition is, however, in most cases ophthalmoscopically stable, and the visual prognosis is excellent.
Adult↗
Contact lenses and corneal shields.
This article reviews literature regarding contact lenses and corneal shields published between February 1996 and January 1997 that will help the ophthalmologist to better understand some of the clinical effects of contact lenses and corneal shields. Progress has been made in understanding the interaction between contact lenses and the eye, and this may improve fitting. However, fitting presbyopic patients with contact lenses still remains a challenge. There is new insight in the pathomechanism of serious corneal infections caused by Acanthamoeba species and Pseudomonas aeruginosa, which may lead to decreases in these complications. Furthermore, in the era of different wear modalities and replacement schedules and the advent of daily disposable lenses, an update of contact lens terminology is provided.
Animals↗
["Curriculum" in ophthalmology: Assistant education in Ulm].
Explore the source record for details and available documents.
Curriculum↗
Adenocarcinoma of the iris pigment epithelium.
We treated an 81-year-old man with a pigmented lesion of his right iris. The lesion was locally excised. Light microscopic examination, including immunohistochemistry, and electron microscopic examination were performed. The diagnosis was low-grade adenocarcinoma arising from the iris pigment epithelium. Adenomatous proliferations of the iris pigment epithelium are exceedingly rare and have not been shown to metastasize. Local resection is recommended if the lesion exhibits growth.
Adenocarcinoma↗
Mushroom-shaped choroidal hemangioma.
PURPOSE: We examined the clinicopathologic features of a mushroom-shaped choroidal tumor that originated in the right eye of a 13-year-old girl. METHODS: The clinical, ultrasonographic, and histopathologic features of the enucleated eye were studied. RESULTS: On clinical examination, the choroidal tumor appeared mushroom-shaped with ultrasonic characteristics of high internal reflectivity and choroidal excavation. The enucleation specimen contained a cavernous hemangioma that extended through Bruch's membrane. CONCLUSION: Choroidal hemangioma may extend through Bruch's membrane and be mushroom shaped.
Adolescent↗
Effect of cataract extraction with intraocular lens implantation on ocular hemodynamics.
PURPOSE: To investigate the effect of cataract extraction on ocular hemodynamics. SETTING: University Eye Clinic of Ulm, Germany. METHODS: In 51 consecutive patients assigned for cataract surgery, pulse amplitude, pulse volume, and pulsatile ocular blood flow were measured 1 day before and 3 days and 12 months after cataract extraction using an ocular blood flow tonograph. Statistical analysis was performed with Student's t-test and Wilcoxon signed-rank test. RESULTS: In the study eyes, 3 days after cataract surgery pulse amplitude, pulse volume, and pulsatile ocular blood flow had decreased from 2.5 to 2.1 mm Hg (P = .0014), 5.0 to 4.4 microliters (P = .0059), and 836.2 to 728.0 microliters/min (P = .0017), respectively. No statistically significant change between preoperative and 3 day postoperative measurements occurred in the fellow eyes. There was no significant difference in systemic blood pressure, heart rate, or IOP in study and fellow eyes before and 3 days after cataract surgery. The early reduction of pulse amplitude, pulse volume, and pulsatile ocular blood flow in the study eyes was not present 1 year postoperatively. CONCLUSION: Uncomplicated cataract extraction is associated with a temporary ipsilateral impairment of ocular hemodynamics. A neural mechanism triggered by cataract extraction may be involved in these temporary changes.
Adult↗
[Ocular side effects of deferoxamine therapy in aplastic anemia with transfusion-induced hemochromatosis].
BACKGROUND: Deferoxamine, an iron chelating agent, has been used for the treatment of hemochromatosis for more than 30 years. Ocular toxicity has begun to be reported only in the last few years. In most cases differentiation of the true etiology, i.e. the underlying disease versus the toxicity of the substance, is not clear. We report a patient with development of severe ocular toxicity during treatment with deferoxamine for transfusional hemochromatosis. HISTORY AND SIGNS: An 8-year-old boy was routinely evaluated in the eye clinic before initiation of treatment with deferoxamine. Over the last three years the boy had developed a transfusional hemochromatosis after multiple blood transfusions for his aplastic anemia. Ophthalmologic examination displayed normal anterior segments with the exception of a unilateral small opacification of the posterior lens cortex, bilateral tortuous vessels, and mottling of the retinal pigment epithelium. After four months the patient developed a decrease in visual acuity, distortion of color vision, visual field defects, alteration of electrophysiological parameters, and severe changes of the retinal pigment epithelium. THERAPY AND OUTCOME: The deferoxamine was discontinued. Over a period of 3 months the patient displayed a normalization of visual acuity and visual fields. The changes of the retinal pigment epithelium and electrophysiological parameters showed further deterioration and did not return to normal. The patient subsequently was restarted on an adequate treatment dose of deferoxamine and maintained an essentially uneventful course with close ophthalmologic followup. CONCLUSION: Deferoxamine can cause severe ocular toxicity with incomplete recovery. Measurement of dark adaptation was especially valuable for follow-up examination.
Anemia, Aplastic↗