Oculometry and detachment surgery.
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Biomedical subjects
Publications and source records attributed to E Gerke.
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In surgery for retinal detachment, such as shortening of the eyeball, volume reducing, and indentating operations, knowledge of the volume of the subretinal fluid is important. A method based on ultrasonography was developed to measure the volume of subretinal fluid preoperatively. After establishing a topography of the fundus, the height of retinal detachment can be measured by ultrasonography at 49 defined points. The diameter of the eyeball is measured at 12 different points. From the height of retinal detachment and the diameter of the eyeball it is possible to calculate the subretinal space, which is divided into 60 segments. The total volume of subretinal fluid is calculated by adding the volumes of these 60 segments. The calculus is programmed on a computer.
In 47 patients (46 children and 1 adult) with unilateral and bilateral retinoblastoma, the titer of the carcinoembryonic antigen (CEA) was determined. The CEA titer of children with active retinoblastomas was 1.44 +/- 0.26 ng/ml (x +/- SEM). Those patients whose retinoblastoma was inactivated by therapy did not show a significantly lower CEA titer. In the group of children with one eye removed because of a unilateral retinoblastoma, the CEA titer was significantly (P less than 0.1) lower. The globes of 25 children were examined histologically. In those cases with invasion of the optic nerve or choroid, the CEA titer was significantly higher (P less than 0.1) as compared with those where the tumor was limited to the retina alone.
The new Zeiss Xenon-photocoagulator has considerable advantages. The possibility of converging the light beam allows coagulating even prominent areas (folds) in lensless eyes without difficulty. From our experience Xenon coagulation with individually adapted coagulation offers advantages over argon-laser coagulation with relatively short coagulation times.
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In an effort to demonstrate biochemical changes occuring in malperfused retinas, oxygen-induced retrolental fibroplasia was produced in kittens. Immediately before the onset of vasoproliferations, that is in the stage of maximal hypoxia, the activities of lactate dehydrogenase (LDH), glucose-6-phosphate dehydrogenase (G-6-PDH), malate dehydrogenase (MDH) and isocitrate dehydrogenase (ICDH) were determined. The activity of MDH was found to be significantly decreased, whereas the activities of the other enzymes showed no major changes.
In order to gain information on the possible role of lactate in the development of neovascularization following retinal malperfusion, the lactate content in vitreous-retina-choroid specimens of 02-treated kittens and streptozotocin-diabetic rats was determined. In both experiments there was no significant difference of lactate content between the diseased eyes and healthy controls.
In a 43-year-old female patient with sclerodermie en coup de sabre on the right forehead, the following changes of the right eye were observed: Partial lack of hairs of the eyebrow; distortion of the upper eyelid, similar to a coloboma; paralysis of the inferior oblique and the superior rectus muscles; decrease of corneal sensibility; formation of a spontaneous filtering bleb in the upper limbal region; ocular hypotension with changes of the papilla.
Systolic intramyocardial pressure (IMP) is measured with a modification of the "closed perfusion technic" in 3 different layers of the myocardium in 8 anesthetized mongrel dogs. In the subendocardium IMP exceed left ventricular pressure (LVP) by about 30% whereas it is 30% lower than LVP in the subepicardium. Under resting conditions the level of isobaric balance of IMP and LVP is at a distance of 57% from the epicardium. During thoracic aortic constriction the ratio of IMP/LVP increases in the subepicardium but decreases in the subendocardium. Occlusion of the left circumflex coronary artery for 30 seconds results in a decrease of IMP and IMP/LVP in the ischemic region. In 25% of all cases, however, an increase of these parameters is found.