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Biomedical subjects

D Weinberger

Publications and source records attributed to D Weinberger.

At least 37 records · Page 2Linked to original sources
PubMed2000

Diclofenac sodium, 0.1% (Voltaren Ophtha), versus sodium chloride, 5%, in the treatment of filamentary keratitis.

PURPOSE: To compare the efficacy and short-term safety of diclofenac sodium, 0.1% (Voltaren Ophtha; Ciba-Vision) and of sodium chloride, 5% ophthalmic solution, in the treatment of filamentary keratitis (FK) in patients with dry-eye syndrome due to secondary Sjögren's syndrome. METHODS: Thirty-two patients (64 eyes) with dry-eye syndrome due to secondary Sjögren' syndrome were enrolled in a randomized study (patients and authors were aware of which medication was being used). All patients had FK. Sixteen patients were treated with sodium chloride, 5% drops, and 16 patients received diclofenac sodium, 0.1% eyedrops. Treatment regimen included instillation of 1 drop, 4 times a day for 28 days, for both groups. Clinical assessment was performed once a week during the study period. Data on the efficacy and safety of the different therapeutic regimens were collected and compared. RESULTS: Both medications achieved disappearance of filaments at the end of the study. Treatment with diclofenac sodium, 0.1%, revealed a significantly more rapid improvement of the clinical symptoms as compared with sodium chloride, 5%. No significant adverse effects were observed in both groups. CONCLUSION: Diclofenac sodium, 0.1%, may be an effective and safe topical therapy in patients with FK caused by secondary Sjögren's disease.

Aged↗
PubMed2000

Diode laser treatment of posterior retinopathy of prematurity.

AIMS: To study the efficacy of infrared diode laser for the treatment of posterior retinopathy of prematurity (ROP). METHODS: 48 eyes of 25 premature babies (mean birth weight 779 (SD 127.7) g; mean gestational age 25.5 (SD 1.47) weeks) with threshold ROP in zone I and posterior zone II were treated by the indirect infrared (810 nm) diode laser. Confluent burns were applied to the avascular retina. In 18 eyes, an additional row of laser burns was added posterior to the ridge. RESULTS: Favourable anatomical results were noted in 41 eyes (85.4%). ROP stage 5 developed in two eyes, ROP stage 4A developed in four eyes, and ROP stage 4B in one eye. Three of the eyes with stage 4A eyes were successfully buckled; the fourth was not operated on and remained demarcated by laser scars. No complications were noted. CONCLUSION: In this series, the diode laser was found to be a safe and effective treatment for posterior ROP.

Female↗
PubMed2000

Analgesic effect of topical sodium diclofenac 0.1% drops during retinal laser photocoagulation.

AIMS: To evaluate the analgesic effect of topical sodium diclofenac 0.1% during retinal laser photocoagulation. METHODS: 87 patients, 45 with proliferative diabetic retinopathy treated with two sessions of panretinal photocoagulation (group A), and 42 patients with non-proliferative diabetic retinopathy who underwent grid treatment of the posterior pole (19 bilaterally) (group B). Sodium diclofenac 0.1% or sodium chloride 0.9% drops were topically applied 30-135 minutes before laser treatment in a masked fashion. Patients who had two sessions were given the alternate drug in the second one. Pain level was evaluated immediately after laser treatment with the visual analogue scale (VAS). The results were statistically analysed. RESULTS: Patients in group A reported pain in 85/90 sessions (94%). The average pain level was 44.2% with sodium diclofenac 0.1% drops and 53.1% with sodium chloride 0.9% drops (p = 0.011 by paired t test). Patients in group B reported pain in only 16/60 sessions (26. 7%), and the pain level ranged from 10% to 60% regardless of the kind of drops used. There was no correlation in either group between level of pain and time interval from application of the drops to laser treatment (30-135 minutes) or average energy level used (100-500 mW). CONCLUSION: Sodium diclofenac 0.1% is useful for pain reduction and should be applied before panretinal photocoagulation.

Analgesics↗
PubMed2000

Pterygium-induced corneal astigmatism.

BACKGROUND: Previous work has suggested an association between increasing size of pterygium and increasing degrees of induced corneal astigmatism. OBJECTIVES: To assess the quantitative relation between pterygium size and induced corneal astigmatism using a computerized corneal analysis system (TMS II) and slit-lamp beam evaluation of pterygium size, and to conclude whether corneal astigmatism is an early indication for surgical intervention. METHODS: We evaluated 94 eyes of 94 patients with unilateral primary pterygium of different sizes, using TMS II and slit-lamp beam measurements of the size of the pterygium (in millimeters) from the limbus to assess parameters of pterygium size with induced corneal astigmatism. Best corrected visual Snellen acuity was performed. RESULTS: Primary pterygium induced with-the-rule astigmatism. Pterygium extending > 16% of the corneal radius or 1.1 mm or less from the limbus produced increasing degrees of induced astigmatism of more than 1.0 diopter. Significant astigmatism was found in 16.16% of 24 eyes with pterygium of 0.2 up to 1.0 mm in size, in 45.45% of 22 eyes with pterygium of 1.1 up to 3.0 mm in size (P < or = 0.0004), and in 100% of 3 eyes with pterygium of 5.1 up to 6.7 mm in size (P = 0.0005). We found that visual acuity was decreased when topographic astigmatism was increased. CONCLUSIONS: When primary pterygium reaches more than 1.0 mm in size from the limbus it induces with-the-rule significant astigmatism (> or = 1.0 diopter). This significant astigmatism tends to increase with the increasing size of the lesion. Topographic astigmatism tends to be improved by successful removal of the pterygium. These findings suggest that early surgical intervention in the pterygium may be indicated when the lesion is more than 1.0 mm in size from the limbus.

Astigmatism↗
PubMed1999

Simultaneous indocyanine green and fluorescein angiography in retinal pigment epithelium tear using the confocal scanning laser ophthalmoscope.

PURPOSE: To describe the indocyanine green angiographic pattern of retinal pigment epithelium tears in the setting of age-related macular degeneration compared with the fluorescein angiographic features. METHODS: Twelve consecutive patients (12 eyes) with a retinal pigment epithelium tear underwent simultaneous indocyanine green angiography and fluorescein angiography with the confocal scanning laser ophthalmoscope. The findings for the two modes were compared. RESULTS: Choroidal neovascular membrane was evident beneath the rolled retinal pigment epithelium on indocyanine green angiograms in 11(92%) of 12 eyes: a focal neovascular membrane was apparent in five (42%) of 12 eyes, whereas a plaque neovascular membrane was seen in six (50%) of 12 eyes. In comparison, fluorescein angiography demonstrated late leakage as a result of occult choroidal neovascular membrane in nine (82%) of 11 eyes but no well-defined choroidal neovascular membrane. CONCLUSIONS: Indocyanine green angiography is superior to fluorescein angiography for imaging choroidal neovascularization in cases of retinal pigment epithelium tear and may serve as an important adjunct to indocyanine green-guided laser treatment in selected cases.

Aged↗
PubMed1999

Digital red-free photography for the evaluation of retinal blood vessel displacement in epiretinal membrane.

OBJECTIVE: To evaluate the displacement of retinal blood vessels during the natural course of epiretinal membrane (ERM) formation. DESIGN: Consecutive observational case series. PARTICIPANTS: Thirteen patients (13 eyes) diagnosed with unilateral idiopathic ERM and 10 normal fellow eyes of the same patients served as a control group and constituted the study group. TESTING: All eyes underwent digital red-free filter photography of the fundus using the Topcon Imagenet-1024 System. Photographs were taken on entry to the study and again after 8 to 13 months. Distances were measured between the major and minor blood vessel junctions at the upper and lower temporal arcades and between the disc margin and vessel junctions temporal to the macula on follow-up examinations. To clearly visualize vessel shift, both photographs of each patient were overlaid using the peripheral landmarks of major blood vessel crossings as reference points. MAIN OUTCOME MEASURES: The parameters measured were shifting of blood vessels caused by the ERM formation. The distances were measured in micrometers using the measurement feature of the Topcon Imagenet System. RESULTS: Blood vessel shift (range, 30 microm-434 microm) was noted in all 13 eyes, but in 15 measurements the shift was less than 30 microm and was considered as no shift. In four eyes (31%), the distances decreased in all directions, indicating contraction of the ERM. In four eyes (31%), the distances increased in all directions, indicating release of the ERMs. A mixed pattern of release and contraction of the ERM in the same eye was noted in five eyes (38%). No shift of blood vessels was noted in the control eyes. Findings on image overlay corresponded with the objective measurements. CONCLUSIONS: Noninvasive digital red-free photography is an informative tool for the objective measurement of the vessel displacement during ERM formation. Contraction and release of the ERM were noted.

Aged↗
PubMed1999

Cystoid macular edema after cataract surgery with intraocular vancomycin.

OBJECTIVE: To determine whether the use of supplemental prophylactic vancomycin in the irrigating solution during extracapsular lens extraction is associated with increased incidence of cystoid macular edema. DESIGN: Prospective, randomized, double-masked clinical study. PARTICIPANTS: Consecutive series of 118 patients 60 years of age or older undergoing cataract surgery. INTERVENTION: The study group received an irrigating balanced salt solution supplemented with vancomycin (10 microg/ml), and the control group received the salt solution only. Fluorescein angiography was performed 1 and 4 months after surgery. MAIN OUTCOME MEASURES: Evidence of angiographic and clinical cystoid macular edema, and visual acuity at 1 and 4 months after surgery. RESULTS: The rate of postoperative angiographic cystoid macular edema was significantly higher in the study patients than in the control group at 1 month (55% vs. 19%, P = 0.0006) and 4 months (26% vs. 4%, P = 0.0099). The rates of clinical macular edema were 23% and 7%, respectively, at 1 month (P = 0.011) and 20% versus 0% at 4 months (P = 0.006). Visual acuity of 20/30 or better was noted at 4 months after surgery in 76% of the study group compared to 95.5% of the control group. CONCLUSIONS: The role of preventive intracameral vancomycin during intraocular surgery should be reassessed in view of the associated increase in the incidence of angiographic cystoid macular edema.

Aged↗
PubMed1999

Corneal topographic changes after retinal and vitreous surgery.

PURPOSE: To investigate the topographic changes in the cornea after retinal and vitreous operations. DESIGN: Observational prospective case series. PARTICIPANTS: The study population included 46 patients after vitreoretinal surgery: 11 underwent pneumatic retinopexy, 10 underwent vitrectomy, and 25 underwent scleral buckling procedure. METHODS: The corneal topography was measured by videokeratography with the absolute program and evaluated statistically by a quantitative comparative method, which was developed for this study, for the whole and the central cornea. MAIN OUTCOME MEASURES: The corneal topographic changes were measured in diopters (D), evaluating and comparing the preoperative and postoperative measurements. RESULTS: None of the operative procedures changed the shape of the whole cornea. Vitrectomy induced radial steepening of the central cornea 1.2 to 1.6 D, corresponding to the scleral sutures. Central steepening (average, 2.2 D) was also noted in the first week after circular buckling, but it flattened (average, 1.4 D) after 1 to 3 months. When an additional radial or circumferential buckling element was added to the circular buckle, steepening of the entire cornea and radial steepening of the central cornea (average, 0.6-0.8 D) occurred in the first week and flattened or returned to baseline after 1 to 3 months. There was no correlation between the location of the additional buckling element and the corneal topographic change. CONCLUSIONS: Corneal videokeratography is a useful tool for evaluating the postoperative corneal curvature. It showed that vitreoretinal surgery alters the shape of the cornea when buckling or scleral sutures are used, but pneumatic retinopexy does not.

Adult↗
PubMed1998

Ultrasound biomicroscopic detection of anterior ocular segment foreign body after trauma.

PURPOSE: To describe the role of ultrasound biomicroscopy in the detection and localization of foreign bodies in anterior ocular segment foreign body after trauma. METHODS: In a prospective study, ultrasound biomicroscopy was performed in five eyes of five consecutive patients with suspected anterior ocular segment foreign body. RESULTS: In all five eyes, ultrasound biomicroscopy detected and precisely localized small foreign bodies (metallic in two eyes, stone in one eye, plastic in one eye, and ceramic in one eye) in the cornea (one eye), superficial sclera (one eye), and anterior ocular segment (three eyes). Operative procedures to remove the intraocular foreign bodies (three cases) were guided by the ultrasound biomicroscopy information. CONCLUSIONS: Ultrasound biomicroscopy is a noninvasive method for detecting anterior segment intraocular foreign bodies after perforating trauma. It can be used to accurately diagnose foreign bodies and assist in surgical management, particularly when direct visualization is obscured because of the trauma. In eyes with partial-thickness corneoscleral lacerations or sealed full-thickness corneoscleral laceration and suspected anterior ocular segment foreign body, ultrasound biomicroscopy is a safe and effective method for detecting and localizing foreign bodies in the anterior ocular segment.

Adolescent↗
PubMed1998

Indocyanine green angiographic findings in nonproliferative diabetic retinopathy.

PURPOSE: To report angiographic findings of nonproliferative diabetic retinopathy patients by means of indocyanine green angiography. METHODS: Forty-two eyes (42 patients) with nonproliferative diabetic retinopathy were evaluated by indocyanine green angiography in addition to fluorescein angiography. Angiographic findings with the two imaging techniques were compared with the red-free fundus appearance. RESULTS: Among the 42 eyes, five (12%) had the appearance on indocyanine green angiography of lobular spotty hyperfluorescent and hypofluorescent areas ("salt and pepper" appearance) in the very late phase. Twenty eyes (48%) presented with diffuse late-phase hyperfluorescence on indocyanine green angiography, corresponding to areas of retinal capillary nonperfusion on fluorescein angiography, and retinal edema. A total of 3,564 microaneurysms were divided into three types: 58 (1.6%) appeared mainly on the fluorescein angiography and very faintly on the indocyanine green angiography, 3,029 (85%) appeared on the fluorescein angiography and the indocyanine green angiography, and 477 (13.4%) were uniquely hyperfluorescent on the indocyanine green angiography. CONCLUSIONS: Indocyanine green angiography in patients with nonproliferative diabetic retinopathy disclosed microvascular findings that were in addition to those shown on fluorescein angiography. These angiographic changes were not observed on fluorescein angiography because of imaging limitations. Indocyanine green angiography may be a useful adjunct to fluorescein angiography in the evaluation of chorioretinal vascular changes in nonproliferative diabetic retinopathy.

Adult↗
PubMed1998

Intravitreal gas injection for hypotony after cataract surgery.

PURPOSE: To evaluate the efficacy and safety of intravitreal perfluoropropane gas injection to treat hypotony after cataract surgery. SETTING: The ophthalmology department of a major tertiary medical center. METHODS: After uneventful cataract extraction, 5 patients with hypotony due to iridocyclitis, choroidal detachment, and serous retinal detachment were treated with an intravitreal injection of 1.0 cc of perfluoropropane gas. RESULTS: The hypotony, choroidal detachment, and exudative retinal detachment resolved in all 5 patients, and visual acuity improved. No complications were observed. CONCLUSION: Intravitreal gas injection can be used to treat hypotony after cataract surgery in selected patients.

Aged↗
PubMed1998

A comparison of the effect of hyaluronic acid versus gentamicin on corneal epithelial healing.

PURPOSE: An animal model study was conducted to compare the efficacy of recurrent topical applications of hyaluronic acid and gentamicin ointment for the treatment of noninfected, mechanical corneal erosions. METHODS: An artificial, controlled wound of identical size and depth was inflicted to the corneas of three groups of rabbit eyes in order to measure their healing rates. One group was treated with hyaluronic acid (10 eyes) while the second group received gentamicin ointment (10 eyes). The third group remained untreated and served as the control (10 eyes). The rate of re-epithelisation was measured at 8-h intervals until complete re-epithelisation was observed. After complete wound closure, the rabbits were killed, and comparative histological examinations were performed. RESULTS: Rabbit eyes treated with hyaluronic acid showed a significantly enhanced rate of epithelial defect closure compared with untreated eyes and a similar rate to that achieved with gentamicin ointment. In the eyes treated with hyaluronic acid a normal, multilayered epithelium was observed 48 h after complete healing, whereas the gentamicin-treated eyes showed an imperfectly layered epithelium, with irregularity of the cuboidal cells. CONCLUSION: While both hyaluronic acid and gentamicin enhance corneal epithelial healing at comparable rates, our study suggests that hyaluronic acid may have a more favourable effect on the structure of the healing epithelium, and can offer an alternative mode of therapy for non-infectious corneal erosions.

Animals↗
PubMed1998

The effect of tear substitute and silicone oil on re-epithelisation of the cornea.

PURPOSE: An animal model study was conducted to compare the effects of recurrent applications of an artificial cellulosic tear substitute and silicone oil on corneal reepithelisation. METHODS: A controlled wound was inflicted to the corneas of two groups of rabbits; one group was treated with tear substitute (5 eyes), while the other group received silicone oil (5 eyes). The left eye served as the control in both groups (10 eyes). The rate of re-epithelisation was measured at intervals of 6 h until complete wound closure was observed. After complete wound closure, the rabbits were killed and histological examinations were performed. RESULTS: The wounds of eyes treated with tear substitute closed at a statistically significant faster rate (at 24, 44, 80 h; p < 0.05) than those treated with silicone oil or the untreated eyes. At 48 h after re-epithelisation, the eyes treated with tear substitute presented a normal epithelium while the untreated and silicone-treated eyes presented an abnormally structured epithelium. CONCLUSION: This study demonstrates a favourable effect of tear substitute on corneal re-epithelisation in an animal model, in terms of both rate of re-epithelisation and histological aspects of the new epithelium.

Animals↗
PubMed1998

Long-term follow-up of perfluorocarbon liquid in the anterior chamber.

BACKGROUND: Perfluorocarbon liquids are used as a vitreous substitute in the operative management of several ophthalmologic conditions. We examined the effects of residual perfluorocarbon droplets in the anterior chamber in patients after retinal detachment surgery. METHODS: The study group consisted of seven patients (seven eyes) aged 28-74 years in whom droplets of perfluorocarbon appeared in the anterior chamber subsequent to retinal detachment surgery involving scleral buckling, perfluorodecalin injection, and perfluorocarbon liquid-silicone oil exchange. Mean follow-up was 9.4 months. RESULTS: From 1 -15 droplets of perfluorocarbon liquid were found in the anterior chamber. There were no corneal complications or inflammatory reactions or blood vessel invasion into the corneal stroma. Some of the droplets appeared to be encapsulated in a membrane-like material. Perfluorocarbon liquid and silicone oil had to be removed in three patients at 20, 12, and 4 months postoperatively because of an increase in intraocular pressure due to blockage of the inferior iridectomy by a droplet of perfluorocarbon, emulsification of the silicone oil, or residual perfluorocarbon liquid on the retina (one patient each). Increased intraocular pressure in a fourth patient was successfully treated pharmacologically. CONCLUSION: Based on our experience, residual perfluorocarbon liquid droplets in the anterior chamber are well tolerated and do not induce corneal damage or ocular inflammation. These patients should be closely followed, however, and the liquid removed if complications develop.

Adult↗
PubMed1998

Retinal thickness variation in the diabetic patient measured by the retinal thickness analyser.

AIM: To evaluate the potential of the retinal thickness analyser (RTA) as an objective tool for assessment and follow up of diabetic macular oedema. METHODS: A prototype of the RTA that operates on the principle of laser slit biomicroscopy was used. Retinal thickness was obtained in 41 eyes of 41 diabetic patients. The clinical diagnosis was cystoid macular oedema (CMO) in 10 eyes, clinically significant macular oedema (CSMO) without retinal cysts in 21 eyes, and "dry" macula following grid pattern laser treatment in 10 eyes. The control group consisted of 46 eyes of age matched healthy volunteers. RESULTS: In normal eyes (46 eyes), the foveal thickness measured was 178 (SD 44) microns and the macular thickness around the fovea was 311 (51) microns. The eyes with CMO displayed the largest foveal thickening, 875 (287) microns (390% increase compared with normal values). The average thickness of the fovea in the non-cystoid CSMO group was 427 (175) microns (144% increase compared with normal fovea). The average thickness of the foveal centre in eyes judged as having "dry" macula after laser treatment was 315 (71) microns (77% increase compared with normal value and a 26% decrease in thickness compared with the CSMO eyes). Statistically significant differences were found in central thickness between these four groups (p = 0.0001). The average thickness at 500 microns surrounding the fovea was 566 (202) microns in the CSMO eyes compared with 311 (51) microns in normal eyes (80% increase). The "dry" macula group (after undergoing laser treatments) had an average thickness of 414 (94) microns (27% decrease compared with CSMO eyes and a 33% increase compared with eyes of healthy controls). CONCLUSIONS: RTA is a system for quantifying macular thickness and imaging of macular pathology. The system can be a useful tool for diagnosis of macular diseases and for evaluation of the effect of treatment modalities.

Adult↗
PubMed1998

Pneumatic retinopexy for late-onset recurrent retinal detachment.

BACKGROUND AND OBJECTIVE: Pneumatic retinopexy is used as a primary procedure for the repair of retinal detachments caused by visible retinal tears. Its application for late-onset recurrent retinal detachments following previous pneumatic retinopexy or scleral buckling procedure has not been reported to date. PATIENTS AND METHODS: Pneumatic retinopexy was performed in 12 patients with recurrent retinal detachments due to new retinal tears who presented 6 months to 10 years after pneumatic retinopexy (8 patients) or scleral buckling surgery (4 patients). Follow-up ranged from 6 to 24 months. RESULTS: All the retinas reattached within the first few postoperative days and remained attached throughout follow-up. No intraoperative or postoperative complications were observed. Visual acuity either remained unchanged (if good before) or improved. CONCLUSION: Pneumatic retinopexy may be a feasible option for recurrent late-onset retinal detachment under the proper clinical conditions.

Cryotherapy↗